Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

OBJECTIVE: To investigate the clinical features and risk factors associated with cutaneous chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. METHODS: A retrospective analysis was conducted on the clinical data of children who underwent allo-HSCT in the Wuhan Children's Hospital from August 1, 2016, to December 31, 2023, and were regularly followed up for 1 year or more. The differences in clinical features between children with and without cutaneous cGVHD were compared, and the risk factors affecting the occurrence of cutaneous cGVHD were analyzed. RESULTS: During the study period, 296 children received allo-HSCT. Until December 31, 2024, follow-up showed that 20 children (6.8%) developed cutaneous cGVHD, which manifested as cutaneous lichenification, hyperpigmentation, keratosis pilaris, sclerotic changes, and hair or nail involvement. According to their skin lesion area and degree of grading, 5 cases were mild, 10 cases were moderate, and 5 cases were severe. Multivariate logistic regression analysis revealed that female donors and previous acute GVHD were risk factors for the development of cutaneous cGVHD after allo-HSCT. All 20 children were treated with glucocorticoid ± calcineurin inhibitors (tacrolimus/cyclosporine) as first-line therapeutic agents. Only 1 child improved after first-line treatment. The remaining 19 children treated with a second-line regimen of combination interventions based on individualized status, including 10 children who could not tolerate hormonotherapy or first-line treatment, and showed no significant improvement after 3 months, as well as 9 children with multi-organ cGVHD. After comprehensive second-line treatment, 17 children showed improvement in cutaneous symptoms. There were 3 deaths, including 1 due to primary disease recurrence and 2 due to pulmonary infections. CONCLUSION The skin is the first manifestation and most common organ involved in cGVHD in children. Cutaneous cGVHD severely affects the daily activities of transplanted children and requires prolonged immunosuppressive therapy, but has a favorable prognosis. First-line treatments for adults are not applicable to children who usually require a combination treatment with multiple drugs.
Humans ; Graft vs Host Disease/etiology* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Retrospective Studies ; Risk Factors ; Female ; Child ; Skin Diseases/etiology* ; Chronic Disease ; Transplantation, Homologous ; Male ; Child, Preschool ; Adolescent

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

Objective:To investigate the correlation of serum interleukin-6 (IL-6) and homocysteine (Hcy) levels, monocyte-to-lymphocyte ratio (MLR), and serum lipid levels [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels] with ulcerative colitis.Methods:The clinical data of 98 patients with ulcerative colitis admitted to Bayannur Hospital from November 2021 to November 2023 (observation group) were retrospectively analyzed. Forty-nine healthy individuals who were selected at a 2:1 ratio during the same period were included in the control group. Serum IL-6 and Hcy levels, MLR, and lipid levels were compared between the two groups. The diagnostic efficacy of serum IL-6, Hcy, MLR, and lipid levels for ulcerative colitis was assessed using receiver operating characteristic (ROC) curves. Additionally, Pearson correlation analysis was conducted to analyze correlation of serum IL-6 and Hcy levels, MLR, and lipid levels with ulcerative colitis.Results:In the observation group, serum IL-6 and Hcy levels and MLR were (39.87 ± 12.36) pg/mL, (13.01 ± 3.52) μmol/L, and (0.38 ± 0.12), respectively, all of which were significantly higher than those in the control group [(22.3 ± 3.26) pg/mL, (10.05 ± 3.26) μmol/L, (0.29 ± 0.08), t = 9.77, 4.92, 4.78, all P < 0.05]. In the observation group, serum levels of TG, TC, LDL-C, and HDL-C levels were (1.16 ± 0.32) mmol/L, (4.12 ± 1.15) mmol/L, (2.60 ± 0.75) mmol/L, and (1.02 ± 0.17) mmol/L, respectively, all of which were significantly lower than those in the control group [(1.45 ± 0.41) mmol/L, (4.91 ± 0.99) mmol/L, (3.20 ± 0.71) mmol/L, (1.13 ± 0.16) mmol/L, t = 4.71, 4.11, 4.65, 3.77, all P < 0.05]. ROC curve analysis indicated that the areas under the curve (AUC) for diagnosing ulcerative colitis based on serum levels of IL-6, Hcy, MLR, TG, TC, LDL-C, and HDL-C were 0.957, 0.749, 0.746, 0.732, 0.678, 0.722, and 0.681, respectively. Pearson correlation analysis showed that serum levels of IL-6, Hcy, MLR, TG, TC, LDL-C, and HDL-C were all correlated with the severity of ulcerative colitis in patients ( r = 0.501, 0.615, 0.605, -0.577, -0.542, -0.548, -0.646, all P < 0.05). Additionally, serum levels of IL-6, Hcy, and MLR were negatively correlated with lipid levels ( r = -0.806, -0.801, -0.791, -0.649, -0.728, -0.671, -0.720, -0.655, -0.857, -0.877, -0.889, -0.583, all P < 0.05). Conclusions:In patients with ulcerative colitis, serum levels of IL-6, Hcy, and MLR are elevated, while lipid levels are decreased. Additionally, serum levels of IL-6, Hcy, MLR, and lipid levels are associated with the severity of the disease. There is also a correlation between serum levels of IL-6, Hcy, MLR, and lipid levels.

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

Objective:To investigate the correlation of serum interleukin-6 (IL-6) and homocysteine (Hcy) levels, monocyte-to-lymphocyte ratio (MLR), and serum lipid levels [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels] with ulcerative colitis.Methods:The clinical data of 98 patients with ulcerative colitis admitted to Bayannur Hospital from November 2021 to November 2023 (observation group) were retrospectively analyzed. Forty-nine healthy individuals who were selected at a 2:1 ratio during the same period were included in the control group. Serum IL-6 and Hcy levels, MLR, and lipid levels were compared between the two groups. The diagnostic efficacy of serum IL-6, Hcy, MLR, and lipid levels for ulcerative colitis was assessed using receiver operating characteristic (ROC) curves. Additionally, Pearson correlation analysis was conducted to analyze correlation of serum IL-6 and Hcy levels, MLR, and lipid levels with ulcerative colitis.Results:In the observation group, serum IL-6 and Hcy levels and MLR were (39.87 ± 12.36) pg/mL, (13.01 ± 3.52) μmol/L, and (0.38 ± 0.12), respectively, all of which were significantly higher than those in the control group [(22.3 ± 3.26) pg/mL, (10.05 ± 3.26) μmol/L, (0.29 ± 0.08), t = 9.77, 4.92, 4.78, all P < 0.05]. In the observation group, serum levels of TG, TC, LDL-C, and HDL-C levels were (1.16 ± 0.32) mmol/L, (4.12 ± 1.15) mmol/L, (2.60 ± 0.75) mmol/L, and (1.02 ± 0.17) mmol/L, respectively, all of which were significantly lower than those in the control group [(1.45 ± 0.41) mmol/L, (4.91 ± 0.99) mmol/L, (3.20 ± 0.71) mmol/L, (1.13 ± 0.16) mmol/L, t = 4.71, 4.11, 4.65, 3.77, all P < 0.05]. ROC curve analysis indicated that the areas under the curve (AUC) for diagnosing ulcerative colitis based on serum levels of IL-6, Hcy, MLR, TG, TC, LDL-C, and HDL-C were 0.957, 0.749, 0.746, 0.732, 0.678, 0.722, and 0.681, respectively. Pearson correlation analysis showed that serum levels of IL-6, Hcy, MLR, TG, TC, LDL-C, and HDL-C were all correlated with the severity of ulcerative colitis in patients ( r = 0.501, 0.615, 0.605, -0.577, -0.542, -0.548, -0.646, all P < 0.05). Additionally, serum levels of IL-6, Hcy, and MLR were negatively correlated with lipid levels ( r = -0.806, -0.801, -0.791, -0.649, -0.728, -0.671, -0.720, -0.655, -0.857, -0.877, -0.889, -0.583, all P < 0.05). Conclusions:In patients with ulcerative colitis, serum levels of IL-6, Hcy, and MLR are elevated, while lipid levels are decreased. Additionally, serum levels of IL-6, Hcy, MLR, and lipid levels are associated with the severity of the disease. There is also a correlation between serum levels of IL-6, Hcy, MLR, and lipid levels.

Objective:To analyze the molecular genetic spectrum of children with acute myeloid leukemia(AML),and explore its correlation with clinical characteristics and prognosis.Methods:The clinical and molecular genetic data of 116 children with newly diagnosed AML in Wuhan Children's Hospital from September 2015 to August 2022 were retrospectively analyzed.The Fisher's exact test was used to analyze the correlation of gene mutations with clinical features,and Kaplan-Meier curve was used to analyze the influences of gene mutations on the prognosis.Results:NRAS(22％),KRAS(14.9％),and KIT(14.7％)mutations were the most common genetic abnormalities in 116 children with AML.Children with KIT,CEBPA and GATA2 mutations showed a higher median onset-age than those without mutations(all P＜0.05).Children with FLT3-ITD mutation exhibited a higher white blood cell count at initial diagnosis compared to those without mutations(P＜0.05).Children with ASXL2 mutation had lower platelet count and hemoglobin at initial diagnosis than those without mutations(both P＜0.05).KIT mutations were often co-occurred with t(8;21)(q22;q22).There was no significant relationship between gene mutation and minimal residual disease(MRD)remission rate after the first and second induction therapy(P＞0.05).KIT and NRAS mutations were not associated with prognosis significantly(P＞0.05).The overall survival(OS)rates of children with CEBPA and FLT3-ITD mutations were superior to those without mutations,but the differences were not statistically significant(P＞0.05).The 3-year OS rate of 61 children treated by allogeneic hematopoietic stem cell transplantation was 89.8％,which was significantly higher than 55.2％of those only treated by chemotherapy(P＜0.001).Conclusions:Gene mutations are common in children with AML,and next-generation sequencing can significantly improve the detection rate of gene mutations,which can guide the risk stratification therapy.In addition,FLT3-ITD and KIT mutations may no longer be poor prognostic factors.

Objective:To investigate the safety and efficacy of mitoxantrone liposome in the treatment of children with high-risk acute myeloid leukemia(AML).Methods:The children with high-risk AML who received the mitoxantrone liposome regimen at Wuhan Children's Hospital from January 2022 to February 2023 were collected as the observation group,and the children with high-risk AML who received idarubicin regimen were enrolled as controls,and their clinical data were analyzed.Time to bone marrow recovery,the complete remission rate of bone marrow cytology,the clearance rate of minimal residual disease,and treatment-related adverse reactions were compared between the two groups.Results:The patients treated with mitoxantrone liposome showed shorter time to recovery of leukocytes(17 vs 21 day),granulocytes(18 vs 24 day),platelets(17 vs 24 day),and hemoglobin(20 vs 26 day)compared with those treated with idarubicin,there were statistical differences(P＜0.05).The effective rate and MRD turning negative rate in the observation group were 90.9％and 72.7％,respectively,while those in the control group were 94.1％and 76.4％,with no statistical difference(P＞0.05).The overall response rate of the two groups of patients was similar.Conclusion:The efficacy of mitoxantrone liposome is not inferior to that of idarubicin in children with high-risk AML,but mitoxantrone liposome allows a significantly shorter duration of bone marrow suppression and the safety is better.

Objective:To summarize the clinical features of reversible posterior encephalopathy syndrome(PRES)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods:The clinical data of six children who developed PRES after undergoing allo-HSCT in the Department of Hematology of Wuhan Children's Hospital from June 2016 to December 2022 were retrospectively analyzed,and their clinical characteristics,imaging examination,laboratory examination,and treatment regression were summarized.Results:Among 281 children underwent allo-HSCT,6 cases(2.14％)developed PRES,with a median age of 5.1(1.5-9.7)years old.4 cases underwent related haploidentical donor transplantation,and 2 cases underwent sibling allografting and unrelated donor allografting donor transplantation,respectively.All six children had an acute onset of illness,with clinical manifestations of nausea and vomiting,seizures,psychiatric disorders,visual disturbances.The five cases elevated blood pressure.All children with PRES were treated with oral immunosuppressive drugs during seizures,and 3 cases were combined with different degrees of graft-versus-host disease.Most of the children showed effective improvement in clinical symptoms and imaging after adjusting/discontinuing suspected medications(cyclosporine,etc.)and symptomatic supportive treatments(oral antihypertensive,diazepam for antispasmodic,mannitol to lower cranial blood pressure),and one of them relapsed more than 8 months after the first seizure.Conclusion:PRES is rare after hematopoietic stem cell transplantation in children,and its onset may be related to hypertension,cytotoxic drugs,graft-versus-host disease,etc.Most of them can be recovered after active treatment,but not completely reversible,and the prognosis of those who combined with TMA is poor.