This study sought to evaluate the efficacy and safety of venetoclax (Ven) in combination with tyrosine kinase inhibitors (TKI) and reduced-dose chemotherapy for the treatment of patients with minimal residual disease (MRD) -positive and relapsed/refractory (R/R) Ph-positive acute lymphoblastic leukemia (Ph + ALL). A retrospective analysis was conducted on the clinical data of 13 patients with MRD-positive and relapsed Ph + ALL admitted between July 2015 and February 2024 at the Affiliated Cancer Hospital of Zhengzhou University. The cohort included seven males and six females, with a median age of 50 years (range: 37-71 years). Reinduction therapy consisted of Ven and TKI administration combined with reduced-dose chemotherapy. Among the 13 patients, 10 were MRD-positive, and three had R/R disease. Of the MRD-positive group, nine (90%) achieved complete molecular response (CMR), with a median time to response of 47 days (range: 30-80) ; one patient did not respond. Among the three patients who had R/R, two (66.6%) achieved complete remission, while one patient was nonresponsive. The median overall survival (OS) and relapse-free survival (RFS) time for the entire cohort were 21.5 months and 7 months, respectively. In patients who achieved CMR, the median OS and RFS time were 35 months and 34 months, respectively. Grade ≥3 hematologic adverse events occurred in five patients (38.4%) ; however, hematopoietic function recovered in all cases, and no grade ≥3 infections or organ-related adverse reactions were observed. These findings suggest that Ven combined with TKI and reduced-dose chemotherapy may be an effective and tolerable therapeutic strategy for MRD-positive and R/R Ph + ALL, particularly in significantly improving MRD clearance rates.

Objective:To compare the efficacy and safety of two induction regimens, homoharringtonine plus venetoclax and azacitidine (VHA) versus venetoclax and azacitidine (VA) , for newly diagnosed acute myeloid leukemia (AML) patients who are elderly or ineligible for intensive chemotherapy.Methods:We retrospectively analyzed the clinical data of 59 newly diagnosed AML patients treated with the VHA or VA regimen at Zhengzhou University Affiliated Cancer Hospital from September 2018 to July 2021. The cohort included 25 males and 34 females, with a median age of 63 years. The overall response rate (ORR) , composite complete remission (CRc) rate [CR+CR with incomplete hematologic recovery (CRi) ], minimal residual disease (MRD) negativity rate, overall survival (OS) , relapse-free survival (RFS) , and adverse events were compared between the two groups. Survival was estimated by the Kaplan-Meier method, and prognostic factors were evaluated using univariable and multivariable Cox regression.Results:At the end of the treatment, the ORR was 88.4% (23/26) in the VHA group [21 CR, 2 partial remissions (PR) ] and 90.9% (30/33) in the VA group (25 CR, 5 PR) , with no significant difference between the groups ( P=0.458) . The MRD negativity rates after one cycle of induction were 73.1% (19/26) in the VHA group and 60.6% (20/33) in the VA group, respectively ( P=0.315) . In the high-risk subgroup, the composite remission rates after one cycle were 78.6% (11/14) with VHA and 50.0% (5/10) with VA ( P=0.143) ; MRD negativity rates were 64.3% (9/14) and 20.0% (2/10) , respectively ( P=0.032) . The main adverse events were myelosuppression, gastrointestinal reactions, and infections during neutropenia. Rates of grade 3-4 neutropenia and decreased hemoglobin were similar between groups, whereas grade 3-4 thrombocytopenia was more frequent with VHA than with VA (76.9% vs 45.5%, P=0.015) . With a median follow-up of 13 months (range, 1-59) , 1 year RFS was 69.9% (95% CI: 53.1%-92.2%) with VHA and 55.6% (95% CI: 40.1%-77.1%) with VA ( P=0.305) . The 1 year OS rates were 91.7% (95% CI: 77.3%-100.0%) and 58.2% (95% CI: 41.7%-81.4%) , respectively ( P=0.024) . Among high risk patients, 1 year RFS and OS were higher with VHA than with VA (RFS: 66.2% vs 37.5%, P=0.046; OS: 85.7% vs 48.0%, P=0.011) . Undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) significantly improved RFS and OS ( P=0.027 and 0.047, respectively) . On multivariable analysis, ELN risk classification and MRD negativity after the first cycle were independent prognostic factors for RFS. Treatment regimen (VHA vs VA) , MRD negativity after the first cycle, and receipt of transplantation were independent prognostic factors for OS. Conclusion:VHA provides clinical benefit in newly diagnosed AML patients who are unfit for intensive chemotherapy and in older adults, with particularly favorable outcomes in high risk patients; sequential allo-HSCT confers additional benefit, and associated adverse events are manageable.

Objective:To compare the efficacy and safety of two induction regimens, homoharringtonine plus venetoclax and azacitidine (VHA) versus venetoclax and azacitidine (VA) , for newly diagnosed acute myeloid leukemia (AML) patients who are elderly or ineligible for intensive chemotherapy.Methods:We retrospectively analyzed the clinical data of 59 newly diagnosed AML patients treated with the VHA or VA regimen at Zhengzhou University Affiliated Cancer Hospital from September 2018 to July 2021. The cohort included 25 males and 34 females, with a median age of 63 years. The overall response rate (ORR) , composite complete remission (CRc) rate [CR+CR with incomplete hematologic recovery (CRi) ], minimal residual disease (MRD) negativity rate, overall survival (OS) , relapse-free survival (RFS) , and adverse events were compared between the two groups. Survival was estimated by the Kaplan-Meier method, and prognostic factors were evaluated using univariable and multivariable Cox regression.Results:At the end of the treatment, the ORR was 88.4% (23/26) in the VHA group [21 CR, 2 partial remissions (PR) ] and 90.9% (30/33) in the VA group (25 CR, 5 PR) , with no significant difference between the groups ( P=0.458) . The MRD negativity rates after one cycle of induction were 73.1% (19/26) in the VHA group and 60.6% (20/33) in the VA group, respectively ( P=0.315) . In the high-risk subgroup, the composite remission rates after one cycle were 78.6% (11/14) with VHA and 50.0% (5/10) with VA ( P=0.143) ; MRD negativity rates were 64.3% (9/14) and 20.0% (2/10) , respectively ( P=0.032) . The main adverse events were myelosuppression, gastrointestinal reactions, and infections during neutropenia. Rates of grade 3-4 neutropenia and decreased hemoglobin were similar between groups, whereas grade 3-4 thrombocytopenia was more frequent with VHA than with VA (76.9% vs 45.5%, P=0.015) . With a median follow-up of 13 months (range, 1-59) , 1 year RFS was 69.9% (95% CI: 53.1%-92.2%) with VHA and 55.6% (95% CI: 40.1%-77.1%) with VA ( P=0.305) . The 1 year OS rates were 91.7% (95% CI: 77.3%-100.0%) and 58.2% (95% CI: 41.7%-81.4%) , respectively ( P=0.024) . Among high risk patients, 1 year RFS and OS were higher with VHA than with VA (RFS: 66.2% vs 37.5%, P=0.046; OS: 85.7% vs 48.0%, P=0.011) . Undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) significantly improved RFS and OS ( P=0.027 and 0.047, respectively) . On multivariable analysis, ELN risk classification and MRD negativity after the first cycle were independent prognostic factors for RFS. Treatment regimen (VHA vs VA) , MRD negativity after the first cycle, and receipt of transplantation were independent prognostic factors for OS. Conclusion:VHA provides clinical benefit in newly diagnosed AML patients who are unfit for intensive chemotherapy and in older adults, with particularly favorable outcomes in high risk patients; sequential allo-HSCT confers additional benefit, and associated adverse events are manageable.

This study sought to evaluate the efficacy and safety of venetoclax (Ven) in combination with tyrosine kinase inhibitors (TKI) and reduced-dose chemotherapy for the treatment of patients with minimal residual disease (MRD) -positive and relapsed/refractory (R/R) Ph-positive acute lymphoblastic leukemia (Ph + ALL). A retrospective analysis was conducted on the clinical data of 13 patients with MRD-positive and relapsed Ph + ALL admitted between July 2015 and February 2024 at the Affiliated Cancer Hospital of Zhengzhou University. The cohort included seven males and six females, with a median age of 50 years (range: 37-71 years). Reinduction therapy consisted of Ven and TKI administration combined with reduced-dose chemotherapy. Among the 13 patients, 10 were MRD-positive, and three had R/R disease. Of the MRD-positive group, nine (90%) achieved complete molecular response (CMR), with a median time to response of 47 days (range: 30-80) ; one patient did not respond. Among the three patients who had R/R, two (66.6%) achieved complete remission, while one patient was nonresponsive. The median overall survival (OS) and relapse-free survival (RFS) time for the entire cohort were 21.5 months and 7 months, respectively. In patients who achieved CMR, the median OS and RFS time were 35 months and 34 months, respectively. Grade ≥3 hematologic adverse events occurred in five patients (38.4%) ; however, hematopoietic function recovered in all cases, and no grade ≥3 infections or organ-related adverse reactions were observed. These findings suggest that Ven combined with TKI and reduced-dose chemotherapy may be an effective and tolerable therapeutic strategy for MRD-positive and R/R Ph + ALL, particularly in significantly improving MRD clearance rates.

Background::Triple-negative breast cancer (TNBC) is a type of highly invasive breast cancer with a poor prognosis. According to new research, long noncoding RNAs (lncRNAs) play a significant role in the progression of cancer. Although the role of lncRNAs in breast cancer has been well reported, few studies have focused on TNBC. This study aimed to explore the biological function and clinical significance of forkhead box C1 promoter upstream transcript (FOXCUT) in triple-negative breast cancer.Methods::Based on a bioinformatic analysis of the cancer genome atlas (TCGA) database, we detected that the lncRNA FOXCUT was overexpressed in TNBC tissues, which was further validated in an external cohort of tissues from the General Surgery Department of the First Affiliated Hospital of Nanjing Medical University. The functions of FOXCUT in proliferation, migration, and invasion were detected in vitro or in vivo. Luciferase assays and RNA immunoprecipitation (RIP) were performed to reveal that FOXCUT acted as a competitive endogenous RNA (ceRNA) for the microRNA miR-24-3p and consequently inhibited the degradation of p38. Results::lncRNA FOXCUT was markedly highly expressed in breast cancer, which was associated with poor prognosis in some cases. Knockdown of FOXCUT significantly inhibited cancer growth and metastasis in vitro or in vivo. Mechanistically, FOXCUT competitively bounded to miR-24-3p to prevent the degradation of p38, which might act as an oncogene in breast cancer. Conclusion::Collectively, this research revealed a novel FOXCUT/miR-24-3p/p38 axis that affected breast cancer progression and suggested that the lncRNA FOXCUT could be a diagnostic marker and therapeutic target for breast cancer.

Objective: To study the impact of sleep characteristics on myopia, among lower primary school students in Shanghai, so as to provide foundation for the prevention of the onset and development of myopia. Methods: A total of 636 students from the first and second grades of two primary schools in Jiading District, Shanghai, were selected through cluster random sampling for questionnaire surveys and ophthalmological examinations in October 2022. The Childrens Sleep Habits Questionnaire (CSHQ) was used to assess sleep quality at baseline. Ophthalmological examinations were conducted in October 2023(479), during which the students study time, screen time and outdoor activity time were monitored for twoweek, repeated twice. Generalized multivariable Logistic regression models and linear regression models were employed to examine the association between sleeprelated factors and myopia, as well as the strength of this association. Results: The baseline survey indicated a myopia prevalence of 18.58%, with 17.18% at followup. The average CSHQ total score was (51.58±4.44), and the average daily sleep duration was (9.43±4.84)h/d, with only 11.6% of participants meeting the recommended sleep sufficiency. Multivariable regression models indicated that insufficient sleep showed positive association with myopia (OR=1.64, 95%CI=1.05-2.56), while bedtime duration was significantly negative associated with myopia (OR=0.74, 95%CI=0.63-0.91, P＜0.05), adjusting for confounding factors. Inconsistency in bed rest time was a risk factor for myopia (OR=1.07, P<0.05), and the consistency of bed rest time, and wakeup time showed statistically significant correlations with SE (P<0.05). There was also statistically significant correlations between consistency in sleep time, bed rest time, and wakeup time with AL (P<0.05). Conclusions Insufficient sleep and bedtime duration are correlated with the onset and progression of myopia. It is critical to ensure sufficient sleep duration and regular sleep habits for children to reduce the occurrence of myopia in the primary school students.

Objective:To compare the mid-term clinical effects of AngioJet rheolytic thrombectomy assisted catheter-directed thrombolysis (ART+CDT) with catheter-directed thrombolysis (CDT) in the treatment of acute deep venous thrombosis of lower extremities.Methods:Ninety-one patients admitted to the Department from Jan 2016 to Dec 2017 were placed with inferior vena cava filters and divided into ART+CDT group (30 cases)and CDT group (61 cases). Total urokinase dosge, thrombolytic time, operative cost, length of hospital stay, detumescence rate, thrombus clearance rate, cumulative patency rate of lower limb veins, Villalta score at 2 years and 5 years, thrombosis recurrence rate and chronic venous insufficiency quality of life questionnaire were compared between the two groups.Results:The success rate of surgery was 100% in both groups, there was no mortality. There were significant differences in the short-term postoperative outcomes between the two groups in terms of total dosage of urokinase, thrombolysis time, total cost of surgery, length of hospital stay, detumescence rate, venous patency scores before and after treatment, and venous patency rate (all P<0.05). For the mid- and long-term postoperative outcomes of 2 and 5 years, there were no significant differences in the incidence of PTS, recurrence rate of thrombus, chronic venous function scale, and cumulative patency rate at 2 years (all P>0.05). Conclusions:ART+CDT has a significant advantage over CDT alone in terms of early efficacy and early reopening of blood flow in patients. Both ART+CDT and CDT have a low incidence of PTS and a low recurrence rate of thrombus in the mid-term follow-up, and both have satisfactory performance in the mid- and long-term efficacy of interventional treatment of deep venous thrombosis of lower limbs.

ObjectiveTo investigate the association of lipid ratios with diabetes and pre-diabetes in residents aged 35-75 years in Changzhou City. MethodsA multistage whole-group random sampling method was used to survey permanent residents aged 35-75 years in Tianning and Wujin districts of Changzhou City， and the study data were obtained by questionnaires， physical examination and laboratory tests. The relationship between lipid ratios and diabetes and pre-diabetes was analyzed by dichotomous logistic regression method. ResultsThe prevalence of diabetes in the surveyed population in Changzhou was 18.69%， and the prevalence of pre-diabetes was 10.53%. In the total population， the risk of pre-diabetes was significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 68%， 93% and 38%， respectively； the risk of diabetes was also significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 105%， 149% and 78%， respectively. The risk of diabetes was also significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 105%， 149% and 78%， respectively. All three lipid ratios increased in women compared to men， leading to a stronger association with increased risk of diabetes and pre-diabetes. ConclusionLipid ratios TC/HDL-C， TG/HDL-C， and LDL-C/HDL-C were correlated with the risk of diabetes and pre-diabetes in people aged 35-75 years， with TG/HDL-C having the strongest association with diabetes and pre-diabetes， and is expected to be a key predictor for assessing the development of diabetes.

Objective:To compare the clinical efficacy between bone transport technique combined with bone grafting plus internal fixation and simple bone transport technique in the treatment of large segmental bone defects at lower limbs after trauma.Methods:A retrospective study was conducted to analyze the clinical data of 42 patients with large segmental bone defects at lower limbs after trauma who had been treated at Department of Trauma Orthopaedics, Honghui Hospital Affiliated to Medicine College, Xi'an Jiaotong University from September 2015 to September 2019. The patients were divided into 2 groups according to the different methods of repairing bone defects. In group A of 18 patients subjected to bone transport combined with bone grafting plus internal fixation, there were 11 males and 7 females with an age of (35.2±10.3) years, and 12 tibial defects and 6 femoral defects; in group B of 24 patients subjected to simple bone transport, there were 15 males and 9 females with an age of (37.3±9.4) years, and 17 tibial defects and 7 femoral defects. The external fixation time (EFT), external fixation index (EFI), total cure time and complications were recorded and compared between the 2 groups. At the last follow-up, the Ennecking score for limb functional recovery (score/total score 30) and Self-rating Anxiety Scale (SAS) were used to evaluate respectively the functional recovery of the limbs and postoperative anxiety.Results:The 2 groups were comparable because there was no significant difference between them in preoperative general data or follow-up time ( P>0.05). There was no statistically significant difference in the number of surgeries between the 2 groups ( P>0.05). The EFT [(5.9±1.5) months], EFI [(0.45±0.09) months/cm], total treatment time [(16.2±2.4) months], Ennecking score for limb functional recovery (87.0%±8.6%), SAS score [(43.2±9.0) points], and complications per capita [(0.4±0.2) times/case] in group A were significantly better than those in group B [(15.3±4.2) months, (1.19±0.28) months/cm, (19.7±3.5) months, (77.3%±9.2%), (58.2±9.3) points, and (1.2±0.5) times/case] (all P<0.05). Conclusion:In the treatment of large segmental bone defects at lower limbs, compared with simple bone transport technique, bone transport technique combined with bone grafting plus internal fixation has advantages of shorter external fixation time and overall cure time, a lower rate of complications, and better functional recovery of the limbs.

Objective:To compare the clinical effects of acute shortening-lengthening technique with antibiotic calcium sulfate-loaded bone transport technique for the treatment of segmental tibial defects after trauma.Methods:The clinical data of 58 patients with large tibial defects treated by Ilizarov technique in Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from May 2014 to December 2019 were retrospectively analyzed. Thirty patients were treated by acute shortening-lengthening (group A), and they were divided into those who were successful in one-time shortening during operation (group A1) and those who needed gradual shortening after operation (group A2) according to different shortening conditions. And 28 patients by antibiotic calcium sulfate-loaded bone transport (group B). The external fixation time (EFT) and external fixation index (EFI) of the two groups were compared. Bone defect healing and limb functions were evaluated according to the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria. Complications were compared by Paley classification. The measurement data of normal distribution were expressed as ± s, and t-test was used for comparison between groups; the count data were expressed as n(%), and the chi-square test, Fisher exact probability method or Mann-Whitney U test were used for comparison between groups. Results:Patients were followed for(27.5±5.1)months. There was no significant difference in EFT, EFI, bone defect healing and limb functions between the two groups( P>0.05). The incidence of Grade-Ⅱ[41.2% (7/17)], Grade-Ⅲ [47.1% (8/17)] pin-tract infection in group A1 and Grade-Ⅱ[46.2% (6/13)], Grade-Ⅲ pin-tract [53.8% (7/13)] in group A2 was significantly higher than those in group B[14.3% (4/28)], [17.9% (5/28)] ( P<0.05). The number of complications per capita in group A1 [(1.4±0.3) times/case] and in group A2 [(1.5±0.3) times/case]was significantly higher than that in group B [(1.1±0.5) times/case]. Conclusions:Patients can be cured successfully by both acute shortening-lengthening and bone transport techniques. Compared with acute shortening-lengthening group, the complication incidence in antibiotic calcium sulfate-loaded bone transport group was lower, especially, the infection-related complications. Therefore, antibiotic calcium sulfate-loaded bone transport technique has a greater application prospect in patients with large segmental bone defects caused by infection or osteomyelitis.