In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective To investigate the cumulative incidence of recurrence(CIR)in children with acute lymphoblastic leukemia(ALL)after treatment with the Chinese Children's Cancer Group ALL-2015(CCCG-ALL-2015)protocol and the risk factors for recurrence.Methods A retrospective analysis was conducted on the clinical data of 852 children who were treated with the CCCG-ALL-2015 protocol from January 2015 to December 2019.CIR was calculated,and the risk factors for the recurrence of B-lineage acute lymphoblastic leukemia(B-ALL)were analyzed.Results Among the 852 children with ALL,146(17.1%)experienced recurrence,with an 8-year CIR of 19.8%±1.6%.There was no significant difference in 8-year CIR between the B-ALL group and the acute T lymphocyte leukemia group(P>0.05).For the 146 children with recurrence,recurrence was mainly observed in the very early stage(n=62,42.5%)and the early stage(n=46,31.5%),and there were 42 children with bone marrow recurrence alone(28.8%)in the very early stage and 27 children with bone marrow recurrence alone(18.5%)in the early stage.The Cox proportional-hazards regression model analysis showed that positive MLLr fusion gene(HR=4.177,95%CI:2.086-8.364,P<0.001)and minimal residual disease≥0.01%on day 46(HR=2.013,95%CI:1.163-3.483,P=0.012)were independent risk factors for recurrence in children with B-ALL after treatment with the CCCG-ALL-2015 protocol.Conclusions There is still a relatively high recurrence rate in children with ALL after treatment with the CCCG-ALL-2015 protocol,mainly bone marrow recurrence alone in the very early stage and the early stage,and minimal residual disease≥0.01%on day 46 and positive MLLr fusion gene are closely associated with the recurrence of B-ALL.

OBJECTIVE: To retrospectively analyze efficacy of single structure internal fixation and double structure internal fixation in the treatment of ipsilateral femoral shaft and neck fracture, and analyze their indications. METHODS: From June 2015 to December 2020, 21 patients with ipsilateral femoral shaft and femoral neck fracture were treated, including 14 males and 7 females, aged 23 to 69 years old with an average of(38.1±12.9) years old. According to different femoral shaft fracture sites, some patients were fixed with cephalomedullary implant for both femoral neck and the femoral shaft(single structure, InterTan or PFNA Ⅱ), some patients were fixed with cannulated screws for the femoral neck and a retrograde locking nail for the femoral shaft (dual structure), and postoperative function and complications were recorded during follow-up. In 10 cases of single-structure fixation, the femoral necks were all basicervical fractures, and the femoral shaft fractures were located in the proximal isthmus;11 cases were double-structure fixation, 9 cases in 11 were basal type of femoral neck, 2 cases in 11 were neck type, and the femoral shaft fractures were located in the isthmus and the distal isthmus. RESULTS: All patients were followed up for 12 to 27 months. No femoral head necrosis, deformity, delay or nonunion occurred in the patients with single-structure fixation, and no delayed union or nonunion occurred in femoral shaft fractures;At the final follow-up, Harris score of patients with single-structure fixation was 91.8±4.1, with 8 cases were excellent and 2 cases were good. The fractures of patients with dual-structure fixation achieved good union without femoral head necrosis, except 1 case of femoral shaft fracture had delayed union;At the final follow-up, Harris score of patients with dual-structure fixation was 92.4±5.9, 7 cases were excellent, 3 cases were good, and 1 case was fair. CONCLUSION Good reduction and fixation is the key to the treatment of such fractures. Both the single-structure fixation and the dual-structure fixation are good methods, and it should be selected according to the locations of femoral shaft and femoral neck fractures. Single-structure fixation is a good choice for femoral shaft fractures located at the proximal isthmus and basal femoral neck fractures. For isthmus and distal femoral shaft fractures combined with ipsilateral femoral neck fractures, dual-structure fixation is recommended.
Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Femur Neck ; Retrospective Studies ; Femoral Neck Fractures/complications* ; Femoral Fractures/complications* ; Fracture Fixation, Internal/methods* ; Femoral Fractures, Distal ; Treatment Outcome ; Fracture Fixation, Intramedullary/methods*

OBJECTIVES: To study the clinical features and prognosis of children with acute leukemias of ambiguous lineage (ALAL) under different diagnostic criteria. METHODS: A retrospective analysis was performed on the medical data of 39 children with ALAL who were diagnosed and treated from December 2015 to December 2019. Among the 39 children, 34 received treatment. According to the diagnostic criteria for ALAL by World Health Organization and European Group for the Immunological Characterization of Leukemias, the 39 children were divided into two groups: ALAL group ( RESULTS: The 34 children receiving treatment had a 3-year event-free survival (EFS) rate of 75%±9% and an overall survival rate of 88%±6%. The children treated with acute myeloid leukemia (AML) protocol had a 3-year EFS rate of 33%±27%, those treated with acute lymphoblastic leukemia (ALL) protocol had a 3-year EFS rate of 78%±10%, and those who had no remission after induction with AML protocol and then received ALL protocol had a 3-year EFS rate of 100%±0% ( CONCLUSIONS ALL protocol has a better clinical effect than AML protocol in children with ALAL, and positive MRD after induction therapy suggests poor prognosis. Hyperleukocytosis and adverse genetic changes are not observed in children with myeloid expression, and such children tend to have a good prognosis, suggesting that we should be cautious to take it as ALAL in diagnosis and treatment.
Acute Disease ; Child ; Disease-Free Survival ; Humans ; Neoplasm, Residual ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Prognosis ; Retrospective Studies

Objective To investigate the expression of interleukin-17 (IL-17) in peripheral blood mononuclear cells (PBMC) of patients with multiple myeloma and analyse it's clinical significance.Methods Thirty patients with multiple myeloma in the Department of Hematopathy,the Third Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2017 were selected as observation group;and thirty healthy donors whose gender and age machted with patients in the observation group were selected as control group.Peripheral blood mononuclear cells were obtained from subjects in observation group and control group by using the method of density gradient centrifugation.The content of IL-17 in supernatant of PBMC culture solution of subjects in the two groups was detected by enzyme linked immunosorbent assay and the expression of IL-17 mRNA in PBMC was detected by quantitative real-time polymerase chain reaction;the cellular morphology of PBMC of subjects in control group was observed by scanning electron microscope after co-culturing with the serum of patients in observation group.Results The content of IL-17 in supernatant of PBMC culture solution of subjects in the observation group and control group was (30.79 ± 4.96),(10.10 ± 4.15) ng · L-1 respectively;the content of IL-17 in supernatant of PBMC culture solution of subjects in the observation group was significantly higher than that in the control group (t =3.412,P ＜ 0.05).The expression of IL-17 mRNA in PBMC in the observation group and control group was 4.28 ± 1.34 and 2.45 ±0.95 respectively;the expression of IL-17 mRNA in PBMC in the observation was significantly higher than that in the control group (t =2.796,P ＜0.05).After co-culturing of PBMC of subjects in the control group with the serum of patients in the observation group,the morphology of PBMC changed obviously,and membrane desquamate,membrane disintegration,even membranolysis were observed in some cells with the prolongation of co-culture time.Conclusion The over-expression of IL-17 in PBMC of patients with multiple myeloma may play a certain role in the occurrence and development of this disease.

ABSTRACT:Objective To discuss the risk factors of ICU patients with catheter-associate-durinary tract infection (CAUTI)so as to provide scientific basis for effective nursing measures. Methods ICU patients from April 2012 to March 2014 in our hospital were monitored,and in-dwelling catheter chances,indwelling catheter days,maintenance of urinary catheter,perineum nursing,the urine property,urine culture results were observed.Results 92 cases of urinary tract infection occurred in 1421 urinary catheter indwelling patients.Patients in emergency department with indwelling catheter more than 7 days and perineum nursing less than 2 times a day had more risk factors of urinary tract infection (P <0.05).A total of 153 pathogenic bacteria were separated in 92 patients.Among these pathogenic bacteria,23 cases were multiple drug-resistant bacteria. The top three pathogens were 17.65% of klebsiella,15.69% of candidaalbicans and 9.80% of es-cherichia coli.Conclusion Effective nursing strategies are to shorten the urine tube indwelling time,improve the technique of emergency patients with catheter,correctly maintain urine tube,en-sure the drainage device sealability,strengthen the perineum nursing,apply multiple drug-resis-tant bacteria isolation measures so as to prevent catheter-associated urinary tract infection.

ABSTRACT:Objective To discuss the risk factors of ICU patients with catheter-associate-durinary tract infection (CAUTI)so as to provide scientific basis for effective nursing measures. Methods ICU patients from April 2012 to March 2014 in our hospital were monitored,and in-dwelling catheter chances,indwelling catheter days,maintenance of urinary catheter,perineum nursing,the urine property,urine culture results were observed.Results 92 cases of urinary tract infection occurred in 1421 urinary catheter indwelling patients.Patients in emergency department with indwelling catheter more than 7 days and perineum nursing less than 2 times a day had more risk factors of urinary tract infection (P <0.05).A total of 153 pathogenic bacteria were separated in 92 patients.Among these pathogenic bacteria,23 cases were multiple drug-resistant bacteria. The top three pathogens were 17.65% of klebsiella,15.69% of candidaalbicans and 9.80% of es-cherichia coli.Conclusion Effective nursing strategies are to shorten the urine tube indwelling time,improve the technique of emergency patients with catheter,correctly maintain urine tube,en-sure the drainage device sealability,strengthen the perineum nursing,apply multiple drug-resis-tant bacteria isolation measures so as to prevent catheter-associated urinary tract infection.

OBJECTIVETo study the effect of ultrasonic irrigation in deactivating and eliminating the endotoxin in the root canals of chronic periapical periodontitis.

METHODS10 maxillary premolars with 2 root canals extracted because of serious chronic periapical periodontitis were opened conventionally and prepared with modified double-flared technique with apical foramen sealed. 30 microL 3% H2O2 solution was introduced into each root canal and 2 minutes ultrasonic vibration was given. Samples were taken before and after ultrasonic vibration. 10 maxillary premolars with 2 root canals of chronic periapical periodontitis of 10 patients in clinic were selected. The root canals of them were instrumented as above, followed by 2 minutes ultrasonic irrigation with asepsis distilled water. Samples were taken before, after root canal preparation and after ultrasonic irrigation. The endotoxin activity of them was tested by kinetic turbidimetric limulus test.

RESULTSThe mean endotoxin activity of extracted premolars before ultrasonic vibration was 4.069 EU x mL(-1) while after ultrasonic vibration it was 16.410 EU x mL(-1). There was great statistical difference between them (P < 0.01). The endotoxin activity after ultrasonic vibration was significantly higher than that of before vibration. The clinically mean endotoxin activity before, after root canal preparation and after ultrasonic irrigation were 44.860, 4.099, and 0.116 EU mL1 respectively. There was great statistical difference between the endotoxin activity before and after root canal preparation (P < 0.01). After the preparation, the endotoxin activity droped obviously. There was great statistical difference between the endotoxin activity before and after ultrasonic irrigation (P < 0.01). After ultrasonic irrigation, the endotoxin activity droped obviously.

CONCLUSIONUnder the condition of simulating clinical work presence, the ultrasonic irrigation can not intensify the effect of the root canal rinse solution in deactivating the endotoxin of infected root canals, but it may intensify the effect of the root canal rinse solution in eliminating the endotoxin of infected root canals.

Bicuspid ; Dental Pulp Cavity ; Endotoxins ; Humans ; Hydrogen Peroxide ; Molar ; Periapical Periodontitis ; Root Canal Irrigants ; Root Canal Preparation ; Root Canal Therapy ; Ultrasonics

Background It has been determined that dipeptidyl peptidase Ⅲ (DPPⅢ) plays an important role in the metabolism and modification of proteins and DPPⅢ of human has highly homologous to rat.Researches have shown that DPPⅢ is associated with the formation of cataract.However,few relevant studies have been reported.ObjectiveThe present study is to find out the relationship between the expression of DPPⅢ in rat lenses and age-related cataract.Methods Lenses were obtained from general Wistar rats of ages 3,6,9,or 12 weeks old (10 lenses each ) and homogenized with different concentrations of standard bovine serum.The proteins were resolved using SDS-PAGE gel electrophoresis.Peak concentration and total concentration of DPPⅢ protein in lenses from rats of different ages were detected by Western blot.Enzyme activity of DPPⅢ was determined by monitoring the amount of dipeptides removed from a special substrate (Arg-Arg-4mb NA) by measuring the absorbance with UV-2500PC at 525 nm.The relationship between the enzyme activity of DPPⅢ in lenses and age of rats was evaluated using regression analysis.Results DPPⅢ was detected at a molecular weight of 82000 Da.The peak concentration and total concentration of DPPⅢ in normal rat lenses increased with the growth of age.The total protease activity of DPPⅢ in the lenses of rats was correlated with the ages of the rats (r=0.99,P＜0.05).Conclusion DPPⅢ may be involved in the alteration of crystallin during the development of lenses,and it may play an important role in the formation and aggravation of age-related cataract.

Animals ; Gene Expression Profiling ; Hepatocytes ; MicroRNAs ; Oligonucleotide Array Sequence Analysis ; Rats