Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorders (PTLD) are one of the most severe complications after hematopoietic stem cell transplantation (HSCT). This study includes 31 cases of aplastic anemia (AA) patients who developed PTLD after haploidentical transplantation, summarizing their clinical characteristics and categorizing them into either rituximab monotherapy group or combination therapy group based on whether their condition improved by 1 log after a single dose of rituximab. The incidence of PTLD after HSCT in children with AA was 10.16%, and the incidence of PTLD in patients with age >10 years was significantly increased ( χ2=11.336, P=0.010). Of the 31 patients, 27 were clinically diagnosed and 4 were pathologically confirmed. Finally, 15 patients were classified into the rituximab treatment group and 15 patients into the combination treatment groups. Finally three patients died, and the 2-year overall survival rate was (89.7±5.6) %. Standard pre-treatment protocols and EBV reactivation are risk factors affecting the prognosis of PTLD. There was no statistically significant difference in the impact of the two treatment schemes on prognosis.

Objective:To investigate the efficacy and safety of venetoclax combined with the decitabine, cytarabine, and homoharringtonine (HHT) regimen and donor lymphocyte infusion (DLI) for the preventive and salvage therapy of pediatric acute myeloid leukemia (AML) /myelodysplastic syndrome (MDS) after allogeneic hematopoietic stem cell transplantation (HSCT) .Methods:A total of 29 relapsed pediatric/minimal residual disease-positive AML after HSCT were recruited at the Peking University Institute of Hematology from January 1, 2021, to June 1, 2023. They were treated with the above combination regimen and administered with DLI after 24-48 hours at the end of chemotherapy, and the treatment response and adverse reactions were regularly assessed.Results:The overall response rate (ORR) was 75.8%, CR rate was 88.9% (8/9) in the hematologic relapse group, and MRD negativity rate was 61.1% (11/18) in the MRD-positive group. The incidence of agranulocytosis, anemia, and thrombocytopenia with a classification above grade 3 were 100%, 82.7%, and 100%, respectively. The median time of the granulocyte deficiency period was 15 days. Acute graft-versus-host diseases (aGVHD) with a classification of grades Ⅲ-Ⅳ occurred in 11.1% of the patients after DLI, while moderate or severe cGVHD occurred in 7.4% of the patients. The single risk factor for ORR was MNC counts of less than 10×10 8/kg, and the relapse occurred within 100 days. At a median follow-up of 406 days, the 1-year OS was 65%, and the 1-year OS was 57% in the group with no reaction ( P=0.164) compared with 71% in the group who had an overall reaction. Conclusion:The combined regimen based on the DAC, VEN, and modified HA regimen showed a high response rate in the salvage therapy for pediatric AML after the relapse of HSCT. However, bridging to transplantation should be performed immediately after remission to result in a long survival rate.

Objective To explore the influencing factors of visual acuity recovery in patients with high myopia after posterior chamber phakic intraocular lens(ICL)implantation.Methods A prospective study was conducted on 210 pa-tients(420 eyes)with high myopia who underwent ICL implantation at the Second Affiliated Hospital of Zhengzhou Univer-sity from May 2021 to March 2023.The patients were divided into a good recovery group[best corrected visual acuity(BC-VA)recovery ≥0.3 D]and a poor recovery group(BCVA recovery＜0.3 D)based on their visual acuity recovery status three months after surgery.The baseline data of patients in the two groups were compared,and the factors affecting visual acuity recovery were analyzed using Logistic regression.The receiver operating characteristic(ROC)curve was used to an-alyze the predictive value of the Logistic regression model for poor visual acuity recovery in patients with high myopia after ICL implantation.Results Three months after surgery,149 patients(298 eyes)were in the good recovery group,and 61 patients(122 eyes)were in the poor recovery group.There were no significant differences in gender,age,years of myopi-a,body mass index,and academic performance between the two groups(all P＞0.05).The proportions of patients with corneal astigmatism＜1.30 D(55.74％),corneal diopter＜45 D(59.02％),Pittsburgh Sleep Quality Index(PSQI)＜7 points(63.93％),and average central radius of curvature[(7.82±0.27)mm]in the poor recovery group were lower than those in the good recovery group[83.89％,81.88％,85.91％,and(7.90±0.24)mm,respectively].The central flat me-ridian curvature(k1)of the anterior corneal surface[(43.27±1.43)D],steep meridian curvature(k2)of the anterior corneal surface[(44.84±1.53)D],and arch height[(628.49±67.28)μm]in the poor recovery group were higher than those in the good recovery group[(42.73±1.42)D,(44.12±1.47)D],and[(417.56±80.14)pm],with significant differences(all P＜0.05).Logistic regression analysis showed that corneal astigmatism,corneal diopter,k1,k2,arch height,and PSQI score were independent influencing factors of poor visual acuity recovery after ICL implantation in pa-tients with high myopia(all P＜0.05).ROC curve analysis showed that the area under the ROC curve for predicting poor visual acuity recovery after ICL implantation in patients with high myopia by Logistic regression model was 0.938(95％CI:0.896-0.966),the sensitivity was 83.61％,and the specificity was 91.95％(P＜0.05).Conclusion The visual acuity recovery after ICL implantation in patients with high myopia is affected by corneal astigmatism,corneal diopter,k1,k2,arch height,and PSQI score.The Logistic regression model based on these factors has high predictive value for visual acui-ty recovery after ICL implantation.

Objective:To observe the clinical effect of adjustable silicone strap suspension in the treatment of myasthenia gravis ptosis.Methods:From January 2019 to January 2020, 60 patients with myasthenia gravis ptosis (35 males, 25 females, age distribution from 25 to 58 years, with average of 35.63 years) were collected from the Department of Ophthalmoplasty of Aier Eye Hospital affiliated to Wuhan University. They were divided into control group and observation group, with 30 cases in each group. The observation group was treated with adjustable silicone band suspension, and the correction effect, satisfaction, recovery status, ocular surface function index, recurrence rate and complications of the two groups were compared.Results:The excellent rate of operation in the observation group was 93.33% (28/30), which was significantly higher than 63.33% (19/30) in the control group (χ 2=6.29, P<0.05), and the satisfaction of patients in the observation group was 100% (30/30), which was significantly higher than 76.67% (23/30) in the control group (χ 2=5.82, P<0.05). The preoperative corneal curvature and fluorescein staining in the observation group and the control group were significantly lower than those in the postoperative state ( t=6.17, 21.48, P<0.05). The corneal curvature and fluorescein staining score of the observation group were significantly higher than those of the control group at 3 months after surgery ( t=3.00, 9.06, P<0.05). There was no significant difference between the two groups in the incidence of complications such as eyelid imclosure, upper eyelid inversion and unnatural upper eyelid curvature (χ 2=0.19, P>0.05). Follow up at 3 months after surgery, the recurrence rate in the observation group was lower than that in the control group (χ 2=4.63, P<0.05). Conclusions:Surgery is an option for patients with myasthenia gravis ptosis who are not responding well to medical treatment and whose condition is stable. Adjustable silicone strap suspension for the treatment of myasthenia gravis ptosis can significantly improve the surgical success rate and patient satisfaction, with low postoperative complication rate and recurrence rate, which is suitable for clinical application.

Objective To establish a universally applicable logistic risk prediction model for diabetes mellitus type 2(T2DM)in the middle-aged and elderly populations based on the results of a Meta-analysis,and to validate and confirm the efficacy of the model using the follow-up data of medical check-ups of National Basic Public Health Service.Methods Cohort studies evaluating T2DM risks were identified in Chinese and English databases.The logistic model utilized Meta-combined effect values such as the odds ratio(OR)to derive β,the partial regression coefficient,of the logistic model.The Meta-combined incidence rate of T2DM was used to obtain the parameter α of the logistic model.Validation of the predictive performance of the model was conducted with the follow-up data of medical checkups of National Basic Public Health Service.The follow-up data came from a community health center in Chengdu and were collected between 2017 and 2022 from 7 602 individuals who did not have T2DM at their baseline medical checkups done at the community health center.This community health center was located in an urban-rural fringe area with a large population of middle-aged and elderly people.Results A total of 40 cohort studies were included and 10 items covered in the medical checkups of National Basic Public Health Service were identified in the Meta-analysis as statistically significant risk factors for T2DM,including age,central obesity,smoking,physical inactivity,impaired fasting glucose,a reduced level of high-density lipoprotein cholesterol(HDL-C),hypertension,body mass index(BMI),triglyceride glucose(TYG)index,and a family history of diabetes,with the OR values and 95% confidence interval(CI)being 1.04(1.03,1.05),1.55(1.29,1.88),1.36(1.11,1.66),1.26(1.07,1.49),3.93(2.94,5.24),1.14(1.06,1.23),1.47(1.34,1.61),1.11(1.05,1.18),2.15(1.75,2.62),and 1.66(1.55,1.78),respectively,and the combined β values being 0.039,0.438,0.307,0.231,1.369,0.131,0.385,0.104,0.765,and 0.507,respectively.A total of 37 studies reported the incidence rate,with the combined incidence being 0.08(0.07,0.09)and the parameter α being-2.442 for the logistic model.The logistic risk prediction model constructed based on Meta-analysis was externally validated with the data of 7 602 individuals who had medical checkups and were followed up for at least once.External validation results showed that the predictive model had an area under curve(AUC)of 0.794(0.771,0.816),accuracy of 74.5%,sensitivity of 71.0%,and specificity of 74.7% in the 7 602 individuals.Conclusion The T2DM risk prediction model based on Meta-analysis has good predictive performance and can be used as a practical tool for T2DM risk prediction in middle-aged and elderly populations.

Objective Ultrasound categories of Breast Imaging Reporting and Data System(BI-RADS)are an important outcome used in the evaluation of the characteristics of breast lesions.In this study,we aim to explore the potential influencing factors that may cause the progression of BI-RADS categories.Methods Based on the cervical cancer and breast cancer screening cohort in Shuangliu District,Chengdu from 2015 to 2021,we collected ultrasound and questionnaire results.Progression was defined as changing from BI-RADS category 1 or 2 to 3 or above,or from the initial screening result of BI-RADS 3 or above to a higher category in subsequent ultrasound screenings.The Cox proportional hazards regression model was used to explore potential influencing factors for BI-RADS classification progression.A restricted cubic spline was used to explore the nonlinear association between the variables and the risk of progression.Results A total of 7 069 participants were included in the analysis and followed up for 23 580 person-years.Compared with other age groups,the proportion of participants of BI-RADS category 3 and above was highest in the 40-44 age group(24.83％).Cox regression analysis showed that postmenopausal women had a lower risk of BI-RADS progression than premenopausal women did(hazard ratio[HR]:0.65,95％confidence interval[CI]:0.44-0.97).In postmenopausal women,late menopause(HR=1.16,95％CI:1.03-1.30)was identified as a risk factor for BI-RADS progression.Obesity in premenopausal women was negatively associated with the risk of progression(HR=0.43,95％CI:0.21-0.88).Conclusion The risk factors for progression in ultrasound BI-RADS categories overlap with the risk factors for breast cancer.A risk score based on the high-risk factors for BI-RADS progression can be constructed to optimize screening programs for high-risk populations and improve the efficiency of breast cancer screening.

Objective:To investigate the effect of long non-coding RNA00461 (LINC00461) on apoptosis of triple negative breast cancer cells.Methods:RT-qPCR was used to detect the expression of LINC00461 in normal breast epithelial cells MCF-10A, TNBC cell lines MDA-MB-231 and MDA-MB-468. The apoptosis rate was detected by Annexin V-FITC/PI double staining cell apoptosis kit. Western blot was used to detect apoptosis-associated protein. The localization of LINC00461 in cells was detected by FISH. RNA pulldown and RIP were used to detect the interaction between LINC00461 and c-Myc. The effect of LINC00461 on TNBC apoptosis was verified by subcutaneous tumorigenesis in nude mice.Results:Compared with MCF-10A, LINC00461 expression in MDA-MB-231 and MDA-MB-468 cells was significantly increased. Interference with LINC00461 significantly reduced the expression of LINC00461 and c-Myc protein. Overexpression of LINC00461 significantly decreased the expression level of apoptosis-related protein. Overexpression of LINC00461 significantly reduced the apoptosis rate by 50%-70%, with a statistically significant difference. FISH results showed that LINC00461 was mainly localized in the cytoplasm. RNA pulldown results showed that LINC00461 interacted with c-Myc. RIP results showed that the concentration of LINC00461 in c-Myc group was more than 400%, and the difference was statistically significant. In addition, overexpression of c-Myc reduced the promotion effect of knockdown LINC00461 on the apoptosis rate of 30%-50%. In animal experiments, overexpression of LINC00461 significantly increased tumor volume (50%-80%) and tumor weight (30%-50%) .Conclusion:LINC00461, mainly located in the cytoplasm, regulates the apoptosis of TNBC cells, and its molecular mechanism may be that LINC00461 interacts with c-Myc protein to play an important role in regulating the apoptosis of TNBC cells.

Objective:To explore the association of different obesity measurement indexes on serum C-reactive protein (CRP) in Chinese adult women.Methods:The data were obtained from baseline and follow-up surveys of the urban Breast Cancer Screening Program in Shuangliu District, Chengdu. A total of 441 adult women were included in the study. A questionnaire survey, physical examination, and laboratory testing were conducted on the subjects. Multivariate logistic regression model, two-level mixed effects logistic regression model, and restricted cubic spline method were used to investigate the linear and nonlinear correlation between different obesity measurement indexes and serum CRP in adult women.Results:For every 1 unit increase in BMI, waist circumference (WC), and adiposity, the risk of elevated serum CRP or exacerbation of chronic low-grade inflammation in adult women increased by 16.5%, 5.0%, and 11.1% ( P<0.05), respectively. Both BMI and adiposity were nonlinear correlated with serum CRP. Using BMI=24.0 kg/m 2 as the reference point, serum CRP level increased with the increase of BMI when BMI >24.0 kg/m 2. Using adiposity=30% as the reference point, serum CRP level increased with the increase of adiposity when adiposity >30%. Conclusions:Overall, obesity reflected by BMI had the strongest association with serum CRP in adult women, followed by body fat content reflected by adiposity, and central obesity reflected by WC had the weakest association with CRP. Adult women with BMI >24.0 kg/m 2 or adiposity >30% are at high risk for obesity-related inflammatory manifestations.

Objective:To observe the changes of corneal curvature and ocular surface after congenital ptosis.Methods:A total of 188 patients with congenital blepharoptosis were treated with frontal muscle flap suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis according to different conditions. The postoperative correction effect, corneal curvature, and ocular surface changes were observed.Results:There was no significant difference in the good correction rate among the three methods ( P>0.05). The corneal curvature at 3 months after operation was lower than that before operation and 7 days after operation ( P<0.05). The fluorescein staining score at 7 days after operation was higher than that before operation and 3 months after operation ( F=2 910.05, P<0.05). The tear film rupture time at 7 days after operation was significantly shorter than that before operation and 3 months after operation ( F=758.12, P<0.05). There was no significant difference in tear secretion test before operation, 7 days after operation and 3 months after operation ( P>0.05). The conjunctival congestion score at 3 months after operation was lower than that at 7 days after operation, and the incidence of meibomian gland dysfunction and abnormal eyelash angle at 3 months after operation was lower than that at 7 days after operation ( t=113.56, χ 2=11.02, 11.46, P<0.05). 3 months after operation, the average diopters of 3 mm and 5 mm were higher than those before operation ( t=12.35, 15.19, P<0.05). Conclusions:Frontal muscle suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis are effective in treating congenital blepharoptosis, and can effectively improve the ocular surface and corneal curvature. Clinically, the appropriate one can be selected according to the condition of the child correction method.