Objective To summarize and analyze the efficacy and influencing factors of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia relapsing after the first allo-HSCT. Methods Clinical data of 17 patients with acute leukemia who underwent second allo-HSCT at Peking University First Hospital from January 2005 to December 2024 were retrospectively analyzed. Results Among the 17 patients, 7 achieved long-term disease-free survival after second transplantation. The median progression-free survival after successful second transplantation was 7 months (range 8 days to 69 months). The relapse fatality was 24%, and the transplant-related fatality was 35%. Conclusions Second transplantation is an effective treatment for relapsed and refractory acute leukemia, but the relapse fatality and transplant-related fatality remain high. Patient age, time of relapse after the first transplantation and disease status before second transplantation are all factors that affect the efficacy of second transplantation. Younger age, late relapse and complete remission of disease before second transplantation are all beneficial for long-term disease-free survival after second transplantation.

ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

Objective To investigate the correlation between levels of low-density lipoprotein cholesterol(LDL-C)and atrial fibrillation in a hypertensive population.Methods Hypertension screening was performed in the Wuyuan County of Jiangxi Province from June to August 2022.Data were collected using face-to-face questionnaire surveys,physical measurements,and biochemical tests.Logistic regres-sion analysis was used to analyze the effect of LDL-C on atrial fibrillation.The restricted cubic spline method was used to fit the correlation curve.Results A total of 14 314 patients with hypertension were included in the analysis,with an average age of 65.7±9.2 years.There were 570 patients detected with atrial fibrillation(the rate of atrial fibrillation was 4.0％).The rates of atrial fibrillation for LDL-C＜1.80 mmol/L,1.80-＜2.60 mmol/L,2.60-＜3.40 mmol/L and≥3.40 mmol/L were 10.2％(67/654),5.7％(216/3 807),3.3％(189/5 805),and 2.4％(98/4 048),respectively.Logistic regression analysis showed that,compared with LDL-C＜1.80 mmol/L group,LDL-C 1.80-＜2.60 mmol/L group,2.60-＜3.40 mmol/L group,and ≥ 3.40 mmol/L group had a lower risk of atrial fibrillation(OR=0.53,95％CI:0.39-0.72,P＜0.001;OR=0.32,95％CI:0.23-0.45,P＜0.001;OR=0.22,95％CI:0.16-0.32,P＜0.001).Curve-fitting results showed that LDL-C levels were negatively associated with the risk of atrial fibrillation.Subgroup analysis showed that LDL-C level was negatively associated with the risk of atrial fibrillation in patients without a history of stroke(OR=0.51,95％CI:0.44-0.58,P＜0.001),while the association was not statistically significant in patients with a history of stroke(OR=0.80,95％CI:0.54-1.19,P=0.273).Conclusion In hyperten-sive patients without a history of stroke,LDL-C levels negatively correlated with the risk of atrial fibrillation.

The “Technical Guideline for Epidemic Prevention and Control Disinfection in Large-Scale Events”(hereinafter referred to as “the Guideline”), organized and compiled by the National Disease Control and Prevention Administration, was officially released in April 2024. This guideline aims to ensure the effective implementation of large-scale group activities, mitigate the impact of infectious disease outbreaks on such events, and maintain hygiene and safety standards at event venues. During the compilation process, data were systematically collected in alignment with epidemic prevention requirements and disinfection principles, incorporating research findings from domestic and international disinfection practices. Information was gathered through field investigations, expert consultations in epidemiology and disinfection, and roundtable discussions with representatives from organizations responsible for disinfection operations at large-scale events, thereby ensuring the scientific rigor and practical applicability of the content. The Guideline provides comprehensive technical disinfection guidance for relevant authorities and event organizers, addressing critical aspects such as disinfection protocols, operational principles, emergency response strategies, and technical specifications. By standardizing hygiene assurance measures for large-scale events, including considerations of participant demographics, venue characteristics, and event scale, the guideline establishes a framework to proactively minimize the risk of infectious disease transmission.

Objective To explore the intrinsic relationship between imaging features of the bony structure in varus-type knee osteoarthritis(KOA).Methods A total of 99 patients diagnosed with varus-type KOA were retrospectively selected.All patients underwent standard weight-bearing full-length X-ray radiographs of both lower extremities and 3D CT scans of the knee joints.The images were observed and analyzed at the picture archiving and communication system(PACS)workstation.The hip-knee-ankle(HKA)angle and tibial medial plateau settlement value were measured,the size of osteophyte was measured and graded,and the distribution of subchondral pseudocysts was counted.Correlation analysis was performed on the above imaging indicators,and scatter plots were drawn for linear correlations.Results There was a correlation between the HKA angle and the tibial medial plateau settlement value,with a correlation coefficient(r)of-0.548.The osteophyte grades in each subregion were correlated with the HKA angle,with r of-0.324,-0.307,-0.534,-0.581,-0.468,-0.245,-0.265,-0.244,-0.706,-0.741,-0.726,-0.326,-0.712,-0.218,respectively.There was correlation between the osteophyte grades in the medial patella,medial femoral subregion,and medial tibial subregion and the tibial medial settlement value,with r of 0.227,0.263,0.295,0.242,0.297,0.361,and 0.407,respectively.No correlation was found between the osteophyte grades in other subregions and the tibial medial settlement value.There was an overall correlation between osteophyte grades and subchondral pseudocysts,with a r of 0.245,but with regional differences.No correlation was found between the medial femoral osteophyte grades and subchondral pseudocysts,while correlations were observed in other zones,with r of 0.213,0.230,0.200,and 0.147,respectively.Conclusion KOA is a disease of the entire knee joint.The imaging features of its bony structure,including the HKA angle,tibial medial plateau settlement value,osteophyte grades,and subchondral pseudocysts,have both intrinsic relationship and regional differences,which are influenced by anatomical structures.

Purpose To investigate the presence,proportion,clinical significance and origin of tumor cells with a macrophage phenotype in tumor tissues of patients with diffuse large B-cell lymphoma(DLBCL),and to explore wheth-er CD68 positive tumor cells can be induced in DLBCL cell lines in vitro.Methods The presence of CD68+CD163+CD20+PAX5-cells in the samples of DLBCL patients was first qualitatively detected by multiplex immunofluorescence staining,and then the proportion of CD79a+B lymphocytes,CD68+macrophages,and CD68+CD79a+double-positive cells were quantified.Patients were grouped according to the proportion of double-positive cells,and the differences in prognosis and clinicopathological features of DLBCL patients between subgroups were investigated.For cases with posi-tive BCL6 gene locus breaks,co-localization of CD68 with BCL6 gene breakapart was performed using combined immu-nofluorescence and immunological in situ hybridization to ascertain the tumor nature of B cell with a macrophage pheno-type.DLBCL cell lines(OCI-LY3,SU-DHL2)were treated with phorbol myristate acetate(PMA),and changes in the proteins levels of CD68 and PAX5 proteins were detected by flow cytometry.Quantitative real-time PCR(qRT-PCR)was used to detect mRNA levels of PAX5,an important transcription factor for B cell differentiation and develop-ment,and macrophage-related genes(CD68,ARG1,CD163,CD206,Dectin-1,PU.1,C/EBPα,C/EBPβ).In ad-dition,PMA-treated DLBCL cell lines(OCI-LY3,SU-DHL2)were co-incubated with pH-sensitive fluorescent dye pHrodo to detect the phagocytosis ability of PMA-treated DLBCL cells.Results The percentage of CD68+B lympho-cytes in 50 patients with DLBCL varied from 0 to 9.3％,and the overall survival(OS)ranged from 0.008 2 to 4.2 years.Patients with the low CD68+B lymphocytes group exhibited a significantly lower OS compared to those in the high CD68+B lymphocytes group(P=0.039).There was a significant difference in the molecular typing of DLBCL patients(P=0.009 5)between different subgroups for the proportion of CD68+B lymphocytes.CD68+B lymphocytes were derived from tumor cells in DLBCL patients.The proportion of CD68+cells and CD68+PAX5-cells significantly increased in DLBCL after treatment with PMA(P＜0.05).The other macrophage markers CD68,ARG1,CD 163,CD206,Dectin-1,PU.1,C/EBPα,C/EBPβ,and the important B-cell transcription factor PAX5 were significantly different from the control group in terms of relative mRNA expression(P＜0.05).Cellular phagocytosis was enhanced after PMA treatment of DLBCL cells.Conclusion Diffuse large B-cell lymphoma tumor tissue contains a certain per-centage of CD68+neoplastic B lymphocytes.The proportion of CD68+B lymphocytes is correlated with patient progno-sis and molecular typing.DLBCL cell lines can be induced to differentiate into CD68+tumor cells in vitro.

Purpose To investigate the presence,proportion,clinical significance and origin of tumor cells with a macrophage phenotype in tumor tissues of patients with diffuse large B-cell lymphoma(DLBCL),and to explore wheth-er CD68 positive tumor cells can be induced in DLBCL cell lines in vitro.Methods The presence of CD68+CD163+CD20+PAX5-cells in the samples of DLBCL patients was first qualitatively detected by multiplex immunofluorescence staining,and then the proportion of CD79a+B lymphocytes,CD68+macrophages,and CD68+CD79a+double-positive cells were quantified.Patients were grouped according to the proportion of double-positive cells,and the differences in prognosis and clinicopathological features of DLBCL patients between subgroups were investigated.For cases with posi-tive BCL6 gene locus breaks,co-localization of CD68 with BCL6 gene breakapart was performed using combined immu-nofluorescence and immunological in situ hybridization to ascertain the tumor nature of B cell with a macrophage pheno-type.DLBCL cell lines(OCI-LY3,SU-DHL2)were treated with phorbol myristate acetate(PMA),and changes in the proteins levels of CD68 and PAX5 proteins were detected by flow cytometry.Quantitative real-time PCR(qRT-PCR)was used to detect mRNA levels of PAX5,an important transcription factor for B cell differentiation and develop-ment,and macrophage-related genes(CD68,ARG1,CD163,CD206,Dectin-1,PU.1,C/EBPα,C/EBPβ).In ad-dition,PMA-treated DLBCL cell lines(OCI-LY3,SU-DHL2)were co-incubated with pH-sensitive fluorescent dye pHrodo to detect the phagocytosis ability of PMA-treated DLBCL cells.Results The percentage of CD68+B lympho-cytes in 50 patients with DLBCL varied from 0 to 9.3％,and the overall survival(OS)ranged from 0.008 2 to 4.2 years.Patients with the low CD68+B lymphocytes group exhibited a significantly lower OS compared to those in the high CD68+B lymphocytes group(P=0.039).There was a significant difference in the molecular typing of DLBCL patients(P=0.009 5)between different subgroups for the proportion of CD68+B lymphocytes.CD68+B lymphocytes were derived from tumor cells in DLBCL patients.The proportion of CD68+cells and CD68+PAX5-cells significantly increased in DLBCL after treatment with PMA(P＜0.05).The other macrophage markers CD68,ARG1,CD 163,CD206,Dectin-1,PU.1,C/EBPα,C/EBPβ,and the important B-cell transcription factor PAX5 were significantly different from the control group in terms of relative mRNA expression(P＜0.05).Cellular phagocytosis was enhanced after PMA treatment of DLBCL cells.Conclusion Diffuse large B-cell lymphoma tumor tissue contains a certain per-centage of CD68+neoplastic B lymphocytes.The proportion of CD68+B lymphocytes is correlated with patient progno-sis and molecular typing.DLBCL cell lines can be induced to differentiate into CD68+tumor cells in vitro.

The cultivation of innovation ability is not only the essential requirement of graduate education,but also the strate-gic demand of the development of the communist party and our country,and is of great significance to the realization of the Chinese dream of the great rejuvenation of the Chinese nation.Curriculum ideology and politics should run through the whole process of post-graduate innovation ability training.However,the curriculum ideology and politics and postgraduate innovation ability training lack deep integration.It's important for postgraduates'growth and scientific research innovation that the curriculum ideology and politics covers the whole process of scientific research activities.Therefore,this paper focuses on the design and specific implementation schemes of the curriculum ideology and politics on the postgraduate innovative ability training at the respiratory disease research team in the department of medical immunology.It makes a basis for optimizing postgraduate curriculum ideology and politics teaching in the future,which also provides ideas for cultivating innovative talents with both morality and ability in medical specialty.

Objective To investigate the correlation between levels of low-density lipoprotein cholesterol(LDL-C)and atrial fibrillation in a hypertensive population.Methods Hypertension screening was performed in the Wuyuan County of Jiangxi Province from June to August 2022.Data were collected using face-to-face questionnaire surveys,physical measurements,and biochemical tests.Logistic regres-sion analysis was used to analyze the effect of LDL-C on atrial fibrillation.The restricted cubic spline method was used to fit the correlation curve.Results A total of 14 314 patients with hypertension were included in the analysis,with an average age of 65.7±9.2 years.There were 570 patients detected with atrial fibrillation(the rate of atrial fibrillation was 4.0％).The rates of atrial fibrillation for LDL-C＜1.80 mmol/L,1.80-＜2.60 mmol/L,2.60-＜3.40 mmol/L and≥3.40 mmol/L were 10.2％(67/654),5.7％(216/3 807),3.3％(189/5 805),and 2.4％(98/4 048),respectively.Logistic regression analysis showed that,compared with LDL-C＜1.80 mmol/L group,LDL-C 1.80-＜2.60 mmol/L group,2.60-＜3.40 mmol/L group,and ≥ 3.40 mmol/L group had a lower risk of atrial fibrillation(OR=0.53,95％CI:0.39-0.72,P＜0.001;OR=0.32,95％CI:0.23-0.45,P＜0.001;OR=0.22,95％CI:0.16-0.32,P＜0.001).Curve-fitting results showed that LDL-C levels were negatively associated with the risk of atrial fibrillation.Subgroup analysis showed that LDL-C level was negatively associated with the risk of atrial fibrillation in patients without a history of stroke(OR=0.51,95％CI:0.44-0.58,P＜0.001),while the association was not statistically significant in patients with a history of stroke(OR=0.80,95％CI:0.54-1.19,P=0.273).Conclusion In hyperten-sive patients without a history of stroke,LDL-C levels negatively correlated with the risk of atrial fibrillation.

BACKGROUND:Fibromyalgia syndrome,as a common rheumatic disease,is related to central sensitization and immune abnormalities.However,the specific mechanism has not been elucidated,and there is a lack of specific diagnostic markers.Exploring the possible pathogenesis of this disease has important clinical significance. OBJECTIVE:To screen the potential diagnostic marker genes of fibromyalgia syndrome and analyze the possible immune infiltration characteristics based on bioinformatics methods,such as weighted gene co-expression network analysis(WGCNA),and machine learning. METHODS:Gene expression profiles in peripheral serum of fibromyalgia syndrome patients and healthy controls were obtained from the gene expression omnibus(GEO)database.The differentially co-expressed genes were screened in the expression profile by differential analysis and WGCNA analysis.Least absolute shrinkage and selection operator(LASSO)and support vector machine-recursive feature elimination(SVM-RFE)machine learning algorithm were further used to identify hub biomarkers,and draw receiver operating characteristic curve(ROC)to evaluate the accuracy of diagnosing fibromyalgia syndrome.Finally,single sample gene set enrichment analysis(ssGSEA)and gene set enrichment analysis(GSEA)were used to evaluate the immune cell infiltration and pathway enrichment in patients with fibromyalgia syndrome. RESULTS AND CONCLUSION:Eight down-regulated differentially expressed genes(DEGs)were obtained after differential analysis of the GSE67311 dataset according to the conditions of log2|(FC)|>0 and P<0.05.After WGCNA analysis,497 genes were included in the module(MEdarkviolet)with the highest positive correlation(r=0.22,P=0.04),and 19 genes were included in the module(MEsalmon2)with the highest negative correlation(r=-0.41,P=6×10-5).After intersecting DEGs and the module genes of WGCNA,seven genes were obtained.Four genes were screened out by LASSO regression algorithm and five genes were screened out by SVM-RFE machine learning algorithm.After the intersection of the two,three core genes were identified,which were germinal center associated signaling and motility like,integrin beta-8,and carboxypeptidase A3.The areas under the ROC curve of the three core genes were 0.744,0.739,and 0.734,respectively,indicating that they have good diagnostic value and can be used as biomarkers for fibromyalgia syndrome.The results of immune infiltration analysis showed that memory B cells,CD56 bright NK cells,and mast cells were significantly down-regulated in patients with fibromyalgia syndrome compared with the control group(P<0.05),and were significantly positively correlated with the above three biomarkers(P<0.05).The enrichment analysis suggested that there were nine fibromyalgia syndrome enrichment pathways,mainly related to olfactory transduction pathway,neuroactive ligand-receptor interaction,and infection pathway.The above results showed that the occurrence and development of fibromyalgia syndrome are related to the involvement of multiple genes,abnormal immune regulation,and multiple pathways imbalance.However,the interactions between these genes and immune cells,as well as their relationships with various pathways need to be further investigated.