Objective:To evaluate the efficacy and safety of the Chi-BEAM regimen (chidamide combined with carmustine, etoposide, cytarabine, and melphalan) followed by autologous hematopoietic stem cell transplantation (ASCT) in patients with high-risk or relapsed/refractory lymphoma.Methods:This retrospective case series included 78 patients with newly treated high-risk or relapsed/refractory lymphoma who underwent ASCT with the Chi-BEAM conditioning regimen in the Department of Hematology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), from June 2021 to May 2024. Descriptive statistics were employed to evaluate clinical characteristics, efficacy, and adverse events. The Kaplan-Meier method was applied to calculate cumulative progression-free survival (PFS) and overall survival (OS) rates.Results:The median age of the 78 evaluable patients was 47 years (range 16-68), with 8 patients (10.3%) aged ≥60 years. At the first post-transplant assessment (3 months), the objective response rate was 94.9% (74/78). The median follow-up was 20.1 months (range 2.9-44.9). The median PFS time was 20.1 months (range 1.6-45.1), with a 2-year cumulative PFS rate of 81.8%. The median OS time was 20.6 months (range 3.1-45.1), with a cumulative 2-year OS rate of 93.2%. The regimen was well-tolerated; mild-to-moderate hypocalcemia within 1 week post-infusion and transient mild erythrocyturia on the infusion day were the primary adverse reactions.Conclusion:The Chi-BEAM regimen combined with ASCT demonstrates both safety and clinical benefit in patients with high-risk or relapsed/refractory lymphoma.

Tuberculosis remains one of the most lethal infectious diseases, posing a significant threat to global public health. Kidney transplant recipients have a higher incidence of latent tuberculosis infection (LTBI) than the general population, which adversely affects transplant outcomes. Early screening and prophylactic treatment are essential in reducing the risk of LTBI reactivation. This review summarizes recent advances in the epidemiology, screening and diagnostic methods, and preventive strategies for LTBI in kidney transplant recipients, providing valuable insights and references for its prevention and management in this high-risk population.

Objective:To evaluate the efficacy and safety of the Chi-BEAM regimen (chidamide combined with carmustine, etoposide, cytarabine, and melphalan) followed by autologous hematopoietic stem cell transplantation (ASCT) in patients with high-risk or relapsed/refractory lymphoma.Methods:This retrospective case series included 78 patients with newly treated high-risk or relapsed/refractory lymphoma who underwent ASCT with the Chi-BEAM conditioning regimen in the Department of Hematology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), from June 2021 to May 2024. Descriptive statistics were employed to evaluate clinical characteristics, efficacy, and adverse events. The Kaplan-Meier method was applied to calculate cumulative progression-free survival (PFS) and overall survival (OS) rates.Results:The median age of the 78 evaluable patients was 47 years (range 16-68), with 8 patients (10.3%) aged ≥60 years. At the first post-transplant assessment (3 months), the objective response rate was 94.9% (74/78). The median follow-up was 20.1 months (range 2.9-44.9). The median PFS time was 20.1 months (range 1.6-45.1), with a 2-year cumulative PFS rate of 81.8%. The median OS time was 20.6 months (range 3.1-45.1), with a cumulative 2-year OS rate of 93.2%. The regimen was well-tolerated; mild-to-moderate hypocalcemia within 1 week post-infusion and transient mild erythrocyturia on the infusion day were the primary adverse reactions.Conclusion:The Chi-BEAM regimen combined with ASCT demonstrates both safety and clinical benefit in patients with high-risk or relapsed/refractory lymphoma.

Tuberculosis remains one of the most lethal infectious diseases, posing a significant threat to global public health. Kidney transplant recipients have a higher incidence of latent tuberculosis infection (LTBI) than the general population, which adversely affects transplant outcomes. Early screening and prophylactic treatment are essential in reducing the risk of LTBI reactivation. This review summarizes recent advances in the epidemiology, screening and diagnostic methods, and preventive strategies for LTBI in kidney transplant recipients, providing valuable insights and references for its prevention and management in this high-risk population.

Objective:This study aimed to assess the efficacy and safety of thioamide as a maintenance therapy for peripheral T-cell lymphoma (PTCL) .Methods:This study retrospectively analyzed the data from 58 patients with PTCL who were treated in the Department of Hematology at the First Affiliated Hospital of Nanjing Medical University from January 2015 to July 2022. Chidamide was orally administered as a maintenance therapy after first-line or salvage treatment. Progression-free survival (PFS), overall survival (OS), and safety were analyzed.Results:Among the 58 patients with PTCL, 43 were males and 15 were females, and the median age was 66 (range: 29-83) years. Thirty-nine patients received thioamide as first-line maintenance therapy, and 19 patients received thioamide as maintenance therapy after salvage treatment. The median maintenance therapy duration was 16 months (range: 1-72 months), with a median PFS time of 33 (2-74) months, and the median OS time had not been reached. Patients who received first-line maintenance therapy with thioamide demonstrated superior PFS and OS outcomes compared with patients who received thioamide maintenance therapy after salvage treatment (median PFS time: not reached vs 7 months, P<0.001; median OS time: not reached vs 67 months, P=0.009). The most prevalent adverse reaction was a hematologic adverse reaction (77.6%). Twelve (20.7%) patients underwent a dose reduction and three patients discontinued treatment. Conclusion:Patients receiving thioamide maintenance therapy demonstrated a promising PFS and OS with a manageable safety profile, especially as the first-line maintenance therapy.

Objective:This study aimed to assess the efficacy and safety of thioamide as a maintenance therapy for peripheral T-cell lymphoma (PTCL) .Methods:This study retrospectively analyzed the data from 58 patients with PTCL who were treated in the Department of Hematology at the First Affiliated Hospital of Nanjing Medical University from January 2015 to July 2022. Chidamide was orally administered as a maintenance therapy after first-line or salvage treatment. Progression-free survival (PFS), overall survival (OS), and safety were analyzed.Results:Among the 58 patients with PTCL, 43 were males and 15 were females, and the median age was 66 (range: 29-83) years. Thirty-nine patients received thioamide as first-line maintenance therapy, and 19 patients received thioamide as maintenance therapy after salvage treatment. The median maintenance therapy duration was 16 months (range: 1-72 months), with a median PFS time of 33 (2-74) months, and the median OS time had not been reached. Patients who received first-line maintenance therapy with thioamide demonstrated superior PFS and OS outcomes compared with patients who received thioamide maintenance therapy after salvage treatment (median PFS time: not reached vs 7 months, P<0.001; median OS time: not reached vs 67 months, P=0.009). The most prevalent adverse reaction was a hematologic adverse reaction (77.6%). Twelve (20.7%) patients underwent a dose reduction and three patients discontinued treatment. Conclusion:Patients receiving thioamide maintenance therapy demonstrated a promising PFS and OS with a manageable safety profile, especially as the first-line maintenance therapy.

Gei Herba is a traditional folk herbal medicine with a variety of functions such as replenishing Qi and invigorating spleen， tonifying blood and nourishing Yin， moistening lung and resolving phlegm， activating blood and alleviating edema， moving Qi， and activating blood. The reports about the pharmacological effects of this herbal medicine have been increasing in recent years. By reviewing the ancient and modern literature about Gei Herba， we systematically organized the name， original plants， nature， taste， and functions of this herbal medicine， and summarized the modern pharmacological studies and clinical applications of Gei Herba in cardiovascular and cerebrovascular diseases. Gei Herba was first recorded in the name of "Dijiao" in the Geng Xin Yu Ce（《庚辛玉册》） written in the Ming Dynasty. It is derived from Geum japonicum var. chinense （Rosaceae） and sometimes confused with Adina rubella （Rubiaceae）. This medicine had numerous synonyms in the local materia medica books. Gei Herba is widely distributed and harvested in summer and autumn， with the dried whole grass used as medicine. The historical records of the nature， taste， meridian tropism， main functions， and indications of Gei Herba are not consistent. It is generally believed that Gei Herba is pungent， bitter， sweet， cool， and has tropism to the liver， spleen， and lung meridians. Based on the effects of tonifying Qi， activating blood， and nourishing Yin， modern pharmacological studies have reported that the extracts of Gei Herba and the tannin phenolic acid compounds and triterpenoids isolated from Gei Herba have therapeutic effects on cardiovascular and cerebrovascular diseases such as hypertension， myocardial ischemia， cerebral ischemia， and vascular dementia. This study provides a reference for discovering the clinical advantages of Gei Herba and developing new drugs.

Objective:To explore the clinical features, etiologies and outcomes of unknown origin fever after simultaneous pancreas-kidney transplantation(SPK).Methods:From March 2015 to January 2020, clinical data were retrospectively reviewed for 120 SPK recipients.According to the definite evidence of fever, such as microbial culture, imaging findings or rejection, they were divided into three groups of free-fever(FF, n=41)and defined-fever(DF, n=47)and fever of unknown origin(FUO, n=32). The differences in general clinical features, surgical complications, laboratory tests and prognoses were compared.Logistic regression was employed for analyzing the risk factors of FUO and Kapla-Meier for survival analysis.And P<0.05 was deemed as statistically significant. Results:Multivariate analysis revealed that preoperative diabetic gastroenteropathy was an independent risk factor for unexplained fever.Significant differences existed between FUO and DF groups in leucocyte count[6.50(5.13, 7.36)vs.10.36(6.11, 12.97)×10 9/L], C-reactive protein(CRP)[11.75(6.25, 16.85)vs.35.00(16.30, 75.00)μg/ml], procalcitonin[0.13(0.06, 0.18)vs.0.19(0.11, 1.05)ng/ml]( P<0.001, P<0.001, P=0.025). As compared with DF group, 19 recipients in FUO group only received 1-2 antibiotics and there was a shorter course of treatment[13(40.6%)vs.32(68.1%), P=0.016]. For 6(18.7%)recipients after a diagnosis of FUO, clinical outcome was achieved with only NSAIDs.Length of stay was(48.72±19.51)days in FUO group versus(57.36±27.46)days in DF group and the difference was statistically significant( P<0.001). Hospitalization expenses of two groups were 253 463.25 and 334 605.96 yuan respectively and the difference was also statistically significant( P=0.002). Conclusions:Diabetic gastroenteropathy is an independent risk factor for early FUO after SPK transplantation.Inflammatory markers of leukocytes, CRP and procalcitonin in FUO patients are significantly lower than DF group.And these clinical features can help diagnose FUO in an early stage.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective: By modeling ischemic foot ulcers in experimental rabbits, the mechanism of healing in animal models was investigated. Methods: Sixty healthy male clean grade New Zealand rabbits were 3 months. The weight range was 2.1-2.5 kg. Randomly draw auording to the number, the experimental rabbits were randomly divided into 4 groups, namely, no ischemia-no ulcer-no intervention group (group A), no ischemia-no ulcer-no intervention group (group B), no ischemia-no ulcer-no intervention group (group C) and no ischemia-ulcer-intervention group (group D), with 15 rabbits in each group. Ischemic foot ulcers experimental rabbit building complete after 24 h, will naturally exposed ischemic foot ulcers in the low frequency electromagnetic field on experimental rabbit 7 d feeding experiment, the experimental rabbits ischemia crus muscle and the ulcer base were collected, and plasma by enzyme-linked immunosorbent assay (ELISA) verification tests in experimental rabbit plasma hypoxia-inducible factor 1 alpha subunit (HIF-1α), matrix metalloproteinases 9 (MMP-9) and soluble leukocyte differentiation antigen 40 ligand 1 (sCD40L1) expression level, while detecting ulcer healing area change, hematoxylin-eosin staining was used to detect and analyzed the pathological changes of ulcerated skin. Measurement data were expressed as mean±standard deviation (Mean±SD), one-way analysis of variance was used for comparison between groups, and LSD method was used for pairwise comparison. Results: The concentration of MMP-9 and sCD40L1 in group D were (40.510±10.155) ng/ml and (44.580±19.138) ng/ml, respectively. Concentrations in group C were (93.210±17.838) ng/ml and (318.500±52.680) ng/ml, respectively. Group D was significantly lower than group C, and the difference was statistically significant (P< 0.000 1). The concentrations of HIF-1α in group D was (249.700±71.824) ng/ml, and that in group C was (124.830±20.110) ng/ml. The concentration in group D was significantly higher than that in group C, and the difference was statistically significant (P< 0.000 1). The concentrations of HIF-1α, MMP-9 and sCD40L1 in group B were (181.590±31.927), (78.950±16.652) and (173.670±43.048) ng/ml, respectively. The concentrations of group A were (35.420±9.916), (32.700±6.449) and (47.440±11.831) ng/ml, respectively. The concentration in group B was significantly higher than that in group A, the difference was statistically significant(P<0.000 1). The concentration of HIF-1α in group D was (249.700±71.824) ng/ml, and the concentration of group A was (35.420±9.916) ng/ml. The concentration of group D was significantly higher than that of group A, and the difference was statistically significant (P=0.000 1). The concentration of the MMP-9 in the group D was compared with the concentration of group A, and the difference was not statistically significant (P=0.207). The concentration of sCD40L1 in group D was (44.580±19.138) ng/ml, and that in group A was (47.440±11.831) ng/ml. The difference between group D and group A was not statistically significant(P=0.858). The healing area of ulcer was (1.855±0.394) cm² in group D and (0.653±0.269) cm² in group C. Group D was significantly higher than group C, and the difference was statistically significant (P<0.000 1). Hematoxylin-eosin staining results of ulcer skin showed that the epithelial of ischemic foot ulcer was significantly atrophied, hyperkeratinized, and the acinous cell layer was atrophied with a small amount of obvious inflammatory cell infiltration and hyperplasia of small vessels. After intervention, the symptoms were relieved. Conclusion Low frequency electromagnetic fields can promote the expression of HIF-1α in experimental rabbits, inhibit the expression of MMP-9 and sCD40L1, and promote the healing of ischemic foot ulcer.