Objective:To investigate the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of BCR::ABL-negative chronic neutrophilic leukemia (CNL) and MDS/MPN with neutrophilia.Methods:This study retrospectively analyzed 12 cases of CNL and MDS/MPN with neutrophilia that underwent allo-HSCT from March 2017 to June 2024, comprising 7 males and 5 females with a median age of 48 ( IQR: 28, 59) years. The 2-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR), and transplantation-related mortality (TRM) rates were analyzed. Complications were also assessed. Results:Of the 12 patients, 6 received matched sibling HSCT and 6 received haploidentical HSCT. All patients had successful engraftment, and the median times of neutrophil and platelet engraftment were 17 ( IQR: 11, 24) days and 15 ( IQR: 9, 28) days, respectively. Grade Ⅱ–Ⅳ acute graft versus host disease (GVHD) and chronic GVHD occurred in 2 and 4 cases, respectively. The 2-year OS, DFS, CIR, and TRM rates were (65.6 ± 16.4) %, (41.7 ± 16.6) %, (47.2 ±18.2) %, and (11.1 ± 11.4) %, respectively, after a median follow-up time of 637 ( IQR: 330, 943) days. One patient died from treatment-related complications due to respiratory failure caused by coronavirus disease 2019. Two patients died due to relapse. Conclusion:Allo-HSCT can be applied as a safe and effective approach to treat CNL and MDS/MPN with neutrophilia.

Objective To explore the expression level of plasma miRNA in patients with swallowing and cognitive dysfunction after ischemic stroke and its correlation with the severity of dysfunction.Methods A retrospective analysis was conducted on the clinical data of 109 patients with ischemic stroke who were hospitalized in the First Affiliated Hospital of Guangxi Medical University and the First Affiliated Hos-pital of Fujian Medical University from January 2023 to March 2024.The expression levels of plasma miR-140-5p,miR-17-5p,and miR-103a-3p were detected by RT-qPCR.The swallowing function was evaluated by the Wada Drinking Water Test and the Functional Oral Feeding Scale,and the cognitive function of stroke pa-tients was evaluated by the modified Rankin Scale(mRS)classification.According to the mRS rating criteria,the patients were divided into the good functional outcome group(grade≤2,n=50)and the poor functional outcome group(grade≥3,n=59).Analyzed the correlation between miRNA expression levels and the degree of functional impairment,compared the clinical characteristics of patients with different mRS grades,and used the receiver operating characteristic(ROC)curve and the area under the curve(AUC)to analyze the efficacy of miRNA in predicting the functional outcome of mRS evaluation.Results The results of Spearman correla-tion analysis showed that the expression level of miR-17-5p was negatively correlated with the classification of the Wada Drinking Water Test(r=-0.317)and the classification of the Functional Oral Feeding Scale(r=-0.457,P<0.05).Compared with the good functional outcome group,the poor functional outcome group had a lower proportion of males,shorter disease course,and higher expression level of miR-103a-3p,the differ-ences were statistically significant(P<0.05).The results of ROC curve analysis showed that miR-103a-3p(AUC=0.709,95%CI:0.611-0.808)had the ability to distinguish functional outcomes in mRS evaluation.However,miR-140-5p(AUC=0.514,95%CI:0.405-0.624)and miR-17-5p(AUC=0.527,95%CI:0.414-0.637)did not have the ability.Conclusion The expression level of plasma miR-17-5p is related to the severi-ty of dysphagia in patients in the recovery period of ischemic stroke,and miR-103a-3p is helpful for judging the functional outcomes of patients in the recovery period of ischemic stroke.

Objective To analyze the research hotspots and frontier trends in the field of physical therapy for Parkinson's disease(PD)from 2014 to 2023.Methods Relevant literatures published from January,2014 to December,2023 were retrieved from the Web of Science Core Collection.CiteSpace 6.3.R1 was used to conduct bibliometric analysis,generating visual maps of coun-tries,institutions,keyword co-occurrence,burst terms,timelines and clustering,and they were summarized based on both visual results and literature content.Results A total of 400 articles were included.The United States had the highest publication volume,followed by China,Italy and Brazil,and the international collaboration was relatively active.Major contributing institutions included Northwestern University,Rush University,Karolinska Institutet and Universidade de S?o Paulo.Keyword co-oc-currence analysis showed that researches mainly focused on interventions such as exercise,postural control,aero-bic exercise and transcranial direct current stimulation.Burst detection analysis showed that keywords with high attention in recent years included motor symptoms,executive function,resistance training and noninvasive brain stimulation.The timeline map indicated a shift in research themes from early focus on electrical stimulation to in-tegrated interventions involving both motor and cognitive functions.Conclusion Over the past decade,researches on physical therapy for PD has shown steady growth,with increasing diver-sity in intervention strategies.There is a clear trend toward multidimensional integration and interdisciplinary col-laboration.Future studies should strengthen interventions targeting non-motor symptoms and promote the clinical application of new rehabilitation technologies.

Objective To analyze the research hotspots and frontier trends in the field of physical therapy for Parkinson's disease(PD)from 2014 to 2023.Methods Relevant literatures published from January,2014 to December,2023 were retrieved from the Web of Science Core Collection.CiteSpace 6.3.R1 was used to conduct bibliometric analysis,generating visual maps of coun-tries,institutions,keyword co-occurrence,burst terms,timelines and clustering,and they were summarized based on both visual results and literature content.Results A total of 400 articles were included.The United States had the highest publication volume,followed by China,Italy and Brazil,and the international collaboration was relatively active.Major contributing institutions included Northwestern University,Rush University,Karolinska Institutet and Universidade de S?o Paulo.Keyword co-oc-currence analysis showed that researches mainly focused on interventions such as exercise,postural control,aero-bic exercise and transcranial direct current stimulation.Burst detection analysis showed that keywords with high attention in recent years included motor symptoms,executive function,resistance training and noninvasive brain stimulation.The timeline map indicated a shift in research themes from early focus on electrical stimulation to in-tegrated interventions involving both motor and cognitive functions.Conclusion Over the past decade,researches on physical therapy for PD has shown steady growth,with increasing diver-sity in intervention strategies.There is a clear trend toward multidimensional integration and interdisciplinary col-laboration.Future studies should strengthen interventions targeting non-motor symptoms and promote the clinical application of new rehabilitation technologies.

Objective:To investigate the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of BCR::ABL-negative chronic neutrophilic leukemia (CNL) and MDS/MPN with neutrophilia.Methods:This study retrospectively analyzed 12 cases of CNL and MDS/MPN with neutrophilia that underwent allo-HSCT from March 2017 to June 2024, comprising 7 males and 5 females with a median age of 48 ( IQR: 28, 59) years. The 2-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR), and transplantation-related mortality (TRM) rates were analyzed. Complications were also assessed. Results:Of the 12 patients, 6 received matched sibling HSCT and 6 received haploidentical HSCT. All patients had successful engraftment, and the median times of neutrophil and platelet engraftment were 17 ( IQR: 11, 24) days and 15 ( IQR: 9, 28) days, respectively. Grade Ⅱ–Ⅳ acute graft versus host disease (GVHD) and chronic GVHD occurred in 2 and 4 cases, respectively. The 2-year OS, DFS, CIR, and TRM rates were (65.6 ± 16.4) %, (41.7 ± 16.6) %, (47.2 ±18.2) %, and (11.1 ± 11.4) %, respectively, after a median follow-up time of 637 ( IQR: 330, 943) days. One patient died from treatment-related complications due to respiratory failure caused by coronavirus disease 2019. Two patients died due to relapse. Conclusion:Allo-HSCT can be applied as a safe and effective approach to treat CNL and MDS/MPN with neutrophilia.

Objective:To analyze the clinical characteristics and outcomes of patients with invasive fungal sinusitis (invasive fungal rhinosinusitis, IFR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and explored the risk factors for IFR after allo-HSCT.Methods:Nineteen patients with IFR after allo-HSCT at Peking University People’s Hospital from January 2012 to December 2021 were selected as the study group, and 95 patients without IFR after allo-HSCT during this period were randomly selected as the control group (1:5 ratio) .Results:Nineteen patients, including 10 males and 9 females, had IFR after allo-HSCT. The median age was 36 (10–59) years. The median IFR onset time was 68 (9–880) days after allo-HSCT. There were seven patients with acute myeloid leukemia, five with acute lymphoblastic leukemia, two with myelodysplastic syndrome, two with chronic myeloid leukemia, one with acute mixed-cell leukemia, one with multiple myeloma, and one with T-lymphoblastic lymph node tumor. There were 13 confirmed cases and 6 clinically diagnosed cases. The responsible fungus was Mucor in two cases, Rhizopus in four, Aspergillus in four, and Candida in three. Five patients received combined treatment comprising amphotericin B and posaconazole, one patient received combined treatment comprising voriconazole and posaconazole, nine patients received voriconazole, and four patients received amphotericin B. In addition to antifungal treatment, 10 patients underwent surgery. After antifungal treatment and surgery, 15 patients achieved a response, including 13 patients with a complete response and 2 patients with a partial response. Multivariate analysis revealed that neutropenia before transplantation ( P=0.021) , hemorrhagic cystitis after transplantation ( P=0.012) , delayed platelet engraftment ( P=0.008) , and lower transplant mononuclear cell count ( P=0.012) were independent risk factors for IFR after allo-HSCT. The 5-year overall survival rates in the IFR and control groups after transplantation were 29.00%±0.12% and 91.00%±0.03%, respectively ( P<0.01) . Conclusion:Although IFR is rare, it is associated with poor outcomes in patients undergoing allo-HSCT. The combination of antifungal treatment and surgery might be effective.

Objectives:To determine the effect of glucose-6-phosphate-dehydrogenase (G6PD) deficiency on patients’ complications and prognosis following allogeneic stem cell hematopoietic transplantation (allo-HSCT) .Methods:7 patients with G6PD deficiency (study group) who underwent allo-HSCT at Peking University People's Hospital from March 2015 to January 2021 were selected as the study group, and thirty-five patients who underwent allo-HSCT during the same period but did not have G6PD deficiency were randomly selected as the control group in a 1∶5 ratio. Gender, age, underlying diseases, and donors were balanced between the two groups. Collect clinical data from two patient groups and perform a retrospective nested case-control study.Results:The study group consisted of six male patients and one female patient, with a median age of 37 (range, 2-45) years old. The underlying hematologic diseases included acute myeloid leukemia ( n=3), acute lymphocytic leukemia ( n=2), and severe aplastic anemia ( n=2). All 7 G6PD deficiency patients achieved engraftment of neutrophils within 28 days of allo-HSCT, while the engraftment rate of neutrophils was 94.5% in the control group. The median days of platelet engraftment were 21 (6–64) d and 14 (7–70) d ( P=0.113). The incidence rates of secondary poor graft function in the study group and control group were 42.9% (3/7) and 8.6% (3/35), respectively ( P=0.036). The CMV infection rates were 71.4% (5/7) and 31.4% (11/35), respectively ( P=0.049). The incidence rates of hemorrhagic cystitis were 57.1% (4/7) and 8.6% (3/35), respectively ( P=0.005), while the bacterial infection rates were 100% (7/7) and 77.1% (27/35), respectively ( P=0.070). The infection rates of EBV were 14.3% (1/7) and 14.3% (5/35), respectively ( P=1.000), while the incidence of fungal infection was 14.3% (1/7) and 25.7% (9/35), respectively ( P=0.497). The rates of post-transplant lymphoproliferative disease (PTLD) were 0% and 5.7%, respectively ( P=0.387) . Conclusions:The findings of this study indicate that blood disease patients with G6PD deficiency can tolerate conventional allo-HSCT pretreatment regimens, and granulocytes and platelets can be implanted successfully. However, after transplantation, patients should exercise caution to avoid viral infection, complications of hemorrhagic cystitis, and secondary poor graft function.

Objective:To explore the feasibility of sirolimus as an alternative graft versus host disease (GVHD) prophylaxis in patients with kidney injury after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Retrospective case series study. Medical records of 11 patients in Peking University People′s Hospital from 1 August 2008 to 31 October 2022, who received sirolimus instead of cyclosporine to prevent GVHD, due to renal insufficiency after allo-HSCT, were analyzed retrospectively. Incidence of GVHD, infection, and transplant-associated thrombotic microangiopathy (TA-TMA), as well as renal function, were evaluated.Results:Among the 11 patients who received sirolimus, 6 were treated with haploidentical donor HSCT, and 5 were treated using matched sibling donor HSCT. The median (range) time of sirolimus administration was 30 (7-167) days after allo-HSCT, and the median (range) sirolimus course duration was 52 (9-120) days. During sirolimus treatment, 1 case did not undergo combined treatment with other prophylactic drugs, 3 cases received combined mycophenolate mofetil (MMF), and 1 case underwent combined CD25 monoclonal antibody treatment, while 6 cases had combined therapy with both MMF and CD25 monoclonal antibody. Of the 11 patients, 2 developed Grade Ⅲ acute GVHD, 1 developed severe pneumonia and died, and 1 developed TA-TMA, while nine patients had normal or improved renal function. Median (range) follow-up time was 130 (54-819) days. Non-relapse mortality was observed in 1 patient. Relapse mortality was also observed in 1 patient.Conclusion:Sirolimus-based alternative GVHD prophylaxis is a potentially viable option for patients undergoing allo-HSCT who cannot tolerate cyclosporine, but its efficacy and safety require further optimization and verification in prospective studies.

Objective:To look into the security of a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) using rabbit anti-human thymocyte immunoglobulin (rATG) .Methods:Twenty-seven patients who used rATG in the first and second allo-HSCT at the Institute of Hematology, Peking University were enrolled in the study. Experienced toxicities associated with the conditioning protocol within 10 days (-5 d to +3 d) following the beginning of the rATG application, including fever, diarrhea, arrhythmia, reduced blood pressure, liver damage, seizures, and other problems.Results:The overall incidence of conditioning regimen early adverse reactions during the first transplantation and the second allo-HSCT conditioning regimen was 96.3% and 77.8% ( P=0.043) . Fever rates were 81.5% and 63.0% ( P=0.129) , diarrhea rates were 59.3% and 25.9% ( P=0.013) , liver damage rates were 22.2% and 25.9% ( P=0.75) , and the rates of other events (cardiac arrhythmia, low blood pressure, and epilepsy) were 3.7% and 18.5% ( P=0.083) . Adverse reactions that occurred during both the first and second course of rATG applications have been improved with symptomatic treatment, and no treatment interruptions occurred. Conclusion:Reusing rATG in a second transplant was risk-free and did not result in higher early toxicities.

Objective:To compare the effects of intermittent feeding and continuous feeding on muscle atrophy, nutritional status and nutritional intolerance of critically ill patients, and to provide a reference for critically ill patients to select more suitable nutritional support in clinic.Methods:An observational study was conducted. The clinical data of 59 critically ill patients who received enteral nutrition admitted to anesthesia intensive care unit (ICU) of the Second Affiliated Hospital of Air Force Military Medical University of the Chinese People's Liberation Army from January 2019 to December 2020 were analyzed. According to different feeding methods, the patients were divided into intermittent feeding group ( n = 32, 200-250 mL nutrient solution was pumped each time, 4-5 times a day, 5-6 hours interval each time) and continuous feeding group ( n = 27, nutrient solution was pumped continuously and evenly). The changes of related indexes before and 7 days after enteral nutrition in ICU were recorded, including rectus femoris thickness and cross-sectional area, nutritional status related indexes [hemoglobin (Hb), albumin (ALB), prealbumin (PA) and blood glucose], incidence of aspiration, diarrhea, constipation, vomiting, abnormal gastric residue volume (gastric residue volume > 250 mL), other nutritional intolerance and the length of ICU stay. Results:After nutritional support for 7 days, the thickness and cross-sectional area of rectus femoris decreased in both groups, indicating muscle atrophy occurred in both groups, and there was no significant difference in change value of thickness or cross-sectional area of rectus femoris between intermittent feeding group and continuous feeding group [the change value of rectus femoris thickness (cm): -0.06±0.04 vs. -0.07±0.03, the change value of rectus femoris cross-sectional area (cm 2): -0.71±0.23 vs. -0.81±0.24, both P > 0.05]. There were no significant differences in nutritional status related indicators after nutritional support for 7 days between intermittent feeding group and continuous feeding group [Hb (g/L): 102.2±10.9 vs. 103.2±11.3, ALB (g/L): 34.1±3.6 vs. 32.9±4.0, PA (mg/L): 209.8±10.6 vs. 205.9±13.7, blood glucose (mmol/L): 6.34±1.91 vs. 6.93±3.54, all P > 0.05]. The patients in both groups had intestinal nutrition intolerance such as aspiration, diarrhea, constipation and vomiting. However, the incidence of abnormal gastric residual volume in intermittent feeding group was significantly lower than that in continuous feeding group [9.4% (3/32) vs. 33.3% (9/27), P < 0.05]. There was no significant difference in the length of ICU stay between intermittent feeding group and continuous feeding group (days: 21.03±11.51 vs. 21.41±9.74, P > 0.05). Conclusions:Compared with continuous feeding, intermittent feeding does not improve the muscle atrophy and nutritional status of critically ill patients, but reduce the symptoms of enteral nutrition intolerance caused by abnormal increase of gastric residual volume. It is an easy-to-implement, safe and feasible feeding method.