Objective:This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy.Methods:This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed. The clinical characteristics of the CMV reactivation and non-activation groups were compared. The factors related to CMV reactivation were analyzed with the Chi-square test and nonparametric rank sum test, and the risk factors were examined with Logistic regression.Results:This study included 86 patients, among whom 18 (20.9%) had CMV reactivation, and the median time of reactivation was 20 (1-95) days. All of the 18 patients had CMV viremia, and no CMV disease was observed. Seven patients turned to the latent state after continuing acyclovir antiviral therapy, and 11 patients returned to the latent state after upgrading the antiviral therapy to first-line drugs, including ganciclovir and foscarnet sodium. Six or more courses of anti-tumor treatment before CAR-T cell therapy, allogeneic hematopoietic stem cell transplantation within 2 years before CAR-T cell therapy, non-remission before treatment, and the use of high-dose glucocorticoids and/or tocilizumab were related to CMV reactivation, among which allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and the use of high-dose glucocorticoids and/or tocilizumab treatment were independent risk factors for CMV reactivation.Conclusion:Patients with B-lymphocyte malignancy who received CAR-T cell therapy have the risk of CMV reactivation, especially for those who received allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and those who received high-dose glucocorticoids and/or tocilizumab treatment.

Objective:This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy.Methods:This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed. The clinical characteristics of the CMV reactivation and non-activation groups were compared. The factors related to CMV reactivation were analyzed with the Chi-square test and nonparametric rank sum test, and the risk factors were examined with Logistic regression.Results:This study included 86 patients, among whom 18 (20.9%) had CMV reactivation, and the median time of reactivation was 20 (1-95) days. All of the 18 patients had CMV viremia, and no CMV disease was observed. Seven patients turned to the latent state after continuing acyclovir antiviral therapy, and 11 patients returned to the latent state after upgrading the antiviral therapy to first-line drugs, including ganciclovir and foscarnet sodium. Six or more courses of anti-tumor treatment before CAR-T cell therapy, allogeneic hematopoietic stem cell transplantation within 2 years before CAR-T cell therapy, non-remission before treatment, and the use of high-dose glucocorticoids and/or tocilizumab were related to CMV reactivation, among which allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and the use of high-dose glucocorticoids and/or tocilizumab treatment were independent risk factors for CMV reactivation.Conclusion:Patients with B-lymphocyte malignancy who received CAR-T cell therapy have the risk of CMV reactivation, especially for those who received allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and those who received high-dose glucocorticoids and/or tocilizumab treatment.

OBJECTIVE:To investigate the effects of dexmedetomidine on neuron injury indexes,inflammatory factors and spinal cord function of cervical operation patients. METHODS:Totally of 112 patients underwent cervical operation of general anesthesia in our hospital during May 2015 to Nov. 2017 were divided into control group and dexmedetomidine group according to random number table,with 56 cases in each group. Anesthesia of both groups was totally maintained by intravenous anesthesia. Dexmedetomidine group was given intravenous infusion of Dexmeimidine hydrochloride injection with loading dose of 0.8 μg/kg and injection time of more than 10 min before anesthesia maintenance,and then was continuously pumped to 30 min before operation at the rate of 0.4 μg/(kg·h). The levels of neuron injury indexes (GFAP,NSE,MMP-9) and inflammatory factors (TNF-α,IL-6,IL-10)of 2 groups were observed before anesthesia induction(T0),1 h after operation(T1),1 d after operation (T2),7 d after operation (T3). Japanese Orthopedics Academy (JOA) scores of cervical vertebra were observed in 2 groups before operation and 7 d after operation,and VAS scores were also observed in 2 groups 1 d and 7 d after operation. The occurrence of ADR was recorded. RESULTS:Each 3 patients of 2 groups withdrew from the study,and each 53 patients of 2 groups completed the study. There was no statistical significance in neuron injury indexes or serum levels of inflammatory factors between 2 groups at T0 (P>0.05). At T1-T3,above indexes of both groups were significantly higher than at T0;the levels of GFAP,NSE,MMP-9,TNF-α and IL-6 in dexmedetomidine group were significantly lower than control group,while the level of IL-10 was significantly higher than control group,with statistical significance (P<0.05). There was no statistical significance in JOA score or VAS score between 2 groups before operation or 1 d after operation (P>0.05). Seven days after operation,JOA scores of 2 groups were increased significantly,while VAS scores were decreased significantly,with statistical significance(P<0.05);but there was no statistical significance between 2 groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Additional use of dexmedetomidine before anesthesia maintenance can improve the serum levels of inflammatory factors in cervical operation patients,and relieve neuron spinal cord and injury to certain extent,but would not influence the safety of drug use.

Objective To establish an animal behavioral model of tinnitus with step -down test ,and make use of the model to analyze the tinnitus genesis site in the salicylate-rats .Methods Forty wistar rats were includscl in this study ,they were randonly into 2 groups(experinent group and constrot group ,20 rats each group) .Ascertain that the animals treated with sodium salicylate(SS) have the sensation of tinnitus with the method of step -down test behavioral model .After having established a behavioral conditioned reflex ,subjects responded correctly to jump onto a climbing pole after hearing the sound .Then animals were under bilateral auditory nerves section ,to test whether the ablated-animals could still jump onto the pole after being treated with SS .Results Animals with the ab‐lating surgery could seldom jump onto the pole ,only reaching 1 .59 ± 0 .12 times average per 10 tests .Compared with con‐trol group ,there were significant differences with t-Test (P<0 .05) ,suggesting that subjects could not hear the tinnitus after the surgery .Conclusion Sodium salicylate could not make the animals with bilateral auditory nerves section to have the sensation of tinnitus .The peripheral auditory system plays an extremely important role in salicylate-induced tinnitus .

A 55 year old man complained of a painless mass at the left maxillofacial region. The mass had continuously grown over 10 years. Upon physical examination a cystic mass with size of 5 cm in length with bulging smooth surface was seen on the left maxillofacial region. Computed tomography (CT) scan showed a giant cyst with bone destruction and invasion in the left maxilla, maxillary sinus and nasal cavity. Needle aspiration of the mass yielded 80 milliliter of brown fluid. The excisional biopsy was made which revealed ghost cells and dysplastic dentin that were features of dentinogenic ghost cell tumor. Finally, a dentinogenic ghost cell was diagnosed.
Cysts ; pathology ; Diagnosis, Differential ; Humans ; Male ; Maxilla ; Maxillary Sinus ; Middle Aged ; Odontogenic Tumors ; pathology