Purpose To investigate the clinical pathologic features of five SMARCA4-deficient non-small lung cancers(SMARCA4-dNSCLCs).Methods Five cases of SMARCA4-dNSCLC was underwent by HE,immunohistochemical staining,and molecular detection,analyzed their clinicopathological char-acteristics and reviewed relevant literatures.Results All 5 ca-ses were male,and mean age was 66 years.Five patients had a history of smoking,three patients were treated with cough and blood in sputum as the first symptom,one was treated with a history of pulmonary tuberculosis combined with limb mobility disorder,and one was diagnosed with pulmonary nodules by physical examination.Under microscopic observation,tumor cells were poorly differentiated,with solid nest sheet distribu-tion,some with glandular structure,tumor cells had abundant e-osinophilic or transparent cytoplasm,vacuolar nuclear chroma-tin,nucleoli was visible,and nuclear mitosis was common.In-flammatory cell infiltration and sheet of necrosis were seen in the stroma.Immunohistochemical staining showed 5/5 diffuse ex-pression of CK(AE1/AE3)and CK7,5/5 loss expression of BRG1,1/5 diffuse expression of p40 and CK5/6,and Ki67 proliferating index ranged from 20％to 90％.FISH tests showed that 4/4 SMARCA4 genes missed.Five patients were followed up for 2-15 months,3 patients died and 2 patients survived.Conclusions SMARCA4-dNSCLC can have extensive morphologi-cal features,high degree of malignancy,and complicated treat-ment.BRG1 deficiency is helpful for diagnosis.Deepening the understanding of SMARCA4-dNSCLC can help the clinical cor-rect choice of treatment strategies and accurately evaluate patient prognosis.

Objective:To investigate the efficacy and safety of autologous hematopoietic stem cell transplantation (ASCT) in the treatment of multiple myeloma (MM).Methods:The clinical data of 64 MM patients who received ASCT in the Second Affiliated Hospital of Xi'an Jiaotong University from October 2015 to March 2022 were retrospectively analyzed. The clinical characteristics, therapeutic effects and adverse reactions of the patients were summarized.Results:Of the 64 patients, 42 were male and 22 were female; the median age was 54 years old (37-69 years old). The median number of CD34 + cells collected from 46 patients in the CE (cyclophosphamide, etoposide) regimen mobilization group and 17 patients in the plerixafor mobilization group were 7.50×10 6/kg [(1.15-24.73)×10 6/kg] and 4.54×10 6/kg [(0.75-10.40)×10 6/kg], and the difference was statistically significant ( Z = 3.02, P = 0.024). Hematopoietic reconstitution was successful in all 64 patients, and the median time for white blood cell and platelet engraftment was 11 d (8-13 d) and 11 d (8-15 d), respectively. The patients' pretreatment regimens were all high-dose melphalan, the median white blood cell and platelet engraftment time of 29 patients in the oral group were 11 d (8-13 d) and 11 d (8-15 d), respectively, the median white blood cell and platelet engraftment time of 35 patients in the intravenous infusion group were 11 d (8-12 d) and 11 d (8-15 d), respectively, and there were no statistical differences (both P > 0.05). The ≥CR rate was 48.4% (31/64) before transplantation and 70.3% (45/64) three months after transplantation, and the difference was statistically significant ( χ2 = 6.35, P = 0.012). The median follow-up time of all patients was 27 months (2-67 months). The 3-year OS and PFS rates were 77.6% and 54.9%, and the median OS and PFS time were 67 and 52 months. The median hospitalization time was 20 d (15-37 d). There was no transplantation-related mortality, and the main adverse reactions were gastrointestinal reactions (100.0%, 64/64), grade 4 thrombocytopenia (98.4%, 63/64), grade 4 neutropenia, and agranulocytosis with fever (40.6%, 26/64). Conclusions:ASCT is effective for MM patients suitable for transplantation, which can further improve the remission rate and remission depth, prolong the PFS and OS time of patients, and the adverse reactions are controllable.

LCH-2011 regimen)was referenced,and the targeted drug Dabrafenib was added to treat those with the BRAF-V600E mutation.The clinical characteristics,BRAF-V600E mutation status,and treatment response between the single-system LCH(SS-LCH)group and the multisystem LCH(MS-LCH)group were summarized.Survival curves were plotted using the Kaplan-Meier method,and the Log-Rank test was used to compare the survival rates between the two groups.Results This study included a total of 31 cases,with 18 males and 13 females.The median age of onset was 10 months(ranging from 1 to 84 months).9 cases were SS-LCH,and 22 cases were MS-LCH,with 5 cases experiencing pituitary involvement/diabetes insipidus.Among the 27 cases that underwent BRAF-V600E mutation testing,20 were positive(3 cases in the SS-LCH group,with a positivity rate of 37.5%;17 cases in the MS-LCH group,with a positivity rate of 89.5%).The difference in the BRAF-V600E mutation positivity rate between the two groups was statistically significant(P = 0.011).The median follow-up time was 24 months(ranging from 3 to 62 months).The effective rate after 6 weeks of induction chemotherapy was 88.9%in the SS-LCH group(8/9)and 81.8%in the MS-LCH group(18/22).The observed progression-free rate at the end of the observation period reached 29.0%(9/31).All three deaths occurred in the MS-LCH group with involvement of high-risk organs.There was no statistically significant difference in the overall survival rate between the SS-LCH and MS-LCH groups,as well as between the BRAF-V600E mutation positive and negative groups(χ2 = 1.156,0.437;P = 0.282,0.508).Conclusion LCH in children is more common in infants and young children,with a high incidence of BRAF-V600E gene mutation in affected children,and is often seen in MS-LCH.Dabrafenib may help improve the prognosis of children with BRAF-V600E mutation.

Chimeric antigen receptor T (CAR-T) cell therapy is a novel cellular immunotherapy that is widely used to treat hematological malignancies, including acute leukemia, lymphoma, and multiple myeloma. Despite its remarkable clinical effects, this therapy has side effects that cannot be underestimated. Cytokine release syndrome (CRS) is one of the most clinically important and potentially life-threatening toxicities. This syndrome is a systemic immune storm that involves the mass cytokines releasing by activated immune cells. This phenomenon causes multisystem damages and sometimes even death. In this study, we reported the management of a patient with recurrent and refractory multiple myeloma and three patients with acute lymphocytic leukemia who suffered CRS during CAR-T treatment. The early application of tocilizumab, an anti-IL-6 receptor antibody, according to toxicity grading and clinical manifestation is recommended especially for patients who suffer continuous hyperpyrexia, hypotensive shock, acute respiratory failure, and whose CRS toxicities deteriorated rapidly. Moreover, low doses of dexamethasone (5-10 mg/day) were used for refractory CRS not responding to tocilizumab. The effective management of the toxicities associated with CRS will bring additional survival opportunities and improve the quality of life for patients with cancer.

Objective To systematically evaluate the risk factors for hospital-acquired pneumonia(HAP) in patients in departments of neurosurgery.Methods Literatures about the risk factors for HAP in patients in departments of neurosurgery published at home and abroad between 2001 and 2016 were retrieved, the standard clinical data were selected for Meta analysis, the combined OR value for each factor was calculated.Results A total of 7 literatures (3 250 studied objects) were included in the study.Publication bias was excluded, a total of 8 factors were statistically significant, which including age (OR, 1.68 [95% CI, 1.16-2.11]), endotracheal intubation or tracheotomy(OR, 11.31 [95% CI, 9.14-13.63]), disturbance of consciousness(OR, 12.74 [95% CI, 10.63-15.91]), length of hospital stay(OR, 2.36 [95% CI, 1.42-4.81]), underlying diseases(OR, 3.17 [95% CI, 2.18-5.24]), use of ventilator(OR, 2.38 [95% CI, 1.56-4.32]), nutritional status(OR, 4.92 [95% CI, 2.69-6.47]), and invasive procedure(OR, 2.13 [95%CI, 1.34-3.86]).Conclusion Risk factors for HAP in patients in departments of neurosurgery are age, endotracheal intubation or tracheotomy, disturbance of consciousness, length of hospital stay, underlying diseases, use of ventilator, nutritional status, and invasive procedure.While smoking, gender, and types of surgery are not identified as risk factors for HAP in patients in departments of neurosurgery.

Objective To explore the effects of nurses′ risk perceptions of occupational HIV exposure and the self-efficacy on their attitudes and behavior of self-protection in nursing care. Methods An anonymous survey was conducted in eligible nurses with self-designed questionnaire in three conveniently selected comprehensive hospitals in Wuhan. Structural equation modeling was applied in the data analysis. Results Risk perceptions exerted positive effects on the attitudes of self-protection. The standardized path coefficient was 0.45 (P=0.009). The attitudes of self-protection and the risk perceptions exerted no impact on the behavior of self-protection (P > 0.05).The impacts of the self-efficacy on the attitudes and the behavior of self-protection was positive. The standardized path coefficient was 0.15(P=0.02)and 0.53 (P<0.01), respectively. Conclusions Risk perceptions exerted positive effects on the attitudes of self-protection. But the attitudes of self-protection and the risk perceptions exerted no impact on the behavior of self-protection. Self-efficacy can improve the attitudes of self-protection and enhance the behavior of self-protection.

ABSTRACT:Objective To explore the effects of virus interleukin‐10 (vIL‐10 ) on different expressions of MHC‐I antigen processing “the operon” .Methods We collected nasopharyngeal carcinoma cells (CNE‐1 and CNE‐2) treated by vIL‐10 at different time points ,and detected the changes of MHC‐I antigen processing “the operons” (TAP‐1 ,TAP‐2 ,LMP‐2 ,LMP‐7 and HLA‐I) by RT‐PCR and Western blot .Results ① mRNA level :There was no difference in the expression of TAP‐1 in CNE‐1 and CNE‐2 cells at various time points .The expressions of TAP‐2 and LMP‐2 in CNE‐1 and CNE‐2 did not change at 1 ,4 ,6 ,12 h ,but downregulated and even disappeared at 24 h .The expression of LMP‐7 in CNE‐1 decreased 4 h after vIL‐10 was added ,and that in CNE‐2 decreased at 6 h .The expression of HLA‐I in CNE‐1 and CNE‐2 showed significant decrease at 24 h .② Protein expression :The expression of TAP‐1 in CNE‐1 and CNE‐2 showed significant decrease at 24 h .The expression of TAP‐2 in CNE‐1 and CNE‐2 was gradually downregulated at different time points .The expressions of LMP‐2 and LMP‐7 in CNE‐2 were gradually downregulated at different periods ,while that in CNE‐1 was only decreased at 12 h .The expression of HLA‐I in CNE‐1 and CNE‐2 was gradually downregulated ,but there was no significant difference at each period in CNE‐1 ,while the expression of HLA‐I in CNE‐2 at 24 h was significantly downregulated .Conclusion vIL‐10 can inhibit the expression of MHC‐I antigen processing “the operon” in NPC in the time‐dependent manner .

Objective To evaluate the effects of different doses of oxycodone on renal ischemiareperfusion (I/R) injury in rats.Methods Forty adult male Sprague-Dawley rats, weighing 220-300 g, aged 10-13 weeks, were randomly divided into 5 groups (n =8 each) using a random number table: sham operation group (group S), group I/R, and low, medium and high doses of oxycodone groups (OL, OM and OH groups).After the rats underwent right nephrectomy, the renal I/R was induced by occlusion of the left renal artery and vein for 45 min with atraumatic microclips followed by 3 h reperfusion in I/R, OL, OM and OH groups.In group S, right nephrectomy was performed, and the left renal artery, vein and ureter were isolated without occluding blood flow.In OL, OM and OH groups, oxycodoue 2, 4, and 6 mg/kg were infused intravenously, respectively, immediately after onset of ischemia.At 3 h of reperfusion, blood samples were taken from the abdominal aorta to determine the concentrations of serum blood urea nitrogen (BUN) and creatiniue (Cr) concentrations.After blood sampling, the animals were sacrificed, and the left kidneys were removed for determination of tumor necrosis factor-alpha (TNF-α) , interleukin-6 (IL-6) and IL-8 and IL-10 contents (by using enzyme-linked immunosorbent assay), and malondialdehyde (MDA) content (by thiobarbituric acid method), and superoxide dismutase (SOD) activity (using xanthine oxidase method).Results Compared with group S, the serum BUN and Cr concentrations, and contents of TNF-α, IL-6, IL-8 and MDA in renal tissues were significantly increased, and the IL-10 content and SOD activity in renal tissues were decreased in the other four groups (P＜0.05).Compared with group I/R, the serum BUN and Cr concentrations, and contents of TNF-α, IL-6, IL-8 and MDA in renal tissues were significantly decreased, and the IL-10 content and SOD activity in renal tissues were increased in OL, OM and OH groups (P＜0.05).The serum BUN and Cr concentrations, and contents of TNF-α,IL-6, IL-8 and MDA in renal tissues were gradually decreased, and the IL-10 content and SOD activity in renal tissues were gradually increased with increasing dosage of oxycodone in OL, OM and OH groups (P＜ 0.05).Conclusion Oxycodone 2, 4, and 6 mg/kg can alleviate renal I/R injury in a dose-dependent manner in rats, and the mechanism is related to inhibition of inflammatory responses and oxidative stress response.

Objective To explore the clinical features of respiratory syncytial virus(RSV) pneumonia in full-term neonatal patients.Methods All 422 full-term newborns diagnosed as pneumonia in NICU of Shenzhen Children's Hospital during January 2014 to January 2015 were included in this study.They had been detected for RSV in the way of direct immunofluorescence assay.According to the detection results, they were divided into RSV positive group and RSV negative group, the clinical data in two groups were analyzed.Results Forty-five cases were RSV positive,377 cases were RSV negative.The proportion of breast feeding was 42.22％ vs.65.25％ ,the proportion of cesarean section was 20.00％ vs.76.12％ in two groups,there were significant differences between the two groups.Hospitalization time, birth weight, gestational age, the age of admission showed no difference between two groups.The incidencs of cough (100％), shormess of breath (88.89％), three depressions (48.89 ％), fine rales (66.67 ％), wheezing (22.22％) in RSV positive group were higher than those in the RSV negative group(84.88％ ,42.44％, 13.26％, 13.53％ ,3.98％ respectively), there were significant differences between the two groups.The incidences of fever, saliva, nasal showed no significant difference between the two groups.There was significant difference in the X-ray chest film performance between two groups,RSV positive group was more emhrysema(71.11％ vs.6.9％) ,and less patch shadow(88.89％ vs.93.10％).The laboratory examination of blood routine test, C-reactive protein,respiratory failure, the positive rate of sputum culture, pneumothorax, pleural effusion were without differences.Conclusion RSV is an important pathogen of full-term neonates with infectious pneumonia.Breastfeeding and eutocia can reduce the incidence of RSV infection.Cough, shortness of breath, pulmonary rales, and emphysema in X-ray were common in RSV pneumonia.

OBJECTIVE: To study the combined transfection of the siRNA target for Hif-lα and Survivin gene to human NPC CNE-2 cell and its effects on the proliferation and cycle of this cell. METHOD: Combined transfection of the siRNA target for Hif-lα and Survivin gene to human NPC CNE-2 cell, these plasmids were respectively transfected into the same cells. Cell proliferation was detected with MTT assay. The inhibitory effects on target genes were evaluated with RT-PCR and Western Blot at the levels of mRNA and protein, respectively. RESULT: MTT showed that CNE-2 cell proliferation in multi-gene plasmid group was more significantly inhibited than a single gene. The expression of mRNA and protein of two different genes were both decreased in HS group, and the interference effect of multiple genes was better than the single-gene(P<0.01). CONCLUSION HS group could restrain cell proliferation and interference the mRNA and protein expression in nasopharyngeal carcinoma CNE-2 cell, which was better than the other groups.
Apoptosis ; Carcinoma ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; Inhibitor of Apoptosis Proteins ; genetics ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; genetics ; Plasmids ; RNA, Messenger ; RNA, Small Interfering ; Survivin ; Transfection