Chimeric antigen receptor (CAR)-modified T-cell therapy has achieved remarkable success in the treatment of acute lymphoblastic leukemia (ALL). Measurable/minimal residual disease (MRD) monitoring plays a significant role in the prognostication and management of patients undergoing CAR-T-cell therapy. Common MRD detection methods include flow cytometry (FCM), polymerase chain reaction (PCR), and next-generation sequencing (NGS), and each method has advantages and limitations. It has been well documented that MRD positivity predicts a poor prognosis and even disease relapse. Thus, how to perform prognostic evaluations, stratify risk based on MRD status, and apply MRD monitoring to guide individual therapeutic decisions have important implications in clinical practice. This review assesses the common and novel MRD assessment methods. In addition, we emphasize the critical role of MRD as a prognostic biomarker and summarize the latest studies regarding MRD-directed combination therapy with CAR-T-cell therapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT), as well as other therapeutic strategies to improve treatment effect. Furthermore, this review discusses current challenges and strategies for MRD detection in the setting of disease relapse after targeted therapy.

【Objective】 To investigate the strategies against blood collection and supply in Hainan Province during the COVID-19 epidemic, so as to provide theoretical and technical support for ensuring blood balance and safety under epidemic situation. 【Methods】 Countermeasures of blood collection and supply against the COVID-19 epidemic, taken by blood centers in Hainan, were reviewed, and data from 2016 to 2020 were collected and analyzed to evaluate the effectiveness of countermeasures by comparison. 【Results】 During the COVID-19 epidemic, the total units of blood collected and issued continued to grow and the annual growth rate reached 10.3% in 2020. The proportion of blood donation by groups increased by 0.3%. The number of blood donations by soldiers and medical personnel has increased significantly, reaching 91.2% and 24.7%, respectively. 【Conclusion】 The countermeasures in Hainan during the COVID-19 epidemic achieved remarkable effects and ensured blood safety in the whole province, which provided references and experience for blood collection and supply under public emergencies.

Objective:To establish a new centrifuge G load profile of simulated aerial combat maneuver (SACM).Methods:The +G z load data of fighter aircraft training at home and abroad were analyzed. A +G z profile of SACM was established according to the results of data analysis. Four volunteers wearing anti-G suit were exposed to SACM on the centrifuge and performed PHP maneuver. +G z value, electrocardiograph and the ear-pulse signal of volunteers were measured. The peripheral light loss, G-LOC or almost loss of consciousness (A-LOC) of volunteers were taken as the indicators of the G-endurance end point. The exposure time of volunteers to the endpoints or the completion of 1 group SCAM was taken as G-duration tolerance. The fatigue degree of volunteers was rated according to their subjective feelings. Results:The new 2-8 G SACM was consisted of 7 plateaus which were +4 G z for 20 s, +2 G z for 5 s, +5 G z for 10 s, +2 G z for 5 s, +6 G z for 15 s, +2 G z for 10 s and +8 G z for 5 s with an onset rate of 3 G/s. The total +G z exposure duration was 85 s. Three of 4 volunteers completed SACM centrifuge exposure. The other one experienced A-LOC and G duration tolerance was 60 s (at 6 s of 6 G z). The mean heart rate of 3 volunteers reached (200±7) beat/min at 8 G z 5 s. All volunteers "obviously felt tired" when they finished SACM exposure. Conclusions:The 2-8 G SACM porposed in the centrifuge test can be conducive to furtherly recognize the influences of the changing characteristics of +G z profiles on pilots in fighter typically operational training of this study. The volunteers′ G-duration tolerance could be preliminarily evaluated according to exposure duration, changes of vision and consciousness of SACM.

Objective:To explore the training methods of strengthening pilots′ waist and abdomen muscle strength free-standing exercises and simple equipment (sandbag, weight plates, Roman chair, etc.) exercises.Methods:Eight healthy male volunteers were trained 3 times a week for 3 months and 1.0-1.5 h each time by using the methods of flying like swallows, curling up the abdomen, swinging legs in supine position, using Roman chair and so on. The improvement project was changed every 4 weeks. The pre-and post-tests consisted of waist and abdomen maximum muscle torque (MMT), 10 s torque equivalent (10 s TE) and the surface electromyography signal of erector spine in the forward flexion, back extension, left and right rotation by using the maximum isometric static muscle strength test method. Furthermore, the multi-step endurance test method was used to test the volunteers′ lumbar and abdominal muscles endurance, including the total torque equivalent (TTE), endurance time and the surface electromyography signal of erector spine in the forward flexion and back extension. The software package SPSS 18.0 was applied for self-contrasted t-test.Results:After 3 months systematic training, the MMT of 8 volunteers increased by 24.99%, 27.55%, 82.00% and 47.76% in the forward flexion, back extension, left and right rotation and the 10 s TE increased by 26.05%, 29.43%, 85.64% and 84.59%. They were significantly different from that before in different directions, so was 10 s TE ( t=3.32-20.45, P<0.05). After training, the left and right erector spine′s average electromyography signal increased significantly ( t=4.30, 9.81, P<0.01) in the back extension and the values were 73.73% and 101.21%, however, they didn′t increased so much in the other 2 directions. In the meantime, the median frequency (MF) in 3 directions changed little under the premise of a significant increase in 10 s TE. The TTE increased by 36.28% and 52.03% in the forward flexion and back extension compared with that before training, the differences were statistically significant ( t=1.24, 1.13, P<0.05), although the endurance time and the MF in the last step did not significantly change while the total training load increased. Conclusions:The effects of the waist and abdomen training based on free-standing exercises and simple equipment are effectual. After training, the volunteers′ muscle strength and endurance increased significantly and the anti-fatigue ability of muscles was enhanced. The training method is simple and easy to carry out in the flying troops.

Objective:To establish a new centrifuge G load profile of simulated aerial combat maneuver (SACM).Methods:The +G z load data of fighter aircraft training at home and abroad were analyzed. A +G z profile of SACM was established according to the results of data analysis. Four volunteers wearing anti-G suit were exposed to SACM on the centrifuge and performed PHP maneuver. +G z value, electrocardiograph and the ear-pulse signal of volunteers were measured. The peripheral light loss, G-LOC or almost loss of consciousness (A-LOC) of volunteers were taken as the indicators of the G-endurance end point. The exposure time of volunteers to the endpoints or the completion of 1 group SCAM was taken as G-duration tolerance. The fatigue degree of volunteers was rated according to their subjective feelings. Results:The new 2-8 G SACM was consisted of 7 plateaus which were +4 G z for 20 s, +2 G z for 5 s, +5 G z for 10 s, +2 G z for 5 s, +6 G z for 15 s, +2 G z for 10 s and +8 G z for 5 s with an onset rate of 3 G/s. The total +G z exposure duration was 85 s. Three of 4 volunteers completed SACM centrifuge exposure. The other one experienced A-LOC and G duration tolerance was 60 s (at 6 s of 6 G z). The mean heart rate of 3 volunteers reached (200±7) beat/min at 8 G z 5 s. All volunteers "obviously felt tired" when they finished SACM exposure. Conclusions:The 2-8 G SACM porposed in the centrifuge test can be conducive to furtherly recognize the influences of the changing characteristics of +G z profiles on pilots in fighter typically operational training of this study. The volunteers′ G-duration tolerance could be preliminarily evaluated according to exposure duration, changes of vision and consciousness of SACM.

Objective:To explore the training methods of strengthening pilots′ waist and abdomen muscle strength free-standing exercises and simple equipment (sandbag, weight plates, Roman chair, etc.) exercises.Methods:Eight healthy male volunteers were trained 3 times a week for 3 months and 1.0-1.5 h each time by using the methods of flying like swallows, curling up the abdomen, swinging legs in supine position, using Roman chair and so on. The improvement project was changed every 4 weeks. The pre-and post-tests consisted of waist and abdomen maximum muscle torque (MMT), 10 s torque equivalent (10 s TE) and the surface electromyography signal of erector spine in the forward flexion, back extension, left and right rotation by using the maximum isometric static muscle strength test method. Furthermore, the multi-step endurance test method was used to test the volunteers′ lumbar and abdominal muscles endurance, including the total torque equivalent (TTE), endurance time and the surface electromyography signal of erector spine in the forward flexion and back extension. The software package SPSS 18.0 was applied for self-contrasted t-test.Results:After 3 months systematic training, the MMT of 8 volunteers increased by 24.99%, 27.55%, 82.00% and 47.76% in the forward flexion, back extension, left and right rotation and the 10 s TE increased by 26.05%, 29.43%, 85.64% and 84.59%. They were significantly different from that before in different directions, so was 10 s TE ( t=3.32-20.45, P<0.05). After training, the left and right erector spine′s average electromyography signal increased significantly ( t=4.30, 9.81, P<0.01) in the back extension and the values were 73.73% and 101.21%, however, they didn′t increased so much in the other 2 directions. In the meantime, the median frequency (MF) in 3 directions changed little under the premise of a significant increase in 10 s TE. The TTE increased by 36.28% and 52.03% in the forward flexion and back extension compared with that before training, the differences were statistically significant ( t=1.24, 1.13, P<0.05), although the endurance time and the MF in the last step did not significantly change while the total training load increased. Conclusions:The effects of the waist and abdomen training based on free-standing exercises and simple equipment are effectual. After training, the volunteers′ muscle strength and endurance increased significantly and the anti-fatigue ability of muscles was enhanced. The training method is simple and easy to carry out in the flying troops.

Objective:To design a set of anti-G physical fitness training program to improve strength tolerance, and further to investigate the effects of anti-G physical fitness training.Methods:According to requirement of the fighter pilots’ anti-G physical fitness on practical training for actual combat, a set of anti-G physical fitness training program was designed. The same expiratory manner as HP maneuver was applied in every item of the training. The training program included barbell squat training, dead lift training, bench press training, tilt board crunch, seated kick, and respiratory muscle training. Eight healthy male subjects volunteered for the study were trained according to the training program for 12 weeks. The strength training was undertaken on 3 separate days per week. Four intensities of the training were performed along with the medium-highest-medium-higher or medium-higher-highest-higher modes. The indicators related to the level of anti-G physical fitness of subjects before and after training were tested. Paired test was performed for the statistical assessment of the anti-G physical fitness level with SPSS software.Results:Compared with those before training, 1 repetition maximum (1 RM) and 10 RM of barbell squat, dead lift, and bench press after training were significantly increased respectively( t=6.382-16.767, P<0.01). 10 RM of the 3 items increased respectively 51.5%, 27.6%, and 46.0%. 1 RM of the three items increased respectively 57.7%, 34.0%, and 45.2%. The number of leg-raising times of tilt board crunch significantly increased ( t=7.508, P<0.01) ,which increased 69.9% under double load of the legs after training. When the tolerance time of abdominal muscle was equivalent, the load of the legs after training was double load before training. Strength tolerance of pedal force of lower limbs significantly increased 188.7% averagely( t=8.213, P<0.01) after training. Maximal expiratory pressure (MEP) and maximum inspiratory pressure (MIP) averagely increased 42.4% and 19.7% respectively ( t=7.361, 4.119, P<0.01) after training. Strength tolerance of respiratory muscle averagely increased 270.0% ( t=7.800, P<0.01) after training. Conclusions:The anti-G physical fitness training program can effectively improve the strength tolerance of the main muscle groups correlated to anti-G ability. The effect of the program on improving the level of the subjects’ anti-G physical fitness is obvious, which establishes the basis of applying the program for verification in fighter pilots.

Objective:To design a set of anti-G physical fitness training program to improve strength tolerance, and further to investigate the effects of anti-G physical fitness training.Methods:According to requirement of the fighter pilots’ anti-G physical fitness on practical training for actual combat, a set of anti-G physical fitness training program was designed. The same expiratory manner as HP maneuver was applied in every item of the training. The training program included barbell squat training, dead lift training, bench press training, tilt board crunch, seated kick, and respiratory muscle training. Eight healthy male subjects volunteered for the study were trained according to the training program for 12 weeks. The strength training was undertaken on 3 separate days per week. Four intensities of the training were performed along with the medium-highest-medium-higher or medium-higher-highest-higher modes. The indicators related to the level of anti-G physical fitness of subjects before and after training were tested. Paired test was performed for the statistical assessment of the anti-G physical fitness level with SPSS software.Results:Compared with those before training, 1 repetition maximum (1 RM) and 10 RM of barbell squat, dead lift, and bench press after training were significantly increased respectively( t=6.382-16.767, P<0.01). 10 RM of the 3 items increased respectively 51.5%, 27.6%, and 46.0%. 1 RM of the three items increased respectively 57.7%, 34.0%, and 45.2%. The number of leg-raising times of tilt board crunch significantly increased ( t=7.508, P<0.01) ,which increased 69.9% under double load of the legs after training. When the tolerance time of abdominal muscle was equivalent, the load of the legs after training was double load before training. Strength tolerance of pedal force of lower limbs significantly increased 188.7% averagely( t=8.213, P<0.01) after training. Maximal expiratory pressure (MEP) and maximum inspiratory pressure (MIP) averagely increased 42.4% and 19.7% respectively ( t=7.361, 4.119, P<0.01) after training. Strength tolerance of respiratory muscle averagely increased 270.0% ( t=7.800, P<0.01) after training. Conclusions:The anti-G physical fitness training program can effectively improve the strength tolerance of the main muscle groups correlated to anti-G ability. The effect of the program on improving the level of the subjects’ anti-G physical fitness is obvious, which establishes the basis of applying the program for verification in fighter pilots.

Objective To evaluate the clinical value of CT urography (CTU) in quantitative analysis of single?kidney renal glomerular filtration rate (GFR) in patients with renal tumor and hydronephrosis.Methods A total of 49 patients with renal tumor or hydronephrosis from January 2018 to September 2018 in the Second Hospital of Tianjin Medical University were prospectively collected. In all cases, the CT urography and 99mTc?DTPA renal dynamic imaging data and related clinical data were collected. All patients were divided into two groups: the experimental group (39 patients with a total of 78 kidneys) and the validation group (10 patients with a total of 20 kidneys). According to the presence or absence of renal diseases, the kidneys of the experimental group and the validation group were further divided into four groups, namely, the single kidney group, the tumor group, the stagnant water group and the healthy group. The CT urography protocol consisted of noncontrast, arterial phase, nephrographic, and excretory phase imaging. The total renal GFR was determined by CT measurement of renal clearance of contrast media (CM), and the total CT?GFR was then split into single?kidney CT?GFR by a left and right kidney proportionality factor. Differences between CT?GFR and SPECT?GFR measurements in each group of the experimental group was compared by paired?sample t test. Correlations between CT?GFR and SPECT?GFR in the experimental group and their correlations with RPV was analyzed by Pearson method. The Bland?Altman mapping method was used to evaluate the consistency between CT?GFR and SPECT?GFR in the experimental group. Results Paired difference between single?kidney CT?GFR (48.76 ± 18.50) ml·min-1·1.73 m-2 and single?kidney SPECT?GFR (45.68±17.95) ml·min-1·1.73 m-2 in the experimental group, P<0.05, demonstrating 6.8% systemic overestimation. A good correlation(r=0.80, P<0.01) and consistency (± 22.50 ml·min-1·1.73 m-2, ± 49.2% measurement deviations) was revealed between both measurements. There were positive correlations between CT?GFR and SPECT?GFR in the renal tumor group, hydronephrosis group, and healthy kidney group (r=0.67, 0.92, 0.80; P<0.01) respectively, and with good agreement (95% CI measurement deviation<30 ml·min-1·1.73 m-2). In all validation groups, there was no statistical difference between the estimated and true values of the Gates?GFR (all P>0.05). Pearson Correlation analysis showed that the correlations between CT?GFR and RPV in all experimental groups were better than the correlation between Gates?GFR and RPV (P<0.05). Conclusions This study demonstrated the feasibility of using CT urography to measure single?kidney GFR, verifying its application value in diseases such as kidney tumors and obstructive hydronephrosis, and proved that the proposed single?kidney CT?GFR correlates better than the SPECT?GFR with RPV.

Tumor neovascularization plays an important role in the occurrence, development and metastasis of cancer. Non-invasive quantification and detection of tumor neovascularization is crucial for early diagnosis and prognosis assessment of cancer. Targeted molecular imaging has arisen in vascular targeting imaging and precise treatment based on the molecular characteristics of neovascularization. Aminopeptidase N (APN, or CD13) is a multifunctional membrane-bound exopeptidase that is overexpressed in neovascular endothelial cells and some tumor cells but rarely expressed in normal blood vessels, which makes it a potential target for tumor neovascularization imaging and anti-angiogenic therapy. This review summarizes the application progress and the future development trend of target molecular imaging and precise treatment based on CD13.