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.

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.

Objective To investgate the application value of low-dose CT scanning in right adrenal vein imaging.Methods A total of 124 patients were enrolled in the study who were suspected as primary aldosteronism and requiring a contrast enhanced CT examination on adrenal glands.Four patients were excluded according to the exclusion criteria,so that the rest 120 patients were divided equally into three groups.Group A was a control group with conventional radiation dose using tube voltage of 120 kV and automatic mA.It was divided into A1,A2 and A3 groups according to arterial phase,portal venous phase and parenchymal phase.Group B was a experimental group with conventional tube voltage of 120 kV and automatic mA,which was divided into B1,B2 and n3 groups according to arterial phase,late arterial phase and portal venous phase.Group C was a low-dose experimental group with a tube voltage of 100 kV and a tube current of 150 mA only in the second phase,the remaining scanning parameters and method were the same as that of group B.The subjective scores of the images of groups A,B and C were statistically analyzed,and the CT values of the right adrenal vein(RAV),the right adrenal gland(RAG),and the fat of anterior abdominal wall at different scan phases were measured.The dose length products (DLP) were recorded and the signal-to-noise ratios (SNR),contrast-to-noise ratios (CNR),effective doses (E) of the three groups were calculated and compared.Results The subjective scores of the two observers were consistent (Kappa value =0.63);the subjective scores of the B2 images were statistically significant (H =7.18,P＜0.05).Difference of subjective scores between B2 and A2was statistically significant (t=-18.03,P＜0.05).The CT values of RAV,SNR,and CNR of the B2 group were higher than those of the A2 group (t=36.99,6.92,9.02,P＜0.05).The radiation dose comparison showed that the effective dose (E) was 45.52％ lower in the low-dose group than the conventional dose group with the statistically significant difference(t =12.19,P＜0.05).Conclusions Using MDCT scanning technique with lower tube voltage and lower tube current of 100 kV-150 mA,the detection rate of right adrenal vein can reach 95％ in the late arterial phase,and the effective dose can be reduced about 45.52％ on the basis of ensuring image quality.