Objective:To summarize the clinical characteristics, prognostic factors and treatment outcomes of childhood aggressive mature B-cell lymphoma after liver transplantation.Methods:This retrospective study included 18 children with newly diagnosed aggressive mature B-cell lymphoma after liver transplantation and treated from June 2018 to June 2022 in the Department of Hematology and Oncology of Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine. Clinical characteristics, treatment and outcomes of patients at last evaluation were analyzed. Overall survival (OS) and event free survival (EFS) rates were calculated by Kaplan-Meier method and Log-Rank analysis was performed to find factors of poor prognosis.Results:Among all 18 patients, there were 6 males and 12 females, and the age of onset was 40 (35, 54) months. The interval from transplant to tumor diagnosis was 21 (17, 35) months and 5 patients had early onset disease (<1 year since transplant). Seventeen patients had abdominal lesions. Diarrhea, vomiting and abdominal masses were the main clinical manifestations. All patients were Epstein-Barr virus (EBV) related posttransplant lymphoproliferative disorders (PTLD). One patient received individualized therapy due to critical sick at diagnosis, and the remaining 17 patients received CP (cyclophosphamide, methylprednisolone plus rituximab) and (or) modified EPOCH (prednisone, etoposide, doxorubicin, vincristine, cyclophosphamide plus rituximab) regimens. Of all 18 patients, 15 cases got complete response, 2 cases got partial response, 1 patient died of severe infection. The 2-year OS and EFS rates of 18 patients were (94±5)% and (83±8)%, respectively. None of age, gender or early onset disease had effect on OS and EFS rates in univariate analysis (all P>0.05). Conclusions:The symptoms of PTLD were atypical. Close surveillance of EBV-DNA for patients after liver transplantation was crucial to early stage PTLD diagnosis. CP or modified EPOCH regimen was efficient for pediatric patients with aggressive mature B cell lymphoma after liver transplantation.

Objective To analyze the detection results and distribution characteristics of serum allergen-specific immunoglobulin(Ig)E antibodies in patients with type Ⅰ allergic diseases(hereinafter referred to as allergic diseases)in Chongqing,and to provide epidemiological data and diagnostic evidence for the prevention and treatment of allergic diseases.Methods A total of 9189 patients who underwent allergen-specific IgE an-tibody detection in this hospital from January 2023 to February 2024 were included in the study.The positive cases of allergen specific IgE antibodies detection were statistically analyzed according to age groups,genders,and sea-sons,and the distribution characteristics and patterns of specific allergens were analyzed.Results Among the 9 189 patients with allergic diseases,4 143 cases showed positive allergen-specific IgE antibodies detection results,with a positive rate of 45.09％.The proportion of patients with multiple sensitization was 68.53％.The main inhalant allergens included Dermatophagoides pteronyssinus(28.95％),Dermatophagoides farinae(23.62％),and Blomia tropicalis(10.95％);while the main ingested allergens were milk(7.57％),shrimp/crab(2.84％),and egg white(1.98％).The positive rate of inhalant allergens was higher than that of ingested al-lergens.The positive rate of allergens in males was higher than that in females(P＜0.05).The allergens in infants and toddlers under 3 years old were mainly ingested and mostly sensitized by single allergen.The posi-tive rate of allergens and multiple sensitization rate were the highest in patients aged 12-＜18 years.The pos-itive rate of allergens was the lowest in patients over 60 years old.The positive rate of allergens was the high-est in autumn,and Dermatophagoides pteronyssinus and Dermatophagoides farinae were the main allergens in all seasons.Conclusion Patients with allergic diseases in Chongqing exhibited the following characteristics:Dermatophagoides pteronyssinus and Dermatophagoides farinae are the main allergens,the positive rate of al-lergens in males is higher than that in females,the majority patients are 12-＜18 years old,and the disease is more prone to occur in autumn.These findings can provide a reference for the prevention and treatment of al-lergic diseases in this region.

Background Occupational and environmental particulate matter may cause fibrosis, accompanied by RNA m⁶A modification changes. Neodymium oxide (Nd₂O₃) can cause mouse lung fibrosis, which contains a large number of fibroblasts. Objective To investigate m⁶A modification of tumor necrosis factor receptor-associated protein 6/nuclear factor-κB (TRAF6/NF-κB) signaling pathway in fibrosis of human embryonic lung fibroblasts induced by Nd₂O₃, and identify the key m⁶A modification sites of TRAF6. Methods Designed concentrations of Nd₂O₃ (0, 1.563, 3.125, 6.25, 12.5, 25, 50, 100, and 200 mg∙L⁻¹) were infected with HELF cells for 24 and 48 h, and cell viability was detected to determine exposure time and dose. Measurements included indicators of fibrosis [hydroxyproline (HYP) and transforming growth factor-β1 (TGF-β1)], m⁶A methylation level, methyltransferases (METTL3 and METTL14), demethylases (FTO and ALKBH5), reading proteins (YTHDC2 and YTHDF2), fibrosis-associated genes (collagen-І, vimentin, and α-SMA), and proteins related to signaling pathway (TRAF6, NFKB1, P65, and P-P65). The enrichment of m⁶A in TRAF6 mRNA was measured by methylated RNA immunoprecipitation-quantitative real-time PCR (MeRIP-qPCR). Results The results of cell viability indicated that 6.25, 12.5, 25 mg∙L⁻¹ Nd₂O₃ and 48 h exposure time were used for subsequent experiments. After 48 h exposure, compared with the control group, the HYP level in the 25 mg∙L⁻¹ Nd₂O₃ group was increased, and the levels of TGF-β1 in the 6.25, 12.5, and 25 mg∙L⁻¹ Nd₂O₃ groups were increased (P<0.05); the overall m⁶A methylation levels of HELF cells in the 12.5 and 25 mg∙L⁻¹ Nd₂O₃ groups were increased (P<0.05). At mRNA level, compared with the control group, the mRNA expression levels of methyltransferases METTL3 and METTL14 (6.25, 12.5, and 25 mg∙L⁻¹ Nd₂O₃) were increased (P<0.05); the mRNA expression level of reading protein YTHDF2 (6.25, 12.5, and 25 mg∙L⁻¹ Nd₂O₃) was increased (P<0.05), while the mRNA expression level of YTHDC2 (25 mg∙L⁻¹ Nd₂O₃) was decreased (P<0.05); the mRNA expression levels of demethylases FTO (12.5 and 25 mg∙L⁻¹ Nd₂O₃) and ALKBH5 (25 mg∙L⁻¹ Nd₂O₃) were decreased (P<0.05); the mRNA expression levels of fibrosis-related genes vimentin, α-SMA, and collagen-Ⅰ (6.25, 12.5, and 25 mg∙L⁻¹ Nd₂O₃) were increased (P<0.05); the mRNA expression levels of pathway-related genes TRAF6 (25 mg∙L⁻¹ Nd₂O₃) and NFKB1 (12.5 and 25 mg∙L⁻¹ Nd₂O₃) were increased (P<0.05). At protein level, compared with the control group, the expression levels of methyltransferases METTL3 (25 mg∙L⁻¹ Nd₂O₃) and METTL14 (12.5 and 25 mg∙L⁻¹ Nd₂O₃) were increased (P<0.05); the expression level of reading protein YTHDF2 (12.5 and 25 mg∙L⁻¹ Nd₂O₃) was increased, while the expression level of YTHDC2 (25 mg∙L⁻¹ Nd₂O₃) was decreased (P<0.05); the expression level of demethylase FTO (25 mg∙L⁻¹ Nd₂O₃) was decreased (P<0.05); the expression level of fibrosis-associated protein vimentin was increased at 25 mg∙L⁻¹ Nd₂O₃, and the expression levels of α-SMA and collagen-Ⅰ were increased at 12.5 and 25 mg∙L⁻¹ Nd₂O₃ (P<0.05); the expression levels of TRAF6 and P-P65 were increased at 25 mg∙L⁻¹ Nd₂O₃ (P<0.05). The MeRIP-qPCR results showed that compared with the control group, the concentrations of m⁶A in all Nd₂O₃ groups were significantly increased (P<0.05). Conclusions Upon exposure of HELF cells to Nd₂O₃, the alterations in fibrosis-related indexes increase the expression of some m⁶A methylases and decrease the expression of demethylases, thereby increasing the m⁶A methylase level, and may promote the progression of fibrosis by activating the TRAF6/NF-κB signaling pathway.

OBJECTIVE: To evaluate the efficacy of internal fixation of lateral and medial borders for displaced scapular body fractures via the minimally invasive approach. METHODS: The internal fixation of lateral and medial borders via minimally invasive approach was applied in surgical treatment of 23 patients with scapular body comminuted fractures from January 2014 to June 2018. The lateral approach was made straightly orienting over the lateral border of scapula. The dissection was taken down to the deltoid fascia. The deltoid was retracted cephalically, revealing the external rotators. Blunt dissection was used down to the lateral border between infraspinatus and teres minor, exposing the fracture site. The medial incision was done along the medial border of the scapula over site of the fracture. Dissections were taken down to the fascia and the periosteum. A subperiosteal dissection was then performed to elevate the infraspinatus to the degree necessary to visualize the fracture. The medial and lateral borders of scapula body were fixed with plates and screws in a frame-like way. RESULTS One patient developed the delayed healing of the incisions due to liquefactive fat necrosis. The other 22 patients showed no complications of the incisions. The glenopolar angle (GPA) of fractured scapula was increased from preoperative (25±12) degrees to postoperative (41±5) degrees (P<0.01). The healing time of fractures healed was 3-8 months, with an average time of (4.4±1.3) months. CONCLUSIONS The lateral-medial combined fixation through minimally invasive surgical approach for the scapula body fractures allows visualization of fracture reduction without extensive muscular or subcutaneous flaps, and is associated with successful fracture healing and high functional scores of the shoulder.

The various mechanisms of kyphosis of the spine and the differential diagnosis of related diseases to guide the selection of appropriate surgical timing, correct spinal osteotomy and reasonable surgical methods. The 24 patients with kyphosis from January 2016 to January 2018 were diagnosed. All patients underwent kyphosis orthopedics, mainly spinal wedge osteotomy, to obtain orbital purpose by wedge osteotomy. The indexes of the spine form, activity, and pain were observed after operation. Of the 24 patients with kyphosis, 5 patients were treated conservatively, and the symptoms of kyphosis were effectively relieved. 19 patients underwent kyphosis orthopedic surgery, and the anterior spine and posterior closed osteotomy. The patients recovered well after surgery and were followed up regularly. The treatment of high anterior spine and posterior closed osteotomy in patients with kyphosis has accurate surgery effect. There are no complications such as pain and internal fixation during the regular follow-up.

Objective To quantitatively compare the diagnostic capability of 68Ga-NGR and 18F-FDG in well-differentiated hepatocellular carcinoma (HCC) bearing mice by microPET/CT imaging.Methods The in vitro cellular uptake, in vivo microPET/CT imaging and biodistribution studies of 68Ga-NGR and 18F-FDG were quantitatively compared in SMMC-7721-based well-differentiated HCC.The human fibrosarcoma (HT-1080) and human colorectal adenocarcinoma (HT-29) cells/xenografts were respectively used as positive and negative reference groups for CD13.The expression of CD13 was qualitatively verified by immunohistostaining.The levels of CD13 and glucose-6-phosphatase (G6Pase) were semi-quantitatively analyzed by Western blot test for all 3 types of tumors.Two-sample t test was used for data analysis.Results The in vitro cellular uptake showed that the 68Ga-NGR uptake in SMMC-7721 and HT-1080 cells was higher than that in HT-29 cells, and the 68Ga-NGR uptake was higher than 18F-FDG uptake in SMMC-7721 cells.The in vivo microPET/CT imaging results revealed that the uptake of 68Ga-NGR in SMMC-7721 tumor was (2.17±0.21) %ID/g, remarkably higher compared to (0.73±0.26) %ID/g of 18F-FDG uptake (t=8.826, P<0.01).The tumor/liver ratio of 68Ga-NGR was 2.05±0.16, which was 2.03-fold higher than that of 18F-FDG.In the HT-1080 tumors, the uptakes of 68Ga-NGR and 18F-FDG were both high, and the values were (2.46±0.23) %ID/g, (3.47±0.31) %ID/g.The uptake of 68Ga-NGR was significantly lower than that of 18F-FDG in HT-29 tumors: (0.67±0.20) %ID/g vs (3.17±0.29) %ID/g;t=4.221, P<0.01.Western blot and immunohistostaining results were as follows: HT-1080(CD13+, G6Pase-), SMMC-7721(CD13+, G6Pase+), HT-29(CD13-, G6Pase-).Conclusions The uptake of 68Ga-NGR is higher than 18F-FDG uptake in SMMC-7721 tumor bearing mice, therefore it is worthwhile to consider the feasibility of clinical translation for PET/CT in diagnosis of HCC.Furthermore, because of the difference in 68Ga-NGR and 18F-FDG avidities in tumors with different molecular phenotypes of CD13 and G6Pase, there is an underlying potential for molecular imaging in the determination of molecular phenotypes.

Objective To quantitatively compare the diagnostic capability of 68Ga-NGR and 18F-FDG in well-differentiated hepatocellular carcinoma (HCC) bearing mice by microPET/CT imaging.Methods The in vitro cellular uptake,in vivo microPET/CT imaging and biodistribution studies of 68Ga-NGR and 18F-FDG were quantitatively compared in SMMC-7721-based well-differentiated HCC.The human fibrosarcoma (HT-1080) and human colorectal adenocarcinoma (HT-29) cells/xenografts were respectively used as positive and negative reference groups for CD13.The expression of CD13 was qualitatively verified by immunohistostaining.The levels of CD13 and glucose-6-phosphatase (G6Pase) were semi-quantitatively analyzed by Western blot test for all 3 types of tumors.Two-sample t test was used for data analysis.Results The in vitro cellular uptake showed that the 68Ga-NGR uptake in SMMC-7721 and HT-1080 cells was higher than that in HT-29 cells,and the 68Ga-NGR uptake was higher than 18F-FDG uptake in SMMC-7721 cells.The in vivo micro-PET/CT imaging results revealed that the uptake of 68Ga-NGR in SMMC-7721 tumor was (2.17±0.21) ％ID/g,remarkably higher compared to (0.73±0.26) ％ID/g of 18F-FDG uptake (t =8.826,P＜0.01).The tumor/liver ratio of 68Ga-NGR was 2.05±0.16,which was 2.03-fold higher than that of 18F-FDG.In the HT-1080 tumors,the uptakes of 68 Ga-NGR and 18F-FDG were both high,and the values were (2.46±0.23) ％ID/g,(3.47±0.31) ％ID/g.The uptake of 68Ga-NGR was significantly lower than that of 18F-FDG in HT-29 tumors:(0.67±0.20) ％ID/g vs (3.17±0.29) ％ID/g;t=4.221,P＜0.01.Western blot and immunohistostaining results were as follows:HT-1080(CD13+,G6Pase-),SMMC-7721(CD13+,G6Pase+),HT-29 (CD13-,G6Pase-).Conclusions The uptake of 68Ga-NGR is higher than 18F-FDG uptake in SMMC-7721 tumor bearing mice,therefore it is worthwhile to consider the feasibility of clinical translation for PET/CT in diagnosis of HCC.Furthermore,because of the difference in 68Ga-NGR and 18F-FDG avidities in tumors with different molecular phenotypes of CD13 and G6Pase,there is an underlying potential for molecular imaging in the determination of molecular phenotypes.

Objective To discussion the feasibility and effect of total hip arthroplasty (THA) of postoperative ankylosis in patients with hip peripheral fracture.Methods From January 2008 to October2013,cementless THA was performed in 23 patients with ankylosis after internal fixation of hip peripheral fracture.There were 16 males and 7 females,aged 23 to 67 years (mean,43 years).Interval between internal fixation and THA was 12 to 73 months (mean,38 months).Results Mean follow-up was 28 months (range,3 to 60 months).All patients presented good press-fit prostheses with mean acetabular valgus of 43.3°,mean acetabular anteversion of 22.5°,and mean femoral anteversion of 16.4°.Primary wound healing was detected with no occurrence of infection,prosthetic loosening or dislocation,and periprosthetic fracture.Femoral vein incomplete embolism was diagnosed in one patient with limb swelling 2 months after operation,but swelling subsided after 3 months of bed rest,elevation of the affected limb and anticoagulant therapy.Length of the bilateral limbs was almost equal in 19 patients with the difference within 0.5 cm,but the affected limb was 0.8-1.4 cm shorter in 3 patients and was 0.8 cm longer in 1 patient.Harris hip score improved from (42.16 ± 3.03)points before operation to (93.08 ± 5.23) points at the last follow-up (P ＜ 0.05).Conclusion THA is associated with good hip function recovery and improved quality of life during the treatment of postoperative ankylosis in patients with hip peripheral fracture.

Objective To investigate the radiographic classification and presentation of atypical spinal tuberculosis in adults.Methods Data of 45 consecutive patients who had suffered from atypical spinal tuberculosis confirmed by surgical interventions and pathologic examinations at our department from February 2000 to August 2012 were retrospectively analyzed.There were 29 males and 16 females,aged from 20 to 71 years (mean,46.2 years).Twenty-five patients presented with low-grade fever,lassitude and loss of weight,and the other 20 patients denied the constitutional symptoms of tuberculosis.An increased erythrocyte sedimentation rate (range,25-107 mm/1 h) was found in 37 patients.All patients were investigated by the following imaging resources:plain X-rays,CT scan and MRI.3D reconstruction CT was performed in 12 patients and PET-CT was performed in 2 patients.All patients were treated surgically and confirmed by pathologic examinations and 3 patients had undergone CT-guided biopsy.Results Atypical spinal tuberculosis presented in different radiographic presentation forms.Nine patients had involvement of a single vertebral body,which was depicted with nonuniformly increased signal intensity on T2-weighted MR images.CT scan showed irregular bony destruction in old patients and solitary osteolytic lesion with well-defined margins in young adults.There were 2 cases of isolated affection in the posterior elements (vertebral appendages type),and the involved vertebral appendages demonstrated hyperintense signal on T2-weighted MR images and bony destruction on CT scan.There were 8 cases of simultaneous affection in the anterior and posterior element of one vertebra (circumferential vertebral involvement type),and CT scan showed multiple bony destruction in vertebral body and neural arch.There were 5 cases of affection in disc (intervertebral disc involvement type),which presented decreased signal in MRI and protruding disc pressing the dural sac could be found.There were 14 cases of multiple vertebral tuberculosis in continuity (contiguous spinal tuberculosis),which presented multiple tuberculosis lesions on 3D-CT.There were 7 cases of multiple vertebral tuberculosis in noncontinuity (noncontiguous spinal tuberculosis),which presented destructive tubercular lesions affected different levels in different regions of the spine on MRI.Conclusion Atypical spinal tuberculosis had multiply radiographic presentation forms and atypical radiographic features.Worm-eaten destruction of bone or vertebral endplate,marrow edema and increased signal intensity of paraspinal ligament are features of radiographic presentation in diagnosis of atypical spinal tuberculosis.

Objective To investigate the clinical significance and effect of total hip arthroplasty (THA) in treatment of bony ankylosis of the hip in patients with ankylosing spondylitis (AS).Methods The study enrolled 23 patients (35 hips) undergone THA for bony ankylosis of the hip in AS between March 2008 and November 2012.Postoperative outcome was measured based on Harris hip score and Xray images.Results Preoperative Harris hip score of (27.6 ± 2.3) points increased to (86.7 ± 2.6)points postoperatively.Hip flexion and adduction deformity presented correction postoperatively.Total hip range of motion (flexion,adduction,abduction,and external rotation) improved from (45.7 ±5.3) o preoperatively to (206.9-±4.7) °postoperatively and mean hip flexion activity was 81 °.Hip activity achieved significant improvement and pain was relieved.X-ray films revealed proper position of prostheses without the presence of loosening or subsidence.Two patients (3 hips) experienced mild pain after a long period of walking.Four patients had heterotypic ossification including Brooker grade Ⅱ in one patient and Brooker grade Ⅰ in three.Conclusion THA is an effective treatment for bony ankylosis of the hip in AS,for it rebuilds joint function,relieves pain of the hip and improves patients' quality of life.