Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.

Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.

Objective To investigate the clinical efficacy of Jiedu Huayu Granules(mainly composed of the Chinese herbal medicines of Artemisiae Scopariae Herba,Rhei Radix et Rhizoma,Hedyotis Diffusae Herba,Paeoniae Radix Rubra,Curcumae Radix and Acori Tatarinowii Rhizoma)in the treatment of liver failure(LF)and to observe their effects on endoplasmic reticulum stress and inflammatory response.Methods From May 2022 to May 2024,a total of 102 patients with LF of toxin-heat-stasis stagnation syndrome were collected from Hepatology Department of Yulin Traditional Chinese Medicine Hospital,and were divided into the control group and the study group by using a table of random numbers,with 51 cases in each group.The two groups were given comprehensive western medicine treatment for inhibiting inflammatory response and protecting liver,regulating intestinal microecology,counteracting viral infection,decreasing transaminase level and treating jaundice.Additionally,the study group was treated with Jiedu Huayu Granules.The course of treatment for the two groups covered eight weeks.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,biochemical indicators,inflammatory factors and endoplasmic reticulum stress indicators.After treatment,the clinical efficacy and the incidence of adverse reactions of the two groups of patients were compared.Results(1)After eight weeks of treatment,the total effective rate of the study group was 86.27%(44/51)and that of the control group was 68.63%(35/51),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the study group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores in both groups were significantly decreased compared with those before treatment(P<0.01),and the decrease in the study group was significantly superior to that in the control group(P<0.05).(3)After treatment,the serum levels of biochemical indicators of total bilirubin(TBIL),total bile acid(TBA),alanine transaminase(ALT),and aspartate transaminase(AST)in the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease in the study group was significantly superior to that in the control group(P<0.05 or P<0.01).(4)After treatment,the serum levels of inflammatory factors of interleukin 6(IL-6),tumor necrosis factor α(TNF-α),transforming growth factor β(TGF-β),and C-reactive protein(CRP)in the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease in the study group was significantly superior to that in the control group(P<0.01).(5)After treatment,the levels of endoplasmic reticulum response indicators such as glucose-regulated protein 78(GRP78),CCAAT enhancer-binding protein homologous protein(CHOP),and cysteine aspartic acid specific protease 12(caspase-12)in the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease in the study group were significantly superior to those in the control group(P<0.01).(6)The incidence of adverse reactions in the study group was 15.69%(8/51)and that in the control group was 17.65%(9/51),and the comparison between the two groups showed that the difference was not statistically significant(P>0.05).Conclusion The combined use of Jiedu Huayu Granules with comprehensive western medicine treatment exerts certain efficacy in treating patients with LF of toxin-heat-stasis stagnation syndrome.The combined therapy is effective on relieving clinical symptoms and improving liver function,and is helpful for relieving endoplasmic reticulum stress and inflammatory response.

Sarcopenia etiology is diverse and the pathogenesis is complex.It is closely related to limited activity, malnutrition and a variety of clinical diseases, which seriously affects the quality of life in the elderly and has become a global common health problem.This review focuses on the literature of non-drug interventions for sarcopenia in the past five years, focusing on the relationship of multimodal exercise, intestinal flora, parenteral nutrition and comprehensive intervention with sarcopenia, in order to provide a new basis for formulating scientific and effective non-drug intervention for sarcopenia.

Objective To assess the value of blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI)in diagnosis and prediction of early acute renal transplant rejection.Methods BOLD-MRI was performed in a cohort of 103 patients undergoing cadaver renal transplantation between Dec 2005 and March 2007.Among them,82 recipients had nomlal renal function,21 had biopsy-proved acute rejection.R2* (1/s)measurements were obtained in the medulla and cortex of grafted kidneys. Results R2* values of the medulla were significantly lower in the acute rejection group[R2*=(14.02±2.68)/s]than that in the normally functioning transplants group [R2*=(16.66+2.82)/s],the difference between these two groups was significant (P＜0.01);ROC curve analyses suggested that medullary MR2* values could accurately identify acute rejection in the early post-transplantation period.In the normal functioning transplant group,those with lower medullary R2* values (MR2*＜14.9/s,n=23) had higher acute rejection rates than those with higher medullary R2* values (MR2*＞14.9/s,n=59) in the first 6 months following transplantation,but the difference between these two groups was not significant (17.39% vs 8.47%,P=0.259). Conclusions Mean R2* values in the medullary regions of grafted kidneys with BOLD-MPd may be a non-invasive diadynamic criteria with good sensitivity and specificity,and may be a valuable predictor of early acute renal transplant rejection.