Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Abstract：Objective To analyze the stabilities of neuraminidase（NA）in influenza vaccine at different temperatures and provide a reference for further complete understanding of overall shelf life of vaccines. Methods Monovalent bulks of influenza H1N1，H3N2 and B vaccines were stored at 4（low temperature），25（room temperature）and 37 ℃（changed temperature）for 0. 5，2，7，24 and 48 h separately，using that at 100 ℃（extreme temperature）for 1 h as control，and determined for NA activity by enzyme⁃linked lectin method. Results The NA activities of influenza H1N1 vaccines stored at 25 and 37 ℃ decreased significantly with the increasing of time. No significant decreases were observed in H3N2 and B vaccines even after storage at two non⁃storage temperatures for 48 h. However，all the NA activities of three vaccines decreased at 100 ℃. Conclusion Both H3N2 and B vaccines showed high stability at abnormal storage temperatures not more than 37 ℃，while H1N1 vaccine was relatively sensitive to the temperature for storage.

OBJECTIVE: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. METHODS: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. RESULTS: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. CONCLUSIONS Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).
Humans ; Male ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Hyperuricemia ; Kidney ; Proteinuria ; Renal Insufficiency, Chronic/complications*

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
Adult ; Humans ; Adolescent ; Imatinib Mesylate/adverse effects* ; Incidence ; Antineoplastic Agents/adverse effects* ; Retrospective Studies ; Pyrimidines/adverse effects* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Treatment Outcome ; Benzamides/adverse effects* ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Aminopyridines/therapeutic use* ; Protein Kinase Inhibitors/therapeutic use*

Objective To analyze the difference in computed tomography (CT) imaging findings between pulmonary alveolar pneumoconiosis Methods proteinosis (PAP) and occupational pneumoconiosis (hereinafter referred to as ). A total of 44 patients with PAP (PAP group) and 44 patients with pneumoconiosis (pneumoconiosis group) were selected as study subjects using Results convenient sampling method. The CT images of these two groups were comparatively analyzed. The detection rates of - - pulmonary CT pattern changes such as map like performance, ground glass opacity, paving stone sign and sphenoid wing like vs vs changes of pulmonary hilum in the PAP group were higher than those in the pneumoconiosis group (77.3% 0.0%, 75.0% vs vs P 2.3%, 56.8% 0.0%, 18.2% 0.0%, all <0.01); the detection rates of lymphadenopathy and calcification of pulmonary hilum, small pulmonary nodules, emphysema and interlobular septal thickening were lower in the PAP group than those in the vs vs vs vs P Conclusion pneumoconiosis group (34.1% 100.0%, 4.5% 100.0%, 2.3% 45.4%, 0.0% 22.7%, all <0.01). Paving - stone sign and map like performance were most commonly found in the CT imaging of patients with PAP, and it is uncommon in pneumoconiosis. These changes could be used as the CT differential diagnosis of the two diseases.

Objective To analyze the difference in computed tomography (CT) imaging findings between pulmonary alveolar pneumoconiosis Methods proteinosis (PAP) and occupational pneumoconiosis (hereinafter referred to as ). A total of 44 patients with PAP (PAP group) and 44 patients with pneumoconiosis (pneumoconiosis group) were selected as study subjects using Results convenient sampling method. The CT images of these two groups were comparatively analyzed. The detection rates of - - pulmonary CT pattern changes such as map like performance, ground glass opacity, paving stone sign and sphenoid wing like vs vs changes of pulmonary hilum in the PAP group were higher than those in the pneumoconiosis group (77.3% 0.0%, 75.0% vs vs P 2.3%, 56.8% 0.0%, 18.2% 0.0%, all <0.01); the detection rates of lymphadenopathy and calcification of pulmonary hilum, small pulmonary nodules, emphysema and interlobular septal thickening were lower in the PAP group than those in the vs vs vs vs P Conclusion pneumoconiosis group (34.1% 100.0%, 4.5% 100.0%, 2.3% 45.4%, 0.0% 22.7%, all <0.01). Paving - stone sign and map like performance were most commonly found in the CT imaging of patients with PAP, and it is uncommon in pneumoconiosis. These changes could be used as the CT differential diagnosis of the two diseases.

Objective To analyze the difference in computed tomography (CT) imaging findings between pulmonary alveolar pneumoconiosis Methods proteinosis (PAP) and occupational pneumoconiosis (hereinafter referred to as ). A total of 44 patients with PAP (PAP group) and 44 patients with pneumoconiosis (pneumoconiosis group) were selected as study subjects using Results convenient sampling method. The CT images of these two groups were comparatively analyzed. The detection rates of - - pulmonary CT pattern changes such as map like performance, ground glass opacity, paving stone sign and sphenoid wing like vs vs changes of pulmonary hilum in the PAP group were higher than those in the pneumoconiosis group (77.3% 0.0%, 75.0% vs vs P 2.3%, 56.8% 0.0%, 18.2% 0.0%, all <0.01); the detection rates of lymphadenopathy and calcification of pulmonary hilum, small pulmonary nodules, emphysema and interlobular septal thickening were lower in the PAP group than those in the vs vs vs vs P Conclusion pneumoconiosis group (34.1% 100.0%, 4.5% 100.0%, 2.3% 45.4%, 0.0% 22.7%, all <0.01). Paving - stone sign and map like performance were most commonly found in the CT imaging of patients with PAP, and it is uncommon in pneumoconiosis. These changes could be used as the CT differential diagnosis of the two diseases.

Objective: To explore metabolic biomarkers associated with the onset of type 2 diabetes. Methods: Cluster random sampling method was used to select 10 867 local residents aged ≥ 20 years in Liangxi district of Wuxi City, Jiangsu Province in 2007. The baseline survey and physical examination were conducted to collect participants' information, including demographic characteristics, behavior and lifestyles, disease history, family history of diabetes, height, weight, waist circumference and blood pressure, etc. Blood samples were collected and biochemical indexes (high density lipoprotein cholesterol, total cholesterol, triglyceride, fasting blood glucose, etc.) were tested. By June 30, 2020, 220 newly diagnosed patients with type 2 diabetes during the follow-up were selected as cases, and 220 healthy individuals were matched as controls with age (±5 years) and the same sex. High performance liquid chromatography mass spectrometer was used to detect and identify metabolites in serum samples of two groups at baseline. Lasso regression and multivariate conditional logistic regression were used to explore the metabolites associated with the onset of type 2 diabetes. Results: The age of participants at baseline was (53±7) years, and 41.82% were male. 25 out of 1 579 metabolites were selected to be potentially associated with the onset of type 2 diabetes in the lasso regression model. The multivariable conditional logistic regression analysis showed that only 7-Methylxanthine had an independent effect on type 2 diabetes (P=0.019). The area under the receiver operating characteristic curve (AUC) (95%CI) of the prediction model of type 2 diabetes based on traditional risk factors was 0.80 (0.76-0.85). After the 7-methylxanthine in the model, the AUC (95%CI) increased to 0.92 (0.89-0.95) (P<0.001). From the second year, 7-methylxanthine could improve the prediction performance (P=0.007). Conclusion: The level of 7-methylxanthine is related to the onset of type 2 diabetes, and can be used as a biomarker to predict its incidence risk.
Humans ; Male ; Female ; Diabetes Mellitus, Type 2/epidemiology* ; Case-Control Studies ; Risk Factors ; Triglycerides ; Biomarkers