OBJECTIVE: To investigate the predictive value of serum soluble interleukin-2 receptor(sIL-2R), tumor necrosis factor alpha(TNF-α), IgG and IgA for the recurrence in patients with multiple myeloma(MM). METHODS: A total of 108 MM patients who were initially diagnosed and treated in our hospital from January 2017 to March 2019, and 72 patients who met the diagnostic criteria and had complete follow-up data were selected as the study subjects. MM recurrence was the endpoint event, and follow-up was conducted until the occurrence of the endpoint event or the deadline of this study. MM patients were divided into recurrent group(RG) and non-recurrent group(NRG) based on whether they have relapsed or not. Venous blood was collected from patients at the first diagnosis and follow-up (at the occurrence of endpoint events or termination of the study), and enzyme-linked immunosorbent assay(ELISA) was used to detect sIL-2R and TNF-α levels in the patient's serum. An automatic immune analyzer was used to detect the levels of IgG and IgA in the patient's serum. The differences in expression levels of the factors between two groups were compared and the correlations between sIL-2R and TNF-α, IgG and IgA at the first diagnosis and follow-up were analyzed. At the same time, venous blood was collected from patients during complete remission, and their serum sIL- 2R levels were measured to compare the differences in sIL-2R expression levels at the first diagnosis, complete remission and recurrence. Receiver operating characteristic(ROC) curves was used to determine the optimal cutoff values for serum sIL-2R, TNF-α, IgG and IgA, and the predictive value of sIL-2R, TNF-α, IgG and IgA in the recurrence of MM patients were analyzed based on the area under the curve(AUC). RESULTS: The serum sIL-2R levels of MM patients at the first diagnosis and recurrence were significantly higher than at complete remission (P < 0.05). At the first diagnosis, the hemoglobin content of RG was lower than that of NRG, while the β₂-microglobulin content was higher than that of NRG (P < 0.001). There was no significant difference in other clinical parameters between the two groups (P >0.05). The levels of sIL-2R, TNF-α, IgG and IgA at the first diagnosis and follow-up of RG were higher than those of NRG (P < 0.05). There was a significant correlation between sIL-2R and TNF-α, IgG and IgA at the first diagnosis and follow-up (P < 0.001). The ROC curve showed that, at the first diagnosis, sIL-2R, TNF-α, IgG and IgA predicted the AUC of MM patients were 0.919, 0.850, 0.766 and 0.795, respectively, after follow-up, they predicted AUC of MM were 0.890, 0.815, 0.760 and 0.794, respectively (P < 0.001). CONCLUSION The serum sIL-2R has the highest predictive value for MM patient's recurrence, and it is possible to detect the TNF-α, IgG and IgA levels at specific times to infer changes in sIL-2R levels and evaluate the patient's prognosis.
Humans ; Multiple Myeloma/blood* ; Immunoglobulin A/blood* ; Immunoglobulin G/blood* ; Tumor Necrosis Factor-alpha/blood* ; Receptors, Interleukin-2/blood* ; Recurrence ; Male ; Female ; Neoplasm Recurrence, Local ; Middle Aged ; Prognosis

OBJECTIVE: To investigate the distribution of GP.Mur antigen in blood donors in Jiangsu Province. METHODS: Genomic DNA was extracted from 1 114 blood donors in Jiangsu region. PCR-SSP was performed to amplify GP.Mur, and gene analysis was conducted by direct sequencing of the PCR products. The frequency of GP.Mur in the blood donor population of Jiangsu region was calculated. RESULTS: Out of 1 114 randomly selected blood samples, 11 positive bands were detected during amplification. Direct sequencing analysis revealed that among the 11 positive samples, 4 were homozygous for GYP .Mur genotype, 3 were heterozygous for GYP .Mur genotype, and the remaining 4 samples were identified as GYP .HF genotype. CONCLUSION This study analyzed the distribution of the GP.Mur antigen and preliminary obtained the frequency data in the blood donor population in Jiangsu region. Further in-depth research on this blood group is of great importance in guiding clinical blood transfusion practices and ensuring transfusion safety.
Humans ; Blood Donors ; China ; Genotype ; Blood Group Antigens/genetics* ; Polymerase Chain Reaction ; Glycophorins/genetics* ; Gene Frequency

BACKGROUND: Blood glucose and serum albumin have been associated with cardiovascular disease prognosis, but the impact of admission-blood-glucose-to-albumin ratio (AAR) on adverse outcomes in critical ill coronary artery disease (CAD) patients was not investigated. METHODS: Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR. The primary outcome was 1-year mortality, and secondary endpoints were in-hospital mortality, acute kidney injury (AKI), and renal replacement therapy (RRT). A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients. Kaplan-Meier survival analysis determined differences in endpoints across subgroups. RESULTS: A total of 8360 patients were included. There were 726 patients (8.7%) died in the hospital and 1944 patients (23%) died at 1 year. The incidence of AKI and RRT was 63% and 4.3%, respectively. High AAR was markedly associated with in-hospital mortality (HR = 1.587, P = 0.003), 1-year mortality (HR = 1.502, P < 0.001), AKI incidence (HR = 1.579, P < 0.001), and RRT (HR = 1.640, P < 0.016) in CAD patients in the completely adjusted Cox proportional hazard model. Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles. Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes. CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality, 1-year mortality, and adverse renal prognosis in critical CAD patients.

Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6％),Mycobacterium tuberculosis 249(20.0％),other bacteria 150(12.0％),fungi 68(5.5％),parasites 18(1.4％),Treponema pallidum 18(1.4％)and rickettsia 1(0.1％).The number of cases increased by 177 cases(33.1％)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ￥29,500(￥16,000,￥59,200).The mortality rate from CNS infectious diseases is 1.6％.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Objective:To compare the short-term effect and adverse reaction of venetoclax(VEN)combined with azacitidine(AZA)versus"7+3"regimen in newly diagnosed elder patients with acute myeloid leukemia(AML).Methods:From January 2021 to January 2022,the clinical data of seventy-nine newly diagnosed elder patients with AML at the Second Hospital of Shanxi Medical University and the Shanxi Bethune Hospital were retrospectively analyzed,including VEN+AZA group(41 cases)and"7+3"group(38 cases).The propensity score matching(PSM)method was used to balance confounding factors,then response,overall survival(OS),progression-free survival(PFS)and adverse reactions between the two groups were compared.Results:The ORR of VEN+AZA group and"7+3"group was 68％and 84％,respectively,and the CRc was 64％and 72％,respectively,the differents were not statistically significant(P＞0.05).In the VEN+AZA group,there were 5 non-remission(NR)patients,4 with chromosome 7 abnormality(7q-/-7),and 1 with ETV6 gene mutation.Median followed-up time between the two groups was 8 months and 12 months,respectively,and the 6-months OS was 84％vs 92％(P=0.389),while 6-months PFS was 84％vs 92％(P=0.258).The main hematological adverse reactions in two groups were stage Ⅲ-Ⅳmyelosuppression,and the incidence rate was not statistically different(P＞0.05).The median time of neutrophil recovery in two groups was 27(11-70)d,25(14-61)d(P=0.161),and platelet recovery was 27(11-75)d,25(16-50)d(P=0.270),respectively.The infection rate of VEN+AZA group was lower than that of"7+3"group(56％vs 88％,P=0.012).The rate of lung infections of two groups was 36％and 64％,respectively,the difference was statistically significant(P=0.048).Conclusion:The short-term effect of VEN+AZA group and"7+3"regimens in eldrly AML patients are similar,but the VEN+AZA regimen had a lower incidence of infection.The presence of chromosome 7 abnormality(7q-/-7)may be a poor prognostic factor for elderly AML patients treated with VEN+AZA.

Objective To establish a dynamic prediction model of fatal massive hemorrhage in trauma based on the vital signs time series data and machine learning algorithms.Methods Retrospectively analyze the vital signs time series data of 7522 patients with trauma in the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ)database from 2008 to 2019.According to the occurrence of posttraumatic fatal massive hemorrhage,the patients were divided into two groups:fatal massive hemorrhage group(n=283)and non-fatal massive hemorrhage group(n=7239).Six machine learning algorithms,including logistic regression(LR),support vector machine(SVM),random forests(RF),adaptive boosting(AdaBoost),gated recurrent unit(GRU),and GRU-D were used to develop a dynamic prediction models of fatal massive hemorrhage in trauma.The probability of fatal massive hemorrhage in the following 1,2,and 3 h was dynamically predicted.The performance of the models was evaluated by accuracy,sensitivity,specificity,positive predictive value,negative predictive value,Youden index,and area under receiver operating characteristic curve(AUC).The models were externally validated based on the trauma database of the Chinese PLA General Hospital.Results In the MIMIC-Ⅳ database,the set of dynamic prediction models based on the GRU-D algorithm was the best.The AUC for predicting fatal major bleeding in the next 1,2,and 3 h were 0.946±0.029,0.940±0.032,and 0.943±0.034,respectively,and there was no significant difference(P=0.905).In the trauma dataset,GRU-D model achieved the best external validation effect.The AUC for predicting fatal major bleeding in the next 1,2,and 3 h were 0.779±0.013,0.780±0.008,and 0.778±0.009,respectively,and there was no significant difference(P=0.181).This set of models was deployed in a public web calculator and hospital emergency department information system,which is convenient for the public and medical staff to use and validate the model.Conclusion A set of dynamic prediction models has been successfully developed and validated,which is greatly significant for the early diagnosis and dynamic prediction of fatal massive hemorrhage in trauma.

Objective To construct a hierarchical inventory model of emergency supplies applicable to uncertain environments in order to provide decision support for emergency responses to infectious disease outbreak.Methods An emergency supplies hierarchical model was constructed with the zigzag uncertainty distribution,which was combined with an economic order quantity(EOQ)model to establish an emergency supplies hierarchical inventory model.An acute respiratory infectious disease event in W city was used as an example to verify the practicality and effectiveness of the model proposed.Results The model was able to accurately classify emergency supplies in most cases,and the inventory quantity determined with the model was close to the demand levels.Conclusion The model proposed is practical and effective in emergency responses to acute respiratory infectious diseases,which facilitates the requirements prediction for emergency supplies and enhances the capacity and efficiency of emergency responses.[Chinese Medical Equipment Journal,2024,45(5):67-74]

This study aimed to evaluate the efficacy and safety of various Chinese patent medicines in the treatment of inflammatory response in chronic glomerulonephritis(CGN) based on network Meta-analysis. Randomized controlled trial(RCT) of oral Chinese patent medicines for improving inflammatory response in patients with CGN was retrieved from databases such as CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science from database inception to March 2023. All investigators independently screened the literature, extracted data, and evaluated the quality. Stata 16.0 and RevMan 5.4.1 software were used to analyze the data of the literature that met the quality standards. Finally, 71 RCTs were included, involving 7 Chinese patent medicines. The total sample size was 6 880 cases, including 3 441 cases in the test group and 3 439 cases in the control group. The network Meta-analysis showed that(1) in terms of reducing TNF-α, the top 3 optimal interventions according to the surface under the cumulative ranking curve(SUCRA) were Shenyanshu Capsules/Granules/Tablets+conventional western medicine, Huangkui Capsules+conventional western medicine, and Bailing Capsules+conventional western medicine.(2) In terms of reducing hs-CRP, the top 3 optimal interventions according to SUCRA were Yishen Huashi Granules+conventional western medicine, Huangkui Capsules+conventional wes-tern medicine, and Bailing Capsules+conventional western medicine.(3) In terms of reducing IL-6, the top 3 optimal interventions according to SUCRA were Yishen Huashi Granules+conventional western medicine, Bailing Capsules+conventional western medicine, and Shenyan Kangfu Tablets+conventional western medicine.(4) In terms of reducing 24hUTP, the top 3 optimal interventions according to SUCRA were Shenyan Kangfu Tablets+conventional western medicine, Bailing Capsules+conventional western medicine, and Huangkui Capsules+conventional western medicine.(5) In terms of reducing Scr, the top 3 optimal interventions according to SUCRA were Bailing Capsules+conventional western medicine, Shenyanshu Capsules/Granules/Tablets+conventional western medicine, and Yishen Huashi Granules+conventional western medicine.(6) In terms of reducing BUN, the top 3 optimal interventions according to SUCRA were Yishen Huashi Granules+conventional western medicine, Shenyanshu Capsules/Granules/Tablets+conventional western medicine, and Bailing Capsules+conventional western medicine.(7) In terms of improving the clinical total effective rate, the top 3 optimal interventions according to SUCRA were Huangkui Capsules+conventional western medicine, Kunxian Capsules+conventional western medicine, and Yishen Huashi Granules+conventional western medicine. The results showed that the combination of conventional western medicine and Chinese patent medicine could reduce the expression of serum inflammatory factors TNF-α, hs-CRP, and IL-6 and inhibit the inflammatory response. The combination of conventional western medicine and Chinese patent medicine was superior to conventional western medicine alone in reducing Scr, BUN, and 24hUTP, and improving the clinical total effective rate of treatment. Due to the limitation of the quantity and quality of literature included, the above conclusions need to be validated by more high-quality studies.
Humans ; Tumor Necrosis Factor-alpha ; Network Meta-Analysis ; Nonprescription Drugs ; C-Reactive Protein ; Interleukin-6 ; Drugs, Chinese Herbal/therapeutic use* ; Glomerulonephritis/drug therapy*

Acute myeloid leukemia (AML) has highly heterogeneous clinical manifestations and poor prognosis, and traditional chemotherapy is the main treatment. In recent years, with the in-depth development of next-generation sequencing technology, the treatment of AML is gradually exploring the precise targeted therapy in the direction of molecular biology and immunophenotype. The advent of various small-molecule inhibitors and immune-targeted drugs has brought hope to patients who cannot tolerate intensive chemotherapy or with relapsed/refractory AML. Compared with traditional chemotherapy, targeted therapy has the advantages of significant curative effect and fewer adverse effects. This article reviews the latest research progress of targeted drug therapy for AML.
Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Immunotherapy ; Immunotherapy, Adoptive ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*