OBJECTIVE: To explore the efficacy and apoptosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of acute myeloid leukemia (AML) with ASXL1 mutation. METHODS: The clinical data of 80 AML patients with ASXL1 mutation treated in our hospital from January 2019 to December 2021 were retrospectively analyzed. The clinical characteristics of the patients were summarized, and the therapeutic effect and prognostic factors of allo-HSCT for the patients were analyzed. RESULTS: Among the 80 patients, 38 were males and 42 were females, and the median age was 39(14-65) years. There were 17 patients in low-risk group, 25 patients in medium-risk group and 38 patients in high-risk group. ASXL1 mutation co-occurred with many other gene mutations, and the frequent mutated genes were TET2 (71.25%), NRAS (18.75%), DNMT3A (16.25%), NPM1 (15.00%), CEBPA (13.75%). Among medium and high-risk patients, 29 underwent allo-HSCT, while 34 received chemotherapy. The 2-year overall survival (OS) rate and disease-free survival (DFS) rate of the allo-HSCT group were 72.4% and 70.2%, while those of the chemotherapy group were 44.1% and 34.0%, respectively. The statistical analysis showed significant differences between the two groups (both P < 0.01). Multivariate analysis showed that age at transplantation >50- years and occurrence of acute graft-versus-host disease after transplantation were poor prognostic factors for OS and DFS in transplantation patients. CONCLUSION Allo-HSCT can improve the prognosis of AML patients with ASXL1 mutation.
Humans ; Leukemia, Myeloid, Acute/therapy* ; Hematopoietic Stem Cell Transplantation ; Female ; Male ; Middle Aged ; Mutation ; Adult ; Repressor Proteins/genetics* ; Adolescent ; Retrospective Studies ; Aged ; Nucleophosmin ; Young Adult ; Transplantation, Homologous ; Prognosis ; Survival Rate

Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.

Objective:To evaluate and summarize the evidence related to the physical restraint of elderly dementia patients, so as to provide a reference for clinical practice.Methods:Relevant literature on the physical restraint of elderly dementia patients in domestic and foreign databases was systematically retrieved, including clinical decisions, guidelines, expert consensus, recommended practices, evidence summaries, systematic reviews/Meta-analyses, and original studies. The retrieval time limit was from the establishment of the database to April 2024. The researchers evaluated the literature according to relevant evaluation criteria and extracted useful evidence.Results:A total of 11 articles were included, including one clinical decision, four guidelines, four systematic reviews, one evidence summary, and one expert consensus. Twenty-one best evidence items were summarized from five aspects: organizational norms, education and training, restraint assessment, alternative therapies, and clinical practice.Conclusions:The evidence on the physical restraint of elderly dementia patients can provide a theoretical basis for medical institution practitioners. When applying the best evidence, medical staff should combine their clinical experience, fully consider the individual specificity of elderly patients and the actual clinical situation, and analyze the differences between the evidence and practice, so as to implement personalized physical restraint for elderly dementia patients in clinical practice.

Objective To analyze the status and influencing factors of Helicobacter pylori(Hp)infection in the occupational population of Chengdu city.Methods A retrospective analysis was conducted on the general data of 8860 occupational population who underwent health examinations in our hospital from June 2021 to June 2023.All study subjects underwent 14 C urea breath test during health check ups.Analyze the Hp infection status of 8860 occupational population,and use logistic regression analysis(single factor and multiple factor)to explore the influencing factors of Hp infection in occupational population in Chengdu.Results Among the 8860 occupational population undergoing physical examinations in Chengdu,2890 cases were positive for Hp infection,with a total Hp infection rate of 32.62%.Univariate analysis found that occupational groups with age≥40 years,male,BMI<18.5 kg/m2(underweight)/24.0 kg/m2～27.9 kg/m2(overweight)/≥28 kg/m2(obese),workers,history of alcohol consumption,smoking,unclean diet,family history of Hp infection,and history of spicy and jelly diet had a higher Hp infection rate(P<0.05).Multivariate analysis showed that age≥40 years old,low BMI,overweight,obesity,alcohol consumption history,unclean diet history,family history of Hp infection,and spicy diet history were all risk factors affecting Hp infection in the occupational population of Chengdu(P<0.05).Conclusion The positive rate of Hp infection in the occupational population of Chengdu is relatively high,associated with age,alcohol consumption history,BMI,history of unclean diet,family history of Hp infection,and history of spicy eating.Therefore,attention should be paid to the Hp infection status of the occupational population.It is not only necessary to strengthen Hp infection publicity and education,but also to intervene in its risk factors early,in order to reduce and prevent Hp infection in the occupational population.

Objective To analyze the status and influencing factors of Helicobacter pylori(Hp)infection in the occupational population of Chengdu city.Methods A retrospective analysis was conducted on the general data of 8860 occupational population who underwent health examinations in our hospital from June 2021 to June 2023.All study subjects underwent 14 C urea breath test during health check ups.Analyze the Hp infection status of 8860 occupational population,and use logistic regression analysis(single factor and multiple factor)to explore the influencing factors of Hp infection in occupational population in Chengdu.Results Among the 8860 occupational population undergoing physical examinations in Chengdu,2890 cases were positive for Hp infection,with a total Hp infection rate of 32.62%.Univariate analysis found that occupational groups with age≥40 years,male,BMI<18.5 kg/m2(underweight)/24.0 kg/m2～27.9 kg/m2(overweight)/≥28 kg/m2(obese),workers,history of alcohol consumption,smoking,unclean diet,family history of Hp infection,and history of spicy and jelly diet had a higher Hp infection rate(P<0.05).Multivariate analysis showed that age≥40 years old,low BMI,overweight,obesity,alcohol consumption history,unclean diet history,family history of Hp infection,and spicy diet history were all risk factors affecting Hp infection in the occupational population of Chengdu(P<0.05).Conclusion The positive rate of Hp infection in the occupational population of Chengdu is relatively high,associated with age,alcohol consumption history,BMI,history of unclean diet,family history of Hp infection,and history of spicy eating.Therefore,attention should be paid to the Hp infection status of the occupational population.It is not only necessary to strengthen Hp infection publicity and education,but also to intervene in its risk factors early,in order to reduce and prevent Hp infection in the occupational population.

Objective:To evaluate and summarize the evidence related to the physical restraint of elderly dementia patients, so as to provide a reference for clinical practice.Methods:Relevant literature on the physical restraint of elderly dementia patients in domestic and foreign databases was systematically retrieved, including clinical decisions, guidelines, expert consensus, recommended practices, evidence summaries, systematic reviews/Meta-analyses, and original studies. The retrieval time limit was from the establishment of the database to April 2024. The researchers evaluated the literature according to relevant evaluation criteria and extracted useful evidence.Results:A total of 11 articles were included, including one clinical decision, four guidelines, four systematic reviews, one evidence summary, and one expert consensus. Twenty-one best evidence items were summarized from five aspects: organizational norms, education and training, restraint assessment, alternative therapies, and clinical practice.Conclusions:The evidence on the physical restraint of elderly dementia patients can provide a theoretical basis for medical institution practitioners. When applying the best evidence, medical staff should combine their clinical experience, fully consider the individual specificity of elderly patients and the actual clinical situation, and analyze the differences between the evidence and practice, so as to implement personalized physical restraint for elderly dementia patients in clinical practice.

OBJECTIVE: To explore the immunological mechanisms underlying spermatogenetic malfunction in patients with non-obstructive azoospermia (NOA) based on bioinformatics and machine learning, and to screen out the key genes associated with spermatogenesis failure. METHODS: NOA-related datasets were obtained from the GEO database, and the differentially expressed genes identified by differential analysis and weighted gene co-expression network analysis (WGCNA). A model of spermatogenesis scoring was established for analysis of the immunological microenvironment and cell interaction networks related to spermatogenesis failure. The key genes were screened out by machine learning, followed by analysis of their correlation with T cells and macrophages. An NOA mouse model was constructed for validation of transcriptome sequencing. RESULTS: Seventy-five differentially expressed genes were identified for the establishment of the spermatogenesis scoring model. The low spermatogenesis score group showed a higher infiltration of the immune cells, with an increased proportion of T cells and macrophages and a correlation of cell interaction signals with immunity. SOX30, KCTD19, ASRGL1 and DRC7 were identified by machine learning as the key genes related to spermatogenesis, with down-regulated expressions in the NOA group, and their expression levels negatively correlated with the infiltration of T cells and macrophages. The accuracy of the spermatogenesis scoring and machine learning models, as well as the trend of the expression levels of the key genes, was successfully validated with the transcriptome sequencing data on the NOA mouse testis. CONCLUSION The development of NOA is closely associated with enhanced immunological microenvironment in the testis. T cells and macrophages may play important roles in spermatogenesis failure. SOX30, KCTD19, ASRGL1 and DRC7 are potential biomarkers for the diagnosis and treatment of NOA.
Male ; Azoospermia/genetics* ; Machine Learning ; Animals ; Computational Biology ; Mice ; Humans ; Spermatogenesis/genetics* ; Gene Expression Profiling ; Macrophages/immunology* ; Gene Regulatory Networks ; T-Lymphocytes/immunology* ; Transcriptome

Objective To investigate the dosimetric effects of different calculation grid size(CGS)in helical tomotherapy(HT)planning system on stereotactic body radiation therapy(SBRT)for non-small cell lung cancer(NSCLC).Methods Nine NSCLC patients receiving radiation therapy for the first time at some hospital from March 2019 to December 2022 were selected as the subjects.SBRT planning was carried out through the HT system with three different CGS plans(Fine,Normal,and Coarse)and the same pitch,modulation factor(MF)and optimization conditions,and the target area indexes of the three CGS plans were compared including conformity index(CI),homogeneity index(HI),dosimetric parameters of the organ at risk(OAR),point dose verification pass rate,treatment time,number of monitor units and Sinograms.SPSS 22.0 was used for statistical analysis.Results For target area HI,there weres significant differences between CGS Fine plan and Coarse plan and between CGS Normal plan and Coarse plan(P＜0.05),while no statistical differences were found between CGS Fine plan and Normal plan(P＞0.05).For target area CI,there were significant differences between CGS Fine plan and Coarse plan(P＜0.05),while no statistical differences were found between CGS Fine plan and Normal plan and between CGS Normal plan and Coarse plan(P＞0.05).For OAR dosimetric parameters,CGS Fine plan and Coarse plan had significant differences in heart Dmax and Dmean,esophageal Dmax and Dmean,V5,V20,V30 and Dmean of the whole lung and affected lung,V5 and Dmax of the affected lung and heart V10 and V30(P＜0.05),CGS Normal plan and Coarse plan had obvious differences in esophageal Dmax(P＜0.05),and the remained dosimetric parameters were not statistically significant(P＞0.05).Fine,Normal and Coarse plans had the point dose verifica-tion pass rates being 0.96％,1.50％and 1.77％,respectively.In terms of treatment time and number of monitor units,there were significant differences between Fine plan and Coarse plan(P＜0.05)while no statistical differences were found between Fine and Normal plans and between Normal and Coarse plans(P＞0.05).Sinograms analyses showed Fine plan had evenly distributed segment color gradient,Coarse plan had areas of very dark and very light color gradients and Normal plan was somewhere in between.Conclusion Low CGS has to be used as much as possible to obtain accurate dose distribution during SBRT planning for NSCLC patients,which contributes to the execution of the radiation therapy plan and the prevention of ad-verse effects.[Chinese Medical Equipment Journal,2024,45(2):52-57]

Objective To develop a symptoms assessment scale for lung transplant recipients in early postoperative period,and assess its reliability and validity so as to provide clinical staff with a tool to evaluate the symptoms in the patients in the early period after lung transplantation.Methods With a symptom experience model,a preliminary item pool was established through literature reviews,semi-structured interviews and expert panel meetings between December 2021 and January 2022.Based on the preliminary item pool,an initial scale was proposed after two rounds of expert consultation between February and March 2022.The initial scale was finalised after all items had revised for language expression based on the results of cognitive interviews conducted in March 2022.Subsequently,the final version of the scale was applied in the survey of 116 recipients of lung transplant in the early postoperative stage at Wuxi People's Hospital between April 2022 and February 2023.The reliability and validity of scale were then further tested.Results A total of 112 patients responded to the questionnaire survey.The developed scale comprised 5 dimensions:psychology-related symptoms,respiratory related symptoms,digestive related symptoms,circulatory related symptoms and other symptoms,with 18 symptom items in total.Content validity indexes of the Item-level content validity index(I-CVI))were 0.833 to 1.000 and the Scale-level content validity index(S-CVI)was at 0.954.Exploratory factor analysis revealed five common factors with a cumulative variance contribution rate of 82.366%.All the factors exhibited positive correlations with the scale,with the correlation coefficient at 0.760 to 0.837(P<0.01).The scale demonstrated a Cronbach α coefficient of 0.943,and the Cronbach α coefficients of the five common factors ranged from 0.869 to 0.941.Additionally,the scale exhibited a split-half reliability of 0.840,and the split-half reliability of the five common factors ranged from 0.830 to 0.937.Conclusions The symptoms assessment scale for lung transplant recipients in early postoperative period developed in this study exhibits good reliability and validity.It is feasible for evaluation of early symptoms in lung transplant recipients.

Objective Naturally,Aedes albopictus carries both the A and B supergroups of Wolbachia strains,which are symbiotic bacteria that can influence the transmission of mosquito-borne diseases by inhibiting the ability of their host to transmit viruses or by reducing the population density of their host,and the strength of this effect is closely related to its density in host cells.In this study,an accurate qPCR-based method for detecting Wolbachia genotype and density in mosquitoes was established.Methods The wsp gene of Wolbachia carried by Ae.albopictus was cloned and sequenced,and specific primers for the non-conserved regions of the w AlbA and w AlbB wsp genes were designed.Results The application of this method showed great sensitivity and specificity.The primers did not cross-react between the two Wolbachia supergroups.Further,with this method,it was possible to detect decreases in Wolbachia density in host cells following treatment with tetracycline at different concentrations,and the optimal tetracycline treatment concentration was determined to be 0.1 mg/mL.Conclusion This method can provide technical supports for studies of the effects of Wolbachia on physiological reproduction and innate immunity in mosquitoes.