Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Glial cells in the mammalian retina include macroglia and microglia.The role of glial cells in the glaucomatous disease process involves morphological changes, dynamic migration, and secretion of reactive factors.Activation of retinal glial cells can regulate the progression of glaucoma at the molecular level and affect the extracellular matrix and structural mechanics.Integrative bioinformatics analysis has been used to discover three core gene modules of astrocytes for the effect of glaucoma with high intraocular pressure.Studies have confirmed that mutations leading to glial cell abnormalities can influence the progression of glaucoma-like lesions in the retina.In terms of imaging, the emergence of new technologies has provided new research directions for in vivo observation of the reactive activation state of glial cells.This article reviews the role of glial cell activation in glaucoma with the aim of providing new directions for the pathogenesis and treatment of glaucoma.

Objective To compare the diagnostic performance of PI-RADS v2.1 and PI-RADS v2 in the detection of clinically significant prostate cancer(csPCa) by Meta-analysis. Methods The major biomedical databases were searched (CNKI, CBM, Medline, and Embase) with the keywords "PIRADS v2.1" or "PI-RADS v2.1". The Quality Assessment of Diagnostic Accuracy Studies Tool v2 (QUADAS-2) was used to evaluate literature quality. Meta-analysis was performed using STATA17.0 and ReMan5.4 software. Forest plots were used to represent the sensitivity and specificity of PI-RADS v2.1 and PI-RADS v2 for each study. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were combined, and diagnostic performance was evaluated using asummary receiver operating characteristic curve (SROC). Subgroup analysis was performed on three covariables: tumor location, threshold, and the nationality of authors. Results A total of 12 studies were included, involving 3 158 patients and 3 243 lesions. Forall zones and the whole gland, PI-RADS v2.1 had a larger area under the SROC curve (AUC) for csPCa performance, compared with PI-RADS v2. Subgroup analysis: PI-RADS v2.1 also had a larger area under the SROC (AUC) to detect transitional zone csPCa. Different diagnostic thresholds: when a score of 4 was used for the threshold, PI-RADS v2.1 had the maximum area under SROC (AUC) for csPCa performance detection. Author nationality: Researches of PI-RADS v2.1 in Chinese authors had the largest area under the SROC (AUC) in detecting csPCa performance. Conclusion Compared with PI-RADS v2, the diagnostic performance of PI-RADS v2.1 in detecting csPCa is not obviously improved and overall specificity is still low.

Objective Retrospective investigate the significant application of bone marrow (BM)morphology in exploring the causes of anemia,and observed the changes of anemia disease spectrum in the past 10 years.Methods BM smears of 1 528 anemia patients from Shanghai Jiao Tong University Affiliated Shanghai First People's Hospital were stained with Wright's staining and cvtochemical staining and observed with microscope.Combined with relevant clinical data,we analyzed the changes of disease types from 1998 to 2002 and from 2008 to 2012.Results 1 139 cases (74.54％) were diagnosed with hematopoietic and lymphatic system diseases.Iron-deficiency anemia,megaloblastic anemia and leukemia were the three main causes of anemia.The BM morphology of 389 patients displayed infection anemia or descriptive diagnosis.Anemia disease spectrum changed a lot,iron-deficiency anemia decreased from 30.34％ (139/458) to 18.69％ (200/1 070),leukemia increased from 13.31％ (61/458) to 21.77％ (233/1 070),descriptive diagnosis of BM increased from 15.72％ (72/458) to 21.86％ (234/1 070).Conclusion BM examination is critical for finding the cause of anemia,which contrihutes to effective treatment.

Objective To study the bacteriostatic activity and stability of pine bark Oligomeric Proantho Cyanidins. Methods By the K-B disk diffusion method, spoilage bacteria as experiment strains, to study the inhibition effects of the pine bark Oligomeric Proantho Cyanidins and the antimicrobial stability under certain temperature, pH, and UV exposure time. Results Pine bark Oligomeric Proantho Cyanidins had significant inhibitory effect on Gram positive bacteria (Staphylococcus aureus and Bacillus Sukatilis), which had better inhibition effects in the media neutral, but temperature and UV had little influence on the antimicrobial effects. The minimum inhibitory concentration (MIC) of pine bark Oligomeric Proantho Cyanidins against Staphylococcus aureus and Bacillus Sukatilis were 12.5 and 6.25 mg/mL, respective. However, on Gram negative bacteria(Escherichia coli and Pseudomonas aeruginosa) there was no obvious inhibition effects. Conclusion The pine bark Oligomeric Proantho Cyanidins has significant inhibitory effect on Gram positive bacteria, the inhibitory effect is stronger in the range of pH 6-7 , and the temperature and UV had a little effect on its antibacterial action, which means that the antibacterial action of pine bark Oligomeric Proantho Cyanidins had good stability.