1.Evaluation of Gradient-Variant Quantum Dot Fluorescence Technology for Rapid Detection of Brucella
Jiquan LI ; Xintong WANG ; Jianling WANG ; Shengnan TIAN ; Cunzhe ZHAO ; Xiaochen WANG ; Wenxiu JIAN ; Shengyu LI ; Qingwen ZHANG ; Lei ZHOU
Journal of Sichuan University (Medical Sciences) 2025;56(5):1208-1214
Objective To establish a brucellosis monitoring and testing technique applicable for the rapid field screening of natural epidemic diseases.Methods A rapid testing technique for Brucella was developed based on a double-antibody sandwich testing model using gradient-variant quantum dots as fluorescent tracers.The sensitivity,linearity,precision,and specificity of the technique were evaluated using suspensions of standard Brucella strains.Methodological comparisons across different sample types were conducted to assess the consistency of the test results.Results The gradient-variant quantum dots detection method was evaluated with standard Brucella strains,exhibiting a sensitivity of 1×103 CFU/mL and a linear correlation coefficient(r)of 0.994(95%CI,0.933-1.055).The maximum coefficient of variation was 12.94%in repeated tests,showing good specificity.A comparative assessment of 305 clinical samples was conducted using the Brucella gradient-variant quantum dots detection method,the Rose Bengal plate agglutination test(RBT),and the serum agglutination test(SAT),yielding a Kappa value of 0.95,indicating almost perfect agreement.Additionally,a comparative assessment of 110 environmental samples collected on-site was conducted using the Brucella gradient-variant quantum dots detection method and quantitative real-time PCR(qPCR).The Kappa values for aerosol collection fluid,surface wipes,and wool samples were all above 0.83,demonstrating near-perfect agreement.For fecal and soil samples,the Kappa values were above 0.62,indicating substantial agreement.Conclusion The Brucella detection method based on gradient-variant quantum dots technology is simple and can be conducted rapidly.The detection method demonstrates high sensitivity,linearity,precision,and specificity.It shows consistent performance in clinical sample testing.It is well-suited for field rapid screening of natural epidemic diseases in field settings and shows good application prospects in the monitoring,prevention,and rapid detection of zoonotic diseases.
2.Temporal regulatory functions of EGR4 in neural development of mice
Yawen LUO ; Murong XU ; Shuping ZHOU ; Hao LI ; Xiaochen BO ; Hebing CHEN
Military Medical Sciences 2025;49(6):437-442
Objective To study the dynamic regulatory role of early growth response 4(EGR4)in mouse neurodevelopment.Methods Data on single-cell chromatin accessibility(single-cell assay for transposase-accessible chromatin by sequencing,scATAC-seq)and transcriptome(single-cell RNA sequencing,scRNA-seq)from seven key stages spanning from the embryonic period to adulthood was collected and analyzed.The transcription factor binding site network was inferred,a quantitative analysis from a temporal perspective was conducted,its functional modules were parsed,and the results were visualized.Results egr4 was significantly highly expressed from the late embryonic stage to adulthood,and specifically activated during the maturation of inhibitory neurons[parvalbumin(PV)and somatostatin(SST)subtypes].Moreover,its transcription was not directly regulated by changes in chromatin accessibility.Temporal network analysis indicated that EGR4 became a regulatory hub in the late embryonic stage and drove neuron differentiation and subtype specification.Functional enrichment analysis showed that EGR4 regulated the"cell differentiation"pathway through dynamic interacting factors,and there were subtype-specific interaction modules in PV/SST neurons respectively.Conclusion EGR4 can participate in the late-stage maturation of cortical neurons through a stage-specific regulatory network.This study provides a new perspective on mechanisms underlying the temporal logic of neural development.
3.Effect of central positioning techniques for anterior capsulotomy in femtosecond laser-assisted cataract surgery on intraocular placement and visual quality
Shuaishuai LIU ; Wei ZHOU ; Xiaochen DING ; Shuang ZHANG ; Qiangqiang CHI ; Yong LIU
International Eye Science 2025;25(4):523-529
AIM: To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center, limbus center, and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS: A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center, Anhui Medical University between January and December 2023 were included in this prospective study. Patients were divided into three groups based on the central positioning mode for anterior capsulotomy: pupil center, limbus center, and lens apex center groups. IOL alignment and displacement were evaluated using the Casia2 device, and the postoperative visual quality was assessed.RESULTS: At 1 d postoperatively, the IOL tilt for the pupil, limbus, and apex groups were 3.96°±1.51°, 4.63°±1.87°, and 3.90°±2.24°, respectively(F=1.07, P=0.35); IOL decentration values were 0.21±0.10 mm, 0.23±0.16 mm, and 0.21±0.12 mm, respectively(F=0.14, P=0.87); total higher-order aberrations were 0.32±0.40 μm, 0.56±0.61 μm, and 0.53±0.60 μm, respectively(F=1.38, P=0.26); and coma aberrations values were 0.13±0.10 μm, 0.16±0.15 μm, and 0.14±0.15 μm, respectively(F=0.3, P=0.74). All results obtained postoperative day 1 did not differ significantly. At 3 mo postoperatively, IOL tilt values were 5.42°±2.00°, 3.96°±1.44°, and 3.20°±1.19°, respectively(F=12.40, P<0.001); IOL decentration values were 0.33±0.07 mm, 0.23±0.11 mm, and 0.21±0.11 mm, respectively(F=4.99, P=0.008); total higher-order aberrations were 0.67±0.29 μm, 0.44±0.37 μm, and 0.42±0.19 μm, respectively(F=5.50, P=0.006); and coma aberrations values were 0.21±0.12 μm, 0.19±0.12 μm, and 0.12±0.11 μm, respectively(F=3.87, P=0.03). All results obtained 3 mo postoperatively were statistically significant.CONCLUSION: Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration. If the lens apex cannot be determined intraoperatively, the limbus center-positioning mode is recommended.
4.Correlation analysis of genetic and environmental factors with clinical characteristics of pediatric upper urinary tract calculi
Youquan ZHAO ; Xiaochuan WANG ; Boyu YANG ; Chen NING ; Houyu ZHOU ; Huimin ZHAO ; Xiaochen WANG ; Ruiyu YUE ; Shao ZHANG ; Manjiang SUN ; Jun LI
Chinese Journal of Urology 2025;46(10):728-733
Objective:To investigate the influence of genetic and environmental factors on the clinical characteristics of upper urinary tract calculi in pediatric patients.Methods:This study was a retrospective case series. The clinical data of 179 children under the age of 14 with upper urinary tract calculi treated at Beijing Friendship Hospital,Capital Medical University,from August 2014 to February 2023 were analyzed. There were 121 males(67.60%)and 58 females(32.40%),with a median age at onset of 2.10(1.14,5.17)years. Thirty-three cases(18.44%)had a family history of urinary stone disease. Stone characteristics was defined by CT,with a median stone burden(sum of the diameters of all stones)of 1.3(1.00,1.60)cm. Fifty-four(30.17%)children had staghorn calculi. Multiple stones were present in 92 cases(51.40%),and bilateral stones in 52 cases(29.05%),with hydronephrosis was present in 119 children(66.48%). The median follow-up time was 67 months,and 36 children(20.11%)experienced stone recurrence. Dietary habits and related information were collected by electronic questionnaire,including a total of 115 children(64.25%)with an unbalanced diet,101(56.42%)with insufficient water intake,and 32 children(17.88%)with a preference for a high-protein diet. Tap water was used as the source of drinking water by 128 patients(71.51%),and 107(59.78%)took dietary supplements. Whole-exome sequencing revealed that 55 children(30.73%)carried pathogenic mutations in stone-related genes. Binary logistic regression was used for univariate analysis of above risk factors. Variables with P < 0.1 in univariate analysis and without multicollinearity were included in multivariate logistic regression to further screen for independent risk factors. Results:Multivariate analysis confirmed that carrying stone-related pathogenic gene mutations( OR = 3.06,95% CI 1.25?7.45, P = 0.014)and insufficient water intake( OR = 3.28,95% CI 1.14?9.47, P = 0.028)were independent risk factors for higher stone burden. A high-protein diet( OR = 2.40,95% CI 1.03?5.63, P = 0.044),carrying stone-related pathogenic gene mutations( OR = 4.57,95% CI 2.21?9.46, P<0.01),and a family history of stones( OR = 3.18,95% CI 1.28 ~ 7.91, P = 0.013)were independent risk factors for staghorn calculi. Multiple stones were closely associated with a family history of stones( OR = 2.66,95% CI 1.15-6.17, P = 0.022)and carrying stone-related pathogenic gene mutations( OR = 3.22,95% CI 1.60-6.48, P = 0.001). Moreover,carrying stone-related pathogenic gene mutations( OR = 5.19,95% CI 2.52?13.82, P < 0.01)were an independent risk factor for stone recurrence,whereas dietary supplement intake was a protective factor( OR = 0.26,95% CI 0.11?0.62, P = 0.002). Conclusions:Genetic and environmental factors play significant roles in the occurrence and development of pediatric upper urinary tract stones. A high-protein diet as well as a positive family history of stones are independent risk factors for staghorn calculi,and insufficient water intake is a critical environmental factor for stone formation,while appropriate use of dietary supplements may help reduce the risk of stone recurrence. Genetic testing indicates that approximately 30% of children carry stone-related pathogenic gene mutations,and these patients prone to severe stone and an increased risk of recurrence.
5.Preparation and immunogenicity evaluation of rotavirus VP8-mRNA vaccine
Qingmei LENG ; Xianqiong TANG ; Rong CHEN ; Xiaoqing HU ; Xiaopeng SONG ; Yan LI ; Jinmei LI ; Lida YAO ; Xiaochen LIN ; Jinyuan WU ; Maosheng SUN ; Hongjun LI ; Yan ZHOU
Chinese Journal of Microbiology and Immunology 2025;45(9):727-732
Objective:To construct a VP8-mRNA vaccine using human rotavirus spike protein VP8 domain as the immunogen and analyze its immunogenicity in mice.Methods:The VP8-mRNA sequence was designed, optimized, and synthesized. The VP8 gene of rotavirus G1P[8] type was used to construct the plasmid pUC57-VP8-Kan-SapⅠ, which was then sequenced. The plasmid confirmed by sequencing was subjected to large-scale amplification and extraction, followed by linearization, in vitro transcription, and capping. The purified capped products were encapsulated with lipid nanoparticles using a microfluidic control apparatus. The encapsulated VP8-mRNA vaccine was administered intramuscularly to mice at 10, 15, and 20 μg. Serum samples were collected for antibody detection by ELISA. Cellular immune responses were detected by flow cytometry and ELISPOT. Statistical analysis was performed using one-way or two-way analysis of variance and Tukey-Kramer test. Results:The encapsulated VP8-mRNA vaccine was rounded and spherical, with a particle size of about 100 nm, a polymer dispersion index of 0.088, and an encapsulation rate of 92.3%. Two doses of VP8-mRNA vaccine immunization could induce a good immune response in mice. The level of IgG antibody induced after immunization in the 15 μg group was comparable to that of the 20 μg group, and there was no statistical difference ( P>0.05), but the antibody levels in the two groups were significantly higher than that in the 10 μg group ( P<0.000 1). VP8-mRNA vaccine could induce neutralizing antibodies against rotavirus G1 and G9 types. The highest level of neutralizing antibodies against rotavirus type G1 was observed in the 15 μg group, which was significantly higher than that in the 10 μg group ( P<0.05). All immunization groups exhibited good neutralizing ability against rotavirus G9 type. The results of ELISPOT showed that lymphocytes from mice in each vaccine group were able to secrete IFN-γ when stimulated with VP8 peptide. Flow cytometry showed that the proportions of CD8 + T cell subsets in the vaccine groups were higher than that in the control group. Conclusion:The VP8-mRNA vaccine has good immunogenicity in mice and can induce good humoral and T-cell immune responses.
6.G protein-coupled estrogen receptor alleviates lung injury in mice with exertional heat stroke by inhibiting ferroptosis.
Ziwei HAN ; Jiansong GUO ; Xiaochen WANG ; Zhi DAI ; Chao LIU ; Feihu ZHOU
Chinese Critical Care Medicine 2025;37(3):268-274
OBJECTIVE:
To investigate whether the G protein-coupled estrogen receptor (GPER) can attenuates acute lung injury in mice with exertional heat stroke (EHS) by inhibiting ferroptosis.
METHODS:
Sixty SPF-grade male C57BL/6 mice were randomly divided into four groups: normal control group (control group), EHS model group (EHS group), dimethyl sulfoxide (DMSO) solvent group (EHS+DMSO group), and GPER-specific agonist G1 group (EHS+G1 group), with 15 mice in each group. All mice underwent 14 days of adaptive training at 24-26 centigrade before modeling, and the EHS model was established using a high-temperature treadmill device. After successful modeling, the mice were allowed to cool naturally at room temperature. In the EHS+G1 group, 40 μg/kg of the GPER-specific agonist G1 was slowly injected intraperitoneally immediately after modeling. In the EHS+DMSO group, 40 μg/kg of DMSO was slowly injected intraperitoneally immediately after modeling. The control group received no treatment. Five hours after modeling, abdominal aortic blood was collected, and lung tissues were harvested after euthanasia. The lung coefficient was calculated to evaluate lung injury. Lung histopathological changes were observed under a light microscope after hematoxylin-eosin (HE) staining, and a lung histopathological score was assigned. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), malondialdehyde (MDA), and Fe2+ in lung tissue. Immunofluorescence was used to detect the expression of glutathione peroxidase 4 (GPX4). Real-time polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of GPX4, ferroportin 1 (FPN1), and ferritin heavy chain 1 (FTH1). Western blotting was performed to detect the protein expression of GPX4, FPN1, and FTH1.
RESULTS:
Compared with the control group, the lung coefficient and lung histopathological score were significantly increased in the EHS group. HE staining showed significant thickening and unevenness of the alveolar septa and alveolar walls, partial alveolar collapse, and extensive erythrocyte, inflammatory cell, and plasma-like material extravasation in the alveolar spaces. Serum levels of TNF-α, IL-1β, MDA, and Fe2+ were significantly elevated. Immunofluorescence staining showed a significant decrease in GPX4-positive expression in lung tissue. Western blotting and RT-PCR showed significantly reduced protein and mRNA expression of GPX4, FPN1, and FTH1 in lung tissue. Compared with the EHS group, the EHS+G1 group showed a significant reduction in lung coefficient and lung histopathological score [lung coefficient (mg/g): 3.9±0.1 vs. 4.6±0.3, lung histopathological score: 4.2±0.2 vs. 6.9±0.2, both P < 0.05]. HE staining revealed reduced severity of lung tissue fluid extravasation, inflammatory infiltration, decreased hemorrhage, and less severe alveolar structural damage. Serum levels of TNF-α, IL-1β, MDA, and Fe2+ were significantly reduced [TNF-α (ng/L): 44.3±0.2 vs. 64.6±0.3, IL-1β (ng/L): 69.3±0.4 vs. 97.8±0.2, MDA (nmol/L): 2.8±0.3 vs. 3.6±0.5, Fe2+ (nmol/L): 0.021±0.004 vs. 0.028±0.004, all P < 0.05]. Immunofluorescence staining showed a significant decrease in GPX4-positive expression in lung tissue (fluorescence intensity: 35.53±2.41 vs. 16.45±0.31, P < 0.05). RT-PCR and Western blotting showed significantly increased mRNA and protein expression of GPX4, FPN1, and FTH1 in lung tissue [mRNA expression: GPX4 mRNA (2-ΔΔCt): 0.44±0.05 vs. 0.09±0.01, FPN1 mRNA (2-ΔΔCt): 0.77±0.17 vs. 0.42±0.14, FTH1 mRNA (2-ΔΔCt): 0.75±0.04 vs. 0.58±0.01; protein expression: GPX4/β-actin: 0.96±0.11 vs. 0.24±0.04, FPN1/β-actin: 1.26±0.21 vs. 0.44±0.14, FTH1/β-actin: 0.27±0.12 vs. 0.15±0.07; all P < 0.05]. However, there were no statistically significant differences in any of the above indicators between the EHS+DMSO group and the EHS group.
CONCLUSION
Activation of GPER can attenuate EHS-related lung injury in mice, and its mechanism may be related to the activation of the GPX4 signaling pathway and inhibition of ferroptosis.
Animals
;
Mice, Inbred C57BL
;
Male
;
Mice
;
Heat Stroke/metabolism*
;
Receptors, G-Protein-Coupled
;
Ferroptosis
;
Receptors, Estrogen
;
Acute Lung Injury/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Interleukin-1beta/metabolism*
;
Lung Injury
;
Lung/metabolism*
7.Preparation and immunogenicity evaluation of rotavirus VP8-mRNA vaccine
Qingmei LENG ; Xianqiong TANG ; Rong CHEN ; Xiaoqing HU ; Xiaopeng SONG ; Yan LI ; Jinmei LI ; Lida YAO ; Xiaochen LIN ; Jinyuan WU ; Maosheng SUN ; Hongjun LI ; Yan ZHOU
Chinese Journal of Microbiology and Immunology 2025;45(9):727-732
Objective:To construct a VP8-mRNA vaccine using human rotavirus spike protein VP8 domain as the immunogen and analyze its immunogenicity in mice.Methods:The VP8-mRNA sequence was designed, optimized, and synthesized. The VP8 gene of rotavirus G1P[8] type was used to construct the plasmid pUC57-VP8-Kan-SapⅠ, which was then sequenced. The plasmid confirmed by sequencing was subjected to large-scale amplification and extraction, followed by linearization, in vitro transcription, and capping. The purified capped products were encapsulated with lipid nanoparticles using a microfluidic control apparatus. The encapsulated VP8-mRNA vaccine was administered intramuscularly to mice at 10, 15, and 20 μg. Serum samples were collected for antibody detection by ELISA. Cellular immune responses were detected by flow cytometry and ELISPOT. Statistical analysis was performed using one-way or two-way analysis of variance and Tukey-Kramer test. Results:The encapsulated VP8-mRNA vaccine was rounded and spherical, with a particle size of about 100 nm, a polymer dispersion index of 0.088, and an encapsulation rate of 92.3%. Two doses of VP8-mRNA vaccine immunization could induce a good immune response in mice. The level of IgG antibody induced after immunization in the 15 μg group was comparable to that of the 20 μg group, and there was no statistical difference ( P>0.05), but the antibody levels in the two groups were significantly higher than that in the 10 μg group ( P<0.000 1). VP8-mRNA vaccine could induce neutralizing antibodies against rotavirus G1 and G9 types. The highest level of neutralizing antibodies against rotavirus type G1 was observed in the 15 μg group, which was significantly higher than that in the 10 μg group ( P<0.05). All immunization groups exhibited good neutralizing ability against rotavirus G9 type. The results of ELISPOT showed that lymphocytes from mice in each vaccine group were able to secrete IFN-γ when stimulated with VP8 peptide. Flow cytometry showed that the proportions of CD8 + T cell subsets in the vaccine groups were higher than that in the control group. Conclusion:The VP8-mRNA vaccine has good immunogenicity in mice and can induce good humoral and T-cell immune responses.
8.Correlation analysis of genetic and environmental factors with clinical characteristics of pediatric upper urinary tract calculi
Youquan ZHAO ; Xiaochuan WANG ; Boyu YANG ; Chen NING ; Houyu ZHOU ; Huimin ZHAO ; Xiaochen WANG ; Ruiyu YUE ; Shao ZHANG ; Manjiang SUN ; Jun LI
Chinese Journal of Urology 2025;46(10):728-733
Objective:To investigate the influence of genetic and environmental factors on the clinical characteristics of upper urinary tract calculi in pediatric patients.Methods:This study was a retrospective case series. The clinical data of 179 children under the age of 14 with upper urinary tract calculi treated at Beijing Friendship Hospital,Capital Medical University,from August 2014 to February 2023 were analyzed. There were 121 males(67.60%)and 58 females(32.40%),with a median age at onset of 2.10(1.14,5.17)years. Thirty-three cases(18.44%)had a family history of urinary stone disease. Stone characteristics was defined by CT,with a median stone burden(sum of the diameters of all stones)of 1.3(1.00,1.60)cm. Fifty-four(30.17%)children had staghorn calculi. Multiple stones were present in 92 cases(51.40%),and bilateral stones in 52 cases(29.05%),with hydronephrosis was present in 119 children(66.48%). The median follow-up time was 67 months,and 36 children(20.11%)experienced stone recurrence. Dietary habits and related information were collected by electronic questionnaire,including a total of 115 children(64.25%)with an unbalanced diet,101(56.42%)with insufficient water intake,and 32 children(17.88%)with a preference for a high-protein diet. Tap water was used as the source of drinking water by 128 patients(71.51%),and 107(59.78%)took dietary supplements. Whole-exome sequencing revealed that 55 children(30.73%)carried pathogenic mutations in stone-related genes. Binary logistic regression was used for univariate analysis of above risk factors. Variables with P < 0.1 in univariate analysis and without multicollinearity were included in multivariate logistic regression to further screen for independent risk factors. Results:Multivariate analysis confirmed that carrying stone-related pathogenic gene mutations( OR = 3.06,95% CI 1.25?7.45, P = 0.014)and insufficient water intake( OR = 3.28,95% CI 1.14?9.47, P = 0.028)were independent risk factors for higher stone burden. A high-protein diet( OR = 2.40,95% CI 1.03?5.63, P = 0.044),carrying stone-related pathogenic gene mutations( OR = 4.57,95% CI 2.21?9.46, P<0.01),and a family history of stones( OR = 3.18,95% CI 1.28 ~ 7.91, P = 0.013)were independent risk factors for staghorn calculi. Multiple stones were closely associated with a family history of stones( OR = 2.66,95% CI 1.15-6.17, P = 0.022)and carrying stone-related pathogenic gene mutations( OR = 3.22,95% CI 1.60-6.48, P = 0.001). Moreover,carrying stone-related pathogenic gene mutations( OR = 5.19,95% CI 2.52?13.82, P < 0.01)were an independent risk factor for stone recurrence,whereas dietary supplement intake was a protective factor( OR = 0.26,95% CI 0.11?0.62, P = 0.002). Conclusions:Genetic and environmental factors play significant roles in the occurrence and development of pediatric upper urinary tract stones. A high-protein diet as well as a positive family history of stones are independent risk factors for staghorn calculi,and insufficient water intake is a critical environmental factor for stone formation,while appropriate use of dietary supplements may help reduce the risk of stone recurrence. Genetic testing indicates that approximately 30% of children carry stone-related pathogenic gene mutations,and these patients prone to severe stone and an increased risk of recurrence.
9.Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection
Xiaochen WANG ; Hailei SUN ; Chaoyu ZHANG ; Zhengchun ZHOU ; Yu WEI ; Haiyang XUAN ; Guangcun CHENG ; Jianjun GE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(07):962-966
Objective To analyze the perioperative outcomes of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection. Methods The perioperative clinical data of patients receiving heart valve replacement in the Department of Cardiovascular Surgery, the First Affiliated Hospital of University of Science and Technology of China from November 2022 to February 2023 were retrospectively analyzed. According to whether the patients were infected with SARS-CoV-2, they were divided into a non-infected group and an asymptomatic group. The perioperative data of the patients were compared between the two groups, and the effect of asymptomatic infection on the result of heart valve replacement surgery was analyzed. Results A total of 66 patients were enrolled including 36 males and 30 females with a mean age of 58.0±11.1 years. There were 51 patients in the non-infected group and 15 patients in the asymtomatic group. There were 2 patients of mitral valve replacement, 20 patients of aortic valve replacement, 1 patient of double valve replacement, 3 patients of aortic valve replacement with tricuspid valvoplasty, 22 patients of mitral valve replacement and tricuspid valvoplasty, 18 patients of double valve replacement and tricuspid valvoplasty. Asymptomatic infected patients received more emergency surgery than uninfected patients (26.7% vs. 0.0%, P<0.01). There was no statistical difference in the duration of extracorporeal circulation, aortic occlusion, mechanical ventilation time after the surgery, ICU stay, postoperative drainage volume, or postoperative complications between the two groups. Conclusion Perioperative results of cardiac valve surgery in patients with asymptomatic SARS-CoV-2 infection and non-infection are almost the same.
10.Efficacy of allogeneic hematopoietic stem cell transplantation based on a total body irradiation conditioning treatment regimen for adult acute lymphocytic leukemia
Qianqian XIAO ; Xiaolin YU ; Xiaochen SONG ; Yixi HOU ; Lei DENG ; Wenjun LI ; Fang ZHOU
Chinese Journal of Hematology 2024;45(3):249-256
Objective:To analyze the efficacy of allo-HSCT with total body irradiation (TBI) and chemotherapy alone in the treatment of adult ALL and to explore the factors affecting prognosis.Methods:The clinical data of 95 adult patients with ALL who underwent allo-HSCT from January 2015 to August 2022 were included. According to the conditioning regimen, the patients were divided into two groups: the TBI plus cyclophosphamide (TBI/Cy) group ( n=53) and the busulfan plus cyclophosphamide (Bu/Cy) group ( n=42). Hematopoietic reconstitution after transplantation, GVHD, transplantation-related complications, relapse rate (RR), non-relapse mortality (NRM), OS, and LFS were compared, and the factors related to prognosis were analyzed. Results:The median time of neutrophil engraftment was 14 (10-25) days in the TBI/Cy group and 14 (10-24) days in the Bu/Cy group ( P=0.106). The median time of megakaryocyte engraftment was 17 (10-42) days in the TBI/Cy group and 19 (11-42) days in the Bu/Cy group ( P=0.488). The incidence of grade Ⅱ-Ⅳ acute GVHD (aGVHD) in the TBI/Cy and Bu/Cy groups was 41.5% and 35.7%, respectively ( P=0.565). The incidence of grade Ⅲ-Ⅳ aGVHD in these two groups was 24.5% and 4.8%, respectively ( P=0.009). The incidence of severe chronic GVHD in the two groups was 16.7% and 13.5%, respectively ( P=0.689). The incidence of cytomegalovirus infection, Epstein-Barr virus infection, severe infection, and hemorrhagic cystitis in the two groups was 41.5% and 35.7% ( P=0.565), 34.0% and 35.7% ( P=0.859), 43.4% and 33.3% ( P=0.318), and 20.8% and 50.0% ( P=0.003), respectively. The median follow-up time was 37.1 months and 53.3 months in the TBI/Cy and Bu/Cy groups, respectively. The 2-year cumulative RR was 17.0% in the TBI/Cy group and 42.9% in the Bu/Cy group ( P=0.017). The 2-year cumulative NRM was 24.5% and 7.1%, respectively ( P=0.120). The 2-year LFS was 58.5% and 50.0%, respectively ( P=0.466). The 2-year OS rate was 69.8% and 64.3%, respectively ( P=0.697). In the multivariate analysis, the conditioning regimen containing TBI was a protective factor for relapse after transplantation ( HR=0.304, 95% CI 0.135-0.688, P=0.004), whereas the effect on NRM was not significant ( HR=1.393, 95% CI 0.355-5.462, P=0.634). Infection was an independent risk factor for OS after allo-HSCT in adult patients with ALL. Conclusion:allo-HSCT based on TBI conditioning regimen had lower relapse rate and lower incidence of hemorrhagic cystitis for adult ALL, compared with chemotherapy regimen. While the incidence o grade Ⅲ/Ⅳ aGVHD was hgher in TBI conditioning regimen than that in chemotherapy regimen.

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