At the time of the reform and adjustment of discipline transformation,the Institute of Respiratory and Critical Care Medicine,the 8th Medical Center of Chinese PLA General Hospital,relies on Beijing Key Laboratory of Organ Transplantation and Immunology Regulatory,to build a multidisciplinary postgraduate joint training mode based on immunology.From the aspects of indi-vidualized postgraduate training background,teaching mode,ability training,etc.,the practice mode of joint training of postgraduates in multiple clinical disciplines is explored.In order to cultivate medical thinking talents with systematic and holistic theory,and pre-pare for future clinical work.

Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)in patients with rosacea erythema telangiectasia and analyze the characteristics of dermoscopy.Methods Thirty patients with erythema telangiectasia rosacea treated in our hospital from January 2021 to August 2023 were collected as the observation targets.All of them received oral drugs(doxycycline hydrochloride combined with hydroxychloroquine sulfate),and were randomized,double-blind,face-divided.The patients with rosacea were injected with botulinum toxin type A(treatment side)and normal saline(control side)respectively,and the skin physiological indexes(transepidermal water loss,oil content,cuticle water content,erythema index)of the patients before and after treatment were compared.The vascular changes before and after dermoscopic treatment were analyzed,and the incidence of adverse reactions of the patients were calculated.Results After treatment,compared with the control side,the water loss,erythema index and oil content in the epidermis of the treatment side were decreased,and the water content in the stratum corneum was increased after treatment,with statistical significance(P<0.05).There was no difference before and after treatment on the control side(P>0.05).On the treatment side,the therapeutic effect was the best at 4 weeks after treatment,and the effect lasted until the 8th week,with no statistical significance(P>0.05),and the therapeutic effect was weakened at 8 weeks to 12 weeks,with statistical significance(P<0.05).The results of dermoscopy showed that after 4 weeks of treatment,compared with before treatment,the distribution proportion of dark red background,red background and polygonal blood vessels decreased,while the distribution proportion of light red background,linear blood vessels,branched blood vessels and punctured blood vessels increased,with statistical significance(P<0.05).There were no significant differences in yellow and red background and blood vessel distribution(P>0.05).The incidence of adverse reactions was 6.67%in the control group and 10.00%in the treatment group,with no statistical difference between the two groups(P>0.05).Conclusion BTX-A has a significant improvement effect on the symptoms of erythematous telangiectatic rosacea with high safety.

The Spt-Ada-Gcn5-acetyltransferase (SAGA) is an ancillary transcription initiation complex which is highly conserved. The ADA1 (alteration/deficiency in activation 1, also called histone H2A functional interactor 1, HFI1) is a subunit in the core module of the SAGA protein complex. ADA1 plays an important role in plant growth and development as well as stress resistance. In this paper, we performed genome-wide identification of banana ADA1 gene family members based on banana genomic data, and analyzed the basic physicochemical properties, evolutionary relationships, selection pressure, promoter cis-acting elements, and its expression profiles under biotic and abiotic stresses. The results showed that there were 10, 6, and 7 family members in Musa acuminata, Musa balbisiana and Musa itinerans. The members were all unstable and hydrophilic proteins, and only contained the conservative SAGA-Tad1 domain. Both MaADA1 and MbADA1 have interactive relationship with Sgf11 (SAGA-associated factor 11) of core module in SAGA. Phylogenetic analysis revealed that banana ADA1 gene family members could be divided into 3 classes. The evolution of ADA1 gene family members was mostly influenced by purifying selection. There were large differences among the gene structure of banana ADA1 gene family members. ADA1 gene family members contained plenty of hormonal elements. MaADA1-1 may play a prominent role in the resistance of banana to cold stress, while MaADA1 may respond to the Panama disease of banana. In conclusion, this study suggested ADA1 gene family members are highly conserved in banana, and may respond to biotic and abiotic stress.
Musa/genetics* ; Phylogeny ; Fungal Proteins ; Cell Nucleus ; Histones ; Stress, Physiological/genetics*

Objective To compare the effects of visual rigid laryngoscope and visual laryngoscope in nasotracheal intubation(NTI)for patients with cervical spine immobilization simulated difficult airway.Methods Ninety patients scheduled for selective surgery under general anesthesia requiring NTI,52 males and 38 females,aged 18-64 years,BMI 18.5-25.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were scheduled for selective surgery under general anesthesia requiring NTI.Before anesthesia induction,the spinal surgeon selected an appropriate cervical collar and adjusted it to fix patient's neck to establishing difficult airway sim-ulation model.All patients were randomly assigned into two groups:visual rigid laryngoscope(group R)and common visual laryngoscope(group C),45 patients in each group.NTI was performed using either visual rigid laryngoscope or visual laryngoscope in groups R and C,respectively.The nasal passage time,glottic exposure time,intubation time,number of successful first intubation attempts,and intubation attempts were recorded.Glottic exposure was assessed using the Cormack-Lehane(C-L)grading system,and the intuba-tion condition was quantitatively evaluated using the modified nasal intubation difficulty scale(NIDS).The blood pressure and heart rate were measured at baseline(T1),immediately after intubation(T2),and at 1 minute(T3)and 3 minutes(T4)after intubation.The occurrence of intubation-related complications(nasal bleeding,sore throat,hoarseness)was recorded.Results Compared with group C,the nasal passage time and proportion of successful intubations without difficulty were significantly increased in group R,and the glottic exposure time and intubation time were significantly decreased in group R(P<0.05).Compared with group C,the HR and MAP at T2 and T3 were significantly decreased in group R(P<0.05).Com-pared with group C,group R had significantly lower incidence rates of nasal bleeding,sore throat,and hoarseness(P<0.05).There were no statistically significant differences in the first intubation success rate,number of intubation attempts,or C-L grade between the two groups.Conclusion Patients with cer-vical spine immobilization simulated difficult airway,both visual rigid laryngoscope and visual laryngoscope can be performed safely and effectively in NTI.Compared with visual laryngoscope,visual rigid laryngoscope can provide faster glottic exposure,shorter intubation time,lower intubation difficulty,less hemodynamic impact,and lower incidence of complications.

Objective:To investigate the genetic risk factors and prognosis of 190 patients with myelodysplastic syndrome(MDS). Methods:The clinical data of 190 patients with MDS admitted to the Department of Hematology,The First Affiliated Hospital of Chongqing Medical University from January 2015 to October 2020 were analyzed retrospectively,and the genetic background and survival curve of the patients were also analyzed. Results:MDS patients with higher risk according to International Prognostic Score System(IPSS)stratification at the time of initial diagnosis had more frequent and complex types of gene mutation and chromosomal abnormalities,indicating poor prognosis.The choice of treatment is associated with the prognosis of MDS patients with intermediate risk(IPSS stratification),and the relative risk of the overall survival rate of patients treated with hypomethylating agents is higher than that of patients on concomitant medication. Conclusion:MDS patients with higher-risk(IPSS stratification)have more complex genetic risk factors and lower survival rate than those with lower-risk(IPSS stratification).MDS patients with multiple genetic risk factors have a poor prognosis,and the type of gene mutation is a predictor of prognosis.

Corona virus disease 2019 （COVID-19） has led to more than 500 million cases， including 6.19 million deaths. Mutated strains of SARS-CoV-2 （alpha， beta， gamma， delta and omicron） have successively emerged. Currently the omicron variant is gradually replacing the delta variant， driving a surge of cases in most countries including China， posing a great challenge to the prevention and treatment of COVID-19. In the face of the severe pandemic situation， a large number of non-medical volunteers are fighting on the front lines of the war against the pandemic and are vulnerable to exposure due to lack of professional knowledge. This paper introduces the routine skills training of volunteers and emergency response， aiming to provide behavioral guidance for non-medical volunteers in designated isolation facilities.

Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease-Free Survival ; Etoposide ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma/therapy* ; Neoplasm Recurrence, Local ; Retrospective Studies ; Transplantation, Autologous

Objective To investigate the value of mean platelet volume(MPV)combined with red blood cell distribution width(RDW)in prognosis of severe acute pancreatitis(SAP). Methods 65 SAP patients from January 1,2013 to December 31,2016 were included in the study and were divided into pospital death group(n=7) and survival group(n = 58). The basic clinical data of two groups were compared,the risk factors for hospital death and the prognostic value of MPV and RDW were analyzed. Results Compared with the survival group,the APACHEⅡ score,RDW,PLT,MPV,PDW were statistically different(P < 0.05). Logistic regression analysis was used to show APACHEⅡ score(OR = 1.793,95% CI: 1.212 ~ 2.654),PLT(OR = 0.982,95% CI: 0.967 ~0.997),MPV(OR=2.964,95% CI: 1.341~6.549),PDW(OR=1.470,95% CI: 1.019~2.122),RDW(OR=3.274,95% CI: 1.271 ~ 8.429)(P < 0.05). ROC curve analysis showed that the area under the curve of APA-CHEII score was 0.861(95% CI: 0.743 ~ 0.979,P = 0.001),MPV was 0.828(95% CI: 0.689 ~ 0.967,P =0.003,RDW was 0.849(95% CI: 0.749 ~ 0.949,P = 0.001),MPV+RDW was 0.914(95% CI: 0.832 ~ 0.997, P = 0.000). Conclusion The APACHEⅡ score,PLT,MPV,PDW,RDW are all the independent risk factors for hospital death with SAP. MPV combined with RDW has an important reference value for the prognosis of SAP patients.

Objective To retrospectively analyze the influence factors during autologous peripheral blood stem cell (PBSC) mobilization and collection process in the patients with non-Hodgkin′s lymphoma (NHL).Methods Forty-eight patients with NHL in our hospital from January 2014 to August 2016 underwent PBPC mobilization and collection.The factors of age,sex,disease stage,bone marrow involvement at diagnosis,chemotherapy frequency,relapse and so on were analyzed retrospectively.Results PBSC mobilization and collection was successful in 37 cases (77.10%).The success rate was affected by the time from diagnosis to mobilization (P=0.038),chemotherapy courses (P=0.016),prior chemotherapy including fludarabine (P=0.049),relapse(P=0.033),and the levels of white blood cell (P=0.014) and platelet (P<0.01) before stem cells collection.Conclusion For the patients planning to receive autologous peripheral blood stem cell transplantation,many times of prior chemotherapy are unfavorable,mobilization and collection should be taken as early as possible,chemotherapeutic agents which possibly injure stem cells should be avoided,it is needed to simultaneously pay attention to peripheral blood WBC and platelet level for determining the collection timing.

Objective To investigate the prognostic value of prognostic nutritional index (PNI) in patients with non-small cell lung cancer.Methods A total of 179 patients with non small cell lung cancer was enrolled in our hospital from November 2010 to January 2014.All patients were pathologically confirmed to be non small cell lung cancer.The clinical data of patients were collected,and the PNI values of each patient were calculated.The patients were divided into 4 groups according to the patients in the PNI of the patients in the treatment group (PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group).The survival curve was drawn by Kaplan-Meier method,and the difference of progression free survival (DFS) and overall survival (OS) of each group was compared by Log-rank method.Results (1) compared with PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group,there was signifi cant difference in age,smoking and KPS score (P ＜ 0.05).(2) the PNIQ0-25 group had a median overall survival of 11.5 months (95％ CI:6.6 ～ 15.4),the 3 year survival rate was 6.7％;PNIQ25-50 group had a median overall survival of 12.2 months (95％ CI:9.1 ～ 18),the 3 year survival rate was 6.4％ in PNIQ50-75 group;the median overall survival was 14.1 the month of (95％ CI:8.7 ～ 13.3),the 3 year survival rate was 11.4％,the PNIQ75-100 group had a median overall survival of 15 months (95％ CI:12.3 ～ 17.8),the 3 year survival rate was 11.6％.The Log-rank test,the four groups of patients with a significant difference in overall survival (x2 =15.6,P =0.001).(3) the PNIQ0-25 group had a median progres sion free survival was 5 months for (95％ CI:4.3 ～5.6),the 3 year progression free survival rate was 4.4％;PNIQ25-50 group had a median progression free survival was 6.4 months for (95％ CI:4.7 ～8.1),the 3 year progression free survival rate was 4.3％ in the PNIQ50-75 group;the median progression free survival was 7.4 months (95％ CI:6 ～ 8.7),the 3 year progression free survival rate was 9.1％ in PNIQ75-100 group,the median progression free survival was 8.9 months for (95％ CI:6.4 ～ 10.8),the 3 year progression free survival rate was 9.3％ by Log-rank test,survival was statistically significant was no difference between the four groups (x2 =26.7,P =0.000).Conclusions PNI has a good application value in the prognosis of patients with non-small cell lung cancer.