Objective To investigate the clinical characteristics and prognostic risk factors in elderly patients with acute myeloid leukemia(AML).Methods A retrospective analysis was conducted on the clinical data of 101 elderly AML patients admitted to Affiliated Hospital of Jiaxing University from January 2022 to December 2024.All patients were treated with azacitidine+venetoclax regimen.The clinical characteristics of patients and the risk factors related to prognosis were explored.Results The median follow-up was 14 months.Among the 101 patients,74 achieved complete remission or complete remission with incomplete hematological recovery.The median overall survival(OS)of patients with aged ≥70 years,white blood cell count＞50 × 109/L,TP53 mutation,complex chromosomes,and high-risk European leukemia net(ELN)risk stratification was significantly shortened(P＜0.05).Multivariate analysis showed that age(HR=0.125,95％CI:0.023-0.662,P=0.015),white blood cell count(HR=0.145,95％CI:0.032-0.662,P=0.013),and ELN risk stratification(HR=100.397,95％CI:14.395-700.207,P＜0.001)were all independent influencing factors for OS in elderly AML patients.Conclusion Age,white blood cell count and ELN risk stratification are all independent influencing factors affecting OS in elderly AML patients.

Objective:To investigate the association between serum 25-hydroxy vitamin D [25-(OH)D] levels at 1 and 4 weeks after birth and bronchopulmonary dysplasia (BPD) in preterm infants.Methods:This case-control study included 125 preterm infants (gestational age<32 weeks) admitted to the Department of Neonatology, Hangzhou Women's Hospital between January 2020 and December 2022. All infants received vitamin D supplementation (900 IU/d) starting at 1 week after birth. According to the clinical diagnosis at 28 d after birth, these participants were divided into BPD ( n=57) and non-BPD ( n=68) groups. Two independent sample t-test, Wilcoxon rank-sum test, and Chi-square test were used to compare the general conditions, maternal perinatal conditions, postnatal treatment, complications, and 25-(OH)D levels between the two groups. Pearson bivariate correlation and partial correlation analyses were performed to assess the relationship between 25-(OH)D levels and BPD. Results:The BPD group had lower gestational age [(28.7±1.8) vs. (30.2±0.9) weeks, t=－6.13], birth weight [(1 166.1±238.1) vs. (1 473.8±224.4) g, t=－7.42], and Apgar scores at 1 min [(7.6±2.1) vs. (9.1±1.3) scores, t=－4.58) and 5 min [(8.9±1.2) vs. (9.5±1.1) scores, t=－2.77) compared to the non-BPD group (all P<0.05). The proportion of infants received surfactant therapy [73.7% (42/57) vs. 50.0% (34/68), χ2=7.30], the incidence of maternal preeclampsia [29.8% (17/57) vs. 14.7% (10/68), χ2=4.19], and the incidence of neonatal asphyxia [31.6% (18/57) vs. 16.2% (11/68), χ2=4.13], pneumonia [14.0% (8/57) vs. 1.5% (1/68), χ2=5.57], sepsis [64.9% (37/57) vs. 19.1% (13/68), χ2=27.10], and patent ductus arteriosus [78.9% (45/57) vs. 48.5% (33/68), χ2=12.23] were higher in the BPD group than in the non-BPD group (all P<0.05). The infants with BPD required longer durations of caffeine therapy [(37.2±15.1) vs. (16.8±11.5) d, t=8.58], mechanical ventilation [0.0 (0.0-3.0) vs. 0.0 (0.0-0.0) d, Z=3.52], non-invasive ventilation [23.0 (11.0-31.0) vs. 6.0 (4.0-9.0) d, Z=6.22], total oxygen therapy [46.0 (40.0-58.0) vs. 13.0 (6.0-19.0) d, Z=6.57], and hospitalization [(60.7±15.0) vs. (37.6±7.8) d, t=10.52] than those without BPD (all P<0.05). Serum 25-(OH)D levels were significantly lower in the BPD group than in the non-BPD group at both 1 week [(32.75±7.81) vs. (43.07±9.36) nmol/L, t=－4.60, P<0.001] and 4 weeks [(49.03±11.12) vs. (60.02±14.39) nmol/L, t=－3.90, P<0.001] after birth. Vitamin D deficiency at 1 week after birth was more prevalent in the BPD group than in the non-BPD group [40.0% (10/25) vs. 12.5% (5/40), χ2=6.55, P=0.010]. Serum 25-(OH)D levels at 1 and 4 weeks after birth were negatively correlated with BPD incidence (bivariate analysis: r=－0.50 and－0.40; partial correlation analysis corrected with birth gestational age, birth weight and other general information, the proportion of preeclampsia/cesarean section and other perinatal information of pregnant women, sepsis/mechanical ventilation time and other postnatal diseases and treatment conditions: r=－0.37 and－0.27; both P<0.05). Conclusion:Low serum 25-(OH)D levels at 1 and 4 weeks after birth may be associated with BPD in preterm infants.

Objective:To analyze the relationship between the expression level of calumenin(CALU)and the prognosis of hepatocellular carcinoma(HCC)patients by bioinformatics tools and establish the prognostic prediction nomogram,and to clarify its possible mechanism.Methods:The data of 374 HCC tissue samples were downloaded from The Cancer Genome Atlas(TCGA)database and the data of 160 normal tissue samples were down loaded from Genotype-Tissue Expression(GTEx)database.Paired sample t-test was used to analyze the difference in CALU expression between the HCC tissue samples and the paired adjacent normal tissue samples.Human Protein Atlas(HPA)database was used to verify the results.DESeq2 package was used to screen the differentially expressed genes(DEGs)between CALU low expression group and CALU high expression group in the HCC tissue samples.R package pROC was used to analyze the receiver operating characteristic(ROC)curve.Univariate and multivariate Cox regression analyses were used to confirm the prognosis value of CALU in the HCC patients with different clinicopathological characteristics,and ggplot2 package was used to construct the forest plot.R packages rms and survival were used to construct the nomogram and its calibration curve,and the diagnostic value of CALU in distinguishing HCC tissue from normal tissue was analyzed.The data from Kaplan-Meier Plotter database were used to further verify the relationship between CALU and the prognosis of HCC patients.The gene transcriptional expression data of 216 HCC samples obtained from GSE14520 dataset were used to verify the prediction accuracy of the nomogram.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were used to determine the function and enrichment pathways of the DEGs,and Gene Set Enrichment Analysis(GSEA)was used to obtain the significantly enriched gene sets of the DEGs.Single-cell sequencing data of 10 HCC tissue samples and 8 adjacent normal tissue samples obtained from GSE149614 dataset were used to verify the relationship between CALU and the prognosis of HCC patients and its mechanism.Results:Compared with normal tissue,the expression level of CALU mRNA in HCC tissue was significantly increased(P＜0.001),and the expression level of CALU protein in HCC samples was also increased.A total of 928 DEGs were identified between CALU low expression group and CALU high expression group in the HCC samples,including 784 upregulated DEGs and 144 downregulated DEGs.The ROC analysis results indicated that CALU showed high diagnostic value in distinguishing cancer tissue from adjacent non-cancer tissue with an area under curve(AUC)of 0.839.Kaplan-Meier survival analysis showed that the survival rate of HCC patients in CALU high expression group was significantly lower than that in CALU group low expression(P＜0.001).Univariate and multivariate Cox regression analyses results demonstrated that high expression of CALU was an independent risk factor of the prognosis in HCC patients,and a prognosis prediction nomogram was constructed.The applicability of nomogram on the prognosis of HCC was verified by GSE14520 dataset.The GO enrichment analysis results showed that DEGs were mainly enriched in pathways related to the oxidative stress,ferroptosis and cuproptosis(P＜0.05).The KEGG enrichment analysis results showed that DEGs were mainly enriched in the pathways related to extracellular matrix(ECM)receptor interaction,linoleic acid metabolism and neuroactive ligand receptor interaction(P＜0.05).The GSEA results showed that high expression of CALU may promote the G1-S phase transition of the cell cycle,ubiquitination protein polymerization and HCC progression,while low expression of CALU may activate oxidative stress,ferroptosis and cuproptosis in HCC cells.Single-cell sequencing analysis results showed that the expression level of CALU mRNA was significantly increased in HCC cells with advanced tumor stages.HCC_CALU_High cell subset was mainly related to ubiquitination,p53 and cell cycle(P＜0.01),and HCC_CALU_Low cell subset was mainly related to oxidative stress,ferroptosis,and histone binding(P＜0.01).Conclusion:The high expression of CALU may be related to the poor prognosis of HCC patients.The constructed nomogram of HCC prognosis shows favourable effect in predicting the survival rate of the HCC patients.The up-regulation of CALU may promote HCC progression by regulating the G1-S phase of the cell cycle and ubiquitination of protein,while down-regulation of CALU may inhibit HCC progression by inducing oxidative stress,ferroptosis and cuproptosis in cells.

Objective To investigate the clinical characteristics and prognostic risk factors in elderly patients with acute myeloid leukemia(AML).Methods A retrospective analysis was conducted on the clinical data of 101 elderly AML patients admitted to Affiliated Hospital of Jiaxing University from January 2022 to December 2024.All patients were treated with azacitidine+venetoclax regimen.The clinical characteristics of patients and the risk factors related to prognosis were explored.Results The median follow-up was 14 months.Among the 101 patients,74 achieved complete remission or complete remission with incomplete hematological recovery.The median overall survival(OS)of patients with aged ≥70 years,white blood cell count＞50 × 109/L,TP53 mutation,complex chromosomes,and high-risk European leukemia net(ELN)risk stratification was significantly shortened(P＜0.05).Multivariate analysis showed that age(HR=0.125,95％CI:0.023-0.662,P=0.015),white blood cell count(HR=0.145,95％CI:0.032-0.662,P=0.013),and ELN risk stratification(HR=100.397,95％CI:14.395-700.207,P＜0.001)were all independent influencing factors for OS in elderly AML patients.Conclusion Age,white blood cell count and ELN risk stratification are all independent influencing factors affecting OS in elderly AML patients.

Objective:To investigate the association between serum 25-hydroxy vitamin D [25-(OH)D] levels at 1 and 4 weeks after birth and bronchopulmonary dysplasia (BPD) in preterm infants.Methods:This case-control study included 125 preterm infants (gestational age<32 weeks) admitted to the Department of Neonatology, Hangzhou Women's Hospital between January 2020 and December 2022. All infants received vitamin D supplementation (900 IU/d) starting at 1 week after birth. According to the clinical diagnosis at 28 d after birth, these participants were divided into BPD ( n=57) and non-BPD ( n=68) groups. Two independent sample t-test, Wilcoxon rank-sum test, and Chi-square test were used to compare the general conditions, maternal perinatal conditions, postnatal treatment, complications, and 25-(OH)D levels between the two groups. Pearson bivariate correlation and partial correlation analyses were performed to assess the relationship between 25-(OH)D levels and BPD. Results:The BPD group had lower gestational age [(28.7±1.8) vs. (30.2±0.9) weeks, t=－6.13], birth weight [(1 166.1±238.1) vs. (1 473.8±224.4) g, t=－7.42], and Apgar scores at 1 min [(7.6±2.1) vs. (9.1±1.3) scores, t=－4.58) and 5 min [(8.9±1.2) vs. (9.5±1.1) scores, t=－2.77) compared to the non-BPD group (all P<0.05). The proportion of infants received surfactant therapy [73.7% (42/57) vs. 50.0% (34/68), χ2=7.30], the incidence of maternal preeclampsia [29.8% (17/57) vs. 14.7% (10/68), χ2=4.19], and the incidence of neonatal asphyxia [31.6% (18/57) vs. 16.2% (11/68), χ2=4.13], pneumonia [14.0% (8/57) vs. 1.5% (1/68), χ2=5.57], sepsis [64.9% (37/57) vs. 19.1% (13/68), χ2=27.10], and patent ductus arteriosus [78.9% (45/57) vs. 48.5% (33/68), χ2=12.23] were higher in the BPD group than in the non-BPD group (all P<0.05). The infants with BPD required longer durations of caffeine therapy [(37.2±15.1) vs. (16.8±11.5) d, t=8.58], mechanical ventilation [0.0 (0.0-3.0) vs. 0.0 (0.0-0.0) d, Z=3.52], non-invasive ventilation [23.0 (11.0-31.0) vs. 6.0 (4.0-9.0) d, Z=6.22], total oxygen therapy [46.0 (40.0-58.0) vs. 13.0 (6.0-19.0) d, Z=6.57], and hospitalization [(60.7±15.0) vs. (37.6±7.8) d, t=10.52] than those without BPD (all P<0.05). Serum 25-(OH)D levels were significantly lower in the BPD group than in the non-BPD group at both 1 week [(32.75±7.81) vs. (43.07±9.36) nmol/L, t=－4.60, P<0.001] and 4 weeks [(49.03±11.12) vs. (60.02±14.39) nmol/L, t=－3.90, P<0.001] after birth. Vitamin D deficiency at 1 week after birth was more prevalent in the BPD group than in the non-BPD group [40.0% (10/25) vs. 12.5% (5/40), χ2=6.55, P=0.010]. Serum 25-(OH)D levels at 1 and 4 weeks after birth were negatively correlated with BPD incidence (bivariate analysis: r=－0.50 and－0.40; partial correlation analysis corrected with birth gestational age, birth weight and other general information, the proportion of preeclampsia/cesarean section and other perinatal information of pregnant women, sepsis/mechanical ventilation time and other postnatal diseases and treatment conditions: r=－0.37 and－0.27; both P<0.05). Conclusion:Low serum 25-(OH)D levels at 1 and 4 weeks after birth may be associated with BPD in preterm infants.

Objective To explore the application effect of multi-component home-based exercise in elderly patients with osteoporosis and frailty.Methods A total of 52 elderly patients with osteoporosis and frailty were recruited from the osteoporosis clinic of a tertiary hospital in Nanjing,Jiangsu Province from March to August 2022 using the convenience sampling method.Subjects were randomly divided into an experimental group and a control group with 26 cases in each group by the random number table.The experimental group was given the home-based exercise program,while the control group maintained the daily lifestyle.Short Physical Performance Battery(SPPB),grip strength,Frail Scale and Chinese Osteoporosis-targeted Quality of Life Questionnaire(COQOL)of the 2 groups were compared at 12 weeks and 24 weeks,and bone mineral density(BMD)was analyzed after 24-week intervention.Results The scores in the experimental group had significant statistical differences in SPPB,grip strength,Frail Scale and COQOL compared with those in the control group after 12-week and 24-week intervention(P＜0.05).The BMD of total hip of the experimental group was significantly higher than it in the control group(P＜0.05).Conclusion The home-based exercise program can help the elderly with osteoporosis and frailty to improve the physical function and upper body strength,improve the frailty state,and enhance the quality of life,and it may be one of the effective intervention methods to prevent and reverse the frailty state of osteoporosis patients.

Objective:To search and summarize the best evidence for preoperative prehabilitation in patients with lung cancer complicated by chronic obstructive pulmonary disease and to inform the management of preoperative prehabilitation in patients with lung cancer combined with COPD by clinical providers.Methods:Systematically guideline websites, professional society websites, evidence-based databases, and comprehensive databases were searched for types of literature including clinical decision making, guidelines, expert consensus, evidence summaries, systematic evaluations, Meta-analyses, and randomized controlled trials. The time for the retrieval was from the inception of databases until October 31th, 2023. And the quality of the included literature was evaluated and evidence was extracted, evaluated the quality of the included literature, and extracted evidence.Results:Finally, 18 articles were included, including 8 guidelines, 8 expert consensus, and 2 systematic reviews. Summarized the 30 best evidence in 4 areas of prerehabilitation: need, timing, location, content (including smoking cessation management, respiratory exercise, exercise, nutritional support, and medication management).Conclusions:This study summarizes the best evidence for preoperative prehabilitation in patients with lung cancer combined with chronic obstructive pulmonary disease, and healthcare professionals should be mindful of the need to develop preoperative prehabilitation protocols judiciously, taking into account the specific clinical context during the subsequent translation of the evidence to the clinic.

Objective:To screen the interacting protein of ubiquitin-conjugating enzyme E2S(UBE2S)and construct the hepatocellular carcinoma(HCC)based on UBE2S interacting protein prognosis model(UIPM),and to discuss the value of UIPM in assessing the prognosis of the HCC patients.Methods:Co-immunoprecipitation(Co-IP)was used to screen the protein complexes binding to Flag-UBE2S.After validation by sodium dodecyl sulphate-polyacrylamide gel electrophoresis(SDS-PAGE)and Western blotting methods;liquid chromatography-mass spectrometer(LC-MS)was used to identify the UBE2S interacting proteins;Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were conducted on these proteins;the prognosis-related proteins from The Cancer Genome Atlas(TCGA)were cross-referenced with UBE2S interacting proteins by survival package of R software;the key proteins were extracted through LASSO regression analysis to build the UIPM;the prognostic model risk scoring formula was established.The HCC patients in TCGA were divided into high risk group and low risk group based on median value of the risk scores.The predictive accuracy of UIPM was evaluated by receiver operating characteristic curve(ROC),and the predictive accuracy was further validated by International Cancer Genome Consortium(ICGC)Database;univariate regression analysis and multivariate Cox regression analysis were used to detect whether the UIPM risk score was an independent prognostic factor for HCC.Furthermore,the nomogram model was built.Results:A total of 97 UBE2S interacting proteins were identified through Co-IP combined with LC-MS analysis.The GO functional enrichment analysis and KEGG signaling pathway enrichment analysis results showed that the interacting proteins were closely associated with cysteine-type endopeptidase activity,oxidative stress,and cell death.The TCGA revealed 5 163 HCC prognosis-related proteins;after intersecting with UBE2S interacting proteins,40 prognosis-related interacting proteins were found.Seven key proteins were determined through LASSO regression analysis,including UBE2S,heat shock protein family A member 8(HSPA8),heterogeneous nuclear ribonucleoprotein H1(HNRNPH1),chaperonin containing TCP1 subunit 3(CCT3),eukaryotic translation initiation factor 2 subunit 1(EIF2S1),receptor for activated C kinase 1(RACK1),and actin related protein 2/3 complex subunit 4(ARPC4),and the UIPM was constructed.There was significant difference in survival rate of the patients between high risk group and low risk group(P<0.05).The ROC curve analysis results showed the area under ROC curve(AUC)values of UIPM for predicting 1-year,2-year,and 3-year survival risk scores of the HCC patients were all greater than 0.7,indicating the model had high predictive accuracy.This was also confirmed by ICGC Database data.The univariate and multivariate Cox regression analysis results showed that the UIPM risk score was an independent prognostic risk factor for the HCC patients(P<0.05).The nomogram results showed good consistency between predicted survival rate and actual survival rate of the patient.Conclusion:A total of 97 interacting proteins that interact with UBE2S may promote the occurence and devolopment of HCC through oxidative stress and dysregulation of ferroptosis pathways.The UIPM risk score is an independent risk factor for the prognosis of HCC and can be used to predict the outcomes of the patients.UBE2S,HSPA8,HNRNPH1,CCT3,EIF2S1,RACK1,and ARPC4 could be regarded as the new biomarkers and therapeutic targets for HCC.

Abstract: To investigate the main occupational hazards of sand casting process enterprises, so as to provide insights into occupational disease prevention and control. Methods: In 2021 and 2022, six typical ferrous metal casting enterprises using sand casting technology in Wenling City, Zhejiang Province were selected to investigate the production processes and equipment, the operation of occupational disease prevention facilities and personal protective equipment. Occupational hazards including silica dust, noise, high temperature and ultraviolet radiation were detected and analyzed. Results: Six sand casting enterprises had not effectively set up and use occupational disease prevention equipment, and some employees had not worn personal protective equipment as required. The participation rate of occupational health examination was 100.00%. Among the 54 silica dust sampling points at the sand mixing, molding, sand falling, shot blasting and mud core drilling positions, the overall dust concentration exceeding the standard rate was 100.00%, and the respiratory dust exceeding the standard rate was 44.44%. Among the 55 noise measurement points at the sand mixing, sand falling, shot blasting, mud core drilling, polishing and blowing positions, 51 exceeded the standard, with a rate of 92.73%. Among the 90 sampling points for melting, painting, polishing, blowing and welding positions, the concentrations of welding fumes, manganese and its compounds, ethyl acetate and other cahmical factors did not exceed the standard. Six ultraviolet radiation measurement points in the welding position and six heat stress measurement points in the melting position did not exceed the standard. Conclusion The main occupational hazards of sand casting process enterprises in Wenling City are silica dust and noise, and occupational disease prevention and control should be further strengthened.

Objective:To investigate the clinical and immunological characteristics of anti-synthetase syndrome(ASS)patients overlap with rheumatoid arthritis(RA).Methods:A retrospective analysis was conducted on ASS patients with arthritis who were treated at Peking University People's Hospital.Data collected included demographic information,clinical manifestations,laboratory features,lymphocyte subsets in peripheral blood,and treatments.The patients with ASS were divided into two groups based on the presence or absence of RA for comparative analysis.Results:A total of 104 ASS patients with arthri-tis were included,among whom 23.1％(24/104)were diagnosed with RA.The ASS with RA group had a significantly higher incidence of rapidly progressive interstitial lung disease(RP-ILD)(41.7％vs.17.6％,P=0.032),number of tender joints[10(7,14)vs.4(0,8),P＜0.001],number of swollen joints[4(2,8)vs.2(0,4),P=0.012],and rate of bone erosion(47.8％vs.2.5％,P＜0.001)compared with the non-RA group.Levels of platelets[(289.57±68.74)× 103/μL vs.(247.94±77.04)×103/μL,P=0.022],erythrocyte sedimentation rate(ESR)[43(19,59)mm/h vs.18(10,44)mm/h,P=0.019],and C-reactive protein(CRP)[19.20(4.80,55.36)mg/L vs.5.68(1.10,14.96)mg/L,P=0.006]were found significantly higher in the ASS with RA group than those in non-RA group.Analysis of immune cells in peripheral blood mononuclear cell(PBMC)showed that sig-nificantly decreased proportions of CLA+Treg cells[(11.12±4.10)％vs.(17.22±8.49)％,P=0.003],B cells[8.56％(4.80％,11.90％)vs.14.55％(8.75％,20.29％),P=0.025],and nat-ural killer(NK)cells[7.56％(4.65％,13.20％)vs.13.25％(7.46％,19.25％),P=0.045]in the overlap group compared with non-RA group.Proportion of Na?ve Th cells[(52.66±17.66)％vs.(40.76±14.96)％,P=0.033)]was significantly increased in overlap group compared with non-RA group.Overlap group had lower rate of complete clinical response than non-RA group(16.7％vs.43.8％,P=0.031).Conclusion:Among ASS patients with arthritis,those with RA have more severe lung and joint involvement and a lower treatment response rate,highlighting the need for early recognition and aggressive intervention.