Objective:To investigate the efficacy and safety of the combination therapy of venetoclax (VEN) and azacitidine (AZA) in treatment of newly diagnosed elderly patients with acute myeloid leukemia (AML).Methods:A retrospective cohort study was conducted. The clinical data of 17 newly diagnosed elderly AML patients who received VEN+AZA regimen at the First Hospital of Putian City from April 2021 to June 2023 were collected. Treatment outcomes and adverse events were analyzed. Survival curves were plotted by using the Kaplan-Meier method, and intergroup comparisons were performed by using the log-rank test.Results:Among the 17 patients, the median age [ M ( Q1, Q3)] was 70 (68, 74) years, with 11 males (64.7%) and 6 females (35.3%). The median number of treatment courses was 4.0 (2.5, 8.5). After the first course, the composite complete remission (cCR) rate was 41.2% (7/17), minimal residual disease (MRD) negativity rate was 5.9% (1/17), and overall response rate (ORR) was 82.4% (14/17). By the end of follow-up in September 2023, the cCR rate reached 64.7% (11/17), MRD negativity rate was 52.9% (9/17), and ORR was 88.2% (15/17). The median number of courses to achieve cCR was 1.0 (1.0, 2.0), and to achieve MRD negativity was 3.0 (2.0, 3.5). The follow-up rate was 88.2% (15/17), and the median follow-up time was 17.3 months (95% CI: 7.0-27.6 months). The median progression-free survival (PFS) time was 6.5 months (95% CI: 1.7-11.3 months), and median overall survival (OS) time was 12.0 months (95% CI: 0.3-23.7 months). The median OS time after progression was 1.5 months (95% CI: 1.0-2.0 months). All patients experienced hematological adverse events, with 94.1% (16/17) experiencing grade ≥ 3 hematological adverse events. The most common non-hematological adverse event was infection (88.2%, 15/17), with the lung being the most frequent site of infection (82.4%, 14/17), while 41.2% (7/17) of patients had pre-existing infections before treatment. Conclusions:The VEN+AZA regimen demonstrates high remission rates and significant efficacies in treating newly diagnosed elderly AML patients. Although adverse events occur in nearly all patients, most are able to tolerate the treatment.

Objective:To investigate the current status and correlation between perceived stress and coping strategies among nurses in the Cardiac Intensive Care Unit (CICU) .Methods:A purposive sampling method was used to select 348 CICU nurses from ten tertiary hospitals in Beijing between March and October 2023. Data were collected using a general information questionnaire, the Chinese version of the Perceived Stress Scale (PSS), and the Simplified Coping Style Questionnaire (SCSQ) .Results:The score of the Chinese PSS among 348 nurses was (28.86±5.06). In the SCSQ, the score for positive coping was (22.71±7.57), while the score for negative coping was (8.57±4.82). Correlation analysis indicated that perceived stress was negatively correlated with positive coping strategies ( P<0.01) and positively correlated with negative coping strategies ( P<0.01). Multiple linear regression analysis showed that years of experience in the CICU, employment status, family support for work, and coping strategies were influencing factors of perceived stress ( P<0.05), explaining 50.2% of the total variance. Conclusions:CICU nurses generally experience high levels of perceived stress, and those who tend to adopt negative coping strategies report even higher stress levels. Nursing administrators should develop targeted interventions based on nurse characteristics to promote effective coping strategies and alleviate perceived stress.

Objective:To investigate the current status and correlation between perceived stress and coping strategies among nurses in the Cardiac Intensive Care Unit (CICU) .Methods:A purposive sampling method was used to select 348 CICU nurses from ten tertiary hospitals in Beijing between March and October 2023. Data were collected using a general information questionnaire, the Chinese version of the Perceived Stress Scale (PSS), and the Simplified Coping Style Questionnaire (SCSQ) .Results:The score of the Chinese PSS among 348 nurses was (28.86±5.06). In the SCSQ, the score for positive coping was (22.71±7.57), while the score for negative coping was (8.57±4.82). Correlation analysis indicated that perceived stress was negatively correlated with positive coping strategies ( P<0.01) and positively correlated with negative coping strategies ( P<0.01). Multiple linear regression analysis showed that years of experience in the CICU, employment status, family support for work, and coping strategies were influencing factors of perceived stress ( P<0.05), explaining 50.2% of the total variance. Conclusions:CICU nurses generally experience high levels of perceived stress, and those who tend to adopt negative coping strategies report even higher stress levels. Nursing administrators should develop targeted interventions based on nurse characteristics to promote effective coping strategies and alleviate perceived stress.

Pure white cell aplasia (PWCA) is a rare hematologic disorder. In this case study, a 67-year-old man presented with severe neutropenia along with thymoma and lung cancer. A comprehensive diagnostic approach was done which included routine blood test, bone marrow cytology, bone marrow pathology, flow cytometry, and thymic pathology. Other potential causes, such as pure red blood cell aplasia and myelodysplastic syndrome, were ruled out. The final diagnosis was determined to be thymoma-related PWCA. Continuous treatment with human granulocyte colony-stimulating factor (G-CSF) was ineffective for treating PWCA in this patient. The patient's white blood cell and neutrophil count increased following treatment with cyclosporine and subsequently returned to normal levels by the 8th day after thymectomy. A recurrence of PWCA was identified 40 days after the operation and coincided with COVID-19 infection. The patient eventually succumbed to a severe infection. Therefore, in cases of severe neutropenia with an unclear etiology, prompt evaluation of mediastinal and bone marrow status is imperative.

In recent years,with the development of gene testing and new drug research,the diagnosis and treatment of inherited diseases have made rapid progress,corresponding to higher requirements for genetics education.As a teacher of medical genetics,the author joined the course remodeling during last 10 years from a web-based study of genetic disorders to a"case-based learning"supported by flipped classroom in order to optimize teaching effects and learning outcomes.The result of this remodeling project proposes a new strategy to guide perspectives course de-sign in future.

Purpose To investigate the correlation and prognostic value of tumor-stroma ratio(TSR)combined with fi-brotic focus(FF)and stromal tumor-infiltrating lymphocytes(sTILs)with pathological complete response(pCR)after neoad-juvant therapy in triple-negative breast cancer(TNBC).Meth-ods The clinical data of 170 cases of TNBC were collected.Af-ter double-blind reading of the sections by two senior patholo-gists,the pathological examination results of all cases were re-viewed,and the results of TSR,FF,sTILs and the expression of CD4 and CD8 were evaluated.Then the relationship between the above information and PCR and prognosis was analyzed.Results 170 cases of TNBC after neoadjuvant therapy,57 patients a-chieved pCR,while 113 patients did not achieve pCR.Statistical analysis revealed the following findings:TSR,FF,sTILs,CD4,CD8,Ki67,vascular invasion,and lymph node metastasis exhib-ited significant differences between the pCR and non-pCR groups.There were also significant differences in TSR,FF and sTILs between different Miller-Payne(MP)grades.TSR,sTILs,TSR combined with FF,sTILs and Ki67 were positively correlated with PCR.Meanwhile,TSR,sTILs,TSR combined with FF and sTILs were also positively correlated with MP grade,while FF,intravascular tumor thrombus and lymph node metasta-sis were negatively correlated with PCR.At the same time,TSR and sTILs were also positively correlated with MP grade,and FF was also negatively correlated with MP grade.The prognosis of patients was optimal with TSR＞1,G0 FF and sTILs＞50％.When TSR combined with FF and sTILs,the prognosis of PCR group was better than that of non-PCR group.Conclusion TSR,FF,and sTILs are anticipated to serve as predictive bio-markers for assessing the efficacy and prognosis of neoadjuvant therapy in TNBC patients.These findings offer novel insights into the treatment and research strategies for TNBC.

Purpose To investigate the correlation and prognostic value of tumor-stroma ratio(TSR)combined with fi-brotic focus(FF)and stromal tumor-infiltrating lymphocytes(sTILs)with pathological complete response(pCR)after neoad-juvant therapy in triple-negative breast cancer(TNBC).Meth-ods The clinical data of 170 cases of TNBC were collected.Af-ter double-blind reading of the sections by two senior patholo-gists,the pathological examination results of all cases were re-viewed,and the results of TSR,FF,sTILs and the expression of CD4 and CD8 were evaluated.Then the relationship between the above information and PCR and prognosis was analyzed.Results 170 cases of TNBC after neoadjuvant therapy,57 patients a-chieved pCR,while 113 patients did not achieve pCR.Statistical analysis revealed the following findings:TSR,FF,sTILs,CD4,CD8,Ki67,vascular invasion,and lymph node metastasis exhib-ited significant differences between the pCR and non-pCR groups.There were also significant differences in TSR,FF and sTILs between different Miller-Payne(MP)grades.TSR,sTILs,TSR combined with FF,sTILs and Ki67 were positively correlated with PCR.Meanwhile,TSR,sTILs,TSR combined with FF and sTILs were also positively correlated with MP grade,while FF,intravascular tumor thrombus and lymph node metasta-sis were negatively correlated with PCR.At the same time,TSR and sTILs were also positively correlated with MP grade,and FF was also negatively correlated with MP grade.The prognosis of patients was optimal with TSR＞1,G0 FF and sTILs＞50％.When TSR combined with FF and sTILs,the prognosis of PCR group was better than that of non-PCR group.Conclusion TSR,FF,and sTILs are anticipated to serve as predictive bio-markers for assessing the efficacy and prognosis of neoadjuvant therapy in TNBC patients.These findings offer novel insights into the treatment and research strategies for TNBC.

Objective:To analyze the external quality control assessment results of urinary iodine, salt iodine and water iodine in iodine deficiency disorders laboratories in Qinghai Province, to evaluate the testing capacity of provincial, municipal and county-level laboratories and the operation of external quality control network, so as to provide quality assurance for consolidating and eliminating iodine deficiency disorders.Methods:In 2021, 1 provincial, 8 municipal, and 43 county-level laboratories in Qinghai Province had participated in the assessment of urinary iodine and salt iodine, while 1 provincial and 8 municipal-level laboratories had participated in the assessment of water iodine. The assessment results were evaluated using the method of reference value ± uncertainty of external quality control samples.Results:All laboratories that participated in the assessment had provided feedback. One provincial-level laboratory passed the assessment of urinary iodine, salt iodine, and water iodine. Among 8 municipal-level laboratories, 2 laboratories failed the urinary iodine assessment, with a pass rate of 6/8; the assessment of salt iodine and water iodine in 8 laboratories were all qualified. Among 43 county-level laboratories, 7 laboratories failed the urinary iodine assessment, with a pass rate of 83.7% (36/43); the assessment of salt iodine in 43 laboratories were all qualified.Conclusions:The external quality control network of iodine deficiency disorders laboratories in Qinghai Province has fully covered all municipal and county-level laboratories. The testing capability of provincial-level laboratory is stable and maintains a high level; the testing quality of some municipal and county-level laboratories is still unstable and needs to be further strengthened.

OBJECTIVE To evaluate the correlation between 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants. METHODS PubMed，Embase，Cochrane Library ，CNKI，Wanfang database ，CBM and VIP database were searched for domestic and foreign literatures on the correlation between 5-HTR1A gene C- 1019G polymorphism and antidepressant efficacy. The retrieval time limit was from the inception to February 2022. According to different outcome measures of drug response，Stata 14.0 and RevMan 5.4 software were used for meta-analysis of efficacy group and remission group ，respectively. RESULTS A total of 18 literature were included. The combined results showed that among recessive gene model in valid group ， the correlation of 5-HTR1A gene C- 1019G polymorphism with the efficacy of antidepressants had statistically significance in Asian population（GG vs. CG+CC ，OR＝0.751，95％CI＝0.585-0.964，P＝0.024）. There was statistical significance in the correlation of 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants in China （GG vs. CG+CC ，OR＝0.677，95％CI＝ 0.508-0.901，P＝0.007）. There was no statistical significance in the correlation of 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants in remission group （P＞0.05）. CONCLUSIONS In the effective group ，5-HTR1A gene C- 1019G polymorphism is correlated with the efficacy of antidepressants in the Asian population and the Chinese population ；while in the remission group ，it is not proved that this polymorphism is correlated with the efficacy of antidepressants.

Objective:To explore the relationship between the expression of SF3B1, UBE2V2, SETD2 and osteoporotic vertebral fracture (OVF) in elderly patients.Methods:Peripheral blood samples were collected from 31 elderly patients with osteoporotic vertebral fractures (VF group) and 16 elderly patients with osteoporotic non-vertebral fractures (NVF group) in Yantai Mountain Hospital. RNA was extracted for transcriptome sequencing to screen for differentially expressed genes. VF related genes were screened by Gene Ontology (GO) analysis, protein protein interaction (PPI) network analysis and ROC curve analysis. Qrt-pcr was used to detect gene expression levels.Results:Compared with NVF group, 691 genes were up-regulated while 131 genes were down regulatedin VF group. qRT-PCR results revealed that, compared with NVF patients (1.55±0.33) (1.70±0.33) (1.64±0.33) , SF3B1 (1.83±0.23) ( t=2.84, P=0.008) , UBE2V2 (2.24±0.43) ( t=3.91, P<0.001) expression were increased while SETD2 (1.18±0.46) ( t=3.25, P=0.003) expression was decreased in peripheral blood of VF patients. ROC curve analysis showed that the AUCs of SF3B1, UBE2V2 and SETD2 in VF were 0.8034 ( P=0.007) , 0.8145 ( P=0.005) and 0.7863 ( P=0.0014) , respectively. Conclusion:SF3B1, UBE2V2 and SETD2 are highly correlated with OVF in elderly patients, and are of great value in the diagnosis and prediction of OVF.