Lymphoma is a highly heterogeneous malignancy characterized by complex molecular regulatory mechanisms that result in significant differences in aggressiveness and prognosis across its subtypes.Gene copy number alteration(CNA)analysis,an emerging technology,has become a pivotal tool in the precision re-search and management of lymphoma.By detecting DNA deletions,amplifications,and chromosomal copy number changes,CNA analysis addresses the limitations of traditional cytogenetic techniques,enhances the ac-curacy of subtype classification,and aids in evaluating tumor heterogeneity and disease progression.This re-view provides a comprehensive summary of CNA detection methods and their applications in lymphoma,with a focus on recent advancements in the field.It offers a comparative analysis of CNA detection techniques and discusses their role in precision diagnosis,subtype classification,monitoring disease progression,predicting therapeutic resistance,and assessing prognosis.Additionally,the review explores the potential applications of CNA analysis in uncovering molecular regulatory mechanisms,optimizing therapeutic strategies,and impro-ving patient survival outcomes.

Roxadustat is the world's first small molecule hypoxia-inducible factor prolyl hydroxylase inhibitor. Its adverse effect of causing hypothyroidism with low thyroid-stimulating hormone (TSH) is relatively rare and manifests subtly in elderly patients with multiple coexisting diseases. This article reports a case of an elderly patient with renal anemia who developed reversible low-TSH hypothyroidism after taking roxadustat for 12 days, with a significant decrease in thyroid hormone levels. After discontinuing roxadustat for 15 days, the thyroid hormone levels gradually returned to normal. Due to the worsening of renal anemia, the patient took roxadustat again, and 9 days later, the thyroid function-related indicators decreased upon re-examination, leading to the initiation of levothyroxine replacement therapy. In conjunction with relevant literature, this article analyzes the adverse reactions that occur during the oral administration of roxadustat in elderly patients with chronic kidney disease, aiming to provide reference for drug treatment of such patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the application value of ultrasound microvascular imaging in monitoring placental blood perfusion and predicting pregnancy outcomes in late pregnancy with pregnancy-induced hypertension. Methods A retrospective analysis was conducted in 150 pregnant women with pregnancy-induced hypertension in late gestation(study group), and another 150 pregnant women with normal pregnancy outcomes in late gestation during the same period were selected as control group. Both groups underwent ultrasound microvascular imaging, and the peak systolic velocity to end diastolic velocity ratio(S/D), pulsatility index (PI), resistance index (RI), vascularization index (VI) of the placenta, and the Apgar score at 1 minute after birth were recorded. Based on the severity of the disease, the study group was further divided into mild group (63 cases), moderate group (49 cases), and severe group(38 cases). According to the occurrence of adverse pregnancy outcomes, the study group was further divided into poor prognosis group (47 cases) and good prognosis group (103 cases). Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator for adverse pregnancy outcomes in pregnant women with pregnancy-induced hypertension. Results The S/D, PI, and RI were higher in the study group than in the control group, while the VI and Apgar scores were lower in the study group (P < 0.05). There were statistically significant differences in S/D, PI, RI, VI, and Apgar scores among pregnant women with different severities of pregnancy-induced hypertension (P < 0.05). The S/D, PI, and RI were higher in the poor prognosis group than in the good prognosis group, while the VI and Apgar scores were lower in the poor prognosis group (P < 0.05). ROC curve analysis showed that the areas under the curve (AUCs) for predicting adverse pregnancy outcomes by S/D, PI, RI, VI, and Apgar scores were 0.741, 0.700, 0.738, 0.774, and 0.680, respectively (P < 0.05). Conclusion Placental blood perfusion decreases significantly in late pregnancy with pregnancy-induced hypertension, and ultrasound microvascular imaging parameters, especially VI, can effectively assist in clinically assessing pregnancy outcomes.

Objective:To analyze the clinical effect of Jiawei Shengxian decoction in the treatment of acquired weakness in patients with mechanical ventilation in intensive care unit (ICU).Methods:A prospective study method was used to select 68 patients with severe mechanical ventilation who met the diagnostic criteria of ICU acquired weakness (ICU-AW) and were admitted to the Department of Critical Care Medicine, Nanchong Hospital of Traditional Chinese Medicine from May 2022 to May 2023 as the study objects, and were divided into observation group and control group according to random number table method, with 34 cases in each group. The control group was treated with conventional Western medicine treatment and rehabilitation treatment, and the observation group was treated with Jiawei Shengxian decoction based on syndrome differentiation of the control group. The muscle strength indexes, symptom scores, inflammatory factors, recovery time, serum biochemical indexes and safety indexes of the two groups were evaluated and compared before and after treatment.Results:Before treatment, there was no statistically significant difference in muscle strength indicators, symptom scores, inflammatory factors, and serum biochemical indicators between the two groups (all P>0.05). After treatment, the Medical Research Council (MRC) muscle strength score, diaphragm thickness and diaphragm motion of observation group were higher than those of control group (all P<0.05). After treatment, the scores of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ), multiple organ failure (MODS) and traditional Chinese medicine syndrome in the observation group were lower than those in the control group, and the Barthel index (BI) score of activities of daily living in the observation group was higher than that in the control group (all P<0.05). After treatment, the serum levels of procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP) and white blood cell count (WBC) in the observation group were lower than those in the control group (all P<0.05). The mechanical ventilation time, ICU admission time, getting out of bed activity time and hospital stay time of the observation group were shorter than those of the control group (all P<0.05). After treatment, the levels of hemoglobin (HGB) and platelet count (PLT) in the observation group were higher than those in the control group, and the levels of serum total bilirubin (TBIL), blood urea nitrogen (BUN) and serum creatinine (Scr) in the observation group were lower than those in control group (all P<0.05). Conclusions:Jiawei Shengxian decoction has a good effect in the adjuvant treatment of acquired asthenia in ICU patients with mechanical ventilation, which can enhance the muscle strength of limbs and the activity ability of diaphragm, improve the symptom score of patients, reduce the expression level of inflammatory factors, shorten the rehabilitation process of patients, and improve the serum biochemical indexes of patients.

Objective:To analyze the clinical effect of Jiawei Shengxian decoction in the treatment of acquired weakness in patients with mechanical ventilation in intensive care unit (ICU).Methods:A prospective study method was used to select 68 patients with severe mechanical ventilation who met the diagnostic criteria of ICU acquired weakness (ICU-AW) and were admitted to the Department of Critical Care Medicine, Nanchong Hospital of Traditional Chinese Medicine from May 2022 to May 2023 as the study objects, and were divided into observation group and control group according to random number table method, with 34 cases in each group. The control group was treated with conventional Western medicine treatment and rehabilitation treatment, and the observation group was treated with Jiawei Shengxian decoction based on syndrome differentiation of the control group. The muscle strength indexes, symptom scores, inflammatory factors, recovery time, serum biochemical indexes and safety indexes of the two groups were evaluated and compared before and after treatment.Results:Before treatment, there was no statistically significant difference in muscle strength indicators, symptom scores, inflammatory factors, and serum biochemical indicators between the two groups (all P>0.05). After treatment, the Medical Research Council (MRC) muscle strength score, diaphragm thickness and diaphragm motion of observation group were higher than those of control group (all P<0.05). After treatment, the scores of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ), multiple organ failure (MODS) and traditional Chinese medicine syndrome in the observation group were lower than those in the control group, and the Barthel index (BI) score of activities of daily living in the observation group was higher than that in the control group (all P<0.05). After treatment, the serum levels of procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP) and white blood cell count (WBC) in the observation group were lower than those in the control group (all P<0.05). The mechanical ventilation time, ICU admission time, getting out of bed activity time and hospital stay time of the observation group were shorter than those of the control group (all P<0.05). After treatment, the levels of hemoglobin (HGB) and platelet count (PLT) in the observation group were higher than those in the control group, and the levels of serum total bilirubin (TBIL), blood urea nitrogen (BUN) and serum creatinine (Scr) in the observation group were lower than those in control group (all P<0.05). Conclusions:Jiawei Shengxian decoction has a good effect in the adjuvant treatment of acquired asthenia in ICU patients with mechanical ventilation, which can enhance the muscle strength of limbs and the activity ability of diaphragm, improve the symptom score of patients, reduce the expression level of inflammatory factors, shorten the rehabilitation process of patients, and improve the serum biochemical indexes of patients.

Objective:To investigate the clinical characteristics, treatment and prognosis of newly-treated patients with primary central nervous system lymphoma (PCNSL).Methods:Clinical data of 117 newly-treated PCNSL patients who were admitted to the First Hospital of Jilin University, the Fifth Medical Center of Chinese PLA General Hospital, Harbin Medical University Cancer Hospital, and Cancer Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College from August 2009 to February 2018 were retrospectively analyzed. The patients' age, sex, Eastern Cooperative Oncology Group (ECOG) physical status (PS) score, pathological type, involvement of deep brain tissue, number of lesions, cerebrospinal fluid protein concentration, International Extranodal Lymphoma Study Group (IELSG) score, Memorial Sloan Kettering Cancer Center (MSKCC) score, treatment strategy, and response after the first-line therapy were analyzed using univariate and multivariate Cox proportional hazards models to identify the independent influencing factors for progression-free survival (PFS) and overall survival (OS) of PCNSL patients. Kaplan-Meier method was used for survival analysis.Results:In 117 newly-treated PCNSL patients, 59 cases (50.4%) presented with increased intracranial pressure or focal neurological symptoms at diagnosis; there were 65 cases (55.6%) with single lesions and 52 cases (44.4%) with multiple lesions; 1 patient (0.9%) had lymphoma of T-cell origin, and 116 cases (99.1%) had diffuse large B-cell lymphoma (DLBCL). Among 95 evaluable patients, 41 patients (43.2%) achieved complete remission (CR), 20 patients (21.1%) achieved partial remission (PR), 16 patients (16.8%) achieved stable disease (SD), and 18 patients (18.9%) had progressive disease (PD). In 117 patients with median follow-up of 66.0 months (95% CI 57.9-74.1 months), the median PFS and OS were 17.4 months (95% CI 11.5-23.3 months) and 45.6 months (95% CI 20.1-71.1 months), respectively. The 2-, 3- and 5-year PFS rates were 41.2%, 28.6% and 19.3%, and OS rates were 63.7%, 52.4% and 46.3%, respectively. Univariate Cox regression analysis showed that baseline high-risk MSKCC score group was an adverse prognostic factor for PFS ( P = 0.037), and the first-line chemotherapy with ≥4 cycles of high-dose methotrexate (HDMTX), HDMTX in combination with rituximab, ≥4 cycles of rituximab in combination with HDMTX, and achieving CR or ≥PR after the first-line treatment reduced the risk of disease progression and prolonged the PFS time (all P <0.01); age >60 years old, ECOG-PS score of 2-4 points, elevated cerebrospinal fluid protein concentration, high-risk IELSG score, and high-risk MSKCC score were adverse prognostic factors for OS, and ≥4 cycles of HDMTX and achieving CR or ≥PR after the first-line treatment were favorable factors for OS. Multivariate Cox regression analysis verified that rituximab in combination with HDMTX (yes vs. no: HR = 0.349, 95% CI 0.133-0.912, P = 0.032) and achieving ≥PR after the first-line chemotherapy (yes vs. no: HR = 0.028, 95% CI 0.004-0.195, P < 0.001) were independent favorable factors for PFS; age >60 years old (>60 years old vs. ≤60 years old: HR = 10.878, 95% CI 1.807-65.488, P = 0.009) was independent unfavorable factor for OS, while ≥4 cycles of HDMTX treatment (≥4 cycles vs. <4 cycles: HR = 0.225, 95% CI 0.053-0.947, P = 0.042) was independent favorable factor for OS. Conclusions:The older the PCNSL patients at initial treatment, the worse the prognosis. Intensive and continuous treatment for achieving deeper remission may be the key for improving the outcome of PCNSL patients.

Objective:To search, screen, and summarize the best evidence-based evidence for procedural pain management in adult patients in the Intensive Care Unit (ICU), so as to provide reference for clinical practice.Methods:Guidelines, clinical decisions, expert consensus, systematic reviews, and randomized controlled trial (RCT) on procedural pain management for adult patients in ICU were searched in domestic and foreign databases, guide websites, and professional association websites. The search time limit was from the establishment of the database to August 31, 2022.Results:A total of 14 articles were included, including six guidelines, three RCTs, three systematic reviews, and two clinical decisions. A total of 8 themes and 27 best evidence were extracted.Conclusions:It is recommended that clinical medical and nursing personnel provide personalized and multimodal procedural pain intervention measures for adult patients in ICU in a timely manner in accordance with the medication principles of procedural pain management, in order to improve the procedural pain experience of ICU patients and the quality of nursing.

Objective:To investigate the correlation between global burden of small vessel disease(CSVD) on MRI and impaired spatial navigation in patients with CSVD.Methods:Patients with CSVD admitted to the Department of Neurology, Nanjing Jiangning Hospital from November 2020 to June 2022 were selected as the research subjects. The global burden of CSVD was scored according to the head MRI findings, and was divided into mild group (0-1 points), moderate group (2 points), and severe group (3-4 points). All patients were tested for spatial navigation function. Multivariate linear regression model was used to analyze the correlation between the global burden of CSVD and the spatial navigation function.Results:A total of 101 patients with CSVD were enrolled, including 37 patients in the mild group (36.6%), 28 in the moderate group (27.7%), and 36 in the severe group (35.6%). Age, glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol and creatinine, as well as the proportions of hypertension, diabetes, previous stroke or transient ischemic attack in the moderate group and the severe group were significantly higher than those in the mild group, while the high-density lipoprotein cholesterol was significantly lower than that in the mild group (all P<0.05). The spatial navigation function test showed that the environment + self-navigation, self-navigation and environment navigation functions of the moderate group and the severe group decreased significantly compared with the mild group (all P<0.05). Multivariate linear regression analysis showed that after adjusting for age, sex, hypertension, previous stroke or transient ischemic attack history and years of education, the global burden of CSVD and environment + self-navigation ( β=0.518, P<0.001), self-navigation ( β=0.481, P<0.001) and environmental navigation ( β=0.699, P<0.001) function had significant correlation. Conclusion:The global burden of CSVD is correlated with spatial navigation functions.

Objective:The purpose of this study was to investigate the expression and role of N-myc downstream regulatory gene 2 (NDRG2) in radiation resistance of bladder cancer cells.Methods:T24 cells were cultured in vitro and irradiated with different doses of X-ray (0, 2, 4, 8, 10 and 20 Gy). The best dose of X-ray was selected for subsequent treatment. The radioresistant BCa cell line T24/R was established. The cytotoxicity of T24/R cells was detected by counting kit-8 (CCK-8) method. The proliferation and invasion ability of T24/R cells and T24 cells were detected by flow cytometry and transwell, respectively. Western blot was used to detect the expression of epithelial mesenchymal transition (EMT) related proteins. The survival rate of T24/R group (control group) and T24/R-NDRG 2 group was detected, and the migration ability of T24/R-NDRG 2 cells was detected after 2 Gy treatment. Results:The cell viability was inhibited significantly when the dose of X-ray was ≥2 Gy X-ray, so 2 Gy X-ray irradiation was chosen as the best condition for BCa cytotoxicity and T24/R radiation resistance cell line was successfully established; Apoptosis test showed that the number of S-phase cells was increased in T24/R group, and the proportion of S-phase cells in T24/R vs T24 was (26.49±4.5)% vs (14±2.6)% ( P<0.05); Transwell test showed that T24/R cells showed stronger migration ability than control group ( P<0.05), but there was no significant difference in EMT related protein expression between the two groups ( P>0.05). Overexpression of NDRG2 can significantly decreased the activity and migration ability of radiation-resistant T24/R cells ( P<0.05) when the radiation dose was gradually increasing in both groups. Conclusions:The radiation resistance of BCa cells is one of the causes of local tumor recurrence. Up-regulation of NDRG2 expression can inhibit the radiation resistance of T24 cells, so it can be used as a candidate for treatment of radiation-resistant BCa patients.