Objective To analyze the clinical characteristics and prognostic factors of patients with double hit multiple myeloma(MM)patients with p53 deletion/mutation.Methods MM patients admitted to Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from June 2017 to June 2023 were selected as the study subjects.They used fluorescence in situ hybridization(FISH)to detect chromosomal changes and gene sequencing to detect p53 gene mutations.According to the detection results,a total of 180 patients with p53 deletion/mutation were selected,and these 180 patients were divided into a p53 deletion/mutation-only group(control group,n=73)and a dual strike group with p53 deletion/mutation(research group,n=107).Compared the clinical characteristics and efficacy of two groups of patients,and analyzed the factors influencing the prognosis of MM patients.Established a risk-scoring model for evaluating and validating the prognosis of MM patients.Results The proportion of patients with extramedullary lesions(46.73%),bone lesions(42.06%),DS stage III(70.09%),ISS stage III(64.49%)and R-ISS stage III(59.81%)in research group with p53 deletion/mutation was significantly higher than that in conctrol group(28.77%,19.18%,45.21%,39.73%,32.88%),and the differences were statistically significant(χ2=5.861～12.600,all P<0.05).The OR of patients in research group with p53 deletion/mutation after treatment was 52.34%,lower than 65.75%in conctrol group.Still,there was no statistically significant difference between the two groups(χ2=3.202,P=0.074).The PFS and OS of MM patients with research group were significantly shorter than those with conctrol group,and the differences were statistically significant(χ2=15.522,16.973,all P＜0.05).Multivariate COX proportional hazards results,bone marrow plasma cell ratio≥30%,β2-MG≥5.5mg/L,PLT<125×109/L,LDH≥240U/L and dual strikes with p53 deletion/mutation were risk factors for PFS rate in MM patients(Wald χ2=2.983～3.942,all P＜0.05).R-ISS stage III,bone marrow plasma cell ratio≥30%,β2-MG≥5.5mg/L,LDH≥240U/L and dual strikes with p53 deletion/mutation were risk factors for OS rate in MM patients(Wald χ2=3.389～3.971,all P＜0.05).Establishing a risk scoring model for evaluating the prognosis of MM patients,and the ROC curve results show that the risk scoring model has good discrimination.The 2-year PFS and OS were shortened sequentially in the low-risk group,medium-risk group and high-risk group,and the differences were statistically significant(F=23.629,17.664,all P<0.05).Conclusion The clinical manifestations of MM patients with double-hit p53 deletion/mutation are mainly extramedullary lesions,bone lesions,DS staging,ISS staging,and R-ISS staging,with stage III being the most common.The double-hit of p53 deletion/mutation and accompanying is an important prognostic factor for MM patients.

Objective To analyze the clinical characteristics and prognostic factors of patients with double hit multiple myeloma(MM)patients with p53 deletion/mutation.Methods MM patients admitted to Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from June 2017 to June 2023 were selected as the study subjects.They used fluorescence in situ hybridization(FISH)to detect chromosomal changes and gene sequencing to detect p53 gene mutations.According to the detection results,a total of 180 patients with p53 deletion/mutation were selected,and these 180 patients were divided into a p53 deletion/mutation-only group(control group,n=73)and a dual strike group with p53 deletion/mutation(research group,n=107).Compared the clinical characteristics and efficacy of two groups of patients,and analyzed the factors influencing the prognosis of MM patients.Established a risk-scoring model for evaluating and validating the prognosis of MM patients.Results The proportion of patients with extramedullary lesions(46.73%),bone lesions(42.06%),DS stage III(70.09%),ISS stage III(64.49%)and R-ISS stage III(59.81%)in research group with p53 deletion/mutation was significantly higher than that in conctrol group(28.77%,19.18%,45.21%,39.73%,32.88%),and the differences were statistically significant(χ2=5.861～12.600,all P<0.05).The OR of patients in research group with p53 deletion/mutation after treatment was 52.34%,lower than 65.75%in conctrol group.Still,there was no statistically significant difference between the two groups(χ2=3.202,P=0.074).The PFS and OS of MM patients with research group were significantly shorter than those with conctrol group,and the differences were statistically significant(χ2=15.522,16.973,all P＜0.05).Multivariate COX proportional hazards results,bone marrow plasma cell ratio≥30%,β2-MG≥5.5mg/L,PLT<125×109/L,LDH≥240U/L and dual strikes with p53 deletion/mutation were risk factors for PFS rate in MM patients(Wald χ2=2.983～3.942,all P＜0.05).R-ISS stage III,bone marrow plasma cell ratio≥30%,β2-MG≥5.5mg/L,LDH≥240U/L and dual strikes with p53 deletion/mutation were risk factors for OS rate in MM patients(Wald χ2=3.389～3.971,all P＜0.05).Establishing a risk scoring model for evaluating the prognosis of MM patients,and the ROC curve results show that the risk scoring model has good discrimination.The 2-year PFS and OS were shortened sequentially in the low-risk group,medium-risk group and high-risk group,and the differences were statistically significant(F=23.629,17.664,all P<0.05).Conclusion The clinical manifestations of MM patients with double-hit p53 deletion/mutation are mainly extramedullary lesions,bone lesions,DS staging,ISS staging,and R-ISS staging,with stage III being the most common.The double-hit of p53 deletion/mutation and accompanying is an important prognostic factor for MM patients.

The fall armyworm (FAW), Spodoptera frugiperda, is a destructive pest native to America and has recently become an invasive insect pest in China. Because of its rapid spread and great risks in China, understanding of FAW genetic background and pesticide resistance is urgent and essential to develop effective management strategies. Here, we assembled a chromosome-level genome of a male FAW (SFynMstLFR) and compared re-sequencing results of the populations from America, Africa, and China. Strain identification of 163 individuals collected from America, Africa and China showed that both C and R strains were found in the American populations, while only C strain was found in the Chinese and African populations. Moreover, population genomics analysis showed that populations from Africa and China have close relationship with significantly genetic differentiation from American populations. Taken together, FAWs invaded into China were most likely originated from Africa. Comparative genomics analysis displayed that the cytochrome p450 gene family is extremely expanded to 425 members in FAW, of which 283 genes are specific to FAW. Treatments of Chinese populations with twenty-three pesticides showed the variant patterns of transcriptome profiles, and several detoxification genes such as AOX, UGT and GST specially responded to the pesticides. These findings will be useful in developing effective strategies for management of FAW in China and other invaded areas.
Animals ; China ; Genomics ; Humans ; Male ; Pesticides ; Spodoptera/genetics* ; Transcriptome

Objective To understand the current situation and existing problems in the training of healthcare-asso-ciated infection(HAI)management,and provide scientific basis for strengthening the management of HAI preven-tion and control system.Methods A questionnaire survey was adopted to investigate situation of training on HAI in 15 provincial-level HAI training agencies in China during the past 30 years,and basic condition of training on HAI management in recent 5 years.Results Among 15 provincial-level training agencies,66.67%(n=10)were respon-sible by HAI management quality control centers,80.00% have already conducted training in each city,53.33%carried out training for 10 to 20 times,33.34% performed training for ≤2 times per year.Of 33 728 trainees in 2011-2015,41.30% were 41-50 years old,61.82% were nursing staff,50.56% had bachelor degree,43.96%were with the intermediate professional title.Most trainers were HAI prevention and control experts in their respec-tive province,accounting for 68.07%,the curriculums were mainly designed on professional course,and only 26.78% were involved in management.Conclusion Professional structure of HAI management personnel is not reasonable,faculty is imbalance,knowledge update is lacking,and HAI training and education system need to be improved further.

OBJECTIVETo investigate the relationship of the mutational status of the ND4 gene and the clinical features of acute myelogenous leukemia (AML) patients with ND4 mutations.

METHODSUsing PCR combined with directly sequencing, we identified somatic mutations of ND4 in 121 primary AML patients to couple with their clinical features.

RESULTSThere were 58 male patients and 63 female patients (median age 49 years, 10-86 years). Eight of 121 patients (6.6%) with de novo AML were found harboring missense mutation of ND4 gene, including 3 patients with A131V (3/8, 37.5%), 2 patients with A404T (2/8, 25%), 1 patient with F149L (1/8, 12.5%), 1 patient with G242D (1/8, 12.5%) and 1 patient with Y409H (1/8, 12.5%), respectively. Patients with ND4 mutations were associated with good karyotype (P=0.049), regardless of gender, age, white blood cell, hemoglobin, platelet, blast cells of bone marrow or immunophenotype (P>0.05). There were no statistical significance in mutations of FLT3-ITD, NPM1, CEBPA, c-KIT and DNMT3A between patients with ND4 mutation and wild-type (wt) ND4 (P>0.05). The median overall survival of patients with ND4 mutations and wt ND4 were all not reached. The median relapse-free survival were not reached and 29(2-53) months, respectively (P>0.05). There was no significance in the ratio of CR and RR patients between wt ND4 and ND4 mutated groups (P>0.05).

CONCLUSIONIt was concluded that novel ND4 mutations could be found in de novo AML patients, especially in patients with good karyotype. Thus, ND4 mutations might play an important role in AML prognosis. However, whether the mitochondria dysfunction contribute to leukemogenesis needs to be further investigated.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; NADH Dehydrogenase ; genetics ; Prognosis ; Young Adult