Objective To explore the efficacy and safety of a zanubrutinib-based combination regimen as first-line treatment for patients with B-cell chronic lymphoproliferative disorder (B-CLPD). Methods A retrospective analysis was performed on 26 patients with B-CLPD, including indolent B-cell non-Hodgkin lymphoma (B-iNHL), mantle cell lymphoma (MCL), and other unclassifiable B-CLPD, who were newly diagnosed and treated at the Department of Hematology, Zhongshan Hospital (Xiamen), Fudan University between January 2021 and January 2025. Patients were divided into two groups according to the treatment regimen: BR (bendamustine plus rituximab) and ZBR (zanubrutinib combined with BR regimen). Baseline characteristics, treatment responses, and the incidence of treatment-related adverse events (TRAE) were compared between the two groups. Results No statistically significant differences in baseline characteristics were observed between the two groups. All patients completed at least four cycles of treatment. There were no significant differences between the BR and ZBR groups in partial response rate (46.2% vs 53.8%), complete response rate (53.8% vs 15.4%), overall response rate (100.0% vs 84.6%), or TRAE incidence. After the first cycle, the lymphocyte count was higher in the ZBR group than in the BR group (P＝0.002); no other statistically significant differences in other hematologic parameters were observed at any treatment cycle. Conclusions In patients with B-iNHL, MCL, and other unclassifiable B-CLPD, the ZBR regimen demonstrates similar safety and response rates to the BR regimen. These findings support further investigation into the clinical value of ZBR as first-line treatment regimen in a limited course for indolent lymphoid malignancies.

With the accelerating aging process,the number of elderly cancer patients is been increasing annually,accompanied by various age-related health issues.Comprehensive Geriatric Assessment(CGA),as a multidimen-sional evaluation tool,has been widely recognized as an important means to optimize the management of elderly cancer patients.Although numerous studies have demonstrated the significant value of CGA in improving clinical outcomes,its practical application still faces various challenges.This review summarizes the status of CGA applica-tion in elderly cancer patients,the main implementation barriers,and corresponding facilitating strategies.Addi-tionally,recommendations for promoting the implementation of CGA are provided,aiming to offer insights for future clinical research and practice on CGA for elderly cancer patients in China.

Recently,diffusion models have emerged as a promising paradigm for molecular design and optimization.However,most diffusion-based molecular generative models focus on modeling 2D graphs or 3D geom-etries,with limited research on molecular sequence diffusion models.The International Union of Pure and Applied Chemistry(IUPAC)names are more akin to chemical natural language than the simplified molecular input line entry system(SMILES)for organic compounds.In this work,we apply an IUPAC-guided conditional diffusion model to facilitate molecular editing from chemical natural language to chemical language(SMILES)and explore whether the pre-trained generative performance of diffusion models can be transferred to chemical natural language.We propose DiffIUPAC,a controllable molecular editing diffusion model that converts IUPAC names to SMILES strings.Evaluation results demonstrate that our model out-performs existing methods and successfully captures the semantic rules of both chemical languages.Chemical space and scaffold analysis show that the model can generate similar compounds with diverse scaffolds within the specified constraints.Additionally,to illustrate the model's applicability in drug design,we conducted case studies in functional group editing,analogue design and linker design.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

OBJECTIVE To understand the drug resistance,serotypes,virulence-associated genes and epidemiologi-cal characteristics of group B Streptococcus(GBS)isolated from puerpera in this area so as to provide bases for prevention of mother-to-infant infections.METHODS Totally 67 strains of GBS were isolated from obstetrics out-patient department of The First Affiliated Hospital of Nanchang University from Jan.2023 to Dec.2023.The spe-cies of the strains were identified by VITEK MS,the drug susceptibility testing was carried out by disc diffu-sion method.Multilocus sequencing types,capsular types,virulence genes and drug resistance genes were analyzed by means of whole genome sequencing technique.RESULTS The 67 strains of GBS were sensitive to penicillin,vancomycin,ceftriaxone and linezolid;the drug resistance rates to erythromycin and clindamycin were 76.12％and 55.22％,respectively.All strains fell into 7 serotypes,with serotype V predominant;21 sequence types were in-volved,with ST529 most prevalent;8 clonal complexes(CCs)were involved,with CC12 most common.Totally 17 types of drug resistance genes were identified,and the carrying rate of macrolide resistance gene ErmB was highest.Among all the virulence genes except for the adhesion genes fbsA and fbsB,the carrying rates of 18 genes involving in invasion,adhesion,and immune evasion-associated virulence genes were more than 86.57％;67.16％of the strains co-expressed both PI-1 and PI-2a pilus islands.CONCLUSIONS The drug resistance rate of the GBS strains isolated from the puerpera is high,and the strains carry multiple drug resistance genes and viru-lence genes and present with molecular clonal diversity.The serotype V/ST529 is the predominant clone,for which the prevention and control should be strengthened.

Objective:To prepare ((2-(2-chlorophenyl)-3-(4-((2- 18F-fluoroethyl)oxy)phenyl)-5, 6, 7, 8-tetrahydrooxepino[3, 2-c]pyrazol-8-yl)amino)methanoic acid methyl ester ( 18F-JR-1001) and evaluate its binding affinity to the cannabinoid type 1 receptor (CB1R). Methods:18F-JR-1001 was synthesized using an integrated automated synthesis module, and its radiochemical yield (RCY) and molar activity were determined. Cell-specific uptake, lipid-water partition coefficient (log P), competitive binding assays, and in vitro stability tests were performed. Rimonabant-fed rat models (blocking group) with pre-occupied CB1R were established. Radioautography and microPET/CT imaging were conducted on both the blocking group and normal Sprague-Dawley (SD) rats to evaluate the brain uptake of 18F-JR-1001 and its blood-brain barrier (BBB) penetration capability. Results:The RCY of the synthetic 18F-JR-1001 after decay correction was (32.5±9.2)% ( n=10), with the molar activity of (194.6±67.3)GBq/μmol. Cell experiments demonstrated that 18F-JR-1001 exhibited specificity for CB1R, with log P of 3.40±0.11 ( n=3) and half-maximal inhibitory concentration of 0.975nmol/L. Within 3h at 37℃, the radiochemical purity of 18F-JR-1001 in physiological saline and blood remained above 92%, with no significant radioactive by-product peaks observed. Radioautography showed that the whole brain uptake of 18F-JR-1001 in the blocking group was 65.6% of that in normal SD rats. MicroPET/CT imaging showed that the mean whole brain uptake of 18F-JR-1001 in the blocking group was 0.4706, which was lower than that in normal SD rats (1.0561). Additionally, continuous scanning for 60min demonstrated that 18F-JR-1001 exhibited good BBB penetration capability. Conclusion:The synthesized 18F-JR-1001 meets the requirements of production and application, and is proved the potential as a CB1R-targeted tracer in the in vitro experiments, microPET/CT imaging and radioautography.

This study retrospectively analyzed 12 patients with transfusion-dependent, non-severe aplastic anemia (TD-NSAA) refractory to cyclosporine A (CsA) , who were treated with lusutrombopag monotherapy. These patients either had a variety of chronic comorbidities or medication-related risks, or they were unresponsive to or intolerant of other thrombopoietin receptor agonists (TPO-RA) . The median treatment duration with lusutrombopag was 4 months (range: 3-11 months) , while the median follow-up period was 8 months (range: 6-11 months) . The overall response (OR) rates at months 3, 6, and the end of follow-up were 50.0%, 58.3%, and 50.0%, respectively, with a median time to OR of 2 months (range: 1-4 months) . Complete response (CR) rates were 8.3%, 16.7%, and 16.7% at the same time points, with a median time to CR of 4 months (range: 2-5 months) . Adverse events were all Grade 1, with an incidence rate of 25.0%. During follow-up, one patient experienced a loss of OR after discontinuing treatment, with a relapse rate of 14.3%; no clonal evolution or mortality was observed. These findings suggest that lusutrombopag is both effective and well-tolerated in CsA-refractory TD-NSAA patients and represents a promising therapeutic option for those with poor treatment tolerability.

Objective:To evaluate the role of the CC chemokine ligand 2/CC chemokine receptor 2 (CCL2/CCR2) signaling pathway in electroacupuncture (EA)-induced reduction of spinal cord injury (SCI) in rats.Methods:Sixty clean-grade healthy adult female Sprague-Dawley rats, weighing 210-250 g, were divided into 5 groups ( n=12 each) using a random number table method: sham operation group (group S), group SCI, SCI+ Anti-CCL2 group (group SCI+ A), SCI+ EA group (group SCI+ EA), and spinal cord injury+ EA+ rCCL2 group (group SCI+ EA+ R). The SCI model was established using the Allen method in anesthetized animals. Group S only underwent spinous process and laminectomy without damaging the spinal cord. In SCI+ A group, CCL2 neutralizing antibody 50 μg/kg was intrathecally injected at 0, 3 and 6 days after successful development of the SCI model. On the 7th day after the successful development of the SCI model, Jiaji, Dazhui and Mingmen acupoints were stimulated with a depth of 2 mm, voltage of 12-15 mV and frequency of 2 Hz for 30 min once a day for 7 consecutive days in SCI+ EA group. In SCI+ EA+ R group, recombinant rat CCL2 2.5 μg/kg was intrathecally injected at the site of injury at 0, 3 and 6 days after successful development of the SCI model, and the remaining treatments were similar to those in SCI+ EA group. At 1 day before developing the model, 0, 3, 7, 14, 21 and 28 days after developing the model, the mechanical paw withdraw threshold (MWT) and thermal paw withdrawal latency (TWL) were measured, and the motor function was assessed by BBB score. The rats were sacrificed after the final behavioral testing, and their spinal cord tissues were obtained for determination of the expression of CCL2 and CCR2 protein and mRNA (by Western blot or quantitative real-time polymerase chain reaction), the expression of GFAP (by immunofluorescence), contents of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and IL-6 (by enzyme-linked immunosorbent assay) and for examination of the pathological changes (using HE staining). Results:Compared with S group, the MWT and BBB scores were significantly decreased and the TWL was shortened at each time point after developing the model, the expression of CCL2 and CCR2 protein and mRNA and GFAP was up-regulated, and the contents of TNF-α, IL-1β and IL-6 were increased in SCI group ( P<0.05). Compared with SCI group, the MWT and BBB scores were significantly increased, and the TWL was prolonged at 7 days after developing the model in SCI+ A group, the MWT and BBB scores were significantly increased, and the TWL was prolonged at 14 days after developing the model in SCI+ EA group, and the expression of CCL2 and CCR2 protein and mRNA and GFAP was significantly down-regulated, and the contents of TNF-α, IL-1β and IL-6 were decreased in SCI+ A and SCI+ EA groups ( P<0.05). Compared with SCI+ EA group, the MWT and BBB scores were significantly decreased at 14 days after developing the model, the TWL was shortened, the expression of CCL2 and CCR2 protein and mRNA and GFAP was up-regulated, and the contents of TNF-α, IL-1β and IL-6 were increased in SCI+ EA+ R group ( P<0.05). Compared with SCI+ A and SCI+ EA groups, the histopathological injury were significantly attenuated in SCI group, and the histopathological injury was aggravated in SCI+ EA+ R group. Conclusions:The CCL2/CCR2 signaling pathway is involved in the process by which EA reduces SCI, and the mechanism is related to the inhibition of astrocyte activation, thereby reducing the inflammatory response.

OBJECTIVE To investigate the distribution and drug resistance of the pathogens isolated from sterile body fluids in a hospital so as to provide reference for clinical treatment of the infections.METHODS The sterile body fluids specimens that were cultured positive for pathogens were retrospectively collected from a three-A hos-pital of Jiangxi Province between 2016 and 2023.The distribution and drug resistance of the isolated pathogens were observed.RESULTS Totally 16,658 strains of pathogens were isolated from the sterile body fluid speci-mens in 2016-2023,among which gram-negative bacteria accounted for 51.74％.The species of bacteria that ranked the top 5 places were as follows:Escherichia coli,Klebsiella pneumoniae,Staphylococcus epidermidis,Staphylococcus hominis,and Staphylococcus aureus.The isolation rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus were 28.32％and 74.94％,respectively;the strains maintained high sensitivity to linezolid and vancomycin,with the drug resistance rates no more than 2.50％.The drug resistance rates of Enterococcus faecium and Enterococcus faecalis to linezolid and vancomycin were always less than 4.20％.Among the species of Enterobacter,the drug resistance rates of the E.coli strains to meropenem declined from 17.65％to 5.94％;conversely,the drug resistance rate of the K.pneumoniae strains to carbapenems reached high up to 54.36％,showing an upward trend on the whole.Among the non-fermenting gram-negative bacteria,the drug resistance rate of the A.baumannii strains to carbapenems remained high(about 80.00％);while the drug resistance rates of the P.aeruginosa strains to meropenem dropped from 60.71％down to 24.32％.CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the ster-ile body fluids in the hospital between 2016 and 2023.Although some major species of drug-resistant pathogens are effectively under control,the pathogens isolated from the sterile body fluid specimens maintain varying degree of drug resistance to various types of antibiotics.

Objective:To analyze the four lab test results of infectious diseases among patients in a stomatological hospital in Shaanxi Province from 2018 to 2023,so as to provide evidence for clinical prevention and control of infection.Methods:The pa-tients who see a doctor in stomatological hospital from January 2018 to December 2023 were tested for four infectious diseases.HB-sAg and anti-HIV were detected by electrochemical luminescence method,and anti-HCV and anti-TP were detected by ELISA method.Results:There was no statistical difference in the positive rates of HBsAg,anti-HCV and anti-HIV in each year,and the positive rate of anti-TP decreased year by year.There was no statistical difference in the positive rate of anti-HCV between different sexes,and the positive rates of HBsAg,anti-TP and anti-HIV are higher in male than in female.HBsAg and anti-HCV positive pa-tients were mostly concentrated in 51-60 years old.Anti-TP positive patients were mostly concentrated in people over 60 years old and anti-HIV positive patients were mostly concentrated in 41-60 years old.78.38％of HIV-positive patients with oral mucosal dis-eases were initially diagnosed as oral candidiasis.Conclusion:Male and people over 41 years old were the high-risk groups of vari-ous infectious diseases.