Objective To construct a prognostic model for patients with in-hospital cardiac arrest(CA)to evaluate their short-term and long-term prognosis and provide a reference for clinical decision-making.Methods Data of in-hospital CA patients were extracted from the Medical Information Mart for Intensive Care Ⅳ 2.2 database,and randomly divided into training set and validation set at a 7∶3 ratio.A predictive nomogram model was constructed in the training set via multivariate COX regression analysis,and internally validated using the validation set.Results A total of 1787 patients were included(1250 in training set and 537 in validation set).Univariate regression,LASSO regression,and multivariate COX regression analyses identified age,body weight,base excess,red cell volume distribution width,model for end-stage liver disease,acute physiology and chronic health evaluation,systemic inflammatory response index,dopamine,norepinephrine,congestive heart failure,diabetes with complications,and metastatic solid tumor were all independent risk factors affecting the prognosis of patients with CA.The receiver operating characteristic curve of the constructed nomogram showed good discrimination,and the decision curve analysis indicated that it had good clinical applicability.Conclusion The constructed nomogram model has certain clinical application value in identifying populations with good and poor prognosis,providing an auxiliary reference for the termination of resuscitation and post-resuscitation treatment.

Objective:To analyze the clinical characteristics, treatment response, and prognosis of patients newly diagnosed with immunoglobulin A multiple myeloma (IgA MM), and to ascertain whether the IgA isotype remains a poor prognostic factor in the bortezomib era.Methods:This study retrospectively enrolled 155 patients newly diagnosed with IgA MM and 420 with non-IgA MM admitted to the Department of Hematology, the First Affiliated Hospital of Nanchang University from March 2014 to December 2021. We compared the two groups in terms of their clinical characteristics, prognoses, and progression-free survival (PFS) and overall survival (OS) following different treatment regimens.Results:Compared with the non-IgA group, the IgA group presented with more aggressive clinical features, including a higher proportion of patients with hemoglobin<85 g/L (61.3% vs 51.4%, P=0.035), extramedullary manifestations (20.0% vs 11.4%, P=0.008), and gain/amp (1q21) (48.6% vs 36.7%, P=0.032). Efficacy analysis revealed a lower overall response rate (ORR) in the IgA group than in the non-IgA group (83.2% vs 92.4%, P=0.001). Among patients treated with bortezomib-based regimens, the ORR was 91.2% in the IgA group and 94.8% in the non-IgA group, but the difference was nonsignificant ( P=0.146). Survival analysis showed that the median PFS and OS were significantly shorter in the IgA group compared with the non-IgA group[23.5 (95% CI: 17.4-29.5) months and 48.8 (95% CI: 30.1-67.5) months vs 40.7 (95% CI: 33.8 - 47.6) months and not reached, respectively; P<0.001 and P=0.002]. In the subgroup of patients who received bortezomib-based therapy without subsequent autologous hematopoietic stem cell transplantation (auto-HSCT), the PFS and OS were significantly shorter in the IgA group compared with the non-IgA group[25.4 (95% CI: 18.7-32.1) months and 53.5 (95% CI: 35.4-71.6) months vs 41.0 (95% CI: 33.7-48.3) months and not reached; P=0.001 and P=0.011]. In patients who underwent bortezomib-based induction therapy followed by auto-HSCT, the 1-, 3-, and 5-year OS rates for the IgA group were 96%, 81%, and 81%, respectively, compared with 93%, 89%, and 79% for the non-IgA group, but the difference was nonsignificant ( P=0.758) . Conclusion:In the bortezomib era, IgA MM is still associated with a poorer overall prognosis than non-IgA MM, likely due to its inherent high-risk biological characteristics. Although bortezomib-based regimens effectively improve the treatment response, they fail to completely bridge the survival gap between the two disease isotypes. Therefore, bortezomib-based therapy followed by auto-HSCT may be a key strategy to overcome the poor prognosis of IgA MM, potentially enabling these patients to achieve long-term survival comparable to that of their non-IgA counterparts.

Objective To compare the long-term efficacy of intradiscal injection of autologous platelet-rich plasma(PRP)and intradiscal injection of autologous PRP combined with pulsed radiofrequency(PRF)therapy for discogenic back pain(DBP).Methods Prospective inclusion of 98 DBP patients who received treatment at Hai'an People's Hospital from July 2019 to December 2023 was conducted.The patients were randomly divided into study group(receiving PRP combined with PRF,n=50)and control group(receiving PRP only,n=48).The preoperative and the postoperative 1-,3-,6-,and 12-month baseline data,visual analog scale(VAS)score,Roland-Morris Disability Questionnaire(RMDQ)score,Leeds Neurological Symptoms and Signs Score(LANSS),European Society for Quality of Life Five Dimensional Questionnaire(EQ-5D)score,and the use of non-steroidal anti-inflammatory and analgesic drugs were compared between the two groups.Results There was no statistically significant differences in the baseline data and the incidence of intraoperative and postoperative adverse reactions between the two groups(both P＞0.05).At 12 months after surgery,the VAS,RMDQ,LANSS,EQ-5D scores,and the use of non-steroidal anti-inflammatory and analgesic drugs in all patients were significantly better than those before surgery(all P＜0.05).The postoperative 3-,6-,and 12-month VAS,RMDQ,LANSS,EQ-5D scores,and the analgesic dosage in the study group were significantly better than those in the control group(all P＜0.05),and the percentages of patients with pain relief greater than 50％and greater than 80％were also significantly higher than those in the control group(all P＜0.01).Conclusion for the treatment of DBP,both CT-guided intradiscal injection of autologous PRP and CT-guided intradiscal injection of autologous PRP combined with PRF can significantly improve pain,body function,and quality of life in DBP patients,and significantly reduce the use of non-steroidal anti-inflammatory and analgesic drugs.The efficacy of autologous PRP combined with PRF is remarkably better than that of autologous PRP alone.

Background and aims:Primary sclerosing cholangitis(PSC)is an autoimmune liver disease characterized by complex pathogenesis and limited available therapeutic options.The mechanisms underlying the development and progression of PSCs remain unclear.Liver X receptor beta(LXR-β)is recognized to modulate lipid metabolism and immune response,but its specific involvement in the PSC has not been elucidated.Here,we explored the role and mechanism of LXR-β in PSC induced by 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine(DDC).Methods:CRISPR-Cas9 technology was applied to generate Abcb4(coding MDR2,next named as Mdr2),Nr1h2(coding LXR-β,next named as Lxrβ),and Rag2(coding RAG2)knockout mice.DDC was used to induce PSC.Hematoxylin and eosin and Sirius red staining were used to assess the extent of hepatic injury and fibrosis.Flow cytometry was used to observe immune cell subsets.Results:We observed a declining trend in hepatic Lxrβ in the PSC model.Unexpectedly,Lxrβ knockout failed to modulate DDC-induced PSC pathogenesis.Concomitantly,assessment of the influence of Rag2 deficiency on PSC progression revealed the absence of aggravated or alleviated hepatic injury or fibrosis in the Rag2-/-DDC mice.However,Lxrβ depletion intensified DDC-induced PSC in the Rag2-/-mice,with more abundant infiltrative inflammatory cells and more severe liver fibrosis.Compared with Rag2-/-DDC mice,Lxrβ-/-Rag2-/-DDC mice had higher serum ALT and AST levels and mRNA expression of proinflammatory and profibrotic genes.Flow cytometry showed that LXR-β deficiency resulted in a diminished population of hepatic innate immune cells.Conclusion:This study indicated innate immune cell LXR-β deficiency can exacerbate hepatic injury and fibrosis in murine models of PSC suggesting that LXR-β may regulate the function of innate immunity in the fibrotic advancement of PSC.

The 2024 American Society of Clinical Oncology(ASCO)Annual Meeting was held in Chicago,the United States,from May 31 to June 4 in 2024.In recent years,antibody-drug conjugates(ADCs)have become one of the most popular targeted therapies because of their high specificity,efficacy,and low toxicity,making them a focal point in this ASCO meeting.Currently,over 100 ADCs are under investigation,demonstrating the considerable development potential of ADCs in the field of targeted cancer therapy.The aforementioned conference reported several recent research advancements regarding ADCs for the treatment of breast cancer(BC).This review summarizes the latest progress of ADCs in BC treatment discussed at the confer-ence.

The 2024 American Society of Clinical Oncology(ASCO)Annual Meeting was held in Chicago,the United States,from May 31 to June 4 in 2024.In recent years,antibody-drug conjugates(ADCs)have become one of the most popular targeted therapies because of their high specificity,efficacy,and low toxicity,making them a focal point in this ASCO meeting.Currently,over 100 ADCs are under investigation,demonstrating the considerable development potential of ADCs in the field of targeted cancer therapy.The aforementioned conference reported several recent research advancements regarding ADCs for the treatment of breast cancer(BC).This review summarizes the latest progress of ADCs in BC treatment discussed at the confer-ence.

Objective To construct a prognostic model for patients with in-hospital cardiac arrest(CA)to evaluate their short-term and long-term prognosis and provide a reference for clinical decision-making.Methods Data of in-hospital CA patients were extracted from the Medical Information Mart for Intensive Care Ⅳ 2.2 database,and randomly divided into training set and validation set at a 7∶3 ratio.A predictive nomogram model was constructed in the training set via multivariate COX regression analysis,and internally validated using the validation set.Results A total of 1787 patients were included(1250 in training set and 537 in validation set).Univariate regression,LASSO regression,and multivariate COX regression analyses identified age,body weight,base excess,red cell volume distribution width,model for end-stage liver disease,acute physiology and chronic health evaluation,systemic inflammatory response index,dopamine,norepinephrine,congestive heart failure,diabetes with complications,and metastatic solid tumor were all independent risk factors affecting the prognosis of patients with CA.The receiver operating characteristic curve of the constructed nomogram showed good discrimination,and the decision curve analysis indicated that it had good clinical applicability.Conclusion The constructed nomogram model has certain clinical application value in identifying populations with good and poor prognosis,providing an auxiliary reference for the termination of resuscitation and post-resuscitation treatment.

Objective:To analyze the clinical characteristics, treatment response, and prognosis of patients newly diagnosed with immunoglobulin A multiple myeloma (IgA MM), and to ascertain whether the IgA isotype remains a poor prognostic factor in the bortezomib era.Methods:This study retrospectively enrolled 155 patients newly diagnosed with IgA MM and 420 with non-IgA MM admitted to the Department of Hematology, the First Affiliated Hospital of Nanchang University from March 2014 to December 2021. We compared the two groups in terms of their clinical characteristics, prognoses, and progression-free survival (PFS) and overall survival (OS) following different treatment regimens.Results:Compared with the non-IgA group, the IgA group presented with more aggressive clinical features, including a higher proportion of patients with hemoglobin<85 g/L (61.3% vs 51.4%, P=0.035), extramedullary manifestations (20.0% vs 11.4%, P=0.008), and gain/amp (1q21) (48.6% vs 36.7%, P=0.032). Efficacy analysis revealed a lower overall response rate (ORR) in the IgA group than in the non-IgA group (83.2% vs 92.4%, P=0.001). Among patients treated with bortezomib-based regimens, the ORR was 91.2% in the IgA group and 94.8% in the non-IgA group, but the difference was nonsignificant ( P=0.146). Survival analysis showed that the median PFS and OS were significantly shorter in the IgA group compared with the non-IgA group[23.5 (95% CI: 17.4-29.5) months and 48.8 (95% CI: 30.1-67.5) months vs 40.7 (95% CI: 33.8 - 47.6) months and not reached, respectively; P<0.001 and P=0.002]. In the subgroup of patients who received bortezomib-based therapy without subsequent autologous hematopoietic stem cell transplantation (auto-HSCT), the PFS and OS were significantly shorter in the IgA group compared with the non-IgA group[25.4 (95% CI: 18.7-32.1) months and 53.5 (95% CI: 35.4-71.6) months vs 41.0 (95% CI: 33.7-48.3) months and not reached; P=0.001 and P=0.011]. In patients who underwent bortezomib-based induction therapy followed by auto-HSCT, the 1-, 3-, and 5-year OS rates for the IgA group were 96%, 81%, and 81%, respectively, compared with 93%, 89%, and 79% for the non-IgA group, but the difference was nonsignificant ( P=0.758) . Conclusion:In the bortezomib era, IgA MM is still associated with a poorer overall prognosis than non-IgA MM, likely due to its inherent high-risk biological characteristics. Although bortezomib-based regimens effectively improve the treatment response, they fail to completely bridge the survival gap between the two disease isotypes. Therefore, bortezomib-based therapy followed by auto-HSCT may be a key strategy to overcome the poor prognosis of IgA MM, potentially enabling these patients to achieve long-term survival comparable to that of their non-IgA counterparts.

Objective: To examine the association of 24 hour movement behaviors with emotional and behavioral problems among left behind children, so as to provide a theoretical reference for the practice of 24 hour activity interventions to promote emotional and behavioral problems in this population. Methods: From February to May 2023, 1 117 left behind children in grades 4-6 from 10 primary schools in five cities in Zhejiang Province were selected using a convenient cluster sampling method to conduct a questionnaire survey examining 24 hour movement behaviors, as well as emotional and behavioral problems. The general linear model was adopted to analyze the association between satisfying the 24 hour movement behavior guidelines, and emotional and behavioral problems among left behind children. Results: The sleep duration compliance rate was the highest (52.19%), while the moderate-to-vigorous PA (MVPA) compliance rate was the lowest (17.73%). The compliance rate of the three activities accounted for 7.43 %. There was a dose response between the number of guidelines satisfied, and the emotional and behavior of left behind children; that was, satisfaction of a higher number of guidelines was associated with a lower risk of emotional and behavioral problems among left behind children (difficulty factor: β=-0.56, 95%CI =-1.23--0.19; strength factor: β=0.50, 95%CI =-0.48-1.22, P < 0.01). Compared to satisfying none of the guidelines, satisfying the guidelines for screen time ( β=-0.23, 95%CI =-2.18- -0.14 ) and sleep duration ( β=-0.13, 95%CI =-1.66--0.11) was negatively correlated with the difficulty factor, while satisfying the guideline for MVPA ( β=0.13, 95%CI =0.09-1.08) and sleep duration ( β=0.18, 95%CI =0.09-1.40) was positively associated with the strength factor. In addition, satisfying two or all three of the guidelines was more strongly associated with these outcomes than satisfying one of the recommendations ( P <0.01). Conclusions Meeting the 24 hour movement behavior guidelines can improve emotional and behavioral problems among left behind children. It is necessary to raise their awareness of the effect of satisfying the 24 hour movement behavior guidelines and formulate comprehensive intervention measures.