Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

AIM:A mouse model of acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)was estab-lished.METHODS:One hundred and twenty male C57BL/6 mice were randomly divided into a negative control group,an IPF group,and an acute exacerbation of interstitial fibrosis(AE-IPF)group.The IPF group received a low dose(3 mg/kg)of bleomycin(BLM)by endotracheal drip on days 0,14,and 28.The AE-IPF group received a high dose(5 mg/kg)of BLM by endotracheal drip on day 56.The control group received an equal volume of saline at different time points.The AE-IPF group was injected with a high dose(5 mg/kg)of BLM via tracheal drip on day 56 on top of the initial IPF induction,while the control group received equal amounts of saline at different time points.Experiments were con-ducted on the 57th,59th,63rd,and 70th days after the initial modeling.Mice were observed for general conditions,CT imaging changes,HE,and Masson staining to assess the degree of alveolitis and fibrosis in lung tissues.Lung function,hydroxyproline(HYP)content in lung tissues,and interleukin-6(IL-6)content in bronchoalveolar lavage fluid(BALF)were also measured.RESULTS:Mice in the AE-IPF group exhibited wheezing,shortness of breath,dyspnea,and weight loss.CT imaging revealed that IPF group mice showed patchy,subpleural reticular fuzzy shadows with irregular thickening of interlobular septa and intralobular linear shadows,along with tractional bronchiectasis.In the AE-IPF group,new ground-glass shadows and solid shadows appeared in addition to the IPF features.AE-IPF group mice demon-strated decreased lung function,elevated lung index,and acute pulmonary edema.HE and Masson staining of AE-IPF group mice showed consistent pathological manifestations of AE-IPF.HYP content in lung tissues,total cell count in BALF,and IL-6 concentration were significantly higher in the AE-IPF group compared to the control group(P<0.05).CONCLUSION:The use of multiple tracheal drip administrations of bleomycin successfully established an AE-IPF ani-mal model in mice.The 63rd day of the experiment was identified as the optimal observation point,as it exhibited the most significant pathological features and clinical symptoms.This model provides ideal conditions for studying AE-IPF patho-genesis and evaluating therapeutic efficacy.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

AIM:A mouse model of acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)was estab-lished.METHODS:One hundred and twenty male C57BL/6 mice were randomly divided into a negative control group,an IPF group,and an acute exacerbation of interstitial fibrosis(AE-IPF)group.The IPF group received a low dose(3 mg/kg)of bleomycin(BLM)by endotracheal drip on days 0,14,and 28.The AE-IPF group received a high dose(5 mg/kg)of BLM by endotracheal drip on day 56.The control group received an equal volume of saline at different time points.The AE-IPF group was injected with a high dose(5 mg/kg)of BLM via tracheal drip on day 56 on top of the initial IPF induction,while the control group received equal amounts of saline at different time points.Experiments were con-ducted on the 57th,59th,63rd,and 70th days after the initial modeling.Mice were observed for general conditions,CT imaging changes,HE,and Masson staining to assess the degree of alveolitis and fibrosis in lung tissues.Lung function,hydroxyproline(HYP)content in lung tissues,and interleukin-6(IL-6)content in bronchoalveolar lavage fluid(BALF)were also measured.RESULTS:Mice in the AE-IPF group exhibited wheezing,shortness of breath,dyspnea,and weight loss.CT imaging revealed that IPF group mice showed patchy,subpleural reticular fuzzy shadows with irregular thickening of interlobular septa and intralobular linear shadows,along with tractional bronchiectasis.In the AE-IPF group,new ground-glass shadows and solid shadows appeared in addition to the IPF features.AE-IPF group mice demon-strated decreased lung function,elevated lung index,and acute pulmonary edema.HE and Masson staining of AE-IPF group mice showed consistent pathological manifestations of AE-IPF.HYP content in lung tissues,total cell count in BALF,and IL-6 concentration were significantly higher in the AE-IPF group compared to the control group(P<0.05).CONCLUSION:The use of multiple tracheal drip administrations of bleomycin successfully established an AE-IPF ani-mal model in mice.The 63rd day of the experiment was identified as the optimal observation point,as it exhibited the most significant pathological features and clinical symptoms.This model provides ideal conditions for studying AE-IPF patho-genesis and evaluating therapeutic efficacy.

A case of a 69-year-old female patient, with cough, expectoration, chest tightness and shortness of breath for 10 days accompanied by left pleural effusion, was reported. Initially, a large number of suspected malignant lymphoma cells were found in the patient′s pleural effusion through routine cell morphological examination after admission, which was the direction of clinical diagnosis and treatment in the next step. Then the patient was diagnosed as primary pulmonary diffuse large B-cell lymphoma (DLBCL) through imaging, bone marrow and lung biopsy pathology. Finally, the patient was treated effectively with R-CHOP regimen, but she died of respiratory failure 9 weeks later, because she did not receive regular follow-up and treatment after the sixth chemotherapy cycle. Primary pulmonary DLBCL, an extremely rare extranodal lymphoma' lacks specificity clinical manifestations and is easy to be missed and misdiagnosed. DLBCL with a large number of malignant pleural effusion progresses rapidly and has a poor prognosis. The routine cell morphology examination of pleural effusion is simple and intuitive, which can capture key information in the shortest time, preliminarily provide clinical diagnosis and treatment ideas, and provide accurate basis for disease diagnosis.

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

Cancer is a heterogeneous disease with complex mechanisms that requires targeted precision medicine strategies. The growth of precision medicine is indispensable from the rapid development of genomics. However, genomics has certain limitations in molecular phenotype analysis, proteogenomics thus arose at the right time. Proteogenomics is the merging of proteomics and genomics. This review describes the limitations of genomic analysis and highlights the importance of proteogenomics to re-understand precision oncology from a proteogenomic perspective. In addition, the application of proteogenomics in precision oncology is briefly introduced, the related public data projects are described, and finally, the challenges that need to be addressed at this stage are proposed.
Humans ; Proteogenomics ; Precision Medicine ; Neoplasms/genetics* ; Proteomics ; Genomics

Objective:To analyze the arsenic exposure of industrial residents and its influencing factors, so as to provide scientific basis for protecting the health of industrial residents.Methods:In 2017, the samples of PM 2.5, drinking water and soil were collected by using cross-sectional survey and were tested for arsenic contents in Xigu District, Lanzhou City. The environmental arsenic exposure was analyzed by using Environmental Protection Agency of USA health risk assessment models. The levels of urinary arsenic and blood arsenic were measured in residents who included adults, children and teenagers. The internal exposure level of arsenic and its influencing factors were analyzed. The correlation between arsenic and internal and external exposure factors were also analyzed. The content of arsenic was expressed by geometric mean. Results:A total of 84 samples of PM 2.5 were collected, and the content of air arsenic was 7.53 ng/m 3. A total of 108 samples of drinking water were collected, and the content of water arsenic was 0.002 2 mg/L. A total of 40 samples of soil were collected, and the content of soil arsenic was 0.14 mg/kg. The total non-carcinogenic risk of environmental arsenic was 0.39, which was lower than the acceptable level of non-carcinogenic risk (1.00). The total carcinogenic risk of environmental arsenic was 6.59 × 10 -5. The total carcinogenic risk of arsenic was the highest through drinking water exposure and followed by the respiratory inhalation exposure, accounting for 78.60% [(5.18 × 10 -5)/(6.59 × 10 -5)] and 20.79% [(1.37 × 10 -5)/(6.59 × 10 -5)] of the total carcinogenic risk of environmental arsenic, respectively. There were 135 subjects, and 135 blood samples were collected. The content of blood arsenic was 0.92 μg/L. The level of blood arsenic of adults (1.05 μg/L) was higher than that of children and teenagers (0.75 μg/L, U = - 3.594, P < 0.05). One hundred and thirty-five urinary samples were collected, and the content of urinary arsenic was 14.17 μg/L. There was a positive correlation between urinary arsenic and blood arsenic ( r = 0.357, P < 0.05). Blood arsenic levels were positively correlated with the total carcinogenic risk and the risk of carcinogenesis through respiratory, oral and skin exposures ( r = 0.252, 0.244, 0.255, 0.255, P < 0.05). Conclusion:Arsenic in the environment of industrial areas has a potential carcinogenic risk to the residents, so the intake of arsenic in drinking water through oral exposure and respiratory inhalation exposure should be limited.

Objective:To investigate the influence of all-trans-retinoic acid (ATRA) on the proliferation and invasion of osteosarcoma 143B cells and its possible regulatory mechanism.Methods:Different concentrations of ATRA were used to treat human osteosarcoma 143B cells, and the optimal concentration and treatment time those affected cell proliferation were selected. The MTS method, Transwell migration and invasion experiments were used to detect the changes in the proliferation, migration and invasion of 143B cells after ATRA treatment. The real-time quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the expression changes of miRNA-34a (miR-34a), E2F1 and Eag1 in osteosarcoma 143B cells after ATRA treatment. Then miR-34a was interfered and E2F1 was overexpressed, and the abilities of cell proliferation, invasion and migration abilities as well as the expression changes of miR-34a, E2F1 and Eag1 in 143B cells were detected.Results:The proliferation inhibition of 143B cells was most obvious when 143B cells were treated with 10 μmol/L ATRA for 72 h. The cell migration and invasion numbers when 143B cells were treated with 10 μmol/L ATRA for 72 h were lower than those in the negative control group [(73±3) cells vs. (182±5) cells, t = 21.46, P<0.01; (94±3) cells vs. (203±7) cells, t = 13.70, P<0.01]. 10 μmol/L ATRA could promote the expression of miR-34a in 143B cells and inhibit the expressions of Eag1 and E2F1 (all P<0.01). Compared with ATRA group, the ability of cell proliferation in ATRA+miR-34a interference group was restored after 72 h of treatment [cell survival rate (41.0±2.2)% vs. (25.0±3.6)%, t = 108.68, P<0.01]. Compared with ATRA group, the abilities of cell migration and invasion in ATRA+miR-34a interference group were restored [(122±14) cells vs. (64±10) cells, t = 21.06, P<0.01; (103±10) cells vs. (59±8) cells, t = 24.27, P<0.01), and the mRNA and protein expressions of Eag1 and E2F1 in cells were promoted (both P<0.01). Compared with ATRA group, the ability of cell proliferation in ATRA+E2F1 overexpression group was restored [cell survival rate (40.0±3.4)% vs. (24.0±3.1)%, t = 108.74, P<0.01]; the abilities of cell migration and invasion in ATRA+E2F1 overexpression group were restored [(78±12) cells vs. (29±8) cells, t = 13.52, P<0.01; (75±12) cells vs. (49±10) cells, t = 6.28, P<0.01], and the mRNA and protein expressions of Eag1 and E2F1 in cells were promoted (both P<0.01). Conclusion:ATRA inhibits the proliferation and invasion of osteosarcoma cells via regulating miR-34a-E2F1-Eag1 signaling pathway, and it may become one of the effective treatment drugs for osteosarcoma.

【Objective】 To analyze the changes of activation, function and metabolism of apheresis platelets during storage. 【Methods】 Five groups of apheresis platelets(n=10per group), stored up to 5 days at 20~24℃ with agitation, were sampledat day0(4 hours within collection), 1, 2, 3 and 4, respectively to assess the activation indexes as PAC-1 and CD62P and platelet function was evaluated by thromboelastogram.The platelet counts and related parameters were determined, and the biochemical indexes such as pH, glucose, lactic acid and lactate dehydrogenase reflecting metabolism were measured and statistically analyzed. 【Results】 The CD62P (%) and PAC-1 (%) of apheresis platelets with different storage duration showed significant differences(P<0.05), and CD62P (%) increased significantly on 4thday of storage (P<0.05). There were significant differences in TEG parameters as R(min), K(min), ANG (min)and MA (mm), and MA value increased significantly after1-daystorage (P<0.05). There was no significant difference in Plt and related indexes among the groups (P>0.05). Significant differences were notable in platelet biochemical indexesby groups using variance analysis(P<0.05). The pH value and glucose were the lowest in platelets with 4-day storage, while lactic acid and lactate dehydrogenase were the highest. 【Conclusion】 The storagelesion of apheresis platelets occurs as the activation, function and metabolism of platelets developed as the storage prolonged.