Objective To explore the changes in serum energy metabolites in patients with peripheral T-cell lymphoma,and investigate serum biomarkers for monitoring peripheral T-cell lymphoma from the perspective of energy metabolism.Methods Multiple/selected reaction monitoring(MRM/SRM)was used to detect the energy-related metabolites in the sera of 16 patients with newly diagnosed peripheral T-cell lymphoma admitted in the Hematology Medical Center of the Second Affiliated Hospital of Army Medical University from November 2020 to December 2021,as well as 10 recruited healthy volunteers.The corresponding clinical data including medical history,laboratory results and image data were collected and retrospectively analyzed.Results Significant differences were seen in the contents and expression profiles of serum energy metabolism-related products between the patients and the healthy volunteers.The patients had significantly reduced serum contents of cyclic AMP,succinate,citrate and cis-aconitate(P＜0.05),and elevated D-glucose 6-phosphate content(P＜0.05).The serum contents of citrate and succinate were negatively correlated with the risk stratification(low-,moderate-and high-risk)and clinical stage of the disease(P＜0.05).Meanwhile,there was a negative correlation between the contents of L-malic acid and citrate and the mid-term efficacy evaluation results,such as complete/partial response(CR/PR)or stable disease(SD)(P＜0.05).For patients with extranodal NK/T cell lymphoma(n=10),there were also significant reductions in the contents of cyclic AMP,succinate,citrate,isocitrate and cis-aconitate in the sera of patients compared with healthy volunteers(P＜0.05),and the contents of citrate and succinate were negatively correlated with the clinical stage(P＜0.05)and were rather correlated with mid-term efficacy evaluation results(CR/PR or SD)(P＜0.05).For patients with angioimmunoblastic T-cell lymphoma(n=6),the serum contents of cyclic AMP,citrate and succinate were significantly lower,while the content of D-glucose 6-phosphate was higher when compared with the healthy volunteers(P＜0.05),and the content of succinate was negatively correlated with both clinical stage and risk grade of the patients(P＜0.05).Conclusion There are 5 serum differential metabolites identified between patients with peripheral T-cell lymphoma and healthy controls,and succinate and citrate are expected to be serum biomarkers of peripheral T-cell lymphoma.

BACKGROUND:The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes,and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified. OBJECTIVE:To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis. METHODS:Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed,including Cobb angle,coronal pelvic tilt,lumbar lordosis,left and right pelvic hip width ratio(sacroiliac-anterior superior iliac spine),spinal rotation angle,pelvic tilt,sacral slope,pelvic incidence,coronal deformity angular ratio,sagittal deformity angular ratio,C7 plumb line-center sacral vertical line,apical vertebral translation,and coronal sacral inclination.The information was summarized as a database.SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman's correlation analysis and linear regression. RESULTS AND CONCLUSION:(1)Cobb angle was highly positively correlated with coronal deformity angular ratio,apical vertebral translation,and spinal rotation angle(r=0.91,r=0.841,r=0.736).(2)Coronal deformity angular ratio was highly positively correlated with apical vertebral translation(r=0.737),moderately positively correlated with C7 plumb line-center sacral vertical line(r=0.514),and moderately negatively correlated with sagittal deformity angular ratio(r=-0.595).(3)There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio(r=0.942)and a moderate negative correlation with coronal deformity angular ratio(r=-0.554).(4)There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination(r=0.522,r=0.534)and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt(r=0.507).Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation(r=0.507,r=0.506).Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation(r=0.512,r=0.538).Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence(r=0.614,r=0.621).(5)Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal,sagittal and coronal planes.When the lumbar spine affects scoliosis and is rotated,the relative position of the pelvis will also change to compensate,which indicates that while correcting scoliosis,the correction of the pelvis cannot be ignored.

Objective:To compare the effect and safety of continuous veno-venous hemofiltration (CVVH)+double plasma molecular absorption (DPMA)+hemoperfusion (HP), CVVH+HP, and CVVH+plasma exchange (PE) in treatment of patient with severe wasp stings injury.Methods:Multicenter, historical cohort study and superiority test were used. From July 2020 to October 2022, patients with wasp sting injury and multiple organ damage admitted to the intensive care units (ICU) of five hospitals were consecutively screened and recruited into the CVVH+DPMA+HP group (intervention group). Propensity score matching was used to establish historical cohorts. Patients with severe wasp sting injury who hospitalized from January 2016 to June 2020 in each ICU were collected and matched 1∶1 with the intervention group, and divided into CVVH+HP group and CVVH+PE group according to their actual hemopurification protocols (historical control groups). The primary outcome was the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on days 3 and 7 after initiation of treatment. Secondary outcomes included complications, length of ICU and hospital stays, and all-cause mortality. Multivariate Cox proportional risk regression was used to analyze the prognosis of patients.Results:After propensity score matching, 56 patients in intervention group and each of the two historical control groups were matched successfully. There were no significant differences in age, gender, comorbidities, biochemical test indices and critical illness scores among the groups. After treatment, APACHE Ⅱ score markedly declined in all groups, and the decrease was faster in the intervention group; treatment with DPMA [hazard ratio ( HR) = 1.04, 95% confidence interval (95% CI) was 1.02-1.08, P = 0.00], the decreased levels of body temperature ( HR = 1.02, 95% CI was 1.00-1.03, P = 0.02), serum creatine kinase (CK; HR = 0.98, 95% CI was 0.96-1.00, P = 0.05) and myoglobin (MYO; HR = 2.88, 95% CI was 1.24-6.69, P = 0.01) were independent risk factors for APACHE Ⅱ score decline to the target value (15 scores). There were no significant differences in the incidence of bleeding complications, filter or perfusion thrombosis, blood pressure reduction, catheter-related infection and anaphylaxis among the groups. Conclusion:CVVH+DPMA+HP regimen can significantly reduce the APACHE Ⅱ score of patients with severe wasp sting injury, and the efficacy is superior to CVVH+HP and CVVH+PE regimens, with safety.

Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.

OBJECTIVE To explore the therapeutic effect of modified Yupingfeng powder combined with Yougui pill on patients with chronic obstructive pulmonary disease （COPD）with deficiency of lung and kidney in remission period . METHODS Ninety-two patients ，who were in remission of COPD and whose traditional Chinese medical syndromes belonged to deficiency of lung and kidney from Fuzhou Hospital of Traditional Chinese Medicine in Jiangxi province during May 2018-January 2020，were divided into control group and observation group according to random number table method ，with 46 patients in each group . Control group was treated with conventional western medicine （given Tiotropium bromide powder spray ，18 μg/inhalation，one dose per day ）；observation group was additionally treated with modified Yupingfeng powder decoction combined with Yougui pill （decocting one dose per day ，filtering 300 mL per time ，150 mL in the morning and afternoon ）on the basis of control group . After 8 weeks of treatment ，the clinical efficacy ，serum inflammatory factors and fibrosis indexes ，T cell subsets and lung function indexes，and the occurrence of adverse drug reactions were compared between 2 groups. RESULTS After treatment ，the total clinical effective rate of treatment （91.30%）in observation group was significantly higher than that of the control group （71.74%）； the levels of serum chemokine C -X3-C motif ligand 1，transforming growth factor β1，interleukin-6，matrix metalloproteinase -2 and tissue inhibitor of metalloproteinase -2 in observation group were significantly lower than control group ；there was statistical significance in CD 4+，CD3+，CD4+/CD8+，forced vital capacity ，the ratio of forced expiratory volume in the one second to forced vital capital （FEV1/FVC%）（P＜0.05）. The adverse drug reactions of the two groups were mainly gastrointestinal reactions and rashes. The incidence of adverse drug reactions in the observation group was 13.04%，and there was no statistical difference compared with control group （10.86%） （P＞0.05）. CONCLUSIONS Modified Yupingfeng powder combined with Yougui pill can reduce airway inflammation ， improve immunity and improve lung function of COPD patients with deficiency of lung and kidney in remission period ，and have good safety .

Objective:To explore the efficacy and safety of amisulpiride at low dosage combined with clozapine in the treatment of refractory schizophrenia. Methods:Totally 160 patients with refractory schizophrenia were chosen from the psychiatric department of 4 hospitals during January to September in 2014 and randomly divided into the observation group and the control group with 80 cases in each. The patients were treated with clozapine plus amisupiride or clozapine plus placebo for 12 weeks. The positive and negative syn-drome scale ( PANSS) and treatment emergent side effect scale ( TESS) was used to respectively evaluate the efficacy and the adverse effects. Results:At the weekend of the 4th, 8th and 12th week after the treatment, the clinical efficacy in the observation group was sig-nificantly better than that in the control group (all P<0. 05). The total and every factors scores of PANSS after the treatment were sig-nificantly lower than those before the treatment in both groups ( P<0. 01), and the decrease in the observation group was more signifi-cant than that in the control group (P<0. 05 or P<0. 01). There was no significant difference in the incidence of adverse effects be-tween the two groups (P>0. 05). Conclusion:Amisulpiride at low dosage combined with clozapine can significantly improve the effi-cacy in the treatment of refractory schizophrenia without added adverse effects.

OBJECTIVETo monitor human cytomegalovirus (HCMV) drug resistance in recipients of hematopoietic stem cell transplantation by phenotypic and genotypic methods.

METHODSHCMV clinical isolates was isolated from the urine of hematopoietic stem cell transplantation recipients treated with GCV. Tissue cell infection median dose (TCID50) of the isolates was calculated using Reed-Muench method, and their drug susceptibility was determined by plaque reduction assay. We amplified the UL97 DNA fragment of the virus by nested PCR followed by automated DNA sequencing.

RESULTSHCMV clinical strain isolated from the urine samples of the recipients using a human fibroblast cell line showed a TCID50 value of 10(-4.618)/0.1 ml and a 50% inhibitory concentration (IC50) to GCV of 5.847 µmol/L, suggesting its sensitivity to GCV. Alignment with the AD169 DNA reference sequence identified 4 point mutations of the virus at 1509 (T-C), 1575 (C-T), 1794 (T-C), and 1815 (C-G), and only the last mutation resulted in one amino acid mutation to D605E. No gene mutation was found in relation to GCV resistance.

CONCLUSIONSPhenotypic and genotypic assays were established to examine antiviral drug resistance of HCMV in recipients of hematopoietic stem cell transplantation. We did not find any drug resistance of the clinical HCMV isolate.

Antiviral Agents ; pharmacology ; Cell Line ; Cytomegalovirus ; drug effects ; genetics ; isolation & purification ; Drug Resistance, Viral ; genetics ; Ganciclovir ; pharmacology ; Genes, Viral ; Genotype ; Hematopoietic Stem Cell Transplantation ; Humans ; Mutation ; Phosphotransferases (Alcohol Group Acceptor) ; genetics

BACKGROUND:Preoperative walking ability and activities are good predictors of functional recovery of patients after hip replacement. But these objective assessment tools are invalid to predict postoperative function of patients with no preoperative walking ability.
OBJECTIVE:To assess the effect of preoperative subjective physical activity questionnaire to predict the 6-month postoperative physical functioning outcomes in elder patients receiving hip arthroplasty, and to determine which aspects of patient’s characteristics influence 6-month postoperative physical activity.
METHODS:A two-center prospective audit was carried out in elder patients who underwent hip arthroplasty between November 2010 and February 2013. These patients were divided into three groups, including the group of total hip arthroplasty for fractures of the femoral neck, the group of total hip arthroplasty for osteoarthritis and the group of hemiarthroplasty for fractures of the femoral neck. Al patients had fulfil ed Longitudinal Aging Study Amsterdam-Physical Activity Questionnaire (LAPAQ) and Short Form 36 (SF-36) recal ing their physical activity at 2 weeks before the fal accident (for fractures of the femoral neck) or admission (for hip osteoarthritis). Preoperative demographic data were also col ected. Postoperative assessment regarding subjective physical activity assessment including LAPAQ and SF-36, and objective physical activity assessment including timed up and go test and six-minute walk test were evaluated at the time of 6-month postoperation.
RESULTS AND CONCLUSION:Total y 115 patients finished the study. Both preoperative LAPAQ and SF-36 can play a predictor to probe 6-month postoperative function of objective and subjective activity in patients with femoral neck fractures or hip osteoarthritis undergoing hip arthroplasty. Preoperative LAPAQ seems better than preoperative SF-36 to predict postoperative physical activity. For hip fracture patients, because preoperative objective function cannot be assessed, preoperative LAPAQ can play an effective and subjective index to predict postoperative function of objective activity, and physical functions can recover 70%-80%at 6 months postoperatively. For hip osteoarthritis patients, postoperative physical function can be increased by approximately 27%compared with before hip arthroplasty. Patient’s characteristics also affect the postoperative physical activity, and the occurrence of preoperative complications is a most important factor.

Objective To research the antiviral activity of artesunate (ART) in vitro fighting against both standard laboratory strains and ganciclovir(GCV)-resistance strains of human cytomegalovims(HCMV) and to explore whether fractionation dosage method can obviously enhance the antiviral effect of ART.Methods 1.Cytotoxicity assay to ART was performed by the use of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetry.The 0％ toxic concentration (TC0) were determined,and median cytotoxic concentration (TC50) was calculated with Probit regression method.2.Antiviral activity assays of ART against HCMV:human embryonic lung fibroblast cells (HELs) were infected with standard laboratory strains and GCV-resistance strains of HCMV,respectively,after which virus was removed and overlays of dulbecco's modified eagle medium(MEM) containing different antiviral drugs were added to the wells.All cells were cultured continuously at 37 ℃ in a 50 mL/L CO2 humidified atmosphere for 7-10 days and the cytopathic effect (CPE) was observed under a microscope.When the degree of CPE was clear (+ + +-+ + + +),the values of absorbency at 490 nm of all cell wells were measured by MTT colorimetry.The cell survival rate (CSR)and drug inhibitory rate (IR) for HCMV were calculated.By Probit regression method,the median inhibitory concentration (IC50) of 2 drugs was calculated respectively.3.To explore whether fractionation dosage method could obviously enhance the antiviral effect of ART against HCMV,the experiment was divided into 3 groups and compared with GCV group,respectively:Group 1:ART antiviral compounds were added to cell layers by one dosage.Group 2:Total drug dosage was divided into 3 parts,and each part was added to cell layers once a day for 3 days.Group 3:Total antiviral compounds were divided into 6 and delivery 2 times a day.The values of absorbency at 490 nm of all cell wells were measured by MTT colorimetry.The CSR and viral inhibitory rates were calculated.All data were statistically analyzed by One-Way ANOVA analyzing using SPSS 18.0 statistical software.P value of ＜0.05 was considered to indicate statistical significance.Results 1.Cytotoxicity assay showed that cytotoxicity was not found in the relevant range of ART concentrations under 62.5 μmol/L.TC0 and TC50 value of ART were 62.5 μmol/L and 171.7 μmol/L.2.In concentration of 5 μmol/L,15 μmol/L and 30 μmol/L,ART and GCV could obviously inhibit growth of HCMV AD169 strains.There was no significant difference between them.The value of GCV IC50 was 3.49μmol/L,and the value of ART IC50 was 2.17 μmol/L.Treatment index (TI) of ART was 28.8,and GCV was 716.3.ART could still obviously inhibit growth of HCMV resistant strains,but GCV couldn't.Differences between them were statistically significant.The value of GCV IC50 to HCMV resistant strains was 44.4 μmol/L,and the value of ART IC50 was 2.5 μmol/L.3.Fractionation dosage method (2 times a day) of ART could improve the inhibition rate of virus significantly compared to that used once a day and single dose method.Difference was statistically significant(P ＜ 0.01).GCV delivered as the same method had little different changes in virus suppression ratio(P ＞ 0.05).Conclusions 1.Cytotoxicity was not found in the relevant range of ART concentrations under 62.5 μmol/L.2.ART could obviously inhibit growth of HCMV resistant strains and standard laboratory strains.3.Fractionation dosage method (2 times a day) of ART could improve the inhibition rate of virus significantly compared to that used once a day and single dose method.4.Because the action mode of ART is different from other anti-HCMV drugs,and ART has a high biological activity and fewer side effects,it is expected to become a kind of new antiviral drugs for HCMV infections.

OBJECTIVE: This article evaluates the auditory and speech perception outcomes of sensorneural hearing loss with cerebral white matter abnormalities after cochlear implantation. METHOD: A retrospective analysis was performed on the cochlear implantatees with cerebral white matter abnormalities by using the categories of auditory performance and speech intelligibility rating, and compared with the non-syndrome patients with sensorineural hearing loss. Paired t-test was used for statistical analysis. RESULT: There was statistical difference between normal group and white matter changes group with sensorineural hearing loss after 6 month. No statistical difference was found after 12 month and 24 month. CONCLUSION In the short term, the cochlear implant can be performed safely in patients with white matter changes. After a formal rehabilitation training,no significant difference in auditory or language ability was found between normal group and white matter changes group with sensorineural hearing loss.
Child, Preschool ; Cochlear Implantation ; rehabilitation ; Female ; Follow-Up Studies ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Leukoencephalopathies ; complications ; Male