Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative method for various hematological diseases. With the optimization of transplantation technology, the clinical application of allo-HSCT is more and more mature. Post-transplant liver injury is one of the common postoperative complications, which seriously affects the quality of life and long-term survival of patients. The causes of liver injury after allo-HSCT can be divided into non-infectious and infectious factors, which show similar clinical manifestations and different treatment principles. Timely diagnosis of post-transplant liver injury and the identification of the disease cause will be beneficial for early prevention or targeted treatment, thereby improving patients' prognosis. This review focuses on the etiology, clinical features, and treatment options of liver injury after allo-HSCT, aiming to deepen the understanding of hematologists on liver injury after allo-HSCT.

Brain computer interface(BCI)is a rapidly developing rehabilitation technology in recent years, which has been gradually used for cognitive rehabilitation of stroke patients.BCI can activate brain regions related to cognition to a greater extent through motor imagery and neural feedback technology, promote functional connectivity between brain regions, and ameliorate cognitive impairment after stroke.This paper summarized the mechanisms involved in BCI promoting cognitive rehabilitation and current applications of BCI in post-stroke cognitive impairment, and identifies the shortcomings of BCI in the treatment of post-stroke cognitive impairment, in order to provide insight for the research and clinical practice of BCI in post-stroke cognitive rehabilitation.

Objective:To document the blood indexes of middle-aged and elderly intracerebral hemorrhage (ICH) patients complicated with deep vein thrombosis (DVT).Methods:A retrospective analysis was conducted of 77 hospitalized ICH patients using venous color Doppler ultrasonography within 3 days of admission. According to the results, they were divided into a DVT group (18 cases) and a non-DVT group (59 cases). The blood routine, biochemistry, coagulation, and D-dimer examinations were conducted on the 2nd day after admission. T-tests and rank sum tests tested the significance of any differences between the groups in average white blood cell counts, neutrophil percentages, platelets, albumin, globulin, fasting blood glucose, urea nitrogen, creatinine, uric acid, electrolytes, fibrinogen or D-dimer.Results:The average levels of albumin, uric acid and calcium in the DVT group were significantly lower than in the non-DVT group. The average levels of fasting blood glucose and D-dimer were significantly higher.Conclusions:Decreased serum uric acid, calcium and albumin levels, together with increased fasting blood glucose and D-dimer are related to the occurrence of DVT in ICH patients. To reduce the risk of DVT it is important to maintain normal levels of serum uric acid, calcium and albumin and to limit D-dimer and fasting blood glucose.

Objective: To observe the effect of Mo-Rubbing abdomen manipulation on glucose metabolism and inflammatory factors in rats with type 2 diabetes mellitus (T2DM). Methods: Sixty Sprague-Dawley rats were randomly divided into a normal group (n=10) and a group for modeling (n=50) using the random number table method. Rats in the group for modeling were induced to form T2DM models by a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin. Thirty successfully modeled rats were randomly divided into a model group, a Mo-Rubbing abdomen group, and a metformin group, with 10 rats in each group. Rats in the normal group and the model group received no intervention, those in the Mo-Rubbing abdomen group received Mo-Rubbing abdomen manipulation, and those in the metformin group received metformin by gavage. After 8-week intervention, fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment for insulin resistance (HOMA-IR) and area under the curve at the oral glucose tolerance test (AUC-OGTT), as well as serum inflammatory factors interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α were detected, and the morphological changes of the pancreas were also observed. Results: After the 8-week intervention, the levels of FINS, FPG, HOMA-IR, and AUC-OGTT of rats in the Mo-Rubbing abdomen group were significantly lower than those in the model group (P<0.05); the pancreatic injury degree in the Mo-Rubbing abdomen group and the metformin group was lower than that in the model group. Compared with the model group, the serum IL-1β, IL-6, and TNF-α levels of rats in the Mo-Rubbing abdomen group were significantly decreased (P<0.05), and the serum IL-1β and TNF-α levels of the metformin group showed a downward trend; the serum IL-6 and TNF-α levels in the Mo-Rubbing abdomen group were significantly lower than those in the metformin group (P<0.01). There was a significant positive correlation between FPG with IL-1β, IL-6, and TNF-α in the T2DM rats (P<0.01). Conclusion: Mo-Rubbing abdomen manipulation reduces the inflammatory response and improves the morphological changes of the pancreas in T2DM rats, thereby achieving the effect of lowering blood glucose.

Objective:To explore the risk factors and follow-up outcomes of pediatric heart transplantation(HT).Methods:Between January 2018 and June 2022, perioperative data are retrospectively reviewed for 41 pediatric HT recipients aged <18 years and donor-recipient weight data for infants aged under 3 years at Guangdong Provincial People's Hospital.Perioperative survivors are followed up until August 31, 2022 through out patient visits and telephone calls.Postoperative survivals are examined by Kaplan-Meier method and possible risk factors for perioperative survival identify with Logistic regression.Results:There are 22 boys and 19 girls with a median age of 120(58~138)months.After preoperative adjuvant therapy of extracorporeal membrane oxygenation(ECMO), 8 cases had a successful transition to HT and 2 children underwent ABO incompatible(ABOi)HT.Six children aged under 3 years had a donor-recipient weight ratio of 2.95.Among 17 children, there are one or more complications, including continuous renal replacement therapy(CRRT, 9 cases, 21.95%), tracheotomy (3 cases, 7.32%), delayed chest closure or redo of sternotomy(6 cases, 14.63%)and acute graft dysfunction(4 cases, 9.76%). Five children died during perioperative period.The possible risk factors for perioperative mortality include preoperative ECMO assistance[ HR: 32.00, 95% CI: (2.83~361.79), P<0.05], preoperative CRRT[ HR: 11.33, 95% CI: (1.15~111.69), P<0.05] and total bilirubin [ HR: 1.02, 95% CI: (1.002~1.040), P<0.05]. During follow-ups, one child died from Epstein-Barr virus (EBV)associated post-transplant lymphoproliferative disease; another case of EBV-associated hepatic leiomyoma underwent transcatheter arterial embolization.With an overall survival rate of 85.37%, the cumulative survival rate is 96.97% for children without preoperative ECMO assistance( P<0.05). Postoperative mortality rate spiked markedly in children with preoperative ECMO assistance ( P=0.0013). However, follow-up results of perioperatively survivors indicate that preoperative usage of ECMO will not affect follow-up survival( P=0.53). In ABOi group or infants aged under 3 years, no mortality occurres postoperatively or during follow-ups. Conclusions:In infant aged under 3 years, the strategies of ABOi HT and large-weight donor HT are both safe and effective and it has no effect upon perioperative and follow-up survivals.Preoperative ECMO assistance, total bilirubin and preoperative use of CRRT are risk factors for perioperative survival.

Objective: To investigate the expression of lysophosphatidic acid(LPA) in mouse silicosis model and its effect on epithelial-mesenchymal transition(EMT) of mouse lung epithelial(MLE-12) cells. Methods: 20 C57 BL/6 male mice were randomly divided into the control group and the model group. The control group was given normal saline, and the model group was given nasal drip of 50 μl silicon dioxide(SiO2) suspension with 100 mg/L every day for 7 consecutive days. They were killed on the 28 th day. Partial lung tissues were taken. Immunohistochemistry was used to observe the expression of lysophosphatidic acid receptor 1(LPAR1), and Western blot was used to detect the protein expression of α-smooth muscle actin(α-SMA),Type Ⅰ collagen( COLⅠ) and LPAR1; the proliferation of MLE-12 was detected by solution cell proliferation assay; scratch test was used to detect the migration ability of SiO2on MLB-12 cells. MLE-12 cells were divided into control group, SiO2stimulation group and inhibitor group, and the expression levels of LPARI and EMT related proteins were detected by Western blot. Results: Western blot detection showed that the expression of α-SMA and COLⅠin the lung tissue of mice from the model group increased, and the model was established successfully; immunohistochemistry showed that the expression of LPAR1 was positive in the epithelial cells around the trachea and bronchus of the model group mice, showing bright brown; Western blot detection found that the expression of LPAR1 protein in the lung tissue of mice from the model group was higher than that from the control group(P<0.05); cell proliferation assay and scratch test showed that SiO2could significantly promote the proliferation and migration of MLE-12 cells; Western blot showed that the expression of LPAR1 and interstitial marker Vimentin protein increased in SiO2stimulation group(P<0.05), while the expression of epithelial marker E-cadherin protein decreased(P<0.05), and the difference was statistically significant compared with the control group and the inhibitor group(P<0.05). Conclusion The expression of LPA increased in mouse silicosis model, which can promote the proliferation and migration of MLE-12 cells by regulating EMT process and exacerbates the process of silicosis in mice.

Objective:To observe factors influencing the risk of urinary tract infection (UTI) after cerebral hemorrhage (ICH).Methods:A total of 77 ICH patients undergoing rehabilitation between August 2015 and August 2017 were studied. Among them, 24 were diagnosed with a UTI according to clinical manifestations and urine routine tests and urine culture. They formed the UTI group. The other 53 were the non-UTI group. Complete clinical evaluations were available for all 77, and those data were used to identify risk factors for UTI using univariate and multivariate logistic regression analysis.Results:The univariate analysis showed that age, side of paralysis, consciousness dysfunction, Brunnstrom staging of the lower extremity, tracheotomy, indwelling catheter, lung infection, white blood cell count, neutrophil percentage, serum natrium, uric acid, D-dimer level and fibrinogen were all significant predictors of UTI. The multivariate analysis identified age, right side hemiplegia and D-dimer level as useful predictors.Conclusions:Advanced age and a high D-dimer level are independent risk factors for UTI after ICH, while hemiplegia on the right side is a protective factor.

Objective:To observe risk factors for lung infection (LI) after cerebral hemorrhage (ICH).Methods:A total of 118 patients with ICH were retrospectively analyzed. Among them, 63 were diagnosed with an LI according to clinical manifestations and X-ray or CT on admission. They were selected into an LI group, while the rest formed the non-LI group. Gender, age, duration of disease, side of paralysis, position and type of ICH, complications, cognitive disorders, consciousness, dysphagia, motor function, and serum levels of albumin, sodium, potassium, calcium and magnesium were recorded on the second day after admission. The risk factors for LI were analyzed using univariate and multivariate logistic regression analysis.Results:Age, duration of disease, side of paralysis, position and type of ICH, tracheotomy, urinary tract infection, cognitive impairment, dysphagia, motor function, and serum levels of albumin, sodium, calcium, and magnesium were all significant predictors of LI after an ICH. Multivariate logistic regression analysis showed that right side hemiplegia, bilateral paralysis, subarachnoid hemorrhage, urinary tract infection, and serum magnesium are all significant predictors.Conclusions:Right or bilateral paralysis, subarachnoid hemorrhage and urinary tract infection are independent risk factors for LI after an ICH. High serum magnesium within the normal range can reduce the incidence of LI.

Objective:To explore the factors related to cognitive dysfunction after traumatic brain injury.Methods:A total of 55 patients with traumatic brain injury were analyzed retrospectively. The clinical information about the patients, including age, gender, paralyzed side, course of the disease, type of injury, degree of injury, treatment, speech function (grades of Boston aphasia severity), swallowing function (7-level evaluation method), limb motor function (Brunnstrom stages of the upper limb, hand and lower limb), complications (tracheotomy, lung infection, urinary tract infection, pressure sores, electrolyte imbalance and hypoproteinemia), whether the patient received rehabilitation therapy, and D-dimer and coagulation examination results were recorded. Univariate analysis and ordered multi-class logistic regression analysis were conducted to screen the related factors using Rancho Los Amigos cognitive function grades as the dependent variable.Results:The results of the univariate analysis showed that consciousness, aphasia severity, swallowing ability, Brunnstrom stages, having received a tracheotomy, urinary tract infection, hypoproteinemia, fibrinogen and D-dimer all significantly predicted Rancho Los Amigos cognitive function grades. The logistic regression analysis showed that disordered consciousness, aphasia severity, Brunnstrom stage of the upper limbs, and urinary tract infection were significant predictors.Conclusions:Disordered consciousness, aphasia severity, Brunnstrom stage of the upper limbs, and urinary tract infection are factors related to cognitive dysfunction after traumatic brain injury.

Objective    To explore the correlation between perioperative blood transfusion and acute kidney injury (AKI) after heart transplantation. Methods    A retrospective study was performed on 67 patients who underwent heart transplantation in the Department of Cardiac Surgery, Guangdong Provincial People's Hospital from January 2016 to December 2018, and finally 63 patients were included according to the exclusion criteria. There were 53 males and 10 females with an average age of 44.3±12.9 years. Twenty patients who adopted continuous renal replacement therapy (CRRT) after heart transplantation were divided into a RT group and the other 43 patients who did not use CRRT were divided into a non-RT group. Baseline characteristics, perioperative blood transfusion data and clinical prognosis were compared between the two groups. Results    The preoperative baseline characteristics of the two groups were basically the same. There were significant differences in perioperative infusion of red blood cells and plasma, postoperative 24 h bleeding and re-exploration (P<0.05) between the two groups. The area under the receiver operating characteristic (ROC) curve was 0.923 (95%CI 0.852 to 0.995, P<0.001). The ROC curve showed that perioperative infusion of red blood cells more than 18 mL/kg would increase the incidence of AKI after heart transplantation. Conclusion    Perioperative blood transfusion is closely related to AKI after heart transplantation. The more blood transfusion is in clinics, the higher incidence of renal injury is and the worse prognosis is. It is suggested that various blood-saving measures can be carried out.