The efficacy and safety of venetoclax combined with reduced dose HAD regimen in the treatment of newly diagnosed acute myeloid leukemia (AML) was investigated. From May 2022 to January 2023, a total of 25 patients with newly diagnosed AML were treated with venetoclax combined with reduced-dose HAD regimen as induction therapy. Accoding to the 2017 ELN recommendations, 13 (52.0%) in favoable, 3 (12.0%) in intemediate, and 9 (36.0%) in adverse. The ORR (CR rate+PR rate) was 88.0%, and the CR rate was 84.0%. By May 30, 2023, with a median follow-up of 9 months, 1 year overall survival, event-free survival, and relapse-free survival were 100%, 94.7%, and 94.7%, respectively. All patients received 1-5 cycles of consolidation therapy and two median cycles. Treatment with venetoclax and reduced dose of HAD regimen in the treatment of patients with newly diagnosed AML was high effective and safe.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective To explore the clinical significance of ultrasound-guided fine needle aspiration cytology in the diagno-sis of papillary thyroid carcinoma.Methods For cases of thyroid nodules with a diameter less than 1 cm and negative clinical palpation detected by ultrasound,ultrasound-guided fine needle aspiration cytological examination was performed,and the cyto-logical results were compared and analyzed with postoperative histopathological results and BRAFV600E detection re-sults.Results Among the 511 cases,the cytopathological results showed 20 cases of failed sampling,14 cases of benign lesions,230 cases of suspected malignancy,242 cases of papillary thyroid carcinoma,2 cases of non-Hodgkin's lymphoma,and 3 cases of medullary thyroid carcinoma.The histopathological results showed 5 benign cases,496 papillary thyroid carcinoma,3 papillary thyroid carcinoma with Hashimoto's thyroiditis,3 non-Hodgkin's lymphoma,and 4 medullary thyroid carcinoma.There were 10 false negative cases in cellular pathology,with no false positive cases.The consistency rate between cellular pathology and histopathology was 94.27％.Conclusion Ultrasound-guided fine needle aspiration cytology has a high diagnostic accuracy for papilla-ry thyroid carcinoma,and provides accurate results for clinical palpation negative masses before surgery.Combined with postoperative histopathology and BRAFV600E gene testing results,it provides a strategy for subsequent treatment and follow-up.

Objective To investigate MRI features and pathological basis of diffuse midline glioma(DMG)with H3 K27 mutation and to improve the understanding of the clinical and preoperative diagnosis.Methods The imaging,histopathological,molecular pathological and prognostic data of 17 cases DMG with H3 K27 mutation confirmed by pathology were analyzed retrospectively.Results All regions located in midline areas and showed diffuse growth.There were 7 cases located in thalamus(1 case involved bilateral thalamus),3 cases in brainstem.Two cases involved thalamus and brainstem simultaneously.Two cases involved cervical spinal cord.Two cases involved ventriculus tertius and fourth ventricle.One case located in cerebella.Most lesions showed mixed signals,mainly with long signal on T1WI and long signal on T2WI.And 9 cases showed slightly narrow strip peritumoral edema and 8 cases showed no peritumoral edema.Of all cases,there were 9 cases with non-enhancement intensity,8 cases with diverse enhancement patterns.A total of 15 cases underwent fluid attenuated inversion recovery(FLAIR)scans,5 cases showed the T2/FLAIR imaging mismatching characteristics.Six cases were complicated with small cystic necrosis and 5 cases with intra-tumoral hemorrhage.Conclusion DMG with H3 K27 mutation has specific locations and MRI characteristics,including diverse contrast-enhancement patterns,non-or slightly narrow strip peritumoral edema.However,the definite diagnosis depends on pathological results.

Osteochondral lesion of talus (OLT) is a foot and ankle disease characterized by ankle pain, which may impact the joint function and life quality. If managed improperly, it may lead to a further ankle arthritis, severely compromising the prognosis. The therapeutic effect of conservative treatment for OLT is still uncertain. Surgery is still the main treatment modality for OLT with various techniques. However, the optimized surgical technique is still inconclusive, furthermore, regeneration and repair of cartilage after debridement is also a great challenge for the treatment of OLT. Platelet-rich plasma (PRP) with good repair effect on cartilage injury is gradually applied in the treatment of OLT. However, there still lacks the unified understanding of the technique and specification of PRP for the treatment of OLT. Therefore, National Orthopedics Center of Shanghai Sixth People′s Hospital allied Foot Ankle Basic Research & Orthopedics Group, Chinese Association of Orthopedic Surgeons; Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians; and Foot and Ankle Group of Orthopedic Specialized Branch of Shanghai Medical Association to organize related experts to formulate the Expert consensus on platelet- rich plasma treatment for osteochondral lesion of talus ( version2023). Fifteen recommendations were put forward upon PRP preparation, indications, contraindications and treatment methods of PRP for OLT, so as to standardize the PRP treatment for OLT.

Objective:To analyze and evaluate the safety and efficacy of a Chinese domestically manufactured Heart Con-type implantable third-generation magnetic and hydrodynamic levitation left ventricular assist device(LVAD) for the treatment of end-stage heart failure(ESHF), by reporting the results of eleven-center clinical trial on 50 cases.Methods:This study was a multicenter clinical trial, designed by means of prospective, multicenter and single-group target value. 50 subjects with ESHF were competitively enrolled and treated with HeartCon as the LVAD in eleven centers. The primary efficacy measure was survival, defined as either the subjects experiencing the transition to heart transplantation(HT) or myocardial recovery assisted by the device within 90 days, or as successfully assisted by the LVAD for full 90 days after implantation. The target survival rate was 60%, other observations included implantation success rate, mortality, pump failure needing replacement or emergency heart transplantation.Results:All enrolled 50 patients received LVAD implantation successfully, 46 survived with the pump for 90 days, 1 patient transitioned to heart transplantation, and 3 patients experienced pump thrombosis, within which 2 patients underwent pump replacement and continued to live with the pump for 90 days, and the other one received emergency heart transplantation. There were no dropout subjects. The survival rate at full 90 days after HeartCon implantation was 100%. The survival rates with pump in the full set analysis and the protocol set analysis were 96.00% and 95.92% respectively, which were higher than the target value of 60%. The differences were both statistically significant( P<0.05). Conclusion:The results of the multicenter clinical trial with the largest sample size in China using domestically manufactured third-generation LVAD has demonstrated that, HeartCon is a safe and effective LVAD to treat ESHF patients.

Objective:To investigate the implementation status of sepsis hour-1 bundle strategy for patients with septic shock in emergency department.Methods:A total of 116 septic shock patients admitted to the emergency department from January 2020 to December 2020 were included in this prospective study, and the implementation of sepsis bundles and the clinical outcomes of patients were recorded.Results:Among 116 patients, 20 cases (17.2%) had lactic acid monitored within 1 h, 20 cases (17.2%) had blood culture before antibiotics, 82 cases (70.1%) received broad-spectrum antibiotics, 16 cases (13.8%) received fluid resuscitation ≥30 ml/kg, and 57 cases (49.1%) received vasoactive drugs during resuscitation. Finally, the sepsis hour-1 bundle strategy was fully implemented only in 13 cases (11.2%). Compared with the group with incomplete implementation of sepsis hour-1 bundle strategy, the volume of fluid recovery in the group with full implementation was significantly increased [33.7 (30.0,37.5) vs. 8.9(7.3,10.8) ml/kg, Z=-4.78, P<0.001], mean artery blood pressure significantly increased [70.0 (70.0,76.7) vs. 67.7 (61.7,76.7)mmHg(1 mmHg=0.133 kPa) , Z=-2.00, P<0.001], and lactic acid significantly decreased [3.0 (2.0,3.2) vs. 4.4 (3.7,7.2) mmol/L, Z=-2.76, P=0.006]. However, there were no significant differences in ICU mortality, in-hospital mortality and 28-day mortality between the two groups ( P>0.05). Conclusions:Septic shock patients in emergency department have poor compliance with the implementation of sepsis hour-1 bundle strategy, and relevant management training should be strengthened.

Objective:To identify the distribution of research hotspots and frontiers of multidrug-resistant bacteria in intensive care units in China through the method of visualization, and to predict future research directions, analyze the research development process, so as to provide reference basis for further research in this field.Methods:Studies related to multidrug-resistant bacteria in intensive care units published in China from 2000 to 2019 by CNKI were reviewed. According to the keywords by CiteSpace 5.6.R2, the co-occurring network was generated to analyze the distribution of research hotspots in this field. Meanwhile, the mutation map of keywords was used to forecast the future research directions to a certain extent.Results:A total of 1 324 articles were finally included in the quantitative analysis. From 2000 to 2019, the number of publications in the field of multi-drug resistant bacteria in intensive care units showed a gradual increase, of which the number of publications increased rapidly from 2008 to 2014 (the number of publications increased from 34 to 124 articles). In the initial stage of research, conceptual keywords appeared, such as intensive care unit, infection, pathogenic bacteria and drug resistance among others. A dense keywords group appeared from 2008 to 2014, which covered several aspects, such as nosocomial infection, Acinetobacter baumannii, pathogenic bacteria, drug resistance, pulsed field gel electrophoresis and nursing etc., suggesting that research in this field has entered a period of vigorous development. High-frequency keywords, such as risk factors, pathogens, antibiotics, nosocomial infections, drug resistance genes and homology appeared from 2015 to 2019, thus representing the hotspots in recent years. Conclusions:The overall research on multidrug-resistant bacteria in intensive care units in China has gradually improved. The current studies focus on homology analysis and multidrug-resistant bacteria infections, among other topics. Further explorations at the genetic level will be conducted to fill the research vacancy in this field and to provide molecular biological basis for reducing the occurrence of multidrug-resistant bacteria in the future.

Clostridia inhabiting in jiupei and pit mud plays key roles in the formation of flavour during the fermentation process of Luzhou-flavour baijiu. However, the differences of Clostridial communities between jiupei and pit mud remains unclear. Here, the species assembly, succession, and metabolic capacity of Clostridial communities between jiupei and pit mud were analysed by high-throughput sequencing and pure culture approaches. The ratio of Clostridial biomass to bacterial biomass in the pit mud was relatively stable (71.5%-91.2%) throughout the fermentation process. However, it varied widely in jiupei (0.9%-36.5%). The dominant Clostridial bacteria in jiupei were Clostridium (19.9%), Sedimentibacter (8.8%), and Hydrogenispora (7.2%), while Hydrogenispora (57.2%), Sedimentibacter (5.4%), and Caproiciproducens (4.9%) dominated in the Clostridial communities in pit mud. The structures of Clostridial community in pit mud and jiupei were significantly different (P=0.001) throughout fermentation. Isolated Clostridial strains showed different metabolic capacities of volatile fatty acids in pure culture. Spatial and temporal heterogeneity of Clostridial communities existed in the baijiu fermentation pit, which was closely related to the main flavour components of Luzhou-flavour baijiu.
Alcoholic Beverages ; microbiology ; Bacteria ; classification ; metabolism ; Clostridium ; physiology ; Fatty Acids, Volatile ; metabolism ; Fermentation ; Food Microbiology

Objective: To investigate the correlation between poorly differentiated clusters (PDCs) in colorectal adenocarcinomas with clinicopathological parameters and its clinicopathological significance. Methods: One hundred and eighty-three colorectal adenocarcinomas resected by radical proctocolecomy were collected at Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, from January to December 2017. There were 122 male and 61 female patients with age ranging from 42 to 89 years (mean of 68 years). Tumor diameter ranged from 2 to 14 cm (mean 4.5 cm). There were 124 colon cancers and 59 rectal cancers. The number and grade of PDCs in the colorectal adenocarcinoma were evaluated by H-E staining. The overall peritumoural inflammatory reaction was also evaluated. The relationship between PDCs and tumor grades and clinicopathological features and overall peritumoural inflammatory reaction of colorectal adenocarcinoma was analyzed. Results: Of 183 cases of colorectal adenocarcinoma, PDCs were seen in 104 cases (56.8%), of which 36 cases (19.7%) were grade 1, 28 cases (15.3%) were grade 2, and 40 cases (21.9%) were grade 3. PDCs were positively correlated with lymph node metastasis, vascular invasion, degree of differentiation, depth of invasion, and pTNM staging(P<0.05). The detection rate of PDCs in colon cancer was higher than that of rectal cancer(P<0.05). PDCs was unrelated to age, gender, tumor size, and degree of overall peritumoural inflammatory reaction (P>0.05). Among clinicopathological parameters, the grade of PDCs was correlated with lymph node metastasis and vascular invasion (higher than those without lymph node metastasis and vascular invasion, P<0.05); There was a positive correlation between the grade of PDCs and age, tumor differentiation and pTNM staging(P<0.05), and no significant difference between the grade of PDCs and gender, tumor size, tumor location, and depth of invasion was seen (P>0.05). There was no correlation between the grade of PDCs and the degree of overall peritumoural inflammatory reaction (P>0.05). Conclusions PDC is a histological feature that predicts the aggressiveness of colorectal adenocarcinoma. Evaluation of PDC grade can better predict the biological behavior of colorectal cancer and more accurately guide the treatment and evaluate prognosis.