Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective:To describe the current status and efficacy of additional acarbose combined with insulin therapy in adult patients with type 1 diabetes mellitus (T1DM) .Methods:Adult T1DM patients with acarbose combined with insulin (acarbose group) or insulin alone (insulin group), age≥18 years and disease course≥1 year, who were registered in the T1DM Translational Medicine Research Project of Guangdong Province from June 2011 to December 2014 were enrolled in the study. The hemoglobin A1c (HbA 1c), body weight, body mass index (BMI), waist-to-hip ratio (WHR), insulin dosage and hypoglycemia of acarbose group and insulin group after 1 year were compared. Results:A total of 717 adult patients with T1DM were included (62 cases in acarbose group and 655 cases in insulin group). At the time of enrollment, the onset age of acarbose group was higher than that of insulin group [(31.1±12.3)years vs (27.4±12.4)years, P=0.019]; There were no significant differences in gender, age, course of disease, body weight, BMI, WHR, proportion of carbohydrate heat ≥50%, proportion of exercise time ≥150 min per week, HbA 1c, dosage of insulin, occurence of hypoglycemia and proportion of patients with dyslipidemia between the 2 groups (all P>0.05). After 1 year of follow-up, the HbA 1c in acarbose and insulin group decreased from baseline ( P=0.014, P<0.001), the body weight and BMI increased from baseline (all P<0.05), but WHR, insulin dosage and hypoglycemia occurrence were not statistically significant between the two groups (all P>0.05). After 1 year of follow-up, there were no significant difference in changes of HbA 1c, body weight, BMI, WHR, insulin dosage and hypoglycemia occurrence in acarbose group compared with insulin group from baseline (all P>0.05). Conclusions:In the clinical practice of T1DM treatment, acarbose is used more frequently in patients with a slightly older age of onset. Treatment of T1DM with insulin combined with acarbose did not increase the incidence of hypoglycemia, and no benefit was observed in improving HbA 1c, maintaining body weight, and reducing insulin use.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To explore the value of contrast-enhanced ultrasound (CEUS) combined with Ovarian-Adnexal Reporting and Data System (O-RADS US) risk stratification and management system in differential diagnosis of ovarian-adnexal mass.Methods:Fifty-six patients with ovarian-adnexal mass who received transabdominal transvaginal ultrasound and CEUS in the Third People′s Hospital of Longgang District from September 2018 to January 2021 were enrolled. The images were classified by O-RADS US and diagnosed by CEUS by experienced and senior radiologist. On the basis of O-RADS US classification, the enhancement time, enhancement level and enhancement mode of CEUS were combined to upgrade or degrade the classification results of O-RADS US. The diagnostic accuracy was assessed using ROC curve analysis, the area under the ROC curve (AUC) was calculated. The reproducibility of O-RADS US was assessed by another senior radiologist.Results:The AUC of O-RADS US for diagnosing benign and malignant ovarian-adnexal masses was 0.844(0.722, 0.927), the AUC of CEUS was 0.833(0.710, 0.920), the AUC of O-RADS US combined with CEUS was 0.940(0.842, 0.986) (compared with O-RADS US, P=0.020; compared with CEUS, P=0.031). The intra-class correlation coefficient (ICC) was 0.897(0.824, 0.940) for O-RADS US. Conclusions:CEUS combined with O-RADS US classification can effectively improve the diagnostic efficiency for benign and malignant ovarian-adnexal masses.

Objective:To evaluate the immunogenicity and immune persistence of purified Vero cells rabies vaccine (PVRV) with Zagreb and Essen regimen.Methods:Prospective study: Patients with first Class II exposure to rabies were recruited from the Dog Injury Cinic of Guangxi Center for Disease Control and Prevention (Guangxi CDC) and randomly divided into the Zagreb (2-1-1) and Essen (1-1-1-1-1) regimen group. All patients were inoculated with the vaccines from the same manufacturer and batch, and 3 ml serum was collected at the 45th day and in 1-year, 2-year and 3-year after immunization. Rapid fluorescent inhibition test (RFFIT) was used to detect rabies virus neutralizing antibody (RVNA). The attenuation of RVNA positive rate and geometric mean titer (GMT) with time was analyzed. Retrospective study: The informed consents for rabies vaccine in the Dog Injury Clinic of Guangxi CDC were checked out. The patients who were injected with PVRV (same manufacturer but unlimited batch) but without passive immune agents for the first time within 3 years were selected and divided into 1-year, 2-year and 3-year group. Each group was further divided into Zagreb and Essen regimen group. The serum (3 ml) was collected at 1 year, 2 years and 3 years after immunization and detected the RVNA by RFFIT.Results:Prospective study: The RVNA positive rates on the 45th day and in 1-year, 2-year and 3-year after immunizationin in the Zagreb and Essen regimen group were 100%, 95%, 85%, 80% and 98.25%, 89.47%, 89.47%, 85.96%, respectively. There was no statistically significant difference in the RVNA positive rates at the same time point between the two regimen groups ( P>0.05). The RVNA GMT on the 45th day and in 1-year, 2-year, and 3-year in the Zagreb and Essen regimen group were 11.32 IU/ml, 1.69 IU/ml, 1.30 IU/ml, 1.30 IU/m and 13.18 IU/ml, 2.13 IU/ml, 1.87 IU/ml, 1.84 IU/m, respectively. There was no significant difference in the RVNA GMT levels at the same time point between the two regimen groups ( F=1.971, P=0.164). The RVNA GMT levels in the two regimen groups had the same trend of attenuation over time (time*group F=0.702, P=0.435). Retrospective study: The RVNA positive rates in 1-year, 2-year and 3-year after immunization in the Zagreb and Essen regimen group were 100%, 95%, 91.43%和94.73%, 86.21%, 87.5%, respectively. There was no statistically significant difference in the RVNA positive rates at the same time point between the two regimen groups ( P>0.05). The RVNA GMT in 1-year, 2-year, and 3-year groups after immunization in the Zagreb and Essen regimen group were 2.65 IU/ml, 2.03 IU/ml, 1.57 IU/ml和3.2 IU/ml, 2.58 IU/ml, 2.45 IU/ml, respectively. There was no significant difference in the RVNA GMT levels at the same time point between the two regimen groups ( P>0.05). Conclusions:The PVRV showed the same excellent immunogenicity and immune persistence after the vaccination with the Zagreb and Essen regimens.

Tripartite motif (TRIM) family proteins are important effectors of innate immunity against viral infections. Here we identified TRIM35 as a regulator of TRAF3 activation. Deficiency in or inhibition of TRIM35 suppressed the production of type I interferon (IFN) in response to viral infection. Trim35-deficient mice were more susceptible to influenza A virus (IAV) infection than were wild-type mice. TRIM35 promoted the RIG-I-mediated signaling by catalyzing Lys63-linked polyubiquitination of TRAF3 and the subsequent formation of a signaling complex with VISA and TBK1. IAV PB2 polymerase countered the innate antiviral immune response by impeding the Lys63-linked polyubiquitination and activation of TRAF3. TRIM35 mediated Lys48-linked polyubiquitination and proteasomal degradation of IAV PB2, thereby antagonizing its suppression of TRAF3 activation. Our in vitro and in vivo findings thus reveal novel roles of TRIM35, through catalyzing Lys63- or Lys48-linked polyubiquitination, in RIG-I antiviral immunity and mechanism of defense against IAV infection.
A549 Cells ; Animals ; Apoptosis Regulatory Proteins/immunology* ; DEAD Box Protein 58/immunology* ; Dogs ; HEK293 Cells ; Humans ; Influenza A Virus, H1N1 Subtype/immunology* ; Madin Darby Canine Kidney Cells ; Mice ; Mice, Knockout ; Orthomyxoviridae Infections/pathology* ; Proteolysis ; RAW 264.7 Cells ; Signal Transduction/immunology* ; THP-1 Cells ; TNF Receptor-Associated Factor 3/immunology* ; Ubiquitination/immunology* ; Viral Proteins/immunology*

Objective:To translate the Empathy for Pain Scale (EPS) and evaluate the reliability and validity of the Chinese version of EPS in medical students.Methods:The items of the Chinese version of EPS were determined by translation, back-translation, semantic analysis, expert consultation and culture adaptation. From June to October 2018, this study selected 531 undergraduate students by convenience sampling to carry out questionnaire survey. Correlation analysis and critical ratio were used to the item analysis. Validity test was implemented with the content validity, construct validity and criterion-related validity; and internal consistency was tested with the Cronbach's α value and split-half reliability.Results:The Chinese version of EPS had 12 items and two factors named as the body and mind discomfort reactions and empathy reactions with 69.059% for the total variance contribution. Content validity of items ranged from 0.83 to 1.00, and the total content validity was 0.94. The total score of the Chinese version of EPS had a positive correlation with the score of the interpersonal reactivity index (IRI-C) ( r=0.370, P< 0.01) . The Cronbach's α value of the scale was 0.914; Cronbach's α values of two dimensions, the body and mind discomfort reactions and empathy reactions, were 0.935 and 0.775 respectively. The split-half reliability of the scale was 0.896. Conclusions:The Chinese version of EPS has four scenes and two dimensions as well as a good reliability and validity which could be used to evaluate the level of empathy for pain among medical students in China.

Objective: To study the effects of three different granular fats on proliferation, differentiation and migration of adipose-derived stem cells. Methods: Ten patients were selected for lumbar liposuction. The adipose tissue was obtained with different sized side-hole fat aspiration devices: 10 ml of Macrofat (n=10), 10 ml of Microfat (n=10) and 10 ml of Nanofat (n=10). Enzyme digestion method was used to separate and extract adipose-derived stem cells(ADSCs). The differences of vascular matrix components in these 3 kinds of fat sources were analyzed. XTT assay was used to detect proliferation and growth ability. The migration ability of the cell injury model was observed in vitro, and the multi-directional differentiation ability was compared by the analysis of adipogenic and osteogenic induction. The experimental data were analyzed using SPSS 13.0 software. One-Way ANOVA was used to compare the difference of multiple groups. P<0.05 was considered as statistically significant. Results: The detection of adipose-derived stem cells was by flow cytometry and it showed Macrofat, Microfat and Nanofat was(4.23±0.37)×10⁵, (2.29±0.33)×10⁵ and(1.56±0.16)×10⁵. The content of fat-derived stem cells in Macrofat was the highest, followed by Microfat, and the content of Nanofat was the least (F=209.533, P<0.001). XTT assay showed that the proliferative ability of adipose-derived stem cells in the first two generations of Macrofat was the highest, followed by Microfat, while the proliferation of Nanofat was the lowest (the absorbance in 3 groups increased in a time-dependent manner). There was no significant difference in the proliferative capacity of the third generation of 3 groups (the absorbance of these 3 groups were compared at each time point). The cellular trauma model showed that the first generation of Macrofat-derived stem cells had the best migration ability, followed by Microfat, while the Nanofat had the weakest migration ability(Compared with the remaining area of wounds at 0 h, 12 h, 24 h point between the three groups, F=306.370, 1409.907, P<0.001). From the second generation, the migration ability of each group of ADSCs gradually self-repaired, and the migration ability at 12 h was similar to that of the first generation (F=11.410, P<0.001), but there was no significant difference in 24 h (F=0.070, P=0.933). Oil red O and alizarin red staining showed that the first generation of Macrofat and Microfat had better fat-forming and osteogenic differentiation ability than Nanofat(F=523.532, 620.022, P<0.001). However, there was no significant change after the second generation (F=2.144, 0.866, P=0.137, 0.432). Conclusions In the process of adipose tissue extraction of Nanofat, the production and activity of adipose-derived stem cells was impacted. However, in the process of culture and passage, the cell activity, proliferation ability, migration ability and differentiation ability can be achieved through self-repair, evenclose to the level of Macrofat or Microfat.

Objective: To investigate the prognostic values of the maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) calculated from pretreatment ¹⁸F-fluorodeoxy glucose (¹⁸F-FDG) PET-CT results of patients with advanced extranodal NK/T cell lymphoma (ENKTL). Methods: The clinic data, follow-up data and pretreatment ¹⁸F-FDG PET-CT data of 45 patients with ENKTL of stage Ⅳ were collected. The optimal cutoff value of progression-free survival (PFS) of SUV_max, MTV and TLG were analyzed by using receiver-operating characteristic (ROC) curve. The Kaplan-Meier method, Log-rank test and COX proportional hazards model were used for survival analysis, univariate analysis and multivariate analysis, respectively. Results: The median SUV_max, MTV and TLG of 45 ENKTL patients were 17.98, 70.18 and 755.42, respectively. ROC curve showed that the area under the curve (AUC) of SUV_max, MTV and TLG were 0.504 (P=0.970), 0.868 (P<0.001) and 0.848 (P=0.001), respectively. The value of SUV_max was too small to fit for calculating the cutoff value of AUC. The cutoff value of MTV was 42.54 (sensitivity =78.1% and specificity =84.6%), and the cutoff value of TLG was 435.15 (sensitivity=75.0% and specificity =76.9%). Univariate analysis showed that lactate dehydrogenase (LDH) level, epstein-barr virus (EBV)-DNA, Eastern Cooperative Oncology Group (ECOG) score, bone marrow, Korean prognostic index (KPI), MTV, TLG were significantly related with PFS (all P<0.05), and lactate dehydrogenase (LDH) level, EBV-DNA, ECOG score, primary tumor location, KPI, MTV, TLG were significantly related with overall survival (OS) (all P<0.05). Multivariate analysis showed that KPI, MTV and TLG were independent prognostic predictors of PFS and OS (all P<0.05). Conclusions MTV and TLG of pretreatment ¹⁸F-FDG PET-CT are independent prognostic factors for PFS and OS of patients with advanced ENKTL. MTV and TLG may be more fit for evaluating the prognosis of ENKTL patients than SUV_max.

Objective To investigate the effect of adipose-derived stem cells (ADSCs) on pho toaging skin after laser pretreatment with GaAlAs.Methods ADSCs were isolated from healthy wistar rats,ADSCs were isolated and cultured to establish an adipose-derived stem cell culture system.ADSCs were pretreated with GaAlAs laser at a wavelength of 650 nm 4 J/cm2.A rat model of pho toaging aging was established.Different doses of ADSCs and low energy laser ADSCs were pretreated with ADSCs for the treatment of photoaging skin,and the morphological changes of epidermis and dermis were observed before and after treatment with low energy laser pretreatment.Results When the concentration of ADSCs was 103/100 μl,there was no significant difference in epidermal thickness and dermal thickness between ADSCs treated group and GaAlAs pretreatment group (P＞0.05).The thickness of epidermis in the GaAlAs pretreatment group was significantly lower than that in the ADSCs group (P＜0.05) at 104/100 μl.When the concentration of ADSCs was 5 × 104/100 μl,the epidermal thickness of the GaAlAs pretreatment group decreased significantly and the thickness of the dermis increased significantly,which was significantly different from that of the ADSCs group (P ＜ 0.05).Conclusions GaAlAs laser pretreatment can enhance ADSCs anti-skin photoaging ability.