Objective To observe the therapeutic effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on acute myeloid leukemia (AML) and analyze the influencing factors of survival prognosis. Methods The clinical data of 32 AML patients who underwent allo-HSCT treatment were retrospectively analyzed. The hematopoietic reconstitution, occurrence of graft-versus-host disease (GVHD), survival status, recurrence, and transplantation-related mortality (TRM) of patients were observed, and the influencing factors of survival prognosis were analyzed. Results All 32 AML patients who underwent allo-HSCT achieved granulocyte reconstitution, with a time range of 10 to 26 days and a median time of 11.0 days. Granulocyte-macrophage lineage reconstitution was achieved in 30 patients, with a time range of 10 to 54 days and a median time of 13.5 days. Among the 30 evaluable patients, 10 developed acute GVHD (with incidence rate of 33.33%) and 10 developed chronic GVHD (incidence rate of 33.33%). Up to May 31, 2023, the follow-up time ranged from 2 to 28 months, with a median follow-up time of 14.5 months. Of the 30 patients, 28 survived (25 patients were in disease-free survival status), and 2 died. Multivariate Cox regression analysis showed that age>35 years (P=0.035, HR=2.021) and recurrence after transplantation (P=0.021, HR=2.546) were independent risk factors of patients' survival prognosis. Among 30 patients, 5 relapsed, with a time range of 6 to 24 months and a median time of 9.0 months. Of 5 relapsed patients, 2 died (non-TRM). Conclusion Allo-HSCT is an effective treatment for AML. Age>35 years and recurrence after transplantation are independent risk factors of patients' survival prognosis.

Objective    To explore the risk factors and predictive value of acute kidney injury (AKI) after total aortic arch replacement. Methods    The clinical data of patients undergoing total aortic arch replacement in our hospital from January 2018 to June 2019 were retrospectively analyzed, and patients receiving preoperative renal replacement therapy and missing creatinine values were excluded. According to whether postoperative AKI occurred, patients were divided into an AKI group and a control group. The univariate and multivariate analyses (logistic regression) were used to explore the independent risk factors of AKI. The receiver operating characteristic curve was used to analyze the significant factors in predicting the occurrence of AKI after total aortic arch replacement. Results    A total of 162 patients were included in the study, including 135 (83.3%) males and 27 (16.7%) females, with an average age of 52.61±9.90 years (range: 22 to 73 years). The incidence of AKI was 68.5% (n=111). The results of univariate and multivariate analyses showed that the postoperative serum cystatin C level (OR=76.145, 95%CI 15.575-372.260, P<0.01) was an independent risk factor for AKI after total aortic arch replacement. When its cut-off value was above 1.08 mg/L, the specificity for predicting postoperative AKI was 70.59%, and the sensitivity was 85.59%. Conclusion    The postoperative cystatin C level is an independent risk factor for AKI after total aortic arch replacement and has predictive value.

Objective: Short-course neoadjuvant radiotherapy (SCRT) combined with delayed surgery seems to be safer than SCRT in combination with immediate surgery. However, the clinical efficacy between SCRT and long-course neoadjuvant radiotherapy (LCRT) combined with delayed surgery has not been compared. Therefore, this meta-analysis was performed to compare the safety and efficacy between SCRT and LCRT followed by delayed surgery in patients with locally advanced rectal cancer. Methods: Relevant literatures were searched using relevant databases. Baseline characteristics and treatment results of patients were extracted. The included studies were subject to bias risk assessment. Evidence assessment and data analysis were conducted. Results: A total of 7 studies with 4967 patients were included. Meta-analysis results illustrated no statistical significance between two groups in terms of sphincter preservation rate, R₀ resection rate, postoperative complications, local recurrence rate (LRR), distant metastasis, recurrence-free survival (RFS), overall survival (OS), length of hospital stay and acute radiotherapy toxicity (all P>0.05). Compared with SCRT with delayed surgery, LCRT with delayed surgery was associated with a significant increase in the tumor downstaging rate (RR=0.84, 95%CI=0.76-0.93, P<0.05) and a considerable increase in pathologically complete remission rate (RR=0.46, 95%CI=0.34-0.61, P<0.05). Conclusions SCRT with delayed surgery is as effective as LCRT with delayed surgery in terms of sphincter preservation rate, R₀ resection rate, postoperative complications, LRR, RFS, OS, grade Ⅲ-Ⅳ acute toxicity and length of hospital stay. However, LCRT in combination with delayed surgery enhances the tumor downstaging rate and pathologically complete remission rate.

Objective: Based on the dual-factor model of mental health, this study aims to explore the effects of acceptance and commitment therapy on the mental health of high school students. Methods: During Oct. to Nov. 2017, General Health Questionnaire12(GHQ-12) and Depression Anxiety and Stress Scale21(DASS-21) was administered among 543 high school students from a middle school in Nanchang. According to the inclusion and exclusion criteria, 20 high school students were screened and were randomly assigned to the intervention group and control group, respectively. The intervention group received one intervention (1.5 h) per week for 8 weeks. The control group did not receive the intervention. Pre-and post-intervention assessment were conducted using the Acceptance and Action Questionnaire-2nd Edition (AAQ-II), the Cognitive Fusion Questionnaire-Fusion (CFQ-F), the Satisfaction With Life Scale (SWLS), the Positive Affect Scale (PAS), the GHQ-12, and the DASS-21. Results: After intervention, the post-test scores of AAQ-II, CFQ-F, GHQ-12, and DASS-21 in the intervention group significantly decreased (t=2.91, 2.47, 4.91, 4.42, P<0.05) and the post-test score on PAS significantly increased (t=-5.27, P<0.01). There were no statistical changes in AAQ-II, CFQ-F, GHQ-12, and DASS-21 scores in the control group after intervention (t=-1.25, -0.09, -0.61, -0.69, -0.81, P>0.05). Conclusion Acceptance and commitment therapy can effectively improve the psychological flexibility and positive emotions, as well as alleviate general psychological distress and negative emotions, and promote the improvement of mental health of high school students.

Objective To study the expression of hypoxia-inducible factors-1 α and pyruvate kinase type M2 in Hp infected gastric carcinoma and their clinical significances.Methods The expression levels of hypoxia-inducible factors-1α and pyruvate kinase type M2 in 85 cases of gastric carcinoma tissues were detected by using RT-PCR and immunohistochemical method.The Virulence level of CagA gene were detected in Hp infected gastric tissue.Results As the degree of tumor differentiation,invasion depth and clinical stage of tumor increased,the positive expression rate of HIF-1 α and PKM2 increased,and the expression level of the two was in positive correlation.The positive expression rate of HIF-1α (73％)was related to lymph node metastasis (x2 =4.204,P =0.041).The positive expression rate of PKM2 (85 ％)was related to tumor diameter.The positive expression rate of HIF-1α and PKM2 (75％ and 85％,respectively)significantly increased in Hp infected gastric carcinoma tissue (x2 =6.486,P =0.010;x2 =7.341,P =0.009,respectively) and related to CagA + type.Conclusion HIF-1α and PKM2 may be closely correlated to development and metastasis of gastric carcinoma with Hp infection.

Objective To investigate the expression of FZD7 (frizzled homolog protein7,FZD7) and IL-6 (interleukin-6,IL-6) in primary hepatocellular carcinoma(HCC) and the impact on the prognosis.Methods Immunohistochemistry(IHC) was used to detect the expression level of FZD7 and IL-6 in 68 HCC tissues,30 para-carcinoma tissues and 10 healthy controls from patients with hepatic hemangioma.Patients were followed-up for survival analysis.Results The expression ratio of FZD7 in HCC tissue,paracarcinoma tissue and healthy controls were 72％,53％ and 0 (P ＜ 0.001),the ratio of IL-6 expression was respectively 69％,57％ and 0 (P ＜0.001).The expressions of FZD7 were positively correlated with that of AFP level (x2 =7.059,P =0.035),pathology classification (x2 =4.732,P =0.043),and the infection of HBs (x2 =3.508,P =0.032).The overall survival (65 ％ vs.84％,x2 =5.525,P ＜ 0.05) and the disease free survival (33％ vs.75％,x2 =5.991,P ＜0.05) of HCC patients with co-positive was significantly lower than that with co-negative expression of FZD7 and IL-6.Conclusion FZD7 and IL-6 play a critical role in development and progression of HCC.

Objective To evaluate positive p-mTOR expression and its significance in gastric cancer.Methods Original studies published for the correlation between p-mTOR and clinicopathological parameters as well as prognostic significance were enrolled from Cohrane Library,Pubmed,EMbase database and CBM,CNKI.Analyses were performed by software REVMAN 5.0.Age,gender,TNM stage,lymph node metastasis,type were analyzed using pooled odds ratio (OR) with 95％ confidence interval (CI),and OS were analyzed using pooled hazard ratio (HR) with 95％ CI.Results Seven studies including 2 477 gastric cancer patients were enrolled in the meta analysis.p-mTOR expression was positive in 1 089 of the cases.p-mTOR positive expression was correlated with age,OR =0.74,95％ CI:0.62-0.89,dcpth of invasion OR =0.76,95％ CI:0.60-0.97,lymph node metastasis,OR =1.95,95％ CI:1.59-2.39,TNM stage,OR =0.57,95％ CI:0.38-0.84,type,OR =0.64,95％ CI:0.50-0.83,and OS,HR =1.86,95％ CI:1.60-2.16.Gastric cancer patients with p-mTOR positive expression tend to be younger,had a higher risk of lymphatic invasion,later TNM stage and poor prognosis.Its positive expression had no relation with the gender.Conclusion p-mTOR positive expression is a significant predictor for advanced TNM stage,more lymph node metastasis,intestinal type and poorer OS.

OBJECTIVETo explore the effect of body mass index (BMI) on postoperative short-term prognosis and survival rate of gastric cancer patients.

METHODSClinical and follow-up date of 153 gastric cancer cases undergoing radical operation in our hospital from January to June 2010 were retrospectively analyzed. According to BMI, patients were divided into low group (BMI<18.5, 23 cases), normal group (18.5≤BMI<25.0, 95 cases) and high group (BMI≥25.0, 35 cases). Clinicopathological features and outcomes were compared the among three groups.

RESULTSAmong three groups, the differences in operation time, intraoperative blood loss, number of lymph node retrieved, postoperative hospital stay, lymph node metastasis rate, tumor staging and postoperative complication morbidity were not statistically significant (all P>0.05). Preoperative hemoglobin in the low group was significantly lower as compared to normal and high groups [(106.1±13.8) g/L vs. 113.5±5.2) g/L and (123.5±8.7) g/L, F=3.265, P=0.041], and so was the preoperative albumin [(38.7±2.5) g/L vs. (41.3±0.8) g/L and (43.5±1.4) g/L, F=8.516, P=0.000]. The ratio of gastric cardiac cancer in the low group was significantly lower as compared to the normal and high groups[34.8%(8/23) vs. 68.4%(65/95) and 62.9%(22/35), χ(2)=8.913, P=0.012]. Five-year survival rate of the low, normal and high groups were 43.5%, 50.5% and 65.7% respectively(P=0.189). Subgroup analysis showed that the 5-year survival rate of patients with gastric cardiac cancer in the low group was significantly lower as compared to those in the high group (25.0% vs. 84.6%, P=0.004).

CONCLUSIONSBMI dose not generally play a role in short-term outcomes and long-term survival of the gastric cancer patients. Nutritional improvement and body weight maintenance may be beneficial to low BMI patients, especially those with gastric cardiac cancer.

Blood Loss, Surgical ; Body Mass Index ; Gastrectomy ; Humans ; Length of Stay ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Staging ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate ; Treatment Outcome

Objective Todetecttheexpressionofvascularendothelialgrowthfactor(VEGF)andmigrationinhibitoryfactor (MIF) in colorectal cancer .Methods The immunohistochemical staining (SP method) was used to measure the expression of VEGF and MIF in 80 samples of colorectal cancer and 80 samples of normal colorectal tissues at 5 cm apart from the tumor edge . The relationship between VEGF and MIF with the clinical pathologic characteristics of colorectal cancer was anlyzed .Results The positive rates of VEGF and MIF in the colorectal cancer tissues were 77 .50% and 82 .50% respectively ,but which in the normal colorectal tissues were 22 .50% and 27 .50% respectively ,the positive rate of VEGF and MIF expression in the colorectal cancer tis‐sues were higher than that in the normal colorectal tissue with statistical difference (P<0 .05) .The expression of VEGF and MIF had correlation with the tumor infiltration depth ,lymph node metastasis ,and clinical stage ,but no correlation with gender ,age and histodifferentiation .Conclusion VEGF and MIF are highly expressed in the colorectal cancer tissues .

Objective To study the expression of clusterin (CLU) and P-glycoprotein (P-gp) in hepatic cell carcinoma (HCC) and its relationship.Methods The expression of CLU gene in the tissue of H CC (41 cases),cirrhosis(10 cases) and normal liver (10 cases) and the expression of P-gp in the tissue of HCC were detected by immunohistochemical method.Results The positive expression rate of CLU was 82.93％(34/41) in HCC,and negative or weak positive were detected in cirrhosis and normal liver tissue.The positive expression rate of CLU was significantly correlated with Edmondson's histological grade (P ＜ 0.05),but had no correlation with patients' age,sex and cirrhosis (P ＞ 0.05).The positive expression rate of P-gp in HCC was 70.73％(29/41).There was significant correlation between the expression of CLU and P-gp (P ＜ 0.05).Conclusions The over expression of CLU is significantly associated with clinical multidrug resistance in HCC.It should be a potential target for treatment of HCC.