1.Summary of the 19 th Chinese Symposium of Burns and Wounds
Yanling LYU ; Yu MO ; Guangping LIANG ; Gaoxing LUO ; Yizhi PENG ; Dan SUN ; Kaizhen QIU ; Luyao WU ; Tingting LI ; Zhixin LIU
Chinese Journal of Burns 2024;40(7):699-700
		                        		
		                        			
		                        			The 19 th Chinese Symposium of Burns and Wounds was successfully held in Foshan of Guangdong Province from June 20 th to 22 nd in 2024. There were more than 700 delegates attending the academic event. The theme of the congress was expansion, integration and standardization, which could promote academic exchanges, multi-disciplinary fusion, and standardization of clinical treatment of burns and wounds. A total of nearly 200 famous experts and scholars had their speeches on the two-day keynote forum and special academic seminars including critical care, wound repair, scar prevention and treatment, rehabilitation nursing, and disciplinary integration sessions. The congress ended successfully with abundant fruits and friendship.
		                        		
		                        		
		                        		
		                        	
2.Expressions of EHD2,miRNA let-7c,and lncRNA FOXD2-AS1 in human laryngeal squamous cell carcinoma tissue and their relationship analyses
Meiheng GONG ; Mo CHEN ; Hui HAN ; Tingting YU
Journal of Jilin University(Medicine Edition) 2024;50(5):1365-1371
		                        		
		                        			
		                        			Objective:To discuss the expression levels of Eps15 homology domain-containing protein 2(EHD2),microRNA let-7c(miR-let-7c),and long non-coding RNA(lncRNA)FOXD2-AS1 in laryngeal squamous cell carcinoma(LSCC)tissue,and to clarify the association between EHD2/miR-let-7c/FOXD2-AS1 signaling axis and occurrence of LSCC.Methods:Forty LSCC tissue samples were collected and classified into low grade group(moderately or high differentiated,32 cases)and high grade group(poorly differentiated,8 cases)according to the pathology results;according to the tumor node metastasis(TNM)clinical staging results,the samples were divided into TNM early stage group(stagesⅠ-Ⅱ,13 cases)and TNM late stage group(stages Ⅲ-Ⅳ,27 cases);based on the lymph node metastasis results,the samples were divided into metastasis group(21 cases)and non-metastasis group(19 cases).Additionally,40 corresponding normal adjacent tissue samples were collected as control group.Immunohistochemistry method was used to detect the expressions of EHD2 in various groups and its relationships with clinical pathoparameters of the LSCC patients were analyzed;bioinformatics method was used to confirm that the miR-let-7c was the candidate microRNA(miRNA)and FOXD2-AS1,which had binding sites in its promoter region,was a candidate lncRNA.Ten pairs of fresh LSCC tissue samples and adjacent normal tissue samples were collected.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of EHD2 mRNA,miR-let-7c,and FOXD2-AS1 in the samples in two groups,and their associations were verified.Results:Compared with adjacent normal tissue,the expression level of EHD2 in LSCC tissue was significantly decreased(P<0.01).The positive expression rate of EHD2 in LSCC tissue of the patients in TNM early stage group was significantly higher than that in TNM late stage group(P<0.05).There was no significant association between EHD2 expression and pathological type or lymph node metastasis(P>0.05).Compared with control group,the expression level of miR-let-7c in LSCC tissue was significantly decreased(P<0.05),while the expression level of FOXD2-AS1 was significantly increased(P<0.05).In LSCC tissue,the expression level of FOXD2-AS1 was negatively correlated with the expression level of miR-let-7c(r=-0.67,P<0.05),and the expression level of miR-let-7c was negatively correlated with the expression level of EHD2 mRNA(r=-0.83,P<0.01).Conclusion:EHD2 and miR-let-7c both express at low levels in LSCC tissue and may be new tumor suppressor genes;FOXD2-AS1 is highly expressed in LSCC tissue and may be a new oncogene.FOXD2-AS1/miR-let-7c/EHD2 signaling axis may be involved in the occurrence and development of LSCC.
		                        		
		                        		
		                        		
		                        	
3.Clinical features and risk factors for invasive fungal sinusitis after allogeneic hematopoietic stem cell transplantation
Haixia FU ; Jiajia LI ; Yuanyuan ZHANG ; Yuqian SUN ; Xiaodong MO ; Tingting HAN ; Jun KONG ; Meng LYU ; Wei HAN ; Huan CHEN ; Yuhong CHEN ; Fengrong WANG ; Chenhua YAN ; Yao CHEN ; Jingzhi WANG ; Yu WANG ; Lanping XU ; Xiaojun HUANG ; Xiaohui ZHANG
Chinese Journal of Hematology 2024;45(1):22-27
		                        		
		                        			
		                        			Objective:To analyze the clinical characteristics and outcomes of patients with invasive fungal sinusitis (invasive fungal rhinosinusitis, IFR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and explored the risk factors for IFR after allo-HSCT.Methods:Nineteen patients with IFR after allo-HSCT at Peking University People’s Hospital from January 2012 to December 2021 were selected as the study group, and 95 patients without IFR after allo-HSCT during this period were randomly selected as the control group (1:5 ratio) .Results:Nineteen patients, including 10 males and 9 females, had IFR after allo-HSCT. The median age was 36 (10–59) years. The median IFR onset time was 68 (9–880) days after allo-HSCT. There were seven patients with acute myeloid leukemia, five with acute lymphoblastic leukemia, two with myelodysplastic syndrome, two with chronic myeloid leukemia, one with acute mixed-cell leukemia, one with multiple myeloma, and one with T-lymphoblastic lymph node tumor. There were 13 confirmed cases and 6 clinically diagnosed cases. The responsible fungus was Mucor in two cases, Rhizopus in four, Aspergillus in four, and Candida in three. Five patients received combined treatment comprising amphotericin B and posaconazole, one patient received combined treatment comprising voriconazole and posaconazole, nine patients received voriconazole, and four patients received amphotericin B. In addition to antifungal treatment, 10 patients underwent surgery. After antifungal treatment and surgery, 15 patients achieved a response, including 13 patients with a complete response and 2 patients with a partial response. Multivariate analysis revealed that neutropenia before transplantation ( P=0.021) , hemorrhagic cystitis after transplantation ( P=0.012) , delayed platelet engraftment ( P=0.008) , and lower transplant mononuclear cell count ( P=0.012) were independent risk factors for IFR after allo-HSCT. The 5-year overall survival rates in the IFR and control groups after transplantation were 29.00%±0.12% and 91.00%±0.03%, respectively ( P<0.01) . Conclusion:Although IFR is rare, it is associated with poor outcomes in patients undergoing allo-HSCT. The combination of antifungal treatment and surgery might be effective.
		                        		
		                        		
		                        		
		                        	
4.The effect of glucose-6-phosphate dehydrogenase deficiency on allogeneic hematopoietic stem cell transplantation in patients with hematological disorders
Jia WANG ; Haixia FU ; Yuanyuan ZHANG ; Xiaodong MO ; Tingting HAN ; Jun KONG ; Yuqian SUN ; Meng LYU ; Wei HAN ; Huan CHEN ; Yuhong CHEN ; Fengrong WANG ; Chenhua YAN ; Yao CHEN ; Jingzhi WANG ; Yu WANG ; Lanping XU ; Xiaojun HUANG ; Xiaohui ZHANG
Chinese Journal of Hematology 2024;45(2):121-127
		                        		
		                        			
		                        			Objectives:To determine the effect of glucose-6-phosphate-dehydrogenase (G6PD) deficiency on patients’ complications and prognosis following allogeneic stem cell hematopoietic transplantation (allo-HSCT) .Methods:7 patients with G6PD deficiency (study group) who underwent allo-HSCT at Peking University People's Hospital from March 2015 to January 2021 were selected as the study group, and thirty-five patients who underwent allo-HSCT during the same period but did not have G6PD deficiency were randomly selected as the control group in a 1∶5 ratio. Gender, age, underlying diseases, and donors were balanced between the two groups. Collect clinical data from two patient groups and perform a retrospective nested case-control study.Results:The study group consisted of six male patients and one female patient, with a median age of 37 (range, 2-45) years old. The underlying hematologic diseases included acute myeloid leukemia ( n=3), acute lymphocytic leukemia ( n=2), and severe aplastic anemia ( n=2). All 7 G6PD deficiency patients achieved engraftment of neutrophils within 28 days of allo-HSCT, while the engraftment rate of neutrophils was 94.5% in the control group. The median days of platelet engraftment were 21 (6–64) d and 14 (7–70) d ( P=0.113). The incidence rates of secondary poor graft function in the study group and control group were 42.9% (3/7) and 8.6% (3/35), respectively ( P=0.036). The CMV infection rates were 71.4% (5/7) and 31.4% (11/35), respectively ( P=0.049). The incidence rates of hemorrhagic cystitis were 57.1% (4/7) and 8.6% (3/35), respectively ( P=0.005), while the bacterial infection rates were 100% (7/7) and 77.1% (27/35), respectively ( P=0.070). The infection rates of EBV were 14.3% (1/7) and 14.3% (5/35), respectively ( P=1.000), while the incidence of fungal infection was 14.3% (1/7) and 25.7% (9/35), respectively ( P=0.497). The rates of post-transplant lymphoproliferative disease (PTLD) were 0% and 5.7%, respectively ( P=0.387) . Conclusions:The findings of this study indicate that blood disease patients with G6PD deficiency can tolerate conventional allo-HSCT pretreatment regimens, and granulocytes and platelets can be implanted successfully. However, after transplantation, patients should exercise caution to avoid viral infection, complications of hemorrhagic cystitis, and secondary poor graft function.
		                        		
		                        		
		                        		
		                        	
5.Clinical outcomes of allogeneic hematopoietic stem cell transplantation from matched sibling donor for myelofibrosis
Rui MA ; Borui TANG ; Tingting HAN ; Xueyi LUO ; Wei HAN ; Yao CHEN ; Xiaodong MO ; Lanping XU ; Xiaohui ZHANG ; Yu WANG ; Xiaojun HUANG ; Yuqian SUN
Chinese Journal of Internal Medicine 2024;63(10):961-967
		                        		
		                        			
		                        			Objective:To evaluate the efficacy and safety of matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of myelofibrosis (MF).Methods:In this case series, the clinical data of 18 patients with MF who received allo-HSCT in the Department of Hematology, Peking University People′s Hospital from December 2008 to December 2023 were retrospectively studied. Kaplan-Meier survival analysis and competitive risk model were used to evaluate the probabilities of 3-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR), and transplant related mortality (TRM). The transplant related complications were also analyzed.Results:Among the 18 patients included, there were 12 males and 6 females, with a median age of 50 (range: 28-64) years. All 18 patients achieved neutrophil engraftment, and the time of neutrophil engraftment [ M ( Q1, Q3)] was 16.0 (11.8, 18.0) days. Twelve patients achieved platelet engraftment, and the platelet engraftment time was 21.0 (16.2, 43.2) days. Six patients had grade Ⅱ to Ⅳ acute graft-versus-host disease (GVHD), and six patients had chronic GVHD. The 3-year OS rate and DFS rate after transplantation were 62.2% and 52.2%, respectively. The 3-year CIR and TRM were 29.7% and 24.6%, respectively. Four patients died during follow-up, with the main cause of death being infections. Conclusion:Matched sibling allo-HSCT is a feasible option for the treatment of MF.
		                        		
		                        		
		                        		
		                        	
6.Severe cardiotoxic characteristics associated with allogeneic hematopoietic stem cell transplantation preconditioning in patients with aplastic anemia
Xue MING ; Yuanyuan ZHANG ; Tingting HAN ; Jingzhi WANG ; Xiaodong MO ; Fengrong WANG ; Chenhua YAN ; Yu WANG ; Yuhong CHEN ; Zhengli XU ; Feifei TANG ; Ting ZHAO ; Kaiyan LIU ; Xiaohui ZHANG ; Xiaojun HUANG ; Lanping XU
Chinese Journal of Internal Medicine 2024;63(11):1096-1103
		                        		
		                        			
		                        			Objective:To delineate the clinical characteristics and outcomes associated with severe cardiac toxicity during the preconditioning phase of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with aplastic anemia (AA).Methods:This retrospective case series study included 31 patients with severe AA who underwent allo-HSCT and were diagnosed with severe cardiac toxicity at the Hematology Department of Peking University People′s Hospital from August 2012 to June 2022. The clinical manifestations of severe cardiac toxicity observed during the preconditioning process were assessed. Patient survival was assessed using the Kaplan-Meier method.Results:In this cohort of 31 patients, the median follow-up period was 9 days (range: 4-365 days). Severe cardiac toxicity manifested within 6 days after the initial cyclophosphamide (Cy) administration. Twenty patients died within 30 days of initiating Cy preconditioning, of which 16 patients died due to severe cardiac toxicity within 25 days. Patients whose cardiac function improved within 30 days post-preconditioning showed a median survival duration of 222 days ( n=11). Troponin I (TNI) levels in patients who died within 30 days of initiating Cy preconditioning began increasing on day 5 post-Cy, peaking sharply by day 9 after a notable rise on day 8. B-type natriuretic peptide (BNP) levels in patients who died within 30 days of initiating Cy preconditioning started to rise from day 1, stabilized between days 2 and 5, and then doubled daily from days 6 to 8, remaining elevated thereafter. Notably, the initial increases in BNP and TNI correlated with electrocardiogram (ECG) signs of low voltage and T-wave inversion in 83.87% of cases ( n=26). Most patients ( n=28, 90.32%) were administered corticosteroid therapy. In those with restored cardiac function, the ejection fraction returned to >50% within 30 days of initiating Cy preconditioning. Conclusions:Patients with severe cardiac toxicity during the preconditioning phase of allo-HSCT typically exhibit early, sustained, and marked elevations in myocardial damage markers, including BNP and TNI, accompanied by ECG abnormalities following Cy administration, with BNP often increasing first. These indicators are associated with rapid disease progression and high mortality. Prompt initiation of treatment upon clinical diagnosis is critical for improving survival outcomes.
		                        		
		                        		
		                        		
		                        	
7.A case of laryngeal carcinoma complicated with Hodgkin's lymphoma.
Mo CHEN ; Tingting YU ; Yongliang TENG ; Xiangyan CUI ; Xin WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(8):667-670
		                        		
		                        			
		                        			A case of laryngeal cancer complicated with Hodgkin's lymphoma treated in the Department of Otolaryngology Head and neck surgery of the First Hospital of Jilin University was reported. Under general anesthesia, right vertical partial laryngectomy, bilateral neck lymph node functional dissection and temporary tracheotomy were performed. No recurrence was found in laryngoscope and color Doppler ultrasound of neck lymph nodes 3 and 5 months after operation.
		                        		
		                        		
		                        		
		                        			Humans
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		                        			Laryngeal Neoplasms/surgery*
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		                        			Hodgkin Disease/complications*
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		                        			Neck/pathology*
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		                        			Neck Dissection
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		                        			Lymph Nodes/pathology*
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		                        			Laryngectomy
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		                        			Carcinoma/pathology*
		                        			
		                        		
		                        	
8.Clinical characteristics of patients with human adenovirus infection undergoing allogeneic hematopoietic stem cell transplantation
Tingting HAN ; Yan HONG ; Fangfang WEI ; Yuqian SUN ; Chenhua YAN ; Xiaodong MO ; Yu WANG ; Xiaohui ZHANG ; Lanping XU ; Xiaojun HUANG ; Xiaosu ZHAO
Chinese Journal of Internal Medicine 2023;62(2):163-168
		                        		
		                        			
		                        			Objective:To investigate the clinical characteristics and prognosis of human adenovirus (HAdV) infection in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This is a retrospective case series study. Patients who received allo-HSCT and had symptoms of HAdV infection were tested in the Hematology Department at Perking University People′s Hospital from August 2015 to October 2019. Real-time quantitative PCR was used to detect HAdV DNA from 2 728 patients with potential infection. HAdV DNA-positive patients were defined as having HAdV infection. The clinical features of these patients were analyzed, and a case-pair method was used to select patients without HAdV infection as the control group in a 1∶3 ratio. The clinical results of the two groups were compared using Kaplan-Meier and Log-rank testing.Results:A total of 7 119 samples were tested for HAdV, of which 99 samples from 36 patients were positive. Of these patients, 22 developed HAdV viremia, and 24 patients had concurrent infection with another virus. Nineteen patients had fever (53%), 25 had gastrointestinal symptoms (69%), 11 had respiratory symptoms (31%), nine had reduced liver function (25%), and six had nervous system symptoms (17%). Twenty-three patients developed acute graft-versus-host disease of grade 2 or higher. Of all the patients with HAdV infection, nine were treated with cidofovir, seven of whom became HAdV negative and two had invalid treatment. The median follow-up time was 496 (216, 940) d post-HSCT. The overall survival at 5 years post HSCT was 48.4%±9.2% vs. 91.3%±3.5% ( χ2=65.03, P<0.001) in patients with and without HADV, respectively. The non-relapse mortality at 5 years post-HSCT was 40.8%±8.8% vs. 4.0%±2.0% ( χ2=34.17, P<0.001) in patients with and without HADV, respectively. Conclusions:After allo-HSCT, HAdV-infected patients are dominated by gastrointestinal and respiratory symptoms and have an increased risk of combined acute graft-versus-host disease of >2 degrees. Patients with HAdV infection have poor overall survival and high non-relapse mortality.
		                        		
		                        		
		                        		
		                        	
9.Erythrocytosis after hematopoietic stem cell transplantation: report of 3 cases and literature review
Lili QIN ; Xiaodong MO ; Tingting HAN ; Wei HAN ; Xiaojun HUANG ; Lanping XU
Chinese Journal of Internal Medicine 2023;62(8):1012-1016
		                        		
		                        			
		                        			This is a report of three cases of three male patients. One of the patients had myelodysplastic syndrome, and two had aplastic anemia; their ages were 28, 32, and 21 years old, respectively. Two patients underwent sibling allogeneic hematopoietic stem cell transplantation, and one underwent haploidentical hematopoietic stem cell transplantation. All the patients showed elevated hemoglobin and hematocrit at 6, 16, and 9 months after transplantation, with normal white blood cells and platelets and no splenomegaly. All causes of secondary polycythemia were ruled out. Bone marrow morphology showed no erythroid hyperplasia. The PCR result for BCR-ABL (P210, P230, P190, and variants) was negative, and there were no mutations at the amino acid site 617 of JAK2, exon 12 of JAK2, exon 9 of CALR, and amino acid site 515 of MPL. All three patients had hypertension. One patient was treated with amlodipine, and the other two patients were treated with angiotensin receptor blockers. The durations of erythrocytosis for these three patients were 6 years and 3 months, 4 years and 7 months, and 5 years and 3 months, respectively through December 2022. There was no tendency for spontaneous remission. Erythrocytosis after hematopoietic stem cell transplantation is a rare complication. Previous reports in the literature suggest that the mechanism of post-transplant erythrocytosis in recipients of allogeneic hematopoietic stem cell transplantation may be different from that of recipients of other transplants.
		                        		
		                        		
		                        		
		                        	
10.Safety and survival analysis of haplo-identical hematopoietic stem cell transplantation in patients with severe aplastic anemia who had previous failure to antithymoglobulin treatment
Yu YU ; Tingting HAN ; Yuanyuan ZHANG ; Yifei CHENG ; Jingzhi WANG ; Xiaodong MO ; Fengrong WANG ; Chenhua YAN ; Yuhong CHEN ; Wei HAN ; Yuqian SUN ; Haixia FU ; Zhengli XU ; Yu WANG ; Feifei TANG ; Kaiyan LIU ; Xiaohui ZHANG ; Xiaojun HUANG ; Lanping XU
Chinese Journal of Internal Medicine 2023;62(10):1209-1214
		                        		
		                        			
		                        			Objective:To investigate the safety and efficacy of haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) conditioning with the same dosage form of antithymoglobulin (ATG) in patients with severe aplastic anemia (SAA) failure to ATG.Methods:This was a retrospective cohort study. A total of 65 patients with SAA who failed ATG treatment and received haplo-HSCT conditioning with the same dosage of ATG at the Institute of Hematology, Peking University People′s Hospital between July 2008 and October 2020 were included as the ATG treatment failure group. An additional 65 SAA patients who applied ATG for the first time during haplo-HSCT were randomly selected by stratified sampling as the first-line haplo-HSCT group. Baseline clinical data and follow-up data of the two groups were collected. Conditioning-related toxicity within 10 days after ATG application and long-term prognosis were analyzed. The Kaplan-Meier was used to calculate the overall survival rate, and the Log-rank test was applied to compare the rates of the two groups.Results:In the ATG treatment failure group, there were 36 males and 29 females, and the age at the time of transplantation [ M ( Q1, Q3)] was 16 (8, 25) years. In the first-line haplo-HSCT group, there were 35 males and 30 females, with a median age of 17 (7, 26) years. Within 10 days of ATG application, the incidence of noninfectious fever, noninfectious diarrhea, and liver injury in the ATG treatment failure group was 78% (51 cases), 45% (29 cases), and 28% (18 cases), respectively, and in the first-line haplo-HSCT group was 74% (48 cases), 54% (35 cases), and 25% (16 cases), respectively; the difference between the two groups was not statistically significant for any of these three parameters (all P>0.05). For graft-versus-host disease (GVHD), there was no significant difference between the ATG treatment failure group and the first-line haplo-HSCT group in the development of 100 day Ⅱ to Ⅳ acute GVHD (29.51%±0.35% vs. 25.42%±0.33%), Ⅲ to Ⅳ acute GVHD (6.56%±0.10% vs. 6.78%±0.11%), and 3-year chronic GVHD (26.73%±0.36% vs. 21.15%±0.30%) (all P>0.05). Three-year overall survival (79.6%±5.1% vs. 84.6%±4.5%) and 3-year failure-free survival (79.6%±5.1% vs. 81.5%±4.8%) were also comparable between these two groups (both P>0.05). Conclusions:Compared with no exposure to ATG before HSCT, similar early adverse effects and comparable survival outcomes were achieved in patients with SAA who failed previous ATG treatment and received haplo-HSCT conditioning with the same dosage form of ATG. This might indicate that previous failure of ATG treatment does not significantly impact the efficacy and safety of salvaging haplo-HSCT in patients with SAA.
		                        		
		                        		
		                        		
		                        	
            
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