Objective:To explore the efficacy and safety of cryopreservation-free integrated autologous hematopoietic stem cell transplantation (HSCT) model for patients with multiple myeloma.Methods:A total of 96 patients with newly diagnosed multiple myeloma (NDMM) between July 31, 2020, and December 31, 2022, were retrospectively analyzed, of which 41 patients in the observation group received integrated non-cryopreserved transplantation mode. After hematopoietic stem cells were mobilized and collected, melphalan was started immediately for pre-transplant conditioning, and non-cryopreserved grafts from the medical blood transfusion refrigerator were directly injected intravenously into the patient within 24-48 h after the melphalan conditioning. The control group consisted of 55 patients who received traditional transplantation mode. After hematopoietic stem cells were collected, stem cell cryopreservation was performed in liquid nitrogen, and then the transplant plans were started at the right time. All patients received mobilization of autologous hematopoietic stem cells using the G-CSF combined with the plerixafor.Results:① A total of 34 patients (82.9% ) with VGPR plus CR in the observation group were significantly higher than 33 patients (60.0% ) in the control group ( P=0.016). ②Compared with the control group, the incidence of grade 1 oral mucosal inflammation was higher in the observation group ( P<0.001) ; however, the incidence of grades 2 and 3 oral mucosal inflammation was lower ( P=0.004, P=0.048), and neither group experienced grade 4 or above oral mucosal inflammation. The incidence of grade 1 diarrhea was higher in the observation group ( P=0.002), whereas the incidence of grade 3 diarrhea was lower ( P=0.007). No statistically significant difference was observed in the incidence of grade 4 diarrhea ( P=0.506), and neither group experienced grade 5 diarrhea. ③ The incidence of bacterial infection in the observation group was lower than that in the control group (34.1% vs 65.5%, P=0.002), whereas no statistically significant difference was observed in the incidence of fungal infection (29.3% vs 31.4%, P=0.863) and viral infection (4.88% vs 3.64%, P=0.831). ④No statistically significant difference was observed in the implantation time of granulocytes and platelets between the observation and control groups [10 (8-20) days vs 11 (8-17) days, P=0.501; 13 (10-21) days vs 15 (10-20) days, P=0.245]. ⑤ All patients did not receive lenalidomide treatment 100 days post-transplantation. At 30 days post-transplantation, the CTL, NK, and Th cell counts in the observation group were lower than those in the control group ( P<0.001, P=0.002, P=0.049), and the NKT cell counts were higher than those in the control group ( P=0.024). At 100 days post-transplantation, the CTL, NKT, and Th cell counts in the observation group were higher than those in the control group ( P=0.025, P=0.011, P=0.007), and no statistically significant difference in NK cell counts was observed between the two groups ( P=0.396). ⑥ The median follow-up was 18 (4-33) months. The overall 2-year survival rates of the observation and control groups post-transplantation were 91.5% and 78.2%, respectively ( P=0.337). The recurrence-free survival rates were 85.3% and 77.6%, respectively ( P=0.386), and the cumulative recurrence rates were 9.8% and 16.9%, respectively ( P=0.373) . Conclusion:In NDMM, the cryopreservation-free integrated autologous HSCT model can achieve similar therapeutic effects as traditional transplantation models, with lower rates of severe mucosal inflammation and infection compared with traditional transplantation models.

Objective:To explore the protective effects of Zhenzhu Tongluo Pills on cerebral ischemia reperfusion injury in rats.Methods:Totally 15 healthy SD rats were randomly divided into sham-operation group, model group and TCM group according to random number table method, with 5 rats in each group. Except for the sham-operation group, cerebral ischemia models in the other two groups were induced by temporary middle cerebral artery occlusion. After the establishment of ischemia models, the TCM group was administered Zhenzhu Tongluo Pills solutions (1 ml/100 g) intragastrically at a dose of 0.5 g/(kg·d), and the sham-operation group and model group were treated with normal saline, for 14 consecutive days. Neurological deficit score was used to evaluate the degree of neurological deficit in cerebral ischemia rats. TTC staining were used for determining the infarct weights. The nerve cell damage was observed using HE staining method. Immunohistochemistry staining was used to observe the expression levels of GFAP, Nestin, and NeuN.Results:Compared with that at the 3 hours after reperfusion, the Bederson score in the TCM group decreased at the 30 minutes after the last administration ( P<0.05); compared with the model group, the infarction ratio of rats in the TCM group decreased ( P<0.05); the NeuN staining of neurons around the ischemic lesion in the model group rats was light, while Nestin and GFAP staining were deep; the Nestin and GFAP staining of neurons in the TCM group was light, while NeuN staining was deeper. Conclusion:Zhenzhu Tongluo Pills can improve the symptom of neurological deficits, reduce the volume of infarction, and protect neurons from injury in rats with cerebral ischemia.

Objective: The research was aimed at exploring the effects of mandelic acid on the proliferation , apoptosis and migration of H1299 lung adenocarcinoma (LUAD) cells and the related molecular mechanisms. Methods: CCK⁃8 was used to detect changes in the proliferation ability of H1299 cells;Hoechst 33258/PI double⁃staining assay was used to analyze the apoptosis of H1299 cells;Transwell and migration assays were used to analyze changes in the invasive and migration ability of H1299 cells;Western blot was used to detect the expression of proliferation ,apoptosis and migration⁃related pathway proteins. Results : Different concentrations of mandelic acid inhibited the proliferation viability and invasion and migration ability of H1299 cells (P < 0. 05) . Mandelic acid induced high expression of bax and cl⁃caspase⁃3 and low expression of p ⁃stat3 in proliferation and apoptosis pathways (P < 0. 05) .In addition , it inhibited the expression of MMP⁃9 and Vimentin proteins ,which were related to invasion and migration (P < 0. 01) . Conclusion Mandelic acid inhibited the proliferation of H1299 LUAD cells and elevated the level of apoptosis , and molecular biological mechanism might be closely related to the decreased activation of stat3 and activation of bax/caspase⁃3 signaling axis. The inhibition of invasive and migrational ability of H1299 cells induced by mandelic acid was associated with the decreased expression of MMP⁃9 and Vimentin proteins.

With the advance of the economy and population aging, the acceleration of urbanization and the change of people's lifestyles, the prevalence of chronic diseases has become very serious. However, the etiologies and pathogeneses of the diseases are not yet clear, and the evidence of effective prevention and treatment strategies is lacking. Cohort study is an important method for exploring etiology and pathogenesis. Therefore, based on the support of the Ministry of Science and Technology for precision medicine in 2016, we launched a prospective cohort study of common chronic and non-communicable diseases in three provinces (Hubei, Hunan and Henan) in central China. Three independent and integratable sub-cohorts consisting of 115 424 participants at baseline survey and 107 252 participants in follow up were established, including dynamic measurements in 39 000 subjects in Dongfeng-Tongji prospective cohort. Each participant was asked to complete a questionnaire survey, an anthropometric measurement, a laboratory measurement, and blood and urine samples were collected from them. The cohort study contributes greatly to elucidating the etiologies and pathogeneses of common chronic and non-communicable disease in Chinese population and the development of precision medicine in China. This paper briefly introduces the design concept, basic information, major achievements and progress, and challenges of the prospective cohort study of common chronic and non-communicable diseases in central China.

Objective:To investigate the efficacy of a machine learning model based on radiomics of brain lesions on T 2WI in differentiating multiple sclerosis (MS) from neuromyelitis optica spectrum disorders (NMOSD). Methods:Totally 223 MS and NMOSD patients who were treated from January 2009 to September 2018 in Beijing Tiantan Hospital Affiliated to Capital Medical University, Donghu Branch of the First Affiliated Hospital of Nanchang University, Tianjin Medical University General Hospital, and Xuanwu Hospital of Capital Medical University were analyzed retrospectively, and according to the proportion of 7∶3, 223 patients were completely randomly divided into training set (156 cases) and test set (67 cases). A total of 74 patients with MS and NMOSD who were treated in Huashan Hospital Affiliated to Fudan University and China-Japan Friendship Hospital of Jilin University from January 2009 to September 2018 and in Xianghu Branch of the First Affiliated Hospital of Nanchang University from March 2020 to September 2021 were collected as an independent external validation set. All patients underwent brain cross-sectional MR T 2WI, radiomics features were extracted from T 2WI, and features were selected by max-relevance and min-redundancy and least absolute shrinkage and selection operator algorithms. Then various machine learning classifier models (logistic regression, decision tree, AdaBoost, random forest or support vector machine) were constructed to differentiate MS from NMOSD. The area under curve (AUC) of receiver operating characteristics was used to evaluate the performance of each classifier model in the training set, test set and external validation set. Results:Based on multi-center T 2WI, a total of 11 radiomics features related to the discrimination between MS and NMOSD were extracted and classifier models were constructed. Among them, the random forest model had the best efficiency in distinguishing MS from NMOSD, and its AUC values for distinguishing MS from NMOSD in the training set, test set and external validation set were 1.000, 0.944 and 0.902, with specificity of 100%, 76.9% and 86.0%, and sensitivity of 100%, 92.1% and 79.7%, respectively. Conclusion:The random forest model based on the radiomic features of T 2WI of brain lesions can effectively distinguish MS from NMOSD.

Objective: To evaluate the therapeutic effect of dental autotransplantation with the application of digital design combined with 3D printing of donor tooth models and recipient alveolar fossa model preoperatively. Methods: Twelve cases that could not be retained due to tooth fracture or extensive absorption of alveolar bone were recruited in the study. Cone-beam computed tomography (CBCT) data were imported into Mimics software for digital design, and the best-matched third molar was selected as the donor tooth. Replicas of the donor teeth and the recipient socket were printed out with three-dimensional (3D) printing technologies as a simulation model for recipient tooth socket preparation. During tooth autotransplantation, preparation of the recipient tooth socket and the donor tooth were guided by the 3D-printed replicas sequentially. Then, the donor tooth was implanted into the recipient tooth pocket. Patients were followed up at 3, 6 and 12 months after the operation, with CBCT examination to evaluate the status of bone reconstruction and periodontal ligaments at each time point. Results: Twelve patients were transplanted with an autogenous third molar with the apical foramen completely closed. Among them, 7 patients had alveolar fossa infection before the operation, of which 1 had extensive resorption of the alveolar bone due to the infection. All 12 patients recovered well after the operation and were followed up for at least 12 months. In total, 11 caseswere successful in tooth autotransplantation with normal mastication, and 1 case had root resorption 14 months postoperation. Conclusion Digital design combined with 3D printing technology can assistin the selection of thebest-matched donor tooth and preparation of the recipient socket before tooth transplantation proceduresand reduce the extra-alveolar exposure time of the donor tooth and number of trial placementsintothe alveolar fossa. Thus, this combined strategy can effectively improve the outcome of dental autotransplantation.

Objective: To analyze the status of personnel in occupational disease prevention and treatment institutions in Hunan Province, China, from 1996 to 2015, to predict staff composition using grey model (GM) (1, 1) , and to provide a scientific basis and reference for optimizing human resource planning of occupational disease prevention and treatment in other provinces and regions and promoting the service capacity of the institutions. Methods: The data of the staff in occupational disease prevention and treatment institutions in Hunan Province, China, from 1996 to 2015 were obtained from the established basic information management system. The descriptive analysis method was used to analyze the dynamic changes in number and composition of the staff and the GM (1, 1) was used to predict the staff composition. Results: The numbers of the staff members in 1996 and 2015 in occupational disease prevention and treatment institutions in Hunan Province, China were 1591 and 1429, respectively. In the twenty years, the main education level of the staff transformed from "technical secondary school education and non-academic qualifications" to "bachelor degree or above and college degree"; the main major of the staff transformed from "other majors" to "public health and clinical medicine"; the proportion of the staff members without professional titles changed from >1/3 to 5%; and the proportions of the staff members with senior, intermediate, and junior professional titles were steadily rising. GM prediction showed that the proportions of highly educated staff members in 2018 and 2020 would be up to 41.00% and 45.61%, respectively; and the proportions of the staff members with a major in public health in 2018 and 2020 would be up to 44.15% and 46.60%, respectively. Conclusion The staff in occupational disease prevention and treatment institutions in Hunan Province, China, in the twenty years have slight changes in staff size and great improvement in staff quality, which is beneficial to sustainable development of the occupational disease prevention and treatment undertakings. The education level and major will be further optimized in the next five years.

Objective To evaluate the clinical application of early total care (ETC) for polytrauma patients combined with thoracolumbar fractures.Methods A retrospective case control study was conducted to analyze the clinical data of 137 polytrauma patients combined with thoracolumbar fractures admitted to the First Affiliated Hospital of Soochow University and the Third People's Hospital of Zhang,jiagang from January 2012 to October 2015.There were 90 males and 47 females,aged 26-69 years,with an average age of 48.2 years.The patients were divided into ETC group (n =59) and TMC group (n =78).In the ETC group,physicians from different departments evaluated the patients and developed individualized therapeutic regimens to allow the patients to undergo surgery at early stage after injury.The TMC group preferentially stabilized the patient's condition or transferred the patients to specialist treatment,and then the surgery was performed electively after the condition of the patient was stable.The ISS of the ETC group was (22.15 ± 9.28)points,and that of the TMC group was (23.37 ± 10.74) points.All patients underwent conventional posterior pedicle screw internal fixation.For patients with burst fracture and nerve injury,posterior spinal canal decompression was performed.The thoracolumbar injury classification and severity score (TLICS),spinal load sharing classification (LSC),preoperative and postoperative Glasgow coma score (GCS),Frankel classification,hospitalization time and postoperative complications were compared between the two groups.Results The TLICS scores of ETC group were significantly lower than those of TMC group (P ＜ 0.05) while the LSC scores showed no significant differences between the two groups (P ＞ 0.05).ETC group had shorter hospitalization time [(11.8 ± 3.7)days ∶ (17.5 ±4.5)days] and lower pressure ulcer incidence [(5％ ∶ 21％)] than the TMC group (P ＜ 0.05 or 0.01),but the former had significantly higher wound infection rate [(17％ ∶ 15％)] (P ＜ 0.05).There was no significant difference in pulmonary infection and deep venous thrombosis incidence between the two groups (P ＞ 0.05).No significant differences were found in the preoperative GCS scores between the two group (P ＞ 0.05) while the postoperative GCS scores of TMC group were higher than those of ETC group (P ＜ 0.01).Postoperative GCS scores in both groups were significantly higher than their preoperative GCS (P ＜ 0.05).The results of postoperative Frankel classification in the ETC group were as follows:Grade A in one patient,Grade B in one,Grade C in three,Grade D in four and Grade E in two patients,with an improvement rate of 82％.The results of postoperative Frankel classification in the TMC group were as follows:Grade A in three patients,Grade B in three,Grade C in three,Grade D in four and Grade E in four,with an improvement rate of 65％.Conclusions For polytrauma patients combined with thoracolumbar fractures,ETC can shorten hospitalization time,reduce the pressure ulcer incidence,and better facilitate the recovery of nerve function,yet with higher wound infection risk compared with TMC.TMC was preferred subjectively for patients with unstable thoracolumbar fractures and high TLICS.

Objective To summarize the clinical and imaging characteristics of primary Rosai-Dorfman disease (RDD)in central nervous system in order to understand well its features and improve the diagnosis.Methods The clinical and imaging features in 3 patients with RDD in CNS proved by pathology were retrospectively analyzed in combination with the related literatures.Results The lesions in 2 patients occurred in brain and other lesion in 1 occurred outside the brain.Iso-or slight hyperintensity on T1 WI and marked enhancement of the lesion were found.Single lesion was found in 2 patients near the dura mater and located near the superior sagittal sinus or cervical spinal cord.Multiple lesions in 1 patient were located in the lateral ventricle.Conclusion It’s suggested that single or multiple lesions in dural or spinal meninges located in the midline or near the intracephalic venous system would be considered as RDD in CNS.

Objective To investigate the prevalence of occupational diseases and treatment implementation in migrant workers in Hunan,China,and to provide a scientific basis for related departments to develop preventive and treatment measures and social security system for migrant workers.Methods A retrospective investigation was performed in 2015 to collect the information of occupational diseases in migrant workers,and age,type of work,type of occupational disease,and implementation of employment injury insurance for occupation diseases were analyzed.Results The migrant workers with occupational diseases accounted for 50.43％ (11 280/22 368) of all patients with occupational diseases in Hunan,among whom 99.4％ (11 212/11 280) were male workers.The mean age of migrant workers with occupational diseases was 55 years.The types of occupational diseases involved 6 categories such as occupational pneumoconiosis and occupational skin diseases,totaling 42 legal occupational diseases;98.31％ of all migrant workers (11 089/11 280) had occupational pneumoconiosis.The main types of work were underground coal miners (62.42％),heading drivers (29.79％),and haulage workers (2.20％) in coal mines and non-coal mines.A total of 27.25％ migrant workers with occupational diseases (2 072/7 605) enjoyed employment injury insurance,and 20.84％(1 585/7 605) did not receive any medical or life compensations.Conclusion The occupational diseases in migrant workers in Hunan are mainly pneumoconiosis,and a large proportion of those with occupational diseases do not enjoy implementation of treatment.Coal mines and non-coal mines are the high-risk areas for occupational diseases in migrant workers and should be the focus of prevention and control.