Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorders (PTLD) are one of the most severe complications after hematopoietic stem cell transplantation (HSCT). This study includes 31 cases of aplastic anemia (AA) patients who developed PTLD after haploidentical transplantation, summarizing their clinical characteristics and categorizing them into either rituximab monotherapy group or combination therapy group based on whether their condition improved by 1 log after a single dose of rituximab. The incidence of PTLD after HSCT in children with AA was 10.16%, and the incidence of PTLD in patients with age >10 years was significantly increased ( χ2=11.336, P=0.010). Of the 31 patients, 27 were clinically diagnosed and 4 were pathologically confirmed. Finally, 15 patients were classified into the rituximab treatment group and 15 patients into the combination treatment groups. Finally three patients died, and the 2-year overall survival rate was (89.7±5.6) %. Standard pre-treatment protocols and EBV reactivation are risk factors affecting the prognosis of PTLD. There was no statistically significant difference in the impact of the two treatment schemes on prognosis.

Objective:To investigate the efficacy and safety of venetoclax combined with the decitabine, cytarabine, and homoharringtonine (HHT) regimen and donor lymphocyte infusion (DLI) for the preventive and salvage therapy of pediatric acute myeloid leukemia (AML) /myelodysplastic syndrome (MDS) after allogeneic hematopoietic stem cell transplantation (HSCT) .Methods:A total of 29 relapsed pediatric/minimal residual disease-positive AML after HSCT were recruited at the Peking University Institute of Hematology from January 1, 2021, to June 1, 2023. They were treated with the above combination regimen and administered with DLI after 24-48 hours at the end of chemotherapy, and the treatment response and adverse reactions were regularly assessed.Results:The overall response rate (ORR) was 75.8%, CR rate was 88.9% (8/9) in the hematologic relapse group, and MRD negativity rate was 61.1% (11/18) in the MRD-positive group. The incidence of agranulocytosis, anemia, and thrombocytopenia with a classification above grade 3 were 100%, 82.7%, and 100%, respectively. The median time of the granulocyte deficiency period was 15 days. Acute graft-versus-host diseases (aGVHD) with a classification of grades Ⅲ-Ⅳ occurred in 11.1% of the patients after DLI, while moderate or severe cGVHD occurred in 7.4% of the patients. The single risk factor for ORR was MNC counts of less than 10×10 8/kg, and the relapse occurred within 100 days. At a median follow-up of 406 days, the 1-year OS was 65%, and the 1-year OS was 57% in the group with no reaction ( P=0.164) compared with 71% in the group who had an overall reaction. Conclusion:The combined regimen based on the DAC, VEN, and modified HA regimen showed a high response rate in the salvage therapy for pediatric AML after the relapse of HSCT. However, bridging to transplantation should be performed immediately after remission to result in a long survival rate.

Objective To explore the influencing factors of visual acuity recovery in patients with high myopia after posterior chamber phakic intraocular lens(ICL)implantation.Methods A prospective study was conducted on 210 pa-tients(420 eyes)with high myopia who underwent ICL implantation at the Second Affiliated Hospital of Zhengzhou Univer-sity from May 2021 to March 2023.The patients were divided into a good recovery group[best corrected visual acuity(BC-VA)recovery ≥0.3 D]and a poor recovery group(BCVA recovery＜0.3 D)based on their visual acuity recovery status three months after surgery.The baseline data of patients in the two groups were compared,and the factors affecting visual acuity recovery were analyzed using Logistic regression.The receiver operating characteristic(ROC)curve was used to an-alyze the predictive value of the Logistic regression model for poor visual acuity recovery in patients with high myopia after ICL implantation.Results Three months after surgery,149 patients(298 eyes)were in the good recovery group,and 61 patients(122 eyes)were in the poor recovery group.There were no significant differences in gender,age,years of myopi-a,body mass index,and academic performance between the two groups(all P＞0.05).The proportions of patients with corneal astigmatism＜1.30 D(55.74％),corneal diopter＜45 D(59.02％),Pittsburgh Sleep Quality Index(PSQI)＜7 points(63.93％),and average central radius of curvature[(7.82±0.27)mm]in the poor recovery group were lower than those in the good recovery group[83.89％,81.88％,85.91％,and(7.90±0.24)mm,respectively].The central flat me-ridian curvature(k1)of the anterior corneal surface[(43.27±1.43)D],steep meridian curvature(k2)of the anterior corneal surface[(44.84±1.53)D],and arch height[(628.49±67.28)μm]in the poor recovery group were higher than those in the good recovery group[(42.73±1.42)D,(44.12±1.47)D],and[(417.56±80.14)pm],with significant differences(all P＜0.05).Logistic regression analysis showed that corneal astigmatism,corneal diopter,k1,k2,arch height,and PSQI score were independent influencing factors of poor visual acuity recovery after ICL implantation in pa-tients with high myopia(all P＜0.05).ROC curve analysis showed that the area under the ROC curve for predicting poor visual acuity recovery after ICL implantation in patients with high myopia by Logistic regression model was 0.938(95％CI:0.896-0.966),the sensitivity was 83.61％,and the specificity was 91.95％(P＜0.05).Conclusion The visual acuity recovery after ICL implantation in patients with high myopia is affected by corneal astigmatism,corneal diopter,k1,k2,arch height,and PSQI score.The Logistic regression model based on these factors has high predictive value for visual acui-ty recovery after ICL implantation.

Objective:To observe the clinical effect of adjustable silicone strap suspension in the treatment of myasthenia gravis ptosis.Methods:From January 2019 to January 2020, 60 patients with myasthenia gravis ptosis (35 males, 25 females, age distribution from 25 to 58 years, with average of 35.63 years) were collected from the Department of Ophthalmoplasty of Aier Eye Hospital affiliated to Wuhan University. They were divided into control group and observation group, with 30 cases in each group. The observation group was treated with adjustable silicone band suspension, and the correction effect, satisfaction, recovery status, ocular surface function index, recurrence rate and complications of the two groups were compared.Results:The excellent rate of operation in the observation group was 93.33% (28/30), which was significantly higher than 63.33% (19/30) in the control group (χ 2=6.29, P<0.05), and the satisfaction of patients in the observation group was 100% (30/30), which was significantly higher than 76.67% (23/30) in the control group (χ 2=5.82, P<0.05). The preoperative corneal curvature and fluorescein staining in the observation group and the control group were significantly lower than those in the postoperative state ( t=6.17, 21.48, P<0.05). The corneal curvature and fluorescein staining score of the observation group were significantly higher than those of the control group at 3 months after surgery ( t=3.00, 9.06, P<0.05). There was no significant difference between the two groups in the incidence of complications such as eyelid imclosure, upper eyelid inversion and unnatural upper eyelid curvature (χ 2=0.19, P>0.05). Follow up at 3 months after surgery, the recurrence rate in the observation group was lower than that in the control group (χ 2=4.63, P<0.05). Conclusions:Surgery is an option for patients with myasthenia gravis ptosis who are not responding well to medical treatment and whose condition is stable. Adjustable silicone strap suspension for the treatment of myasthenia gravis ptosis can significantly improve the surgical success rate and patient satisfaction, with low postoperative complication rate and recurrence rate, which is suitable for clinical application.

Objective:To investigate the effect of long non-coding RNA00461 (LINC00461) on apoptosis of triple negative breast cancer cells.Methods:RT-qPCR was used to detect the expression of LINC00461 in normal breast epithelial cells MCF-10A, TNBC cell lines MDA-MB-231 and MDA-MB-468. The apoptosis rate was detected by Annexin V-FITC/PI double staining cell apoptosis kit. Western blot was used to detect apoptosis-associated protein. The localization of LINC00461 in cells was detected by FISH. RNA pulldown and RIP were used to detect the interaction between LINC00461 and c-Myc. The effect of LINC00461 on TNBC apoptosis was verified by subcutaneous tumorigenesis in nude mice.Results:Compared with MCF-10A, LINC00461 expression in MDA-MB-231 and MDA-MB-468 cells was significantly increased. Interference with LINC00461 significantly reduced the expression of LINC00461 and c-Myc protein. Overexpression of LINC00461 significantly decreased the expression level of apoptosis-related protein. Overexpression of LINC00461 significantly reduced the apoptosis rate by 50%-70%, with a statistically significant difference. FISH results showed that LINC00461 was mainly localized in the cytoplasm. RNA pulldown results showed that LINC00461 interacted with c-Myc. RIP results showed that the concentration of LINC00461 in c-Myc group was more than 400%, and the difference was statistically significant. In addition, overexpression of c-Myc reduced the promotion effect of knockdown LINC00461 on the apoptosis rate of 30%-50%. In animal experiments, overexpression of LINC00461 significantly increased tumor volume (50%-80%) and tumor weight (30%-50%) .Conclusion:LINC00461, mainly located in the cytoplasm, regulates the apoptosis of TNBC cells, and its molecular mechanism may be that LINC00461 interacts with c-Myc protein to play an important role in regulating the apoptosis of TNBC cells.

Objective:To explore the association of different obesity measurement indexes on serum C-reactive protein (CRP) in Chinese adult women.Methods:The data were obtained from baseline and follow-up surveys of the urban Breast Cancer Screening Program in Shuangliu District, Chengdu. A total of 441 adult women were included in the study. A questionnaire survey, physical examination, and laboratory testing were conducted on the subjects. Multivariate logistic regression model, two-level mixed effects logistic regression model, and restricted cubic spline method were used to investigate the linear and nonlinear correlation between different obesity measurement indexes and serum CRP in adult women.Results:For every 1 unit increase in BMI, waist circumference (WC), and adiposity, the risk of elevated serum CRP or exacerbation of chronic low-grade inflammation in adult women increased by 16.5%, 5.0%, and 11.1% ( P<0.05), respectively. Both BMI and adiposity were nonlinear correlated with serum CRP. Using BMI=24.0 kg/m 2 as the reference point, serum CRP level increased with the increase of BMI when BMI >24.0 kg/m 2. Using adiposity=30% as the reference point, serum CRP level increased with the increase of adiposity when adiposity >30%. Conclusions:Overall, obesity reflected by BMI had the strongest association with serum CRP in adult women, followed by body fat content reflected by adiposity, and central obesity reflected by WC had the weakest association with CRP. Adult women with BMI >24.0 kg/m 2 or adiposity >30% are at high risk for obesity-related inflammatory manifestations.

Objective:To observe the changes of corneal curvature and ocular surface after congenital ptosis.Methods:A total of 188 patients with congenital blepharoptosis were treated with frontal muscle flap suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis according to different conditions. The postoperative correction effect, corneal curvature, and ocular surface changes were observed.Results:There was no significant difference in the good correction rate among the three methods ( P>0.05). The corneal curvature at 3 months after operation was lower than that before operation and 7 days after operation ( P<0.05). The fluorescein staining score at 7 days after operation was higher than that before operation and 3 months after operation ( F=2 910.05, P<0.05). The tear film rupture time at 7 days after operation was significantly shorter than that before operation and 3 months after operation ( F=758.12, P<0.05). There was no significant difference in tear secretion test before operation, 7 days after operation and 3 months after operation ( P>0.05). The conjunctival congestion score at 3 months after operation was lower than that at 7 days after operation, and the incidence of meibomian gland dysfunction and abnormal eyelash angle at 3 months after operation was lower than that at 7 days after operation ( t=113.56, χ 2=11.02, 11.46, P<0.05). 3 months after operation, the average diopters of 3 mm and 5 mm were higher than those before operation ( t=12.35, 15.19, P<0.05). Conclusions:Frontal muscle suspension, levator eyelid muscle shortening and fixation, and levator aponeurosis are effective in treating congenital blepharoptosis, and can effectively improve the ocular surface and corneal curvature. Clinically, the appropriate one can be selected according to the condition of the child correction method.

Objective:To explore the diagnostic value of hand tenosynovitis in rheumatoid arthritis (RA).Methods:Seventy-six RA patients were enrolled for hands ultrasound examination. Forty-five RA patients with synovitis and tenosynovitis were selected as the study group, clinical characteristics, laboratory test results, disease activity score for 28 joint counts (DAS28), were evaluated and assessed, and the health assessment questionnaire (HAQ) was filled out, and semi-quantitative classification the ultrasonic indicators (synovial hyperplasia, synovitis, tenosynovitis, bone erosion) were also assessed. Forty-two non-RA patients with hand tenosynovitis were selected as the control group. Mann-whitney U test, Spearman correlation and paired U test were used for statistical analysis. Results:① In the RA group, synovial hyperplasia [7.50(3.00, 17.50)], synovitis [6.00(2.00, 14.00)], tenosynovitis [6.00(2.00, 12.00)], bone erosion [0.50(0.00, 4.00)] were statisticantly different when compared with in non-RA group in hyperplasia [5.00(3.00, 6.00)], synovitis [3.00(2.00, 4.30)], tenosynovitis [2.00(1.00, 3.00)], bone erosion [0.00(0.00, 1.00)] ( Z=2.143, P=0.032; Z=2.756, P=0.006; Z=5.560, P<0.01; Z=2.550, P=0.011). ② In the RA group, synovial hyperplasia and synovitis were positively correlated with swollen joint counts (SJC), tender joint counts (TJC), platelet (PLT), C-reactive pro-tein (CRP) and DAS28 [synovial hyperplasia ( r=0.806, P<0.01; r=0.486, P<0.01; r=0.326, P<0.05; r=0.450, P<0.01; r=0.413, P<0.01); and synovitis ( r=0.819, P<0.01; r=0.446, P<0.01; r=0.351, P<0.05; r=0.481, P<0.01; r=0.412, P<0.01)]. Tenosynovitis was positively correlated with SJC, CRP and DAS28 ( r=0.436, P<0.01; r=0.496, P<0.05; r=0.359, P<0.05) , bone erosion was positively correlated with disease course and anti-cyclic citrullinated peptide (CCP) antibody ( r=0.418, P<0.01; r=0.338, P<0.05) . ③ The sensitivity of synovial hyperplasia, synovitis, tenosynovitis, bone erosion and synovitis combined with tenosynovitis for the diagnosis of RA was 0.41, 0.61, 0.57, 0.48, 0.61 and the specificity was 0.95, 0.76, 1, 0.83, 0.93, respectively. ④ The largest area under the ROC curve was tenosynovitis [area under the curve (AUC)=0.841], the area under the curve of tenosynovitis and synovitis combined with tenosynovitis was significantly different from synovitis hyperplasia, synovitis and bone erosion [tenosynovitis( Z=3.291, P=0.001; Z=2.651, P=0.008; Z=3.032, P=0.002); synovitis combined with tenosynovitis( Z=4.346, P=0.001; Z=3.753, P=0.001; Z=2.547, P=0.012)]. Conclusion:Synovitis has a high sensitivity for the diagnosis of RA, and tenosynovitis has a high specificity for the diagnosis of RA, synovitis combined with tenosynovitis can improve the specificity for the diagnosis of RA.

Our recent studies demonstrated that the natural product nobiletin (NOB) served as a promising multidrug resistance (MDR) reversal agent and improved the effectiveness of cancer chemotherapy . However, low aqueous solubility and difficulty in total synthesis limited its application as a therapeutic agent. To tackle these challenges, NOB was synthesized in a high yield by a concise route of six steps and fourteen derivatives were synthesized with remarkable solubility and efficacy. All the compounds showed improved sensitivity to paclitaxel (PTX) in P-glycoprotein (P-gp) overexpressing MDR cancer cells. Among them, compound exhibited water solubility 280-fold higher than NOB. A drug-resistance A549/T xenograft model showed that at a dose of 50 mg/kg co-administered with PTX (15 mg/kg), inhibited tumor growth more effective than NOB and remarkably increased PTX concentration in the tumors P-gp inhibition. Moreover, Western blot experiments revealed that inhibited expression of NRF2, phosphorylated ERK and AKT in MDR cancer cells, thus implying of multiple mechanisms to reverse MDR in lung cancer.