Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective:The outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndromes-evolved acute myeloid leukemia (MDS-AML) were explored.Methods:A retrospective review was conducted for 54 patients with MDS-AML treated with allo-HSCT in the Institute of Hematology and Blood Disease Hospital from January 2018 to August 2022. The clinical effects after transplantation were observed, and the related risk factors influencing prognosis were explored.Results:Of the total 54 patients, 26 males, 28 females, and 53 patients achieved hematopoietic reconstruction. After a median follow-up of 597 (15-1 934) days, the 1 year overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (CIR) and non-relapse mortality (NRM) rate were 75.8%±5.8%, 72.1%±6.1%, 12.7%±4.9%, and 17.1%±5.2%, respectively. The 3 year estimated OS, DFS, CIR, and NRM rates were 57.8%±7.5%, 58.1%±7.2%, 23.2%±6.6%, and 23.7%±6.6%, respectively. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 57.5%±6.9%, and the cumulative incidence of chronic graft-versus-host disease (cGVHD) was 48.4%±7.7%. Hematopoietic cell transplantation comorbidity index (HCT-CI) before transplantation was ≥2, minimal residual disease (MRD) was positive on the day of reconstitution, grade Ⅲ/Ⅳ aGVHD, bacterial or fungal infection and no cGVHD after transplantation were adverse prognostic factors for OS ( P<0.05). COX regression model for multivariate analysis showed that HCT-CI score before transplantation, bone marrow MRD on the day of response, grade Ⅲ or Ⅳ aGVHD, and cGVHD after transplantation were the independent adverse factors for OS ( P=0.001, HR=6.981, 95% CI 2.186-22.300; P=0.010, HR=6.719, 95% CI 1.572-28.711; P=0.026, HR=3.386, 95% CI 1.158-9.901; P=0.006, HR=0.151, 95% CI 0.039-0.581) . Conclusion:For patients with MDS-AML and high risk of relapse, allogeneic transplantation must be considered as soon as possible. The enhanced management of post-transplantation complications and maintenance treatment should be provided whenever possible after transplantation.

Advances in novel drugs, therapies, and genetic techniques have revolutionized the diagnosis and treatment of cancers, substantially improving cancer patients' prognosis. Although rare tumors account for a non-negligible number, the practice of precision medicine and development of novel therapies are largely hampered by many obstacles. Their low incidence and drastic regional disparities result in the difficulty of informative evidence-based diagnosis and subtyping. Sample exhaustion due to difficulty in diagnosis also leads to a lack of recommended therapeutic strategies in clinical guidelines, insufficient biomarkers for prognosis/efficacy, and inability to identify potential novel therapies in clinical trials. Herein, by reviewing the epidemiological data of Chinese solid tumors and publications defining rare tumors in other areas, we proposed a definition of rare tumor in China, including 515 tumor types with incidences of less than 2.5/100 000 per year. We also summarized the current diagnosis process, treatment recommendations, and global developmental progress of targeted drugs and immunotherapy agents on the status quo. Lastly, we pinpointed the current recommendation chance for patients with rare tumors to be involved in a clinical trial by NCCN. With this informative report, we aimed to raise awareness on the importance of rare tumor investigations and guarantee a bright future for rare tumor patients.
Humans ; Neoplasms/pathology* ; Biomarkers ; Prognosis ; Oceans and Seas ; China/epidemiology*

Objective:To evaluate the effect of lipoxin A4 on lipopolysaccharide (LPS)-induced activation of microglia and role of silent information regulator sirtuin 1 (SIRT1)/NF-κB signaling pathway.Methods:This experiment was performed in two parts.PartⅠ The well-growth BV2 microglia were divided into 4 groups ( n=30 each) using a random number table method: control group (group C), LXA4 group (group LXA4), LPS group (group LPS) and LPS+ LXA4 group (group LLI). PartⅡ The well-growth BV2 microglia were divided into 2 groups ( n=30 each) using a random number table method: LPS+ LXA4 group (group LL2) and LPS+ LXA4+ SIRT1 inhibitor EX527 group (group LLE). Cells in group C were commonly cultured without any treatment. In LXA4 group and LPS group, LXA4 (final concentration 100 nmol/L) and LPS (final concentration 100 ng/ml) were added respectively, and then the cells were incubated for 24 h. In LL1 group and LL2 group, LXA4 (final concentration 100 nmol/L) was added at 1 h before treatment with LPS, and the other treatments were similar to those previously described in LPS group. EX527 (final concentration of 5 μmol/L) was added at 30 min before treatment with LXA4, and the other treatments were similar to those previously described in LL2 group.The expression of inducible nitricoxide synthase (iNOS), CD32, arginine synthase 1 (Arg-1), CD206, interleuckin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α) and IL-10 mRNA was detected by real-time polymerase chain reaction. The concentrations of IL-1β, IL-6, TNF-α and IL-10 in the supernatant were measured using enzyme-linked immunosorbent assay. The content of ROS was detected by DCFH-DA. The activity of SOD was measured by WST-8 assay. The expression of NADPH oxidase 2 (NOX2), superoxide dismutase 1 (SOD1), heme oxygenase-1 (HO-1), SIRT1 and acetylated NF-κB p65 was detected by Western blot. Results:Compared with group C, the expression of iNOS, CD32, IL-1β, IL-6 and TNF-α mRNA was significantly up-regulated, the concentrations of IL-1β, IL-6 and TNF-α in the supernatant were increased ( P<0.05), no significant change was found in the expression of Arg-1, CD206 and IL-10 mRNA and IL-10 concentrations in the supernatant, the expression of NOX2 and HO-1 was up-regulated, SOD1 expression was down-regulated, the activity of SOD was decreased, the content of ROS was increased, the expression of SIRT1 was down-regulated, and the expression of acetylated NF-κB p65 was up-regulated in group LPS ( P<0.05). Compared with group LPS, the expression of iNOS, CD32, IL-1β, IL-6 and TNF-α mRNA was significantly down-regulated, the expression of Arg-1, CD206 and IL-10 mRNA was up-regulated, concentrations of IL-1β, IL-6 and TNF-α in the supernatant were decreased, the concentration of IL-10 was increased, the expression of NOX2 was down-regulated, the expression of HO-1 and SOD1 was up-regulated, the activity of SOD was increased, the content of ROS was decreased, the expression of SIRT1 was up-regulated, and the expression of acetylated NF-κB p65 was down-regulated in group LL1 ( P<0.05). Compared with group LL2, the concentrations of IL-1β, IL-6 and TNF-α in the supernatant were significantly increased, the activity of SOD was decreased, the content of ROS was increased ( P<0.05), and no significant change was found in the IL-10 concentration in the supernatant in group LLE ( P>0.05). Conclusions:LXA 4 can inhibit LPS-induced polarization of microglia to M1 phenotype, and the mechanism may be related to enhancement of SIRT1 activity and inhibition of NF-κB transcriptional activity.

Objective:To explore the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloid leukemia (AML) patients with BCR::ABL1 fusion.Methods:The clinical data of seven AML patients with BCR::ABL1 fusion from November 2012 to January 2022 were retrospectively analyzed, and their survival status was followed up.Results:The median age of patients at the time of diagnosis was 35 years. Four cases (57.1%) were diagnosed with high leukocyte counts. All cases were assayed as BCR::ABL1 positive and accompanied by four types of gene mutations (NPM1, RUNX1, ASXL1, PHF6) . Seven patients received tyrosine kinase inhibitor (TKI) combined with induction chemotherapy and bridged to allo-HSCT, and six patients received maintenance therapy with TKI. Before allo-HSCT, six patients achieved complete remission, and four patients achieved complete molecular remission (CMR) . After allo-HSCT, the three remaining cases also achieved CMR. All patients were in remission post-allo-HSCT. One case died of infection, and the remaining cases survived without relapse. The 3-year cumulative overall survival rate was (80.0±17.9) %.Conclusions:TKI combined with traditional chemotherapy could achieve a high response rate in AML patients with BCR::ABL1 fusion. In addition, allo-HSCT could enhance the molecular response rate. Maintenance therapy post-HSCT with TKI could improve prognosis.

Objective:To construct and validate a risk prediction model for work-related musculoskeletal disorders (WMSDs) among nurses, so as to provide a scientific and objective reference tool for the screening of high-risk groups of WMSDs among nurses.Methods:This study was a cross-sectional study. From March to July 2021, convenience sampling was used to select 1 050 nurses from 25 hospitals in Beijing as the research subject. The risk factors for WMSDs were evaluated by issuing the Musculoskeletal Disease Questionnaire. All survey subjects were randomly divided into the training set ( n=715) and the validation set ( n=304) according to the ratio of 7∶3, and the training set was used to build the model. The predictive ability of the risk model was evaluated using the area under receiver operating characteristic curve (AUC) and the validation set was used for validation. A total of 1 050 questionnaires were distributed and 1 019 valid questionnaires were recovered, with a valid recovery rate of 97.05%. Results:Among 1 019 nurses, the weekly incidence of WMSDs was 84.0% (856/1 019) and the annual incidence was 86.7% (883/1 019) . The neck was the site with the highest incidence of WMSDs, the weekly incidence and annual incidence were 70.3% (716/1 019) and 70.1% (714/1 019) , respectively. The results of multivariate Logistic regression analysis showed that the risk factors of the weekly incidence of WMSDs among nurses included age ≥40 years old ( P<0.001) , tense work atmosphere ( P<0.001) , forward neck posture ( P=0.002) , doing the same job daily ( P=0.039) , needing to dealing with patients ( P=0.012) and keeping the back in the same posture for a long time ( P=0.002) , and the risk factors of the annual incidence of WMSDs among nurses included age ≥40 years old ( P=0.001) , did not participation in safety protection training ( P=0.003) , high education ( P=0.041) , stressful work atmosphere ( P=0.005) , significantly forward neck posture ( P=0.008) , needing to dealing with patients frequently ( P=0.001) , work involving cold or temperature changes ( P=0.017) , insufficient rest time ( P=0.019) , frequent shift change ( P=0.035) , frequent repetition of the same action of the trunk at work ( P=0.025) , hand bending ( P=0.006) . Based on the above screening variables, a nomogram model was established to predict the risk of weekly and annual incidence of WMSDs among nurses, and the AUC values of the model in the training set were 0.794 [95% CI: (0.750-0.838) ] and 0.789 [95% CI: (0.718-0.860) ], respectively. The validation set further confirmed the predictive ability of the nomogram model. The AUC values for predicting the risk of weekly and annual incidence of WMSDs among nurses were 0.782 [95% CI: (0.729-0.835) ] and 0.794 [95% CI: (0.721-0.868) ], respectively. Conclusions:The nomogram model has good predictive ability for the occurrence risk of WMSDs among nurses, which can help to screen high-risk groups and give effective intervention in time.

Objective:To evaluate the relationship between early postoperative cognitive dysfunction and neuromodulator protein 1β(NRG1β) in aged rats.Methods:Pathogen-free healthy male Sprague-Dawley rats, aged 18-20 months, weighing 600-700 g, were divided into 3 groups ( n=10 each) using a random number table method: control group (group C), operation group (group O) and NRG1β group (group N). Exploratory laparotomy was performed in group O and group N. NRG1β 0.5 μg/kg was slowly injected into the lateral ventricle on 1 day before surgery in group N, while the equal volume of 0.1 mol/L phosphate buffer solution was given instead in C and O groups.Learning and memory function was assessed using Morris water maze test performed at day 3 after operation.The rats were then sacrificed, and the hippocampi were removed for determination of the expression of nuclear factor kappa B (NF-κB) p65 (by Western blot) and contents of interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbent assay). Results:Compared with group C, the postoperative escape latency was significantly prolonged, the expression of NF-κB p65 was up-regulated, and the contents of IL-1β and TNF-α were increased in group O and group N ( P<0.05). Compared with group O, the postoperative escape latency was significantly shortened, the expression of NF-κB p65 was down-regulated, and the contents of IL-1β and TNF-α were decreased in group N ( P<0.05). Conclusion:NRG1β is involved in the endogenous protective mechanism of early postoperative cognitive dysfunction probably by inhibiting the activation of NF-κB pathway and inhibiting inflammatory responses in aged rats.

Objective: To evaluate the outcomes of myelodysplastic syndromes (MDS) patients who received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation (MSD-PBSCT) . Methods: The clinical data of 138 MDS patients received MSD-PBSCT from Sep. 2005 to Dec. 2017 were retrospectively analyzed, and the overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (RR) , non-relapse mortality (NRM) rate and the related risk factors were explored. Results: ①After a median follow-up of 1 050 (range 4 to 4 988) days, the 3-year OS and DFS rates were (66.6±4.1) % and (63.3±4.1) %, respectively. The 3-year cumulative incidence of RR and NRM rates were (13.9±0.1) % and (22.2±0.1) %, respectively. ②Univariate analysis showed that patients with grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) or hematopoietic cell transplantation comorbidity index (HCT-CI) ≥2 points or patients in very high-risk group of the Revised International Prognostic Scoring System (IPSS-R) had significantly decreased OS[ (42.9±13.2) %vs (72.9±4.2) %, χ²=8.620, P=0.003; (53.3±7.6) %vs (72.6±4.7) %, χ²=6.681, P=0.010; (53.8±6.8) %vs (76.6±6.2) %vs (73.3±7.7) %, χ²=6.337, P=0.042]. For MDS patients with excess blasts-2 (MDS-EB2) and acute myeloid leukemia patients derived from MDS (MDS-AML) , pre-transplant chemotherapy or hypomethylating agents (HMA) therapy could not improve the OS rate[ (60.4±7.8) %vs (59.2±9.6) %, χ²=0.042, P=0.838]. ③Multivariate analysis indicated that the HCT-CI was an independent risk factor for OS and DFS (P=0.012, HR=2.108, 95%CI 1.174-3.785; P=0.008, HR=2.128, 95%CI 1.219-3.712) . Conclusions HCT-CI was better than the IPSS-R in predicting the outcomes after transplantation. The occurrence of grade Ⅲ-Ⅳ aGVHD is a poor prognostic factor for OS. For patients of MDS-EB2 and MDS-AML, immediate transplantation was recommended instead of receiving pre-transplant chemotherapy or HMA therapy.

Objective: To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation. Methods: Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results: Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.

Colon cancer associated transcript 2 (CCAT2) is found recently an important member of cancer-related long non-coding RNA (lncRNA).Dysregulation of CCAT2 plays a pivotal role in tumor pathophysiological processes,especially in tumourigenesis and progression of digestive system neoplasms,thus,CCAT2 likely represents a novel cancer biomarker or therapeutic target.Elucidation of the molecular mechanisms of CCAT2 will provide a feasible theoretical basis and potential interventional target for the diagnosis and treatment of malignancies.The present review summarizes current evidences of CCAT2 in digestive system neoplasms.