Objective To explore the clinical characteristics of patients with diffuse large B-cell lymphoma (DLBCL) accompanied with KMT2D gene mutation and the impact of its co-mutated genes on prognosis. Methods Clinical data of 155 newly diagnosed DLBCL patients were obtained. The second-generation sequencing method was used to detect 475 hotspot genes, including KMT2D mutation. Patients were divided into the KMT2D mutation group and KMT2D wild-type group based on the presence or absence of KMT2D gene mutation. Clinical characteristics, differences in co-mutated genes, and survival differences between the two groups were compared. Results The frequency of KMT2D mutation was 31%, which is predominantly observed in elderly patients (P=0.07) and less in the double-expressor phenotype (P=0.07). Compared with the KMT2D wild-type group, KMT2D gene mutation was associated with higher co-mutation rates of CDKN2A (OR=2.82, P=0.01) and BCL2 (OR=3.84, P=0.016), while being mutually exclusive with MYC gene mutation (OR=0.11, P=0.013). In univariate survival analysis, no statistically significant difference in overall survival (OS) was found between the KMT2D mutation group and the wild-type group (P=0.54). Further analysis of the prognostic significance of KMT2D with other gene mutations indicated that patients with KMT2D^mutBTG2^mut had poorer OS than those with KMT2D^wt BTG2^mut (P=0.07) and KMT2D^wt BTG2^wt (P=0.05). On the contrary, patients with KMT2D^mut CD79B^mut had better OS than those with KMT2D^mut CD79B^wt (P=0.09), with no prognostic impact observed for other co-mutated genes. Multivariate Cox regression analysis revealed that Ann Arbor stages Ⅲ and Ⅳ (HR=2.751, 95%CI: 1.169-6.472, P=0.02), elevated LDH levels (HR=2.461, 95%CI: 1.396-4.337, P=0.002), Ki-67 index>80% (HR=1.875, 95%CI: 1.066-3.299, P=0.029), and KMT2D^mutBTG2^mut(HR=4.566, 95%CI: 1.348-15.471, P=0.015) were independent risk factors for OS in patients with DLBCL (P<0.05). Conclusion DLBCL patients with KMT2D mutation often have multiple gene mutations, among which patients with a co-mutated BTG2 gene have poor prognosis.

Objective To establish typical values for interventional diagnosis and treatment at our institution, use these values as a tool to evaluate patient medical exposure doses, and optimize radiation protection measures. Methods From June to December 2023, we collected information on 593 adult cardiovascular interventional diagnosis and treatment surgeries, including surgery type, equipment model, air kerma-area product (KAP), incident reference point air kerma (K_a,r), perspective time (FT), and exposure mode. Results The typical value of cardiovascular interventional diagnosis at our institution in 2023 was 27.5 Gy·cm². The typical value of cardiovascular interventional treatment was 70.0 Gy·cm². The FT, KAP, and K_a,r of interventional surgeries were significantly higher than those of interventional diagnosis (P < 0.01). There were significant correlations between FT, KAP, and K_a,r (P < 0.01). Conclusion The results of this study were slightly different from those of other studies. They provide typical data and reference values for cardiovascular interventional diagnosis and treatment dose levels in Beijing and are helpful for dose optimization between different medical institutions.

ObjectiveTo investigate the clinical features and outcomes of recompensation in patients with autoimmune hepatitis （AIH）-related decompensated cirrhosis， to identify independent predictive factors， and to construct a nomogram prediction model for the probability of recompensation. MethodsA retrospective cohort study was conducted among the adult patients with AIH-related decompensated cirrhosis who were admitted to The Fifth Medical Center of PLA General Hospital from January 2015 to August 2023 （n=211）. The primary endpoint was achievement of recompensation， and the secondary endpoint was liver-related death or liver transplantation. According to the outcome of the patients at the end of the follow-up， the patients were divided into the recompensation group （n=16） and the persistent decompensation group（n=150）.The independent-samples t test was used for comparison of normally distributed continuous data with homogeneity of variance， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data with heterogeneity of variance； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups； the Kaplan-Meier method was used for survival analysis； the Cox proportional-hazards regression model was used to identify independent predictive factors， and a nomogram model was constructed and validated. ResultsA total of 211 patients were enrolled， with a median age of 55.0 years and a median follow-up time of 44.0 months， and female patients accounted for 87.2%. Among the 211 patients， 61 （with a cumulative proportion of 35.5%） achieved recompensation. Compared with the persistent decompensation group， the recompensation group had significantly higher white blood cell count， platelet count （PLT）， total bilirubin （TBil）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， total bile acid， prothrombin time， international normalized ratio （INR）， SMA positive rate， Model for End-Stage Liver Disease （MELD） score， Child-Pugh score， and rate of use of glucocorticoids （all P0.05）， as well as significantly lower age at baseline， number of complications， and death/liver transplantation rate （all P0.05）. At 3 and 12 months after treatment， the recompensation group had continuous improvements in AST， TBil， INR， IgG， MELD score， and Child-Pugh score， which were significantly lower than the values in the persistent decompensation group （all P0.05）， alongside with continuous increases in PLT and albumin， which were significantly higher than the values in the persistent decompensation group （P0.05）. The multivariate Cox regression analysis showed that baseline ALT （hazard ratio ［HR］=1.067， 95% confidence interval ［CI］： 1.010 — 1.127， P=0.021）， IgG （HR=0.463，95%CI：0.258 — 0.833， P=0.010）， SMA positivity （HR=3.122，95%CI：1.768 — 5.515， P0.001）， and glucocorticoid therapy （HR=20.651，95%CI：8.744 — 48.770， P0.001） were independent predictive factors for recompensation， and the nomogram model based on these predictive factors showed excellent predictive performance （C-index=0.87，95%CI：0.84 — 0.90）. ConclusionAchieving recompensation significantly improves clinical outcomes in patients with AIH-related decompensated cirrhosis. Baseline SMA positivity， a high level of ALT， a low level of IgG， and corticosteroid therapy are independent predictive factors for recompensation. The predictive model constructed based on these factors can provide a basis for decision-making in individualized clinical management.

Objective To discuss the clinical safety,feasibility and efficacy of transcatheter arterial infusion chemotherapy(TAI)combined with lipiodol chemoembolization in the treatment of advanced colorectal cancer(CRC).Methods The clinical data of 37 patients with advanced CRC,who received TAI combined with lipiodol chemoembolization at the First Affiliated Hospital of Zhengzhou University of China between June 2016 and December 2022,were retrospectively analyzed.The clinical efficacy was evaluated,the progression-free survival(PFS)and the serious complications were recorded.Results A total of 55 times of TAI combined with lipiodol chemoembolization procedures were successfully accomplished in the 37 patients.The mean used amount of lipiodol emulsion was 2.9 mL(0.8-10 mL).No serious complications such as bleeding and intestinal perforation occurred.The median follow-up time was 24 months(range of 3-48 months).The postoperative one-month,3-month,6-month and 12-month objective remission rates(ORR)were 67.6%(25/37),67.6%(25/37),64.9%(24/37)and 56.8%(21/37)respectively,and the postoperative one-month,3-month,6-month and 12-month disease control rates(DCR)were 91.9%(34/37),91.9%(34/37),89.2%(33/37)and 81.1%(30/37)respectively.The median PFS was 16 months(range of 2-47 months).As of the last follow-up,22 patients survived and 15 patients died of terminal stage of tumor.Conclusion Preliminary results of this study indicate that TAI combined with lipiodol chemoembolization is clinically safe and effective for advanced CRC,and it provide a new therapeutic method for patients with advanced CRC.

BACKGROUND:With the continuous improvement and progress of the magnetically controlled growing rod technology in the field of the treatment of spinal deformities,numerous studies have been put into this field,but the main research status,hot spots,and development trends are not clear enough. OBJECTIVE:Based on bibliometrics,this paper discusses the quality and quantity of articles in the field of using magnetically controlled growing rods to treat spinal deformities from different countries,aiming to clarify the global development trend of magnetically controlled growing rods and evaluate the research productivity,research trends,and research hotspots in the world. METHODS:The articles published from 1998 to 2023 were retrieved mainly based on the Web of Science database.CiteSpace 5.8 and VOSviewer 1.6.19 software were used to analyze the data and generate a visual knowledge map.The following parameters were evaluated for all studies:the total number of published papers,centrality,h index,the contribution of countries,authors,and journals,and the trend and hot spots were explored through the analysis of co-citation,highly cited literature,and literature keyword explosion. RESULTS AND CONCLUSION:(1)Finally,138 articles were included.From 2009 to 2020,the number of published articles in this field gradually increased.The United States has the largest number of articles(53,37.32%),and the United States has the highest h index and centrality of articles.(2)The results of keyword analysis showed that:the top ten keywords,such as early-onset scoliosis,surgery,complications,and so on,objectively and truly reflected the current situation and hot spots of magnetically controlled growing rod in the field of spinal deformity treatment.In recent years,the research focus in this field is the treatment failure caused by risk factors such as the pull-out of the magnetically controlled growing rod,implantation failure,and rod fracture,the accurate use of the corresponding medical classification,the monitoring and treatment of complications such as quality of life and cerebral palsy.(3)The co-citation results showed that:combined with the innovative and effective research of the magnetically controlled growing rod technology,the classification application of spinal deformity and the monitoring and treatment of related complications may be the research trend in this field.(4)Many highly cited articles further emphasized the therapeutic effect of magnetically controlled growing rod technology,providing an effective new idea and technical support for the field of spinal deformity correction.(5)The results of literature keyword explosion analysis demonstrate that the risk factors,medical classification,quality of life,and cerebral palsy of the application of magnetically controlled growing rods may become the research frontier in this field.(6)It can be seen that the application of magnetically controlled growing rod technology in the classification of spinal deformities and the in-depth study of related complications are the development trend in this field,but to further understand the effectiveness and safety of magnetically controlled growing rod technology in the treatment of spinal deformities,we still need long-term follow-up evidence.The overall research level of this field has steadily improved in recent years,but there are also problems such as the small number of high-quality articles and the unbalanced development of research in various regions.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective To compare the response capability of active personal dosimeters (APDs) in the pulse radiation field of interventional radiology, and to find APDs that can be used for dose optimization monitoring for interventional radiology staff. Methods Seven models of APDs and dose monitoring systems were tested in the following four types of radiation fields: continuous radiation field (Cs-137), single-pulse radiation field (80 kV, 10 mA, 10～1000 ms), multi-pulse standard radiation field (70 kV, 20～500 mA, 1～20 ms/pulse, frames per second 1～20), and multi-pulse scattering field (angiography machine, irradiation field: 15 cm × 15 cm, 22 cm × 22 cm, 27 cm × 27 cm, angiography: 65～74 kV, 6.2～8.2 mA; photography: 65 kV, 343～479 mA). Results All APDs showed good dose responses in the continuous radiation field. The ratio of the results obtained with and without phantom was 1～1.1. In the single-pulse radiation field, DMC3000 and TruDose showed good dose response, linearity, and repeatability. Under the main ray of the multi-pulse radiation field, DMC3000 and TruDose showed good dose response, linearity, and repeatability as the dose rate increased, and there were 5%～13% differences in the response ability between the two models. In angiography machine scattering field, the ratios of the results obtained from DMC3000, TruDose, and RaySafei3 to those from thermoluminescence dosimeter were 1.08 ± 0.09, 0.95 ± 0.11, and 1.13 ± 0.11, respectively. Conclusion DMC3000, TruDose, and RaySafei3 can be used in clinics as auxiliary dosimeters to optimize radiation dose monitoring and radiation protection measures for people at high risk of occupational diseases. Interventional radiology workers can implement actions to reduce the cumulative dose based on real-time dose information, thereby reducing the radiation dose.

Objective To explore the comprehensive analysis of mRNA/microRNA(miRNA)networks in peripheral blood of patients with schizophrenia.Methods A total of 6 schizophrenic patients treated in a hos-pital from December 2022 to February 2023 were included as the experimental group and 4 volunteers as the control group.Blood samples of the two groups were collected and the mRNA and miRNA expression levels were detected by RNA-seq technique.Finally,the gene set GSE145554 in Gene Expression Omnibus was used for bioinformatics verification analysis.Results Compared with the control group,a total of 2 133 mRNA differences were detected in the experimental group,including 1 410 mRNA up-regulated and 723 mRNA down-regulated.There were 150 differential miRNAs,including 72 up-regulated miRNAs and 78 down-regula-ted miRNAs.Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment biological processes and signaling pathways mainly include mammalian target of rapamycin(mTOR)signaling pathway,phos-phatidylinositide 3-kinases(PI3K)-serine/threonine-protein kinase(AKT)signaling pathway,necroptosis,and protein processing in the endoplasmic reticulum endoplasmic reticulum signaling pathways etc.Conclusion PI3K-AKT,mTOR,necroptosis and protein processing in endoplasmic reticulum signaling pathways are in-volved in the occurrence and development of schizophrenia,and provide a new research direction for the pre-vention,diagnosis and treatment of schizophrenia.

Objective To explore the predictive value of serum soluble osteoclast-associated receptor(sOSCAR)for cardiovascular adverse events after percutaneous coronary intervention(PCI)in patients with acute non-ST segment elevation acute myocardial infarction(NSTEMI).Methods From January 2020 to Jan-uary 2022,124 NSTEMI patients admitted to Weifang People's Hospital who underwent PCI were selected as the NSTEMI group,and another 100 healthy volunteers in the same period were selected as the control group.The NSTEMI patients were classified into 31 cases of poor prognosis and 93 cases of good prognosis group ac-cording to whether major adverse cardiovascular events occurred 1 year after PCI.Multivariate Logistic regres-sion model was constructed to analyze the factors affecting the prognosis of NSTEMI patients after PCI,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of sOSCAR level on the prognosis of NSTEMI patients after PCI.Results Compared with the control group,serum angiopoietin-2(Ang-2)levels were increased and sOSCAR levels were decreased in the NSTEMI group(P＜0.05).At 1-year follow-up,the incidence of poor prognosis after PCI in 124 NSTEMI patients was 25.00％(31/124).Multivariate Logistic regression analysis showed that increasing age and Ang-2 were independent risk factors affecting the prognosis after PCI in patients with NSTEMI(P＜0.05),and elevated left ventricular ejection fraction and elevated sOSCAR were independent protective factors(P＜0.05).ROC curve analysis showed that the area under the curve of serum Ang-2 and sOSCAR levels combined to predict the prognosis after PCI in NSTEMI patients was 0.865,which was greater than that of serum Ang-2 and sOSCAR levels alone,which were 0.791 and 0.786(P＜0.05).Conclusion Serum sOSCAR level is decreased in patients with NSTEMI and is closely related to the poor prognosis of patients after PCI.Serum sOSCAR combined with Ang-2 has a high predictive value for the poor prognosis of NSTEMI patients after PCI.