Objective: To explore the clinical characteristics of transfusion-associated graft-versus-host disease (TA-GVHD) in Chinese population, and to provide reference for effective prevention. Methods: Chinese and English medical databases were searched, and literature was screened based on inclusion and exclusion criteria. Data on patient information, clinical manifestations, outcomes and related risk factors from the selected studies were summarized and systematically analyzed. Results: A total of 17 studies were included in this study, involving 55 non-duplicated patients [14 males (14/55, 25.45%) and 41 females (41/55, 74.55%)], with a mean age of 51.72±18.34 years, (range: 2 months to 82 years). Among these cases, 2 had congenital immune deficiency (2/55, 3.64%), 16 had malignant hematological diseases (16/55, 29.09%), 4 had a history of surgery or trauma (4/55, 7.27%), 2 received non-surgical treatment (2/55, 3.64%), 31 were critically ill patients (31/55, 56.36%). Whole blood was transfused in 3 cases (3/55, 5.45%), erythrocyte in 9 (9/55, 16.36%), plasma in 2 (2/55, 3.64%), platelets in 7(7/55, 12.73%), human fibrinogen in 1 (1/55, 1.82%), and granulocytes in 2 (2/55, 3.64%). Two or more types of blood components were transfused in 16 cases (16/55, 29.09%). The main clinical signs and symptoms included fever (23/55, 41.82%), rash (22/55, 40.00%), diarrhea (14/55, 25.45%), abnormal liver function (18/55, 32.73%), bone marrow suppression and pancytopenia (22/55, 40.00%). The survival rate of 55 patients was 43.64% (24/55), and the mortality was 56.36% (31/55). Logistic regression analysis suggested that gender, misdiagnosis or missed diagnosis were major risk factors for mortality in TA-GVHD patients. Conclusion: The lack of specific indications for TA-GVHD often causes clinical misdiagnosis and missed diagnosis, and current treatments have limited efficacy. Therefore, it is of great significance to standardize clinical diagnosis criteria and improve prevention techniques to reduce the risk and mortality rate of TA-GVHD.

Humans ; PPAR gamma/metabolism* ; Multiple Sclerosis ; Transcription Factors/metabolism* ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha

Aim To explore the possible mechanism of "component-target-pathway" of Radix Hedysari against target organ damage caused by radiotherapy and chemotherapy, and to verify the " dose-effect" relationship of the main active components. Methods TCMSP, Uniprot, Swiss Target Prediction, GeneCards, Cytoscape, Omicshare and other platforms were used for network pharmacology analysis. Autodock, Pymol and Ligplot were used for molecular docking. The water extract of Radix Hedysari was used for animal experiment verification. The contents of eight main components were determined by HPLC. Results Four active components, eight key targets and four key pathways of Radix Hedysari were identified to resist the damage of target organs caused by radiotherapy and chemotherapy. Molecular docking showed that formononetin and quercetin had good binding activity with HSP90AA1, naringenin and MAPK3, and ursolic acid and TP53. Animal experiments showed that gastrointestinal factors MTL and VIP increased significantly, liver and kidney factors Cr, BUN, AST and ALT decreased significantly, inflammatory factor IL-10 increased significantly and TNF-a decreased significantly. The content of ononm was the highest (2 . 884 8 µg • g "

Objective To investigate the therapeutic effect of Huatan Jieyu Anshen Decoction(mainly with the actions of resolving phlegm,relieving depression and calming mind)combined with abdominal vibration tuina manipulations on chronic insomnia in the elderly.Methods Ninety-four cases of elderly patients with chronic insomnia of phlegm-heat harassing the interior type were randomly divided into the observation group and the control group,with 47 cases in each group.The control group was given Huatan Jieyu Anshen Decoction orally,while the observation group was given oral use of Huatan Jieyu Anshen Decoction combined with abdominal vibration tuina manipulations.The course of treatment for the two groups lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)score,Athens Insomnia Scale(AIS)score,Fatigue Scale-14(FS-14)score,World Health Organization Quality-of-Life Brief Scale(WHOQOL-BREF)score,and the serum levels of melatonin(MT),dopamine(DA),and cortisol(CORT).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 97.88%(46/47),while that of the control group was 87.23%(41/47),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the scores of primary and secondary TCM symptoms in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores of primary and secondary TCM symptoms in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the PSQI scores,AIS scores,and FS-14 scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the WHOQOL-BREF scores were significantly increased compared with those before treatment(P＜0.05).The decrease of the PSQI scores,AIS scores and FS-14 scores as well as the increase of the WHOQOL-BREF scores in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the serum MT level of both groups was significantly higher than that before treatment(P＜0.05),and the serum DA and CORT levels were significantly lower than those before treatment(P＜0.05).The increase in serum MT level and the decrease in serum DA and CORT levels of the observation group were significantly superior to those of the control group(P＜0.01).Conclusion The combined therapy of Huatan Jieyu Anshen Decoction combined with vibration tuina manipulations can achieve satisfactory efficacy in the elderly patients with chronic insomnia of phlegm-heat harassing the interior syndrome.The therapy is effective on regulating the central nervous system of the patients,improving the quality of the sleep,and promoting the relief of fatigue and the enhancement of the quality of life,which has great significance to the enhancement of the overall therapeutic efficacy of insomnia.

Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three⁃dimensional finite element model of the C

Objective To summarize the epidemiological and clinical features of infectious diseases of the central nervous system(CNS)by a single-center analysis.Methods A retrospective analysis was conducted on the data of 1247 cases of CNS infectious diseases diagnosed and treated in the First Medical Center of PLA General Hospital from 2001 to 2020.Results The data for this group of CNS infectious diseases by disease type in descending order of number of cases were viruses 743(59.6％),Mycobacterium tuberculosis 249(20.0％),other bacteria 150(12.0％),fungi 68(5.5％),parasites 18(1.4％),Treponema pallidum 18(1.4％)and rickettsia 1(0.1％).The number of cases increased by 177 cases(33.1％)in the latter 10 years compared to the previous 10 years(P<0.05).No significant difference in seasonal distribution pattern of data between disease types(P>0.05).Male to female ratio is 1.87︰1,mostly under 60 years of age.Viruses are more likely to infect students,most often at university/college level and above,farmers are overrepresented among bacteria and Mycobacterium tuberculosis,and more infections of Treponema pallidum in workers.CNS infectious diseases are characterized by fever,headache and signs of meningeal irritation,with the adductor nerve being the more commonly involved cranial nerve.Matagenomic next-generation sequencing improves clinical diagnostic capabilities.The median hospital days for CNS infectious diseases are 18.00(11.00,27.00)and median hospital costs are ￥29,500(￥16,000,￥59,200).The mortality rate from CNS infectious diseases is 1.6％.Conclusions The incidence of CNS infectious diseases is increasing last ten years,with complex clinical presentation,severe symptoms and poor prognosis.Early and accurate diagnosis and standardized clinical treatment can significantly reduce the morbidity and mortality rate and ease the burden of disease.

Tranexamic acid is widely used in joint orthopedic surgery.At the same time,it has high safety and few adverse drug reactions.It can effectively improve intraoperative bleeding and promote early functional recovery of patients.This article reviews the mode of administration,safe dose,administration time and adverse drug reactions of tranexamic acid in the perioperative period of joint replacement and arthroscopic surgery,in order to provide reference for the clinical application of tranexamic acid.

Quercetin can mediate the activation of mitogen-activated protein kinase(MAPK)signaling pathways to prevent osteoporosis(OP).This paper comprehensively discusses the interrelationship between MAPK and osteoporosis-related cells based on the latest domestic and international research.Additionally,it elucidates the research progress of quercetin in mediating the MAPK signaling pathway for OP prevention.The aim is to provide an effective foundation for the clinical prevention and treatment of OP and the in-depth development of quercetin.

Objective:To investigate the clinical effect of progressive transfer of penile flap combined with local scrotal flap in correction of severe concealed penis in children.Methods:The clinical data of children with severe concealed penis admitted to the Children’s Hospital Affiliated to Zhengzhou University from July 2021 to July 2023 were retrospectively analyzed. The concealed penis was corrected by progressive transfer of penile flap combined with local scrotal flap. During the operation, a small amount of excess inner prepuce was removed and the outer prepuce was cut in the middle of the dorsal side of the penis. Then the penile flap was transferred from dorsal to ventral, gradually covering the wound without tension. The local scrotal flap was lifted upwards and sutured to the frenulum for covering the ventral foreskin defect of the penis. The amount of blood loss during the operation was recorded. The pain tolerance, the duration of prepuce edema, the length of penis extension and the healing of skin flap were observed. The appearance of the penis was followed up to observe whether the penis was retracted, and the satisfaction of the children and their guardians was recorded.Results:A total of 32 male children were enrolled, ranging in age from 3 to 10 years, with an average age of 7.2 years. The penis of all the children had a conical appearance, and the penile shaft was buried under the subcutaneous anterior pubis, which was difficult to palpate in its natural state. The average intraoperative blood loss was about 5 ml. All patients had pain after the operation. Two patients needed a pump to relieve pain, and the rest could tolerate it after rectum administration of indomethacin suppositories. The edema of the prepuce was mild after the operation, and the edema basically disappeared when the patient was discharged 7-9 days later. The penis could be lengthened by 1.5-3.0 cm under static conditions, averaging about 2.0 cm. After surgery, only 1 patient had a small area (about 5 mm × 4 mm) of infection in the scrotal flap and poor incision healing, and scar healing after dressing change and intensive nursing. The other flaps healed well. After 6 to 12 months of follow-up, the penis length of 2 cases was slightly retracted from the time of discharge, and the remaining 30 cases had no significant change. The patients and their guardians were satisfied with the operation results.Conclusion:The progressive transfer of penile flap combined with local scrotal flap correction of severe concealed penis in children can fully lengthen the penile body, and the degree of postoperative retraction is low, the appearance of the penis is good, and the patient satisfaction is high.

Objective:To present the experience of the anatomical of dartos fascia and describe a new technique for the correction of congenital severe concealed penis.Methods:This retrospective study was conducted on patients with congenital severe concealed penis who underwent surgery at Department of Urology, Children’s Hospital Affiliated with Zhengzhou University from January 2021 to December 2022. Reflex erection tests were routinely performed before surgery. The technique involved creating a median longitudinal incision combined with a curved incision of the ventral penile skin, dividing and excising the deep layer of dartos fascia, fixing the subcutaneous dermis at the pubic symphysis with sutures to the tunica albuginea of the penile root, and transferring the skin of the ventral root of the penis and scrotum to match the internal plate to cover the shaft of the penis. Follow-up of complications occurred after surgery, and the surgical effect was evaluated 6 months after surgery.Results:A total of 54 patients were enrolled, aged 2.8-10.0 years, with a median age of 6.7 years. In the presence of reflex erection, the penile skin was severely deficient in children with congenital severe concealed penis. The surgery was successfully completed, and the postoperative appearance was circumcised. In 43 cases with partial penile scrotal transposition, the transposition was corrected simultaneously. The incision healed well after surgery, with no infection or incisional dehiscence. Follow-up for 6 to 20 months, with an average of 12 months, showed mild edema of the prepuce in all children, which disappeared within 2 to 4 weeks after surgery. In 51 cases, the penis body showed good exposure, with no swelling of the penis skin and no retraction of the penis. The family members were satisfied with the appearance of the penis. The penis was partially retracted in 3 cases, that affected the appearance of the penis during the sitting position.Conclusion:In congenital severe concealed penis with severe skin deficiency, a deep dartos fascia was excised using a ventral median penile combined with a curved scrotal incision approach, and the penile root and scrotal skin covered the penile body with a circumcised appearance after surgery. The scrotal transposition of the penis was corrected at the same time to give the external genitalia an optimal appearance and provide good functional and cosmetic result.