PD-1 blockade combined with ICE regimen in relapsed/refractory diffuse large B-cell lymphoma.

The prognosis of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) is poor. The efficacy of salvage therapy with ICE (ifosfamide, carboplatin, and etoposide) is limited. DLBCL can evade immune surveillance by upregulating programmed cell death ligand 1 (PD-L1). The purpose of this study was to explore the efficacy and safety of programmed cell death 1 (PD-1) blockade combined with ICE regimen (P-ICE) in the treatment of R/R DLBCL patients. In this study, we retrospectively explored efficacy and toxicity in R/R DLBCL patients treated with P-ICE. Prognostic biomarkers, including clinical features and molecular markers related to efficacy, were explored. From February 2019 to May 2020, a total of 67 patients treated with the P-ICE regimen were analyzed. The median follow-up time was 24.7 months (range: 1.4-39.6 months), with an objective response rate (ORR) of 62.7% and a complete response rate (CRR) of 43.3%. The 2-year progression-free survival (PFS) and overall survival (OS) rates were 41.1% (95% CI: 35.0-47.2%) and 65.6% (95% CI: 59.5-71.7%), respectively. Age, Ann Arbor stage, international prognostic index (IPI) score, and response to first-line chemotherapy were correlated with the ORR. Grade 3 and 4 adverse events (AEs) related to the P-ICE regimen were reported in 21.5% of patients. The most common AE was thrombocytopenia (9.0%). No treatment-related deaths occurred. In patients with R/R DLBCL, the P-ICE regimen has promising efficacy and mild toxicity.

Plastic bronchitis associated with respiratory syncytial virus infection: a case report.

BACKGROUND: The etiology of Plastic bronchitis (PB) is unknown. The incidence of pulmonary infection associated with PB has increased year by year, but respiratory syncytial virus (RSV) as a pathogen causes PB has rarely been reported. CASE PRESENTATION: A 2-year-old immunocompromised girl was admitted to the hospital with cough, fever for 5 days, and aggravated with shortness of breath for 1 day. With mechanical ventilation, her respiratory failure was not relieved, and subcutaneous emphysema and mediastinal pneumatosis appeared. Extracorporeal membrane oxygenation (ECMO) was administrated, but the tidal volume was low. Therefore, a bronchoscopy was performed, by which plastic secretions were found and removed. Pathology of the plastic secretions confirmed the diagnosis of type I PB. RSV was the only positive pathogen in the alveolar lavage fluid by the next-generation sequencing test. After the bronchoscopic procedure, her dyspnea improved. The patient was discharged with a high-flow nasal cannula, with a pulse oxygen saturation above 95%. Half a year after discharge, she developed sequelae of bronchitis obliterans. CONCLUSION: RSV could be an etiology of PB, especially in an immunocompromised child. In a patient with pulmonary infection, if hypoxemia is presented and unresponded to mechanical ventilation, even ECMO, PB should be considered, and bronchoscopy should be performed as soon as possible to confirm the diagnosis and to treat.

Ultrasound-guided superficial cervical plexus block combined with clavipectoral fascial plane block or interscalene brachial plexus block in clavicle surgery: a single-centre, double-blind, randomized controlled trial.

The sensory innervation of the clavicle is complex, and the best regional block technology for clavicular surgery has yet to be determined. The purpose of this study was to compare the application of ultrasound-guided superficial cervical plexus block combined with clavipectoral fascial plane block verses interscalene brachial plexus block in clavicular surgery. Fifty patients undergoing internal fixation surgery for elective clavicle fractures were randomly divided into two groups (n = 25 for each group): group I and group II. Superficial cervical plexus block combined with clavipectoral fascial plane block was used in group I, and superficial cervical plexus block combined with interscalene brachial plexus block was used in group II. The primary outcome measure was the duration of analgesia. The duration of analgesia in group I was significantly longer than that in group II (P < 0.05). The modified Bromage scale function score in group II was lower than that in group I (P < 0.01). There was no significant difference in the skin acupuncture pain score 30 min after block and visual analog scale (VAS) scores at 6 and 12 h after surgery. However, the 24 h VAS score in group I was lower than that in group II (P < 0.05). The incidence of diaphragmatic paralysis was significantly increased in group II (P < 0.01). Ultrasound-guided superficial cervical plexus block combined with clavipectoral fascial plane block can be used for clavicular surgery. It has a long postoperative analgesia time, can retain the motor function of the involved upper limb and does not cause hemidiaphragmatic paresis.Clinical trial number and registry URL: Clinical Trials.gov; Trial registration number: ChiCTR2000039383; Date of registration: 25 October 2020.

Extraction methods optimization of available heavy metals and the health risk assessment of the suburb soil in China.

Heavy metal pollution has attracted increasing concern due to its high toxicity and persistence. A suitable extraction procedure for available heavy metals in soil is necessary for assessing the ecological risk. In this work, the single extraction methods aided by shaking and microwaves were investigated and analyzed for their ability to extract available heavy metals from soil samples, and a total of 42 soil samples were collected from suburbs of Zhengzhou city in China. The extraction efficiency of Cu, Zn, As, and Cd in the certified fluvo-aquic soil was compared using eight different types of solutions: CaCl2, CH3COONH4, NH4NO3, CH3COOH, Na2EDTA, DTPA, HNO3, and NH4H2PO4. Results indicated that the shaking-assisted method that utilized Na2EDTA as an extractant demonstrated satisfactory efficiency and was chosen for further optimization and that the optimal conditions were obtained using 0.05 M Na2EDTA at pH 7, soil-liquid ratio 1:20, and extraction duration 2 h, which gained the perfect extraction efficiency ranging from 85.8 to 109.5%. The proposed approach has been applied to extract available Cu, Zn, As, and Cd in soils of Zhengzhou suburbs, where the mean values varied from 0.129 to 6.881 mg/kg. The bioavailability of different heavy metals in the soil varies greatly, with Cd having the highest activity in the survey region. Significant (p < 0.01) positive relationships were observed between the available state and the total amount of all the heavy metals. The assessment of health risks associated with heavy metals indicated that there was no risk for chronic non-carcinogenic effects. Even though the total amount of metal elements in suburban soil of Zhengzhou is 1.6% with high carcinogenic risk, the risk of available elements is still within the acceptable range, which verified that the risk grade obtained by the total amount is higher than the actual risk.

AO distractor and manual traction reduction techniques repair in distal tibial fractures: a comparative study.

BACKGROUND: Minimally invasive plate osteosynthesis (MIPO) via percutaneous plate placement on the distal medial tibia can be performed with minimizes soft tissue injury and produces good clinical results. However, the difficulty with MIPO lies in how to achieve satisfactory fracture reduction and maintain that reduction via indirect reduction techniques to facilitate internal fixation. The purpose of this study was to compare the effects of AO distractor and manual traction reduction techniques combined with MIPO in the treatment of distal tibia fractures. METHODS: Between January 2013 and December 2019, 58 patients with a distal tibia fracture were treated using MIPO. Patients were divided into two groups according to the indirect reduction method that was used: 26 patients were reduced with manual traction(group M), and 32 were reduced with an AO distractor (group A).Time until union and clinical outcomes including AOFAS ankle-rating score and ankle range of ankle motion at final follow-up were compared. Mean operative time, incision length, blood loss and postoperative complications were recorded via chart review. Radiographic results at final follow-up were assessed for tibial angulation and shortening by a blinded reader. RESULTS: Mean operative time, incision length, and blood loss in group A were significantly lower than in group M(p = 0.019, 0.018 and 0.016, respectively).Radiographic evidence of bony union was seen in all cases, and mean time until union was equivalent between the two groups (p = 0.384).Skin irritation was noted in one case(3.1%) in group A and three cases(11.5%)in group M, but the symptoms were not severe and the plate was removed after bony union. There was no statistically significant difference in postoperative complications between the two groups(p = 0.461). Mean AOFAS score and range of ankle motion were equivalent between the two groups, as were varus deformity, valgus deformity, anterior angulation and posterior angulation. No patients had gross angular deformity. Mean tibial shortening was not significantly different between the two groups, and no patients had tibial shortening > 10 mm. CONCLUSION: Both an AO distractor and manual traction reduction techniques prior to MIPO in the treatment of distal tibial fractures permit a high fracture healing rate and satisfying functional outcomes with few wound healing complications. An AO distractor is an excellent indirect reduction method that may improve operative efficiency and reduce the risk of soft tissue injury.

First Report of Stem Rot Caused by Botryosphaeria dothidea and Phomopsis velata on Forsythia suspensa in China.

Forsythia suspensa (Thunb.) Vahl (Oleaceae) is a well-known traditional Chinese medicine. It exhibits antioxidant activity and exerts antibacterial, antiviral, and antiemetic effects (Li and Chen 2005). From May 2020 to October 2021, a disease was observed on field-grown forsythia plants in Lingbao City, Henan Province, China (110°33'25.74″E, 34°30'19.34″W). The diseased plants were characterized by stem rot, retarded growth, a declined fruit quality, and in extreme cases, death of F. suspensa. Approximately 3.0% to 5.0% individuals exhibited stem rotten in the main branches. On average, 60% of the branches of infected individual trees were affected by this disease. During the initial infection stage, the bark of the plants was raised and curled, and the xylem and phloem of the stems turned brown color, whereas in the late stage of the infection, the outer bark had dried and become detached, and the inner xylem and phloem had blackened. Upon infection, the growth of plants was reduced, and the main branches became desiccated as the disease progressed. We randomly selected five diseased branches from five plant fields, the bark tissues (about 25 mm²) of which were surface-sterilized in 75% ethanol for 30 s, treated with 1% NaClO for 5 min, rinsed five times with sterile water, and placed on potato dextrose agar (PDA). After incubating 3 days, 20 clones were observed, and two representative strains (FSJF11 and FSJF13, three replicates for each) was selected for intensive study. Samples of these strains have been deposited in Institutes of Traditional Chinese Medicine, Henan University. On PDA, the colonies of FSJF11 were initially white and fluffy in appearance, later turning gray, and finally black. The vigorously growing hyphae were branched and septate. However, no spores was observed during culture. FSJF13 colonies were rapidly growing, initially white in color and later turning gray. After culturing for 20 days, black conidia appeared and yellow conidial horns were released. The alpha conidia were elliptical, slightly pointed at both ends, and each end possessed an oil ball (6.40±0.60 × 1.86±0.25 µm). The beta conidia were slender, linear, and hook shaped with a slightly curved end (28.92±2.81 × 0.96±0.14 µm). DNA of the isolates was extracted using a Fungal Genome DNA Extraction Kit (Sangon Biotech, Shanghai), and selected genes were amplified using the primer pairs ITS1/ITS4 (Tian et al. 2018), LROR/ LR5, and NS1/NS4 (Aiello et al. 2020). Sequences have been deposited in GenBank (ITS: MW834579 and MW834580; LSU: MW829566 and MW829567; SSU: MW834582 and MW834583). The lengths of the amplified ITS, LSU and SSU sequences were 491, 759, and 1013 bp for FSJF11, respectively, and these in FSJF13 were 543, 927, and 901 bp, respectively. The ITS, LSU, and SSU sequences of FSJF11 were found to have sequence identities of 99.19%, 100%, and 100% with those of Botryosphaeria dothidea stains AY259092, EU673243, and Eu673174, respectively, and a phylogenetic tree was constructed based on the concatenated sequences (ITS, LSU, and SSU) revealed that FSJF11 and B. dothidea formed a clade with 96% support. A BLAST search of the Genbank database revealed that the ITS sequence of FSJF13 showed 99.81% identity with that of Phomopsis velata (MN183778). Given that no LSU or SSU sequences of this species are currently available, we constructed a phylogenetic tree based solely on ITS sequences, which revealed that FSJF13 and P. velata formed a clade with 99% support. Based on the morphological and molecular characteristics(Qi et al. 2007), the isolates of FSJF11 and FSJF13 were identified as B. dothidea and P. velata, respectively. Healthy branches of F. suspensa were wounded in vitro after inoculating active fungal cake of B. dothidea or P. velata (diameter = 5 mm) on the bark, and control branches were treated with PDA. In total, each branch was inoculated via four holes were inoculated on each branch, and three branches were used for each treatment. The inoculation sites were covered with a piece of wet absorbent cotton and then wrapped with plastic film, and the branches were incubated at 26 °C. The branches continued to grow after removal of the cotton and the film on the fourth day. All inoculated points on the branches showed lesions similar to those observed in the field, whereas the control branches were asymptomatic. The pathogenicity rates of FSJF11 and FSJF13 (three replicates for each) were 66.67% and 83.33%, respectively. Both species were re-isolated from the symptomatic branches respectively, thereby fulfilling Koch's postulates. To the best of our knowledge, this is the first report of B. dothidea and P. velata causing branches rot in F. suspensa. The findings of this study will contribute to developing effective strategies for the control of this newly emerging plant disease.

Physiological and transcriptional changes provide insights into the effect of root waterlogging on the aboveground part of Pterocarya stenoptera.

Pterocarya stenoptera is a tree species that occurs along rivers and has high tolerance to waterlogging. Identification of waterlogging response genes in the aboveground part of P. stenoptera will increase understanding of tolerance mechanisms under root waterlogging conditions. In this study, we employed four physiological indicators and comparative transcriptome sequencing to investigate the waterlogging tolerance mechanism in P. stenoptera. The physiological results showed that the aboveground part of P. stenoptera was not obviously affected by waterlogging. P. stenoptera enhanced waterlogging tolerance by increasing the synthesis of alpha-Linolenic acids and flavonoids and activating the jasmonic acid, ethylene, and auxin signaling pathways. Our results confirmed our hypothesis that P. stenoptera, a species that is widely distributed along rivers, has evolved a range of mechanisms in response to waterlogging. Our research will provide new insights for understanding the tolerance mechanism of species to waterlogging.

Comparative analysis of drought-responsive and -adaptive genes in Chinese wingnut (Pterocarya stenoptera C. DC).

BACKGROUND: Drought is the main stress factor for the cultivation of Pterocarya stenoptera in urban areas, and this factor will cause its dehydration and affect its growth. Identifying drought-related genes will be useful for understanding the drought adaptation mechanism of P. stenoptera. RESULTS: We used physiological indicator detection, comparative transcriptome sequencing, and reanalysis on the results of previous landscape genomics studies to investigate the drought adaptation mechanism in P. stenoptera. The changes in malondialdehyde content showed that P. stenoptera was remarkably affected by drought stress, and the increase in soluble sugar content suggested its important role in response to drought stress. Results of comparative transcriptome sequencing showed that P. stenoptera initiated a series of programs, such as increasing the gene expression of unsaturated fatty acids, tyrosine, and plant pathogen resistance, to deal with the transient drought stress. According to the annotated results in a previous study, P. stenoptera adapts to the long-term differential drought stress by regulating the thickness of cell walls and expressing upper or lower limits of the downstream genes in the hormone signaling pathway. Through the comparative analysis of drought-responsive and -adaptive genes in P. stenoptera, this study supports the hypothesis that the environment-responsive genes (ERGs) introduced by the transient environmental stresses will be substantially more than the environment-adaptive genes (EAGs) in response to long-term differential environmental stresses, and the EAGs are not necessarily ERGs. CONCLUSIONS: Our study identified drought-responsive and -adaptive genes in P. stenoptera and revealed that P. stenoptera increased the gene expression of unsaturated fatty acids, tyrosine, and plant pathogen resistance in response to transient drought stress. This study reveals the different adaptation mechanism of P. stenoptera under the transient and long-term differential drought stresses.

Physiological analysis and transcriptome sequencing reveal the effects of drier air humidity stress on Pterocarya stenoptera.

Identifying physiological and transcriptomic changes can provide insights into the effects of drier air humidity stress on plants. In this study, we selected 6-month-old seedlings of Pterocarya stenoptera as study materials and used physiological index detection and transcriptome sequencing to investigate the adaptation mechanism of P. stenoptera in response to drier air humidity stress. Proline content, and superoxide dismutase and peroxidase activities did not increase significantly under drier air humidity stress. The physiological results showed that the drier air humidity stress only had slight effects on P. stenoptera. However, transcriptome sequencing showed that P. stenoptera initiated a series of metabolic pathways including L-phenylalanine catabolic process, NAD biosynthetic process, ATP biosynthetic process, and thiamine metabolism under drier air humidity stress. The enriched Kyoto Encyclopedia of Genes and Genomes results at 2 and 4 weeks under the drier air humidity stress showed that the genes THI1 and THIC in thiamine metabolism exhibited significantly differential expression. Previous studies confirmed that the two genes can improve drought tolerance. Our results implicitly indicated that exogenous thiamine might improve drought tolerance and alleviate the yellowing of the P. stenoptera leaves. Our study provides insights into the adaptation mechanism of P. stenoptera in response to drier air humidity stress and important clues into the cultivation and management of P. stenoptera in northern cities in China.

Landscape genetics reveals that adaptive genetic divergence in Pinus bungeana (Pinaceae) is driven by environmental variables relating to ecological habitats.

BACKGROUND: Understanding the genetic basis of local adaptation has long been the concern of biologists. Identifying these adaptive genetic variabilities is crucial not only to improve our knowledge of the genetic mechanism of local adaptation but also to explore the adaptation potential of species. RESULTS: Using 10 natural populations and 12 start codon targeted (SCoT) markers, a total of 430 unambiguous loci were yielded. The Bayesian analysis of population structure clearly demonstrated that the 10 populations of P. bungeana could be subdivided into three groups. Redundancy analysis showed that this genetic divergence was caused by divergence selection from environmental variables related to the ecological habitats of "avoidance of flooding" and "avoidance of high temperature and humidity." LFMM results indicated that Bio1, Bio5, Bio8, Bio12, Bio14, and Bio16, which are related to the ecological habitat of P. bungeana, were correlated with the highest numbers of environment-associated loci (EAL). CONCLUSIONS: The results of EAL characterization in P. bungeana clearly supported the hypothesis that environmental variations related to the ecological habitat of species are the key drivers of species adaptive divergence. Moreover, a method to calculate the species landscape adaptation index and quantify the adaptation potential of species was proposed and verified using ecological niche modeling. This model could estimate climatically suitable areas of species spatial distribution. Taking the results together, this study improves the current understanding on the genetic basis of local adaptation.

MRI signal intensity differentiation of brainstem encephalitis induced by Enterovirus 71: a classification approach for acute and convalescence stages.

BACKGROUND: The objective of this study is to assess standardized histograms of signal intensities of T1 signal and T2 signal on sagittal view without enhancement during (1) acute stage, and (2) convalescence stage of pediatric patients with Enterovirus 71 related brainstem encephalitis (BE), and with respect to (3) healthy normal. METHODS: Our subjects were hospitalized between March 2010 and October 2012, and underwent pre- and post-contrast MRI studies. The research question to be answered is whether the comparison of the MRI image intensity histograms and relevant statistical quantification can add new knowledge to the diagnosis of BE patients. So, both 25 cases in acute stage with prolonged T1 and T2 signal, without enhancement, and 13 cases in convalescence stage were introduced. In additional, a healthy group with 25 cases was recruited for comparison. RESULTS: MRI signal intensity histogram changes of the lesions were compared at the acute and convalescence stages of the disease. Our preliminary results suggest that standardized histograms of signal intensities and their statistical properties are able to provide diagnostic information for the clinical assessment of the disease. Different stages pertaining to the histogram plots comparison showed that overall T1 signal intensity values increase as we traverse from the acute stage to the convalescence stage. And then for the healthy subjects, the T2 signal intensity values changed their magnitudes in a reverse direction. However, exceptions of this can happen in four cases where the primary lesions occurred in the brainstem that developed encephalomalacia resulting in a lower signal in T1WI and higher signal in T2WI. Statistical analysis revealed there was significant difference of T1 signal intensity among the three groups; and also, the T2 signal intensity was lower than other two groups. CONCLUSIONS: Standardized histogram of T1 and T2 intensity provide valuable and useful information for disease diagnosis and evaluation, which can potentially help medical doctors to save the lives of children.

Comparative analyses of phenotypic methods and 16S rRNA, khe, rpoB genes sequencing for identification of clinical isolates of Klebsiella pneumoniae.

The present work aimed to evaluate 16S rRNA, khe and rpoB gene sequencing for the identification of Klebsiella pneumoniae in comparison with phenotypic methods. Fifteen clinical isolates were examined, which were initially identified as K. pneumoniae subsp. pneumoniae using the automated VITEK 32 system in two hospitals in Enshi City, China. Their identity was further supported by conventional phenotypic methods on the basis of morphological and biochemical characteristics. Using Bayesian phylogenetic analyses and haplotypes network reconstruction, 13 isolates were identified as K. pneumoniae, whereas the other two isolates (K19, K24) were classified as Shigella sp. and Enterobacter sp., respectively. Of the three genes, 16S rRNA and khe gene could discriminate the clinical isolates at the genus level, whereas rpoB could discriminate Klebsiella at the species and even subspecies level. Overall, the gene tree based on rpoB is more compatible with the currently accepted classification of Klebsiella than those based on 16S rRNA and khe genes, showing that rpoB can be a powerful tool for identification of K. pneumoniae isolates. Above all, our study challenges the utility of khe as a species-specific marker for identification of K. pneumoniae.

Reference Intervals of Routine Coagulation Assays During the Pregnancy and Puerperium Period.

BACKGROUND: Significant changes occur in the coagulation and fibrinolytic systems during pregnancy and puerperium in the plasma levels. However, reference ranges based on healthy people are not optimal for informing clinical decisions during the pregnancy and puerperium. Therefore, it is essential to explore coagulation assays' reference ranges during the pregnancy and puerperium. METHODS: Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib.), and D-dimer were all measured according to the manufacturer's specifications and laboratory standard operating procedure of the STA-R evolution coagulation analyzer. A total of 11,601 women were enrolled in this study. RESULTS: The reference ranges for PT, APTT, TT, Fib., and D-dimer in nonpregnancy period were 10.87-13.76 s, 29.22-44.61 s, 15.39-20.15 s, 1.59-3.97 g/l, and 0-0.56 mg/l, respectively. In early-pregnancy period, the ranges were 11.14-14.07 s, 29.97-44.69 s, 14.92-19.03 s, 1.98-4.13 g/l, and 0-1.67 mg/l, respectively. In midpregnancy period, the ranges were 9.98-12.84 s, 28.53-40.70 s, 13.51-19.82 s, 2.63-5.19 g/l, and 0-2.81 mg/l, respectively. In late-pregnancy period, the ranges were 9.48-12.58 s, 28.61-40.80 s, 14.10-19.61 s, 2.80-5.56 g/l, and 0-27.08 mg/l, respectively. In puerperium period, the ranges were 10.85-13.72 s, 30.51-43.02 s, 15.31-19.64 s, 1.14-5.07 g/l, and 1.27-4.85 mg/l, respectively. CONCLUSION: We presented reference intervals for coagulation assays from the nonpregnancy to puerperium period that can be adopted in other laboratories after further validation.

Macro-/micro-environment-sensitive chemosensing and biological imaging.

Environment-related parameters, including viscosity, polarity, temperature, hypoxia, and pH, play pivotal roles in controlling the physical or chemical behaviors of local molecules. In particular, in a biological environment, such factors predominantly determine the biological properties of the local environment or reflect corresponding status alterations. Abnormal changes in these factors would cause cellular malfunction or become a hallmark of the occurrence of severe diseases. Therefore, in recent years, they have increasingly attracted research interest from the fields of chemistry and biological chemistry. With the emergence of fluorescence sensing and imaging technology, several fluorescent chemosensors have been designed to respond to such parameters and to further map their distributions and variations in vitro/in vivo. In this work, we have reviewed a number of various environment-responsive chemosensors related to fluorescent recognition of viscosity, polarity, temperature, hypoxia, and pH that have been reported thus far.

Timing theory integrated nursing combined behavior change integrated theory of nursing on primiparous influence.

BACKGROUND: The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara. This has the potential to enhance the psychological well-being and overall quality of life for primipara, while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum. AIM: To explore the effect of timing theory combined with behavior change on self-efficacy, negative emotions and quality of life in patients with primipara. METHODS: A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022. These cases were divided into two groups, namely the observation group and the control group, with 40 cases in each group. The nursing interventions differed between the two groups, with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change. The study aimed to compare the pre- and post-nursing scores of Chinese Perceived Stress Scale (CPSS), Edinburgh Postpartum Depression Scale (EPDS), Self-rating Anxiety Scale (SAS), breast milk knowledge, self-efficacy, and SF-36 quality of life in both groups. RESULTS: After nursing, the CPSS, EPDS, and SAS scores of the two groups was significantly lower than that before nursing, and the CPSS, EPDS, and SAS scores of the observation group was significantly lower than that of the control group (P = 0.002, P = 0.011, and P = 0.001 respectively). After nursing, the breastfeeding knowledge mastery, self-efficacy, and SF-36 quality of life scores was significantly higher than that before nursing, and the breastfeeding knowledge mastery (P = 0.013), self-efficacy (P = 0.008), and SF-36 quality of life (P = 0.011) scores of the observation group was significantly higher than that of the control group. CONCLUSION: The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals, while also enhancing their self-efficacy and overall quality of life. This study focuses on the key concepts of timing theory, behavior change, primipara individuals, negative mood, and quality of life.

A Nomogram Model Based on the Inflammation-Immunity-Nutrition Score (IINS) and Classic Clinical Indicators for Predicting Prognosis in Extranodal Natural Killer/T-Cell Lymphoma.

Background: Systemic inflammation, immunity, and nutritional status are closely related to patients' outcomes in several kinds of cancers. This study aimed to establish a new nomogram based on inflammation-immunity-nutrition score (IINS) to predict the prognosis of extranodal natural killer/T-cell lymphoma (ENKTL) patients. Methods: The clinical data of 435 patients with ENTKL were retrospectively reviewed and randomly assigned to training cohort (n=305) and validation cohort (n=131) at a ratio of 7:3. Cox regression analysis was employed to identify independent prognostic factors and develop a nomogram in the training cohort. Harrell's concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) curve were employed to assess the performance of the nomogram and compare it with traditional prognostic systems (PINK, IPI, KPI). Internal validation was performed using 1000 bootstrap resamples in the validation cohort. Kaplan-Meier survival analyses were conducted to compare the overall survival (OS) of patients in different risk groups. Results: In the training cohort, in addition to several classic parameters, IINS was identified as an independent prognostic factor significantly associated with the OS of patients. The nomogram established based on the independent prognostic indicators showed superior survival prediction efficacy, with C-index of 0.733 in the training cohort and 0.759 in the validation cohort compared to the PINK (0.636 and 0.737), IPI (0.81 and 0.707), and KPI (0.693 and 0.639) systems. Furthermore, compared with PINK, IPI, and IPI systems, the nomogram showed relatively superior calibration curves and more powerful prognostic discrimination ability in predicting the OS of patients. DCA curves revealed some advantages in terms of clinical applicability of the nomogram compared to the PINK, IPI, and IPI systems. Conclusion: Compared with traditional prognostic systems, the nomogram showed promising prospects for risk stratification in ENKTL patient prognosis, providing new insights into the personalized treatment.

Sintilimab (anti-PD-1 antibody) plus chidamide (histone deacetylase inhibitor) in relapsed or refractory extranodal natural killer T-cell lymphoma (SCENT): a phase Ib/II study.

Anti-PD-1 antibodies are a favorable treatment for relapsed or refractory extranodal natural killer T cell lymphoma (RR-ENKTL), however, the complete response (CR) rate and the duration of response (DOR) need to be improved. This phase 1b/2 study investigated the safety and efficacy of sintilimab, a fully human anti-PD-1 antibody, plus chidamide, an oral subtype-selective histone deacetylase inhibitor in 38 patients with RR-ENKTL. Expected objective response rate (ORR) of combination treatment was 80%. Patients received escalating doses of chidamide, administered concomitantly with fixed-dose sintilimab in 21-days cycles up to 12 months. No dose-limiting events were observed, RP2D of chidamide was 30 mg twice a week. Twenty-nine patients were enrolled in phase 2. In the intention-to-treat population (n = 37), overall response rate was 59.5% with a complete remission rate of 48.6%. The median DOR, progression-free survival (PFS), and overall survival (OS) were 25.3, 23.2, and 32.9 months, respectively. The most common grade 3 or higher treatment-emergent adverse events (AEs) were neutropenia (28.9%) and thrombocytopenia (10.5%), immune-related AEs were reported in 18 (47.3%) patients. Exploratory biomarker assessment suggested that a combination of dynamic plasma ctDNA and EBV-DNA played a vital prognostic role. STAT3 mutation shows an unfavorable prognosis. Although outcome of anticipate ORR was not achieved, sintilimab plus chidamide was shown to have a manageable safety profile and yielded encouraging CR rate and DOR in RR-ENKTL for the first time. It is a promising therapeutic option for this population.

A self-calibrating bipartite viscosity sensor for mitochondria.

A self-calibrating bipartite viscosity sensor 1 for cellular mitochondria, composed of coumarin and boron-dipyrromethene (BODIPY) with a rigid phenyl spacer and a mitochondria-targeting unit, was synthesized. The sensor showed a direct linear relationship between the fluorescence intensity ratio of BODIPY to coumarin or the fluorescence lifetime ratio and the media viscosity, which allowed us to determine the average mitochondrial viscosity in living HeLa cells as ca. 62 cP (cp). Upon treatment with an ionophore, monensin, or nystatin, the mitochondrial viscosity was observed to increase to ca. 110 cP.

Folate-based near-infrared fluorescent theranostic gemcitabine delivery.

A series of heptamethine cyanine (1-3) derivatives bearing a carbamate ethyl disulfide group and gemcitabine, an anticancer drug, have been newly synthesized. Their disulfide bonds are readily cleaved by various thiols including glutathione, to result in a subsequent decomposition of the carbamate into amine followed by release of the active gemcitabine, which can be monitored by the fluorescence changes. In the biological experiment, prodrug 1 is preferentially up-taken by folate-positive KB cells over folate-negative A549 cells via receptor-mediated endocytosis to release gemcitabine causing cell death and to emit fluorescence in endoplasmic reticulum. Moreover, it is selectively accumulated in the KB cells which were treated to mice by dorsal subcutaneous injection. This drug delivery system is a new theranostic agent, wherein both therapeutic effect and drug uptake can be easily monitored at the subcellular level, by in vivo and in vitro fluorescence imaging.

Clinical and MRI features of neurological complications after influenza A (H1N1) infection in critically ill children.

BACKGROUND: Influenza A (H1N1) can cause severe neurological complications. OBJECTIVE: The purpose of this study was to analyze clinical and MRI features of neurological complications after H1N1 infection in critically ill children. MATERIALS AND METHODS: We retrospectively analyzed clinical and neuroimaging findings in 17 children who were hospitalized in an intensive care unit with severe neurological complications after H1N1 infection in South China between September 2009 and December 2011. All children underwent pre- and post-contrast-enhanced brain MRI. Postmortem studies were performed in two children. RESULTS: Six children died, five because of acute necrotizing encephalopathy (ANE) and one because of intracranial fungal infection. Eleven recovered; their manifestations of H1N1 were meningitis (3), encephalitis (1) and influenza encephalopathy (7). MRI features of ANE included multiple symmetrical brain lesions demonstrating prolonged T1 and T2 signal in the thalami, internal capsule, lenticular nucleus and pontine tegmentum. Postmortem MRI in two children with acute necrotizing encephalopathy showed diffuse prolonged T1 and T2 signal in the bilateral thalami, brainstem deformation and tonsillar herniation. CONCLUSION: Fatal neurological complications in children after H1N1 infection include ANE and opportunistic fungal infection. MRI is essential for identification of neurological complications and for clinical evaluation.