Integrative genomic and transcriptomic profiling reveals distinct molecular subsets in adult mixed phenotype acute leukemia.

Mixed phenotype acute leukemia (MPAL) is a subtype of leukemia in which lymphoid and myeloid markers are co-expressed. Knowledge regarding the genetic features of MPAL is lacking due to its rarity and heterogeneity. Here, we applied an integrated genomic and transcriptomic approach to explore the molecular characteristics of 176 adult patients with MPAL, including 86 patients with T-lymphoid/myeloid MPAL (T/My MPAL-NOS), 42 with Ph+ MPAL, 36 with B-lymphoid/myeloid MPAL (B/My MPAL-NOS), 4 with t(v;11q23), and 8 with MPAL, NOS, rare types. Genetically, T/My MPAL-NOS was similar to B/T MPAL-NOS but differed from Ph+ MPAL and B/My MPAL-NOS. T/My MPAL-NOS exhibited higher CEBPA, DNMT3A, and NOTCH1 mutations. Ph+ MPAL demonstrated higher RUNX1 mutations. B/T MPAL-NOS showed higher NOTCH1 mutations. By integrating next-generation sequencing and RNA sequencing data of 89 MPAL patients, we defined eight molecular subgroups (G1-G8) with distinct mutational and gene expression characteristics. G1 was associated with CEBPA mutations, G2 and G3 with NOTCH1 mutations, G4 with BCL11B rearrangement and FLT3 mutations, G5 and G8 with BCR::ABL1 fusion, G6 with KMT2A rearrangement/KMT2A rearrangement-like features, and G7 with ZNF384 rearrangement/ZNF384 rearrangement-like characteristics. Subsequently, we analyzed single-cell RNA sequencing data from five patients. Groups G1, G2, G3, and G4 exhibited overexpression of hematopoietic stem cell disease-like and common myeloid progenitor disease-like signatures, G5 and G6 had high expression of granulocyte-monocyte progenitor disease-like and monocyte disease-like signatures, and G7 and G8 had common lymphoid progenitor disease-like signatures. Collectively, our findings indicate that integrative genomic and transcriptomic profiling may facilitate more precise diagnosis and develop better treatment options for MPAL.

Clinical practice guidelines for the management of adult patients with neurogenic lower urinary tract dysfunction: a systematic review protocol.

INTRODUCTION: Neurogenic lower urinary tract dysfunction (NLUTD) both threatens the health of affected patients long-term and also has a significantly negative impact on the patients' quality of life. present, many clinical practice guidelines (CPGs) have been developed for NLUTD patients, but these CPGs may confuse healthcare professionals and patients due to their great difference in terms of scope, quality and content. This review aims to identify the CPGs for NLUTD patients published from 2012 to 2022, assess their quality and then analyse them in an integrated manner. METHODS AND ANALYSIS: We will systematically search electronic healthcare databases (English databases including PubMed, EMBASE, OVID, Scopus, Web of Science, Cochrane Library, CINAHL, UpToDate, and Best Practice and Chinese databases including China National Knowledge Infrastructure, Wanfang Database, VIP Periodical Resource Integration Service Platform and SinoMed), online CPG repositories and relevant professional association websites to identify eligible CPGs. The CPGs published in English and Chinese with full texts available within the period from January 2012 to March 2022 will be included in this study. The Appraisal of Guidelines for Research and Evaluation (AGREE) II will be used to assess the quality of included CPGs. According to the predesigned data table, the general characteristics of these CPGs, proposed recommendations and their quality of evidence, strength of recommendation and other information will be extracted. Qualitative thematic analysis will be applied to the extracted recommendations. A summary of the proposed recommendations, their quality of evidence, strength of recommendation and other information will eventually be described in a table. This review is expected to identify knowledge gaps in current CPGs and to identify the areas of the proposed recommendations derived from low-level evidence. ETHICS AND DISSEMINATION : This systematic review does not involve the participation of any subjects, and therefore no ethical approval is required. The findings of this review will be published in a peer-reviewed journal and disseminated via conference presentations. PROSPERO REGISTRATION NUMBER: CRD42022318180.

Effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease.

BACKGROUND: Patients with benign prostatic disease often experience detrusor morphological changes and dysfunction. In severe cases, it leads to bladder detrusor dysfunction, resulting in dysuria, frequent urination, urgent urination, incomplete urination, and other symptoms including renal function injury. An operation to restore normal urination function and to control postoperative complications, as far as possible, is the most common method for benign prostatic disease. AIM: To observe the effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease. METHODS: In total, 130 patients diagnosed with benign prostatic disease, from January 2018 to June 2021, in our hospital, were selected and divided into observation and control groups according to their treatment options. Sixty-five cases in the control group were given routine nursing mode intervention and 65 cases in the observation group received precise nursing service mode intervention. The intervention with the observation group included psychological counseling about negative emotions, pelvic floor exercises, and post-hospital discharge care. The complications of the two groups were counted, and the general postoperative conditions of the two groups were recorded. The urinary flow dynamics indexes of the two groups were detected, and differences in clinical international prostate system score (IPSS) and urinary incontinence quality of life questionnaire (I-QOL) scores were evaluated. RESULTS: Postoperative exhaust time (18.65 ± 3.23 h and 24.63 ± 4.51 h), the time of indwelling catheter (4.85 ± 1.08 d and 5.63 ± 1.24 d), and hospitalization time (8.78 ± 2.03 d and 10.23 ± 2.28 d) in the observation group were lower than in the control group. The difference was statistically significant (P < 0.05). After the operation, the maximum urinary flow rate (Qmax) increased (P < 0.05), the residual urine volume (RUV) decreased (P < 0.05), and the maximum closed urethral pressure (MUCP) was not statistically significant (P > 0.05) compared to pre-operation. The Qmax of the observation group was higher than that of the control group, while the RUV was lower than that of the control group. There was no significant difference in MUCP between the observation and control groups (P > 0.05). The I-QOL score of the two groups improved (P < 0.05), and the IPSS decreased (P < 0.05). After the operation, the I-QOL score of the observation group was higher than that of the control group, and the IPSS was lower than that of the control group (P < 0.05). There were no significant differences in the incidence of urethral injury (1.54% and 3.08%), bladder spasm (0.00% and 1.54%), and secondary bleeding (1.54% and 4.62) between the observation and control groups (P > 0.05). CONCLUSION: The precise nursing service mode can reduce the incidence of postoperative urinary incontinence in patients with prostate disease, thus improving postoperative urodynamics and rehabilitation, and quality of life.

Incidence of and social-demographic and obstetric factors associated with postpartum depression: differences among ethnic Han and Kazak women of Northwestern China.

BACKGROUND: Studies on postpartum depression (PPD) in China have focused primarily on women of Han ethnicity, whereas work on other ethnic groups has proven limited. This study explored the ethnic differences of associated social-demographic and obstetric factors for PPD between Han-majority and Kazak-minority women in northwestern China. METHODS: Han and Kazak women who received routine examinations at four hospitals in a multi-ethnic area of China six weeks after childbirth between March 2016 and December 2016 were included in the study. Data on the women's socio-demographic characteristics, obstetric factors, and possible depression at six weeks after childbirth were collected. We examined the associated factors of PPD using multivariable logistic regression analyses by ethnic group. RESULTS: The overall incidence of PPD was 14.6% (184/1,263) at six weeks after childbirth. PPD was detected more frequently among Kazak (16.1%) than Han women (13.1%). Kazak women exhibited a higher risk of PPD (adjusted OR = 1.561, 95% CI [1.108-2.198], P = 0.011). Urinary incontinence (UI) represented a significant risk factor of PPD for Kazak compared with Han women (OR = 1.720, 95% CI [1.056-2.804], P = 0.003). In contrast, the presence of the mother-in-law as a caregiver after childbirth demonstrated a positive association with PPD among Han (OR = 2.600, 95% CI [1.499-4.512], P = 0.001), but not with Kazak women. CONCLUSIONS: Kazak women were more likely to develop PPD than Han women, even after controlling for confounders. Moreover, distinct risk factors for PPD existed for Han and Kazak women. Future research that explores the relationships between Han women and their mothers-in-law as well as Kazak women's attitudes toward UI could help us further understand PPD in these populations.

High fatigue and its associations with health and work related factors among female medical personnel at 54 hospitals in Zhuhai, China.

The present study aimed to investigate the prevalence of fatigue and determine factors associated with fatigue in female medical personnel. Based on a cross-sectional study, a total of 1608 female medical personnel at 54 hospitals in Zhuhai, China were recruited by a multistage stratified cluster sampling method. The Symptoms Checklist-90-Revised and Chalder Fatigue Scale were used to assess psychiatric symptoms and fatigue, respectively. Data regarding demographic, health, and work related variables were also collected. Multivariate logistic regression model was constructed to determine the influencing factors of fatigue. Approximately 83% of participants had experienced fatigue in the past week. The risk of fatigue was higher in aged 30-39 years old than older or younger participants; Longer sleeping time predicted a lower prevalence of fatigue (OR = .35), while tense physician-patient relationship predicted a higher prevalence of fatigue (OR = 1.77). Depression (OR = 1.76) and anxiety (OR = 1.96) were found related to fatigue. Additionally, fatigue was associated with marital status, occupation, health related factors (exercise, regular diet, and health status), and work related factors (hospital rank and turnover intention). These study findings might facilitate development and implementation of targeted interventions and preventive measures.

[Risk Factors of Leukemia-free Survival in Ph+ ALL Patients with Allogeneic Hematopoietic Stem Cell Transplantation].

OBJECTIVE: To explore the effect of BCR-ABL gene transcripts on Leukemia-free survival (LFS) and prognosis of patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: The clinical data of 107 cases of Ph+ B-ALL patients received allo-HSCT from July 2006 to November 2014 in the First Affiliated Hospital of Soochow University were collected and the relationship between the clinical characteristics and LFS after transplantation was analyzed. RESULTS: Out of 107 Ph+ ALL patients (64 males and 43 females) with a median age of 30(7 to 54)years old, 35.5% (38/107) cases relapsed after transplantation within a median time of 6.9 (1.5 to 40.7) months. A total of 39 (36.4%) cases died within a median time of 19.8 (3.6 to 83.7) months after HSCT, of which 51.3% (20/39) due to disease relapse and 25.6% (10/39) due to infection. BCR-ABL gene transcripts of 49 cases turn into negative before transplantation, of which the expected 5-year cumulative incidence of relapse (CIR), non-relapse mortality (NRM) and overall survival (OS) were 26.5%, 29.5% and 41.6%, respectively. Another 49 cases still had a positive BCR-ABL gene transcripts before transplantation, of which the life expectancy of 5 year CIR, NRM and OS were 64.4%,8.9% and 48.9%, respectively. Compared with BCR-ABL positive patients, BCR-ABL negative patients showed a lower CIR (P<0.001), a higher NRM (P=0.030) and a similar OS (41.6% versus 48.9%, P=0.497). Multivariate analysis showed that BCR-ABL positive (P=0.016) and a disease statusphase ≥CR2 (P<0.001) before HSCT were independent risk factors for LFS, while the age underwent HSCT was the principal element affecting prognosis (P<0.001). CONCLUSION: Both the relapse and infection are the main causes of death in the patients after transplantation. A disease status ≥CR2 and the BCR-ABL positive before transplantation are 2 independent risk factors of LFS in the patients with Ph+ ALL after allo-HSCT.

Effect of occlusive wound dressing supplemented with antiphlogistic and analgesic agents on plasma beta-endorphin in hot and humid environments: a study in pigs.

OBJECTIVE: To study the changes of plasma beta-endorphin (beta-EP) in pigs with traumatic injury after occlusive wound dressing supplemented with antiphlogistic and analgesic agents in hot and humid environments (HHE). METHODS: Traumatic models were established in 10 pigs, 5 of which received antiphlogistic- and analgesic-supplemented occlusive dressings of the wounds (experiment group, EG), while the rest pigs were assigned to control group (CG) to receive routine wound management. The pigs in both groups were then exposed to artificial HHE and at different time points during the exposure, the plasma beta-EP level, respiratory frequency and heart rates were measured respectively. RESULTS: The plasma beta-EP concentration of EG was significantly lower than that of CG (P <0.01) after the injury, but in both groups, the levels before the injury were similar to those measured at hour 8 during HHE exposure and at hour 24 following the injury. The variation range of the respiratory frequency and heart rates during HHE exposure were significantly smaller in EG than CG (P <0.01). CONCLUSION: This supplemented occlusive wound dressing can help restrain the peak of plasma beta-EP level and the variation range of respiratory frequency and heart rates of pigs exposed to HHE.