Global research on emerging trends of obstetrics during the COVID-19 pandemic: A bibliometric analysis.

Coronavirus disease-2019 (COVID-19) has caused continuous effects on the global public, especially for susceptible and vulnerable populations like pregnant women. COVID-19-related studies and publications have shown blowout development, making it challenging to identify development trends and hot areas by using traditional review methods for such massive data. Aimed to perform a bibliometric analysis to explore the status and hotspots of COVID-19 in obstetrics. An online search was conducted in the Web of Science Core Collection (WOSCC) database from January 01, 2020 to November 31, 2022, using the following search expression: (((TS= ("COVID 19" OR "coronavirus 2019" OR "coronavirus disease 2019" OR "SARS-CoV-2" OR "2019-nCoV" OR "2019 novel coronavirus" OR "SARS coronavirus 2" OR "Severe Acute Respiratory Syndrome Coronavirus-2" OR "SARS-COV2")) AND TS= ("obstetric*" OR "pregnancy*" OR "pregnant" OR "parturition*" OR "puerperium"))). VOSviewer version 1.6.18, CiteSpace version 6.1.R6, R version 4.2.0, and Rstudio were used for the bibliometric and visualization analyses. 4144 articles were included in further analysis, including authors, titles, number of citations, countries, and author affiliations. The United States has contributed the most significant publications with the leading position. "Sahin, Dilek" has the largest output, and "Khalil, Asma" was the most influential author with the highest citations. Keywords of "Cov," "Experience," and "Neonate" with the highest frequency, and "Systematic Review" might be the new research hotspots and frontiers. The top 3 concerned genes included ACE2, CRP, and IL6. The new research hotspot is gradually shifting from the COVID-19 mechanism and its related clinical research to reviewing treatment options for pregnant women. This research uniquely delves into specific genes related to COVID-19's effects on obstetrics, a focus that has not been previously explored in other reviews. Our research enables clinicians and researchers to summarize the overall point of view of the existing literature and obtain more accurate conclusions.

Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study.

Background: Bladder cancer is a common urinary tract malignancy. Minimally invasive radical cystectomy has shown oncological outcomes comparable to the conventional open surgery and with advantages over the open procedure. However, outcomes of the two main minimally invasive procedures, robot-assisted and pure laparoscopic, have yet to be compared. This study aimed to compare in-hospital outcomes between these two techniques performed for patients with bladder cancer. Methods: This population-based, retrospective study included hospitalized patients aged ≥ 50 years with a primary diagnosis of bladder cancer who underwent robot-assisted or pure laparoscopic radical cystectomy. All patient data were extracted from the US National Inpatient Sample (NIS) database 2008-2018 and were analyzed retrospectively. Primary outcomes were in-hospital mortality, prolonged length of stay (LOS), and postoperative complications. Results: The data of 3284 inpatients (representing 16,288 US inpatients) were analyzed. After adjusting for confounders, multivariable analysis revealed that patients who underwent robot-assisted radical cystectomy had a significantly lower risk of in-hospital mortality (adjusted OR [aOR], 0.50, 95% CI: 0.28-0.90) and prolonged LOS (aOR, 0.63, 95% CI: 0.49-0.80) than those undergoing pure laparoscopic cystectomy. Patients who underwent robot-assisted radical cystectomy had a lower risk of postoperative complications (aOR, 0.69, 95% CI: 0.54-0.88), including bleeding (aOR, 0.73, 95% CI: 0.54-0.99), pneumonia (aOR, 0.49, 95% CI: 0.28-0.86), infection (aOR, 0.55, 95% CI: 0.36-0.85), wound complications (aOR, 0.33, 95% CI: 0.20-0.54), and sepsis (aOR, 0.49, 95% CI: 0.34-0.69) compared to those receiving pure laparoscopic radical cystectomy. Conclusions: Patients with bladder cancer, robot-assisted radical cystectomy is associated with a reduced risk of unfavorable short-term outcomes, including in-hospital mortality, prolonged LOS, and postoperative complications compared to pure laparoscopic radical cystectomy.

Reference ranges of cardiac size and morphology for low-risk fetuses at 28-39 gestational weeks based on two-dimensional speckle tracking technique / 复旦学报（医学版）

Objective To construct reference ranges of cardiac size and morphologic parameters in low-risk fetuses at 28-39 gestational weeks using two-dimensional speckle tracking technique.Methods A prospective collection of 453 low-risk singleton pregnancies with echocardiography at Obstetrics and Gynecology Hospital,Fudan University was used to assess the size(length,width,and area)and morphology(sphericity index,i.e.,the ratio of length to width)of the fetal four-chamber view and two ventricles using two-dimensional speckle tracking technique.Repeated inter-and intra-observer agreement of measurements was assessed using the intraclass correlation coefficients(ICCs).Statistical analysis of cardiac measurement parameters was performed to establish reference ranges of values for cardiac size and morphology in low-risk fetuses.Results The inter-and intra-group ICCs for reproducibility tests of fetal cardiac parameters measurements were 0.691 to 0.980.Fetal four-chamber view and ventricular size increased with gestational week(all P<0.001),the end-diastolic length of the left ventricle was larger than that of the right ventricle,and the end-diastolic diameter was smaller than that of the right ventricle(both P<0.001),while there was no significant difference in the end-diastolic area of the two ventricles(P= 0.050).The spherical index of four-chamber view did not correlate with gestational week(P=0.811).The sphericity index of the basal and intermediate segments of the left ventricle was greater than that of the right ventricle,and the sphericity index of the apical segment was less than that of the right ventricle,the differences were statistically significant(all P<0.01).Conclusion The two-dimensional speckle tracking technique for measuring fetal cardiac parameters has good reproducibility.The reference ranges for cardiac size and morphology in low-risk fetuses developed in this study will be useful for prenatal evaluation of cardiac remodeling.

Clinical application status and research progress in fetal growth standards / 复旦学报（医学版）

Ultrasound measurement of fetal biological parameters is an important indicator for evaluating fetal intrauterine growth and development,and its corresponding fetal growth standards are important criteria for determining whether the measurement parameters are normal or have fetal growth restriction.There are classic regional standards of prenatal ultrasonic measurement that have been used for many years,as well as international standards that have received widespread attention in recent years.However,there is no unified global standard.This paper reviewed the development process and clinical application status of fetal growth standards,explore future research trends,with a view to providing reference value for clinical practice.

High Expression of TIMM17B Is a Potential Diagnostic and Prognostic Marker of Breast Cancer.

Breast cancer (BC) is the most common malignant tumor in women. TIMM17B has been found to be related to the cell cycle. The purpose of this study was to explore the diagnostic and prognostic value of TIMM17B in BC and its correlation with tumor immune infiltration and ferroptosis. For this purpose, the transcription and expression profile of TIMM17B between BC and normal tissues was downloaded from The Cancer Genome Atlas (TCGA). To verify the expression of TIMM17B in BC, we analyzed it by immunohistochemical staining. The correlation between TIMM17B and clinical features was analyzed using the R package to establish a ROC diagnostic curve. The GSVA package was used to determine the relationship between TIMM17B gene expression levels and immune infiltration. The GDSC was used to predict the IC50 of the drug. Expression of TIMM17B in tamoxifen-resistant breast cancer cells was detected by protein immunoblot analysis. Results showed that the expression of TIMM17B in many kinds of malignant tumors was higher than that in paracancer, with a significantly high expression in BC (P < 0.001). We validated this result by analyzing tissue microarrays. ROC curve analysis showed an AUC value in TIMM17B of 0.920. The Kaplan-Meier method showed a better prognosis for patients with high expression of TIMM17B in basal BC than that of patients with low expression of TIMM17B (HR=2.32 (1.09-4.94), P=0.038). In addition, the expression of TIMM17B in BC was negatively correlated with the level of immune infiltration, Tcm cells, T helper cells, and immune targets such as CD274, HAVCR2, and PDCD1LG2. At the same time, the expression of TIMM17B in BC was significantly correlated with the drug resistance and the expression of GPX4 and other key enzymes of ferroptosis. Protein immunoblot analysis revealed high expression of TIMM17B in tamoxifen-resistant breast cancer cells. In conclusion, the expression of TIMM17B in BC was significantly increased, and it was related to immune infiltration, drug resistance and ferroptosis in BC. Our research shows that TIMM17B can be used as a diagnostic index of BC and one of the targets of immunotherapy.

The Impact of Intraoperative Graft Blood Flow Measurement on Early Graft Function.

BACKGROUND: The aim of this study is to evaluate the impact of intraoperative allograft vascular flow on early kidney graft function. METHODS: A total of 159 patients underwent kidney transplantation from January 2017 to March 2022 at Linkou Chang Gung Memorial Hospital. Graft arterial and venous blood flow was measured separately with a transient time flowmeter (Transonic HT353; Transonic Systems, Inc, Ithaca, NY, United States) after ureteroneocystostomy. The early outcomes, including the postoperative creatinine level, were analyzed accordingly. RESULTS: There were 83 males and 76 females, with a mean age of 44.5 years. The mean graft arterial flow measured was 480.6 mL/min, and the mean venous flow was 506.2 mL/min. Delayed graft function (DGF) incidence was 36.5%, 32.5%, and 40.8% in total, living, and deceased donor groups, respectively. Living donor and deceased donor kidney transplantation were analyzed separately. In the DGF subgroup, there were lower graft venous flows, higher body mass index (BMI), and more male patients in the living kidney transplant group. Similarly, the deceased donor kidney transplantation group with delayed graft function tended to have higher body height, higher body weight, higher BMI, and more diabetes mellitus. The multivariate analysis showed that lower graft venous blood flow (odds ratio [OR] = 0.995, P = .008) and higher BMI (OR = 1.144, P = .042) were significantly correlated with delayed graft function in living donor kidney transplantations. In the deceased donor group, a multivariate analysis of risk factors showed that BMI had a significant correlation with delayed graft function (OR = 1.41, P = .039). CONCLUSIONS: Graft venous blood flow was significantly associated with delayed graft function in living donor kidney transplantation, and high BMI was correlated with DGF in all patients receiving kidney transplantation.

Obesity Affects Short-Term Renal Function After Renal Transplantation.

BACKGROUND: The literature has shown a significant association between body mass index (BMI) and patient and graft outcomes after renal transplantation. The purpose of this study was to reveal the effect of obesity on graft function in a Taiwanese kidney transplant cohort. METHODS: Two hundred consecutive patients who received kidney transplantation were enrolled in our study. Eight pediatric cases were excluded due to differing definitions of BMI among children. According to the national obesity criteria, these patients were divided into underweight, normal, overweight, and obese groups. Their estimated glomerular filtration rate (eGFR) was compared accordingly using t tests. Cumulative graft and patient survivals were calculated using Kaplan-Meier analysis. A P value of ≤ .05 was considered significant. RESULTS: The mean age of our cohort (105 men and 87 women) was 45.3 years. There was no significant difference comparing biopsy-proven acute rejection, acute tubular necrosis, and delayed graft function between the obese and nonobese groups (P values: .293, .787, and .304, respectively). Short-term eGFR was inferior in the overweight group, but this effect was insignificant beyond 1 month. The 1-month and 3-month eGFR were found to be correlated with BMI groups (P = .012 and P = .008, respectively) but not significant after 6 months post-kidney transplantation. CONCLUSIONS: Our study found that short-term renal function was affected by obesity and being overweight, possibly due to the higher prevalence of diabetes and dyslipidemia in obese patients and the increased surgical difficulty.

Intraoperative Hemodynamic Parameters Associated With Delayed Graft Function in Kidney Transplant Patients.

PURPOSE: Intraoperative hemodynamic instability was proven to be associated with delayed graft function (DGF) after kidney transplantation. This retrospective study aims to find the specific intraoperative hemodynamic parameters as an efficient predicting factor of DGF. MATERIALS AND METHODS: Patients who underwent kidney transplantation between 2020 and 2022 were enrolled and classified into DGF and non-DGF groups. Pediatric and multiorgan recipients were excluded. Hemodynamic parameters such as central venous pressure, mean arterial pressure, cardiac output, and cardiac index (CI) at the timings of wound incision, graft reperfusion, and operation completion were recorded, respectively. A comparison of parameters between these 2 groups was analyzed. RESULTS: We enrolled 42 recipients, with 26 in the DGF group and 16 in the non-DGF group. Compared with the DGF group, CI around graft reperfusion was significantly higher in the non-DGF group (3.97 vs 4.67 L/min/m2, P = .043). Other hemodynamic variables revealed no statistical difference. In the results of multivariate analysis, the deceased donor source, the greater volume of blood loss, and the lower CI around graft reperfusion were considered independent risk factors for DGF. Using CI around graft reperfusion to conduct a receiver operating characteristic (ROC) curve for DGF prediction, the area under the ROC curve achieved a value of 0.739 (95% confidence interval, 0.579-0.900), with the optimal cut-point value at CI = 4.245 L/min/m2. CONCLUSION: The cardiac index value around graft reperfusion was statistically associated with the incidence of DGF and might be used as a valid predicting factor.

Diagnosis and treatment strategy of periodontitis with diabetes / 中华口腔医学杂志

The number of diabetic patients visiting stomatology for periodontal disease is increasing, and the symptoms are relatively severe, and often complications increase the complexity of periodontal treatment. This article briefly describes the research progress and clinical manifestations of the epidemiology and related pathological mechanisms of periodontitis with diabetes, focusing on the treatment and providing reference for stomatologists in the clinical diagnosis and treatment of patients with diabetic periodontitis.

Value of femoral head CT for diagnosing hip osteoporosis / 医疗卫生装备

Objective To analyze the correlation between femoral head CT values in routine abdominopelvic CT scanning and hip bone mineral density(BMD)values in hip quantitative CT(QCT)measurements,and to investigate the diagnostic value of femoral head CT values for hip osteoporosis.Methods Totally 176 patients undergoing non-enhanced abdominopelvic CT scanning at some hospital from June 1,2021 to January 20,2022 were selected prospectively,and femoral head CT values and hip BMD values were measured on the scanned images.The patients were divided into a normal bone mass group,a reduced bone mass group and an osteoporosis group according to hip T values and the"China Guideline for the Diagnosis Criteria of Osteoporosis with Quantitative Computed Tomography(2018)".Analyses were carried out for the correlation between femoral head CT values and hip BMD values,the difference between femoral head CT values and BMD values of the two sides with paired t-test,the difference of CT values between the three groups with ANOVA and the diagnostic efficacy of femoral head CT values for diagnosing hip osteoporosis with AUC curve.Results The values of femoral head CT and hip BMD had a strong correlation(r=0.696),which were slightly higher on the left than on the right.The three groups had statistically significant differences of femoral head CT values at two sides(P=0.000),which were ranked according to CT values as the normal bone mass group,the reduced bone mass group and the osteoporosis group.Femoral head CT values and hip BMD values both reached the peak at the age of 41 to 50 years,and then decreased gradually.Femoral head CT values behaved well in predicting hip osteoporosis,with femoral head AUC value being 0.859 on the left and 0.846 on the right.Conclusion The values of femoral head CT and hip BMD had a strong correlation,and femoral head CT values are valuable for diagnosing osteoporosis.[Chinese Medical Equipment Journal,2023,44(9):64-68]

Application of artificial intelligence based on multimodal fundus image data in the diagnosis and treatment of cardiovascular diseases / 中国胸心血管外科临床杂志

@#Cardiovascular diseases is the leading cause of threat to human life and health worldwide. Early risk assessment, timely diagnosis, and prognosis evaluation are critical to the treatment of cardiovascular diseases. Currently, the evaluation of diagnosis and prognosis of cardiovascular diseases mainly relies on imaging examinations such as coronary CT and coronary angiography, which are expensive, time-consuming, partly invasive, and require high professional competence of the operator, making it difficult to promote in the community or in areas where medical resources are scarce. The fundus microcirculation is a part of the human microcirculation and has similar embryological origins and physiopathological features to cardiovascular circulation. Several studies have revealed fundus imaging biomarkers associated with cardiovascular diseases, and developed and validated intelligent diagnosis and treatment models for cardiovascular diseases based on fundus imaging data. Fundus imaging is expected to be an important adjunct to cardiovascular disease diagnosis and treatment given its noninvasive and convenient nature. The purpose of this review is to summarize the current research status, challenges, and future prospects of the application of artificial intelligence based on multimodal fundus imaging data in cardiovascular disease diagnosis and treatment.

Diagnostic Value of American Thyroid Association Guidelines,American College of Radiology Thyroid Imaging Reporting and Data System,and Chinese Thyroid Imaging Reporting and Data System Alone and Combined With BRAFV600E Mutation in Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance / 中国医学科学院学报

Objective To explore the diagnostic efficacy of American Thyroid Association(ATA)guidelines,American College of Radiology Thyroid Imaging Report and Data System(ACR-TIRADS),and Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)alone and combined with BRAFV600E mutation in atypia of undetermined significance/follicular lesion of undetermined significance(AUS/FLUS).Methods A total of 138 patients who underwent ultrasound-guided fine needle aspiration(FNA)in the Chinese PLA General Hospital from January 2020 to May 2023 were selected.The clinicopathological and ultrasound characteristics were retrospectively analyzed for each nodule.Each nodule underwent preoperative BRAFV600E mutation testing and was diagnosed according to the ATA guidelines,ACR-TIRADS,and C-TIRADS.The diagnostic efficacy of ATA guidelines,ACR-TIRADS,and C-TIRADS alone and combined with BRAFV600E mutation was assessed based on the results of histopathological diagnosis.Results The 138 AUS/FLUS thyroid nodules included 45(32.6%)benign ones and 93(67.4%)malignant ones.The patient age(t=1.444,P=0.151),gender(χ2=0.259,P=0.611),and location of nodules(χ2=2.055,P=0.358)had no statistical significance for the differentiation between benign and malignant nodules,while nodule size(Z=2.500,P=0.012),echo(χ2=14.693,P<0.001),composition(χ2=17.075,P<0.001),aspect ratio ≥1(χ2=9.477,P=0.002),and microcalcification(χ2=6.892,P=0.009)were of significance for the differentiation.When applied alone,BRAFV600E mutation showed high specificity(95.56%)and positive predictive value(95.65%).Among the three ultrasound grading systems,ACR-TIRADS had the highest sensitivity(χ2=37.923,P<0.001;χ2=40.462,P<0.001)and accuracy(χ2=81.595,P<0.001;χ2=76.912,P<0.001),while C-TIRADS had the highest specificity(χ2=11.746,P<0.001;χ2=21.235,P<0.001).However,the three systems showed no statistically significant difference in the diagnostic efficiency when applied alone(Z=1.177,P=0.239;Z=0.213,P=0.831;Z=1.016,P=0.310).The combination of BRAFV600E mutation with ACR-TIRADS or C-TIRADS improved the diagnostic efficacy of BRAFV600E mutation in distinguishing the benign and malignant AUS/FLUS nodules(Z=2.107,P=0.035;Z=2.752,P=0.006).The combination of ATA guidelines with BRAFV600E mutation increased the diagnostic accuracy of BRAFV600E mutation(χ2=20.679,P<0.001),while it had no statistically significant difference in distinguishing the benign and malignant AUS/FLUS nodules(Z=1.321,P=0.186).The combination of ATA guidelines,ACR-TIRADS,or C-TIRADS with BRAFV600E mutation improved the diagnostic efficacy of ultrasound grading systems for AUS/FLUS nodules(Z=2.770,P=0.006;Z=2.770,P=0.006;Z=2.890,P=0.004).Specifically,ACR-TIRADS combined with BRAFV600E mutation showed the highest sensitivity(χ2=4.712,P=0.030;χ2=4.712,P=0.030),while C-TIRADS combined with BRAFV600E mutation showed the highest accuracy(χ2=77.627,P<0.001;χ2=85.827,P<0.001).However,there were no statistically significant differences in diagnostic performance between the combinations(Z=1.276,P=0.202;Z=0.808,P=0.419;Z=1.615,P=0.106).Conclusion ATA guidelines,ACR-TIRADS,and C-TIRADS combined with BRAFV600E mutation can improve the diagnostic efficacy of BRAFV600E mutation or ultrasound grading system alone in AUS/FLUS nodules,which can facilitate the further management and treatment of such patients.

High-Throughput Sequencing Technology for Detection of Gene Mutations in Myeloid Malignancies and Its Clinical Prognostic Significance / 中国实验血液学杂志

OBJECTIVE@#To detect the gene mutations in patients with myeloid malignancies by high-throughput sequencing and explore the correlation between gene mutations and prognosis.@*METHODS@#A retrospective analysis was performed on 56 patients with myeloid malignancies who were hospitalized in the department of hematology, Peking University International Hospital from January 2020 to May 2021. The genetic mutations of the patients were detected by next-generation sequencing technology, and the correlation between the genetic mutations and prognosis of myeloid malignancies was analyzed.@*RESULTS@#In 56 patients, the number of mutated genes detected in a single patient is 0-9, with a median of 3. Sequencing results showed that the most common mutated genes were RUNX1(21.4%), TET2(17.9%), DNMT3A(17.9%), TP53(14.3%) and ASXL1(14.3%), among which the most common mutations occurred in the signaling pathway-related genes (23.3%) and the transcription factor genes (18.3%). 84% of the patients carried multiple mutated genes (≥2), and correlation analysis showed there were obvious co-occurring mutations between WT1 and FLT3, NPM1 and FLT3-ITD, and MYC and FLT3. TP53 mutation was more common in MDS patients.The overall survival time of patients with NRAS mutation was significantly shortened (P =0.049). The prognosis of patients with TP53 mutation was poor compared with those without TP53 mutation, but the difference wasn't statistically significant (P =0.08).@*CONCLUSION@#The application of next-generation sequencing technology is of great significance in myeloid malignancies, which is helpful to better understand the pathogenesis of the disease, to judge the prognosis and to find possible therapeutic targets.

Endoscopic Enucleation of Prostate Could Increase Testosterone Levels in Hypotestosteronemic Patients with Bladder Outlet Obstruction.

Background: We evaluated the impact of endoscopic enucleation of the prostate on testosterone levels in hypotestosteronemic patients with bladder outlet obstruction. Methods: We enrolled 294 men with lower urinary tract symptoms (LUTS) who received surgery between January 2019 and December 2020 in simple tertiary centre. The inclusion criteria were as follows: being a male patient aged 45−95 years and having recurrent urinary tract infection, having previously failed medical treatment for LUTS or urine retention, and undergoing bipolar or thulium laser enucleation of the prostate. The preoperative and postoperative data were retrospectively reviewed. Results: This study included 112 men with a mean age of 69.4 years. The mean preoperative and postoperative testosterone levels were 4.8 and 4.98, respectively. Of the patients, 88 (78.6%) received ThuLEP and 24 received BipolEP. We divided the patients into two groups according to preoperative serum testosterone levels: normal-testosterone (≥3 ng/mL) and low-testosterone (<3 ng/mL) groups. A significant change in testosterone levels (p = 0.025) was observed in the low-testosterone group. In contrast, no significant difference in testosterone levels was noted in the normal-testosterone group (p = 0.698). Conclusions: Endoscopic enucleation surgery of the prostate could improve postoperative testosterone levels in hypotestosteronemic patients with bladder outlet obstruction.

A multicenter retrospective study on the real-world outcomes of autologous vs. allogeneic hematopoietic stem cell transplantation for peripheral T-cell lymphoma in China / 中华医学杂志(英文版)

BACKGROUND@#There were few studies on real-world data about autologous hematopoietic stem cell transplantation (auto-HSCT) or allogeneic HSCT (allo-HSCT) in peripheral T-cell lymphoma (PTCL). This study aimed to investigate the clinical outcomes of patients who received auto-HSCT or allo-HSCT in China.@*METHODS@#From July 2007 to June 2017, a total of 128 patients who received auto-HSCT (n  = 72) or allo-HSCT (n  = 56) at eight medical centers across China were included in this study. We retrospectively collected their demographic and clinical data and compared the clinical outcomes between groups.@*RESULTS@#Patients receiving allo-HSCT were more likely to be diagnosed with stage III or IV disease (95% vs. 82%, P = 0.027), bone marrow involvement (42% vs. 15%, P = 0.001), chemotherapy-resistant disease (41% vs. 8%, P = 0.001), and progression disease (32% vs. 4%, P < 0.001) at transplantation than those receiving auto-HSCT. With a median follow-up of 30 (2-143) months, 3-year overall survival (OS) and progression-free survival (PFS) in the auto-HSCT group were 70%(48/63) and 59%(42/63), respectively. Three-year OS and PFS for allo-HSCT recipients were 46%(27/54) and 44%(29/54), respectively. There was no difference in relapse rate (34%[17/63] in auto-HSCT vs. 29%[15/54] in allo-HSCT, P = 0.840). Three-year non-relapse mortality rate in auto-HSCT recipients was 6%(4/63) compared with 27%(14/54) for allo-HSCT recipients (P = 0.004). Subanalyses showed that patients with lower prognostic index scores for PTCL (PIT) who received auto-HSCT in an upfront setting had a better outcome than patients with higher PIT scores (3-year OS: 85% vs. 40%, P = 0.003). Patients with complete remission (CR) undergoing auto-HSCT had better survival (3-year OS: 88% vs. 48% in allo-HSCT, P = 0.008). For patients beyond CR, the outcome of patients who received allo-HSCT was similar to that in the atuo-HSCT group (3-year OS: 51% vs. 46%, P = 0.300).@*CONCLUSIONS@#Our study provided real-world data about auto-HSCT and allo-HSCT in China. Auto-HSCT seemed to be associated with better survival for patients in good condition (lower PIT score and/or better disease control). For patients possessing unfavorable characteristics, the survival of patients receiving allo-HSCT group was similar to that in the auto-HSCT group.

Predictors of Intravesical Recurrence After Radical Nephroureterectomy and Prognosis in Patients with Upper Tract Urothelial Carcinoma.

PURPOSE: We investigate factors that may contribute individually to bladder recurrence and find out the potential candidate to receive postoperative single dose intravesical chemotherapy. MATERIALS AND METHODS: A total of 217 patients who were diagnosed with upper tract urothelial carcinoma (UTUC) underwent radical nephroureterectomy (RNU) between 2012 and 2016 in a single hospital. The possible risk factors that may contribute to development of bladder recurrence and overall survival were analysed. In order to find out the relationship between 1st bladder recurrence timing and outcome, we divided the 54 of 56 patients (2 patients with prophylactic intravesical chemotherapy excluded) with bladder recurrence after RNU into 2 groups, using the median time of 1st bladder recurrence and confirmed with the "minimum P-value" approach. The primary endpoint was the development of relapsing high-risk non-muscle invasive bladder cancer (NMIBC). The predictive factors of early recurrence and prognostic factors of survival were also analysed. RESULTS: Among 217 patients with UTUC under RNU, intravesical recurrence occurred in 56 (25.8%) patients after a median follow-up of 35.2 (1.18-83.34) months. On multivariable analysis, the preoperative ureter manipulation (p=0.009) was a significant predictor for the development of bladder tumours. As for overall survival, renal rein invasion (p=0.017), neutrophil to lymphocyte ratio (p=0.021), and main tumour size (p=0.015) were significant predictors. For 54 patients who developed bladder recurrence, the optimal cut-off point of early recurrence was determined to be 10 months after surgery (p=0.042). Preoperative ureter manipulation (p=0.005) and tumour located both pelvicalyceally and ureterically (P=0.042) were identified as independent factors associated with early recurrence. An end-stage renal disease history and surgical margin positive patient has more late bladder recurrence. CONCLUSION: Bladder recurrence was common in UTUC after RNU. Early bladder recurrence was associated with more relapsing high-risk NMIBC and preoperative ureter manipulation was identified as an independent factor associated with early recurrence.

The hemocompatibility of the modified polysulfone membrane with 4-(chloromethyl)benzoic acid and sulfonated hydroxypropyl chitosan.

Polysulfone (PSf) membrane is widely employed in blood purification fields, but the blood compatibility of PSf membrane is not adequate. To improve the hemocompatibility of PSf membrane, 4-(chloromethyl)benzoic acid (CMBA) and sulfonated hydroxypropyl chitosan (SHPCS) were grafted onto PSf membrane surface. In our strategy, CMBA was firstly grafted on the PSf membrane surface through the Friedel-Crafts alkylation reaction, and the product was named BAPSf membrane. Then, SHPCS was grafted onto the BAPSf membrane surface by esterification, and the product was named SHPCS-BAPSf membrane. The effects of temperature and reaction time on the productivity of BAPSf and the grafting density of carboxyl and the effects of reaction time on the grafting density of SHPCS grafted onto the BAPSf membrane surface were studied. The SHPCS-BAPSf membranes are investigated by ATR-FTIR, XPS, contact angle measurements and evaluated by blood compatibility in vitro. The results reveal that the hydrophilicity of SHPCS-BAPSf membranes were grealy improved and the evaluation of protein adsorption, hemolysis test, platelet adhesion plasma recalcification time(PRT), activated partial thromboplastin time(APTT), prothrombin time(PT) and thrombin time(TT) confirmed that the SHPCS-BAPSf membranes have remarkable blood compatibility.

Research progress of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in the treatment of adult severe respiratory failure / 中国胸心血管外科临床杂志

@#As an extracorporeal life support technology, veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been demonstrated its role in the treatment of patients with severe respiratory failure. Its main advantages include the ability to maintain adequate oxygenation and remove excess CO2, increase oxygen delivery, improve tissue perfusion and metabolism, and implement lung protection strategies. Clinicians should accurately assess and identify the patient's condition, timely and accurately carry out VV-ECMO operation and management. This article will review the patient selection, cannulation strategy, anticoagulation, clinical management and weaning involved in the application of VV-ECMO.

Clinical Analysis for Patients with AML Treated after Allo-HSCT / 中国实验血液学杂志

OBJECTIVE@#To analyze risk factors that affect survival and relapse of AML patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to investigate the therapy choices after AML relapse.@*METHODS@#Clinical data of 180 AML patients achieved complete remission (CR) before HSCT from January 2009 to December 2018 treated in our center were analyzed retrospectively. Risk factors for survival and relapse after allo-HSCT were analyzed by COX regression.@*RESULTS@#Among 180 AML patients, 134 survived (74.4%), 46 patients died (25.6%), and 40 patients relapsed (22.2%). The rate of overall survival (OS), event-free survival (EFS) and cumulative rate of relapse in 5-years was 74.3%、42.5% and 25.0%, respectively. High-risk, adverse cytogenetics, CR at HSCT and no cGvHD were independent risk factors that affect OS. CR at HSCT, high-risk were independent risk factors that affect EFS. High-risk, MRD after one course of induction therapy, adverse cytogenetics and no cGVHD were independent risk factors that affect relapse. The OS rate of relapse patients could be improved by the usage of hypomethylation agents combined with G-CSF mobilized donor lymphocyte infusion (DLI), and 2-year OS rate was 62.5%.@*CONCLUSION@#The survival rate of AML is greatly improved by allo-HSCT, but relapse is still one of the most important factors that influence survival of the AML patients. The maintenance therapy of hypomethylation agents combined with DLI may be a new effective treatment option for patients who relapse after HSCT.

Changes in Cold and Hot Syndrome and Gastrointestinal Bacterial Community Structure in Mice by Intervention with Food of Different Nature / 中国结合医学杂志

OBJECTIVE@#To reveal the effect of foods with different natures on cold or hot syndrome and gastrointestinal bacterial community structure in mice.@*METHODS@#Forty-five 6-week-old male ICR Kunming mice of clean grade were divided into 5 groups, 9 per group, including the control (CK), hot nature herbs (HM), Hong Qu glutinous rice wine (RW), tea rice wine (TW), and cold nature herbs (CM) groups. Distilled water or corresponding herbs were administered to mice (0.01 mL/g body weight) in the 5 groups by gastric infusion respectively, once daily for 28 d. Appearance, behavior, and serum biochemical indicators, including 5-hydroxytryptamine (5-HT), thyroid stimulating hormone (TSH), noradrenaline (NE), cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), the hot nature index, as well as the gastrointestinal bacterial community structure were analyzed in all groups after treatment.@*RESULTS@#After supplementation for 28 d, CM and TW mice showed different degrees of cold syndrome, and HM and RW mice showed different degrees of hot syndrome. Compared with the HM and RW mice, the TSH, NE, cAMP levels and hot nature indices in the CM and TW mice were significantly decreased and 5-HT and cGMP levels were significantly increased (P<0.05). There was no obvious change in appearance or behavior in CK mice. Results of clustering analysis showed that the gastrointestinal bacterial community structures were highly similar in TW and CM mice as well as in RW and HM mice, and that they were from the same branch, respectively, when the distance was 0.02. The key microbes associated with cold syndrome were Lachnospiraceae uncultured, Lactococcus, etc., and the key microbes associated with hot syndrome were S24-7 norank, Ruminococcaceae uncultured, etc. CONCLUSION: The interventions with different nature foods could change cold or hot syndrome in mice, leading to changes in gastrointestinal bacterial community structure.