Lenalidomide, rituximab, and methotrexate are effective in newly diagnosed primary central nervous system lymphoma.

Not available.

ST11 KPC-2-Producing Klebsiella pneumoniae Isolated from Patient with Acute Myelocytic Leukemia.

Background: The emergence of the ST11-CRKP (ST11-CRKP) strain is expected to become a serious public health problem in China. As one of the most serious complications in patients with acute myeloid lymphoma, infections can cause systemic infection and life-threatening sepsis, seriously affecting the morbidity, mortality, and quality of life of patients. Thus, ST11-CRKP infections in patients with acute myeloid lymphoma are worthy of our attention. Aim: To investigate the occurrence and genetic characteristics of the ST11-CRKP from a patient with acute myeloid lymphoma. Methods: Species identification was determined by MALDI-TOF MS. Antimicrobial susceptibility testing (AST) was conducted by VITEK 2 system with AST-N335 panel. Whole-genome sequencing was performed on the Illumina NovaSeq 6000 platform. Phylogenetic analyses were performed using Snippy based on the core-genome SNPs. Findings: S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), Southern blot and Whole-genome analysis indicated blaKPC-2 genes were located on plasmids with a conserved genetic environment. Moreover, the eight ST11-CRKP strains carry a variety of antimicrobial resistance genes (ARGs) and virulence factors. The ability of biofilm formation of eight strains was verified by a crystal violet assay. Core genome single-nucleotide polymorphism (cgSNP) analysis suggesting a possible bacterial translocation event. Conclusion: We performed a comprehensive analysis of ST11-CRKP strains from a patient with acute myelocytic leukemia. Our study emphasized the need for continuous surveillance of ST11-CRKP in the clinic especially in the immunocompromised population.

Establishment of an efficient callus transient transformation system for Vitis vinifera cv. 'Chardonnay'.

Grape (Vitis L.), a highly valued fruit crop, poses significant challenges in genetic transformation and functional characterization of genes. Therefore, there is an urgent need for the development of a rapid and effective method for grape transformation and gene function identification. Here, we introduce a streamlined Agrobacterium-mediated transient transformation system for grape calli. Optimal conditions were established with a leaf-derived callus induction medium; chiefly B5 medium supplemented with 0.05 mg/L NAA, 0.5 mg/L 2,4-D, and 2.0 mg/L KT; and a callus proliferation medium (B5 medium supplemented with 0.5 mg/L NAA and 2.0 mg/L 6-BA), respectively. Notably, GUS enzyme activity peaked (352.96 ± 33.95 mol 4-MU/mg/min) by sonication with Agrobacterium tumefaciens EHA105 and 100 µM AS for 4 min, followed by vacuum infection for 5 min, and co-culture at 25 °C in the dark for 1 day using callus as explants at an optical density (OD600) of 0.8. VaCIPK18 gene was transiently transformed into calli, and transcripts of the gene (endogenous and exogenous) were detected at higher levels than in non-transformed calli (endogenous). Moreover, after 10 days of treatment at 4 °C or -4 °C, the callus net weight of transformed callus was significantly higher than that of the untransformed callus, indicating that the VaCIPK18-overexpressing grape callus could improve cold tolerance. Overall, we establish a simple but effective transient transformation approach for grape callus, which could serve as a useful tool for the rapid assessment of gene function in this important crop.

Exogenous Melatonin Promotes Cold Tolerance in Grape Seedlings: Physiological, Transcriptomic, and Functional Evidence.

Melatonin (MEL) is an antioxidant molecule that enhances plant tolerance to environmental stress. However, the mechanisms by which MEL regulates cold signaling pathways in grapes under cold stress remain elusive. Here, we investigated the physiological and transcriptomic changes in grape seedlings treated with exogenous MEL to determine their protective role under cold stress. Results showed that 150 µM MEL effectively attenuated cold-induced cell damage by reducing reactive oxygen species (ROS) and preserving the chloroplast structure and function. MEL also inhibited tannin degradation, which contributed to its protective effect. Exogenous MEL promoted the synthesis of endogenous MEL, abscisic acid, auxin, and cytokinin while inhibiting gibberellin. Transcriptomic profiling revealed 776 differentially expressed transcripts in MEL-treated samples compared to controls. Functional analysis of a candidate hub gene, VvHSFA6b, showed that its overexpression in grape calli enhances cold tolerance by activating jasmonic acid synthesis pathway genes, promoting JA accumulation, and inhibiting JAZ-repressed transcription factors.

Clinical characteristics and outcomes of COVID-19 infection in Chinese patients with hematologic malignancies in the Omicron era.

Patients with hematologic malignancies are often immunodeficient and therefore have a higher risk of severe symptoms from coronavirus disease 2019 (COVID-19). We retrospectively examined a cohort of 289 patients from 16 hospitals in Zhejiang Province who had hematologic malignancies and COVID-19 during a period when the Omicron variant was predominant. Univariate analysis showed that some clinical characteristics, including elder age (P = 0.014), multiple comorbid conditions (P = 0.011), and receipt of active antineoplastic therapy (P = 0.018) were associated with an increased risk of severe COVID-19. Patients with severe/critical COVID-19 had significantly lower levels of lymphocytes and serum albumin, and significantly higher levels of D-dimer, lactate dehydrogenase, C-reactive protein, and interleukin-6 (all P < 0.05). Fifty-four patients (18.7%) had symptoms lasting ≥3 weeks, suggesting that persistent long-term COVID-19 infection is likely present in a significant proportion of patients. Receipt of the inactivated vaccine was unrelated to disease severity (P = 0.143), which indicated that many patients with hematologic malignancies may not have effective humoral immunity to inactivated vaccines.

Phosphorus and naphthalene acetic acid increased the seed yield by regulating carbon and nitrogen assimilation of flax.

To evaluate the impact of phosphorus (P) combined with exogenous NAA on flax yield, enhance flax P utilization efficiency and productivity, minimize resource inputs and mitigate negative environmental and human effects. Therefore, it is crucial to comprehend the physiological and biochemical responses of flax to P and naphthylacetic acid (NAA) in order to guide future agronomic management strategies for increasing seed yield. A randomized complete block design trial was conducted under semi-arid conditions in Northwest China, using a factorial split-plot to investigate the effects of three P (0, 67.5, and 135.0 kg P2O5 ha-1) and three exogenous spray NAA levels (0, 20, and 40 mg NAA L-1) on sucrose phosphate synthase (SPS) and diphosphoribulose carboxylase (Rubisco) activities as well as nitrogen (N) and P accumulation and translocation in flax. Results indicated that the SPS and Rubisco activities, N and P accumulation at flowering and maturity along with assimilation and translocation post-flowering, fruiting branches per plant, tillers per plant, capsules per plant, and seed yield were 95, 105, 14, 27, 55, 15, 13, 110, 103, 82, 16, 61, 8, and 13% greater in the P treatments compared to those in the zero P treatment, respectively. Moreover, those characteristics were observed to be greater with exogenous spray NAA treatments compared to that no spray NAA treatment. Additionally, the maximum SPS and Rubisco activities, N and P accumulation, assimilation post-flowering and translocation, capsules per plant, and seed yield were achieved with the application of 67.5 kg P2O5 ha-1 with 20 mg NAA L-1. Therefore, these findings demonstrate that the appropriate combination of P fertilizer and spray NAA is an effective agronomic management strategy for regulating carbon and nitrogen assimilation by maintaining photosynthetic efficiency in plants to increase flax productivity.

One-step preparation of magnetic N-doped sodium alginate-based porous carbon and efficient adsorption of bisphenol A.

To resourcefully utilize algal biomass and effectively remove bisphenol A (BPA) from water, sodium alginate (SA) was prepared as the nitrogen-doped magnetic porous carbon material (SAC/N/Fe) with well-developed pore structure according to a one-step method using K2CO3, melamine, Fe(NO3)3·9H2O as the activator, nitrogen dopant, and magnetic precursor, respectively, in this study. The best product, SAC/N/Fe-0.2, was obtained by adjusting the mass ratio of raw materials, and its specific surface area and pore volume were 2240.65 m2 g-1 and 1.44 cm3 g-1, respectively, with a maximum adsorption capacity of 1248.23 mg g-1 for BPA at 308 K. SEM, XRD, XPS, VSM, and FT-IR characterization confirmed that the iron was successfully doped, giving the porous carbon a magnetic separation function. The adsorption process of BPA was more consistent with the Langmuir model and the proposed secondary kinetics, and the adsorption effect was stable and efficient in a wide pH range and under the interference of different metal ions. At the same time, the porous carbon was easy to separate and recover with good regeneration performance.

Genome-Wide Identification and Expression Analysis of Auxin Response Factor Gene Family in Linum usitatissimum.

Auxin response factors (ARFs) are critical components of the auxin signaling pathway, and are involved in diverse plant biological processes. However, ARF genes have not been investigated in flax (Linum usitatissimum L.), an important oilseed and fiber crop. In this study, we comprehensively analyzed the ARF gene family and identified 33 LuARF genes unevenly distributed on the 13 chromosomes of Longya-10, an oil-use flax variety. Detailed analysis revealed wide variation among the ARF family members and predicted nuclear localization for all proteins. Nineteen LuARFs contained a complete ARF structure, including DBD, MR, and CTD, whereas the other fourteen lacked the CTD. Phylogenetic analysis grouped the LuARFs into four (I-V) clades. Combined with sequence analysis, the LuARFs from the same clade showed structural conservation, implying functional redundancy. Duplication analysis identified twenty-seven whole-genome-duplicated LuARF genes and four tandem-duplicated LuARF genes. These duplicated gene pairs' Ka/Ks ratios suggested a strong purifying selection pressure on the LuARF genes. Collinearity analysis revealed that about half of the LuARF genes had homologs in other species, indicating a relatively conserved nature of the ARFs. The promoter analysis identified numerous hormone- and stress-related elements, and the qRT-PCR experiment revealed that all LuARF genes were responsive to phytohormone (IAA, GA3, and NAA) and stress (PEG, NaCl, cold, and heat) treatments. Finally, expression profiling of LuARF genes in different tissues by qRT-PCR indicated their specific functions in stem or capsule growth. Thus, our findings suggest the potential functions of LuARFs in flax growth and response to an exogenous stimulus, providing a basis for further functional studies on these genes.

Single injection of lidocaine to reduce tourniquet hypertension in ambulatory arthroscopic patients under general anaesthesia: randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND: This prospective study investigated whether a single dose of intravenous lidocaine could alleviate tourniquet hypertension in patients undergoing ambulatory arthroscopy under general anaesthesia. METHODS: Patients aged 18-65 years undergoing knee arthroscopy under general anaesthesia were randomly divided into the lidocaine group (L group) and the normal saline group (N group). Patients received an intravenous injection 10 min before tourniquet inflation of either 1.5mg/kg lignocaine made up to 10ml with 0.9 per cent normal saline, or 10ml of 0.9 per cent normal saline. The primary outcome was the incidence of tourniquet hypertension. Secondary outcomes included haemodynamic changes, degree of elevation of blood pressure, changes in serum inflammatory indicators including interleukin 6 and tumour necrosis factor-α, the numerical rating scale, 15-item quality of recovery after surgery, the incidence of adverse events and the duration of hospital stay. Randomization was computer-generated with allocation concealment by sealed envelopes. Patients, caregivers and researchers were all blind to the allocation group throughout the study. RESULTS: Ninety-six patients were included in the study; 48 in each group. Compared with the N group, the incidence of tourniquet hypertension in the L group was significantly lower (37.5 per cent versus 68.8 per cent; P < 0.002). The degree of elevation of systolic blood pressure from baseline to the end of surgery in the L group was significantly lower than the N group (17.1 per cent versus 23.6 per cent; P = 0.020). The concentration of tumour necrosis factor-α in the L group 5 min after tourniquet deflation was lower than in the N group (32.12 pg/ml versus 39.89 pg/ml; P = 0.029). The median numerical rating scale of the L group was significantly lower at 6 h (0 versus 3.0; P = 0.003) and 24 h (0 versus 2.0; P < 0.001) after surgery. In the L group, the total 15-item quality of recovery was significantly increased (131 versus 128; P = 0.017). CONCLUSION: Single injection of intravenous lidocaine alleviated tourniquet hypertension in ambulatory arthroscopic patients under general anaesthesia. Intravenous lidocaine can inhibit tourniquet hypertension formation by reducing tumour necrosis factor-α release, and has beneficial effects on postoperative pain and recovery. REGISTRATION NUMBER: ChiCTR2200055551 (http://www.chictr.org.cn/edit.aspx? pid=148235&htm=4).

A first case of successful using of ibrutinib in treating paraneoplastic pemphigus related bronchiolitis obliterans concurrent with CLL.

Paraneoplastic pemphigus (PNP) is a rare life-threatening disease which always associated with an underlying neoplasm. Tumor-related PNP most commonly precedes the detection of a hematological malignancy, with some cases seen during disease remission following cytotoxic drug therapy or radiotherapy. The lung is the most frequently-involved site in PNP, second only to the eyes, and involvement is seen in 59.2% to 92.8% of PNP cases. Bronchiolitis obliterans (BO) is the end stage of respiratory involvement and is regarded as life-threatening. The key point in treatment of PNP is to control the associated underlying hematologic neoplasia. High-dose systemic corticosteroids combined with other immunosuppressants are considered the first line of treatment. Other therapies that have shown beneficial effects include plasmapheresis, intravenous immunogloblin (IVIG), and more recently, daclizumab, alemtuzumab, and rituximab. There is no effective treatment for BO with PNP, and suppression of the cellular immune response may be necessary. Patients with PNP-BO associated with lymphoma mostly die within approximately 1 year. Herein, we reported a patient who diagnosed with PNP-BO concurrent with chronic lymphocytic leukemia. He was successful treated with ibrutinib and had achieved the longest survival which suggested that ibrutinib may be the best treatment choice for such patient.

Effect of Adductor Canal Block Combined with Local Infiltration Analgesia on Postoperative Pain of Knee Arthroscopy Under General Anesthesia: A Randomized Controlled Trial.

INTRODUCTION: Postoperative pain in knee arthroscopy (KA) is a common and troublesome problem. The best local analgesic technique for relieving postoperative pain in patients with KA has not been well studied. This prospective trial aimed to observe whether adductor canal block (ACB) combined with local infiltration analgesia (LIA) could further decrease the incidence of postoperative pain undergoing KA. METHODS: This randomized controlled study recruited 60 patients aged 18-65 years, ASA I-II, who received KA, and randomly divided them into ACB + LIA group and LIA group. The primary outcome was the incidence of postoperative pain 24 h after surgery. The secondary outcomes included the incidence of quadriceps femoris weakness, and the consumption of opioids during operation. RESULTS: A total of 60 participants completed the trial. The incidence of postoperative pain 24 h after surgery in ACB + LIA group was lower than that in the LIA group (10% [3 of 30] vs. 33% [10 of 30]; P = 0.028). There was no difference in the incidence of quadriceps muscle weakness 24 h after surgery between the two groups. The consumption of remifentanil and sufentanil in ACB + LIA group was significantly lower than that in LIA group (P = 0.006, P < 0.001). CONCLUSIONS: Compared with patients receiving LIA alone, ACB combined with LIA could reduce the incidence of postoperative pain while retaining the strength of the quadriceps femoris in patients undergoing KA and reduce the consumption of opioids during surgery. CLINICAL TRIAL NUMBER AND REGISTRY URL: This study was registered at the Chinese Clinical Trial Registry with the registration number ChiCTR1800018463 on September 20, 2018. ( http://www.chictr.org.cn/showproj.aspx?proj=31192 ).

Regulatory mucosa-associated invariant T cells controlled by ß1 adrenergic receptor signaling contribute to hepatocellular carcinoma progression.

BACKGROUND AND AIMS: The innate-like mucosa-associated invariant T (MAIT) cells are enriched in human liver and have been linked to human HCC. However, their contributions to the progression of HCC are controversial due to the heterogeneity of MAIT cells, and new MAIT cell subsets remain to be explored. APPROACH AND RESULTS: Combining single cell RNA sequencing (scRNA-seq) and flow cytometry analysis, we performed phenotypic and functional studies and found that FOXP3 + CXCR3 + MAIT cells in HCC patients were regulatory MAIT cells (MAITregs) with high immunosuppressive potential. These MAITregs were induced under Treg-inducing condition and predominantly from FOXP3 - CXCR3 + MAIT cells, which displayed mild Treg-related features and represented a pre-MAITreg reservoir. In addition, the induction and function of MAITregs were promoted by ß1 adrenergic receptor signaling in pre-MAITregs and MAITregs, respectively. In HCC patients, high proportion of the intratumoral MAITregs inhibited antitumor immune responses and was associated with poor clinical outcomes. CONCLUSIONS: Together, we reveal an immunosuppressive subset of MAIT cells in HCC patients that contributes to HCC progression, and propose a control through neuroimmune crosstalk.

Recent progress in metabolic reprogramming in gestational diabetes mellitus: a review.

Gestational diabetes mellitus is a prevalent metabolic disease that can impact the normal course of pregnancy and delivery, leading to adverse outcomes for both mother and child. Its pathogenesis is complex and involves various factors, such as insulin resistance and ß-cell dysfunction. Metabolic reprogramming, which involves mitochondrial oxidative phosphorylation and glycolysis, is crucial for maintaining human metabolic balance and is involved in the pathogenesis and progression of gestational diabetes mellitus. However, research on the link and metabolic pathways between metabolic reprogramming and gestational diabetes mellitus is limited. Therefore, we reviewed the relationship between metabolic reprogramming and gestational diabetes mellitus to provide new therapeutic strategies for maternal health during pregnancy and reduce the risk of developing gestational diabetes mellitus.

Liquid-Metal-Based Magnetic Controllable Soft Microswitch with Rapid and Reliable Response for Intelligent Soft Systems.

When combined with diverse sensors, soft robots significantly improve their functionalities and intelligence levels. However, most of the existing soft sensors require complex signal analysis devices or algorithms, which severely increase the complexity of soft robot systems. Here, based on the unique fluidic property of liquid metal, we propose a magnet-controllable soft microswitch that can be well-integrated into a soft robot system, e.g., a soft gripper to help it facilely detect and precisely grab objects. The microswitch consists of a flexible soft beam electrode and a fixed electrode, forming a soft microsystem. By tuning the cohesion force of the liquid metal between the electrodes, the microswitch can convert its states between an individual and a self-locking state. The microswitch can achieve a reasonable rapid response (~12 ms) and high switching frequency (~95 Hz). Furthermore, soft microswitches can be customized into logic units and also coupled to control a digital tube showing various numbers. Our work provides a new simple soft sensor unit that may enhance the intelligence of soft systems.

Phenotypic analysis of Longya-10 × pale flax hybrid progeny and identification of candidate genes regulating prostrate/erect growth in flax plants.

Flax is a dual-purpose crop that is important for oil and fiber production. The growth habit is one of the crucial targets of selection during flax domestication. Wild hybridization between cultivated flax and wild flax can produce superior germplasms for flax breeding and facilitate the study of the genetic mechanism underlying agronomically important traits. In this study, we used pale flax, Linum grandiflorum, and L. perenne to pollinate Longya-10. Only pale flax interspecific hybrids were obtained, and the trait analysis of the F1 and F2 generations showed that the traits analyzed in this study exhibited disparate genetic characteristics. In the F1 generation, only one trait, i.e., the number of capsules per plant (140) showed significant heterosis, while the characteristics of other traits were closely associated with those of the parents or a decline in hybrid phenotypes. The traits of the F2 generation were widely separated, and the variation coefficient ranged from 9.96% to 146.15%. The quantitative trait locus underlying growth habit was preliminarily found to be situated on chromosome 2 through Bulked-segregant analysis sequencing. Then linkage mapping analysis was performed to fine-map GH2.1 to a 23.5-kb interval containing 4 genes. Among them, L.us.o.m.scaffold22.109 and L.us.o.m.scaffold22.112 contained nonsynonymous SNPs with Δindex=1. Combined with the qRT-PCR results, the two genes might be possible candidate genes for GH2.1. This study will contribute to the development of important germplasms for flax breeding, which would facilitate the elucidation of the genetic mechanisms regulating the growth habit and development of an ideal architecture for the flax plant.

Crop yield and water use efficiency in response to long-term diversified crop rotations.

Crop production and water productivity may be impacted by diverse crop rotation and management practices. A field study was conducted from 2017-2020 in the Loess Plateau to evaluate the effects of crop rotation sequences on pre-planting and post-harvest soil water storage (SWS), annualized crop yield, water use, and water productivity. Crops in rotation included oil flax (Linum usitatissimum L.) (F), wheat (Triticum aestivum L.) (W), potato (Solanum tuberosum L.) (P). Twelve 4-year-cycle crop rotation treatments, along with a continuous oil flax treatment as a baseline, were included. The results showed that the average soil water content under the 0-150 cm soil layer in all treatments was increased after one rotation cycle, and the PWFW treatment achieved the highest SWC (17.1%). The average soil water storage (winter fallow season) and evapotranspiration (ETa) (growing season) under different crop rotation sequences were lower than those under continuous oil flax cropping. The ETa of FFFF increased by 28.9, 2.7, 15.3, and 28.4%, compared to average crop rotations in 2017, 2018, 2019, and 2020, respectively. Crop rotation had a significant effect on average annual yield and water use efficiency (WUE), which varied by year and rotation sequence. The crop rotations with the highest grain yield of oil flax were FFWP (2017), WFWP (2018),WPFF (2019) and FWPF (2020); the grain yield of wheat was highest when the two pre-crops (previously cultivated crops) were F-F, and potato yield was highest when the two pre-crops were W-F (except 2018). On average, the WUE of oil flax was 8.6, 38.7, 22.7, and 42.1% lower with FFFF than other diversity crop rotations in 2017, 2018, 2019, and 2020. We found that the WUE was not the largest when the grain yield of oil flax and wheat was highest. The treatments with maximum grain yield and WUE were not consistent. Our findings also revealed that wheat-potato-oil flax or potato-wheat-oil flax rotation could increase oil flax grain yields while wheat-oil flax-potato-oil flax markedly improved oil flax WUE.

Tumor immune cell infiltration score based model predicts prognosis in multiple myeloma.

The tumor microenvironment plays an important role in various processes, including tumorigenesis, cancer progression, and metastasis. Immune signatures have been identified and verified for use in diagnosis and prognosis prediction. We used single-sample Gene Set Enrichment Analysis to evaluate tumor immune cell infiltration score (TIICs) and verify their prognostic significance in both training and validation cohorts and using this information to build a prognostic model. A total of 1281 samples were obtained for further evaluation of the immune enrichment scores of 28 immune cells, showing that Th17 cell contributed most significantly to survival. Using the median TIICs as a cutoff to divide the samples into two groups, we found that the high-TIICs group was associated with favorable outcomes in both the training and validation sets. We then constructed a prognostic model to predict the 6, 8, and 10-year survival outcomes. Further analysis showed that immune score and tumor purity were higher in the high-TIICs group, while the matrix score was lower in this group. Forty-two differentially expressed genes were identified between the two groups. This new prognostic model based on immune cell infiltration indicates the potential for TIICs in predicting prognosis and as targets for treatment.

Overexpression of WRINKLED1 improves the weight and oil content in seeds of flax (Linum usitatissimum L.).

Seeds of flax (Linum usitatissimum L.) are highly rich in both oil and linolenic acid (LIN). It is crucial for flax agricultural production to identify positive regulators of fatty acid biosynthesis. In this study, we find that WRINKLED1 transcription factors play important positive roles during flax seed oil accumulation. Two WRINKLED1 genes, LuWRI1a and LuWRI1b, were cloned from flax, and LuWRI1a was found be expressed predominantly in developing seeds during maturation. Overexpression of LuWRI1a increased seed size, weight, and oil content in Arabidopsis and increased seed storage oil content in transgenic flax without affecting seed production or seed oil quality. The rise in oil content in transgenic flax seeds was primarily attributable to the increase in seed weight, according to a correlational analysis. Furthermore, overexpression or interference of LuWRI1a upregulated the expression of genes in the fatty acid biosynthesis pathway and LAFL genes, and the expression level of WRI1 was highly significantly positively associated between L1L, LEC1, and BCCP2. Our findings give a theoretical scientific foundation for the future application of genetic engineering to enhance the oil content of plant seeds.

Cost-Effectiveness of Posaconazole vs. First-Generation Triazoles for the Prevention of Invasive Fungal Infections Among High-Risk Patients With Hematological Malignancies in China.

Background: Posaconazole is confirmed to be more effective for preventing invasive fungal infections (IFIs) than first-generation triazoles (fluconazole and itraconazole), but its economic value has not been comprehensively evaluated in China. This study compared the cost-effectiveness of these two antifungal prophylaxis regimens in hematological-malignancy patients at high risk for IFIs from the Chinese healthcare perspective. Methods: A hybrid decision tree and Markov model were built using published data to estimate the total costs and quality-adjusted life-years (QALYs) of antifungal prophylaxis with posaconazole oral suspension and first-generation triazoles. Regimens with an incremental cost-effectiveness ratio (ICER) lower than the threshold of willingness to pay (WTP) were considered cost-effective. One-way and probabilistic sensitivity analyses were performed to assess model robustness. The regional imbalance of economic development and the tablet formulation of posaconazole were considered in the scenario analyses. Results: In the base-case analysis, posaconazole oral suspension provided an additional 0.109 QALYs at an incremental cost of $954.7, yielding an ICER of $8,784.4/QALY, below the national WTP threshold of $31,315/QALY. One-way and probabilistic sensitivity analyses showed that the results were robust. Scenario analyses showed that the base-case ICER was consistently below the WTP thresholds of all 31 Chinese provinces, with the likelihood of posaconazole being cost-effectiveness ranging from 78.1 to 99.0%. When the posaconazole oral suspension was replaced by the tablet formulation, the ICER increased to $29,214.1/QALY, still below the national WTP threshold and WTP thresholds of 12 provinces. Conclusions: Posaconazole oral suspension is a highly cost-effective regimen for preventing IFI in high-risk hematological-malignancy patients from the Chinese healthcare perspective. Posaconazole tablets may also be considered in some high-income regions of China.

Effects of resistance exercise on blood glucose level and pregnancy outcome in patients with gestational diabetes mellitus: a randomized controlled trial.

INTRODUCTION: To date, the effects of resistance exercise on diabetes-related parameters (blood glucose level and insulin use) and pregnancy outcome in participants with gestational diabetes mellitus (GDM) have not been compared with those of aerobic exercise. To investigate the effect of resistance exercise versus aerobic exercise on blood glucose level, insulin utilization rate, and pregnancy outcome in patients with GDM. RESEARCH DESIGN AND METHODS: From December 2019 to December 2020, 100 pregnant women with GDM were selected and divided into a resistance exercise group (49 patients) and an aerobic exercise group (51 patients) randomly. The aerobic exercise group received an aerobic exercise intervention, while the resistance exercise group received a resistance exercise intervention. Both groups received exercise intervention for 50-60 min, 3 times per week, lasting for 6 weeks. In addition, patients in both groups received the same routine care, including personalized dietary intervention, online education, and school courses for pregnant women. RESULTS: The blood glucose level in the resistance exercise group and the aerobic exercise group was lower after the intervention than before the intervention (p<0.05). After the intervention, no significant differences were observed in the fasting blood glucose level, insulin utilization rate, and incidence of adverse pregnancy outcomes between the two groups (p>0.05); however, significant differences were noted in 2-hour postprandial blood glucose level and exercise compliance between the two groups (p<0.05), with the resistance exercise group showing better outcomes than the aerobic exercise group. CONCLUSIONS: Resistance exercise is more compliant for pregnant women with GDM than aerobic exercise; hence, it is necessary to popularize resistance exercise in this specific population group. Long-term effects of resistance exercise should be evaluated in future studies. TRIAL REGISTRATION NUMBER: ChiCTR 1900027929.