Abstract:A 59-year-old female patient with advanced lung adenocarcinoma developed acute left heart failure after one cycle of immunotherapy with tislelizumab 200 mg.The brain natriuretic peptide was significantly increased,and the myocardial enzyme spectrum remained normal.The cause may be immune-related non-myocardial inflammatory left ventricular dysfunction.After active glucocorticoid therapy,the patient's symptoms of heart failure were significantly relieved,but left ventricular dysfunction could not be reversed.Therefore,for patients with tumor immunotherapy of left ventricular function after injury,while myocardial enzyme spectrum continue to normal,still should take into account the immune correlation of the left ventricular function of myocardial inflammatory damage,need to use hormone therapy,and the left ventricular function damage is irreversible.

Abstract:Objective To investigate the effect of Qingkailing oral liquid combined with human interferon α2b spray in the treatment of hand-foot-mouth disease(HFMD)in children.Methods A total of 98 children with mild HFMD admitted to the First Hospital of Yulin,Shaanxi Province from December 2021 to December 2023 were selected.According to different treatment methods,the children were divided into control group and observation group,with 49 cases in each group.The control group was treated with human interferon α2b spray,and the observation group was treated with Qingkailing oral liquid combined with human interferon α2b spray.The thera-peutic effect,recovery time of clinical symptoms,serum indexes,T lymphocyte subsets,and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[95.9％(47/49)vs 83.7％(41/49)](x2=4.009,P=0.045).The time for body temperature recovery,rash and herpes regression time in the observation group were shorter than those in the control group(both P＜0.05).After treatment,the levels of C-reactive protein,interleukin-17 and tumor necrosis factor αin the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the levels of CD3+,CD4+and CD4+/CD8+ratio in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group(all P＜0.05).There were no adverse reactions such as shivering,gastrointestinal reactions,and headache in the two groups.Conclusion Qingkailing oral liquid combined with human interferon α2b spray can achieve satisfactory effect in the treatment of children with HFMD,which can effectively improve the body's inflammation and the expression of T lymphocyte subsets,and has high safety.

Abstract:Objective To investigate the correlation of serum long non-coding RNA(lncRNA)OIP5-AS1 and microRNA-137(miR-137)levels with cardiac function and adverse cardiovascular events in patients with unstable angina pectoris(UA).Methods A total of 102 UA patients admitted to Hainan Second People's Hospital from May 2022 to August 2023 were selected as the observation group.A total of 102 healthy people in the same period were selected as the control group.UA patients were divided into occurrence group(n=35)and non-occurrence group(n=67)according to the occurrence of adverse cardiovascular events during 6 months of follow-up.The levels of serum lncRNA OIP5-AS1 and miR-137 were detected by real-time quantitative polymerase chain reaction.The Pearson method was used to analyze the correlation between serum lncRNA OIP5-AS1 and miR-137 in UA patients,and the correlation between lncRNA OIP5-AS1,miR-137 and cardiac function indicators.Logistic regression model was used to analyze the potential factors affecting the occurrence of adverse cardiovascular events in UA patients.The receiver operating characteristic curve was used to evaluate the efficacy of serum lncRNA OIP5-AS1 and miR-137 levels in predicting adverse cardiovascular events in UA patients.Results The levels of serum miR-137 and left ventricular end diastolic diameter(LVEDD)in the observation group were significantly higher than those in the control group,and the levels of serum lncRNA OIP5-AS1 and left ventricular ejection fraction(LVEF)were significantly lower than those in the control group(all P＜0.001).The levels of serum miR-137 and LVEDD in the occurrence group were significantly higher than those in the non-occurrence group,and the serum levels of lncRNA OIP5-AS1 and LVEF were significantly lower than those in the non-occurrence group(all P＜0.001).There was a negative correlation between serum lncRNA OIP5-AS1 and miR-137(r=-0.555,P＜0.001).Serum lncRNA OIP5-AS1 was negatively correlated with LVEDD(r=-0.441,P＜0.001)and positively correlated with LVEF(r=0.479,P＜0.001).Serum miR-137 was positively correlated with LVEDD(r=0.466,P＜0.001)and negatively correlated with LVEF(r=-0.472,P＜0.001).The increased levels of miR-137 and LVEDD were the risk factors for adverse cardiovascular events in UA patients,while the increased levels of lncRNA OIP5-AS1 and LVEF were the protective factors(all P＜0.05).The areas under the curve of serum lncRNA OIP5-AS1 and miR-137 in predicting cardiovascular events in UA patients were 0.845,0.832 and 0.924,respectively.The combination of serum lncRNA OIP5-AS1 and miR-137 was better than that of serum lncRNA OIP5-AS1(Z=2.146,P=0.032)and miR-137(Z=2.114,P=0.035)alone.Conclusion The serum levels of lncRNA OIP5-AS1 were decreased and miR-137 were increased in UA patients with adverse cardiovascular events.The serum levels of lncRNA OIP5-AS1 and miR-137 were potential factors affecting the occurrence of adverse cardiovascular events in UA patients.And the combination of the two shows higher efficacy in predicting cardiovascular adverse events in UA patients.

Abstract:Objective To investigate the efficacy of herombopag olamine tablet in the treatment of chemo-therapy-induced thrombocytopenia(CIT)after breast cancer surgery.Methods A total of 120 patients with CIT caused by chemotherapy after breast cancer surgery diagnosed in Affiliated Hospital of Hebei University from December 2021 to December 2023 were selected.According to the random number table method,the patients were divided into recombinant human thrombopoietin(rhTPO)group and combined group,with 60 cases in each group.The rhTPO group was treated with rhTPO,and the combination group was treated with rhTPO and herombopag olamine tablets.Both groups were treated for 4 weeks.The clinical efficacy,platelet parameters,thrombopoietin(TPO),inflammatory factors,platelet count(PLT),immune function indexes and adverse reactions were compared between the two groups after treatment.Results The total effective rate in the combined group was significantly higher than that in the rhTPO group[91.7％(55/60)vs 75.0％(45/60)](P=0.014).After treatment,the platelet volume distribution width and mean platelet volume in the two groups were lower than those before treatment,and those in the combined group were lower than those in the rhTPO group,and the platelet crit was higher than that before treatment,and those in the combined group were higher than those in the rhTPO group(all P＜0.05).After treatment,the levels of IL-6,TPO and tumor necrosis factor-α in the two groups were lower than those before treatment,and those in the combined group were significantly lower than those in the rhTPO group(all P＜0.05).After 3,7 and 14 days of treatment,the PLT levels of the two groups were higher than those before treatment,and the PLT levels of the combined group were higher than those of the rhTPO group(all P＜0.05).Compared with before treatment,the levels of CD3+,CD4+,and CD4+/CD8+ratio in the two groups after treatment were significantly increased,and those in the combined group were higher than those in the rhTPO group(all P＜0.05).After treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P=0.488).Conclusion Herombopag olamine tablet combined with rhTPO in the treatment of CIT caused by chemotherapy after breast cancer surgery can improve the clinical efficacy of patients,reduce the levels of serum interleukin-6,TPO and tumor necrosis factor-α,improve PLT and immune function,and has high safety.

Abstract:Objective To investigate the relationship between the levels of serum nuclear factor erythroid 2-related factor 2(Nrf2),hepcidin 25(Hepc-25)and insulin-like growth factor 1(IGF-1)and anemia in cancer patients undergoing chemotherapy.Methods A total of 142 tumor patients admitted to the Affiliated Hospital of Yangzhou University from January 2022 to January 2024 were selected.According to whether anemia occurred after chemotherapy,they were divided into observation group(anemia occurred,89 cases)and control group(no anemia occurred,53 cases).According to the severity of anemia,the patients in the observation group were divided into mild group(23 cases),moderate group(44 cases)and severe group(22 cases).The levels of Nrf2,Hepc-25 and IGF-1 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of anemia in patients during tumor chemotherapy.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of Nrf2,Hepc-25 and IGF-1 in anemia.Results The hemoglobin and red blood cell count of the observation group were significantly lower than those of the control group,and the proportions of female and gastric cancer patients were significantly higher than those of the control group(all P＜0.05).The serum levels of Nrf2 and IGF-1 in the observation group were lower than those in the control group[(1.36±0.24)μg/L vs(2.98±0.53)μg/L,(166±20)μg/L vs(192±27)μg/L],and the serum levels of Hepc-25 were higher than those in the control group[(49±6)μg/L vs(23±4)μg/L](all P＜0.05).The serum levels of Nrf2 and IGF-1 in the mild group,the moderate group and the severe group decreased in turn,and the serum levels of Hepc-25 increased in turn(all P＜0.05).The results of multivariate Logistic regression analysis showed that Hepc-25,female,gastric cancer were the risk factors for anemia(all P＜0.05),while Nrf2,IGF-1,hemoglobin and red blood cell count were protective factors for anemia induced by tumor chemotherapy(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of Nrf2,Hepc-25 and IGF-1 in predicting anemia was 0.867,0.841 and 0.797,respectively.When combined,the AUC increased to 0.954.Conclusion The serum levels of Nrf2 and IGF-1 are decreased and Hepc-25 is increased in the cancer patients with anemia after chemotherapy.The serum levels of Nrf2 and IGF-1 are related to the occurrence of anemia in the cancer patients with anemia after chemotherapy,and the combined use of the three factors can effectively predict the occurrence of anemia in the cancer patients with anemia after chemotherapy.

Abstract:Objective To investigate the effect of different antiplatelet therapy on the prognosis of patients with epistaxis.Methods The clinical data of 243 patients with epistaxis who were admitted to Beijing Anzhen Hospital,Capital Medical University from January 2020 to December 2023 were retrospectively analyzed.According to the use of antiplatelet drugs before epistaxis,78 patients with coronary atherosclerotic heart disease who took aspirin combined with ticagrelor or clopidogrel were divided into dual antibody group,83 patients who took single antiplatelet drugs were divided into single antibody group,and 82 patients who did not use antiplatelet drugs were divided into control group.The clinical and laboratory indexes,therapeutic effects and complications of epistaxis were compared among the three groups,and the related factors affecting the prognosis of epistaxis were analyzed.Results The proportions of multiple epistaxis(≥3 times within 1 month)and persistent epistaxis(≥30 minutes within 24 hours)in the dual antibody group were higher than those in the single antibody group and the control group(all P＜0.05).The cure rate of the double antibody group was lower than those of the control group and the single antibody group,and the recurrence rate was significantly higher than that of the control group[67.9％(53/78)vs 91.5％(75/82),81.9％(68/83);9.0％(7/78)vs 1.2％(1/82)](all P＜0.05).The total incidence of complications in the dual antibody group was higher than those in the control group and the single antibody group[25.6％(20/78)vs 8.5％(7/82),10.8％(9/83)](both P＜0.05).Logistic regression analysis showed that the possibility of healing of epistaxis within 1 month after dual antiplatelet therapy was significantly lower than that of the control group(odds ratio=1.759,95％confidence interval:1.032-5.925,P=0.034).Conclusions Dual antiplatelet therapy significantly increases the risk of severe epistaxis and has adverse effects on the prognosis of patients with epistaxis,which should be paid more attention.

Abstract:Rectal multiple neuroendocrine neoplasms is a rare malignant tumor of the rectum.The risk of lymph node metastasis is significantly increased,and the small lesions are occult.There is no consensus on the treatment and follow-up strategy.Herein,this paper reports a case of rectal multiple micro neuroendocrine neoplasms with lymph node metastasis,and reviews the relevant literature to discuss the clinicopathological features and diagnosis and treatment experience of the disease,in order to strengthen clinicians'understanding of rectal multiple micro neuroendocrine neoplasms.

Abstract:Epstein syndrome is a non-muscle myosin heavy chain 9(MYH9)-related disease with throm-bocytopenia.It is caused by defects in the MYH9 gene,which encodes the non-muscle myosin heavy chain Ⅱ A protein.The common clinical manifestation is bleeding caused by thrombocytopenia,and the platelet recovery is not obvious after blood transfusion and immunotherapy.In the process of diagnosis and treatment,the diagnosis should be made as soon as possible according to the cell morphology and gene detection results to avoid delayed diagnosis and misdiagnosis.In this paper,the clinical data and genetic test results of a child with Epstein syndrome were retrospectively analyzed,and the related literature was reviewed to further improve the understanding of Epstein syndrome.The patient was a 2-year-old boy with no clinical manifestations of bleeding.Routine blood test showed thrombocytopenia,and the peripheral blood smear and bone marrow cytology showed giant platelets without neutrophil inclusion bodies.Gene sequencing showed a MYH9 gene mutation,exon c.287C＞T(p.Ser96Leu).The patient was clinically diagnosed with Epstein syndrome,and his parents were normal wild type.For patients with incomplete clinical symptoms at the time of diagnosis,relevant complications and comorbidities should be clearly informed.At present,there is no clear and effective treatment for this disease,and unrelated hematopoietic stem cell transplantation has been used in clinical treatment,but the efficacy is not clear.Most children need to be followed up regularly.

Abstract:Objective To investigate the clinical effect of Jianpi Wenyang decoction in the treatment of epigastric pain syndrome(EPS)of spleen and stomach weakness in grassroots training participants.Methods A total of 84 patients with functional dyspepsia of spleen and stomach weakness admitted to the First Medical Center of Chinese PLA General Hospital from February to August 2023 were selected as the research objects.According to the random number table method,they were divided into the control group(42 cases)and the observation group(42 cases).The control group was treated with omeprazole magnesium enteric-coated tablets on the basis of basic treatment,and the observation group was treated with external application of Jianpi Wenyang decoction on the basis of basic treatment.The gastrointestinal symptom scores,gastric motor function,traditional Chinese medicine syndrome scores,efficacy and safety were compared between the two groups.Results During the experiment,2 cases of control group dropout occurred.After treatment,the gastrointestinal symptom scores of the two groups were significantly lower than those before treatment,and the scores of postprandial fullness and early satietythe in the observation group were lower than those in the control group(all P＜0.05).After treatment,the antral contraction amplitude,antral contraction frequency and antral motility index of the two groups were higher than those before treatment,and the antral motility index of the observation group was higher than that of the control group(all P＜0.05).After treatment,the traditional Chinese medicine syndrome scores of the two groups were lower than those before treatment,and the traditional Chinese medicine syndrome scores of poor appetite,fatigue,and aggravation after eating in the observation group were lower than those in the control group(all P＜0.05).The total effective rate of the observation group was higher than that of the control group[95.2％(40/42)vs 72.5％(29/40)(x2=7.940,P=0.005).During the treatment,no adverse reactions occurred in the two groups.Conclusion Jianpi Wenyang decoction can not only significantly improve the clinical symptoms of EPS such as abdominal distension and early satiety,but also relieve the accompanying symptoms such as fatigue and poor appetite,so as to improve the quality of life of the training participants.

Abstract:Epilepsy is a group of chronic brain diseases.This article summarizes the clinical data,whole exome sequencing test results,diagnosis and treatment process of a 4-month-old boy with epilepsy with SCN8A gene variation who was admitted to Shaanxi Provincial People's Hospital and presented with seizures as the first symptom.The child was admitted to the hospital due to"paroxysmal seizures for half a day".After admission,the child still had recurrent seizures,and the brain magnetic resonance imaging and video electroencephalogram were normal.The whole exome sequencing test report shows that:SCN8A,chr12:52184185;c.4223G＞A(p.Gly1475Arg)variation.After the treatment with antiepileptic drugs,the symptoms were relieved.Combined with the relevant literature review,we believe that for infants less than 6 months of age with unexplained seizures,routine examination results can not identify the cause,gene sequencing should be actively improved to help the diagnosis,to provide ideas for the development of precise treatment plans,and to provide help for family genetic counseling.

Abstract:Niemann-Pick disease(NPD)is a rare lipid storage disease.Hemophagocytic syndrome(HPS)is a rare and highly inflammatory disease,which can be triggered by infection,malignant tumors,or autoimmune diseases.Due to the limited number of reported cases,the clinical features of NPD with HPS are unknown.A 41-year-old man was admitted to the hospital due to yellow skin,fatigue for 2 months,and chronic liver failure.Bone marrow aspiration revealed a large number of Niemann-Pick cells with erythrocyte phagocytosis.The patient's condition developed rapidly,and his family finally gave up after active diagnosis and treatment,and he died at day 22.This is one of the rare HPS phenomenon associated with NPD found in adult patients.This case is reported in order to improve clinicians'understanding of the disease and avoid misdiagnosis and missed diagnosis.

Abstract:Objective To analyze the relevant factors affecting the instability of international normalized ratio(INR)in patients with pulmonary embolism,and to construct a nomogram prediction model and verify it.Method A retrospective analysis was performed on 562 patients with pulmonary embolism admitted to Beijing Anzhen Hospital,Capital Medical University from January 2017 to August 2022.Patients were divided into INR instability group(47 cases)and INR stability group(515 cases).The clinical data of the two groups were compared.The influencing factors of INR instability in patients with pulmonary embolism were analyzed by Logistic regression method and verified by receiver operating characteristic(ROC)curve.Results There were significant differences in gender ratio,body mass index,total bilirubin level and the proportions of active tumor,infection,heart failure,lower limb swelling,rheumatic heart disease,hypertension and anemia between the two groups(all P＜0.05).Logistic regression analysis showed that male(odds ratio=2.94,95％confidence interval:1.41-6.13,P＜0.01),rheumatic heart disease(odds ratio=17.70,95％confidence interval:2.78-112.64,P＜0.01),anemia(odds ratio=7.76,95％confidence interval:3.37-17.87,P＜0.01)were risk factors for INR instability in patients with pulmonary embolism.ROC curve analysis showed that the area under the curve of male,rheumatic heart disease and anemia to predict INR instability was 0.787.Conclusions Gender,rheumatic heart disease and anemia are independently correlated with INR instability in patients with pulmonary embolism,and the combined prediction of INR instability is better than that of a single index,which is a good reference value for medical staff in clinical practice.

Abstract:Hippo signaling pathway is a signaling pathway that plays an important role in biological processes,which can regulate cell proliferation,apoptosis and differentiation.Osteoporosis(OP)is a bone metabolic disease characterized by loss of bone mass and destruction of bone microstructure.Hippo signaling pathway can balance the proportion of osteoblasts and osteoclasts,which plays an important role in the regulation of OP.Hippo has multiple regulatory effects on bone development and homeostasis,including the effects on the differentiation of mesenchymal stem cells,the proliferation and maturation of hematopoietic stem cells,the function of fibroblast-like synoviocytes,and the promotion of macrophage differentiation.This article focuses on the mechanism of Hippo signaling pathway in osteoblasts,osteoclasts and mesenchymal stem cells in OP,and focuses on the relationship between OP and Hippo signaling pathway and its treatment prospects,such as targeted regulation of related molecules,the use of exosomes to mediate therapy,the combination of other therapeutic methods,and the application of traditional Chinese medicine.It is expected to provide new ideas for the follow-up research of OP.In addition to summarizing related studies,this review also points out that further studies are needed to explore the role of Hippo signaling pathway in OP-related pathways.Clarifying the precise function of Hippo signaling pathway is of great significance for the development of new therapeutic targets and methods.

Abstract:Objective The purpose of this study is to explore the changes of brain structure in mice with heart failure with preserved ejection fraction(HFpEF)using high-resolution magnetic resonance imaging(MRI),in order to provide scientific basis for understanding the pathophysiological mechanism of the disease and developing new treatment methods.Methods Sixty specific pathogen free male C57BL/6J mice were selected and divided into control group and HFpEF group by body weight stratification,with 30 mice in each group.The control group was given normal diet and drinking ordinary water freely.In HFpEF group,HFpEF model was established by high-fat diet combined with L-nitroarginine methyl ester double hit.The brain structure of mice was assessed by high-resolution MRI combined with the voxel-based morphometry technique,and significant regions were identified by statistical analysis.Results Compared with the control group,the HFpEF group had a significant increase in gray matter volume in the right parahippocampal gyrus at 36 and 60 weeks of intervention[(0.92±0.08),(1.05±0.09)mm3 vs(0.78±0.06)mm3](both P＜0.05).The peak MNI coordinates were X=-11.4,Y=-14.1,Z=16.2,F value was 47.62,and the cluster size was 2 060 voxels.The gray matter volume of arcuate nucleus and paraventricular nucleus of the HFPEF group in the 36 week and 60 week were significantly greater than those of the control group,and the gray matter volume of ventromedial nucleus and dorsolateral nucleus of the HFPEF group also showed a significant increase in the 60 week(P＜0.05 or P＜0.01).In addition,the gray matter volume of the anterior thalamus of the HFPEF group was also significantly greater in the 60 week than that of the control group(P＜0.01).Conclusion HFpEF can lead to significant changes in brain structure in mice,especially in the parahippocampal gyrus and some nuclei of the hypothalamus.These structural changes may be closely related to the pathophysiological mechanism of HFpEF.

Abstract:Chinese patent medicine is an important part of clinical treatment drugs in China.Scientific evaluation and replacement of Chinese patent medicine shortage can provide a good guarantee for clinical diagnosis and treatment and standardized supply of drugs in medical institutions.In this paper,literature review was used to systematically review the process,dimensions and methods of clinical evaluation of Chinese patent medicine,to construct the evaluation process and index system of shortage varieties reflecting the characteristics of Chinese patent medicine,and to initially form an index pool.Delphi method was used to select and optimize the evaluation indicators,and the analytic hierarchy process was used to assign weights to the indicators of each dimension and level.Finally,the evaluation process of"Urgency evaluation of clinical use of CPM shortage-Evaluation of determining equivalent substitutable varieties-Comprehensive evaluation of equivalent substitutable varieties"was formed.From the different dimensions of clinical application,effectiveness,safety,economy,innovation,suitability and accessi-bility,the evaluation system was constructed,including 15 first-level indicators,30 second-level indicators and 65 third-level indicators.It provides a scientific and operational tool for medical institutions to replace or evaluate the shortage of Chinese patent medicine,and promotes medical institutions to continuously optimize the drug use list and drug use structure,and improves the level of clinical rational use of Chinese patent medicine and the quality of pharmaceutical services.

Abstract:This article reports a case of autosomal dominant optic atrophy to provide a reference for the clinical diagnosis of this type of disease.The patient had poor vision in both eyes without any obvious cause,and was diagnosed with autosomal dominant optic atrophy after combining auxiliary examinations and genetic testing.There is currently no effective treatment for this disease,and the key to treatment is to improve the patient's visual quality.Lifestyle changes and regular follow-up examinations are usually recommended.

Abstract:Objective To investigate the relationship between left atrial appendage emptying velocity(LAAeV)and the risk of ischemic stroke after catheter ablation in patients with persistent atrial fibrillation.Methods Patients with persistent atrial fibrillation who underwent ablation for the first time in Beijing Anzhen Hospital,Capital Medical University from March 2017 to December 2019 were retrospectively enrolled.The clinical and echocardiographic characteristics of the patients were collected.LAAeV was measured by transesophageal echocardiography before operation.Patients were followed up regularly to observe the primary outcome of ischemic stroke.Results A total of 926 patients were enrolled,and LAAeV was(40.1±18.3)cm/s.During a median follow-up of3.0(2.5,3.5)years,28 patients had ischemic stroke.Univariate analysis showed that previous ischemic stroke history(hazard ratio=2.925,95％confidence interval:1.323-6.465,P=0.008),left atrial anteroposterior diameter(hazard ratio=1.092,95％confidence interval:1.016-1.174,P=0.017),and LAAeV(hazard ratio=0.976,95％confidence interval:0.951-1.001,P=0.063)were associated with the incidence of ischemic stroke after atrial fibrillation ablation.Multivariate analysis showed that only the previous history of ischemic stroke(hazard ratio=2.494,95％confidence interval:1.085-5.734,P=0.031)was significantly related to the incidence of ischemic stroke after atrial fibrillation ablation.Conclusions The risk of ischemic stroke after catheter ablation in patients with persistent atrial fibrillation is related to previous ischemic stroke history.There is no significant correlation between the LAAeV and the risk of ischemic stroke in patients after catheter ablation.

Abstract:Metronomic chemotherapy(MCT)is a treatment characterized by low-dose and high-frequency administration,which has the advantages of low toxicity,long duration of drug effect,high compliance,and low cost.It is often used as a salvage measure for patients with advanced hematological malignancies and has certain clinical practicability.In this review,we discuss the mechanisms of MCT,including inhibition of tumor stem cells,anti-angiogenesis and immune stimulation,and summarize the current research results of MCT in multiple myeloma,acute myeloid leukemia and lymphoma.We also elaborate the current status of MCT and point out the shortcomings,so as to provide reference for its clinical application in hematological malignancies.It also provides a reference for the in-depth development of MCT research.

Abstract:Objective To investigate the impact of novel coronavirus infection(COVID-19)on new-onset subclinical atrial fibrillation in patients with dual-chamber pacemaker implantation.Methods The clinical data of 420 patients who were implanted with permanent dual-chamber pacemaker for the first time in Beijing Anzhen Hospital,Capital Medical University from January 2016 to June 2023 were retrospectively analyzed.The patients were divided into infection group and non-infection group according to whether they were complicated with COVID-19.The follow-up data and the incidence of subclinical atrial fibrillation were compared between the two groups.Multivariate Logistic regression model was used to analyze the independent risk factors for subclinical atrial fibrillation.Results A total of 395 of 420 patients completed 24.0(6.0,54.0)months of follow-up,including 323 patients in the infection group and 72 patients in the non-infection group.Three patients died during the follow-up,including one with renal failure and the other two with unknown causes,all of whom were complicated with COVID-19.The incidence of subclinical atrial fibrillation in the infection group was significantly higher than that in the non-infection group[16.7％(54/323)vs 6.9％(5/72)](P=0.035).Multivariate Logistic regression analysis showed that COVID-19,longer RR interval(＞2 s)and enlarged left atrial diameter were independent risk factors for subclinical atrial fibrillation(all P＜0.05).Conclusion COVID-19,longer RR interval(＞2 s),and enlarged left atrial diameter are independent risk factors for subclinical atrial fibrillation in patients with permanent dual-chamber pacemaker implantation.

Abstract:Objective To investigate the effect of ABBV-744,a novel small molecule inhibitor of the bromo-domain and extra-terminal domain(ABBV-744)on cardiac fibrosis in mice with heart failure.Methods Twenty-four male C57BL/6J mice aged 8-10 weeks were randomly divided into sham-operated group,model group,JQ1 intervention group and ABBV-744 intervention group,with 6 mice in each group.Heart failure model was not established in the sham operation group,and the heart failure model was established by transverse aortic constriction(TAC)in the other three groups.The success of the model was determined by detecting the flow velocity of the aortic arch.After 18 d TAC surgery,JQ1 intervention group were administered by intraperitoneal injection,and ABBV-744 was administered by gavage once a day for 30 d.Cardiac function was detected by echocardiography.Cardiac hypertrophy was analyzed by cardiac related index.Hematoxylin eosin(HE)staining was used to analyze the infiltration of inflammatory cells in the heart and kidney.Sirius red staining was used to evaluate the degree of cardiac fibrosis in mouse heart tissue.Western blotting and quantitative polymerase chain reaction were used to detect the expression of α-smooth muscle actin(α-SMA),type α1-Ⅰ collagen(COL1A1),and type α1-Ⅲ collagen(COL3A1).Aspartate aminotransferase,total bilirubin,serum creatinine and blood urea nitrogen were detected to evaluate the effect of drugs on liver and kidney function.Results Echocardiography showed that the left ventricular ejection fraction and fractional shortening were significantly increased in the ABBV-744 intervention group as compared with the model group[(55±4)％vs(45±4)％,(28.0±2.6)％vs(22.4±2.4)％],and both left ventricular endsystolic diameter and left ventricular enddiastolic diameter were significantly reduced(P＜0.05 or P＜0.01).Compared with the model group,the ratio of heart weight to body weight and the ratio of heart weight to tibia length were significantly decreased in the ABBV-744 intervention group(P＜0.05 or P＜0.001).HE staining showed that ABBV-744 reduced the infiltration of inflammatory cells in cardiac microvessels.Sirius red staining showed that ABBV-744 could reduce collagen deposition and cardiac fibrosis in heart failure after TAC.Compared with the model group,the protein expression of α-SMA and the mRNA expression of COL1A1 and COL3A1 in the ABBV-744 intervention group was significantly down-regulated(P＜0.05 or P＜0.01).Compared with the JQ1 intervention group,HE staining of the kidney and biochemical analysis of the plasma showed that ABBV-744 had less damage to the liver and kidney.Conclusion ABBV-744 can effectively improve TAC mice heart failure and reduce cardiac fibrosis,which may be related to the inhibition of fibroblast activation protein.Compared with JQ1 intervention group,ABBV-744 has less effect on liver and kidney function.