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In this study, a novel gas sparging regime was applied, in which filtration was conducted without gas sparging to create a pseudo dead-end (DE) filtration cycle followed by membrane relaxation/backwashing for a short period of time with gas sparging until the TMP set-point was achieved. Compared with conventional continuous filtration and continuous gas sparging (CGS) modes and temporal pseudo DE filtration modes, this pseudo DE filtration coupled with TMP set-point control mode can achieve lower energy demand with sustainable membrane operation. The impacts of the TMP set-point value, imposed flux and physical cleaning process (membrane relaxation/backwash coupled with gas sparging) were evaluated. The result indicated that a moderate TMP set-point value (10–12 kPa) should be selected. Backwashing can significantly reduce the irreversible fouling and enhance the net permeate flux. However, when the TMP set-point value was higher (TMPset = 14 kPa), severe cake layer consolidation occurred and no appreciable improvement of fouling control was observed even with backwashing coupled with gas sparging. The optimum condition can be established when the TMP set-point value was 12 kPa at a flux of 15 L m−2 h−1 in terms of a higher net flux and lower specific energy demand. Importantly, sustainable membrane operation can be achieved under pseudo DE filtration coupled with TMP set-point control mode with a low energy demand (0.09 kWh m−3) and low operational cost ($0.027 per m3), promoting energy neutral municipal wastewater treatment to be realized.

Strobilanthes cusia (Nees) Kuntze is a vital medicinal and industrial herb, planted extensively in southern China (Hu, et al. 2011.). In July and August of 2021, leaf spot incidence on60% plants and reduced yields20% for fresh leaves were observed in S. cusia cultivar 'Malan No.1' across the Shufeng whole Township, Xianyou County, Fujian province. Initial symptoms on leaves were observed as small, dark-brown, spots surrounded by a yellow halo, expanding irregularly or into semicircular spots. As symptoms developed, the spots became dark brown, thin and fragile, forming small holes. In severe cases plants were defoliated. The pathogen was isolated from the margin of 60 symptomatic leaf lesions， surfacesterilized with 75% ethanol for 45 s, rinsed three times with sterile water, air dried, and cultured on PDA at 25°C in the dark. Pure cultures were obtained by single-spore isolation after subculture. Ten representative single-spore isolates (MY-1 to MY-10) from 154 pathogens in 10 sampling points were selected for morphological characterization and identification. After 7 days, mycelial colonies were gray to dark gray with few aerial hyphae. Conidia (32.3 to 132.8 × 5.8 to 8.4 μm, average 81.4 × 6.3 μm, n=50) were pale to brown, erect or curved, solitary or in chains, with 0 to 15 pseudosepta. Based on morphological characteristics, the isolates were preliminarily identified as Corynespora cassiicola. Genomic DNA of isolate MY-2 (randomly selected from 10 isolates as representative) was extracted from mycelia using the Ezup DNA extraction kit (Sangon Biotech Co., Ltd. Shanghai, China). The ITS (internal transcribed spacer) region of rDNA, TEF1-α (translation elongation factor 1 alpha) and TUB2 (beta-tubulin) genes were amplified and sequenced with primers ITS4/ITS5, EF1-728F/EF-986R (Wang et al. 2021) and Bt2a/Bt2b (Glass et al. 1995), respectively. BLASTN sequence analyses of ITS (538 bp), TEF1-α (302 bp) and TUB2 (436 bp) of isolate MY-2 (GenBank accessions OK355515, OM339443, OM339442) showed 100%, 97.6%, 100% identity with C. cassiicola in GenBank (Accession numbers JX908713, MW961421, AB539228). A neighbor-joining phylogenetic analysis based on ITS and TEF1-α sequences using MEGA7 showed that MY-2 clustered in the same clade with C. cassiicola. For pathogenicity tests, five S. cusia plants were inoculated onto the adaxial surface of leaves with mycelial plugs from ten isolates of 8-day-oldcultures on PDA. Five leaves per plant were inoculated, covered with wet cotton, and kept in a controlled greenhouse (26~33 °C, RH 80% ~ 90%). Leaves inoculated with sterile PDA plugs served as a negative control. At 3-5 days post inoculation, all 25 inoculated leaves of each isolate showed leaf spot lesions similar to those observed in the field, and control leaves were symptomless. C. cassiicola was successfully reisolated from the diseased leaves. The pathogenicity tests were repeated three times under the same conditions and similar results were observed. In view of morphology, pathogenicity and sequence results, the isolates were identified as C. cassiicola, a pathogen reported from many important crops (Lu et al. 2021). This is the first report of C. cassiicola as a pathogen in China which poses a potential threat to leaf production and S. cusia processing. References: Glass, N. L., et al. 1995. Appl. Environ. Microb. 61:1323 Hu, J.Q., et al. 2011. Flora of China. Science Press, Beijing, China. Volume 19: 407 Li, Q.L., et al. 2013. Plant Dis. 97 (5): 690 Lu, P. et al. 2021. Plant Dis. 105:3753 Wang S. H., et al. 2021.Forest Pathology, 51(2):1 Keywords: fungal disease, Strobilanthes cusia, medicinal plants, etiology, leaf spot.

Hyperkalemia, one of the common complications of patients with chronic kidney disease (CKD), contributes an crucial risk factor affecting the prognosis of patients. The prevention and treatment of hyperkalemia has long been a clinically important topic. This article reviews the diagnosis, treatment and management of CKD combined with hyperkalemia in order to standardize its clinical diagnosis and treatment, achieve early detection, early diagnosis and early treatment, and thus improve the prognosis of patients.高钾血症是慢性肾脏病（CKD）患者常见的并发症之一，是影响患者预后的重要危险因素。高钾血症的防治一直是临床上需要高度重视的问题。本文对CKD合并高钾血症的诊治、管理进行阐述，以期规范CKD合并高钾血症的临床诊治，做到早发现、早诊断、早治疗，改善患者预后。.

目的 调查中国慢性髓性白血病（CML）患者的治疗现状。 方法 横断面研究，2020年4月末至5月中旬，以填写调研问卷的形式在全国范围内调研CML患者，分析酪氨酸激酶抑制剂（TKI）一线选择、目前用药、药物转换和获得主要分子学反应（MMR）的比例及其影响因素。 结果 2933份来自全国31个省市自治区CML受访者的问卷可供分析，男性1683例（57.4％），中位年龄38（16～87）岁。一线选择：伊马替尼2481例（84.6％），原创性新药（原研药）1803例（61.5％）。填写问卷时用药：伊马替尼1765例（60.2％），原研药1791例（61.1％）。共1185例（40.4％）受访者曾经历TKI药物转换。1944例初发慢性期受访者TKI中位治疗45（3～227）个月，1417例（72.9％）获得≥MMR的疗效。多因素分析显示，城镇户籍（OR＝0.6，95％CI 0.5～0.8，P

Purpose: This content analysis examined the literature underlying the Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children (i.e., the “Guideline”) to determine the extent to which social determinants of health (SDH) were examined or addressed. Methods: A published systematic review, that formed the basis for the Guideline, included 37 studies addressing diagnosis, prognosis, and treatment/rehabilitation. We examined those studies to identify SDH domains and associated subcategories derived from the Healthy People 2020 and 2030 websites. Pairs of raters coded each article with disagreements resolved by consensus. Results: At least one SDH domain was represented in 60% of the articles, usually mentioned descriptively, as a covariate, or as a design consideration. Very few were addressed as a primary focus of the study. The most frequently represented SDH domain was Education Access (43.2% of studies), receiving credit most often for reporting on participants with learning disabilities. Social and Community Context, broadly defined, was represented in nearly 1 of 3 studies (29.7%). Economic Stability and Health Care Access domains were included in 6 studies (16.2%). Some studies (k = 6, 16.2%) referenced SDH as important to consider for future research. The Guideline includes some commentary on health literacy and socioeconomic status. Conclusions: Social determinants of health are largely unrepresented as important or meaningful variables influencing the Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children, or in the studies included in the systematic review that informed the guideline.

Purpose: Immediate Post-Concussion and Cognitive Testing (ImPACT®) is among the most commonly used neuropsychological measures to establish a baseline estimate of neuropsychological functioning for concussion management. We sought to identify correlates of invalid performance on ImPACT® baseline testing in adolescents. Methods: The sample included 67,009 English-speaking adolescents (ages 14–18, mean: 15.51, SD: 1.22) who completed ImPACT® baseline tests in English between 2009 and 2019. The association between invalid performance (as determined by the embedded invalidity indicators) and demographic and health variables was assessed using chi-square tests and with odds ratios (OR). Results: Overall, 7.2% of adolescents produced invalid baseline tests. Boys (7.9%) produced more invalid baselines than girls (6.2%; χ2 = 70.35, p

目的 评价达沙替尼联合多药化疗方案在Ph染色体阳性急性淋巴细胞白血病（Ph+ ALL）患者中的疗效及安全性。 方法 前瞻性、单臂、开放的临床研究。2016年1月至2018年4月中国医学科学院血液病医院收治的30例初诊成人Ph+ ALL患者入组。采用多药化疗方案，标准诱导化疗为期4周，自诱导化疗第8天开始口服达沙替尼（商品名依尼舒，正大天晴药业集团股份有限公司产品）100 mg/d，持续应用至整体治疗结束。有条件和意愿进行移植者，可进行异基因造血干细胞移植或自体造血干细胞移植。 结果 所有30例患者在诱导治疗4周后均达到血液学完全缓解（HCR），累积完全分子学反应（MCR）率为70.0％（21/30）。中位随访时间为37.8（32.0～46.6）个月。3年总生存（OS）率为68.1％，3年无血液学复发生存（HRFS）率为61.6％。63.3％的患者在治疗3个月时达到主要分子学反应（MMR）（其中有43.3％患者达到MCR）。6个月时60.0％的患者达到MCR，达到MCR的患者具有更好的OS（P＝0.004）、HRFS（P＝0.049）和EFS（P＝0.001）。15例（50.0％）患者在第1次HCR期内进行移植，移植组患者HRFS（P＝0.030）和EFS（P＝0.010）优于化疗组。 结论 达沙替尼联合多药化疗方案治疗初诊Ph+ALL安全有效。 临床试验注册 ClinicalTrials.gov，NCT02523976。

Diabetic kidney disease (DKD) is the most common chronic complication of diabetes mellitus and the major cause of end stage renal disease (ESRD). Prediction, early diagnosis and evaluation of disease progression are crucial to improve the prognosis of DKD. Estimated glomerular filtration rate (GFR) and urinary albumin excretion rate (AER) are the main diagnostic biomarkers of DKD. However, the sensitivity and specificity are insufficient. In recent years, more and more attention has been paid to the value of novel biomarkers of DKD. This article reviews the clinical studies of novel biomarkers of DKD, in order to provide reference for clinical diagnosis and prognosis evaluation of DKD.糖尿病肾病（DKD）是糖尿病最常见的慢性并发症，是终末期肾脏病（ESRD）的主要病因。DKD的预警、早期诊断和评估疾病进展对于改善预后至关重要。估算肾小球滤过率（eGFR）和尿白蛋白排泄率（AER）是DKD的主要诊断依据，但灵敏度和特异度存在不足。近年来，DKD新型生物标志物的价值逐渐受到重视。本文对近年来DKD新型生物标志物的临床研究进行评述，为DKD临床诊断和预后评估提供参考。.

目的 评估伊马替尼对慢性髓性白血病慢性期（CML-CP）儿童身高的影响。 方法 2018年7月至2019年7月，在全国范围内对诊断时年龄0.05）。多因素分析显示，服药初始年龄较小（偏回归系数为0.122，B＝0.572，t＝10.733，P

目的 探讨利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病患者的疗效和安全性。 方法 收集2006年1月30日至2018年9月12日中国医学科学院血液病医院收治的11例Burkitt白血病患者病例资料，分析统计患者的临床特征、完全缓解（CR）率、总生存率、无复发生存率及不良事件。 结果 11例患者中位年龄34（15~54）岁，其中男6例，女5例。发病时中位WBC 12.28（2.21~48.46）×109/L，HGB 113（74~147）g/L，PLT 35（13~172）×109/L，乳酸脱氢酶2 721（803~17 370）U/L，外周血中位原始细胞比例0.40（0.03~0.76），骨髓中位原始细胞比例0.840（0.295~0.945）。10例患者接受利妥昔单抗联合短疗程、高强度化疗，其中2例患者巩固化疗后行自体造血干细胞移植。所有治疗患者1个疗程CR率为100%，4年总生存率为90%，4年无复发生存率为90%。所有治疗患者中，只有1例患者在诱导化疗中出现肿瘤溶解综合征，经血液透析等治疗后肾功能恢复。无治疗相关性死亡病例。 结论 利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病疗效及安全性均较为理想。

Cytokine storm syndrome (CSS) is a critical clinical condition induced by a cascade of cytokine activation, characterized by overwhelming systemic inflammation, hyperferritinaemia, haemodynamic instability and multiple organ failure (MOF). At the end of 2019, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) emerged in Wuhan, China, and rapidly developed into a global pandemic. More and more evidence shows that there is a dramatic increase of inflammatory cytokines in patients with COVID‐19, suggesting the existence of cytokine storm in some critical illness patients. Here, we summarize the pathogenesis, clinical manifestation of CSS, and highlight the current understanding about the recognition and potential therapeutic options of CSS in COVID‐19.

To investigate the role of long non-coding RNA (lncRNA) CACNA1G-AS1 in regulating proliferative and invasive abilities of colorectal cancer (CRC) cells by mediating p53, thus influencing the progression of CRC.CACNA1G-AS1 level in CRC tissues and adjacent normal tissues was first determined. Its level in CRC patients with different tumor stages was detected as well. Changes in proliferative and invasive abilities of HCT116 and SW480 cells influenced by CACNA1G-AS1 were evaluated. Subcellular distribution of CACNA1G-AS1 was analyzed. Through Western blot, RNA immunoprecipitation (RIP), and chromatin immunoprecipitation (ChIP) assay, the interaction between CACNA1G-AS1 and EZH2 was assessed. The biological function of the target gene of CACNA1G-AS1 was finally explored.CACNA1G-AS1 was upregulated in CRC tissues compared to adjacent normal ones. Its level remained higher in CRC patients with stage III-IV compared to those with stage I-II. Knockdown of CACNA1G-AS1 reduced proliferative and invasive abilities of HTC116 and SW480 cells. CACNA1G-AS1 was mainly distributed in the nucleus. Moreover, CACNA1G-AS1 was verified to interact with EZH2. Knockdown of CACNA1G-AS1 or EZH2 upregulated p53 level and decreased the recruitment ability of EZH2 on p53. Finally, p53 knockdown could partially reverse the regulatory effect of CACNA1G-AS1 on the proliferative ability of HCT116 cells.CACNA1G-AS1 downregulates p53 level by forming a carcinogenic complex with EZH2, thereby enhancing the proliferative and invasive abilities of CRC cells.

This study aims to detect the expression pattern of microRNA-375 in colorectal cancer (CRC), and to examine its specific mechanism in regulating the progression of CRC.We detected microRNA-375 expression in 50 pairs of CRC and paracancerous tissues by quantitative real-time polymerase chain reaction (qRT-PCR). Correlation between microRNA-375 expression and pathological indexes of CRC patients was analyzed. Cellular expression of microRNA-375 in CRC cell lines was detected as well. Regulatory effect of microRNA-375 on biological behaviors of CRC cells was examined, including proliferative, invasive and migratory abilities. We used bioinformatics method to predict the potential target of microRNA-375 and finally explored their interactive functions in regulating CRC progression.MicroRNA-375 expression remained higher in CRC tissues relative to paracancerous ones. CRC patients with a high level of microRNA-375 tended to have higher rates of lymph node metastasis and distant metastasis compared with those with a low level. Transfection of microRNA-375 inhibitor greatly reduced proliferative, invasive and migratory abilities of CRC cells. RECK was predicted to be the target of microRNA-375, which was downregulated in CRC tissues and cells. Besides, RECK expression was negatively regulated by microRNA-375 in CRC. Rescue experiments confirmed that microRNA-375/RECK axis promoted the malignant progression of CRC.MicroRNA-375 is upregulated in CRC, and correlated to lymph node metastasis and distant metastasis. MicroRNA-375 enhances invasive and migratory abilities of CRC cells via regulating RECK.

OBJECTIVE: To study the clinical outcomes and characteristics of fracture healing of a modified internal fixation method, which was implemented by placing four and two screws respectively at the proximal and distal end of the locking plate in the minimally invasive percutaneous plate osteosynthesis (MIPPO) for patients with proximal humeral fractures. METHODS: Patients in Peking University Third Hospital from February 2010 to December 2016 were brought into this retrospective study. Based on different operation methods, they were divided into minimally invasive (MI) group and non-minimally invasive (non-MI) group, and the patients in MI group were performed with the modified internal fixation. In order to observe the varying efficacy for different fracture types between the two groups, we further investigated the patients with Neer two-part and three-part fracture, respectively. The follow-up parameters included general physical examination, X-ray, visual analogue scale (VAS) and Constant-Murley score. RESULTS: A total of 117 patients with an average age of (61.5±16.2) years met the inclusion criteria, and MI group included 45 patients, non-MI group included 72 patients. According to the Neer classification, there were 46 cases of two-part fracture, 63 cases of three-part fracture and 8 cases of four-part fracture. In MI group, there were 17 males and 28 males with an average age of (62.2±17.1) years, including 18 cases of two-part fracture, 23 cases of three-part fracture and 4 cases of four-part fracture. In non-MI group, there were 27 males and 45 females with an average age of (60.1±17.7) years, including 28 cases of two-part fracture, 40 cases of three-part fracture and 4 cases of four-part fracture. There were no significant differences between the two groups in terms of gender (P=0.975), age (P=0.545) and fracture type (P=0.756). The average hospital-stay in MI group and non-MI group was (2.8±1.1) days and (4.3±1.3) days (P=0.023), the operation time was (67.8±14.9) min and (102.3±34.1) min (P

目的 回顾性分析中国慢性髓性白血病（CML）酪氨酸激酶抑制剂（TKI）自动停药患者的临床特征及转归情况。 方法 回顾性分析2005年6月1日至2018年3月1日国内7家单位109例自动停用TKI的慢性期CML患者临床资料，将其中具有明确停药结局及相对完整临床资料的91例患者进行统计分析，观察患者自动停药后获得无治疗缓解（TFR）情况及其影响因素。 结果 91例患者累积服用TKI中位时间为65（7~138）个月，其中21例患者有减停药史；患者达到主要分子学缓解（MMR）中位时间为开始服用TKI后6（3~57）个月；全部患者停药前达MR4.0。停药后中位随访9（1~72）个月，53例（58.2%）患者继续维持MMR，获得TFR；38例（41.8%）失去MMR。12个月和25个月的TFR率分别为61.4%和52.6%。31例停药后复发的患者再启动药物治疗，用药后再获得MMR的中位时间为3（1~12）个月。对比分析发现，Sokal评分（P=0.294）、累积服用TKI时间（P=0.827）、获得MMR所需时间（P=0.553），是否减停TKI（P=0.125）等因素对复发无明显影响。而停药前MMR维持时间越长（≥24个月）患者后期复发率越低（P=0.027）。 结论 达停药标准的中国CML患者能够安全停用TKI，停药后TFR率与国外报道相当。停药前MMR时间维持越长，停药后复发率越低。

目的 探讨微小残留病（MRD）水平在Ph染色体阴性的急性B淋巴细胞白血病（Ph− B-ALL）中的预后意义。 方法 采用多色流式细胞术对2010年9月至2017年11月初诊的193例Ph− B-ALL患者在治疗后1、3、6个月进行骨髓MRD监测，并对不同MRD水平患者的预后进行比较。 结果 中位随访22（1~92）个月，所有193例患者共行497次MRD检测。1个月时MRD水平

SUMMARYOne of the probable adverse effects of climate change on agriculture is yield loss due to water scarcity. Assessment of meteorological drought risk with the index of crop water deficit (CWD) can help in determining appropriate adaptation strategies to counter such losses. Using daily weather data from 68 stations in Northeast China (NEC) for 1961–2010, the spatial and temporal behaviour ofCWDwas assessed and the sensitivity of climatic variables related toCWDduring the potential growth period of maize was explored. The results indicated that the potential maize growth period decreased by 26 days due to climate warming. The deficit (i.e. a negative value for water demand) decreased from east to west and decreased gradually during 1978–1984 and sharply during 2000–2010. It is noteworthy that NEC experienced severe droughts especially in the 1970s and the 2000s, and relative humidity was the most sensitive parameter affecting evapotranspiration. Regions in the middle of Heilongjiang and Jilin should take precautions concerning climate change effects onCWD, while the northern part of NEC should take precautions concerning changes in temperature and sunshine hours. Growing late-maturing and drought-tolerant maize varieties is therefore a good option for higher production in NEC, coupled with enhancing the availability of water in this limited-rainfall region, and should form a part of the strategy to cope with climate change.

目的 分析MLL基因重排成人急性髓系白血病（AML）的临床、实验室特征及预后情况。 方法 回顾性分析2010年1月至2016年12月确诊的92例MLL基因重排成人AML患者的临床和实验室资料。 结果 1 417例成人AML（不包括急性早幼粒细胞白血病，均采用FISH方法进行了MLL基因重排分析）患者中检出92例（6.5%）MLL基因重排患者，男女性别比为1∶1，诊断时中位年龄为35.5（15~64）岁，中位WBC 21.00（0.42~404.76）×109/L。按FAB分型标准，78例（84.8%）患者属于急性单核细胞白血病。32例患者检测了11种MLL常见伙伴基因，其中MLL/AF9阳性9例（28.1%），MLL/AF6阳性5例（15.6%），MLL/ELL阳性5例（15.6%），MLL/AF10阳性2例（6.3%），MLL/SETP6阳性1例（3.1%），余10例（31.3%）患者的伙伴基因未知。83例患者可进行疗效分析，中位随访时间为10.3（0.3~74.0）个月，完全缓解（CR）率为85.5%，中位总生存（OS）和无复发生存（RFS）时间分别为15.4和13.1个月，2年OS和RFS率分别为36.6%和29.5%。31例患者进行了异基因造血干细胞移植（allo-HSCT），移植患者的2年OS和RFS率分别为57.9%和52.7%，未移植患者分别为21.4%和14.9%，差异均有统计学意义（P值均

目的 研究WT1基因作为微小残留病（MRD）监测指标在急性髓系白血病（AML）预后中的应用，并探索WT1 mRNA预测复发的阈值。 方法 回顾性分析121例诱导缓解并行巩固治疗的AML患者（非急性早幼粒细胞白血病）WT1 mRNA的动态表达水平。比较巩固治疗后不同转归组患者的WT1 mRNA表达水平，依据受试者工作特征（ROC）曲线确定可预测临床复发的WT1 mRNA阈值。WT1 mRNA水平采用实时定量聚合酶链反应（RQ-PCR）法检测。 结果 确立WT1 mRNA>2.98%提示高风险复发。为了临床应用方便，将提示复发的WT1 mRNA阈值设为3.00%。41例患者初诊时检测了WT1 mRNA水平，剔除3例初诊WT1 mRNA低于3.00%的患者，余下38例患者初诊WT1 mRNA中位值为44.09%（7.19%~188.06%）。缓解期351份标本WT1 mRNA检测值中位为0.48%（0~8.41%）。初诊WT1 mRNA水平高于缓解期水平。除外初诊WT1 mRNA水平低于3.00%的3例患者，巩固治疗开始后WT1阳性组（>3.00%）和阴性组（≤3.00%）复发率分别为70.0%（14/20）和12.2%（12/98）（P3.00%提示存在复发风险。

目的 研究泊沙康唑初级预防急性髓系白血病（AML）诱导化疗期侵袭性真菌感染（IFI）的发生率及静脉抗真菌药物使用率。 方法 回顾性分析2014年2月至2016年1月≥15岁初诊且接受初始缓解诱导化疗的147例AML（除外急性早幼粒细胞白血病）患者，观察诱导化疗期间接受泊沙康唑抗真菌预防治疗（泊沙康唑组）和未进行广谱抗真菌预防治疗（对照组）IFI的发生率及静脉抗真菌药物使用率。 结果 147例患者中，81例诱导化疗期间接受泊沙康唑抗真菌预防治疗，为泊沙康唑组；66例未进行广谱抗真菌预防，为对照组。泊沙康唑组中7例发生IFI，发生率为8.6%，均为拟诊病例。对照组患者中19例发生IFI，发生率为28.8%，其中确诊3例，临床诊断4例，拟诊12例。泊沙康唑组IFI发生率显著低于对照组（χ2=10.138，P=0.001）。泊沙康唑组静脉抗真菌药物使用率为18.5%（15/81），显著低于对照组的50.0%（33/66）（χ2=16.390，P

目的 分析CD10阴性的前B急性淋巴细胞白血病（CD10−pre B-ALL）患者的临床特征和预后。 方法 对6例成人CD10− pre B-ALL患者的临床和实验室资料进行回顾性分析，结合文献复习明确该类型患者的临床特征及预后。 结果 CD10−pre B-ALL占ALL的1.5%（6/409），占B-ALL的1.8%（6/343），占pre B-ALL的11.5%（6/52）。6例患者均为男性，中位年龄为33.5岁，起病时中位WBC为101.78×109/L，所有患者均伴有MLL-AF4融合基因表达。5例患者经1个疗程诱导化疗即获得完全缓解（CR），1例患者经3个疗程化疗后才获得CR。2例患者在CR1期行异基因造血干细胞移植（allo-HSCT），1例患者CR后短期内即复发，在CR2期行allo-HSCT。1例患者正在等待移植。2例未移植患者1例复发死亡，1例尚处于缓解状态。 结论 CD10−pre B-ALL是一类具有独特临床特征的成人ALL亚型，发生率较低，常见于男性，起病时白细胞水平较高，MLL-AF4融合基因表达率高，常规化疗具有较高的缓解率，但易复发，allo-HSCT有可能改善其预后。

To evaluate the effect and mechanism of bone marrow stem cells (BMSCs) modified with CXCR-4 gene combined with stromal derived factor-1α (SDF-1α) in the treatment of acute spinal cord injury (SCI) in rats.CXCR-4 gene was transfected by a virus. Spinal cord injury rats were randomly divided into four groups: control group, SDF-1α group, CXCR-4/BMSC group and combined group. The motor function was evaluated with Blood Brain Barrier (BBB) score and the RNA expression of CXCR-4 were measured by PCR. Apoptosis of spinal cord was measured by TUNEL kit (Hu Bei, China). The protein level of Bcl-2 and Bax were measured by Western-blot. The BBB scores, mRNA CXCR-4 expression, and apoptosis rate were compared between four groups at 1d, 3d, 7d, 14d, 21d after the operation.The exercise ability in combined group restored in early and late periods of SCI. The apoptosis rates in the combined group are less than other three groups; the difference was statistically significant (p0.05). Bcl-2 in combined group is higher than the other 3 groups and Bax is less than the other 3 groups, the difference is statistically significant (p0.05).The neurological function of rats with a spinal cord can be improved by BMSCs modified with CXCR-4 combined with SDF-1α. The main mechanism may improve the expression of SDF-1α and decrease the apoptosis of the spinal cord.

目的 探讨真实世界中伊马替尼(IM)联合化疗治疗BCR-ABL阳性急性淋巴细胞白血病(ALL)的疗效及相关预后因素。 方法 2003年4月至2015年8月收治的209例治疗中包含IM的BCR-ABL阳性ALL患者纳入研究，106例患者接受造血干细胞移植(HSCT)。对患者的疗效和预后影响因素进行分析。 结果 初诊患者诱导完全缓解(CR)率为97.9%。初诊时WBC≥100×109/L是总生存(OS)的不良预后因素(P=0.043)。未接受HSCT、诱导治疗4周内未达CR和治疗过程中未达到分子生物学完全缓解(CMR)是OS(P值分别为0.05)。首次诱导治疗时联用IM的患者较未联用者显示出更高的5年RFS率(37.0％对24.0%，P= 0.005)。在治疗过程中持续规律服用酪氨酸激酶抑制剂(TKI，40例患者由于复发、转录本水平下降不理想或出现突变换用其他TKI)的患者生存情况最佳，其次为骨髓抑制期间断停用TKI的患者，不规律服用TKI的患者生存情况最差，三组5年OS率分别为46.0%、28.0%、17.0%(P=0.004)，5年RFS率分别为38.0%、28.0%、17.0%(P

The aim of this study was to evaluate the diagnostic values by detecting sera autoantibodies to eight tumor-associated antigens (TAAs) of P53, IMP1, P16, cyclin B1, P62, C-myc, Survivn and Koc full-length recombinant proteins for the screening of high-risk subjects and early detection of esophageal squamous cell carcinoma (ESCC). Enzyme-linked immunosorbent assay was used to detect autoantibodies against the eight selected TAAs in 567 sera samples from four groups, including 200 individuals with normal esophageal epithelia (NOR), 214 patients with esophageal basal cell hyperplasia (BCH), 65 patients with esophageal dysplasia (DYS), and 88 patients with ESCC. In addition, the expression of the eight antigens in esophageal tissues was analyzed by immunohistochemistry. Statistically significant distribution differences were identified among the four groups for each of the individual autoantibodies to six TAAs (P53, IMP1, P16, cyclin B1, P62, and C-myc); the detection rates of antoantibodies were positively correlated with the progression of ESCC. When autoantibody assay successively accumulated to six TAAs (P53, IMP1, P16, cyclin B1, P62, and C-myc), a stepwise increased detection frequency of autoantibodies was found in the four sera groups (6% in NOR, 18% in BCH, 38% in DYS, and 64% in ESCC, respectively), the risks to BHC, DYS, and ESCC steadily increased about 3-, 9-, and 27-folds. The sensitivity and the specificity for autoantibodies against the six TAAs in diagnosing ESCC reached up to 64% and 94%, respectively. The area under the receiver operating characteristic curve for the six anti-TAA autoantibodies was 0.78 (95% confidence interval 0.74-0.83). No more increasing in sensitivity was found with the addition of new anti-TAA autoantibodies. A combination detection of autoantibodies to TAAs might distinguish ESCC patients from normal individuals and the patients with esophageal precancerous lesions.

Poster presentada en el 50th ERA-EDTA Congress (European Renal Association - European Dialysis Transplant Association), celebrado del 18 al 21 de mayo de 2013 en Estambul (Turquia)

To explore the cytogenetic and prognostic significance of monosomal karyotype (MK) in adult patients with acute myeloid leukemia (AML).From September 2002 to November 2014 in Blood Diseases Hospital, Chinese Academy of Medical Sciences, 97 cases with AML were enrolled, including 96 cases within unfavorable cytogenetic category and an MK case within the intermediate category. The clinical data of MK-positive cases and unfavorable risk MK-negative cases were analyzed.There were 31 MK cases, accounting for 2.5% of the AML patients treated at the same period. Thirty of them were complex aberrant karyotypes defined as showing three or more clonal abnormalities and classified into adverse group based on SWOG criteria. The rest one of these 31 MK was intermediate risk according to SWOG criteria. Among MK cases, the most frequent monosomal chromosome were -17, -5, -7, -21, -8, -22. In 96 cytogenetic unfavorable AML cases, the median OS period was 6.1 months for MK, the median OS period did not reach for non-MK AML (P=0.001). And the median relapse free survival (RFS) period was 3.1 and 18.6 months for MK and non-MK AML (P0.001), respectively. Both overall survival (OS) and RFS varied significantly between MK and non-MK categories. In 49 complex karyotype AML cases, the median OS was 6.1 and 10.8 months for MK and non-MK AML (P=0.088), respectively. And the median RFS was 3.1 and 8.6 months for MK and non-MK AML (P=0.009), respectively. The RFS varied significantly between MK and non-MK categories.Most MK patients were complex karyotype in cytogenetic unfavorable group. Within unfavorable or complex karyotype categories, MK-positive cases had a more adverse prognosis than MK-negative cases.

To compare the efficacy and toxicities of combining homoharringtonine (HHT)±daunorubicin (DNR) with all-trans-retinoic acid (ATRA) based therapy and DNR plus ATRA based therapy in newly diagnosed low/intermediate risk acute promyelocytic leukemia (APL).A total of 96 newly diagnosed patients with APL were randomized to HHT group, DNR group and HHT+ DNR group prospectively. The complete remission (CR) rate, the overall survival (OS) and event-free survival (EFS) of three groups were analyzed.There were 31 patients in HHT group, 33 patients in DNR group and 32 patients in HHT+ DNR group. The baseline characteristics of three groups were similar. No patient died during induction therapy. The morphologic CR rate was 100.0%. The median time to peak WBC counts in HHT+DNR group (4 days, range: 1-23 days) was significantly shorter than that in HHT group (9 days, range: 1-27 days) (P=0.008) and DNR group (7 days, range: 1-27 days) (P=0.240). There was no difference among three groups about the incidence of differentiation syndrome, the median interval to achieve CR, peak WBC counts and transfusions (P0.05). All patients achieved complete molecular remission (CMR) during consolidation therapy. The interval to achieve CMR was no significantly difference among three groups (P0.05). The 3-year OS rates for HHT group, DNR group and HHT+DNR group were 95.0%, 100.0% and 91.0%, respectively (P=0.595). The 3-year EFS rates for three groups were 93.0%, 90.0% and 85.0% (P=0.382). No difference was found in the incidence of adverse events among three groups (P0.05).Similar to DNR plus ATRA based therapy, HHT plus ATRA based induction and consolidation therapy should be one of highly-efficient treatment options for newly diagnosed APL. Clinical trial registration Chinese Clinical Trial Registry, ChiCTR-TRC-12002628.

We investigate the two pion production in NN collision reaction at threshold with Chiral Perturbation Theory (ChPT). The leading-order diagrams are presented and as an example we give the results of complete calculation of the reaction pn → d ππ at threshold. It is found that the leading order diagrams are of equal importance as expected by power counting. The role of initial, intermediate and final state interactions in nucleon-nucleon system is also investigated and found to be very important. The calculations also show that the non-resonant contributions near threshold in the two-pion production in NN collision reaction is sizable and important.

A mathematical model based on an inverse heat transfer calculation was built to determine the heat flux between the mould and slab based on the measured mould temperatures. With K–ϵ turbulence model, a mathematical model of three-dimensional heat transfer and solidification of molten steel in continuous slab casting mould is developed. Solidification has been taken into consideration, and flow in the mushy zone is modelled according to Darcy’s law as is the case of flow in the porous media. The heat flux prescribed on the boundaries is obtained in the inverse heat conduction calculation; thus, the effect of heat transfer in the mould has been taken into consideration. Results show that the calculated values of mould temperature coincide with the measured ones. Results also reveal that the temperature distribution and shell thickness are affected by the fluid flow and heat transfer of slab which is governed by the heat flux on the mould/slab interface.

Displacement results are usually used as the criterion for distortion of castings during casting and heat treatment processes. However, the displacement results consist of both contraction and distortion. Contraction is a kind of uniform volume change, which can be solved by enlarging the castings by a contraction coefficient. However, the actual distortion has to be deleted by giving inverse distortion or by mechanical correction method. In this paper, algorithms are presented to evaluate the distortion of castings. One method is to subtract the uniform contraction from the displacement results. The other is to calculate the deflection angle between the normal direction of the discretised surface triangle of the original casting shape in stereolithography format and that of the simulated casting shape. The third one is the application of actual machining allowance in the evaluation of distortion. These methods are validated by three case studies, including a heavy hydroturbine blade casting.

A coupled thermomechanical finite element model has been developed to simulate the temperature, stress and shape development during the solidification process of squeeze casting. In the model, the effect of latent heat and volume shrinkage due to solidification, and the mutual dependence of interfacial heat transfer and casting deformation were taken into account. A thermo-elasto-viscoplastic constitutive model was adopted for simulating the response of the solidified shell to the squeeze pressure, and an iterative approach was employed to calculate the displacement of the punch in each time step. The model can be used to investigate the evolution of temperature and stress distribution in the casting during the solidification process.

A water modelling experiment was conducted to study the meniscus instability in a continuous thin slab casting mould using particle image visualisation. The results show that the level fluctuation, circulation centre position and jet impinging depth are unsteady and periodic with a similar period. The probability distributions of the fluctuating meniscus and wave height have been obtained with the highest frequency near the average position. The flow pattern and meniscus profile may be momentarily asymmetrical, and the phase difference of level fluctuation in the two sides of mould centreline is a half period. The average meniscus profile, the highest and lowest meniscus positions are generally symmetrical about the mould centreline. The wave height mainly depends on the jet impinging depth and circulation centre position. The wave height increases as the jet impinging position rises and the circulation centre approaches to the submerged entry nozzle.