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Chronic myeloid leukemia (CML) is a rare disease among children. A retrospective study was conducted from November 2002 to March 2019 at a single institution in China. A total of 36 pediatric CML patients (25 male and 11 female) were enrolled. Median follow-up time was 51 months (range 8–144), and 5-year overall survival and event-free survival were 95.5 ± 4.4% and 88.9 ± 6.0%, respectively. Among the 25 patients whose response to imatinib mesylate (IM) was regularly monitored, 92.0% achieved complete hematologic response at 3 months, 80.0% achieved complete cytogenetic response at 12 months, and 64.0% achieved major molecular response at 18 months after IM therapy. A higher WBC count at diagnosis was associated with failure to achieve early molecular response (EMR). Height standard deviation score after long-term treatment was significantly and positively correlated with age at diagnosis and at the start of IM therapy. Overall, IM therapy was effective in treating pediatric CML, and WBC count at diagnosis might be an ideal predictor of EMR. Moreover, retardation of height and weight growth due to IM tended to affect patients younger than 9 years old at diagnosis, and longitudinal growth might normalize further into treatment.

Background To determine the risk-assessment role of the immune-inflammatory biomarkers on myocardial damage in COVID-19 patients with diabetes mellitus (DM). Methods This retrospective study was conducted on 822 COVID-19 inpatients from 1 January to 10 March 2020 at Renmin Hospital of Wuhan University. The demographic data, clinical data, and immune-inflammatory parameters of participants were collected. The predictors of cardiac injury were assessed by Logistics regression analysis. Results A total of 246 COVID-19 inpatients were diagnosed with DM (29.9%). The incidence of cardiac injury was higher in patients with DM than in non-DM cases (28.9% vs 9.0%, p < 0.001), even grouped by age, gender, and the level of fasting plasma glucose (FPG). The mortality in diabetic COVID-19 patients with cardiac injury and without cardiac injury was 42.9% and 3.4%, respectively ( p  < 0.001). COVID-19 patients with DM and cardiac injury presented a decreased number of immunocyte subsets, lower C3 concentration, and a higher level of interleukin-6 (IL-6) and immunoglobulin A (IgA). The independent risk factors for cardiac injury in COVID-19 patients with DM were CD3 + CD4 + T cells counts ≤ 288 cells/μl (adjusted Odds ratio (OR), 2.501; 95% confidence interval (CI) 1.282–4.877; p  = 0.007) and IL-6 > 25.68mpg/ml (adjusted OR, 4.345; 95% CI 2.192–10.374; p  < 0.001) (all P interaction < 0.05). Conclusions For diabetic patients with COVID-19, cardiac injury not only induce severer immune-inflammatory responses, but also increase in-hospital mortality. The decreased number of CD3 + CD4 + T cells and increased IL-6 are recommended to distinguish the people who refer to high risk of cardiac injury and mortality from those persons. However, it remains a testable theory whether decision-making strategies based on the risk status of cardiac injury in COVID-19 patients, especially with DM, would be expected to get better outcomes.

The aim of the present study was to investigate the effects of Ginkgo biloba leaf extract (GBLE), shenmai (S), and matrine (M) on human embryonic lung fibroblasts (HELFs). HELFs were allocated into the following groups: Group A (control group), group B [transforming growth factor β1 (TGF-β1) model group], groups C1-3 (TGF-β1 + low-, moderate- and high-dose GBLE), groups D1-3 (TGF-β1 + low-, moderate- and high-dose S) and groups E1-3 (TGF-β1 + low-, moderate- and high-dose oM). Cell proliferation was assessed with an MTT assay and apoptosis was measured by annexin V/propidium iodide double staining and flow cytometry analysis. Collagen type I (COL-I), collagen type III (COL-III), α-smooth muscle actin (α-SMA) and extracellular superoxide dismutase (ECSOD) mRNA expression levels were measured using semi-quantitative reverse transcription-polymerase chain reaction, and protein content was measured using ELISA. The cell growth inhibition rates of the S groups were significantly higher than those of the other treatment groups (P<0.05). The rate of apoptosis was significantly increased in the treatment groups compared with the model group (P<0.05), and S induced a significant increase in HELF apoptosis compared with the other treatment groups (P<0.05). The mRNA and protein expressions of COL-III, COL-I and α-SMA in the GBLE, S and M groups were significantly decreased, while the expression of ECSOD was significantly increased when compared with the model group (P<0.05). In conclusion, GBLE, S and M inhibited the pro-fibrotic role of TGF-β1 by targeting different steps in TGF-β1-mediated fibrosis.

Objective Waist circumference (WC) has been linked to exacerbations in chronic obstructive pulmonary disease (COPD), but the relationship between WC, height, and the Body Roundness Index (BRI) with mortality in COPD patients remains unclear. This study investigates the association between BRI and both all-cause and cardiovascular mortality in COPD patients. Methods Data from 3,672 COPD participants (1,517 men and 2,155 women; mean age: 53.17 ± 16.46 years) were obtained from NHANES (1999–2018). Multivariable Cox proportional hazards models, Kaplan–Meier analysis, Nelson-Aalen cumulative hazard plots, and restricted cubic spline analyses were used to assess the relationship between BRI and mortality. ROC curves were constructed to evaluate BRI’s predictive performance. Subgroup and sensitivity analyses ensured robustness of the models. Results The BRI was associated with all-cause (HR: 1.12, 95% CI: 1.05–1.19) and cardiovascular mortality (HR: 1.14, 95% CI: 1.01–1.29). Kaplan–Meier curves and Nelson-Aalen plots demonstrated that higher BRI quartiles correlated with lower survival probabilities and increased cumulative mortality incidence. ROC curve analysis showed that BRI outperformed other models in predicting all-cause [AUC: 0.81 (0.79–0.82)] and cardiovascular mortality [AUC: 0.79 (0.76–0.81)]. A significant interaction was observed between BRI and alcohol consumption for all-cause mortality. Results remained consistent after excluding participants who died within two years (HR: 1.10, 95% CI: 1.03–1.18) and in the alcohol-consuming subgroup (HR: 1.14, 95% CI: 1.05–1.24). Conclusion The BRI is associated with increased all-cause and cardiovascular mortality in COPD patients, with higher BRI quartiles linked to greater mortality risk. Targeting BRI may offer a potential strategy to reduce mortality in this population.

Objectives To explore the relationship between waist-to-height ratio (WHtR) and the risk of cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD), and to analyze the mediating role of prognostic nutritional index (PNI) in this association. Methods This study was based on the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2018, including a total of 1,013 eligible COPD patients. Multivariate logistic regression analysis was used to evaluate the association between WHtR and CVD, and restricted cubic spline regression was applied to explore their non-linear relationship. Meanwhile, mediating effect analysis (Hayes Process Macro Model 4) was conducted to investigate the mediating role of PNI between WHtR and CVD. Results WHtR was an independent risk factor for cardiovascular disease in COPD patients (OR = 5.76, P  = 0.028). Restricted cubic spline results showed a positive correlation between WHtR and CVD risk without a significant non-linear relationship (P for non-linearity = 0.247). Mediation analysis revealed that PNI played a partial mediating role between WHtR and CVD (the indirect effect accounted for 7.98% of the total effect, P  < 0.001), suggesting that WHtR may increase CVD risk by affecting the body’s nutritional status. Conclusion WHtR is an important predictor of CVD in COPD patients, and PNI exerts a partial mediating effect between them. Controlling WHtR and improving nutritional status may help reduce the risk of cardiovascular disease in COPD patients.

This study aims to elucidate the role of mitochondrial autophagy in metabolic dysfunction-associated steatohepatitis (MASH) by identifying and validating key mitophagy-related genes and diagnostic models with diagnostic potential. The gene expression profiles and clinical information of MASH patients and healthy controls were obtained from the Gene Expression Omnibus database (GEO). Limma and functional enrichment analysis were used to identify the mitophagy-related differentially expressed genes (mito-DEGs) in MASH patients. Machine learning models were used to select key mito-DEGs and evaluate their efficacy in the early diagnosis of MASH. The expression levels of the key mito-DEGs were validated using datasets and cell models. A nomogram was constructed to assess the risk of MASH progression based on the expression of the key mito-DEGs. The mitophagy-related molecular subtypes of MASH were evaluated. Four mito-DEGs, namely MRAS, RAB7B, RETREG1, and TIGAR were identified. Among the machine learning models employed, the Support Vector Machine demonstrated the highest AUC value of 0.935, while the Light Gradient Boosting model exhibited the highest accuracy (0.9189), kappa (0.7204), and F1-score (0.9508) values. Based on these models, MRAS, RAB7B, and RETREG1 were selected for further analysis. The logistic regression model based on these genes could accurately predict MASH diagnosis. The nomogram model based on these DEGs exhibited excellent prediction performance. The expression levels of the three mito-DEGs were validated in the independent datasets and cell models, and the results were found to be consistent with the findings obtained through bioinformatics analysis. Furthermore, our findings revealed significant differences in gene expression patterns, immune characteristics, biological functions, and enrichment pathways between the mitophagy-related molecular subtypes of MASH. Subtype-specific small-molecule drugs were identified using the CMap database. Our research provides novel insights into the role of mitophagy in MASH and uncovers novel targets for predictive and personalized MASH treatments.

Background Defects of bone marrow mesenchymal stem cells (BM-MSCs) in proliferation and differentiation are involved in the pathophysiology of aplastic anemia (AA). Infusion of umbilical cord mesenchymal stem cells (UC-MSCs) may improve the efficacy of immunosuppressive therapy (IST) in childhood severe aplastic anemia (SAA). Methods We conducted an investigator-initiated, open-label, and prospective phase IV trial to evaluate the safety and efficacy of combination of allogenic UC-MSCs and standard IST for pediatric patients with newly diagnosed SAA. In mesenchymal stem cells (MSC) group, UC-MSCs were injected intravenously at a dose of 1 × 10 6 /kg per week starting on the 14th day after administration of rabbit antithymocyte globulin (ATG), for a total of 3 weeks. The clinical outcomes and adverse events of patients with UC-MSCs infusion were assessed when compared with a concurrent control group in which patients received standard IST alone. Results Nine patients with a median age of 4 years were enrolled as the group with MSC, while the data of another 9 childhood SAA were analysed as the controls. Four (44%) patients in MSC group developed anaphylactic reactions which were associated with rabbit ATG. When compared with the controls, neither the improvement of blood cell counts, nor the change of T-lymphocytes after IST reached statistical significance in MSC group (both p  > 0.05) and there were one (11%) patient in MSC group and two (22%) patients in the controls achieved partial response (PR) at 90 days after IST. After a median follow-up of 48 months, there was no clone evolution occurring in both groups. The 4-year estimated overall survival (OS) rate in two groups were both 88.9% ± 10.5%, while the 4-year estimated failure-free survival (FFS) rate in MSC group was lower than that in the controls (38.1% ± 17.2% vs. 66.7% ± 15.7%, p  = 0.153). Conclusions Concomitant use of IST and UC-MSCs in SAA children is safe but may not necessarily improve the early response rate and long-term outcomes. This clinical trial was registered at ClinicalTrials.gov, identifier: NCT02218437 (registered October 2013).

This study retrospectively analyzed the clinical outcome of 172 children with newly diagnosed severe aplastic anemia (SAA) between January 2008 and April 2018, who received rabbit antithymocyte globulin (ATG) and cyclosporine (CsA) as first-line treatment. The median age at diagnosis was 5 years (range, 1–14). The overall response rates were 22.7%, 45.3%, and 61% at 40 days, 3 months, and 6 months, respectively, after rabbit ATG. In multivariate analysis, mild disease severity was the only predictor of favorable response at 6 months (P = 0.006). In the present study, median follow-up period was 63 months (range, 1–135). The 5-year overall survival (OS) and failure-free survival (FFS) rates were 90.5% and 70.4%. Multivariate analysis showed that erythroid burst-forming units (BFU-E) > 2/105 bone marrow mononuclear cell (BMMNC) (P = 0.037) and time interval before IST ≤ 30 days (P = 0.017) were independent positive predictors for OS, meanwhile BFU-E > 2/105BMMNC (P = 0.029) was the only favorable prognostic factor for FFS.

This study aimed to examine the association between hypertension and cardiovascular comorbidities in patients with chronic obstructive pulmonary disease (COPD) and to construct a nomogram for predicting the risk of cardiovascular comorbidities in this population. This retrospective study included 1,447 patients with chronic obstructive pulmonary disease (COPD) and no pre-existing cardiovascular disease (CVD) from January 2018 to February 2022 at the Second Affiliated Hospital of Guangdong Medical University, with follow-up extending until August 2025. Patients were randomly assigned to a training cohort ( = 1,012) and an internal validation cohort ( = 435) in a 7:3 ratio. Additionally, 624 patients treated at the Affiliated Hospital of Guangdong Medical University between January 2019 and December 2019 were included as an external validation cohort. Variables with non-zero coefficients were first selected using least absolute shrinkage and selection operator (LASSO) regression and were subsequently entered into univariable and multivariable logistic regression analyses. A nomogram was then constructed based on the results of the multivariable logistic regression, and the predictive performance of the nomogram was further evaluated. The predictors incorporated into the nomogram model were age, diabetes mellitus, hypertension, and edema. The nomogram demonstrated good discriminative performance, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.82 (95% CI: 0.78-0.85) in the training cohort, 0.82 (95% CI: 0.77-0.87) in the internal validation cohort, and 0.90 (95% CI: 0.87-0.93) in the external validation cohort. This study demonstrated that the nomogram shows good discriminative performance and can effectively estimate the risk of cardiovascular disease in patients with chronic obstructive pulmonary disease. Age, diabetes mellitus, hypertension, and edema were identified as independent predictors.

Juvenile myelomonocytic leukemia (JMML) is an aggressive pediatric myeloproliferative disease, and newly diagnosed patients frequently cannot tolerate hematopoietic stem cell transplantation (HSCT) at diagnosis due to their poor condition. This retrospective analysis aimed to explore the short-term effect of decitabine-dominant therapy on improving the condition of JMML patients before HSCT. The subjects were 10 JMML patients. All patients were treated with decitabine after low-dose chemotherapy with an interval of 4 weeks before bridging to HSCT. The median treatment course was 3 cycles, and the overall response rate (ORR) was 70.0% after one cycle and 71.4% after three cycles. White blood cell (WBC) and monocyte counts were significantly lower after treatment, and spleen volume was also lower, though not significantly lower. The 12 month progression-free survival rate (PFS) was 80.0 ± 12.6%. Decitabine-dominant therapy was beneficial for reducing tumor burden and improving clinical condition.