The effects of nitrogen (N) application rates and N topdressing at different leaf growth stages on the yield, N absorption, and utilization of japonica rice cultivar Nanjing 9108 were studied to screen the optimal N management mode for high yield and high N use efficiency. A field experiment was conducted from 2023 to 2024, with nine N regulation treatments (94-351 kg ha-1) established through dynamic allocation of basal, tillering, and topdressing fertilizers. The results showed that with the increase of N application rate, the yield and N use efficiency of Nanjing 9108 first increased and then decreased. At a total N application rate of 270 kg ha-1, the N6 treatment (basal N + tiller N + topdressing at the 13th leaf stage) demonstrated optimal overall performance, achieving the highest yield and N use efficiency. Topdressing at the 13th leaf stage (coinciding with young panicle differentiation) promoted spikelet differentiation and large panicle formation, increasing grains per panicle by 2.36-2.20% compared to other treatments under the same N rate. The N6 treatment exhibited enhanced N uptake and utilization: N accumulation increased by 39.27-67.12% during the elongating to heading stage and by 7.14-62.24% during heading to maturity, while N apparent efficiency and agronomic efficiency rose by 3.51-14.68% and 29.22-58.25%, respectively. At heading, the proportion of high-effective leaf area in N6 was 1.52-7.05% higher than in N4, N5, and N7 treatments, accompanied by a slower leaf area decay rate. These traits provided sustained photosynthetic support for dry matter accumulation in mid-to-late growth stages. Consequently, dry matter accumulation in N6 increased by 5.85-33.44% (elongating to heading) and 0.42-26.98% (heading to maturity), leading to a yield advantage of 3.8-17.2% over other treatments. In summary, the N management strategy combining basal, tiller, and 13th-leaf topdressing at 270 kg ha-1 is most effective for achieving both high yield and high N efficiency in Nanjing 9108.

Context: Currently, indica rice cultivation faces significant challenges in achieving coordinated enhancement of high yield, superior quality, and nitrogen use efficiency (NUE). Carbon-nitrogen (C-N) metabolic coordination is recognized as a pivotal trait for attaining this goal. Objective: This study aims to systematically analyze the dynamic characteristics of C-N metabolism under nitrogen (N) regulation and clarify their mechanistic roles in synergistically improving the yield-quality-NUE relationship. Methods: In this study, the indica rice cultivar Quanliangyou 851 was used with nine N regulation treatments (78.75-292.5 kg ha-1) established through dynamic allocation of basal, tillering, supplementary, and panicle fertilizers. This approach shaped distinct C-N metabolic patterns across the growth cycle. Results: Treatments under phased insufficient N supply conditions always exhibited low yield and poor rice appearance quality, treatments with a total N application of 225 kg ha-1 achieved yield increases (9.50-10.35 x 103 kg ha-1) through supplementary or panicle fertilization. Notably, appropriate dosage and application period of nitrogen (N6 treatment, panicle fertilizer applied at the 13th leaf stage) significantly increased the total spikelet number and stem-sheath non-structural carbohydrate (NSC) translocation rate, thereby achieving higher yield and partial factor productivity of nitrogen (PFPN). Furthermore, its optimization of carbon-dominated assimilate allocation during grain filling mitigated the negative impact of excessive protein accumulation on rice taste value, ultimately demonstrating optimal yield-quality-NUE synergy through balanced carbon-nitrogen metabolism. A comprehensive evaluation of yield-quality-NUE based on the Analytic Hierarchy Process (AHP) model revealed strong correlations between comprehensive evaluation scores and C-N metabolism indicators. Stepwise regression modeling further validated that SPAD decay rate ((3=-0.4), the ratio of stemsheath NSC accumulation (NSCA) to stem-sheath N accumulation (NA) at heading (NSCA/NA) ((3= 0.62), and the ratio of LAI to SPAD value at heading stage (LAI/SPAD) ((3=1.20) collectively explained 87.1 % of the synergistic variation (R2=0.871). This demonstrates that efficient C-N metabolic coordination is crucial for synergistic yield-quality-NUE improvement. Conclusion: The synergistic improvement in yield, quality, and NUE achieved by applying panicle fertilizer at the 13th leaf stage (225 kg ha-1) is fundamentally underpinned by the regulated balance of C-N metabolism. This balance optimizes sink strength, assimilate allocation, and nitrogen remobilization. Furthermore, NSCA/NA, LAI/SPAD, and SPAD decay rate are validated as key diagnostic indicators for guiding this precision management. Implications: The findings are expected to provide a theoretical basis for varietal selection and cultivation practices aimed at achieving high yield, good quality, and high nitrogen use efficiency in indica rice.

This study investigates the material foundations underpinning the variations in appearance quality among different types of japonica rice and within different grain positions, thereby providing a theoretical basis for enhancing the quality of soft rice varieties. The experimental results indicate that relative to non-soft rice, soft varieties demonstrate markedly higher levels of chalkiness and reduced transparency in both grain classifications. Structural analyses indicate that soft rice grains, particularly the inferior ones, exhibit lower amylose content along with higher proportions of small starch granules and Fa chains, alongside enhanced crystallinity and short-range order. These characteristics compromise the crystalline integrity and amplify light scattering. Furthermore, the protein network in soft rice is characterized by increased levels of albumin and glutelin, a reduction in prolamin content, and a transition towards α-helix and random coil structures. These changes suggest a diminished integration of starch and protein and introduce spatial limitations. The compounded defects across multiple scales in starch and protein structures are more accentuated in inferior grains, leading to enhanced porosity and optical heterogeneity within the endosperm. This synergistic degradation of starch and protein architectures emerges as the primary mechanism responsible for the relatively poor appearance quality of soft rice.

Background Pre-exposure prophylaxis (PrEP) is an effective biomedical intervention for HIV prevention, yet its uptake among men who have sex with men (MSM) in China remains suboptimal. This study aimed to explore PrEP awareness and uptake and their associated factors among MSM in China. Methods A cross-sectional study was conducted between May and June 2024 in Hubei Province, China. Participants were recruited via Blued, a geosocial networking app widely used by MSM in China. A structured questionnaire collected data on sociodemographic characteristics, sexual behaviors, HIV testing history, and PrEP-related information. Binary logistic regression analysis was performed to identify factors associated with PrEP awareness and uptake. Results A total of 679 MSM were included, with 61.0% aged 18–29, and 62.0% were urban residents. PrEP awareness was relatively high (82.3%), but ever use of PrEP was only 6.9%, and current use was 6.5%. The most frequently reported barriers to PrEP uptake included concerns about side effects (41.4%), cost (46.1%), lack of knowledge about where to obtain PrEP (35.4%), and concerns about being discovered (13.1%). Factors associated with PrEP uptake included higher number of male sexual partners(≥ 5 partners: aOR = 2.600, 95% CI: 1.259–5.368, p = 0.010), group sex (aOR = 1.868, 95% CI: 1.099–3.173, p = 0.021), condomless sex (aOR = 1.752, 95% CI: 1.025–2.995, p = 0.040), HIV testing in the past 6 months (aOR = 2.240, 95% CI: 1.114–4.503, p = 0.024), receiving HIV-related health education (aOR = 2.445, 95% CI: 1.484–4.026, p < 0.001). Conclusions Despite high awareness of PrEP among MSM in Hubei, actual uptake remains very low, highlighting a significant awareness-uptake gap. Multifaceted interventions addressing financial barriers, improving access, reducing stigma, and integrating PrEP education into existing HIV testing services are urgently needed to bridge this gap.

This study examined the endosperm structural characteristics of superior and inferior grains in broad-ovate and slender soft japonica rice cultivars, and their relationship with appearance quality across grain shapes. Results revealed that superior grains of broad-ovate cultivars exhibited significantly higher chalky grain rates (16.27%-17.75% vs. 0.39%-0.40%) and chalkiness degrees (3.35%-3.44% vs. 0.04%-0.05%), along with lower transparency (9.14%-10.48% vs. 11.59%-12.69%), compared with slender cultivars. Structural analysis indicated decreased amylose content (3.84%-17.89%), larger starch granule proportions (19.25%-20.48%), and lower proportions of long amylopectin chains (7.95%-12.29%), resulting in a looser endosperm matrix and reduced optical uniformity. Protein composition further showed higher total protein content (4.10%-10.64%) and increased α-helix proportions (2.18%-2.94%) with uneven distribution. These effects were more pronounced in inferior grains. In contrast, slender cultivars maintained a more compact and uniform endosperm structure, improving transparency and reducing chalkiness. These findings suggest that grain shape influences starch and protein structures, providing insights for improving japonica rice appearance quality.

Abstract Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. While genomic studies have identified key molecular subtypes and aberrations in ALL, it requires integrating multi-omics data to complete complex and time-consuming analyses in large retrospective cohorts. It is challenging to perform individualized clinical genomic analysis in real-world. We present a nationwide precision genomic study as part of the Chinese Children Cancer Group ALL 2020 clinical trial. Between 2020 and 2023, 6486 pediatric ALL patients were enrolled from 25 medical centers across 15 provinces in China. RNA-seq was performed for 5103 patients during diagnosis. We developed the National Children's Medical Center ALL Bio-Cloud (NCMC-ABC), an automated, cloud-based framework for real-time RNA-seq data process. NCMC-ABC is designed to analyze multiple clinically relevant genomic aberrations from single RNA-seq data, including molecular subtypes, coding and noncoding driver mutations, fusions and CNVs. The median turnaround time from sample collection to clinical reporting was 14 days across all hospitals, aligning with clinical treatment timelines. We established a molecular subtype classification framework for pediatric ALL, and successfully classified 94.94% of B-ALLs into 20 subtypes and 86.38% of T-ALLs into 11 subtypes. This framework significantly improved the traditional MICM approach, which classified only 48.58% of B-ALLs and did not account for T-ALL subtypes. The enhanced classification is due to the improved detection of key fusions (DUX4, PAX5, ZNF384, MEF2D rearrangements) and mutations (PAX5 P80R and IKZF1 N159Y). Meanwhile, we achieved more precise subtyping of HYPO, HYPER and KMT2A BALLs. The refined subtypes unveiled a distinct profile of Chinese B-ALL patients, with higher frequencies of HYPER, ETV6, DUX4 and PH subtypes, and lower frequencies of Ph-like, iAMP21 and HYPO, compared to Western cohorts. Importantly, the refined framework directly improved the risk stratification of patients. We identified a median of 2.44 pathogenic SNPs/indels and 1.28 fusions per patient. The driver mutations were detected in 259 genes in B-ALL and 156 in T-ALL. We observed different driver mutation profiles in our cohort compared to the Western cohort. Mutations in RAS pathway (NRAS, KRAS and PTPN11) were more frequent in Chinese patients, whereas the JAK-STAT (JAK2, IL7R, SH2B3 and CRLF2) pathway was more frequently mutated in Western cohort. We observed direct clinical relevance of these aberrations. For example, patients with TP53 and NR3C1 mutations showed inferior treatment response. The implementation of NCMC-ABC in a nationwide multicenter pediatric ALL clinical trial demonstrated its effectiveness and feasibility in real-world, improving risk stratification and therapeutic decision making in clinic. Citation Format: Han Wang, Jiaoyang Cai, Jie Yu, Shaoyan Hu, Yongjun Fang, Ju Gao, Jian Li, Hua Jiang, Xiuli Ju, Sixi Liu, Wenyong Kuang, Runming Jin, Liangchun Yang, Xuedong Wu, Xiaowen Zhai, Qun Hu, Hui Jiang, Ningling Wang, Chi Kong Li, Lirong Sun, Jiao Jin, Chun Li, Changda Liang, Yan Dai, Kaili Pan, Hao Xiong, Ching-Hon Pui, Shuhong Shen, Yu Liu. Cloud-based computational framework for individualized genomic analysis in pediatric acute lymphoblastic leukemia: A nationwide multi-center real-world clinical study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 5283.

Background Infections in immunocompromised pediatric hematology-oncology patients present a major challenge. This study utilized pathogen NGS (metagenomic next generation sequencing (mNGS) / targeted next generation sequencing (tNGS)) to characterize the microbial spectrum in this population, thereby enhancing detection and enabling targeted antimicrobial therapy. Methods This retrospective study enrolled pediatric patients with hematologic malignancies. The analysis employed descriptive statistics for pathogen profiles and comparative statistics to assess variations by clinical stage and outcome, and to evaluate NGS against traditional pathogen detection (TPD). Results This study included 72 children with a median age of 8 years. A total of 83 NGS tests were performed. Microbial organisms were detected by NGS in 70 samples, yielding 26 bacterial, 14 viral, and 12 fungal species. No statistically significant difference in NGS positivity was observed between the non-agranulocytosis (A1) and agranulocytosis (A2) groups ( P = 0.374). Escherichia coli (n = 5), Candida albicans (n = 5), and Human beta herpesvirus 5 (CMV, n = 21) were the most prevalent bacterial, fungal, and viral pathogens, respectively. Analysis of blood samples revealed that Escherichia coli, Aspergillus flavus , and Human gamma herpesvirus 4 (EBV) were the predominant bacterial, fungal, and viral pathogens, respectively. Statistical comparison revealed comparable rates of viremia between groups A1 and A2 ( P >0.999), whereas group A2 had a greater risk of bloodstream infection ( P = 0.023). Among the 61 blood samples, 49 (80.3%) were positive by mNGS, whereas only 7 were positive by TPD)(all of which were also mNGS-positive). All 11 pulmonary samples tested by tNGS were positive, while TPD was positive in only 1 specimen. tNGS identified Pneumocystis jirovecii in 3 samples, all of which were missed by TPD. NGS-guided antibiotic adjustment in 53.5% of patients with bacterial/fungal infections led to a favorable outcome, with an 88.4% cure rate after a median treatment of 12.1 days. Conclusions This study identified predominant pathogens ( Escherichia coli . Candida albicans s, CMV) and demonstrated that NGS, which is agranulocytosis, enhances detection of bacterial/fungal infections, enabling precision antimicrobial therapy in pediatric chemotherapy patients. Clinical trial number: not applicable. Trial registration: not applicable.

The application of targeted therapy with arsenic and all-trans retinoic acid (ATRA) has significantly improved outcomes in pediatric acute promyelocytic leukemia (APL), but relapse remains a major obstacle to cure. This study aimed to identify risk factors for relapse in pediatric APL and to evaluate the relationship between arsenic concentration and relapse. In this multicenter retrospective study, a total of 566 pediatric patients with newly diagnosed APL treated with the CCLG-APL 2016 or CCLG-APL 2018 protocol were enrolled. The median follow-up was 68.0 months, and 44 patients experienced relapse. The analysis showed complex karyotypes (≥ 3 additional chromosomal abnormalities) (HR = 3.238, 95% CI: 1.134–9.244, P = 0.028) and MCR ≥ 72 days (HR = 1.995, 95% CI: 1.132–3.757, P = 0.024) were independent risk factors for relapse. Logistic regression indicated that arsenic trioxide (ATO) used during induction was associated with a lower relapse risk compared to Realgar-Indigo naturalis formula (RIF) (OR = 0.310, 95% CI: 0.105–0.916, P = 0.034]. In 64 patients with arsenic monitoring, blood arsenic levels on days 7, 14, and 28 were significantly higher in ATO group than the RIF group (all P < 0.01), and were significantly lower in the relapse group compared to the non-relapse group ( P = 0.031, 0.036, 0.034, respectively). ROC analysis identified a blood arsenic cutoff of < 25.6 ng/mL after 7 days of induction as predictive of higher relapse risk. Our study confirmed risk factors for relapse in pediatric APL, and suggested that maintaining a blood arsenic concentration ≥ 25.6 ng/mL after seven days of induction may be beneficial for prognosis.

To investigate the differences in carbon and nitrogen metabolism between superior and inferior grains of southern soft and non-soft japonica rice and their relationships with appearance quality, the metabolic characteristics and appearance quality of superior and inferior grains during the grain-filling stage were compared between the two rice types. The results showed that, compared with non-soft japonica rice, the activities of AGPase and GBSS in superior grains of soft rice were significantly lower, whereas the activities of SSS, SBE, and DBE were significantly higher. The amylose content decreased by 32.68-44.72%, while amylopectin increased by 7.27-10.73%. The limitation in carbon metabolism was more pronounced in inferior grains, and the non-structural carbohydrate content was 9.33-17.33% lower than that in superior grains. In terms of nitrogen metabolism, GS activity decreased whereas GOGAT activity increased in superior grains, resulting in a 6.28-8.38% increase in protein content. The protein content of inferior grains was 1.75-6.44% higher than that of superior grains. In addition, the chalky grain rate and chalkiness degree of superior grains in soft rice were 79.00-481.03% higher than those in non-soft japonica rice, while the increases in inferior grains ranged from 67.51% to 136.31%. Correlation analysis indicated that the chalky grain rate of superior grains was positively correlated with starch content during the early grain-filling stage, whereas the chalkiness degree of inferior grains was positively correlated with protein content. These results suggest that differences in carbon and nitrogen metabolism between grain positions are closely associated with the formation of appearance quality.

ABSTRACT:Asparaginase-associated pancreatitis (AAP) is a significant complication in pediatric acute lymphoblastic leukemia (ALL) therapy, often leading to treatment delays or discontinuation. This study aimed to identify AAP risk factors, assess outcomes after first and second episodes, and evaluate the impact of asparaginase rechallenge. We retrospectively analyzed 7640 patients (aged 1 month to 18 years) treated under the Chinese Children Cancer Group ALL 2015 protocol. Patients were stratified as low risk (LR), intermediate risk (IR), or high risk (HR) based on clinical features and measurable residual disease (MRD). AAP was categorized as early or late onset depending on treatment phase. Older age and IR/HR status were independent risk factors for AAP. The cumulative AAP incidence was 2.2% in LR and 5.8% in IR/HR groups. Among 298 patients who developed AAP, 92 were rechallenged with asparaginase; second episodes occurred in 20.8% of LR and 33.8% of IR/HR patients, with no increase in severity. Lack of rechallenge and day 46 MRD of ≥0.01% were independently associated with inferior event-free survival (EFS). Among patients with early-onset AAP, those who were rechallenged had superior 5-year EFS than those who were not rechallenged (80.1% vs 60.2%; P = .003). Similarly, among IR/HR group, those who were rechallenged had better 5-year EFS than those who were not rechallenged (82.4% vs 60.6%; P = .004). IR/HR patients with early-onset AAP who were not rechallenged had especially poor outcomes (5-year EFS, 53.3%). These findings support considering asparaginase rechallenge in IR/HR patients with early-onset AAP when alternative therapies are limited. This trial was registered at www.chictr.org.cn as #ChiCTR2000032211.

Purpose:Cytomegalovirus (CMV) infection represents a severe complication following hematopoietic cell transplantation (HCT), resulting in high mortality. The prevention of CMV reactivation is crucial for enhancing patient prognosis post-HCT. Letermovir prophylaxis has effectively reduced the incidence of clinically significant CMV infection (csCMVi) in adult HCT recipients. However, clinical data in pediatric patients remain limited. Patients and methods:We included 106 children who underwent HCT at our hospital between March 2019 and July 2024. The patients were grouped based on whether or not they received letermovir prophylaxis. By analyzing their general characteristics and laboratory findings, exploring the risk factors of csCMVi, and assessing the efficacy and safety of letermovir in pediatric patients. Results:Among the 106 patients, all patients were at high risk for CMV reactivation. Forty-four received letermovir prophylaxis, while 62 did not. CsCMVi occurred in 45 patients, with a significantly lower incidence in the letermovir group compared to the control group (5 [11.3%] vs 40 [64.5%], p < 0.001). Umbilical cord blood (UCB) was used in 7 patients (15.9%) in the letermovir group and in 1 patient in the control group (p < 0.05). There was no statistically significant difference in all-cause mortality between the two groups. Grade II-IV GvHD and the use of letermovir were associated with csCMVi, with letermovir identified as the only independent preventive factor for csCMVi during the first 100 days post-HCT, especially in patients with 4-5 risk factors of csCMVi. In patients with aplastic anemia, the incidence of csCMVi was notably lower in those who received letermovir prophylaxis. No patients in the study withdrew from treatment due to adverse reactions. Conclusion:Letermovir is both effective and safe for CMV prophylaxis in pediatric patients following HCT, especially in patients with more risk factors of csCMVi. Grade II-IV GvHD increases the risk of csCMVi, while letermovir prophylaxis reduces the risk.

ABSTRACT Unmanned aerial seeding (UAS) is a promising rice direct seeding method with excellent regional adaptability, operational efficiency, and economic benefits. To characterize the plant type and lodging resistance of the optimal UAS population and to distinguish it from other unmanned planting methods, a 2‐year field experiment was conducted. Four UAS populations (UAS105, UAS150, UAS195 and UAS240 = 105, 150, 195 and 240 seedlings m−2) were established using the inbred japonica cultivar Nanjing5718 as the material, and the appropriate unmanned populations of dry direct seeding (UDDS) and carpet transplanting (UCT) were employed as controls. The results showed that more UAS basic seedlings caused lower grain yield per panicle (9.56%–29.48%), worse leaf and culm configurations, and higher lodging risk (2.43%–9.11% and 0.86%–10.60% in the 2nd and 3rd basal internodes, respectively). But the proper increase (UAS195) improved population yield (3.38%–16.52%), leaf area index (LAI) and grain‐leaf ratio. Among the methods, UAS195 ranked behind UCT in all aspects of plant type and lodging resistance, as well as population yield and grain‐leaf ratio, and only the LAI excelled. However, it produced more population yield (4.86% on average) and larger panicles (2.02% on average in grain yield per panicle) than UDDS, due to the larger basal and drooping angles, longer pillow distances, and higher SPAD values in high‐efficiency leaves, more LAI, and grain‐leaf ratio. Furthermore, UAS195 had taller plant height, gravity center height, and basal internodes with more bending moment, but its relative gravity center height and lodging index did not deteriorate significantly. This was attributed to increased breaking strength from stronger internodes with thicker walls. The findings suggest that the optimal increase in UAS basic seedlings (UAS195) could produce more population yield by improving photometric area and grain‐leaf ratio, despite compromises in plant type and lodging resistance. Furthermore, not comparable to UCT, but it provides better vertical canopy structure and population yield than UDDS and maintains similar lodging resistance.

Thrombocytosis is a common condition in children,classified into primary and secondary types.Secondary thrombocytosis is mainly caused by factors such as infection,anemia,iron deficiency,trauma,or surgical intervention,and it typically occurs without severe thrombosis or bleeding events.Platelet counts can return to normal after control of the primary factors,with favorable clinical outcomes.Primary thrombocytosis is mainly caused by myeloproliferative neoplasms such as polycythemia vera,essential thrombocythemia,and myelofibrosis,often accompanied by gene mutations in hematopoietic cells.In children,clinical manifestations are atypical compared to adults,with few thromboembolic or bleeding events.No special treatment is required for patients who are asymptomatic or have mild symptoms,and it is recommended to regularly monitor platelet counts.Antiplatelet therapy with aspirin can be considered for patients at risk of thrombosis or those with extreme thrombocytosis,and cytoreductive therapy can be performed when necessary,but the toxicities and side effects of drugs should be closely monitored.At present,hydroxyurea,interferon-alpha,and anagrelide are commonly used for cytoreductive therapy.This article provides an overview of the etiology,classification,clinical manifestations,diagnosis,and treatment of childhood thrombocytosis to guide healthcare professionals in treatment decisions.

Mounting labor shortages and rising operational costs are threatening the sustainability of mechanized rice production in Southern China, underscoring the urgent need for innovations that reduce labor inputs during nursery preparation and transplanting. To address these challenges, this study developed an innovative double-blanket seedling tray measuring 120 cm in length-twice that of a conventional tray. Based on this design, experiments were conducted to identify suitable lightweight substrates capable of producing cohesive and structurally stable double-blanket rice seedling mats. Two lightweight substrates-crop straw boards and matrix cotton-were evaluated in comparison to traditional nursery soil. Results demonstrated that, when combined with the nutrient solution "Miao Zhuang Feng", both lightweight substrates significantly improved seedling quality, transplanting performance, and final yield. Notably, the fresh weight of double-blanket seedlings grown on lightweight substrates was comparable to single-blanket seedlings cultivated in soil while being 47.46% lighter than double-blanket seedlings raised with soil. To optimize double-blanket seedling mat formation and transplanting quality, five seeding densities (300, 360, 420, 480, and 540 g/tray) and four seedling ages (10, 15, 20, and 25 d) were tested using crop straw board as the substrate. The results revealed that optimal combinations varied by condition: 480 and 540 g/tray were suitable for 15-day-old seedlings, 420 g/tray for 20-day-old seedlings, 360 g/tray for 20 similar to 25-day-old seedlings, and 300 g/tray for 25-day-old seedlings. Compared with single-blanket seedlings, the double-blanket approach reduced the number of trays required per hectare and the total seedling cultivation and transportation cost by 57.97% and 16.67%. Furthermore, increasing the seeding density from 300 to 360, 420, 480, and 540 g/tray led to additional reductions of 16.31%, 26.24%, 34.75%, and 41.13%, respectively-substantially lowering labor requirements for tray handling and seedling feeding during transplanting.

Purpose:Pediatric Rosai-Dorfman disease (RDD) is extremely rare, and the current treatment plan is not unified. We hope that our study provides new ideas for the clinical treatment of RDD. Methods:We report a case in which RDD was successfully treated with prednisone and vincristine, resulting in regression of enlarged lymph nodes. In this study, informed consent forms were obtained from participants for their involvement in the research and publication of relevant case details. Moreover, this study aimed to conceal personal patient information. Results:The child underwent two pathological examinations before a definitive diagnosis was made. Percutaneous fine-needle aspiration biopsy was performed on his first admission, and pathological examination showed a purulent granulomatous reaction under a microscope; however, antibiotic treatment was ineffective. The second pathological biopsy performed at the time of surgery showed RDD. After treatment with vincristine and prednisone, the neck mass significantly shrank and did not increase in size after the treatment was stopped. The patient remains under follow-up. Conclusions:Sufficient pathological tissue samples were obtained via surgical biopsy to diagnose RDD. Treatment with chemotherapy, including prednisone and vincristine, can induce remission of RDD.

Pediatric pancreatic acinar cell carcinoma (PACC) is an exceptionally rare and poorly understood malignancy with a challenging prognosis. Its clinical presentation is often atypical, and standardized treatment guidelines are currently unavailable. While genetic alterations in adult PACC have been studied to some extent, knowledge of genetic abnormalities in pediatric cases remains limited. We report a case of pediatric PACC in a 7-year-old male presenting with a large, non-tender abdominal mass (11 cm x 11 cm) on the right side. Pathological and imaging evidence confirmed the diagnosis of PACC, with no lymph node infiltration or distant metastasis. Comprehensive genomic profiling by next-generation sequencing identified a non-canonical BRAF fusion with KMT2C at the DNA level and a classic SND1-BRAF fusion at the RNA level. The patient underwent surgical resection through a Whipple operation followed by six cycles of mFOLIRINOX chemotherapy and radiation therapy, achieving a favorable outcome up to now. Next-generation sequencing has demonstrated significant value in identifying genetic fusions in pediatric PACC. In our case report, we identified both the classical SND1-BRAF fusion, commonly associated with PACC, and a previously unreported nonclassical BRAF-KMT2C fusion. These findings underscore the critical role of BRAF alterations as key drivers of oncogenesis in PACC. A multidisciplinary treatment strategy integrating surgery, chemotherapy, and radiation therapy offers a promising precedent for improving therapeutic outcomes and prolonging survival in pediatric PACC cases.