Many randomized controlled trials (RCTs) have revealed the benefits of caffeic acid tablets on leukopenia and thrombocytopenia, but the results are inconclusive. This meta-analysis of RCTs aimed to assess the effects of caffeic acid tablet supplementation on treating leukopenia. A systematic review of PubMed, Scopus, Embase, Cochrane library, China Knowledge Network, China Biomedical Literature Database, Wipu.com and Wanfang Data were conducted, and the search time frame was from the establishment of the database up to May 2025. Data were pooled using a random-effects model to calculate standardized mean differences (SMDs) and 95

OBJECTIVE:Develop a diagnostic model using common hematological and immunological indicators to assist in the early screening and differential diagnosis of Multiple Myeloma (MM) in clinical settings, reducing the risk of misdiagnosis. METHODS:A retrospective analysis was conducted on 274 newly diagnosed and treated MM patients and 137 connective tissue disease patients treated at Zhejiang Provincial People's Hospital from January 2008 to August 2023. Laboratory indicators, including complete blood count, biochemistry, coagulation function, and immunoglobulin markers, were collected. The cohort was randomly divided into a 70% training set and a 30% validation set. Relevant variables were selected through univariate and multivariate analyses in the training set. A discriminative diagnostic model was developed using a multivariate logistic regression algorithm. The model's predictive accuracy and generalizability were evaluated by validating and conducting receiver operating characteristic (ROC) curves and calibration curves. RESULTS:The developed differential diagnostic model in this study included the following observed indicators: IgM, glomerular filtration rate, high-density lipoprotein, red cell distribution width, and thrombin time. The model demonstrated excellent discriminatory power and good calibration, with an area under the curve (AUC) value of 0.980 (95% CI: 0.967-0.994). Additionally, the model exhibited high sensitivity (0.963), specificity (0.938), accuracy (0.955). The validation set further confirmed the generalization and accuracy of the model, with an AUC value of 0.954 (95% CI: 0.961-0.992). CONCLUSIONS:The constructed differential diagnostic model in this study can accurately predict and differentiate MM patients and those with elevated Ig abnormalities, thereby enhancing the efficiency of clinical diagnostic decision-making.

This study aims to identify clinical laboratory parameters for the diagnosis of newly diagnosed multiple myeloma (NDMM), establish optimal cutoffs for early screening, and develop a diagnostic model for precise diagnosis. The study conducted a retrospective analysis of 279 NDMM patients and 553 healthy subjects at Zhejiang Province People’s Hospital between January 2008 and June 2023. Multifactor LR was employed to explore clinical laboratory indicators with diagnostic value for NDMM, determine optimal cutoff values and contract a diagnostic model. The diagnostic efficacy and clinical utility were evaluated using receiver operating characteristic curves (ROC), sensitivity, specificity, and other indicators. Multifactor analysis revealed that hemoglobin (Hb), albumin (Alb), and platelet distribution width (PDW) were significant diagnostic factors for NDMM. Optimal cutoff values for Hb, Alb, and PDW in MM diagnosis were determined, and the results showed a significant increase in the probability of NDMM diagnosis when Alb was below 39.3 g/L, Hb was below 11.6 g/dL, and PDW was below 14.1 fL. The diagnostic model constructed from the development cohort demonstrated a high area under the ROC curve of 0.960 (95

BackgroundBloodstream infection (BSI) represent a prevalent complication in haematological malignancies (HMs). Typically, Patients with BSI usually undergo empirical treatment pending pathogen identification. The timely and effective management of BSIs significantly influences patient prognosis. However, pathogen distribution in BSIs exhibits regional variation. In this study, we investigated the clinical characteristics, pathogen spectrum, drug resistance, risk factors of short-term prognosis and long-term prognostic factors of acute myeloid leukemia (AML) patients with BSI at Zhejiang Provincal People’s Hospital.MethodsFrom 2019 to 2021, a total of 56 AML patients with BSI were treated in the Department of Haematology at Zhejiang Province People’s Hospital. Data regarding pathogen spectrum and drug resistance were collected for analysis. The patients were stratified into non-survivor cohort and survivor cohort within 30 days after BSI, and the predictors of 30-days mortality were identified through both univariate and multivariate Logistic regression analyses. Furthermore, Kaplan-Meier survival analysis and Cox regression analysis were employed to ascertain the risk factors associated with poor prognosis in AML patients complicated by BSI.ResultsA total of 70 strains of pathogenic bacteria were isolated from 56 AML patients with BSI. Gram-negative bacteria constituted the predominant pathogens (71.4%), with Klebsiella pneumoniae being the most prevalent (22.9%). Gram-positive bacteria and fungi accounted for 22.9% and 5.7%, respectively. Univariate and multivariate analyses revealed significant differences in total protein, albumin levels, and the presence of septic shock between the non-survivor cohort and the survior cohort 30 days post-BSI. COX regression analysis showed that agranulocytosis duration exceeding 20 days (HR:3.854; 95% CI: 1.451–10.242) and septic shock (HR:3.788; 95% CI: 1.729–8.299) were independent risk factors for poor prognosis in AML patients complicated by BSI. Notably, the mortality rate within 30 days after Stenotrophomonas maltophilia infection was up to 71.4%.ConclusionsIn this study, Gram-negative bacteria, predominantly Klebsiella pneumoniae, constituted the primary pathogens among AML patients with BSIs. Serum albumin levels and the presence of septic shock emerged as independent risk factors for mortality within 30 days among AML patients with BSI. In terms of long-term prognosis, extended agranulocytosis duration exceeding 20 days and septic shock were associated with elevated mortality rates in AML patients with BSI. Additionally, in our centre, Stenotrophomonas maltophilia infection was found to be associated with a poor prognosis. Early intervention for Stenotrophomonas maltophilia infection in our centre could potentially improve patient outcomes.

Analyzing the levels of anticancer medications in biological samples and body fluids reveals important details on the course and effects of chemotherapy. p (L-Cys)/graphitic-carbon nitride (g-C3N4)/GCE, a modified glassy carbon electrode, was created for the current study's electrochemical detection of methotrexate (MTX), a drug used to treat breast cancer, in pharmaceutical fluid samples. L-Cysteine was electro-polymerized on the surface of the g-C3N4/GCE after the g-C3N4 was first modified to prepare the p (L-Cys)/g-C3N4/GCE. Analyses of morphology and structure showed that well-crystalline p (L-Cys) on g-C3N4/GCE was successfully electro-polymerized. Studying the electrochemical characteristics of p (L-Cys)/g-C3N4/GCE using CV and DPV tech-niques revealed a synergistic impact between g-C3N4 and L-cysteine that improved the stability and selectivity of the electrochemical oxidation of MTX while enhancing the electrochemical signal. Results showed that 7.5-780 mu M was the linear range, and that 0.11841 mu A/mu M and 6 nM, respectively, were the sensitivity and limit of detection. The applicability of the suggested sensors was assessed using real pharmaceutical preparations, and the results showed that p (L-Cys)/g-C3N4/GCE had a high degree of precision. Five breast cancer patients who volunteered and provided prepared blood serum samples between the ages of 35 and 50 were used to examine the validity and accuracy of the proposed sensor in the current work for the determination of MTX. The results showed good recovery values (greater than 97.20%), appropriate accuracy (RSD less than 5.11%), and good agreement between the ELISA and DPV analysis results. These findings showed that p (L-Cys)/g-C3N4/GCE can be applied as a trustworthy MTX sensor for MTX level monitoring in blood samples and pharmaceutical samples.

According to Elie Metchnikoff, an originator of modern immunology, several pivotal functions for disease and health are provided by indigenous microbiota. Nonetheless, important mechanistic insights have been elucidated more recently, owing to the growing availability of DNA sequencing technology. There are 10 to 100 trillion symbiotic microbes (such as viruses, bacteria, and yeast) in each human gut microbiota. Both locally and systemically, the gut microbiota has been demonstrated to impact immune homeostasis. Primary B-cell immunodeficiencies (PBIDs) are a group of primary immunodeficiency diseases (PIDs) referring to the dysregulated antibody production due to either intrinsic genetic defects or failures in functions of B cells. Recent studies have found that PBIDs cause disruptions in the gut's typical homeostatic systems, resulting in inadequate immune surveillance in the gastrointestinal (GI) tract, which is linked to increased dysbiosis, which is characterized by a disruption in the microbial homeostasis. This study aimed to review the published articles in this field to provide a comprehensive view of the existing knowledge about the crosstalk between the gut microbiome and PBID, the factors shaping the gut microbiota in PBID, as well as the potential clinical approaches for restoring a normal microbial community.

目的 比较宏基因组二代测序(mNGS)技术与传统标准病原菌检测(血培养)在血液恶性肿瘤患者疑似合并血流感染治疗过程中的优效性,评估临床应用价值.方法 回顾性分析2020年1月至2021年7月74例血液恶性肿瘤疑似血流感染患者的临床资料,从检测报告周期、病原菌检出率、指导用药获益程度等方面比较血培养和mNGS检测致病病原菌的优效性.结果 mNGS阳性检出占78.38％,血培养阳性检出占10.81％;其中mNGS检测致病菌结果与临床综合诊断匹配相符占72.97％.血培养阳性的8例患者中,mNGS与血培养一致占75％;血培养阴性且mNGS检测阳性52例患者中,根据mNGS结果指导用药后患者病情转好占57.69％.mNGS检测报告周期2.5 d,血培养检测报告周期5 d.结论 mNGS检测明显短于血培养检测报告周期,且病原菌阳性检出率、病原菌检测多样性和指导临床医师精准用药均优于传统血培养,尤其在血培养结果呈阴性情况下,mNGS可作为一种快速有效的辅助诊断方式,同时为临床医师由经验性治疗转向精准治疗提供科学依据,具有良好的临床应用价值.

Objective Considering the role of lncRNAs reported as regulators in acute myeloid leukemia (AML) progression, the current research aims to investigate the role of PAX8-AS1 in chemo-resistant AML. Methods Human AML cells HL60 and human doxorubicin (ADM)-resistant AML cells (HL60/ADM cells) were used to establish in vitro models of chemo-sensitive AML and refractory/recurrent AML, respectively. CCK-8 assay and flow cytometry were used to determine cell resistance to ADM, viability, and apoptosis. PAX8-AS1, miR-378g, and ERBB2 expressions in the models and/or AML patients were quantified via qRT-PCR or Western blot. The miRNA/mRNA axis targeted by PAX8-AS1 was analyzed using Starbase, TargetScan, or GEO and validated through a dual-luciferase reporter assay. The expressions of Bcl-2, Bax, and C Caspase-3 in cells were quantitated by Western blot. Results The highly expressed PAX8-AS1 was observed in AML patients and HL60 cells, which was more evident in refractory/recurrent AML patients and HL60/ADM cells. Compared with that in ADM-treated parental HL60 cells, the viability of ADM-treated HL60/ADM cells remained strong. PAX8-AS1 overexpression increased viability and Bcl-2 expression, while diminishing apoptosis, Bax, and C Caspase-3 expressions in HL60 cells. However, the abovementioned aspects were oppositely impacted by PAX8-AS1 silencing in HL60/ADM cells. PAX8-AS1 directly targeted miR-378g, whose expression pattern is opposite to that of PAX8-AS1 in AML. MiR-378g upregulation abrogated the effects of PAX8-AS1 overexpression on HL60 cells. MiR-378g downregulation offset PAX8-AS1 silencing-induced effects on HL60/ADM cells. Moreover, ERBB2 was recognized as the target of miR-378g, with a higher expression in HL60/ADM cells than in HL60 cells. Conclusion PAX8-AS1 silencing decreases cell viability, enhances apoptosis, and suppresses ADM resistance in AML via regulating the miR-378g/ERBB2 axis.

Background: Acute promyelocytic leukemia (APL) mainly harbors PML-RARα fusion gene, which is sensitive to all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) treatment. However, APL harboring other RARα fusion genes exhibit different drug sensitivity. Here, we investigated the role and mechanism of TBLR1-RARα, a rare RARα fusion gene, on ATO treatment in leukemia cells. Methods: By constructing two cell models of leukemia cell line HL-60 and U937 with overexpressed TBLR1-RARα, we detected the cell differentiation in the two cell models after ATO treatment by flow cytometry and Wright staining. Meanwhile, cell viability, colony formation and apoptosis were also determined after ATO treatment. Results: We found that TBLR1-RARα enhanced ATO-induced apoptosis and cell proliferation inhibition. Besides, TBLR1-RARα also promoted ATO-induced cell differentiation. Furthermore, we found that the mitochondrial caspase pathway was involved in the apoptosis induced by ATO treatment in TBLR1-RARα positive leukemia cells. Moreover, ATO mediated TBLR1-RARα protein degradation via proteasome pathway, which accounts for the transcriptional activation of RARα target gene and is further involved in cell differentiation of TBLR1-RARα positive leukemia cells. Conclusions: Our study provides evidence that TBLR1-RARα positive APL patients may benefit from ATO treatment, thereby improving the appropriate management in TBLR1-RARα positive APL.

A previous research study on differentiating gastric cancer (GC) into distinct subtypes or prognostic models was mostly based on GC tissues, which neglected the role of nontumour tissues in GC subtypes. The purpose of the research was to identify GC subtypes on the basis of tumour and adjacent nontumour tissues to assess the prognosis of GC patients. We characterized three GC subtypes on the basis of the immunologic and hallmark gene sets in GC and adjacent nontumour tissues: among them, the GC patients with subtype I had the longest survival time compared to patients with other subtypes. The classification was closely associated with T stage and pathological stage of GC patients. A prognostic model containing two gene sets was constructed by LASSO analysis. Kaplan–Meier analysis showed that patients in the high-risk group survived longer than those in the low-risk group and the two prognostic genes sets in the model were strongly correlated with survival status. Then, GO and KEGG analyses and PPI network show that nontumour and tumour tissues are influencing the prognosis of GC patients in separate manners. In summary, we emphasized the prognostic value of nontumour tissue in GC patients and proposed a novel insight that both changes in tumour and nontumour tissues should be taken into account when selecting a treatment strategy for GC.

Acute myeloid leukemia (AML) is an aggressive type of blood cancer affecting bone marrow (BM). In AML, hematopoietic precursors are arrested in the early stages of development and are defined as the presence of ≥ 20

Objective: To elucidate the clinical characteristics of bloodstream infection in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in our hospital and improves the survival of transplant patients with bloodstream infection. Methods: Two hundred and ten patients with allo-HSCT from the Department of Hematology were retrospectively analyzed between October 2014 and September 2019. Pathogen distribution, drug resistance, risk factors, and outcomes were investigated in 49 allo-HSCT patients with bloodstream infections. Results: Forty-nine of 210 patients with allo-HSCT had bloodstream infection, and 59 pathogenic microorganisms were identified, mainly Gram-negative bacteria (67.8%) , of which E. coli had the highest incidence (23.7%) , CRO accounted for 42.5%, and Grampositive bacteria accounted for 23.7% (without vancomycin or linezolid-resistant strain) . Additionally, fungi accounted for 8.5%. Univariate analysis suggested that the risk factors of bloodstream infection were gender, pretransplant disease status, and conditioning regimen. In contrast, multivariate analysis showed that bloodstream infection was mainly related to conditioning regimens. Further grouping results showed that 77.6% of patients with neutropenia had bloodstream infections, and 22.4% of patients with non-neutropenia had bloodstream infections; 81.0% of patients with active infections before transplantation had bloodstream infections, while bloodstream infection occurred in 16.9% of patients without active infection. Survival analysis showed that long-term survival of patients with bloodstream infection is shorter than that of patients without bloodstream infection and long-term survival of patients with CRO infection is shorter than that of patients without CRO infection. The survival of patients with neutropenia longer than 14 d is shorter than that of patients with neutropenia shorter than 14 d. Furthermore, there is no correlation between whether there is an active infection before transplantation and whether they are in a neutropenic state at the time of infection and survival. Conclusion: Our results suggest that effective prevention of bloodstream infections from drug-resistant bacteria, particularly CRO, shortening the duration of neutropenia, eradication of potential infections before transplantation, and patient-adaptive conditioning could reduce transplant-related mortality and improve prognosis.

目的 探讨中高危骨髓增生异常综合征(MDS)及其转化急性髓系白血病(MDS-AML)异基因造血干细胞移植(allo-HSCT)治疗的时机和疗效.方法 回顾性分析2014年2月至2020年6月于浙江省人民医院行异基因造血干细胞移植的中高危MDS患者20例及MDS-AML患者12例.预处理采用改良马利兰+环磷酰胺方案23例,氟达拉+环磷酰胺减剂量方案2例,序贯CLAG/FLAG+改良马利兰+环磷酰胺增强方案7例.结果 32例患者中31例获得造血重建.中位随访14(1～59)个月,移植后预期3年总生存率(OS)(45.5±11.4)％;3年无白血病生存率(LFS)(48.5±11.4)％;3年累计复发率(8.9±6.0)％(3/31),非复发死亡率(11.8±6.4)％.急性移植物抗宿主病(aGVHD)累计发生率为(63.6％±8.6)％,其中Ⅱ～Ⅳ度aGVHD发生率为(38.0±8.7)％.慢性移植物抗宿主病(cGVHD)3年累计发生率为(35.6±11.5)％.多因素分析显示,移植前病程≥6个月是影响OS(P=0.012)及LFS(P=0.011)的独立危险因素.MDS-AML患者中移植前CR组3年OS及LFS显著优于非CR组(P=0.013,P=0.018).结论 对于中高危MDS尽早allo-HSCT可获得更好生存;MDS-AML患者移植前有效降低肿瘤负荷可使生存获益.

Acute promyelocytic leukemia (APL) is characterized by a specific chromosome translocation involving RARα and its fusion partners. For decades, the advent of all- trans retinoic acid (ATRA) synergized with arsenic trioxide (As 2 O 3 ) has turned most APL from highly fatal to highly curable. TBLR1-RARα (TR) is the tenth fusion gene of APL identified in our previous study, with its oncogenic role in the pathogenesis of APL not wholly unraveled. In this study, we found the expression of TR in mouse hematopoietic progenitors induces blockade of differentiation with enhanced proliferative capacity in vitro. A novel murine transplantable leukemia model was then established by expressing TR fusion gene in lineage-negative bone marrow mononuclear cells. Characteristics of primary TR mice revealed a rapid onset of aggressive leukemia with bleeding diathesis, which recapitulates human APL more accurately than other models. Despite the in vitro sensitivity to ATRA-induced cell differentiation, neither ATRA monotherapy nor combination with As 2 O 3 confers survival benefit to TR mice, consistent with poor clinical outcome of APL patients with TR fusion gene. Based on histone deacetylation phenotypes implied by bioinformatic analysis, HDAC inhibitors demonstrated significant survival superiority in the survival of TR mice, yielding insights into clinical efficacy against rare types of APL.

目的 分析微小RNA(miRNA)-21-5p在食管癌中的潜在诊断价值,并探索其可能的作用机制.方法 选取2016年1月—2018年6月在浙江大学医学院附属邵逸夫医院下沙院区治疗的食管癌患者78例(病例组)以及体检健康者69名(对照组).采集患者治疗前血液及术中癌组织、癌旁组织,通过实时聚合酶链反应(PCR)检测血清中miRNA-21-5p的表达,通过picTar、TagetScan、Tarbase 3个数据库分别预测miRNA-21-5p的靶基因;利用Draw venn diagram选取3个数据库预测靶基因交集;采用实时PCR检测食管癌患者癌组织和癌旁组织中信号传导和转录激活子3(STAT3)mRNA的表达情况.结果 实时PCR结果显示,miRNA-21-5p在食管癌患者血清中高表达,且显著高于对照组(P<0.01);STAT3 mRNA在食管癌患者癌组织中高表达,显著高于癌旁组织(P<0.01);Spearman相关性分析发现两者呈正相关.结论 在食管癌患者血清中miRNA-21-5p呈高表达,同时在癌组织中miRNA-21-5p的预测靶基因STAT3 mRNA也呈高表达,并且两者呈正相关.

Background: To explore the application effect of accelerated rehabilitation surgery on laparoscopic radical gastrectomy cancer for patients aged ≥70 years. Methods : Retrospective analysis of 120 aged ≥70 patients’ clinical data undergoing laparoscopic radical gastrectomy in our hospital from January 2017 to December 2018, which were divided into accelerated rehabilitation group (n = 73) and control group (n = 47). By comparing the postoperative clinical data of the two groups, we explored the application effect of accelerated rehabilitation surgery on laparoscopic radical gastrectomy cancer for patients aged ≥70 years. Results : Compared with the control group, the first time to get out of bed (2.1 ± 0.9 days vs 3.8 ± 1.5 days, P<0.01), the first exhaust time (3.2 ± 0.8 days vs 3.9 ± 1.2 days, P<0.01) and the first time to eat liquid food after surgery (1.8 ± 0.9 days vs 3.2 ± 1.3 days, P<0.01), and postoperative hospital stay (12.7 ± 4.3 days vs 15.8 ± 6.4 days, P<0.01) in the rehabilitation group were significantly lower. There was no significant difference in the overall postoperative complications between the two groups (P<0.05), however, the complications of pulmonary infection in the accelerated rehabilitation group was significantly lower than that in the control group (1.4% vs 10.6%, P = 0.03). Conclusions: The application of accelerated rehabilitation surgery concepts and measures after surgery in laparoscopic radical gastrectomy cancer for patients aged ≥70 years can promote early postoperative rehabilitation, reduce postoperative hospital stay, and reduce the incidence of postoperative pulmonary infection complications.

KDM1A-mediated H3K4 demethylation is a well-established mechanism underlying transcriptional gene repression, but its role in gene activation is less clear. Here, we report a critical function and mechanism of action of KDM1A in glucocorticoid receptor (GR)-mediated gene transcription. Biochemical purification of the nuclear GR complex revealed KDM1A as an integral component. In cell-free assays, GR modulates KDM1A-catalyzed H3K4 progressive demethylation by limiting the loss of H3K4me1. Similarly, in cells, KDM1A binds to most GR binding sites in the genome, where it removes preprogrammed H3K4me2 but leaves H3K4me1 untouched. Blocking KDM1A catalytic activity prevents H3K4me2 removal, severely impairs GR binding to chromatin, and dysregulates GR-targeted genes. Taken together, these data suggest KDM1A-mediated H3K4me2 demethylation at GRBSs promotes GR binding and plays an important role in glucocorticoid-induced gene transcription, broadening the mechanisms that contribute to nuclear receptor-mediated gene activation.

Background/Aim: As the knowledgebase of acute myeloid leukemia (AML) has grown, classification systems have moved to incorporate these new findings. Methods: We assessed 32,941 patients with AML whose records are contained in the Surveillance, Epidemiology, and End Results (SEER) database. Results: Half of all patients diagnosed between 2001 and 2013 did not have a World Health Organization (WHO) classification. Acute promyelocytic leukemia and acute panmyelosis with myelofibrosis were associated with the longest leukemia-specific survival (110 and 115 months, respectively), and AML with minimal differentiation and acute megakaryoblastic leukemia with the shortest (30 and 28 months, respectively). For patients in the WHO groups AML not otherwise specified (AML-NOS) and AML with recurrent genetic abnormalities (AML-RGA), the risk of death was greater for older patients and less for married patients. Black patients with any type of AML-NOS also had a higher risk of death. Patients whose case of AML did not receive a WHO classification were older and this group had a higher risk of death when compared to patients with a WHO type of AML-NOS. Conclusion: Our findings highlight the divergent outcomes of patients with AML and the importance of using the WHO classification system and demographic factors to gauge their prognosis.

Objective To investigate the relationship between nutritional status and the incidence of nosocomial infection in patients with high risk acute lymphoblastic leukemia.Methods A self-designed questionnaire was used to collect relevant data of 286 cases of high risk patients with acute lymphoblastic leukemia in,Zhejiang Provincial People's Hospital from January,2013 to June,2016.Subjective global assessment(PG-SGA) method was used to evaluate the nutritional status of patients with maintenance treatment phase,analysis of the infection rate of correlation between nutritional status and hospital patients.Results Two hundred and eighty-six cases of high-risk acute lymphoblastic leukemia patients do not need nutritional support in 104 cases,the need for nutritional support in 182 cases,including 98 cases of hospital infection,accounting for 34.27 ％ (98/286) in patients with acute lymphoblastic leukemia;hospital infection rate and nutritional status were negatively correlated (r =-0.724,P ＜ 0.01);Univariate analysis showed that significant length of time,the intensity of chemotherapy,hemoglobin,leukocyte count,neutrophils,species,application of antibiotics,antibiotic use time,albumin PG-SGA score difference (P ＜ 0.05).There was no significant difference in age,sex,glucocorticoid use (P ＞ 0.05).Logistic regression analysis showed that the PG-SGA score,the intensity of chemotherapy,neutrophil count,hemoglobin,albumin,antibiotic use time are the risk factors of nosocomial infection in patients with high-risk acute lymphoblastic leukemia.Conclusion The nutritional status of high risk acute lymphoblastic leukemia patients is closely related to the incidence of nosocomial infection and the nutritional status of the patients is a risk factor for the occurrence of hospital infection.

Introduction: TBLR1-RARα is the tenth fusion gene of acute promyelocytic leukemia (APL) first identified in a rare case of APL with t(3;17)(q26;q21) chromosomal translocation in our previous study. The characteristics of its basic structure and functions had been clarified in our previous study. In this study, we successfully established a novel TBLR1-RARα leukemia mouse model (TR mouse) which fully recapitulated the most relevant features of human APLs. The therapeutic effects of retinoic acid (ATRA), arsenic trioxide (As2O3), cytarabine (Ara-C) and histone deacetylase inhibitors (HDACi) on TR mice were examined. The differentially expressed genes (DEGs) between TR mice and normal mice were compared to explore the possible mechanisms and better therapeutic targets for this kind of APL.