People's Liberation Research Articles

Clinicopathological analysis of gonadal differentiation of sex development disorder

Objective: To investigate pathological features and differential diagnosis in the gonads with disorder of sex development. Methods: Thirty-six cases of clinically diagnosed hermaphroditism with gonadal biopsy in the Department of Pathology, the Seventh Medical Center of People's Liberation Army General Hospital from April 2007 to July 2021, were collected. All biopsy pathological sections were reviewed, and the gonadal cases with abnormal pathological morphology were screened out. The clinical and imaging data and karyotype of these cases were reviewed. Additional immunohistochemical staining was performed and relevant literature was reviewed. Results: Seven cases of ovotesticular disorder of sex development (OTDSD) were identified, which were characterized by the presence of testicular and ovarian differentiation in the same individual. All patients were under 15 years old and presented with abnormal appearance of external genitalia, and the ratio of male to female was 2∶5. Ultrasonography showed testicular structure in all female patients and cryptorchidism in all male patients. The most common karyotype was 46, XX. One case with undifferentiated gonadal tissue (UGT) and one case with streak gonads were screened out. UGT germ cells were neither in seminiferous tubules nor in follicles, but randomly distributed in an ovarial-type interstitial background, sometimes accompanied by immature sex cords. Streak gonads resembled UGT without germ cells. FOXL2 was positive in granulosa cells, but negative in Sertoli cells. SOX9 expression was opposite. OCT4 was weakly positively/negatively expressed in oocytes and positively expressed in the germ nuclei of UGT. Conclusions: Four differentiation patterns need to be identified in the gonadal biopsy: ovarian differentiation, testicular differentiation, undifferentiated gonadal tissue and streak gonad. The positive expression of SOX9 indicates testicular differentiation, while the positive expression of FOXL2 confirms ovarian differentiation, and the expression of both markers in the same tissue indicates ovotestis differentiation. It is very important to identify UGT, because that has a high probability of developing into gonadoblastoma in the future.

Symptoms of posttraumatic stress, anxiety, and depression, along with their associated factors, among Eritrean refugees in Dabat town, northwest Ethiopia, 2023

BackgroundRefugee populations are forcibly displaced from their homes as a consequence of natural disasters and armed conflicts. Eritreans, initially displaced to the Maiayni camp within the Tigray region, have faced further relocation to Dabat town due to the conflict between the Tigray People Liberation Front (TPLF) and Ethiopian government forces. Subsequently, another conflict has arisen between the Amhara Popular Force (Fano) and Ethiopian government forces in Dabat town, disrupting its stability. These collective challenges in the new environment may contribute to the development of symptoms such as posttraumatic stress disorder (PTSD), anxiety, and depression. Currently, there is a lack of available data on these symptoms and their associated variables in Dabat Town. Thus, the objective of this study was to assess the prevalence of PTSD, anxiety, and depression symptoms, along with associated factors, among Eritrean refugees in Dabat town, northwest Ethiopia. This will provide significant evidence for developing and implementing mental health intervention strategies that specifically address the particular difficulties faced by refugees.MethodA community-based cross-sectional study was carried out from July 25 to September 30, 2023, in the Eritrean refugee camp in Dabat town. A systematic random sampling method was employed to select a total of 399 Eritrean refugees with 100 response rate. Data were collected using the standard validated Depression, Anxiety, and Stress Scale (DASS-21) questionnaire, which included socio-demographic characteristics. Summary statistics such as frequency and proportion were utilized to present the data in tables and figures. Binary logistic regression was employed to identify associated factors, and variables with a p-value (p ≤ 0.05) were considered statistically significant factors.ResultThe findings of this study indicated that 45% (95% CI: 35.6-48.23), 33.6% (95% CI: 31.66–37.45), and 37.3% (95% CI: 35.56–40.34) of the participants had symptoms of depression, anxiety, and PTSD, respectively. Sex, age, employment status, lack of food or water, experience of torture or beating, and imprisonment emerged as statistically significant predictors of depression. Employment status, murder of family or friends, rape or sexual abuse, torture or beating, and lack of housing or shelter were statistically significantly associated with anxiety. PTSD was found to be significantly associated with sex, length of stay at the refugee camp, lack of housing, shelter, food, or water, experience of rape or sexual abuse, abduction, employment status, and murder of family or friends.Conclusions and recommendationThe results of this study revealed that more than one-third of Eritreans living in the refugee camp in Dabat town had symptoms of PTSD, anxiety, and depression. This prevalence is higher than the previously reported studies. Various factors, including age, gender, monthly income, unemployment, experiences of rape or sexual abuse, witnessing the murder of family or friends, being torched or beaten, imprisonment, and deprivation of basic needs such as food, shelter, and water, were identified as contributors to the development of depression, anxiety, and PTSD. This research underscores the need for both governmental and non-governmental organizations to secure the provision of essential necessities such as food, clean water, shelter, clothing, and education. This study also suggested that Eritrean refugees be legally protected from rape, sexual abuse, arson, detention without cause, and kidnapping. Moreover, the study calls for health service providers to develop a mental health intervention plan and implement strategies to deliver mental health services at healthcare facilities for Eritrean refugees in the Dabat town Eritrean refugee camp.

Establishment and efficiency test of a clinical prediction model of bronchopulmonary dysplasia associated pulmonary hypertension in very premature infants

Objective: To develop a risk prediction model for identifying bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (PH) in very premature infants. Methods: This was a retrospective cohort study. The clinical data of 626 very premature infants whose gestational age <32 weeks and who suffered from BPD were collected from October 1st, 2015 to December 31st, 2021 of the Seventh Medical Center of the People's Liberation Army General Hospital as a modeling set. The clinical data of 229 very premature infants with BPD of Hunan Children's Hospital from January 1 st, 2020 to December 31st, 2021 were collected as a validation set for external verification. The very premature infants with BPD were divided into PH group and non PH group based on the echocardiogram after 36 weeks' corrected age in the modeling set and validation set, respectively. Univariate analysis was used to compare the basic clinical characteristics between groups, and collinearity exclusion was carried out between variables. The risk factors of BPD associated PH were further screened out by multivariate Logistic regression, and the risk assessment model was established based on these variables. The receiver operating characteristic (ROC) area under curve (AUC) and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the model's discrimination and calibration power, respectively. And the calibration curve was used to evaluate the accuracy of the model and draw the nomogram. The bootstrap repeated sampling method was used for internal verification. Finally, decision curve analysis (DCA) to evaluate the clinical practicability of the model was used. Results: A total of 626 very premature infants with BPD were included for modeling set, including 85 very premature infants in the PH group and 541 very premature infants in the non PH group. A total of 229 very premature infants with BPD were included for validation set, including 24 very premature infants in the PH group and 205 very premature infants in the non PH group. Univariate analysis of the modeling set found that 22 variables, such as artificial conception, fetal distress, gestational age, birth weight, small for gestational age, 1 minute Apgar score ≤7, antenatal corticosteroids, placental abruption, oligohydramnios, multiple pulmonary surfactant, neonatal respiratory distress syndrome (NRDS)>stage Ⅱ, early pulmonary hypertension, moderate-severe BPD, and hemodynamically significant patent ductus arteriosus (hsPDA) all had statistically significant influence between the PH group and the non PH group (all P<0.05). Antenatal corticosteroids, fetal distress, NRDS >stage Ⅱ, hsPDA, pneumonia and days of invasive mechanical ventilation were identified as predictive variables and finally included to establish the Logistic regression model. The AUC of this model was 0.86 (95%CI 0.82-0.90), the cut-off value was 0.17, the sensitivity was 0.77, and the specificity was 0.84. Hosmer-Lemeshow goodness-of-fit test showed that P>0.05. The AUC for external validation was 0.88, and the Hosmer-Lemeshow goodness-of-fit test suggested P>0.05. Conclusions: A high sensitivity and specificity risk prediction model of PBD associated PH in very premature infants was established. This predictive model is useful for early clinical identification of infants at high risk of BPD associated PH.

The Associations of Two Novel Inflammation Biomarkers, SIRI and SII, with Mortality Risk in Patients with Chronic Heart Failure.

The associations of two novel inflammation biomarkers, systemic inflammation response index (SIRI) and systemic immune inflammation index (SII), with mortality risk in patients with chronic heart failure (CHF) are not well-characterized. This retrospective cohort study included patients with CHF in two medical centers of Chinese People's Liberation Army General Hospital, Beijing, China. The outcomes of this study included in-hospital mortality and long-term mortality. Associations of SIRI and SII with mortality were assessed using multivariable regressions and receiver operating characteristic (ROC) analyses. A total of 6232 patients with CHF were included in the present study. We documented 97 cases of in-hospital mortality and 1738 cases of long-term mortality during an average 5.01-year follow-up. Compared with patients in the lowest quartile of SIRI, those in the highest quartile exhibited 134% higher risk of in-hospital mortality (adjusted odds ratio, 2.34; 95% confidence interval [CI], 1.16-4.72) and 45% higher risk of long-term mortality (adjusted hazard ratio, 1.45; 95% CI, 1.25-1.67). Compared with patients in the lowest quartile of SII, those in the highest quartile exhibited 27% higher risk of long-term mortality (adjusted hazard ratio, 1.27; 95% CI, 1.11-1.46). In ROC analyses, SIRI showed better prognostic discrimination than C-reactive protein (area under the curve: 69.39 vs 60.91, P = 0.01, for in-hospital mortality; 61.82 vs 58.67, P = 0.03, for 3-year mortality), whereas SII showed similar prognostic value with C-reactive protein. SIRI and SII were significantly associated with mortality risk in patients with CHF. SIRI may provide better prognostic discrimination than C-reactive protein.

Analisis Kegagalan Consociational Approach dalam Perjanjian Naivasha Sudan

The Second Sudanese Civil War was a conflict between the Sudanese government and a separatist group from South Sudan, namely the Sudan People's Liberation Movement/Army (SPLM/A). It was the most prolonged violent conflict in African history (1983-2005). The conflict officially ended after the signing of the Naivasha Agreement in 2005. In this agreement, there was an effort to resolve the conflict with a consociational approach that carried out project sharing between the conflicting parties. However, this agreement did not succeed in making Sudan free from conflict. This article will present an analysis of the failure to implement the consociational approach in creating positive peace in Sudan and South Sudan The findings of this research are that the power-sharing carried out in this agreement only involves elites. Apart from that, the distribution of resources other than oil has yet to be carried out, which should also be divided, taking into account identity factors.

Black Consciousness and Black Theology: Di ya thoteng di bapile (relationship for liberation)

The aim of this article is to point out that Black Consciousness and Black Theology are conceptually and philosophically comrades in arms, fighting side-by-side for the liberation of the oppressed masses, especially the black people emerging from apartheid South Africa. Through the literature review, the two philosophical disciplines are historically sketched, defined, and compared. The Setswana idiom, Di ya thoteng di bapile (comradeship), like many African proverbs and idioms, is philosophically employed as a way of decolonising theology. The idiom is used to demonstrate the symbiotic relationship between Black Consciousness and Black Theology in fighting against structural injustices in societies. Historical evolvement of the two disciplines is narratively presented to demonstrate how the two philosophies can continue to fight together towards the liberation of the marginalised masses in post-apartheid South Africa. The article concludes by sketching some strategic initiatives that can be undertaken to create the space for these two disciplines to symbiotically lead to the liberation of people living under the new form of political, cultural and socio-economic marginalisations. The strategic initiatives include the enhancement of self-reliance, prophetic role, and dialogical processes that lead to emancipation of those who sense self-pity, dependency syndrome, and loss of sense of quality life. These initiatives can be achieved through symbiotic cooperation of Black Consciousness and Black Theology, eventually leading to human liberation from any form of oppression.Contribution: There is a symbiotic cooperation of Black Consciousness and Black Theology, eventually leading to human liberation from any form of oppression.

Clinicopathological analysis of adult hepatic mesenchymal hamartoma

Objective: To explore the clinicopathological and molecular genetic features of adult hepatic mesenchymal hamartoma (MHL). Methods: A total of five confirmed adult MHL cases diagnosed at the Pathology Department of the First Medical Center of the People's Liberation Army General Hospital between 2009 and 2022 were collected. Histomorphological observation and immunohistochemical staining were conducted. Gene detection was performed by next-generation sequencing. Results: Among the five cases, four were male and one was female, aged 46-67 years, with an average age of 56.2 years. The maximum diameter was 5.3-13.5cm, and the average diameter was 9.2cm. Tumors were generally cystic, solid, or mixed cystic-solid. Histopathologically, in four out of five cases of MHL, malignant transformation occurred, of which three cases were malignantly transformed into undifferentiated embryonal sarcoma and one case was malignantly transformed into a malignant solitary fibrous tumor. NAB2-STAT6 gene rearrangements were identified. Conclusion: Adult MHL is a rare kind of tumor with malignant potential, and it is difficult to diagnose with preoperative imaging examinations. A fine-needle biopsy is rarely used for diagnosis, but surgical resection of symptomatic or enlarged lesions is recommended to rule out the possibility of malignancy and further diagnosis. Genetic testing results revealed the complex genetic alterations in MHL, and it was found that adult MHL can malignantly transform into malignant solitary fibrous tumors. We believe that genome-wide analysis is necessary to determine the unique molecular characteristics of MHL and identify potential targets for therapeutic intervention.

Enhancing Efficacy and Safety in Laparoscopic Partial Nephrectomy for Localized Renal Tuberculosis: The Skirted Continuous Suture Technique.

BACKGROUND Limited research has been conducted on laparoscopic partial nephrectomy for kidney tuberculosis. This study aimed to evaluate the effectiveness of the skirted continuous suture technique in laparoscopic partial nephrectomy for localized renal tuberculosis. MATERIAL AND METHODS Five patients with kidney tuberculosis underwent standard retroperitoneal laparoscopic partial nephrectomy after computed tomography evaluation. The skirted continuous suture technique was utilized during the procedure. This retrospective study analyzed the outcomes of these patients who received treatment between January 2011 and December 2020 at Beijing Tsinghua Changgung Hospital and Eighth Medical Center of Chinese People's Liberation Army General Hospital. RESULTS The surgical success rate was 100%. Renal function was well preserved, with a decrease of glomerular filtration rate by 9.6±9.0 ml/min. Only 1 patient experienced postoperative urinous infiltration and lymphatic fistula, while the others did not have any surgical complications. Antituberculous therapy was continued postoperatively, and 1 patient had recurrence during follow-up. CONCLUSIONS The laparoscopic continuous suturing technique offers a reliable and straightforward method for extensively closing incision edges of the renal parenchyma in laparoscopic surgery. It contributes to the improved efficacy and safety of treating localized renal tuberculosis with exceptional application.

Retrospective Study on Genetic Diversity and Drug Resistance among People Living with HIV at an AIDS Clinic in Beijing.

(1) Background: The objective of this study was to investigate the prevalence of genetic diversity and drug resistance mutations among people living with HIV (PLWH) attending clinics in Beijing. (2) Methods: A retrospective analysis was conducted on PLWH admitted to the Fifth Medical Center of People's Liberation Army (PLA) General Hospital between 1 March 2013 and 31 July 2020. The participants were analyzed for pretreatment drug resistance (PDR) and acquired drug resistance (ADR). Nested polymerase chain reaction (PCR) was utilized to amplify the pol gene from plasma RNA samples obtained from the participants. Genotypic and HIV drug resistance were determined using the Stanford University HIV Drug Resistance Database. Univariate and multifactorial logistic analyses were used to assess the risk factors for PDR. (3) Results: The overall prevalence rates of PDR and ADR were 12.9% and 27.8%, respectively. Individuals treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) exhibited the highest prevalence of mutations. Specific mutation sites, such as V179D for NNRTIs and M184V and K65R for nucleoside reverse transcriptase inhibitors (NRTIs), were identified as prevalent mutations. Individuals treated with efavirenz (EFV) and nevirapine (NVP) were found to be susceptible to developing resistance. The multifactorial regression analyses indicated that the factors of circulating recombination form (CRF) genotype CRF07-BC and a high viral load were associated with an increased risk of PDR. CRF01-AE and CRF07-BC were the most prevalent HIV genotypes in our study. (4) Conclusions: The distribution of HIV genotypes in Beijing is complex. There is a need for baseline screening for HIV drug resistance among ART-naive individuals, as well as timely testing for drug resistance among ART-experienced individuals.

Safety and efficacy of donor-derived chimeric antigen receptor T-cell therapy in patients with relapsed B-cell acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation

Objective: To investigated the safety and efficacy of donor-derived CD19+ or sequential CD19+ CD22+ chimeric antigen receptor T-cell (CAR-T) therapy in patients with B-cell acute lymphoblastic leukemia (B-ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: The data of 22 patients with B-ALL who relapsed after allo-HSCT and who underwent donor-derived CAR-T therapy at the Zhujiang Hospital of Southern Medical University and the 920th Hospital of Joint Logistics Support Force of the People's Liberation Army of China from September 2015 to December 2022 were retrospectively analyzed. The primary endpoint was overall survival (OS), and the secondary endpoints were event-free survival (EFS), complete remission (CR) rate, and Grade 3-4 adverse events. Results: A total of 81.82% (n=18) of the 22 patients achieved minimal residual disease-negative CR after CAR-T infusion. The median follow-up time was 1037 (95% CI 546-1509) days, and the median OS and EFS were 287 (95% CI 132-441) days and 212 (95% CI 120-303) days, respectively. The 6-month OS and EFS rates were 67.90% (95% CI 48.30%-84.50%) and 58.70% (95% CI 37.92%-79.48%), respectively, and the 1-year OS and EFS rates were 41.10% (95% CI 19.15%-63.05%) and 34.30% (95% CI 13.92%-54.68%), respectively. Grade 1-2 cytokine release syndrome occurred in 36.36% (n=8) of the patients, and grade 3-4 occurred in 13.64% of the patients (n=3). Grade 2 and 4 graft-versus-host disease occurred in two patients. Conclusion: Donor-derived CAR-T therapy is safe and effective in patients with relapsed B-ALL after allo-HSCT.

"Professionals Talk Logistics": Why Resupplying Taiwan in a Future War Will Be Harder Than Resupplying Ukraine

executive summary: This article compares the logistical challenges associated with the West's military resupply of Ukraine and those of resupplying Taiwan in a potential future conflict. main argumentDespite facing critical munitions shortages and growing political divisiveness over the substantial financial burden of this policy, the West's resupply of the Ukrainian military during Ukraine's current war with Russia has—so far—been a success, keeping forces battle-worthy and able to continue fighting after nearly two years of high-intensity conventional warfare. Would the resupply of Taiwan against China in wartime be similarly feasible for the U.S. and its regional partners in the Pacific? Major obstacles distinguish the Taiwan scenario. In prioritizing planning for a Taiwan contingency, the U.S. government should consider five major logistical factors: geopolitical ambiguity, the tyranny of distance, the need to resupply by air and sea, the involvement of reliable regional partners, and China's tolerance for the supply of armament to Taiwan in wartime. policy implications• Pre-positioning war materiel forward on allied soil is crucial to enable a rapid response to any military aggression against Taiwan. Besides increasing stocks of arms and ammunition in Taiwan itself, materiel should be pre-positioned with short reach to Taiwan in Japan, South Korea, and the Philippines and closely linked with depots in Guam, Hawaii, Australia, and the continental U.S. in a hub-and-spoke framework. • To assist Taiwan in establishing reserves of arms and munitions, the U.S. should increase technology transfer and joint production of critical war materiel with and in Taiwan. Boosting Taiwan's own defense industry base will help ensure the security of supply and an independent maintenance, repair, and overhaul capability in a conflict. Moreover, to ensure the materiel survives, hardening, decentralization, and the ability to disperse at least parts of the industrial production and maintenance, repair, and overhaul capability should be advanced. • In a war across the Taiwan Strait, Taiwanese ports and airports would come under attack early on, and even if they were not destroyed, the People's Liberation Army would try to block access to them, hindering resupply efforts. Strong emphasis should be placed on the development of robust amphibious and civilian roll-on/roll-off capabilities, buildup of temporary piers, and improvement of Taiwan's transportation infrastructure.

«Мать-Россия новых родных деток нашла…»: о роли образа ребенка в трактовке славянской идеи в «Дневнике писателя» Ф.М. Достоевского

Perceptions of the Russo-Turkish War and Russia’s foreign policy of the 1870s received much attention in “A Writer”s Diary” by Fyodor Dostoevsky. Within the narrative of Slavic suffering in the Balkans, the writer frequently employs the image of a suffering child, the central motif in the “Diary.” This paper argues for the importance of examining sections related to the Eastern Question within the broader ideological context of Dostoevsky’s journal. The identification of parallels between journalistic and artistic segments facilitates a more comprehensive understanding of the author’s perspective on the Slavic idea, particularly the significance of the child’s image in its portrayal throughout the “Diary.” While the author provides vivid depictions of Slavic children’s sufferings, he also characterizes Slavs collectively as Russia’s children in need of its advocacy and protection. The portrayal of suffering Slavic Orthodox children is integrated into the overarching system of child imagery in the “Diary,” serving as poignant evidence for the necessity of pan-Slavism. Dostoevsky associates the liberation of Orthodox peoples in the Balkans with Russia’s religious mission, emphasizing its duty to provide altruistic assistance to Slavic “children” in the name of true Christ, whose genuine image endures solely within Orthodoxy.

Discussion Of Armenian National-Political Problems In The Periodical “The Fight” (1897-1901)

In 1887 the theoreticians of the Hunchakyan party, which was founded in Geneva, unlike other parties, believed that after the liberation of the Armenian people from Turkish and then Russian rule, a socialist social order should be established in democratic Armenia. Going ahead of the natural development of events, Hunchakyans were engaged in propaganda of socialism in Western Armenia in the late 1880s - early 1890s.

Safety and feasibility of minimally invasive gastrectomy after neoadjuvant immunotherapy for locally advanced gastric cancer: a propensity score-matched analysis in China.

The effect of neoadjuvant immunotherapy on minimally invasive gastrectomy (MIG) for locally advanced gastric cancer (LAGC) remains controversial. This study aimed to compare short-term outcomes between MIG after neoadjuvant chemo-immunotherapy (NICT-MIG) and MIG after neoadjuvant chemotherapy alone (NCT-MIG), and determine risk factors for post-operative complications (POCs). This retrospective study included clinicopathologic data from 193 patients who underwent NCT-MIG or NICT-MIG between January 2020 and February 2023 in the Department of General Surgery, Chinese People's Liberation Army General Hospital First Medical Center (Beijing, China). Propensity score-matched analysis at a ratio of 1:2 was performed to reduce bias from confounding patient-related variables and short-term outcomes were compared between the two groups. The baseline characteristics were comparable between 49 patients in the NICT-MIG group and 86 patients in the NCT-MIG group after propensity score matching. Objective and pathologic complete response rates were significantly higher in the NICT-MIG group than in the NCT-MIG group (P < 0.05). The overall incidence of treat-related adverse events, intraoperative bleeding, operation time, number of retrieved lymph nodes, time to the first flatus, post-operative duration of hospitalization, overall morbidity, and severe morbidity were comparable between the NCT-MIG and NICT-MIG groups (P > 0.05). By multivariate logistic analysis, estimated blood loss of >200 mL (P = 0.010) and prognostic nutritional index (PNI) score of <45 (P = 0.003) were independent risk factors for POCs after MIG following neoadjuvant therapy. Safety and feasibility of NICT were comparable to those of NCT in patients undergoing MIG for LAGC. Patients with an estimated blood loss of >200 mL or a PNI score of <45 should be carefully evaluated for increased POCs risk.

Implications for China from the War in Ukraine: Comparison of the Western and Taiwanese Views

The Russian decision to conduct a full-scale invasion of Ukraine changed our world forever. European states are actively considering an increase in defense expenditures and trying to learn from ongoing armed conflict. On the other hand, Europeans are not the only ones learning from this war. The most dangerous geopolitical rival of the US, China, is watching this conflict closely as well and trying to learn as much as possible for its Taiwan campaign not only in the military domain, but also in diplomatic, information, and economic domains. This paper discusses possible implications for China in these domains. The authors pay special attention to the military domain divided into two subdomains, air and naval. First, a review of the literature of the Western view is conducted. Then data from semi-structured interviews with Taiwanese experts are used to compare those two views and identify possible implications for China and especially the People 's Liberation Army on the Taiwan campaign. Those two views are overall similar with minor differences.

Efficacy and Prognostic Factors of Nonmyeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Acute Myeloid Leukemia

To retrospectively analyze the efficacy and complications of our institution's modified nonmyeloablative allogeneic hematopoietic stem cell transplantation (NST) in treating intermediate-risk acute myeloid leukemia (AML) - first complete remission (CR1) and prognostic factors. Clinical data of 50 intermediate-risk AML-CR1 patients who underwent matched related NST at the Fifth Medical Center of Chinese People's Liberation Army General Hospital from August 2004 to April 2021 were collected, the hematopoietic recovery, donor engraftment and complications were observed, and overall survival (OS) rate, leukemia-free survival (LFS) rate, treatment-related mortality (TRM), and cumulative relapse rate were calculated. Statistical analysis of factors affecting prognosis was also preformed. The median times for neutrophil and platelet recovery after transplantation were 10 (6-16) and 13 (6-33) days, respectively. One month after transplantation, 22 patients (44%) achieved full donor chimerism (FDC), and 22 patients (44%) achieved mixed chimerism (MC), among whom 18 cases gradually transited to FDC during 1-11 months, 4 cases maintained MC status. The overall incidence of acute graft-versus-host disease (aGVHD) was 36%, with a rate of 18% for grade II-IV aGVHD and a median onset time of 45 (20-70) days after transplantation. The overall incidence of chronic GVHD (cGVHD) was 34%, with 20% and 14% of patients having limited or extensive cGVHD, respectively. The incidence rates of infections, interstitial pneumonia, and hemorrhagic cystitis were 30%, 10%, and 16%, respectively. The 5-year OS rate, LFS rate, TRM, and cumulative relapse rate were 68%, 64%, 16%, and 20%, respectively. The increase of the number of CD34+ cells infused had shortened the recovery time for neutrophils and platelets (r =0.563, r =0.350). The number of CD34+ cells infused significantly influenced the occurrence of extensive cGVHD (OR =1.36, 95%CI : 1.06-1.84, P =0.024). Modified NST is effective in treating intermediate-risk AML-CR1 patients, however, further expansion of sample size is needed to study prognostic factors.

Analysis of clinicopathological features and prognostic factors of breast cancer brain metastasis.

Breast cancer (BC) has become the most common malignancy in women. The incidence and detection rates of BC brain metastasis (BCBM) have increased with the progress of imaging, multidisciplinary treatment techniques and the extension of survival time of BC patients. BM seriously affects the quality of life and sur-vival prognosis of BC patients. Therefore, clinical research on the clinicopathological features and prognostic factors of BCBM is valuable. By analyzing the clinicopathological parameters of BCBM patients, and assessing the risk factors and prognostic indicators, we can perform hierarchical diagnosis and treatment on the high-risk population of BCBM, and achieve clinical benefits of early diagnosis and treatment. To explore the clinicopathological features and prognostic factors of BCBM, and provide references for diagnosis, treatment and management of BCBM. The clinicopathological data of 68 BCBM patients admitted to the Air Force Medical Center, Chinese People's Liberation Army (formerly Air Force General Hospital) from 2000 to 2022 were collected. Another 136 BC patients without BM were matched at a ratio of 1:2 based on the age and site of onset for retrospective analysis. Categorical data were subjected to χ2 test or Fisher's exact probability test, and the variables with P < 0.05 in the univariate Cox proportional hazards model were incorporated into the multivariate model to identify high-risk factors and independent prognostic factors of BCBM, with a hazard ratio (HR) > 1 suggesting poor prognostic factors. The survival time of patients was estimated by the Kaplan-Meier method, and overall survival was compared between groups by log-rank test. Multivariate Cox regression analysis showed that patients with stage III/IV tumor at initial diagnosis [HR: 5.58, 95% confidence interval (CI): 1.99-15.68], lung metastasis (HR: 24.18, 95%CI: 6.40-91.43), human epidermal growth factor receptor 2 (HER2)-overexpressing BC and triple-negative BC were more prone to BM. As can be seen from the prognostic data, 52 of the 68 BCBM patients had died by the end of follow-up, and the median time from diagnosis of BC to the occurrence of BM and from the occurrence of BM to death or last follow-up was 33.5 and 14 mo, respectively. It was confirmed by multivariate Cox regression analysis that patients with neurological symptoms (HR: 1.923, 95%CI: 1.005-3.680), with bone metastasis (HR: 2.011, 95%CI: 1.056-3.831), and BM of HER2-overexpressing and triple-negative BC had shorter survival time. HER2-overexpressing, triple-negative BC, late tumor stage and lung metastasis are risk factors of BM. The presence of neurological symptoms, bone metastasis, and molecular type are influencing prognosis factors of BCBM.

Explaining the Decline Of Suicide Terrorism in Turkey

AbstractSince the 9/11 attacks, there has been a growing interest in the terrorism problem, in general, and the strategy of suicide bombing, in particular. Between 1996 and 2016, Turkey experienced several deadly suicide attacks by groups like the Kurdistan Workers’ Party, the Revolutionary People's Liberation Party/Front, al‐Qaeda, and the Islamic State. These attacks can be explained by individual‐oriented, institutional, socio‐psychological/economical/identity, and structural theories. However, a central question now is why there have been no suicide attacks since 2016—that is, until the attempted bombing of the Ministry of the Interior on October 1, 2023. This article advances five main reasons for this success: a shift in Turkey's antiterrorism strategy, the introduction of new technologies, terror groups’ concerns about losing legitimacy among supporters, the failure of these organizations to achieve their objectives through suicide terrorism, and changes in Turkey's external environment. The article concludes that, as the October 1 attack demonstrates, the renewal of suicide terrorism is likely, given Ankara's sole focus on the institutional and international/structural aspects of the problem, which does not allow enough attention on individual and sociological factors.

Peran United Nations High Commissioner for Refugee dalam Membantu Kebutuhan Kesehatan Pengungsi Konflik Tigray di Ethiopia (2022-2023)

This article aims to explain the health conditions of Tigray Conflict refugees and the role of the United Nations High Commissioner for Refugees (UNHCR) in assisting the health needs of Tigray Conflict refugees in Ethiopia in the period 2022-2023. The author uses the theory of international organizations which sees that international organizations have five important roles in resolving problems. This theory is very relevant to the context of the author’s research by looking at UNHCR as an international organization which has one of the five important roles of international organizations, namely as an Aid Provider in resolving conflict in the Tigray region. The type of research used in this article is descriptive, using a library study method which is carried out by collecting data from journals, books, websites and articles as a data collection technique. Based on the results of this research, UNHCR as an international organization working in the field of refugees took part in handling refugees due to the conflict that occurred in Ethiopia, specifically in the Tigray region, namely the conflict between the central government and the Tigrayan People's Liberation Front (TPLF), so the author found that UNHCR had plays a role in providing assistance in the form of basic health services, distribution of vaccines and immunizations, as well as workshops and mental health services.

Bosnia and Herzegovina and the establishment of the AVNOY Yugoslavia (1943-1945)

Many states, like Yugoslavia, emerged from conflicting historical currents. A critical examination of the socio-historical multi-directional flows after the chaotic April War of 1941 and the rapid disintegration of monarchical Yugoslavia also encompasses rational knowledge of opposing political and national perspectives dating back to 1918 when it was established, with its problematic events between the two World Wars, their causes, and consequences. The turbulent interwar legacy and the failure to address acute problems within the state influenced the dramatic situation and conflicts in occupied Yugoslavia, leading to polarization, collaboration, and alignments. The state of war is a complex crisis situation. The breakup of Yugoslavia was met with divided opinions on whether (and if so, how and on what basis) to reestablish the state. Each Yugoslavia (the „old” and the „new”) also represented a „new constitutional concept of the relationship between its major nations/political groups” (Dejan Jović). The successful antifascist liberation struggle from 1941 to 1945 was primarily led by the partisan movement, with the dominant role of the Communist Party of Yugoslavia (CPY). Vladimir Dedijer wrote that in 1941, a revolutionary war began, and „no one dreamed what its nature would be.” It was a civil war, destroying the idea that this state could be rebuilt in the form it took in 1918. It was a complex war („a war of all against all”) with numerous burdens (national, religious, social, historical). Anti-Yugoslav forces were long more numerous than pro-Yugoslav forces, which eventually triumphed. The speech of Yugoslav antifascism is most symbolically recognizable by the phrase: „Death to fascism – freedom to the people,” and „brotherhood and unity.” By the decision on the federal organization of the state at the Second Session of the Anti-Fascist Council of National Liberation of Yugoslavia (AVNOJ) in Jajce in 1943, the foundational pillar of the previous Yugoslavia—state and national unitarism—was denied. AVNOJ's decisions were of a framework and principle nature. The federation was established, but until the end, the forms of all its units related to their borders and the structure of alliance members („unitary or complex”) were not fully defined. The emergence of the federal Bosnia and Herzegovina was accompanied by harmonization at the top of the CPY and the People's Liberation Movement. The specificity of the „AVNOJ formula” was also reflected in the fact that in 1943, a federal state was formed, and in 1944, the members of the federation (republics). At that time, their provincial antifascist councils were constituted as the highest legislative and executive representative bodies. Many accompanying issues addressed in the decisions in Jajce on the structure of Yugoslavia remained under detailed consideration and clarification by the state-party leadership and AVNOJ in 1945. These issues have continued to be the subject of more detailed review and analysis in the context of the developments in historiography and have been exposed to considerations in a broader context. They have been reinterpreted, their facts have been analyzed, and there have been „in-depth” searches for more complete, multiperspective answers. The development of historiography is „marked by controversy.” Research into the formation of the „new” Yugoslavia should not be conducted with ideological biases and prejudices but should consider new experiences present in the flow of time and in the minds of contemporaries, including historians, as „children of their time.” Relevant historical contents must be separated from „declarative proclamations, pathos statements, ceremonial-protocol stances.” In a simplified understanding of the past, „everything appears simple and linear.” It is necessary to interpret historical phenomena and processes in a multidimensional, layered, and grounded manner.