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Clearance of hepatitis B surface antigen (HBsAg) is an ideal therapeutic goal for patients with chronic hepatitis B virus (HBV) infection. Haematopoietic stem cell transplantation (HSCT) is the most effective therapy for a variety of haematological diseases. For patients with chronic HBV infection who received allo-HSCT, recipient hepatitis B serological status might change after allo-HSCT; however, data on the loss of HBsAg following allo-HSCT are relatively rare. We first reviewed patients with chronic HBV infection who received allo-HSCT in our centre from 2010 to 2020, and 125 patients were included in our study. A total of 62 patients (49.6%) with chronic HBV infection achieved HBsAg loss after allo-HSCT. Positivity for HBeAb and HBsAb in donors as well as no cytomegalovirus (CMV) infection were identified as independent risk factors for HBsAg loss after allo-HSCT. A predictive model including positivity for HBeAb and HBsAb in donors and no CMV infection was subsequently developed and performed well with effective discrimination and calibration. In addition, patients could benefit when this model is used in the clinic, as revealed via decision-curve analysis (DCA). However, multicentre prospective studies are required for validation.

Natural killer/T-cell lymphomas (NKTCL) represent rare and aggressive lymphoid malignancies. Patients (pts) with relapsed/refractory disease after Asparaginase (ASPA)-based chemotherapy have a dismal prognosis. To better define the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT), we conducted a retrospective analysis of data shared with the European Society for Blood and Marrow Transplantation (EBMT) and cooperating Asian centers. We identified 135 pts who received allo-HSCT between 2010 and 2020. Median age was 43.4 years at allo-HSCT, 68.1% were male. Ninety-seven pts (71.9 %) were European, 38 pts (28.1%) Asian. High Prognostic Index for NKTCL (PINK) scores were reported for 44.4%; 76.3% had >1 treatment, 20.7% previous auto-HSCT, and 74.1% ASPA-containing regimens prior to allo-HSCT. Most (79.3%) pts were transplanted in CR/PR. With a median follow-up of 4.8 years, 3-year progression-free(PFS) and overall survival were 48.6% (95%-CI:39.5–57%) and 55.6% (95%-CI:46.5–63.8%). Non-relapse mortality at 1 year was 14.8% (95%-CI:9.3–21.5%) and 1-year relapse incidence 29.6% (95%-CI:21.9–37.6%). In multivariate analyses, shorter time interval (0–12 months) between diagnosis and allo-HSCT [HR = 2.12 (95%-CI:1.03–4.34); P = 0.04] and transplantation not in CR/PR [HR = 2.20 (95%-CI:0.98–4.95); P = 0.056] reduced PFS. Programmed cell death protein 1(PD-1/PD-L1) treatment before HSCT neither increased GVHD nor impacted survival. We demonstrate that allo-HSCT can achieve long-term survival in approximately half of pts allografted for NKTCL.

Hepatitis-associated aplastic anemia (HAAA), a rare subtype of aplastic anemia (AA), is defined as bone marrow failure occurring after acute hepatitis. Severe HAAA requires immunosuppressive therapy (IST) or hematopoietic stem cell transplantation (HSCT) as lifesaving treatment. The outcomes of HAAA patients who underwent haploidentical hematopoietic stem cell transplantation (haplo-HSCT) have not been systematically evaluated. We retrospectively compared the characteristics of 15 patients with HAAA and 60 non-hepatitis-associated aplastic anemia (non-HAAA) patients, all 75 of whom underwent haplo-HSCT in our hospital between January 2006 and October 2021. The median ages of the patients were 18 years old (range, 3-36) for HAAA patients and 13 years (range, 2-45) for non-HAAA patients (p = 0.693). The median time for neutrophil engraftment was 14 days (range, 11-22) in the HAAA group and 12 days (range, 10-21) in the non-HAAA group (p = 0.363). At the time of analysis, 15 HAAA patients and 58 non-HAAA patients were alive, and their median follow-up times were 37 (range, 3-87) months and 31 (range, 2-110) months (p = 0.347), respectively. There were no significant differences in the three-year overall survival (OS) rates (100% vs. 96.7 ± 0.33%, P = 0.638) or liver event-free survival (LEFS) (80.0 ± 0.17% vs. 76.7 ± 0.19%, P = 0.747) between the two groups. Despite the small number of HAAA patients due to the rarity of the disease, these results, such as the similar incidence rates of 3-year OS and fewer liver events than expected, suggest that haplo-HSCT is a feasible treatment for HAAA a when there are no human leukocyte antigen (HLA)-matched donors available and has a low risk of transplant-related mortality and complications.

Yang Gao,1,&ast; Ling Yue,2,&ast; Zhilin Miao,1 Fengrong Wang,3 Shuai Wang,3 Bo Luan,1 Wenjun Hao1 1Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China; 2Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China; 3Department of Cardiology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenjun Hao, Department of Cardiology, The People’s Hospital of Liaoning Province, NO. 33, Wenyi Road, Shenhe District, Shenyang, Liaoning Province, 110016, People’s Republic of China, Email wjunheart@sina.comPurpose: To observe the effect of cardiac rehabilitation (CR) in patients with partial revascularization performed on multiple coronary artery lesions and explore its possible mechanism.Patients and Methods: A total of 400 patients with multiple coronary artery lesions were enrolled and randomly divided into a complete revascularization group and a CR group, with 200 cases in each group. Target lesion revascularization was performed radically in the complete revascularization group, while it was partially completed in the CR group, and postoperative CR was performed. All the patients were put under conventional treatment. Left ventricular end diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety and levels of serum nitric oxide (NO), nitric oxide synthase (NOS), superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF) were evaluated and compared between two groups before and after training.Results: There was no significant difference in LVEDD, LVEF, 6-MWD, quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two groups before training (p> 0.05). 1 year later, compared with the complete revascularization group, the occurrence of major adverse events in the CR group declined (p> 0.05); the measurements of LVEDD decreased and LVEF increased (p> 0.05), 6-MWD increased significantly (p< 0.05), quality-of-life scores were higher (p< 0.05), the levels of serum NO, NOS, and SOD increased noticeably, and the levels of serum VEGF decreased significantly in the CR group (p< 0.05). There were significant differences within the same group, before and after training (p< 0.05).Conclusion: Cardiac rehabilitation training, not increase in the incidence of adverse events, is effective and safe after partial revascularization in patients with multiple coronary artery lesions, which has notable clinical advantages in promoting patients’ exercise endurance and quality-of-life by improving the nitric oxide synthase system and antioxidant system and reducing the level of VEGF.Keywords: multiple coronary artery lesions, cardiac rehabilitation, coronary revascularization, 6-MWD, quality-of-life, NO/NOS

Backgrounds: To assess the impact of SGLT2i on the cardiovascular and safety outcomes of patients with chronic kidney disease (CKD). Methods: Eligible articles were chosen via a systematic search of the PubMed, Embase, and Cochrane electronic databases. We screened for randomized placebo-controlled clinical trials (RCTs) investigating the outcome of SGLT2i on patients with CKD. The main cardiovascular outcomes were major adverse cardiovascular events (MACE), which involved non-fatal myocardial infarction, non-fatal stroke and cardiovascular death, cardiovascular death and hospitalization for heart failure. On the other hand, acute renal injury, hypoglycemia, diabetic ketoacidosis, and amputation were considered as safety indicators for this trial. Renal insufficiency was defined as eGFR2. In case the heterogeneity outcome index was ≥50%, we conducted sensitivity analysis on relevant data to ensure the reliability of our conclusions. Results: Overall, 7 articles, involving 26739 total participants, conformed to our inclusion and exclusion criteria. Compared to placebo, SGLT2i significantly modulated cardiovascular outcomes MACE (OR: 0.76 95% CI: 0.68 to 0.86 I2:40.7% P: 0.168), cardiovascular death (OR: 0.83 95% CI: 0.72 to 0.95 I226.4% P: 0.236), and hospitalization for heart failure (OR: 0.67 95% CI: 0.60 to 0.76 I2:0.0% P: 0.538), as well as safety outcomes, such as, acute renal injury (OR: 0.83 95% CI: 0.68 to 1.00 I2:0.0% P: 0.576), hypoglycemia (OR: 0.88 95% CI: 0.73 to 1.07 I2:18.4% P: 0.297), diabetes ketoacidosis (OR: 2.57 95% CI: 1.50 to 4.41 I2:46.3% P: 0.133), and amputation (OR: 1.09 95% CI: 0.87 to 1.36 I2; 0.0% P: 0.703). Conclusion: In patients with CKD, SGLT2i usage markedly diminished incidences of cardiovascular outcomes MACE, cardiovascular death and hospitalization for heart failure. In addition, it also reduced the related risks of safety outcomes, such as, acute renal injury, hypoglycemia, diabetic ketoacidosis, and amputation. However, since the safety outcome selection was not complete in this trial, further investigations are necessary to assess all safety outcomes among a larger patient population.

Background: Checkpoint inhibitors targeting the PD-1/PD-L1 have changed the treatment and prognosis for patients with advanced solid tumors. There remains a unmet need for additional therapies due to treatment resistance. Tumor-necrosis superfamily members, such as CD137 and CD40, have been shown to synergize with the checkpoint inhibitors in preclinical studies. However, agonists antibodies have exhibited limited clinical activity for severe liver toxicity. Here we have developed a Fc-silenced bispecific antibody targeting PD-L1 and CD137, HK010, which could overcome these limitations by tumor-directed T-cell activation and checkpoint blockade. Methods: The antigen binding specificity and affinity of HK010 were determined by enzyme-linked immunosorbent assay (ELISA), surface plasmon resonance (SPR) and flow cytometry. The functional activity of HK010 was determined using in vitro cell-based assays and reporter gene assay. Transgenic mice expressing human PD-L1 and 4-1BB were transplanted with human PD-L1-expressing murine MC38 cells to assess in vivo antitumor activity. Cytokine release assay was conducted by incubating HK010 with peripheral blood mononuclear cells (PBMCs) from healthy donors (n=6). The pharmacokinetic (PK) behavior and safety profiles of HK010 were characterized in cynomolgus monkeys. Results: HK010 is a IgG4 PD-L1 × 4-1BB bsAb, which was designed to maintain a high affinity for human PD-L1 and a low affinity for human 4-1BB (KD PD-L1: 2.27 nM; KD 4-1BB: 493 nM) to achieve strong blocking of PD-1/PD-L1 and appropriate agonism of 4-1BB. HK010 retained full blockade activity on PD-1/PD-L1 signaling and enhances T-cell proliferation and IFN-γ production in vitro primary cell assays and Mixed lymphoid reaction (MLR). In addition, it led to a dose-dependent increase in the CD137-driven NFκB reporter gene activation through the bridging of PD-L1 on target cells and CD137 on effector cells. In humanized PD-L1/4-1BB transgenic mice bearing with MC38/hPDL1 tumor, HK010 showed robust single agent anti-tumor activity and induced durable antigen-specific immunological memory that prevents the growth of the same tumor cells in the mice re-challenged. There were no signs of toxicity in human cytokine release assay for HK010. Toxicology data in cynomolgus monkeys showed that HK010 was well-tolerated up to 150 mg/kg (MTD≥150mg/kg) dose without systemic toxicity. Furthermore, HK010 was confirmed to be highly safe in the 5-week repeated-dose toxicity study with no observed treatment-related mortality, abnormality in hematological indexes, important organs. Conclusion: These data demonstrate that HK010, an anti-PD-L1 × CD137 bispecific antibody, may exert a strong localized anti-tumor therapeutic efficacy with a low risk of liver toxicity through tumor-directed T-cell activation and checkpoint blockade in tumors. Citation Format: Liangwei Li, Wenting Liu, Guodong Shen, Dayan Zhang, Weiming Zhou, Fengrong Wang, Xiaoli Zeng, Yang Huang, Liansheng Cheng. HK010, a novel anti-PDL1 × CD137 bispecific antibody, exhibits potent anti-tumor immunity and low toxicity. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5657.

Background: CD137 (TNFRSF9, 4-1BB) is a member of the tumor necrosis factor receptor superfamily that functions as a costimulatory molecule of immunocytes and is mainly expressed on the surface of immune cells including activated T and natural killer (NK) cells. Agonists against CD137 have shown promising therapeutic activity in mouse tumor models but have suffered setback in the clinic due to notably hepatotoxicity, or suboptimal agonistic potency. Here, we developed a fully human agonistic anti-CD137 monoclonal IgG4 antibody, ZG033, with an exclusive epitope, to achieve a better efficacy and safety profile for immunotherapy. Methods: The antigen binding specificity and affinity of ZG033 were determined by ELISA, surface plasmon resonance (SPR). X-ray crystallography was conducted to resolve the binding epitopes of the respective binding arms. The activities were determined using cell-based and reporter gene assays. In vivo antitumor activities were evaluated in human 4-1BB transgenic mice bearing with syngeneic tumors, and possible toxicity was evaluated in humanized mice and cynomolgus monkeys. Cytokine release assay was conducted by incubating ZG033 with PBMCs from healthy donors. The pharmacokinetic (PK) behavior of ZG033 were characterized in cynomolgus monkeys. A phase 1 study was initiated to evaluate the safety and preliminary clinical activities of ZG033, as well as the immunogenicity and pharmacokinetics. Results: ZG033 showed high specificity for human CD137 without cross-species reactivity across mouse, rat and exhibited potent CD137 agonist activity dependent on FcγR crosslinking. The binding affinity of ZG033 determined by surface plasmon resonance (SPR) was moderate (KD=10 nM). X-ray crystallography revealed that the Fab of ZG033 binds CD137 at an epitope overlap with the ligand binding interface. ZG033 increased CD137-driven NFκB reporter gene activation and the production of IFN-γ by human T cells in a FcγR-dependent manner. In human CD137 transgenic mice, ZG033 showed robust antitumor activity and induced durable antigen-specific immunological memory that prevented the tumor formation in the rechallenged mice. There were no signs of toxicity in human cytokine release assay which confirmed that ZG033 did not induce pro-inflammatory cytokines in the absence of TCR stimulation. Toxicology data in mice showed that ZG033 was well-tolerated with normal ALT and AST levels. ZG033 was further confirmed to well tolerated up to 180 mg/kg (MTD≥180mg/kg) dose without systemic toxicity in cynomolgus monkeys. Patients with advanced tumors, who are refractory after exhausting available therapies, were enrolled for ZG033 treatment. We will report the results from early dose escalation part of the study. Conclusion: These data demonstrate that ZG033 is an FcγR crosslinking-dependent CD137 agonist that displays a favorable safety profile and has potential in either mono- or combinational immunotherapies. Citation Format: Yang Huang, Liangwei Li, Wenting Liu, Dayan Zhang, Pengfei Zhou, Qing Fang, Weiming Zhou, Fengrong Wang, Guodong Shen, Liansheng Cheng. A novel CD137 agonist exhibits potent antitumor efficacy with a good safety profile [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1880.

Little is known regarding the utilization rate of autologous hematopoietic stem cell transplantation (AHSCT) for lymphoma and multiple myeloma (MM) in the mainland of China. In 2019, the autologous stem cell transplantation group of Chinese Society of Clinical Oncology reported 4556 first transplantations with a utilization rate of 3.8% for lymphoma and MM. The AHSCT utilization rates were 2.4% for lymphoma and 11.3% for MM. For lymphoma, the transplantation utilization rate was over 5.0% in the age group of 20–50 years with a peak of 6.5% in the age group of 40–44 years; for MM, the rate was over 10.0% in the age group of 35–65 with a peak of 33.8% in the age group of 45–49 years. The eastern region had higher transplantation utilization rate than central and western regions (4.6% vs. 3.0% vs. 3.3%). There was a wide gap in AHSCT utilization rates between the developed and developing provinces. Beijing had the highest transplantation utilization rate for both lymphoma and MM. This study provided a comprehensive evaluation of AHSCT utilization for lymphoma and MM in China, which will be useful for policy-making with respect to healthcare resource allocation and disease control strategies.

Haploidentical hematopoietic stem cell transplant (haplo-HSCT) provides an important alternative for children and adolescents with acquired severe aplastic anemia (SAA) lacking matched donors. To test whether pretransplant serum ferritin (SF) represents a candidate predictor for survival and a potential biomarker for graft-versus-host disease (GvHD) in pediatric haplo-HSCT, we retrospectively evaluated 147 eligible patients with SAA who underwent haplo-HSCT. The patients were divided into the low-SF group ( 1000 ng/mL) and the high-SF group (≥ 1000 ng/mL). We found that SF ≥1000 ng/mL independently increased the risk of grade II-IV aGvHD (HR = 2.596; 95% CI, 1.304-5.167, P = 0.007) and grade III-IV aGvHD (HR = 3.350; 95% CI, 1.162-9.658, P = 0.025). Similar probabilities of transplant-related mortality at 100 days were observed in the two groups (6.19 ± 2.45% vs 8.00 ± 3.84%, P = 0.168). The two-year overall survival (85.29 ± 3.89% vs 92.00% ± 3.84%, P = 0.746) and failure-free survival (83.23% ± 4.08% vs 83.37% ± 6.27%, P = 0.915) were comparable. GvHD-/failure-free survival were 60.06 ± 5.10% and 75.56 ± 6.87%, respectively (P = 0.056). In conclusion, elevated pretransplant SF level is associated with higher incidences of grade II-IV aGvHD and grade III-IV aGvHD. However, it is not associated with worse survival after haplo-HSCT for children and adolescent patients with SAA.

A higher CD34A total of 975 ALL patients were enrolled and classified into pre-HSCT MRD-positive and MRD-negative subgroups. Cox proportional hazard regression models were built for time-to-event outcomes. Multivariate analysis was performed to determine independent influencing factors from the univariate analysis.An appropriate CD34Our results indicated that no additional CD34

This study examines the implications of board interlocks on stock liquidity using a sample of listed Brazilian firms. The instrumental variable two-stage least squares estimation is used to minimize endogeneity concerns. This study provides evidence that board interlocks are positively related to stock liquidity. Our cross-sectional study findings reveal that the impact of board interlocks on stock liquidity is more pronounced for firms with high uncertainty, in competitive industries, and with poor governance. Our findings suggest that board interlocks aid businesses in accessing external capital from potential investors.

Financial agglomeration (FA) may play an essential role in enhancing energy efficiency (EE) and, thus, is important from both theoretical and empirical viewpoints. However, few studies have investigated the causal nonlinear relationship between FA and EE. Hence, we first extend the novel ray slacks-based measure with global technology to evaluate the urban EE in China during 2003–2018. Next, we reexamine the nonlinear causality of FA on EE and then explore the underlying impact mechanism. The empirical results show that China’s urban EE is generally relatively low with distinct patterns of regional differences. Moreover, we find that the causal relationship between FA and EE follows an inverted U-shaped function rather than a linear one. FA promotes the improvement of EE only up to a certain threshold point, after which it reverses into an inhibitory effect. A further analysis based on the two-regime spatial Durbin panel model suggests that FA can indeed improve the EE of surrounding cities through positive externalities when the degree of FA in focal cities is not substantially greater than that in surrounding cities. However, when financial resources absorbed in certain focal cities become increasingly higher than that in most surrounding cities, the positive spillover effect would gradually disappear and even reverse into an undesirable siphon, thereby inhibiting the improvement of overall EE. These findings provide new insights for understanding the role of FA in sustainable development.

Mitochondria fulfill essential roles in ATP production, metabolic regulation, calcium signaling, generation of reactive oxygen species (ROS), and additional determinants of cellular health. Recent studies have highlighted a role for mitochondria during cell differentiation, including in skin epidermis. The observation of oxidative stress in keratinocytes from Krt16 null mouse skin, a model for pachyonychia congenita (PC)-associated palmoplantar keratoderma, prompted us to examine the role of Keratin (K) 16 protein and its partner K6 in regulating the structure and function of mitochondria. Electron microscopy revealed major anomalies in mitochondrial ultrastructure in late stage, E18.5, Krt6a/Krt6b null embryonic mouse skin. Follow-up studies utilizing biochemical, metabolic, and live imaging readouts showed that, relative to controls, skin keratinocytes null for Krt6a/Krt6b or Krt16 exhibit elevated ROS, reduced mitochondrial respiration, intracellular distribution differences, and altered movement of mitochondria within the cell. These findings highlight a novel role for K6 and K16 in regulating mitochondrial morphology, dynamics, and function and shed new light on the causes of oxidative stress observed in PC and related keratin-based skin disorders.

Purpose The purpose of this paper studies the transformation effect of research and development (R&D) subsidies on firm performance in emerging economies from the perspective of capital and product markets. It also studies the mechanisms behind R&D subsidies’ transformation effect. Design/methodology/approach This study mainly explores the transformation effect of government R&D subsidies on corporate performance and its non-linear characteristics using Chinese A-share listed companies’ data from 2008 to 2016. The authors use the instrumental variable method to reduce endogenous problems and conduct a series of robustness tests to support the conclusions. The mechanisms of the transformation effect are explored via mediation effect models. The impact of firm heterogeneities on the transformation effect is also addressed. Findings Results indicate that R&D subsidies promote firm performance and experience obvious transformation effects only within a “moderate interval.” R&D subsidies play a vital role in enhancing firm performance mainly via two mechanisms, namely, signal financing and innovation incentives. Further, the transformation effect is much greater in non-state-owned, young and large enterprises. Originality/value This paper contributes to understanding how R&D subsidies affect corporate performance from the perspective of capital and product markets by applying the linear and non-linear techniques that can clarify the relationship between the selected variables under study. The findings of this study might be helpful to identify the right directions for the government to implement and promote the R&D subsidy policies more effectively.

The cut-off value for gain/amplification of 1q21(1q21+) was 20% according to the recommendations of the European Myeloma Network and there were limited studies concerning less than 20%. Meanwhile, the copy number variation of 1q21+ remains controversial. Our purpose was to evaluate the significance of clone size and copy numbers of 1q21+ in Chinese newly diagnosed multiple myeloma (NDMM).We retrospectively analyzed 161 consecutive NDMM patients who were tested for common cytogenetic abnormalities at diagnosis by fluorescence in-situ hybridization and 5% was set for the threshold for 1q21+ by a comparative study.Ninety-six (59.6%) patients were determined for 1q21+ by fluorescence in-situ hybridization including 38 had ≥4 copies. In clone size analyses, the 2-year progression-free survival (PFS) in5% group was superior in comparison with 5% to 20% (65.2% vs. 47.0%, P = .041) and20% group (65.2% vs. 37.5%, P.001), whereas there was no significant difference between the 2 latter groups. Patients with ≥ 4 copies of 1q21 had inferior 2-year PFS compared to patients with 3 copies (23.3% vs. 50.6%, P = .028) and 2 copies (23.3% vs. 65.2%, P.001). Bortezomib-based treatment might benefit the PFS for patients with 3 copies but could not improve the adverse effect of ≥ 4 copies. 1q21+ was an independent risk factor for inferior PFS and OS in multivariate analysis (P.001 and P = .028).Our results demonstrated that 5% was a reliable cut-off value for 1q21+, and 1q21+ was an adverse prognostic factor in NDMM, especially when ≥ 4 copies were present.

Skin and soft tissue infections (SSTIs) refer to infections involving the skin, subcutaneous tissue, fascia, and muscle. In transplant populations with hematological malignancies, an immunocompromised status and the routine use of immunosuppressants increase the risk of SSTIs greatly. However, to date, the profiles and clinical outcomes of SSTIs in hematopoietic stem cell transplantation (HSCT) patients remain unclear. This study included 228 patients (3.67%) who developed SSTIs within 180 days after allogeneic HSCT from January 2004 to December 2019 in Peking University People's Hospital. The overall annual survival rate was 71.5%. We compared the differences between survivors and non-survivors a year after transplant and found that primary platelet graft failure (PPGF), comorbidities of acute kidney injury (AKI), and hospital-acquired pneumonia (HAP) were independent risk factors for death in the study population. A PPGF-AKI-HAP risk stratification system was established with a mortality risk score of 1×PPGF+1×AKI+1×HAP. The areas under the curves of internal and external validation were 0.833 (95% CI 0.760-0.906) and 0.826 (95% CI 0.715-0.937), respectively. The calibration plot revealed the high consistency of the estimated risks, and decision curve analysis showed considerable net benefits for patients.

Aims Qishen Yiqi dripping pills (QSYQ) may be beneficial in patients with ischaemic heart failure (IHF). We aimed to assess the efficacy and safety of QSYQ administered together with guideline-directed medical therapy in patients with IHF.Methods and results This prospective randomized, double-blind, multicentre placebo-controlled study enrolled 640 patients with IHF between March 2012 and August 2014. Patients were randomly assigned to receive 6 months of QSYQ or placebo in addition to standard treatment. The primary outcome was 6 min walking distance at 6 months. Among the 638 IHF patients (mean age 65 years, 72% men), the 6 min walking distance increased from 336.15 +/- 100.84 to 374.47 +/- 103.09 m at 6 months in the QSYQ group, compared with 334.40 +/- 100.27 to 340.71 +/- 104.57 m in the placebo group (mean change +38.32 vs. +6.31 m respectively;P Conclusions Treatment with QSYQ for 6 months in addition to standard therapy improved exercise tolerance of IHF patients and was well tolerated.