Progress of minimal residual disease monitoring in adult acute lymphoblastic leukemia / 白血病·淋巴瘤

Acute lymphoblastic leukemia (ALL) is a malignancy originating from B-/T-lineage lymphoid progenitor cells. With the continuous development of new drugs as well as therapeutic regimens, adult ALL patients have improved complete remission rates and overall survival rates, but the survival rate of patients after relapse remains low. The positive minimal residual disease after complete remission is an important reason for relapse. Although minimal residual disease monitoring has been found to be important in predicting patients prognosis in recent years, the uniform stratified treatment protocols have not yet been developed in the clinical practice of adult ALL. This article reviews the prognostic significance of minimal residual disease monitoring at different time points, as well as the progress of removal methods of minimal residual disease.

Clinical development of chimeric antigen receptor-T cell therapy for hematological malignancies / 中华医学杂志(英文版)

Cellular therapies have revolutionized the treatment of hematological malignancies since their conception and rapid development. Chimeric antigen receptor (CAR)-T cell therapy is the most widely applied cellular therapy. Since the Food and Drug Administration approved two CD19-CAR-T products for clinical treatment of relapsed/refractory acute lymphoblastic leukemia and diffuse large B cell lymphoma in 2017, five more CAR-T cell products were subsequently approved for treating multiple myeloma or B cell malignancies. Moreover, clinical trials of CAR-T cell therapy for treating other hematological malignancies are ongoing. Both China and the United States have contributed significantly to the development of clinical trials. However, CAR-T cell therapy has many limitations such as a high relapse rate, adverse side effects, and restricted availability. Various methods are being implemented in clinical trials to address these issues, some of which have demonstrated promising breakthroughs. This review summarizes developments in CAR-T cell trials and advances in CAR-T cell therapy.

Research progress experimental and detection method on pulmonary blast injury / 国际生物医学工程杂志

Due to the air-filled alveoli and delicate vascular structure,the lung is the most easily damaged organ when human or animal is subjected to a shock wave.Primary pulmonary blast injury resulting from shock wave is an important cause of trauma not only in military conflicts but also in terrorism or accidents involving civilians.The physiological,pathological and biochemical changes after blast injury may lead to inflammatory response,cell apoptosis in the lung,boost the activation of cytokines including TNF-α,IL-6,IL-8 and IL-1β,and finally result in acute respiratory distress syndrome (ARDS).This paper presents the evolution and characteristics of pulmonary blast injury,and demonstrates four relevant experimental setups including biological shock tube,segmented shock wave generator,mini blast wave generator and laser-induced stress wave generator.Besides,this paper reviews the scoring system of pulmonary blast injury,pathological and biochemical measurement aiming to provide helpful reference to establish pulmonary blast injury models.

Analysis on injury characteristics and treatment of the hospitalized patients attributable to 2008 Wenchuan earthquake in China: a report of 826 cases / 中华创伤杂志

Objective To analyze injury characteristics and treatment of hospitalized patients wounded in Wenehuan earthquake so as to provide references for medical rescue in disasters. Methods The study involved data of seismic patients from Trauma Database System Version 3.0 that collected clini-cal data of seismic patients admitted into West China Hospital of Sichuan University, Chengdu, and First and Second Hospitals of Deyang City. Trauma Database System Version 3.0 was developed by Research Institute for Traffic Medicine of PLA, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing. A comparative analysis was done on patient distribution, injury severity and medical treatment. Results There were 826 qualified patients including 410 males and 416 females ( at age range of 1-102 years, mean 45.8 years). Of all, the patients at age of 31-60 years accounted for 50. 2%. The patients were mainly peasants (43.8%, 208/477), workers (15.7%, 75/477) and students (14.1%, 67/477). Blunt injury (53.2%), crush/bury injury (22.5%) and slip/fall injury were three main causes for injury. The patients for 92.1% were admitted into two hospitals of the City of Deyang within four days after earthquake, while 81.7% of patients were admitted into West China Hospital in Chengdu at days 3-9 after earthquake. Patients with bone injuries accounted for 75.3%. The patients had abbreviated injury score (AIS) for mainly 1-3 points, with incidence rate of se-vere multiple trauma ( ISS > 16 points) of 8.2%. Internal fixation was done in 120 patients ( 34. 1% ), debridement and suturing in 103 (29.3%), external fixation in 55 ( 15.6% ), extremity amputation in 22 (6.3%) and intracerebral surgery in 2 (0.6%). Conclusions The injuries are mainly induced by collapse of buildings during earthquake. Bone injuries are predominant injury type, with AIS of mainly 1-3 points and few severe multiple trauma. The results show that the patients receive late special treat-ment and slow evacuation, indieating necessity of strengthening capacity of early medical treatment and ef-fective evacuation during destructive natural disasters.

Effects of intact vagus nerve stimuiation on liver inflammation and mRNA expression of cytokine suppressors in rats / 中华创伤杂志

Objective To observe the effect of intact vagus nerve stimulation(IVNS)on liver inflammation and mRNA expression of suppressors of cytokoine signaling(SOCS)in rats. Methods Eighty Sprague Dawley rats were randomly divided into control group(n=20),sham group(n=20),LPS group(n=20,with intravenous injection of LPS to induce system inflammatory response)and LPS +IVNS group(n=20,with intact vagus nerve stimulation after LPS administration).The level of TNFαand IL-10 in the liver was detected with enzyme linked immunosorbent assay at 0,2,4,6 hours post-injection time.mRNA expressions of SOCS1 and SOCS3 in the liver were also determined with reverse transcription and polymerase chain reaction(RT-PCR). Resuits The liver TNFαin LPS+INVS group was lower than that of LPS group after LPS injection at 2,4 and 6 hours(P＜0.05).Compared with LPS group,liver IL-10 level in LPS+IVNS group was higher(P＜0.05)at post-injection time points(4 and 6 hours).After four hours of LPS challenge,mRNA expressions of both SOCS1 and SOCS3 were significantly increased.Compared with LPS group,mRNA expression of SOCS3 in LPS+INVS group was upregulated more significantly(P＜0.01),while mRNA expression of SOCS1 showed insignificant difference. Conclusions IVNS can depress liver inflammation and the anti-inflammatory mechanism involves SOCS signal transduction pathway.

Study on traffic injury of front crash in rabbits / 第三军医大学学报

Objective To study the mechanism and characteristic of traffic injury of front crash. Methods Thirty rabbits were divided randomly into 3 groups according to crash velocity. The initial velocity of GroupⅠ was 30 km/h, group Ⅱ 40 km/h, and group Ⅲ 50 km/h. The rabbits were fixed on the seats in a sitting position and the injury process were started by driving power system with the velocity and acceleration set primarily. The crashing velocity and deceleration were recorded by laser velocity measuring system and high speed camera system. The injury characteristics of rabbits were observed and then the AIS-ISS score was compared. Results During 1 hour after injury, all rabbits survived except one in group Ⅱ and three in group Ⅲ. No organ injury was found in group Ⅰ, but organ injuries in thorax and abdomen were found in group Ⅱ and Ⅲ. The score of AIS (MAIS) and ISS were (2.30?0.65), (14.50?2.10) in group Ⅱand (4.20?0.70), (36.40?4.58) in group Ⅲ respectively. Conclusion The velocity and deceleration of crash have impact on the injury character of animal, and the main injury organs are the thorax and abdomen in traffic injury of front crash in rabbits.

Development and application of a device for stretch-induced injury to cultured cell and testing system / 第三军医大学学报

Objective To develop a device for stretch-induced injury to cultured cells and measure the injury parameters.It makes possible to observe the changes of cell configuration and function directly after injury. Methods The device was developed based on aero-dynamical principle,and consisted of mini-type air compressor,electromagnetic valve,pressure transmitter,PGA amplifier,A/D converter and computer.The computer can accurately control the injury parameters.A new method and device were first introduced to measure the deformation rate and deformation degree of silastic membrance in the stretch induced cultured cell injury process.The device controlled by the computer was used to cause the astrocyte injury.The degree of cell injury was assessed qualitatively by electron microscopy,and quantitatively by lactate dehydrogenase(LDH) enzyme release and trypan blue staining.Results The experiment results showed that the injury of different levels could be reproduced by our device under the injury parameters we set.Conclusion The injury device and the measuring system meet the requirements of our design.The results suggested that the new device and the method were much better than those reported in foreign literature.It has the advantages of simple and convenient manipulation,high precision and real-time processing.It can be used for the cell-level experiment research.

Changes of cervical vagal efferent discharge induced by lipopolysaccaride in rats / 第三军医大学学报

Objective To investigate the changes of cervical vagal efferent discharge induced by lipopolysaccaride in rats. Methods Ten rats were randomly divided into two groups, receiving lipopolysaccaride (5 mg/kg) or normal saline through intravenous injection. Frequency of cervical vagal efferent discharge was recorded at 30 min, 1, 2 and 4 h after the injection. Results The frequency of cervical vagal efferent discharge was significantly increased after LPS injection (P

Pathological observation of the dog lungs after underwater blast injury / 第三军医大学学报

Objective To explore pathological changes of the dog lungs after underwater blast injury. Methods Lungs from 37 adult dogs were taken after different underwater blast explosions, and observed with gross examination, light microscopy (LM) and electron microscopy (EM). Results Pulmonary hemorrhage and edema were the main morphological changes. Under LM the alveolus space was seen to be filled with edematous fluid and bloody components. Part of alveolus walls were ruptured and fused into bigger cavities while under EM the mitochondria of alveolar epithelium were vacuolated and some of the capillary predominant endothelium were broken. Hemorrhage was the pathological feature of intestinal tract. Conclusion Severe pulmonary hemorrhage and edema may be the main cause of early death of dogs with underwater blast injury.

Pathomorphological changes after liver impact injury in rabbits / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the histopathological changes in the liver and other organs after impact injury.</p><p><b>METHODS</b>The rabbits were impacted with a BIM-IV biological impacting machine at the xiphoid process. The severity of liver injury was graded and scored through gross anatomy. At the same time, the pathological changes in the liver, heart, and lung were observed by light and electron microscopes.</p><p><b>RESULTS</b>Light microscopy showed that the pathological changes in the liver were: 1) loss of normal structure, hemorrhage and distortion of hepatic lobules; 2) cloudy swelling, degeneration, vacuolation and necrosis of liver cells; 3) infiltration of neutrophils. The lungs were injured and there were liver cell emboli in the small pulmonary arteries. Electron microscopy showed that the ultrastructure of the liver cells was severely damaged and the cells had significant features of necrosis.</p><p><b>CONCLUSIONS</b>The major pathomorphological changes in the liver after impact injury are hemorrhage and necrosis. They may be complicated by exfoliation of liver cells to hepatic sinusoids. These cells circulate with the blood to form emboli in the pulmonary blood vessels.</p>

Observation on the craniocerebral injury of sheep by high explosive shell / 第三军医大学学报

Objective　To observe the characteristics and rules of craniocerebral injury resulting from a high explosive shell to provide the bases for treating explosive injury. Methods　A total of 36 sheep were distributed at the distance 6 to 48 m away from the explosive center and the shell was exploded electrically at 7 m above the earth. At the same time, the velocity of fragments and shock wave pressure were determined. Gross and pathological observations were performed after injury. Results　Among all sheep with fragment injury, craniocerebral injury was 32%. Their immediate death rate was 75% and all died 6 h later. The incidence rates of penetrating wound and blind wound were 75% and 25% respectively. Pollution of wound track was heavy. The percentage of head lost was 50% in sheep and 50% of injured animal suffered from comminuted fracture of skull base. Bleeding was found extensively on the surface of the cerebrum, even medulla oblongata was involved. Hemorrhage, edema, rupture of small blood vessels and degeneration of neuron were found at the regions 4 cm away from the wound tract with light microscopy. Combined blast injury was found and occurred most often in the abdomen and limbs, both accounting for 62.5%, and combined thoracic injury was the third, up to 50%. All the animals of craniocerebral injury combined with lung blast injury. Conclusion　High explosive shells destroy cranium badly and extensively. Many skulls are lost and the cranial base is readily fractured. The wound track is heavily polluted. Combined injury is more often occurred.

The dynamic response of heart and its injury involving chest impact / 中华创伤杂志(英文版)

OBJECTIVE: The dynamic response of the heart during chest impact and the characteristics of heart injuries were investigated to further understand the mechanisms of heart impact injuries. METHODS: Eleven dogs and thirty-four rabbits were subjected to front thoracic impact with different impact velocities and compression response. The accelerated movement of thoracic wall during the impact period was monitored. The pathological examination of the injured heart was done and the dynamic responses and mechanisms of injuries were analyzed with mathematics models. RESULTS: The analysis of mathematics model and experimental results showed that the injury severity of heart was well correlated with the viscous criterion. The thoracic wall was involved in bi-directional movement of compression and expansion. The injured heart showed spotty or stripy hemorrhages in the ventricle endocardium. Light microscopic examination showed interstitial bleeding and rupture of the myocardial fibers in the contusion area. The biomechanical analysis indicated that there was a large deformation caused by the stress concentration on the lateral ventricle wall. CONCLUSIONS: There is a high speed and excessive deformation of the heart during the impact period, which might be the key mechanism of heart injury. The strong impact and press coming from both sternum and vertebral column and the rapid elevation of pressure in the ventricle are the main cause of deformation.

Preliminary Observations on the Biological Effect of Shock Waves with Prolonged Overpressure Duration and Exposures Repeated / 第三军医大学学报

Eight sheep and eigat goats were iniured in BST-I biological shock tube in order to observe the effects of shock waves with overpressure duration prolonged and exposure repeated on the injury severity. It is found that the more the overpresure dration prolonged and exposures repeated, the higher the incidence and the severity of the injury are seen. It suggestes that overpressure duration and number of times of exposure have marked effect on the severity of injury above certain peak pressure.

Infusion of No.2 Fluorocarbon Blood Substitute in Normal Volunteers / 第三军医大学学报

Fifty to 145 ml of No. 2 fluorocarbon blood substitute was intravenously given to 10 normal adult volunteers ( 7 male and 3 female) . Their vital signs were stable during and after the infusion. The ECG, the cardiac, hepatic and renal functions, the mutagenicity test and the routine urine test were maintained in the normal range. NO overt changes in the blood picture except a slight elevation of white count were found at the beginning of the infusion. Transient changes were observed in the function of platelets and the coagulofibrinolytic and immune systems.These results suggest that the infusion of No. 2 fluorocarbon blood substitute is rather safe and the possibility qf its clinical application is great bat further investigation is essential to find out measures to prevent and treat the ana-phylactoid reactions of this fluorocarbon emulsion observed in our study.

Morphological changes of the lungs after blast,shell-fragment, and blast-fragment combined injuries in dogs / 第三军医大学学报

After the dogs were inflicted with blast injury,high velocity shell fragment injury on one extremity,and blast-fragment combined injury,the morphological changes of the lungs were examined under gross inspection and with optical and transmission electron microscopes,and the lung/body weight index and lung water ratio were determined.It was found that high velocity shell fragment injury on one extremity could intensify the blast injury on the lungs by one grade.

Changes of prostacyclin and thromboxane and their significance in blast,shell-fragment and combined blast-fragment injuries in dogs / 第三军医大学学报

The changes of mean pulmonary arterial pressure (PAP) and 6-keto-PGF1a and TXB2 in the plasma and lung tissues of 3 groups of dogs (7 in each group) with blast injury (group Ⅰ),high velocity shell fragment injury on one of the extremities (group Ⅱ),and combined injury of the both (group Ⅲ) were investigated.It was found that PAP and TXB2 in the plasma and lung tissues increased after all the 3 kinds of injuries.The changes of PAP was most marked in group Ⅰ while those of TXB2 was more marked in groups Ⅲ and Ⅲ than in group Ⅰ.6-kcto-PGF1a increased in the plasma and lung tissues after blast and shell fragment injury but decreased in the plasma and showed no changes in the lung tissues after combined injury.The significance of these changes of 6-keto-PGF1a and TXB2 in the 3 kinds of injuryies were discussed.

A Pathomorphological Observation on the Accumulation of No.Ⅱ Fluorocarbon Blood Substitute in Rats / 第三军医大学学报

No. Ⅱ fluorocarbon blood substitute in divided doses was infused into the rats in a 12-day-period. Pathomorphological changes of the various organs of the animals were observed dynamically in the first year after the completion of the infusion. Fluorocarbon particles mainly accumulated in the organs with abundant reticulo-endothelial tissue particularly the liver and spleen. The changes of the weight of the liver and spleen and the existence of foam cells could be considered as the criteria to indicate the severity of the accumulation. It was found that at the end of the first year after the completion of No. Ⅱ fluorocarbon blood substhue infusion, the liver and spleen essentially resumed their normal weight but a small number of foam cells still existed, However, accumulated fluorocarbon particles exerted no harmful effects on the functions and structures of the organs observed.

A study on the dose-effects relationship of underwater blast injury / 解放军医学杂志

Objective To study the dose-effects relationship of underwater blast injury. Methods Sixty-one adult mongrel dogs were exposed to underwater explosion of 200g, 500g, and 1 000g of TNT, respectively. The physical parameters of blast wave were recorded by PCB pressure transducers (USA). Survival or death was observed 6 hours after injury. Correspondingly, the relationship between the physical parameters and injury severity was analyzed. Results Twenty-three among 61 dogs died after injury, the mortality rate was 37.70% (23/61). The main reasons of death were severe lung bleeding, lung edema, perforation of gastrointestinal tract, and rupture of liver and spleen. Half lethal (5/10) impulse of underwater blast wave was 337.7?14.3kPa?ms. The impulses resulting in mild, moderate, severe, and critical underwater blast injuries were 140.46?34.2, 199.2?25.2, 247.8?69.6, and 478.7?183.8kPa?ms, respectively. Conclusion The physical parameters were well related to the injury severity in underwater blast. The early main treatment consist of active and effective management of severe lung injuries, perforation of gastrointestinal tract, and rupture of liver and spleen.

A comparative study on the propagation speed and physical parameters of underwater blast wave and air blast wave / 解放军医学杂志

Objective To compare the propagation speed and physical parameters between underwater blast wave and air blast wave. Methods The physical parameters of blast wave were measured by PCB pressure transducers (USA) during underwater and air explosions of 200g, 500g and 1000g TNT respectively. Consequently, the propagation speed, peak overpressure value, positive duration and impulse of blast wave were analyzed. Results Underwater blast wave was characterized by high propagation speed, high peak overpressure value, great impulse, however, short duration. Compared with air blast wave, the propagation speed of underwater blast wave was 3.70-4.30 times higher than that of air blast wave, the peak overpressure value was 227.15-247.86 times higher, and the impulse was 8.48-11.80 times greater than that of air blast wave. Conclusion Underwater blast wave propagates faster than that air blast wave. Meanwhile, it also peoduces higher peak overpressure value and impulse. This result is helpful for the evaluation of injury severity and treatment of underwater blast injury.

Experimental protective garment against underwater personal blast injury / 解放军医学杂志

Objective To explore the possibility for preventing the underwater blast injuries. Methods Fifty rabbits were divided into two groups: protection and control groups. The animals were placed at the rang of 5.0m to 17.5m far from the explosion point. 0.2kg of TNT Explosives was placed 3 meters under water. Physical parameters of blast wave were measured using pressure transducers. At 6 hours after injury, the mortality rate and morphological alternations were observed. Results The safe devices were shown to be effective against underwater blast injuries. Most of the animals had no or mild pulmonary and intestinal injuries. The whole injury severity was reduced by 2 to 3 degrees with our own made device. Conclusion Our safe device could be used to protect against underwater blast injueirs.