Mismatched donor cell infusion-related syndrome following microtransplant in patients with acute myeloid leukemia / 中华医学杂志(英文版)

BACKGROUND@#Immunotherapies such as adoptive immune cell infusion and immune-modulating agents are widely used for cancer treatment, and the concomitant symptoms, including cytokine release syndrome (CRS) or immune-related adverse events (irAEs), are frequently reported. However, clinical manifestations induced by mismatched donor granulocyte colony-stimulating factor mobilized peripheral blood mononuclear cell (GPBMC) infusion in patients receiving microtransplant (MST) have not yet been well depicted.@*METHODS@#We analyzed 88 cycles of mismatched GPBMC infusion in patients with acute myeloid leukemia receiving MST and 54 cycles of chemotherapy without GPBMC infusion as a comparison. Clinical symptoms and their correlation with clinical features, laboratory findings, and clinical response were explored.@*RESULTS@#Fever (58.0% [51/88]) and chills (43.2% [38/88]) were the significant early-onset symptoms after GPBMC infusion. Patients possessing less human leukocyte antigen-matching loci with the donor or those with unrelated donors experienced more chills (3 [2-5] loci vs. 5 [3-5] loci, P  = 0.043 and 66.7% [12/18] vs. 37.1% [26/70], P  = 0.024). On the other hand, those with decreased CD4 + /CD8 + T-cell ratio developed more fever (0.8 [0.7-1.2] vs. 1.4 [1.1-2.2], P  = 0.007). Multivariable analysis demonstrated that younger patients experienced more fever (odds ratio [OR] = 0.963, 95% confidence interval [CI]: 0.932-0.995, P  = 0.022), while patients with younger donors experienced more chills (OR = 0.915, 95% CI: 0.859-0.975, P  = 0.006). Elevated ultra-sensitive C-reactive protein levels in the absence of cytokine storm were observed following GPBMC infusion, which indicated mild and transient inflammatory response. Although no predictive value of infusion-related syndrome to leukemia burden change was found, the proportion of host pre-treatment activated T cells was positively correlated with leukemia control.@*CONCLUSIONS@#Mismatched GPBMC infusion in MST induced unique infusion-related symptoms and laboratory changes, which were associated with donor- or recipient-derived risk factors, with less safety and tolerance concerns than reported CRS or irAEs.

Strategy of dental clinics to cope with the epidemic period of infectious diseases based on the experience of corona virus disease outbreak / 华西口腔医学杂志

The outbreak of corona virus disease (COVID-19) has raised concerns among dentists to develop strategies to prevent infection of dental equipment, materials, and patients during an epidemic period. Strategies following the National Laws and Standards of China and local standards of several provinces for controlling cross-infection and instituting protective measures for medical staff in dental clinics during an epidemic period are discussed. A proposal is put forth for dental clinics that will face similar situations in the future. Further research is warranted to address potential problems that will be encountered under such dire circumstances.

Deep residual convolutional neural network for recognition of electrocardiogram signal arrhythmias / 生物医学工程学杂志

Electrocardiogram (ECG) signals are easily disturbed by internal and external noise, and its morphological characteristics show significant variations for different patients. Even for the same patient, its characteristics are variable under different temporal and physical conditions. Therefore, ECG signal detection and recognition for the heart disease real-time monitoring and diagnosis are still difficult. Based on this, a wavelet self-adaptive threshold denoising combined with deep residual convolutional neural network algorithm was proposed for multiclass arrhythmias recognition. ECG signal filtering was implemented using wavelet adaptive threshold technology. A 20-layer convolutional neural network (CNN) containing multiple residual blocks, namely deep residual convolutional neural network (DR-CNN), was designed for recognition of five types of arrhythmia signals. The DR-CNN constructed by residual block local neural network units alleviated the difficulty of deep network convergence, the difficulty in tuning and so on. It also overcame the degradation problem of the traditional CNN when the network depth was increasing. Furthermore, the batch normalization of each convolution layer improved its convergence. Following the recommendations of the Association for the Advancements of Medical Instrumentation (AAMI), experimental results based on 94 091 2-lead heart beats from the MIT-BIH arrhythmia benchmark database demonstrated that our proposed method achieved the average detection accuracy of 99.034 9%, 99.498 0% and 99.334 7% for multiclass classification, ventricular ectopic beat (Veb) and supra-Veb (Sveb) recognition, respectively. Using the same platform and database, experimental results showed that under the comparable network complexity, our proposed method significantly improved the recognition accuracy, sensitivity and specificity compared to the traditional deep learning networks, such as deep Multilayer Perceptron (MLP), CNN, etc. The DR-CNN algorithm improves the accuracy of the arrhythmia intelligent diagnosis. If it is combined with wearable equipment, internet of things and wireless communication technology, the prevention, monitoring and diagnosis of heart disease can be extended to out-of-hospital scenarios, such as families and nursing homes. Therefore, it will improve the cure rate, and effectively save the medical resources.

Quality standard for Ershiwuwei Feibing Pills / 中成药

AIM To establish the quality standard for Tibeten medicine Ershiwuwei Feibing Pills [Inula racemosa Hook.f.,Swertia bimaculata (Sieb.et Zucc.) Hook.Thors.ex Clarke,Phyllanthus emblica Linn.,Terminalia billerica (Gaertn.) Roxb.,etc.].METHODS TLC was applied to the qualitative identification of L racemosa,S.bimaculata,P.emblica and T.billerica,and HPLC was adopted in the quantitative determination of alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A.RESULTS The TLC spots were clear without negative interference.Alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A showed good linear relationships within the ranges of 4.324-216.2 μg/mL (r =0.999 9),32.222-1 611.1 μg/mL (r =0.999 9),4.072-203.6 μg/mL (r =0.999 9) and 4.266-213.3 μg/mL (r =0.999 9),whose average recoveries (RSDs) were 100.6％ (0.93％),100.3％ (2.1％),101.5％ (3.0％) and 100.1％ (1.8％),respectively.CONCLUSION This simple method can be used for the rapid quality control of Ershiwuwei Feibing Pills.

Current state of secondary prevention medication for patients with high risk of recurrent ischemic stroke in Changzhou city / 中华老年医学杂志

Objective To investigate the application of secondary prevention medication for patients with high risk of recurrent ischemic stroke in Changzhou city,analyze the reasons for decreased medication compliance,and evaluate the current secondary prevention medication.Methods We investigated 300 consecutive hospitalized patients with acute non-cardiogenic and ischemic stroke high risk.High risk of recurrent stroke was defined as ESSEN Stroke Risk Score (ESRS) ≥3.Different ESRS scales consisting of different parameters were analyzed.All of the patients received standard secondary prevention of ischemic stroke at discharge.After three months and a year follow up,antiplatelet therapy,therapy of risk factors (hypertension and diabetes mellitus),lipid lowering therapy,and medication compliance were investigated.Results Except for age (x2 =126.54,P =0.000) and previous cerebral ischemic stroke or transient ischemic attack (TIA) (x2 =21.27,P =0.000),there were no significant differences in other risk factors (hypertension,diabetes,previous myocardial infarction,heart diseases,smoke) in patients with different ESRS scale scores (all P＞ 0.05).Antiplatelet therapy utilization was 98.3％ (295/300),antihypertensive and antidiabetic drug use rates were 95.0％(255/268) and 100％(72/72),statin use rate reached to 99％ (297/300) at discharge.After three months follow up,medication compliance in hypertension and diabetes mellitus therapy was the best [88.1％(222/252)and 86.2％ (56/65)],followed by aspirin [82.0％ (228/278)],and clopidogrel [6.1％ (17/278)].The medication compliance in lipid lowering therapy was the worst [60.1％ (167/278)].After a year follow-up versus the previous three-month follow-up,the medication compliance in hypertension and diabetes mellitus therapy was increased,but had no significant difference [89.9 ％ (220/245) vs.88.1％ (222/252),93.4％(57/61)vs.86.2％(56/65),P＞0.05],and the medication compliances inantiplatelet therapy with aspirin and clopidogrel,and lipid lowering therapy were increased significantly [93.2％ (245/263)vs.82.0％ (228/278),30.8(81/263) vs.6.1％ (17/278),88.9％ (234/263) vs.60.1％ (167/278),all P＜0.01].The increment of use rate was higher in clopidogrel therapy than in aspirin therapy.Conclusions The secondary prevention medication achieves certain efficacies in patients with high risk of recurrent ischemic stroke in changzhou city.Long term follow-up and good communication between doctor and patient can effectively improve the medication compliance in secondary prevention,and can increase the use rate of antiplatelet therapy in patients with high risk of recurrent ischemic stroke.

Statins may promote stroke-associated pneumonia recovery and not affect stroke outcome: a retrospective case series study / 国际脑血管病杂志

Objective To investigate the effect of statin therapy on pneumonia and stroke outcome after acute ischemic stroke.Methods The patients with pneumonia after acute ischemic stroke were enrolled retrospectively.The demographic and clinical data of the patients were collected,including whether using statins,the clinical features of pneumonia,the days of using antibiotics,and neutrophil count.They were divided into either a statin group or a control group according to whether they used statins or not.Stroke outcome was evaluated with the modified Rankin scale.Results A total of 53 patients with pneumonia after acute ischemic stroke were enrolled in the study,20 of them were in the statin group and 33 were in the control group.There were no significant differences in age and the proportions of male and complicated with hypertension,diabetes and coronary heart disease between the statin group and the control group (all P ＞ 0.05).The cure rate,improvement rate,invalid rate and mortality in the statin group were 50.00％,35.00％,15.00％ and 0.00％,respectively; and in the control group were 15.15％,39.40％,33.30％ and 15.15％,respectively.There were significant differences (P =0.003).The days of temperature returning to normal (2.10 ± 3.29 d vs.4.61 ±3.54 d; P =0.002),pulmonary rales disappearing (3.60 ±2.46 d vs.7.67 ±4.09 d; t =-4.019,P =0.000)and using antibiotics (7.05 ± 3.13 d vs.9.73 ± 4.00 d; t =-2.562,P =0.013) in the statin group were significantly shorter than those in the control group,while there were no significant differences in the days of cough and sputum production retuming to normal between the 2 groups.The proportions of diabetes (20.83％ vs.55.17％ ;x2 =6.473,P =0.011),posterior circulation stroke (4.7％ vs.27.59％ ; P =0.031)and bilateral lung shadows (29.17％ vs.55.17％ ;x2 =5.705,P=0.017),as well as baseline National Stroke Association NIH Stroke Scale (NIHSS) score (4.00 ± 4.54 vs.10.66 ± 6.33; t =1.898,P =0.001) in a good outcome group were significantly lower than those in a poor outcome group.But there was no significant difference in the proportion of the patients treated with statins between the good outcome group and the poor outcome group (41.67％ vs.34.48％ ;x2 =0.288,P =0.591).Multivariate logistic regression analysis showed that diabetes (odds ratio [OR] 5.146,95％ confidence interval [CI] 1.166-22.709; P =0.031) and baseline NIHSS score (OR 1.251,95％ CI 1.080-1.449; P =0.003) were the independent risk factor for patient with poor outcomes.Conclusions Statins may promote the pneumonia recovery in patients with acute ischemic stroke; however,it has no effect on stroke outcome.

Re-expression of cell adhesion molecule inhibits growth and induces apoptosis of human pancreatic cancer cell line PANC-1 / 华中科技大学学报（医学）（英德文版）

This study examined the expression of cell adhesion molecule 1 (CADM1) in pancreatic cancer and the possible mechanism. The expression of CADM1 was detected by immunohistochemistry in tissues of pancreatic cancer, pancreatitis, and normal pancreas. The plasmid pcDNA3.1-Hygro(+)/CADM1 was transfected into PANC-1 cells (a pancreatic cancer cell line). The expression of CADM1 in the transfected cells was determined by RT-PCR and Western blotting. Cell growth was measured by the MTT method and cell apoptosis by flow cytometry. The results showed that CADM1 was weakly expressed in tissues of pancreatic cancer in contrast to its high expression in normal pancreatic and pancreatitis tissues. The expression level of CADM in pancreatic caner was intensely correlated with the differentiation degree, lymph node metastasis and TNM stages. The growth of CADM1-transfected PANC-1 cells was significantly suppressed in vitro by a G1 cell cycle arrest and apoptosis occurrence. It was concluded that re-expression of CADM1 inhibits the growth of pancreatic cancer cells and induces their apoptosis in vitro. As a tumor suppressor gene, CADM1 plays an important role in the occurrence, progression and metastasis of pancreatic cancer.

Depressive symptom and correlative factors in patients with obstructive sleep apnea-hypopnea syndrome / 中南大学学报(医学版)

OBJECTIVE@#To investigate the depression and its influencing factors in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHODS@#The scales of the demographic data, Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Beck depression inventory(BDI), and simplified coping style questionnaire (SCSQ) were tested in 114 patients with OSAHS.@*RESULTS@#The BDI score was (8.29 ± 6.46), and 32.5% of the patients had depression. The BDI score was related to the coping style, PSQI total score and the subjective sleep quality, sleep time, sleep efficiency, sleep disturbance, using hypnotic drugs, and day-time dysfunction. There were no correlations between the ESS, body mass index, apnea hyponea index(AHI), lowest oxygen saturation (LSaO₂), mean oxygen saturation (MSaO₂) and depression.@*CONCLUSION@#About 1/3 of the OSAHS patients have depressive symptoms. PSQI score,negative coping style, positive coping style, using hypnotic drugs, and time for falling asleep are influential factors in OSAHS patients.

The clinicopathological significances of expression of PI3K, AKT and MRP in pancreatic carcinoma / 中华胰腺病杂志

Objective To investigate the expressions of PI3K, AKT and MRP protein in pancreatic carcinoma and to determine the clinicopathological significance and the correlation among three protein expressions. Methods The immunohistochemical method was used to detect the expressions of PI3K, AKT and MRP in forty three pancreatic carcinoma, nine chronic pancreatitis and eight normal pancreatic tissue samples. Results The positive expression rates of PI3K, AKT and MRP were 46.51%, 55.81% and 39.53%, respectively in pancreatic carcinoma, which were remarkably higher than those in normal pancreatic tissue and in chronic pancreatitis (P<0.01 and P<0.05, respectively). The aberrant expression of PI3K, AKT and MRP were associated with lymph node metastasis and TNM stages (P<0.05). The abnormal expression rate in both MRP and PI3K was 32.56%, the normal expression rate of both MRP and PI3K was 46.51%, and there was positive correlation between the expression of MRP and PI3K(r=0.581, P<0.01). The abnormal expression rate of both MRP and AKT was 32.56%, the normal expression rate was 37.21%, and there was a positive correlation between MRP and PI3K (r=0.432,P<0.05). The abnormal expression rate of both MRP and PI3K was 37.21%, the normal expression rate of both MRP and PI3K was 32.56%, there was also a positive correlation between MRP and PI3K (r=0.306,P<0.05). Conclusions The expressions of PI3K, AKT and MRP were up-regulated in pancreatic carcinoma. The expressions of PI3K and AKT may be related to the lymph node metastasis and TNM staging.

A survey of antibiotic application for hospitalized patients receiving oral and maxilla facial surgery / 实用口腔医学杂志

Objective:To investigate the situation for clinical antibiotic usage in West China Hospital of Stomatology. Methods:By using specially designed survey table, a retrospective study was carried out and the data of antibiotic usage for all the patients from March to August 2003 were analyzed by computer.Results:A total of 1139 cases were investigated and antibiotics were used in 84.72% of the cases. Single drug,2-drug-combination and 3 or more were used in 36.52%,43.91% and 4.30% of the patients.Antibiotics were administrated by intravenous injection in 93.7% of the cases.The antibiotic application for preventive purpose was in 64.87% of all the subjects.The cost of antibiotics contributed to 48.78% in total drug expenses.Conclusion:It is necessary to strengthen the management of antibiotic application.

Effect of Rheum emodi Wall on express level of TNF-?、IL-1? and IL-6 on acute ischemic stroke at high altitude / 中成药

AIM:To observe the effect of Rheum emodi Wall on expess level of TNF-?、IL-1? and IL-6 on acute ischemic stroke(ACI)at high altitude. METHODS: 65 patients aith ACI at high altitude(2 260 m)were randomly divided into treatment group(34) and control groups(31).both groups received danshen-safflower injection.Meanwhile treatment group took Rheum emodi decoction orally for 4 weeks,while control group doesn't.Serum levels of TNF-?、IL-1? and IL-6 were measured by radioimmumoassay. RESULTS: The treatment group showed much higher rates of improvement than control group(88.24%;70.97%)after weeks.Serum levels of TNF-?、IL-1? and IL-6 decreased significantly in patients with ACI at treatment group as compared with those of control group. CONCLUSION: Rheum emodi Wall can improve the nervous function of ACI by reducing TNF-?、IL-1? and IL-6 content in serun.