Logistic Regression Analysis of the Mechanism of Blunt Brain Injury Inference Based on CT Images / 法医学杂志

OBJECTIVES@#To study the correlation between CT imaging features of acceleration and deceleration brain injury and injury degree.@*METHODS@#A total of 299 cases with acceleration and deceleration brain injury were collected and divided into acceleration brain injury group and deceleration brain injury group according to the injury mechanism. Subarachnoid hemorrhage (SAH) and Glasgow coma scale (GCS), combined with skull fracture, epidural hematoma (EDH), subdural hematoma (SDH) and brain contusion on the same and opposite sides of the stress point were selected as the screening indexes. χ2 test was used for primary screening, and binary logistic regression analysis was used for secondary screening. The indexes with the strongest correlation in acceleration and deceleration injury mechanism were selected.@*RESULTS@#χ2 test showed that skull fracture and EDH on the same side of the stress point; EDH, SDH and brain contusion on the opposite of the stress point; SAH, GCS were correlated with acceleration and deceleration injury (P<0.05). According to binary logistic regression analysis, the odds ratio (OR) of EDH on the same side of the stress point was 2.697, the OR of brain contusion on the opposite of the stress point was 0.043 and the OR of GCS was 0.238, suggesting there was statistically significant (P<0.05).@*CONCLUSIONS@#EDH on the same side of the stress point, brain contusion on the opposite of the stress point and GCS can be used as key indicators to distinguish acceleration and deceleration injury mechanism. In addition, skull fracture on the same side of the stress point, EDH and SDH on the opposite of the stress point and SAH were relatively weak indicators in distinguishing acceleration and deceleration injury mechanism.

Deep Learning-Based Cardiac Imaging Data Measurement and Its Application in Diagnosis of Sudden Cardiac Death / 法医学杂志

In the field of forensic medicine, diagnosis of sudden cardiac death is limited by subjective factors and manual measurement methods, so some parameters may have estimation deviation or measurement deviation. As postmortem CT imaging plays a more and more important role in the appraisal of cause of death and cardiopathology research, the application of deep learning such as artificial intelligence technology to analyze vast amounts of cardiac imaging data has provided a possibility for forensic identification and scientific research workers to conduct precise diagnosis and quantitative analysis of cardiac diseases. This article summarizes the main researches on deep learning in the field of cardiac imaging in recent years, and proposes a feasible development direction for the application of deep learning in the virtual anatomy of sudden cardiac death at present.

Application of A Dynamic Wrist-hand Orthosis for Upper Limb and Hand Function Rehabilitation in Chronic Stroke Patients / 中国康复理论与实践

Objective:To observe the effect of grasping training under a dynamic wrist-hand orthosis (Saebo Glove) on upper limb and hand function in chronic stroke patients. Methods:From October, 2018 to January, 2019, eleven patients with hemiplegia in upper limb and hand after chronic stroke were recruited. They received conventional rehabilitation and grasping training under dynamic wrist-hand orthosis for three weeks. They were tested surface electromyography of flexor and extensor muscle of wrist and upper limb, assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Reach Arm Test (ARAT), modified Ashworth Scale (MAS), modified Tardieu Scale (MTS) and Triple Spasticity Scale (TSS), and measured grip force, active range of motion of wrist and metacarpophalangeal joints before and after treatment. Results:The scores of FMA, ARAT and TSS, and active range of motion of wrist flexor improved after treatment (t > 2.739, P < 0.05). Conclusion:Grasping training assisted with dynamic wrist-hand orthosis can improve upper limb and hand function of motor and release spasticity in hemiplegics after chronic stroke.

Research Progress on Postmortem Interval Estimation by Vitreous Humor / 法医学杂志

Postmortem interval (PMI) estimation is one of the most challenging problems in the field of forensic science. Vitreous humor is a hotspot which has been used for PMI estimation and postmortem chemical analysis in forensic pathology. In order to provide novel perspectives for the future research of PMI estimation using vitreous humor, the comparison between vitreous humor with other common body fluids, the effect of temperature on vitreous humor, vitreous humor detection method and data fitting method have been reviewed in this paper.

Application of Mixed-effect Model in PMI Estimation by Vitreous Humor / 法医学杂志

Objective To test the changes of the potassium(K+)and magnesium(Mg2+)concentrations in vitreous humor of rabbits along with postmortem interval(PMI)under different temperatures, and explore the feasibility of PMI estimation using mixed-effect model. Methods After sacrifice, rabbit carcasses were preserved at 5℃, 15℃, 25℃ and 35℃, and 80-100μL of vitreous humor was collected by the double-eye alternating micro-sampling method at every 12 h. The concentrations of K+and Mg2+in vitreous humor were measured by a biochemical-immune analyser. The mixed-effect model was used to perform analy-sis and fitting, and established the equations for PMI estimation. The data detected from the samples that were stoned at 10℃, 20℃ and 30℃ with 20, 40 and 65 h were used to validate the equations of PMI estimation. Results The concentrations of K+and Mg2+[f(x,y)] in vitreous humor of rabbits under different temperature increased along with PMI(x). The relative equations of K+and Mg2+concentration with PMI and temperature under 5℃~35℃ were fK+(x,y)=3.413 0+0.309 2 x+0.337 6 y+0.010 83 xy-0.002 47 x2 (P<0.000 1), and fMg2+(x,y)=0.745 6+0.006 432 x+0.033 8 y(P<0.000 1), respectively. It was proved that the time of deviation for PMI estimation by K+and Mg2+was in 10 h when PMI was between 0 to 40 h, and the time of deviation was in 21 h when PMI was between 40 to 65 h. Conclusion In the ambient temperature range of 5℃-35℃, the mixed-effect model based on temperature and vitreous humor sub-stance concentrations can provide a new method for the practical application of vitreous humor chemi-cals for PMI estimation.

Value of Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio for Prognostic Evaluation of Diffuse Large B-cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) for the patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>The clinical data of 57 DLBCL patients admitted in the First Affiliated hospital of Anhui Medical University were analyzed retrospectively. According to ROC curve, the cut-off value for NLR and PLR was deterimined, and the patients were divided into high and low NLR/PLR groups before first chamotherapy. Then the relation of NLR and PLR with overall survival (OS) and progression-free survival (PFS) was analyzed by univariate and multivariate COX regression.</p><p><b>RESULTS</b>The optimal cut-off value for NLR and PLR was 2.915 and 270.27, respectively. NLR at the diagnosis was found to be an independent predictor for OS and PFS by univariate and multivariate analysis, while the PLR was an independent predictor for PFS, but did not affect the OS.</p><p><b>CONCLUSION</b>NLR and PLR may provide additional prognostic information for DLBCL patients.</p>

Expression of DNA Methyltransferase Genes and Its Significance in AML Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect the expression of DNA methyltransferases (DNMT) mRNA in the patients with acute myelogenous leukemia (AML) and to analyze the retationship between the mRNA expression of DNMT and cellular and moleculogenetic risk stratifieation in AML patients, and to evaluate the role of the DNMT mRNA expression in AML prognosis and clinical treatment.</p><p><b>METHODS</b>The mRNA expression of DNMT was detected by real-time PCR in 123 AML patients and 20 healthy people.</p><p><b>RESULTS</b>the mRNA expression levels of DNMT were lower in the healthy people and higher in AML patients; the mRNA expression levels of DNMT in the patients after the consolidation therapy were lower than that in the patients of initial diagnosis and replapse; The mRNA expression levels of DNMT did not correlate with age, sex and the clinical characteristics at initial diagnosis, such as white blood cell count, FAB classification and chromosomal karyotype in AML patients. In CR patients after standard treatment, the initial mRNA expression level of DNMT3b was higher. Based on cellular and moleculogenetic risk stratificantion, the DNMT expression level in the intermediate risk AML patients was higher.</p><p><b>CONCLUSION</b>The mRNA expression of DNMT may play an important role in AML pathogenesis and can serve as an index for evaluating AML prognosis and for instructing clinical treatment.</p>

Clinical study on platelet engraftment by thrombopoietin in patients with hematological malignancies after allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of thrombopoietin (TPO) on platelet engraftment in hematological malignancies patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>One hundred and twenty patients were enrolled in a multicenter, open-label, randomized, controlled clinical trial, and were randomized into 4 treatment groups following allo-HSCT. Group A was the control arm without TPO, while group B, C and D were trial arms with received 300 U×kg(-1)×d(-1) of TPO starting from day +1, +4 and +7, respectively. A total of 89 cases were evaluated, of which 22 cases in group A, 23 in group B, 20 in group C and 24 in group D. Efficacy evaluation (the time of platelet engraftment, the number of platelet transfusion) and safety evaluation \[adverse events, routine blood tests, liver and renal function, coagulation function and occurrence of graft-versus-host disease (GVHD)\] were observed.</p><p><b>RESULTS</b>The median platelet engraftment time in experimental groups (groups B, C and D) were on day (13.17 ± 2.89), day (12.15 ± 2.08), day (12.33 ± 1.76), respectively, and that in control group was on day (14.82 ± 5.05). There was statistically significant difference between two groups (P = 0.029), There were no statistically significant difference in the average amount of platelet transfusion, platelet engraftment time, and platelet nadir value among the 3 experimental groups. No significant adverse events were observed in experimental groups.</p><p><b>CONCLUSIONS</b>TPO administration following allo-HSCT for patients with hematologic malignancies appears to shorten platelet engraftment time. TPO given starting from day +7 is effective and safe.</p>

Mechanism of apoptosis in human leukemia NB4 cells induced by total astragalosides / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effect of total astragalosides (TA) on proliferation and apoptosis in human leukemia NB4 cells in vitro.</p><p><b>METHODS</b>The NB4 cells were treated with TA at different concentrations for 48 h in culture. Growth inhibition rates were measured by CCK-8 method. Flow cytometry was used to explore the cell apoptosis and the activity of NF-κB and Akt during apoptosis.</p><p><b>RESULTS</b>TA at different concentrations (200, 400, 600, 800 mg/L) inhibited proliferation of NB4 cells in a dose-dependent manner (P < 0.05), and the inhibitory rates of TA on NB4 cells were (14.54 ± 3.20)%, (24.79 ± 3.98)%, (57.28 ± 4.71)% and (88.28 ± 4.65)%, respectively. In terms of the induction of apoptosis, there was a significant difference between the TA group and blank control [(1.80 ± 1.24)%, P < 0.05]. At TA doses of 200, 400 and 600 mg/L, the apoptotic rates of NB4 cells were (10.03 ± 3.31)%, (14.87 ± 3.65)%, (23.45 ± 1.90)%, respectively. Besides, TA induced apoptosis of NB4 cells in a dose-dependent manner in the groups of 200 mg/L, 400 mg/L, 600 mg/L (P < 0.05). But there was no significant difference in apoptotic rates between the groups of 800 mg/L and 600 mg/L [(23.45 ± 1.90)%, P > 0.05]. In the group of 800 mg/L, the necrotic cells increased highly and the necrotic rate reached (45.65 ± 3.16)%. After TA treatment of NB4 cells at different concentrations (200, 400, 600 mg/L), the expression of NF-κB protein was significantly decreased compared with that of the blank control (9.79 ± 0.95, P < 0.05), while Akt protein was not significantly decreased (P > 0.05).</p><p><b>CONCLUSION</b>TA can inhibit the growth of NB4 cells and induce apoptosis in NB4 cells through an Akt-independent NF-κB signaling pathway.</p>

Detection of ABL kinase domain point mutations in chronic myeloid leukemia patients receiving imatinib treatment / 中国实验血液学杂志

This study was purposed to evaluate ABL tyrosine kinase point mutations in imatinib-treated chronic myeloid leukemia (CML) patients and their clinical significance. 51 bone marrow samples from 28 imatinib-resistant patients and 10 newly diagnosed CML patients were collected. ABL kinase domain of bcr-abl allele was amplified by nested reverse transcription-polymerase chain reaction, followed by purifying, directly sequencing and sequence homology analysis of amplified products in order to determine the existence and type of point mutation. The results showed that the point mutations were found in 12 of 38 patients, and all the 12 ones progressed to advanced disease or death. 2 patients showed Met351Thr mutation, 7 patients showed Glu252His, 2 patients showed Glu279Lys, the other types were Glu255Val and Glu355Gly, each of which was tested in one patient. The incidence of the point mutation was 17.6%, 45.5% and 44.4% in chronic, accelerated and blast phase respectively. The incidences of point mutation in hematologically and genetically resistant patients were 50% (5/10) and 44.4% (8/18), and the 95% confidence interval (CI) was 12.3% - 87.7% and 19% - 69.9% respectively. It is concluded that ABL kinase point mutation is an important mechanism of imatinib resistance, monitoring the ABL kinase domain point mutation is helpful to estimating the prognosis and adjusting the therapeutic strategy.

Experimental study on IL-2- and IL-15 application in allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the impact of IL-2- and IL-15-activated donor natural killer (NK) cell infusion on graft-versus-host-disease (GVHD) and graft-versus-leukemia (GVL) effect post allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>The C57BL/6 mice splenic NK cells were selected by microbeads, and then expanded in the media containing IL-2 and IL-15. The killing activity of NK cells was detected. In the leukemia mouse model, recipients (BALB/c) were intravenously inoculated with EL9611 leukemia cells 8 days before transplantation. Lethally irradiated BALB/c recipient mice were transplanted with 5 x 10(6) bone marrow cells (BMCs), or 5 x 10(6) BMCs plus 1 x 10(7) splenocytes with or without 1 x 10(7) activated NK cells. Additionally, NK cell infusion group mice were intraperitoneally injected with a mixture of IL-2 and IL-15 post transplant. Survival time, GVHD occurrence, lineage chimerism, TRBV spectra-typing were observed post transplant.</p><p><b>RESULTS</b>The purity of isolated splenic NK cells was 95.7% - 97.1%. The killing activity of NK cells after activation was increased by 3 times. GVHD did not occurred in allogeneic BMCs infusion group, whereas did from 1 week after transplant in allogeneic BMCs + splenocytes infusion group. The severity of GVHD in total body irradiation (TBI) experimental group was significantly lower than in splenocytes infusion group (P < 0.05). The survival time was 9.5 - 14.0 d in TBI alone conditioning group. In leukemia mouse model, 100 day survival rate was 10% the rest of them were died of leukemia while in experimental group, the more than 100 days survival rate was 80% (P < 0.01). PB NK cells at 2 week post-transplant were 4.8% in experimental group and 2.8% in control group. NK cells recovery in experimental group was earlier than that in control group (P < 0.05). TRBV reconstitution was faster in experimental group than in control group, moreover, the number of TRBV family expression was more in experimental group than in control group which mainly expressed monoclone or oligo-clone.</p><p><b>CONCLUSIONS</b>Donor alloreactive NK cells can be efficiently expanded and activated with IL-2 and IL-15. Donor activated NK cell infusion and IL-2, IL-15 treatment can promote immune reconstitution, mitigate GVHD and reduce leukemia relapse.</p>

Preliminary study of the effect of HLA-Cw on haploidentical hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of HLA-Cw on haploidentical hematopoietic stem cell transplantation (HHSCT) without T-cell depletion.</p><p><b>METHODS</b>HLA-Cw were detected with PCR-SSP, the clinical data of 21 cases of haploidentical hematopoietic stem cell transplantation, including 8 standard risk and 13 high risk cases from July 2002 to March 2006 were summarized, and the effect of HLA-Cw in HHSCT was analyzed.</p><p><b>RESULTS</b>Twenty patients achieved sustained, full-donor-type engraftment. The HLA-Cw matched and mismatched groups attained neutrophil recovery at a median of 12 days and 13 days, and platelet recovery to more than 20 x 10(9)/L at a median of 20 days and 23 days respectively (P > 0.05). The cumulative incidences of grades II-IV acute GVHD were 76.9% in HLA-Cw matched group and 14.3% in the mismatched group(P < 0.05). The incidences of chronic GVHD were 85.7% in HLA-Cw matched group and 57.1% in the mismatched group(P > 0.05). The 28 months disease-free survival probabilities were 49.0% in HLA-Cw matched group, and 85.7% in the mismatched group (P > 0.05). The Karnofsky score of survival patients was over 90%.</p><p><b>CONCLUSION</b>HLA-Cw mismatched in donor and recipient of HHSCT is beneficial for reducing II-IV aGVHD, and being in favor of long term survival.</p>