CLAG Regimen Composed of Continuous Intravenous Infusion of Cladribine in the Treatment of Refractory/Relapsed Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To study the efficacy and safety of continuous intravenous infusion of 2-Chlorodeoxyadenosine (2-CdA) combined with high-dose cytarabine (Ara-C) and granulocyte colony-stimulating factor (G-CSF) (CLAG regiem) in the treatment of relapsed/refractory acute myeloid leukemia (AML).@*METHODS@#Fifteen patients with refractory/relapsed AML hospitalized in 5 medical units such as Department of Hematology, the Affiliated Tumor Hospital of Zhengzhou University and received one course of CLAG regimen from June 2014 to August 2019 were analyzed retrospectively (specifically: cladribine 5 mg/M@*RESULTS@#Among the 15 patients with refractory/relapsed AML, 9 males and 6 females, the median age was 35 (13-63) years old. FAB classification: 1 case of M@*CONCLUSION@#The CLAG regimen consisting of continuous intravenous infusion of cladribine shows high CR in the treatment of AML patients, but the duration of CR is short, myelosuppression is sever, so that infection control is the key. Allogeneic hematopoietic stem cells transplantation should be performed as soon as possible after CR.

Synergistic Mechanism of Interferon alpha-1b, Interleukin-2 and Thalidomide for Immune Regulation in Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the synergistic immunomodulatory mechanism of interferon alpha-1b, interleukin-2 and thalidomide (ITI) regimen on patients with acute myeloid leukemia (AML).@*METHODS@#Sixty eight untreated de novo or relapsed or refractory or maintenance therapy patients with AML admitted in the Affiliated Cancer Hospital of Zhengzhou University and the other 11 medical units from March 2016 to May 2019 were treated with ITI regimen. Peripheral blood specimen per patient was collected into EDTA-K3 anticoagulation vacuum tube before the administration of ITI and 3 months after the treatment; peripheral blood lymphocyte subsets and perforin and Granzyme B expression were analyzed by using flow cytometry; the levels of VEGF, IFN-γ, TNF-α and IL-6 in the plasma were detected by using a cytometric bead array. Thirty-five healthy subjects from the hospital physical examination centre were selected as normal controls.@*RESULTS@#The ratio of CD4@*CONCLUSION@#The ITI regimen can raise the ratio of CD4

Analysis of the Irregular Antibodies of the Patients and Its Clinical Significance / 中国实验血液学杂志

OBJECTIVE@#To retrospectively analyze the identification results of irregular antibodies, to clarify the distribution features and to explore the relation of alloantibodies and autoantibodies with the immunized history of patients and disease kinds.@*METHODS@#49 820 patients who applied for red blood transfusion during Sep 1st 2017 to Sep 1st 2018 were selected. All the specimens were screened for the antibody by microcolumn gel antiglobulin technique, which then were identified for irregular antibody.@*RESULTS@#Antibodies were found in 861 (1.73%) of all 49 820 transfused samples. The alloimmunization history of the patients with antibodies was significantly different between male and female (χ=18.54，P＜0.01). The alloantibody was the most common, accounting for 59.50% in all of the antibodies. Warm autoantibody, anti-E, anti-M, anti-cE and anti-Ce accounted for 68.5% of the antibodies. The blood group of Rh, MNS and Lewis were responsible for 92.40% of alloantibody, especially anti-E accounted for the largest percentage(38.60%) of alloantibody. Patients with alloantiboies experienced much more the alloimmunization and transfusion history (χ=20.13，P＜0.01；χ=5.40，P＜0.05) . The distribution of auto and alloantibody was very significantly different among the ddifferent isease (χ=51.8，P＜0.01), Hematopathy, solid tumor and osteoarthropathy were often associated with alloantibody, otherwise, autoantibodies often occurred in hematopathy and autoimmune disease.@*CONCLUSION@#The most important factor that results in antibody-screening positive is alloantibody, in which anti-E antibody from Rh blood group system in most common.

Current status of blood pressure control in patients with coronary heart disease / 中国应用生理学杂志

OBJECTIVE@#To evaluate the level of blood pressure control in patients with coronary heart disease (CHD) of China in order to provide guidance for the prevention and treatment of CHD.@*METHODS@#The patients with CHD were retrospectively collected from 2011~2014 in PLA General Hospital and Hainan Branch Hospital. Then analyzed the difference of blood pressure compliance rate between different surgical methods percutaneous coronary intervention (PCI), coronary artery bypass grafting(CABG), secondary preventive drugs(aspirin, clopidogrel, nitrates, trimetazidine, nicorandil, hypotensor, hypoglycemic, lipid-lowering drugs) and lifestyle(smoking, drinking, exercise).@*RESULTS@#①Effects of surgical methods on blood pressure:Male's systolic blood pressure (SBP) and diastolic blood pressure(DBP) in the CABG group were lower in the PCI group and control group, and female's DBP in the CABG group were lower in the PCI group. ②Usage rate of secondary prevention drugs:usage rate of trimetazidine, calcium antagonist, β-blockers, angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor antagonist (ARB) in hypertension group were higher than in normal blood pressure group. ③ Lifestyle condition:compliance rate of blood pressure in the smoking group was lower than that in the non smoking group. And there was no significant difference in blood pressure compliance rate among whether drinking and doing exercise or not.@*CONCLUSIONS@#Blood pressure control in patients with CHD was still not satisfied. Compared with PCI, CABG may be more beneficial in the control of blood pressure in patients with CHD. Smoking cessation and improving the usage rate of secondary preventive drugs are still the main means of blood pressure control.

Relationship between Depression and Quality of Life in Patients with Severe Obesity / 中国医学科学院学报

Objective To investigate the depression status and quality of life (QoL) of patients with severe obesity who have undergone bariatric surgery and to evaluate their potential correlation.Methods A total of 50 patients with severe obesity who had undergone elective bariatric surgery in the general surgical ward of Peking Union Medical College from January 2013 to December 2017 were enrolled in this study. The general data were collected. The patient's depression status and QoL were assessed by the Zung's Depression Self-Assessment Scale and the SF-36 Quality of Life Scale,respectively.Results The depression score was (44.85±9.07) scores in these 50 patients,including 38 patients (76%) without depression and 12 (24%) with mild depression. The scores of the mental-emotional,physical,psychomotor,and psychological barrier dimensions of patients with severe obesity were (3.70±1.25),(18.65±4.10),(4.25±1.35),and (18.75±5.46)scores,respectively. The physiological function score of patients with mild depression was (95.83±10.21)scores,which was significantly higher than those without depression (68.42±38.95) scores(F=6.209,P=0.011). The vitality and mental health scores were (46.67±14.72) and (57.33±14.68) scores in patients with mild depression,which were significantly lower than those [(65.79±21.94) (F=4.867,P=0.030) and (75.16±17.21) scores (F=0.212,P=0.032)] in patients without depression. Correlation analysis showed that the mental-emotional score was positively correlated with physical score in patients with severe obesity (r=0.503,P=0.015),whereas the depression score was negatively correlated with the general health status (r=-0.430,P=0.032),vitality (r=-0.594,P=0.002),social functioning (r=-0.455,P=0.022),mental health (r=-0.562,P=0.003),and QoL score (r=-0.439,P=0.028).Conclusions The QoL is remarkably affected by depression in patients with severe obesity before surgery. Assessment of the mental status of patients with severe obesity may help to identify this problem and thus improve the QoL.

Comparison of the efficacy of imatinib and dasatinib for treatment of newly diagnosed chronic my-elogenous leukemia chronic phase patients / 新乡医学院学报

Objective To explore the efficacy of imatinib and dasatinib for treatment of newly diagnosed chronic my-elogenous leukemia chronic phase(CML-CP)patients. Methods Forty patients with CML-CP were selected in the Luoyang Central Hospital Affiliated to Zhengzhou University from January 2010 to June 2016. The patients were divided into imatinib group(n = 22)and dasatinib group(n = 18)according to the treatment method. The patients in imatinib group received ima-tinib orally for 1 year;the patients in dasatinib group received dasatinib orally for 1 year. The treatment response and curative effect of patients in the two groups were evaluated at 3,6 months after treatment;the aderverse reactions of patients in the two groups were evaluated at 12 months after treatment. Results The rate of optimal cytogenetic response of patients in imatinib group and dasatinib group was 45. 5％(10 / 22),55. 6％(10 / 18)at 3 months after treatment and 36. 4％(8 / 22),38. 9％(7 /18)at 6 months after treatment;the rate of optimal molecular response of patients in imatinib group and dasatinib group was 50. 0％(11 / 22),55. 6％(10 / 18)at 3 months after treatment and 31. 8％(7 / 22),38. 9％(7 / 18)at 6 months after treatment;the rate of failture to achieve a complete cytogenetic responses(CCyR)of patients in imatinib group and dasatinib group was 18. 2％(4 / 22),5. 6％(1 / 18)at 12 months after treatment;the rate of failure to achieve BCR-ABLIS≤1％ of patients in ima-tinib group and dasatinib group was 18. 2％(4 / 22),5. 6％(1 / 18)at 12 months after treatment. The rate of optimal cytogenetic response and optimal molecular response of patients in dasatinib group at 3,6 months after treatment were significantly higher than those in the imatinib group(P < 0. 05);the rate of failure to achieve a CCyR and BCR-ABLIS≤1％ of patients in dasat-inib group at 12 months after treatment were significantly lower than those in the imatinib group(P < 0. 05). The mutation rate of BCR-ABL kinase domain of patients in imatinib group and dasatinib group was 13. 6％(3 / 22)and 5. 6％(1 / 18)respective-ly;the mutation rate of BCR-ABL kinase domain of patients in imatinib group was significantly higher than that in the dasatinib group(P < 0. 05). Conclusion Compared with imatinib,dasatinib has better efficacy in treatment of CML-CP patients,and with lower mutation rate of BCR-ABL kinase domain. So,dasatinib is suitable for clinical use.

Application and Exploration of Big Data Mining in Clinical Medicine / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review theories and technologies of big data mining and their application in clinical medicine.</p><p><b>DATA SOURCES</b>Literatures published in English or Chinese regarding theories and technologies of big data mining and the concrete applications of data mining technology in clinical medicine were obtained from PubMed and Chinese Hospital Knowledge Database from 1975 to 2015.</p><p><b>STUDY SELECTION</b>Original articles regarding big data mining theory/technology and big data mining's application in the medical field were selected.</p><p><b>RESULTS</b>This review characterized the basic theories and technologies of big data mining including fuzzy theory, rough set theory, cloud theory, Dempster-Shafer theory, artificial neural network, genetic algorithm, inductive learning theory, Bayesian network, decision tree, pattern recognition, high-performance computing, and statistical analysis. The application of big data mining in clinical medicine was analyzed in the fields of disease risk assessment, clinical decision support, prediction of disease development, guidance of rational use of drugs, medical management, and evidence-based medicine.</p><p><b>CONCLUSION</b>Big data mining has the potential to play an important role in clinical medicine.</p>

Two mechanical methods for thromboembolism prophylaxis after gynaecological pelvic surgery: a prospective, randomised study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Venous thromboembolism is known to be an important social and health care problem because of its high incidence among patients who undergo surgery. Studies on the mechanical prophylaxis of thromboembolism after gynaecological pelvic surgery are few. The aim of our study was to evaluate the effect of mechanical thromboembolism prophylaxis after gynaecological pelvic surgery using a combination of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) or GCS alone.</p><p><b>METHODS</b>The study was performed on 108 patients who were randomly assigned to two groups. The first group received GCS before the operation and IPC during the operation (IPC + GCS group). The second group received GCS before the operation (GCS group). To analyze the effect of the preventive measures and the laboratory examination on the incidence of thrombosis and to compare the safety of these measures, the incidence of adverse reactions was assessed.</p><p><b>RESULTS</b>The morbidity associated with DVT was 4.8% (5/104) in the IPC + GCS group and 12.5% (14/112) in the GCS group. There were significant statistical differences between the two groups. There were no adverse effects in either group.</p><p><b>CONCLUSIONS</b>The therapeutic combination of GCS and IPC was more effective than GCS alone for thrombosis prevention in high-risk patients undergoing gynaecological pelvic surgery, and there were no adverse effects in either group.</p>

Effects of matrix metalloproteinase-9 inhibitor in Lewis rats with experimental autoimmune myocarditis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of matrix metalloproteinase-9 (MMP-9) inhibitor minocyclin hydrochloride in Lewis rats with experimental autoimmune myocarditis (EAM).</p><p><b>METHODS</b>EAM was induced by injection of cardiac C protein emulsified in completed Freund adjuvant in double footpad and intraperitoneal injection of pertussis toxin on 6- to 8-week old Lewis rats. Sixty EAM Lewis rats were divided into 3 groups (early, middle and late intervention groups, n = 20 each: 10 minocyclin treated and 10 control rats). In early intervention group, rats in treatment group received intraperitoneal injection of minocyclin hydrochloride from 1(st) to 21(st) day after immunization; in middle intervention group, rats were treated from 8(th) to 28(th) day after immunization and in late intervention group, rats were treated from 15(th) to 35(th) day after immunization (50 mg/kg body weight, once daily). Control rats received intraperitoneal injection of same volumetric physiological saline at corresponding time periods. At the end of intervention, rats were euthanatized and hearts were harvested. Paraffin sections were used for hematoxylin and eosin stain to determine the inflammatory score, for picrosirius stain to determine fibrosis score and collagen content, and for immunohistological stain to determine macrophages and T lymphocytes. Real time PCR was used to detect mRNA expression of myocardial MMP-2 and MMP-9. Cryostat sections were used for in situ zymography to detect protein activity of gelatinase.</p><p><b>RESULTS</b>Inflammatory score in cardiac paraffin slides, number of cardiac macrophages and T lymphocytes, cardiac interstitial fibrosis score and content, expression of MMP-2, 9 mRNA and activity of gelatinase in treatment group were all significantly lower than in control group for early and middle intervention groups (inflammatory score: early control group vs. treatment group: 3.03 ± 1.35 vs.1.51 ± 0.36, P < 0.05, middle control group vs. treatment group: 3.75 ± 0.29 vs. 2.11 ± 0.82, P < 0.01; cardiac interstitial fibrosis score, early control group vs. treatment group: 2.75 ± 0.29 vs.1.51 ± 0.35, P < 0.01, middle control group vs. treatment group: 2.50 ± 0.41 vs. 1.61 ± 0.42, P < 0.05; gelatinase, early control group vs. treatment group: 162 367 ± 5095 vs. 62 366 ± 2131, P < 0.01, middle control group vs. treatment group: 184 256 ± 5427 vs. 113 197 ± 4809, P < 0.01) while these parameters were similar between minocyclin-treated and control rats in late intervention group (all P > 0.05).</p><p><b>CONCLUSIONS</b>MMP-9 plays an important role in the pathogenesis of autoimmune myocarditis. Inhibition of MMP-9 in early and middle stage could significantly attenuate inflammatory responses and myocardial fibrosis in this experimental EAM model.</p>

Detection and screening for human cytomegalovirus infection in allogeneic hematopoietic stem cell transplantation recipients by different methods / 中国实验血液学杂志

The aim of study was to explore the better detection method for cytomegalovirus (CMV) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients and to compare the efficiency of fluorogenic quantitative PCR (FQ-PCR), flow cytometry (FCM) and ELISA. The plasma DNA loading and serum level of IgM antibody against CMV in 214 clinical specimens from 19 allo-HSCT patients were detected by real-time FQ-PCR and ELISA respectively, the pp65 antigen in 118 peripheral blood leukocyte samples were measured by FCM. The results showed that the positive rates of pp65 antigen, IgM antibody and DNA load were 30.85% (58/188), 13.08% (28/214) and 35.51% (76/214) respectively, the coincidence between their sequential detection positive rates and clinical diagnosis were 7/8, 7/8 and 3/8 respectively. There was no statistical significant difference between the positive rate of pp65 antigen and of DNA amount (P > 0.05), and they have manifested relationships (P < 0.05). The positive rate of IgM antibody detected by ELISA was obvious lower than that of DNA quantitated by FQ-PCR and pp65 antigen detected by FCM, but the difference between them showed statistical significance (P < 0.05), Smaller relativity was found between IgM antibody detection and the other two methods (P > 0.05). It is concluded that FQ-PCR and FCM are sensitive, rapid, suitable and reliable methods for monitoring recipient reactive CMV infection of allo-HSCT recipients and are worthy to extensively use for guiding antiviral therapy.