ABSTRACT
Objective:To evaluate the outcome of laser coagulation under fetoscope for placental chorioangioma (CA).Methods:The clinical data of three pregnant women with giant CA treated by laser coagulation under fetoscope in Peking University Third Hospital from January 2018 to December 2020 were analyzed retrospectively. Relevant articles up to September 2022 were retrieved from Wanfang Database, China National Knowledge Infrastructure and PubMed, and the clinical data of all patients were retrospectively summarized. Indications and intervention effects of fetoscopic laser therapy were analyzed. Descriptive statistics was used to describe the data.Results:Thirteen patients were involved in this study including 10 cases retrieved from the databases. The average age of the pregnant women was (30.3±6.2) years old. There were 12 cases of single pregnancy and one case of twin pregnancy (monochorionic diamnionic twin pregnancy). Except for cases for which data were not available in the literatures, at the diagnosis of CA, the average gestational age was (19.9±4.5) weeks ( n=7) and the average maximum diameter of the mass was (6.1±4.1) cm ( n=6). The patients underwent fetoscopic laser therapy at an average gestational age of (25.0±2.0) weeks ( n=13) with the average maximum tumor diameter of (7.6±2.8) cm ( n=9). After treatment, the amniotic fluid volume of three cases decreased to normal. In one case, the amniotic fluid volume decreased but was still above the upper limit of the normal range. Moreover, the maximum tumor diameter decreased in four cases; the peak systolic velocity of the fetal middle cerebral artery decreased to normal in one case; fetal heart function became normal in two cases and fetal edema was relieved in one case. Among the three patients treated in our hospital, the blood supply of CA disappeared after treatment. Intrauterine fetal death occurred in two cases. The other 11 patients gave birth to live babies at the gestational age of (36.6±3.8) weeks with five through cesarean section (5/11), five through vaginal delivery (4/11) and two not reported. The birth weight of the neonates was (2 712±1 023) g and all of them survived. The gender of five neonates were reported and all were females, two of them were monochorionic diamnionic twins. No abnormality was found in the three neonates delivered in our hospital during a six-month follow-up. No abnormality was reported in the other neonates during ten days to six months of follow-up. Conclusions:Fetoscopic laser coagulation may help reduce the size of CA, decrease complications and improve pregnancy outcomes.
ABSTRACT
Objective:To investigate the value of real-time shear wave elastography (SWE) in the assessment of splenic congestion in patients with chronic right heart failure.Methods:Sixty patients with chronic right heart failure with cardiac function grade Ⅱ-Ⅳ of New York Heart Association (NYHA) treated in Lianyungang First People′s Hospital from March 2020 to February 2021 were collected as the study group, and 20 healthy subjects in the same period were selected as the control group. Routine echocardiography was performed on all subjects; spleen stiffness measurement (SSM) was detected by SWE, and blood biochemical indicators related to patients with right heart failure were detected and recorded. SSM and other related parameters between the two groups were analyzed; the SSM in patients of different cardiac function classifications and course of disease were compared; 60 patients were divided into low SSM group (SSM≤15.0 kPa), middle SSM group (15.0 kPa<SSM<21.3 kPa) and high SSM group (SSM≥21.3 kPa) according to the measured SSM (9.1-34.5 kPa). The differences in clinical indicators between the three groups were analyzed and compared, and the adverse events of the three groups were analyzed by the kaplan-Meier (KM) method. Receiver operating characteristic (ROC) curve was used to evaluate the value of SSM for predicting right atrial pressure (RAP)≥10 mmHg in patients with chronic right heart failure. Multiple linear regression was used to analyze the independent risk factors of increased SSM in patients with chronic right heart failure.Results:Compared with the control group [(10.23±1.95)kPa], the SSM of the study group [(22.09±6.99)kPa] was significantly higher, and the difference between the two groups was statistically significant ( P<0.05); the SSM in patients with cardiac function grade Ⅳ [(25.24±4.53)kPa] was higher than those of grade Ⅲ [(16.71±3.12)kPa] and grade Ⅱ [(11.89±2.10)kPa] (all P<0.001); the SSM in patients with course of disease≥1 year [(24.71±4.61)kPa] was higher than those with a course of <1 year [(14.95±4.00)kPa] ( P<0.001); Compared with the low SSM group and the middle SSM group, the estimated RAP, N-terminal pro B-type natriuretic peptide (NT pro-BNP) and right atrial volume index (RAVI) of the high SSM group were higher (all P<0.05), and the inferior vena cava collapsible index (IVC-CI) was lower ( P<0.05). KM survival analysis showed that the incidence of adverse events in high SSM group was significantly higher compared with the middle SSM group and lower SSM group ( P<0.001). SSM in patients with right heart failure was positively correlated with NT pro-BNP, estimated RAP, and RAVI (all P<0.05), negatively correlated with IVC-CI ( P<0.05); When SSM≥26.1 kPa, the area under ROC curve was of predicting RAP≥10 mmHg 0.863 (95% CI: 0.771-0.955), and the sensitivity and specificity were 76.5% and 81.4%. Multiple linear stepwise regression analysis showed that NT pro-BNP, estimated RAP and IVC-CI were independent risk factors of SSM in patients with chronic right heart failure. Conclusions:The increase of SSM can reflect the increase of RAP, the severity of right heart failure and heart failure. The detection of SSM by SWE technology can conveniently and effectively monitor and evaluate the degree of splenic congestion and injury.
ABSTRACT
Objective:To investigate the efficacy of allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia associated with 11q23/MLL.Methods:Retrospection and analysis 50 cases of acute myeloid leukemia with 11q23/MLL and who were treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT)in our hospital from September 2012 to December 2019. The efficacy was evaluated by analyzing the transplantation success rate, graft-versus-host disease rate, infection rate, transplant-related mortality(TRM), accumulative recurrence rate, disease-free survival rate(DFS), and overall survival rate(OS).Results:Except for 1 patient had an unsuccessful stem cell transplantationas the result of multiple organ failure, the remaining 49 patients were successfully transplanted. The median time of leukocyte transplantation was 15(9~18)days, and the median time of platelet transplantation was 13(8~33)days. Bone marrow was assessed 28 days after transplantation, and 49 patients were in CR status. The median follow-up time was 38(3~79)months. Between remission group and non-remission group after transplantation, the 3-year OS rates were(83.3±10.8)%, (30.9+ 8.2)%( P=0.002)and the 3-year DFS rates were(83.3+ 10.8)%, (28.4±8.0)%( P=0.003), respectively. Conclusions:Allogeneic hematopoietic stem cell transplantation is an effective method for the treatment of 11q23/MLL rearranged AML. Patients in remission before transplantation have a higher survival rate, and recurrence after transplantation is the primary problem currently faced.
ABSTRACT
Objective:To investigate the effect of ionizing radiation on the N 6-methyladenine (m 6A) modification profile of circular RNA (circRNA) in mouse bone marrow cells and provide scientific basis for revealing the relationship between RNA epigenetic modification and hematopoietic radiation injury. Methods:A total of twenty four C57BL/6 J mice were randomly divided into two groups: the healthy control group ( n=12), and ionizing radiation group ( n=12) irradiated in total body with 4 Gy of 137Cs γ-rays. At 5 min after irradiation, mice were killed and bone marrow cells were collected from the femur. Total RNAs were extracted and the changes in circRNA m6A modification profiles were investigated by RNA immunoprecipitation-high-throughput sequencing (MeRIP-Seq) technology and bioinformatics analysis. The representative alterations of m 6A peaks were validated by MeRIP-PCR assay. Results:325 and 455 m 6A sites were identified on circRNAs in the healthy control group and ionizing radiation group (178 common sites, 147 specific sites in the healthy control group and 277 specific sites in ionizing radiation group), respectively. 1 275 and 1 017 deriving genes of m 6A-circRNAs were identified in the healthy control group and ionizing radiation group (767 common genes, 508 specific genes in the healthy control group and 250 specific genes in ionizing radiation group), respectively. Compared with the control healthy group, 414 (178) m 6A peaks was significantly up- (down-) regulated in the ionizing radiation group( P < 10 -10; fold-change cut-off > 5). Moreover, Gene Ontology (GO) assay revealed that the deriving genes of circRNAs with differentially methylated m 6A sites between two groups involves various functions including chromatin regulation, ciliary transition fiber and poly (A)-specific ribonuclease activity. Kyoto Encyclopedia of Genes and Genomes (KEGG) assay revealed that the deriving genes of circRNAs with differentially methylated m 6A sites between two groups included numerous pathways such as platelet activation, Fc γ R-mediated phagocytosis and B cell receptor signaling pathway. Conclusions:Ionizing radiation triggers rapid alterations in the m 6A modification profile of circRNA in mouse bone marrow cells. The deriving genes of differentially methylated circRNAs are associated with a variety of functions and signaling pathways of hematopoietic radiobiology.
ABSTRACT
Objective:To study the effect of emulsifier Tween-80 on radiation-induced bile acid enterohepatic circulation disturbance and the treatment strategy.Methods:Male C57BL/6 J mice were randomly divided into healthy control group, radiation-only group, radiation + Tween-80 group and radiation + Tween-80 + butyric acid group. The mice were exposed to total abdominal irradiation (TAI) using a specific steel lead chamber and γ-ray irradiator was used throughout the experiments. Mice in radiation+ Tween-80 group and radiation+ Tween-80+ butyric acid group were intragastrically administrated with Tween-80 for 7 d before irradiation, while healthy control group and radiation-only group were treated with sterile water. After irradiation, butyric acid was administrated to mice in radiation+ Tween-80+ butyric acid group until euthanasia, while healthy control group, radiation-only group and radiation+ Tween-80 group were treated with sterile water until euthanasia. Small intestine and fecal particles were collected 21 d after irradiation. The concentrations of bile acid in small intestinal and fecal samples were measured using enzyme linked immunosorbent assay (ELISA), the expression of TGR5 and JAM-A, as well as the ratio of IL-10/IL-12 in intestine were detected by quantitative real-time PCR (qRT-PCR). The expression levels of GPR43 in the colon were compared using immunohistochemistry (IHC).Results:Tween-80 pretreated mice exhibited lower concentration of bile acid in small intestine and higher level of bile acid in fecal sample after irradiation (7.92%, 7.99%, t=3.93, 2.94, P<0.05), the expression of TGR5, which mediating the biological function of bile acid, and it′s downstream JAM-A gene were down-regulated (20.93%, 9.91%, t=4.85, 5.14, P<0.05), the ratio of IL-10/IL-12 (indicator related to inhibition of inflammation) (4.59%, t=3.39, P<0.05) as well as the expression of GPR43 protein, a G-protein-coupled receptor for butyric acid, decreased in the colon of Tween-80-pretreated mice compared with the radiation-only group. ELISA assay revealed that butyric acid administration elevated bile acid level in small intestines (8.06%, t=9.25, P<0.05), but reduced that in feces (14.41%, t=4.71, P<0.05). In addition, TGR5 and JAM-A showed higher expression in the intestine of butyric acid-treated mice (19.35%, 32.71%, t=7.69, 19.23, P<0.05), as well as the ratio of IL-10/IL-12 (2.39%, 4.05%, t=3.38, 5.92, P<0.05) and the content of GPR43 protein in colon. Conclusions:Tween-80 deteriorates the disturbance of bile acid enterohepatic circulation induced by ionizing radiation in mice. Butyric acid administration erases the adverse effects of Tween-80.
ABSTRACT
Objective:To investigate the clinical effect and short-term and long-term effect of total hip replacement (THA) and hemiarthroplasty of hip (HA) in elderly patients with femoral neck fracture (FNF).Methods:59 elderly patients with FNF in South District of Guang′anmen Hospital, Chinese Academy of Traditional Chinese Medicine from March 2017 to January 2019 were retrospectively analyzed. The observation group ( n=29) was treated with THA; The control group ( n=30) was treated with HA. The operation related indexes, short-term and long-term clinical effect (average follow-up of 24.1 months), hip function improvement, pain and complications were compared between the two groups. Short term and long-term clinical effects: the short-term and long-term clinical effects of the two groups were observed by the Harris Hip Score (HHS) of the first month, the third month, the sixth month, the ninth month and the first year after operation. Results:Both THA and HA were effective on elderly FNF, but the effective rate of THA (96.6%) was significantly higher than that of HA (90.0%), with statistically significant difference ( P<0.05); in terms of operation related indicators, compared with the control group, the observation group had longer operation time [ (104.46±3.24)min vs (84.34±3.64)min], more amount of bleeding [(296.64±15.16)ml vs (281.44±12.16)ml], lower postoperative drainage volume [(101.24±4.15)ml vs (74.56±3.24)ml], while the functional recovery of the observation group was better than the control group by HHS ( P<0.05); the postoperative complications and HHS score of observation group were significantly lower than the control group ( P<0.05). Conclusions:THA has the advantages of low complication, fast functional recovery and better effect. The clinical decision should be based on the patient′s physical condition. THA should be used for elderly patients with good basic condition, good surgical tolerance and more daily activities. HA should be used for elderly patients with poor basic condition, low surgical tolerance and less daily activities.
ABSTRACT
Objective To evaluate the diagnostic value of quantitative detection of cytomegalovirus (CMV) DNA from different sources [plasma, sputum and bronchoalveolar lavage fluid(BALF)] for CMV pneumonia after allogeneic hematopoietic stem cell transplantation. Methods Clinical data of 405 recipients undergoing allogeneic hematopoietic stem cell transplantation were retrospectively analyzed. Among them, 19 recipients diagnosed with CMV pneumonia were assigned into the CMV pneumonia group, and 229 recipients with CMV viremia alone, 11 recipients without CMV pneumonia who received fiberoptic bronchoscopy and 16 recipients diagnosed with bacterial or fungal pneumonia based on pathogenic evidence receiving sputum culture were assigned into the control A, B and C groups, respectively. The incidence of CMV pneumonia was summarized. The CMV DNA load of specimens from different sources (plasma, sputum and BALF) of recipients with CMV pneumonia was analyzed. The clinical prognosis of recipients with CMV pneumonia was evaluated. Results Among 405 recipients undergoing allogeneic hematopoietic stem cell transplantation, 19 cases developed CMV pneumonia, and the overall incidence of CMV pneumonia was 4.7%(19/405). The CMV DNA load in the plasma, sputum and BALF of recipients with CMV pneumonia was higher than those in the control A, B and C groups (all P < 0.05). In the 19 recipients, 12 cases were cured after antiviral treatment and 7 died from treatment failure(3 cases abandoned treatment). The fatality was 37%(7/19). Conclusions Quantitative detection of CMV DNA in the plasma, sputum and BALF may increase the diagnostic rate of CMV pneumonia, thereby improving clinical prognosis of recipients undergoing allogeneic hematopoietic stem cell transplantation.
ABSTRACT
Objective@#To investigate the relationship between childhood abuse and recent negative life events with suicidal ideation and attempt, and to provide reference for prevention and control of suicidal behaviors in middle school students.@*Methods@#Stratified cluster sampling method was used to select 7 986 middle school students from Shenzhen, Nanchang and Shenyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse, negative life events, suicidal ideation and suicide attempt, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and negative life events with suicidal ideation and suicide attempt.@*Results@#The prevalence of suicidal ideation and suicide attempt was 22.9% and 4.7%. After adjusted for confounding variables, with the increase of childhood abuse and negative life events, suicidal ideation and attempt in middle school students showed an increasing trend(P<0.05). Compared those with low level of childhood abuse and negative life events, students with high childhood abuse and high negative life events had a higher suicidal ideation and suicide attempt risk, the multiple adjusted odds ratio was 10.43 and 19.75(P<0.05).@*Conclusion@#Childhood abuse and negative life events are important risk factors affecting suicidal ideation and attempt in middle school students. Strategies to reduce childhood abuse and negative life events should be an integral component of targeted mental health interventions.
ABSTRACT
Objective:To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on therapy-related leukemia (TRL).Methods:The clinical data of 14 patients with TRL who received allo-HSCT in Aerospace Central Hospital from April 2012 to February 2020 were retrospectively analyzed, and the therapeutic efficacy and survival status were also analyzed.Results:Of the 14 patients, 5 were males and 9 were females; the median age was 35 years old (12-59 years old). There were 12 patients with acute myeloid leukemia, 1 patient with chronic lymphocytic leukemia/small cell lymphoma, and 1 patient with acute lymphoblastic leukemia. At the time of transplantation, 4 patients achieved bone marrow complete remission, 3 patients achieved bone marrow partial remission, and the remaining 7 patients had no remission. Five patients received HLA-matched sibling transplantation, 9 patients received haplotype transplantation, and they all received myeloablative pretreatment schemes. All 14 patients were successfully implanted; the median engraftment time of granulocyte was 16 d (10-24 d), and the median engraftment time of platelet was 13 d (10-34 d). Grade Ⅰ-Ⅱ acute graft-versus-host disease (GVHD) occurred in 7 patients, chronic GVHD occurred in 6 patients, and grade Ⅲ intestinal GVHD occurred in 2 patients. The median follow-up time was 32 months (4-97 months). Among 14 patients, 5 patients died.Conclusion:The allo-HSCT can improve the prognosis and long-term survival rate of TRL patients.
ABSTRACT
OBJECTIVE@#To study the anti- fibrotic effect of human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-EXOs) and explore the mechanism.@*METHODS@#Twenty-four C57 BL/6 mice were divided into 4 groups (=6), including the control group treated with intratracheal injection of saline (3 mg/kg); lung fibrosis model group with intratracheal injection of 1.5 mg/mL bleomycin solution (prepared with saline, 3 mg/kg); EXOs1 group with intratracheal injection of 1.5 mg/mL bleomycin solution (3 mg/kg) and hUCMSC-EXOs (100 μg/250 μL, given by tail vein injection on the next day after modeling); and EXOs2 group with intratracheal injection of 1.5 mg/mL bleomycin solution (3 mg/kg) and hUCMSC-EXOs (100 μg/250 μL, given by tail vein injection on the 10th day after modeling). At 21 days after modeling, pulmonary index, lung tissue pathology and collagen deposition in the mice were assessed using HE staining and Masson staining. The expression level of TGF-β1 was detected using ELISA, and vimentin, E-cadherin and phosphorylated Smad2/3 (p-Smad2/3) were detected using immunohistochemical staining. CCK8 assay was used to evaluate the effect of hUCMSCEXOs on the viability of A549 cells, and Western blotting was used to detect the expression levels of p-Smad2/3, vimentin, and E-cadherin in the cells.@*RESULTS@#Compared with those in the model group, the mice treated with hUCMSC-EXOs showed significantly reduced the pulmonary index ( < 0.05), collagen deposition, lung tissue pathologies, lowered expressions of TGF-β1 ( < 0.05), vimentin, and p-Smad2/3 and increased expression of E-cadherin. hUCMSC-EXOs given on the second day produced more pronounced effect than that given on the 11th day ( < 0.05). CCK8 assay results showed that hUCMSC-EXOs had no toxic effects on A549 cells ( > 0.05). Western blotting results showed that hUCMSC-EXOs treatment significantly increased the expression of E-cadherin and decreased the expressions of p-Smad2/3 and vimentin in the cells.@*CONCLUSIONS@#hUCMSC-EXOs can alleviate pulmonary fibrosis in mice by inhibiting epithelialmesenchymal transition activated by the TGF-β1/Smad2/3 signaling pathway, and the inhibitory effect is more obvious when it is administered on the second day after modeling.
Subject(s)
Animals , Humans , Mice , Epithelial-Mesenchymal Transition , Exosomes , Mesenchymal Stem Cells , Pulmonary Fibrosis , Transforming Growth Factor beta1 , Umbilical CordABSTRACT
OBJECTIVE@#To study the anti- fibrotic effect of human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-EXOs) and explore the mechanism.@*METHODS@#Twenty-four C57 BL/6 mice were divided into 4 groups (=6), including the control group treated with intratracheal injection of saline (3 mg/kg); lung fibrosis model group with intratracheal injection of 1.5 mg/mL bleomycin solution (prepared with saline, 3 mg/kg); EXOs1 group with intratracheal injection of 1.5 mg/mL bleomycin solution (3 mg/kg) and hUCMSC-EXOs (100 μg/250 μL, given by tail vein injection on the next day after modeling); and EXOs2 group with intratracheal injection of 1.5 mg/mL bleomycin solution (3 mg/kg) and hUCMSC-EXOs (100 μg/250 μL, given by tail vein injection on the 10th day after modeling). At 21 days after modeling, pulmonary index, lung tissue pathology and collagen deposition in the mice were assessed using HE staining and Masson staining. The expression level of TGF-β1 was detected using ELISA, and vimentin, E-cadherin and phosphorylated Smad2/3 (p-Smad2/3) were detected using immunohistochemical staining. CCK8 assay was used to evaluate the effect of hUCMSCEXOs on the viability of A549 cells, and Western blotting was used to detect the expression levels of p-Smad2/3, vimentin, and E-cadherin in the cells.@*RESULTS@#Compared with those in the model group, the mice treated with hUCMSC-EXOs showed significantly reduced the pulmonary index ( < 0.05), collagen deposition, lung tissue pathologies, lowered expressions of TGF-β1 ( < 0.05), vimentin, and p-Smad2/3 and increased expression of E-cadherin. hUCMSC-EXOs given on the second day produced more pronounced effect than that given on the 11th day ( < 0.05). CCK8 assay results showed that hUCMSC-EXOs had no toxic effects on A549 cells ( > 0.05). Western blotting results showed that hUCMSC-EXOs treatment significantly increased the expression of E-cadherin and decreased the expressions of p-Smad2/3 and vimentin in the cells.@*CONCLUSIONS@#hUCMSC-EXOs can alleviate pulmonary fibrosis in mice by inhibiting epithelialmesenchymal transition activated by the TGF-β1/Smad2/3 signaling pathway, and the inhibitory effect is more obvious when it is administered on the second day after modeling.
Subject(s)
Animals , Humans , Mice , Epithelial-Mesenchymal Transition , Exosomes , Gene Expression Profiling , Gene Expression Regulation , Mesenchymal Stem Cells , Cell Biology , Pulmonary Fibrosis , Therapeutics , Transforming Growth Factor beta1 , Genetics , Umbilical Cord , Cell BiologyABSTRACT
Objective@#To investigate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of leukemia patients also suffering from central nervous system leukemia (CNSL) .@*Methods@#A total of 48 leukemia patients with central nervous system leukemia admitted to our hospital from May 2012 to December 2017 were retrospectively analyzed.@*Results@#① Including 22 cases of acute lymphocytic leukemia (ALL) , 21 cases of acute myeloid leukemia (AML) , and 5 cases of chronic myelogenous leukemia (CML) . Before transplantation, 19 patients achieved complete remission (CR) , and the rest 29 ones without remission. ②The conditioning regimen used TBI as the main protocol, and 6 patients were combined with whole brain and total spinal cord radiotherapy, 2 with Cyber knife treatment, and children with modified IDA combined with BUCY. ③All 48 patients were successfully transplanted, the median time for leukocyte engraftment was 14 (10-23) days, the median time for platelet transplant 16 (6-78) days. ④Bone marrow was evaluated 28 days after transplantation, all 48 patients reached CR, and DNA testing confirmed that they were all full donor chimerism. ⑤The median follow-up was 14 (2-69) months. Of them, 28 cases survived, 10 relapsed and the rest 3 had recurrence of CNSL after transplantation. One year after allo-HSCT, the overall survival (OS) of CR and non-CR groups were (77.3±10.0) % and (57.6±9.3) % (P=0.409) , respectively, the disease-free survival rates (DFS) were (71.2±11.0) % and (53.9±9.5) % (P=0.386) , respectively. The 1-year OS rates of ALL and AML groups after transplantation were (54.2±10.7) %, (80.1±8.9) %, respectively (P=0.200) , and DFS rates were (49.2±10.8) %, (75.0±9.7) % (P=0.190) , respectively.@*Conclusion@#Allo-HSCT was safe and effective for leukemia patients with CNSL.
ABSTRACT
Objective To understand the status of type 2 diabetes mellitus (T2DM) patients′ trust in their family physicians, and to explore the role of the trust on patients′ medication adherence. Methods A total of 1078 patients with T2DM were recruited by cluster and systematic sampling method, from ten rural communities in Sanlong township in Yancheng city and five rural communities of Pingchao township in Nantong city, during February to April in 2018. The survey covered their trust behavior and attitude scale (PTBAS), and an 8-item Morisky medication adherence scale ( MMAS-8). Both measurement data and enumeration data were subject to descriptive analysis by mean ± SD and proportion respectively. Multiple linear regression was employed to explore the determinants of trust in physicians. Ordered logistic regression analysis was used to explore the relationship between patient-physician trust and medication adherence. Results The mean scoring of patients′ trust and medication adherence was 20. 16 ± 2. 13, 7. 07 ± 1. 54 respectively. 55. 40 percent of the patients had high medication compliance, 28. 53 percent of them had medium compliance and 16. 07 percent had poor compliance. Multiple linear regression analysis showed that the patient′s occupation, course of disease, self-reported health status and mental health status influenced their trust behavior (P < 0. 05). Ordered logistic regression analysis showed that each 1 point increase in patient′s trust in physicians, the medication compliance increased by 11. 0％ (OR = 1. 110, P < 0. 001). Medication adherence is also affected by age, employment status, course of illness, and mental health status. Conclusions Diabetes patients′ trust in their family physicians improves their medication adherence.
ABSTRACT
Objective@#To evaluate the efficacy and safety of purified CD34+ stem cell boost in the treatment of poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (HSCT) .@*Methods@#12 patients with poor graft function, reported in our hospital during January 2014 to March 2018, were retrospectively analyzed; The donors of 12 patients were HLA mismatched family members, and all treated with donor purified CD34+ stem cell after G-CSF mobilization, calculating and statistical analyzing the purity of separation and the recovery rate of CD34+ stem cells. The related complications and the recovery of blood cells after infusion were observed.@*Results@#The purity of CD34+ cells in the separation products was 92.0% (44.0%-97.0%) , and the recovery rate was 55.0% (45.0%-96.7%) . The median number of CD34+ cells was 1.9 (0.9-4.4) ×106/kg with CD3+ cells as 0.6 (0.3-2.0) ×104/kg. The median durations of white blood cells, platelet and red blood cells recoveries were 18 (14-39) , 29 (16-153) and 60 (9-124) days, respectively. All 12 patients didn’t experience serious adverse reactions in the process of infusion, 10 patients achieved hematopoietic recovery, 1 case partial remission, 1 case no recovery, without occurrence of aggravated infection, graft versus host disease and other complications.@*Conclusion@#The infusion of donor purified CD34+ stem cell was a safe and effective method for PGF after allogeneic HSCT.
ABSTRACT
Objective To investigate the correlation between serum tumor abnormal protein (TAP) a nd chemotherapeutic effect in patients with lung adenocarcinoma. Methods A prospective study was conducted on 90 patients with lung adenocarcinoma Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2012 to April 2016. The patients were divided into adjuvant chemotherapy group (30 cases) and palliative chemotherapy group (60 cases) according to the different treatment regimen. The adjuvant chemotherapy group was treated with FOLFOX regimen for postoperative adjuvant chemotherapy. The palliative chemotherapy group was treated with pemetrexed. The t test was used to compare the expression levels of TAP in both groups. The χ2 test was used to compare the relationship among expression of TAP, the positive results of tumor markers and the efficacy of chemotherapy. Pearson correlation analysis was used to analyze the expression level of TAP and changes of tumor markers. Results There was no statistically significant difference in serum TAP between the two groups before palliative chemotherapy [area of TAP condensed matter were (230±80)μm2 and (206±50) μm2, t=1.487, P<0.05]. The serum TAP expression in both groups was 100％. There was no statistically significant difference in serum TAP area between adjuvant chemotherapy group and palliative chemotherapy group (46.7 ％ vs. 48.3％, χ2= 0.022, P> 0.05). There was no statistically significant difference between the two groups in positive expression of tumor markers CA125, CEA, CA19-9 and ALP (χ2 values were 4.02, 3.81, 4.01, 5.01, all P>0.05). In the two groups, the changes of serum TAP before and after chemotherapy had no relationship with age, gender, pathological differentiation degree and the number of transfer viscera (all P>0.05). The expression of serum TAP, CEA and CA19-9 after chemotherapy in palliative chemotherapy group were related to the efficacy of chemotherapy (χ2=6.62, 7.78, 8.62, all P<0.01). Pearson correlation analysis showed that the changes of serum TAP in palliative chemotherapy group had no relationship with tumor markers CA125, CEA, CA19-9 and ALP (r values were 0.42, 0.19, 0.09, 0.28, all P> 0.05). The serum TAP level of the adjuvant chemotherapy group was positively correlated with the level of tumor marker CA125 (r=0.51, P=0.02), with no correlation with the changes of CEA, CA19-9 and ALP levels (r values were 0.20, 0.24, 0.19, all P>0.05). Conclusion The detection of serum TAP level in patients with lung adenocarcinoma has good accuracy and high sensitivity, which indicates that the serum level of TAP in patients with lung adenocarcinoma before and after chemotherapy can be used as an index to evaluate the efficacy of chemotherapy and an independent detection of lung adenocarcinoma.
ABSTRACT
Objective To explore the safety and efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in refractory or relapsed leukemia patients undergoing total body irradiation and FLAG regimen consisting of fludarabine,cytarabine,granulocyte colony stimulating factor (TBI/FLAG).Methods Forty-seven cases of refractory or relapsed leukemia treated in our hospital between May 2012 and December 2015 were analyzed retrospectively,including 14 cases of acute lymphoblastic leukemia,31 cases of acute myeloid leukemia,2 cases of acute transformation of chronic myelocytic leukemia.All patients did not achieve remission before bone marrow transplantation.The proportion of blast cells was 10％-98％.The TBI/FLAG was the main conditioning regimen.Kaplan-meier curve was used to analyze the cumulative incidence of GVHD,cumulative recurrence rate,overall survival rate (OS) and disease-free survival rate (DFS).Results Of 47 cases,there was only one patient with infection during the preconditioning and the cell engraftment was not successful,and the rest 46 patients were successfully engrafted.The median time of leukocyte engraftment was 17 (11-25) days,and the median time of platelet engraftment was 21 (11-70) days.The cumulative incidence of acute GVHD was (62.3 ± 7.3)％,including 51.1％ and 28.4％ in Ⅱ and Ⅲ-Ⅳ grade respectively.Twenty-four patients suffered chronic GVHD in 44 assessable patients,and the cumulative incidence was (77.1 ± 11.2)％.The bone marrow was assessed 28 days after transplantation,and the results showed that 46 patients achieved complete remission,and DNA test confirmed complete donor chimerism.The median follow-up time was 12 (1-44) months,25 patients survived (53.19％,25/47),and 13 relapsed (27.65％,13/47).The 1-yearOS and DFS was 47.9％ and 45.5％ after transplantation.Conclusion TBI/FLAG-based regimen is safe and effective for refractory or relapsed leukemia,and the major risk still is relapse for refractory or relapsed leukemia patients after transplantation.The method of preventing recurrence needs to be further explored.
ABSTRACT
Objective To evaluate the safety and efficacy of haploidentical hematopoietic stem cell transplan-tation(haplo-HSCT)treatment in children with hematological diseases.Methods Fifty-nine cases of less than 14 years old children with hematonosis were analyzed retrospectively,who were enrolled in the Aerospace Central Hospital from July 2012 to June 2016.And the evaluation was carried out by analyzing the success rate of implantation,occu-rrence rate of graft versus host disease(GVHD),infection rate and transplant related mortality(TRM),cumulative re-currence rate,overall survival rate(OS)and disease-free survival rate(DFS).Results In total of 59 cases,the 59 engraftments were successfully transplanted,the median time of leukocyte engraftment was 18(8-23)days,the median time of platelet engraftment was 21(11-68)days,the bone marrow was assessed 28 days after transplanta-tion,which showed that 59 patients achieved complete remission(CR)and DNA test confirmed complete donor chime-rism.With a median of follow-up time of 19(5-56)months,the cumulative recurrence rates ofⅠ,Ⅱgrade andⅢ,Ⅳ grade acute GVHD were(38.3 ± 6.3)%(23 cases)and(16.7 ± 4.8)%(10 cases),respectively,the chronic GVHD cumulative recurrence rate was(65.6 ± 7.5)%(30 cases),the cytomegalovirus(CMV)viremia cumulative recurrence rate was(45.1 ± 6.5)%(27 cases),the Epstein-Barr virus(EBV)viremia cumulative recurrence rate was(10.0 ± 3.9)%(6 cases),the viral cystitis cumulative recurrence rate was(20.0 ± 5.5)%(12 cases),the transplant related mortality was(12.8 ± 6.0)%,the 2-year cumulative recurrence rate of CR group was(8.0 ± 5.4)%,and that of non-remission(NR)group was(64.1 ± 11.9)%.The 2-year OS of CR group was(78.9 ± 7.5)%,the 2-year OS of NR group was(32.5 ± 12.9)%,the 2-year DFS of CR group was(79.5 ± 9.8)%,the 2 years DFS of NR group was(27.4 ± 7.9)%.Conclusions Haplo-HSCT is safe and effective in treating children with hematonosis,and haplo-HSCT has high survival rate and low recurrent,especially when transplantation is per-formed in the remission stage.But the prognosis of haplo-HSCT is poor in the refractory and relapsed patients,and to explore the preventing recurrence measures are very urgent.
ABSTRACT
BACKGROUND:Chronic hepatitis B virus infection can impact the biological characteristics of bone marrow mesenchymal stem cel s. Adipose-derived mesenchymal stem cel s have gained more and more attention due to their high safety, little invasiveness, easy purification and rapid proliferation. OBJECTIVE:To establish the isolation and culture method of adipose-derived mesenchymal stem cel s from patients with hepatitis B virus infection in vitro, and to observe the biological characteristics of cel s. METHODS:Adipose-derived mesenchymal stem cel s were isolated from the subcutaneous fat of hepatitis B virus infection patients by col agenase digestion and adherent method. Growth curve of adipose-derived mesenchymal stem cel s were detected by MTT method and cel phenotypes were detected by flow cytometry. The adipogenic and osteogenic differentiation potential of adipose-derived mesenchymal stem cel s were detected in vitro. RESULTS AND CONCLUSION:(1) Adipose-derived mesenchymal stem cel s from 10 patients with hepatitis B virus infection were al isolated and cultured successful y. The primary passage time of adipose-derived mesenchymal stem cel s was (8.3±1.2) days. The growth curve of cel s was“S”shaped. Cel s came into a logarithmic phase at days 3-4, and came into platform at day 7. (3) Passage 3 adipose-derived mesenchymal stem cel s highly expressed CD29, CD166, HLA-ABC and CD44, but did not express or lowly expressed CD34 and HLA-DR. (3) Adipose-derived mesenchymal stem cel s differentiated into adipocytes after adipogenic induction, and differentiated cel s were positive for oil red O staining;after osteogenic induction, adipose-derived mesenchymal stem cel s differentiated into osteoblasts that were positive for alkaline phosphatase staining. These findings indicate that the col agenase digestion and adherent method can be used to effectively isolate adipose-derived mesenchymal stem cel s from patients with hepatitis B virus infection, and the cel proliferation is rapid so that a large number of cel s can be obtained in the short term.
ABSTRACT
Objective To investigate the impacts of soluble dietary fiber (SDF) on gastric emptying,postprandial blood glucose and insulin in patients with type 2 diabetes mellitus (T2DM).Methods Totally 30 T2DM patients and 10 healthy subjects (control group) were randomized to receive SDF-free liquid (500 ml,2092 kJ) and isocalorie SDF liquid (at β-glucan 7.5 g,500 ml,2092 kJ) on two separate days based on a Cross-over order.Gastric emptying was monitored by ultrasomography at intervals of 30 min for 2 hours.Fasting and postprandial blood samples were collected at intervals of 30-60 min for 180 min to determine blood glucose and insulin.Results The proximal gastric emptying was delayed in SDF both in T2DM group (P =0.001)and control group (P =0.037).SDF significantly decreased the area under the curve of postprandial glucose (P =0.001) and insulin (P =0.001) in T2DM group.Postprandial glucose (r=-0.547,P =0.047) and insulin (r =-0.444,P =0.030) had negative correlation with distal emptying of SDF in T2DM patients.The distal gastric emptying was delayed significantly in T2DM patients with HbAlc≥6.5％ (n =13,P =0.021)by SDF.Conclusions SDF can improve the postprandial glucose level,which may be related with the delayed gastric emptying.T2DM patients with higher average blood glucose has remarkably delayed gastric emptying after the administration of SDF.
ABSTRACT
OBJECTIVE@#To screen aptamers binding CD33+/CD34- cells from patients with acute myeloblastic leukemia M2 subtype (AML-M2).@*METHODS@#CD33+/CD34- cells from patients with AML-M2 were taken as targeted cells, CD33+/ CD34- cells from normal people were taken as anti-selecting cells, and aptamers in the single strand deoxyribonucleic acid (ssDNA) library were then selected repeatedly by cell-systematic evolution of ligands by exponential enrichment (C-SELEX) technology, and amplified by polymerase chain reaction (PCR) to generate sub-ssDNA library. During the experiment, PCR amplification with fluorescently labeled primer and flow cytometry were performed to analyze the aptamers'enrichment of sub-library, and the final round product of the sub-ssDNA library was cloned. After the sequencing, the primary and secondary structures of the aptamers were analyzed.@*RESULTS@#Electrophoresis indicated that the product of PCR amplification for each round subssDNA library was able to see a clear DNA band in the agarose gel. After 13 rounds of screening, the fluorescence intensity of the sub-ssDNA library binding the cells ranged from 2.14% to 51.12%, reaching a steady state at the 13th round. A total of 30 clones were selected and sequenced, 22 of which contained 1 of the 4 conserved sequences of AAGTA, TATCT, AGATG and AAATT in their primary structure, but the remained eight aptamers contained none of the conserved sequence. Secondary structure analysis indicated that four stem-loops and loop simulation convex structures existed in the aptamers.@*CONCLUSION@#C-SELEX technology can be used to screen the aptamers binding primary cells from patients with leukemia. The aptamers selected from the CD33+/CD34- cells from the patients of AML-M2 subtype might be used for the diagnosis and treatment for leukemia.