Serosurvey for SARS-CoV-2 among blood donors in Wuhan, China from September to December 2019

The emerging of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused COVID-19 pandemic. The first case of COVID-19 was reported at early December in 2019 in Wuhan City, China. To examine specific antibodies against SARS-CoV-2 in biological samples before December 2019 would give clues when the epidemic of SARS-CoV-2 might start to circulate in populations. We obtained all 88,517 plasmas from 76,844 blood donors in Wuhan between 1 September and 31 December 2019. We first evaluated the pan-immunoglobin (pan-Ig) against SARS-CoV-2 in 43,850 samples from 32,484 blood donors with suitable sample quality and enough volume. Two hundred and sixty-four samples from 213 donors were pan-Ig reactive, then further tested IgG and IgM, and validated by neutralizing antibodies against SARS-CoV-2. Two hundred and thirteen samples (from 175 donors) were only pan-Ig reactive, 8 (from 4 donors) were pan-Ig and IgG reactive, and 43 (from 34 donors) were pan-Ig and IgM reactive. Microneutralization assay showed all negative results. In addition, 213 screened reactive donors were analyzed and did not show obviously temporal or regional tendency, but the distribution of age showed a difference compared with all tested donors. Then we reviewed SARS-CoV-2 antibody results from these donors who donated several times from September 2019 to June 2020, partly tested in a previous published study, no one was found a significant increase in S/CO of antibodies against SARS-CoV-2. Our findings showed no SARS-CoV-2-specific antibodies existing among blood donors in Wuhan, China before 2020, indicating no evidence of transmission of COVID-19 before December 2019 in Wuhan, China.

Clinical and molecular genetics research of a Chinese Han family with Wagner syndrome / 中华实验眼科杂志

Objective:To explore the clinical features and pathogenic causes of a Chinese Han family with Wagner syndrome, and to analyze the relationship between VCAN gene mutation and patient phenotype. Methods:The method of family pedigree investigation was adopted.A Chinese Han family with Wagner syndrome in 3 generations including 13 family members was collected in Xiamen Eye Center of Xiamen University in January 2020, and 5 patients from 3 generations were diagnosed.All members underwent a comprehensive medical history collection and routine ophthalmological examinations, including visual acuity, intraocular pressure, slit lamp microscopy, and ophthalmoscopy to analyze the condition of anterior segment and fundus.Anterior segment photography, fundus photography, optical coherence tomography and ultrasound biological microscopy were carried out in the proband and some patients to analyze the condition of anterior segment, fundus and anterior chamber angle.The peripheral venous blood of all family members was collected for genomic DNA extraction, and pathogenic gene variation analysis for verification was through high-throughput target region capture sequencing and Sanger sequencing.Variants were scored using the American College of Medical Genetics and Genomics (ACMG) guidelines, and the structure and function of variants were predicted through PredictProtein.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Xiamen Eye Center of Xiamen University (No.MR-35-22-002800).Written informed consent was obtained from each subject.Results:The Chinese pedigree with Wagner syndrome was in accordance with autosomal dominant inheritance pattern, and all patients had no history of systemic disease or other abnormal manifestations.The common ophthalmic features of the patients were abnormal suspensory ligament, premature cataract, vitreous cavity, vitreous condensation, veil-like proliferative membrane in the vitreous cavity, retinal choroid atrophy and thinning, tractional retinal detachment, and retinal pigmentation.The proband had binocular cataract surgery, and binocular intraocular lens dislocation occurred after the operation.Genetic analysis revealed that a heterozygous splice site variation c.9265+ 1G>A in the VCAN gene in this family was co-segregated with the disease phenotype and graded as a likely pathogenic variant by the ACMG guidelines.This variant base pair substitution could cause the formation of a protein product with 1 754 amino acids shorter, resulting in insufficient haploid dosage and severe reduction of glycosaminoglycan attachment sites, making the versican protein dysfunctional. Conclusions:It is the first time to report a Chinese family with Wagner syndrome in China, and it is confirmed that the family has a heterozygous variation in the VCAN gene c.9265+ 1G>A by molecular genetic analysis.

Effects of different doses of dexmedetomidine on intracranial pressure in patients undergoing gynecological laparoscopic surgery / 中国药房

OBJECTIVE To investigate the effects of different doses of dexmedetomidine on intracranial pressure in patients undergoing gynecological laparoscopic surgery. METHODS Ninety patients undergoing selective gynecological laparoscopic surgery in trendelenburg position were divided into low-dose experimental group （group D 1），high-dose experimental group （group D 2） and control group （group C ）according to random number table ，with 30 cases in each group. Group D 1 and group D 2 received continuous intravenous infusion of dexmedetomidine 1.0 μ g/kg for 10 min for induction of anesthesia ，and then continued intravenous infusion at the rate of 0.4 μg（/ kg·h）and 0.6 μg（/ kg·h）respectively. Group C was continuously pumped with the constant volume of Sodium chloride injection. Three groups stopped pumping 30 minutes before the end of the operation. The heart rate（HR）and mean arterial pressure （MAP）were recorded when entering the room （T0），10 min after intravenous pump of dexmedetomidine（T1），10 min（T2），30 min（T3），60 min（T4）after pneumoperitoneum ，10 min after pneumoperitoneum was closed to restore the supine position （T5）. At the same time ，optic nerve sheath diameter （ONSD）in both eyes was measured by ultrasound，and the occurrence of intraoperative bradycardia and the use of atropine were recorded. RESULTS There was no statistical significance in ONSD ，HR or MAP among 3 groups at T 0（P＞0.05）. Compared with T 0，ONSD of 3 groups were decreased significantly at T 1（except for group C ）；ONSD of 3 groups were increased significantly at T 2-T5，while MAP and HR were all decreased significantly （P＜0.05）. HR of group D 2 was decreased significantly at T 1（P＜0.05）. Compared with group C ， ONSD and HR of group D 1 and D 2 were all decreased significantly at T 1-T5（P＜0.05）. Compared with group C ，the number of patients with bradycardia and those who used atropine in group D 1 and D 2 were increased significantly （P＜0.05）. CONCLUSIONS Continuous pumping of dexmedetomidine during gynecologic laparoscopic surgery can reduce the increase of intracranial pressure in patients ；compared with pumping rate of 0.6 μg（/ kg·h），the change of patient ’s HR tends to be more stable with a pumping rate of 0.4 μg（/ kg·h）.

Progress in the Treatment of Antisense Oligonucleotides in Duchenne Muscular Dystrophy / 罕见病研究

In recent years, antisense oligonucleotide (ASO) has been very active in the field of rare disease research and development, especially in Duchenne muscular dystrophy, where it made a major breakthrough. Duchenne muscular dystrophy (DMD) is a rare childhood myopathy caused by mutations in the dystrophin gene. Currently, the four ASO drugs approved internationally for DMD are all targeted at dystrophin, including eteplirsen, golodirsen, viltolarsen and casimersen. They all belong to phosphorodiamidate morpholino oligomers (PMO) antisense oligonucleotide drugs, so that their pharmacokinetic characteristics are similar. The drugs quickly spread to other tissues after intravenous administration. Because of the electrical neutrality of the PMO, they have a low binding rate to plasma proteins and are quickly metabolized by the kidney and excreted in the urine as archetypes. In addition, the likelihood of drug-drug interactions of ASO is low. Existing clinical studies have shown that they have certain clinical benefits and good tolerability, bringing new options for DMD treatment. This paper mainly discusses the pharmacological effects, pharmacokinetic characteristics, efficacy, and safety of ASO drugs for the treatment of DMD, hoping to provide scientific reference for the rational and safe clinical use of such drugs.

Molecular genetic analysis and predigree of a new FUT1 allele of para-Bombay blood group: a case report / 中国输血杂志

【Objective】 To study the serological and molecular mechanism of a case of para-Bombay blood group caused by 236delG mutation of FUT1 gene and investigate the pedigree. 【Methods】 The ABO, H and Lewis antigens of the proband and her family members were detected serologically, and the ABO blood group was confirmed by gene testing. The FUT1 gene was amplified by PCR and then sequenced. The structure of FUT1 236delG enzyme of the proband was simulated in 3D by SwissModel online server. 【Results】 Serological results showed that the proband was rare para-Bombay ABhm, Le(a-b-). Her father and mother was type A and type B, respectively. The gene results showed that the proband was type AB, while her father and mother was type A and type B, respectively. The sequencing results showed that the proband had 236delG/551_552delAG gene mutation, while her mother had 236delG FUT1 gene mutation, and her father had 551_552delAG FUT1 gene mutation. The 3D simulation of the enzyme structure of the proband FUT1 236delG showed that the translated product was an alpha helix structure with no actual function. 【Conclusion】 The 236delG mutation is a new discovered mutation in FUT1 genotype, with 551_ 552delAG mutation(FUT1* 01N.06 genotype), which can result in the generation of para-Bombay blood group.

Investigation on current Hepatitis E virus infection among voluntary blood donors / 中国输血杂志

【Objective】 To investigate the situation of hepatitis E virus(HEV) infection among voluntary blood donors in Wuhan area and provide evidences for enhancing blood screening strategies. 【Methods】 HEV nucleic acid detection(NAT) was performed on blood samples from eligible blood donors in Wuhan from November to December 2020. The testing results were analyzed, and the blood donors with repeated reactive results were followed up to clarify the status of infection. 【Results】 Routine screening was performed on 17 409 blood samples from November to December 2020. A total of 17 322 blood samples of eligible blood donors were tested for HEV NAT, and one case of HEV RNA reactivity was detected. The results from the follow-ups showed that the blood donor should be in the window period of HEV seroconversion. The current HEV infection rate of voluntary blood donors in Wuhan arewas 0.058‰(1/17 322), which was lower than other domestic areas. 【Conclusion】 The current HEV infection rate of voluntary blood donors was at a relatively low prevalence level in Wuhan area. Selective blood screening strategies can be taken to further reduce potential risk of blood transfusion infection with hepatitis E virus.

The clinical study of thromboelas-tography combined with coagulation four items and platelet count to guide platelet transfusion in critically ill patients / 中国输血杂志

【Objective】 To explore the clinical value of thromboelas-tography, coagulation four items and platelet count in guiding platelet transfusion in critically ill patients. 【Methods】 A total of 188 critically ill patients in Intensive Care Unit of our hospital from January 2020 to January 2022 were selected as subjects, and were divided into study group(n=89) and the control(n=99) according to the presence of bleeding symptoms. T-test was used for comparative analysis between the two groups. Spearman was used to analyze the correlation between TEG, coagulation four items and platelet count, and binary Logistic regression analysis was used to predict the influential factors of bleeding in critically ill patients, ROC curve was used to analyze the guiding value of the above-mentioned indexes for platelet transfusion. 【Results】 1) K and PT values in the study group, above the normal range, were significantly higher than those in the control, while the Angle value, MA value, CI value, FIB value and platelet count were significantly lower than those of the control, among which MA value, CI value and platelet count were below the normal range. 2) TEG, coagulation four items and platelet count were correlated. MA and CI values were positively correlated with platelet count, instead, R and K values were negatively correlated. R value was positively correlated with PT and APTT, CI value, on the contrary, was negatively correlated, K value was positively correlated with PT, while Angle value and MA value were negatively correlated. 3) Binary Logistic regression analysis showed that decreased MA value and decreased platelet count were independent risk factors for predicting bleeding in critically ill patients(P<0.05). 4) ROC curve analysis showed that the areas under ROC curve corresponding to Angle value, MA value, CI value, FIB value and platelet count were 0.866, 0.932, 0.9, 0.838 and 0.987(P<0.05). The sensitivity was highest in platelet count and lowest in FIB. The specificity was highest in MA and lowest in Angle. Compared with the single index, the area under the curve of the combined index(K value, MA value, CI value, PT value and platelet count) was 0.995(P<0.05), Yoden index 0.944, sensitivity 100%, specificity 93.3%, all higher than the individual index. 【Conclusion】 Thromboelas-tography combined with coagulation four items and platelet count can be used to accurately predict the critically ill patients with bleeding risk. To guide clinical platelets transfusion, the combined use of indexes, including K value, MA, CI value, PT and platelet count, is superior to separate use of them as the former showed better sensitivity and specificity, demonstrating a good clinical value.

Hepatitis E virus prevalence among blood donors in Wuhan / 中国输血杂志

【Objective】 To investigate the prevalence and risk factor of hepatitis E virus(HEV) infection among blood donors in Wuhan. 【Methods】 A total of 1 302 serum samples (including 1 076 with normal ALT and 226 with elevated ALT) from blood donors were randomly collected from January to December 2021 in Wuhan Blood Center. Anti-HEV IgG, IgM and HEV antigen (Ag) were examined by enzyme-linked immunosorbent assay (ELISA). The IgM or Ag positive and elevated ALT samples were subjected to real time-PCR to detect HEV RNA. Multivariable logistic regression modeling was used to examine the risk factors associated with HEV prevalence. 【Results】 Overall, the positive rates of anti-HEV IgG, IgM, and Ag were 16.44%, 1.0% and 0.08%, respectively. However, none of the serum samples were HEV RNA positive. The prevalence of anti-HEV IgG and anti-HEV IgM was similar in samples with increased ALT and normal ALT (IgG 13.72% vs 17.01%, P>0.05; IgM 1.33% vs 0.93%, P>0.05). Multivariate analysis revealed a strong statistical association between age and HEV IgG seroprevalence. The prevalence increased with increasing age, from 5.4% (18~25 years old) to 68.7%(the highest) in blood donors above 46 years (P<0.05). 【Conclusion】 HEV showed a seroprevalence among blood donors in Wuhan, some of whom were recent infections, suggesting a threat to the safety of blood transfusions. A low anti-HEV prevalence in young adults (18~25 years) is indicative of a susceptible population and implicates a higher risk of HEV infections in this age group in the future.

Prognostic significance of immunoparesis in newly diagnosed multiple myeloma patients who achieved deep response / 中华内科杂志

Objective:To evaluate the effect of immune status on disease progression in patients with newly diagnosed multiple myeloma (NDMM) achieving deep response.Methods:Clinical data of 125 NDMM patients at Beijing Chaoyang Hospital from August 2015 to February 2020 were retrospectively analyzed who achieved very good partial response (VGPR) or better after front-line treatment. The immune status and its influence on progression-free survival (PFS) were analyzed.Results:(1) All patients received novel drug regimens, and 50.4% (63/125) patients followed by autologous stem cell transplantation (ASCT). The rate of complete response (CR) as best efficacy was 89.6%, in which 66.4% achieved CR and MRD negativity tested by second generation flow cytometry. (2) Cox multivariate analysis suggested that persistent severe immunoparesis 3 months and 6 months since the best response was an independent poor prognostic factor for PFS. (3) The 3-year PFS rate in the severe immunoparesis group was significantly lower than that in the control group (41.3% vs. 64.4%, P=0.021). (4) The 3-year PFS rates in patients with persistent severe immunoparesis at 3 months or 6 months were significantly lower (30.0% vs. 63.5%, P<0.001; 16.4% vs. 63.8%, P<0.001 respectively). (5) Even in those achieving CR and negative MRD, the 3-year PFS rate when severe immunoparesis lasted 6 months was significantly lower (22.2% vs. 83.2%, P=0.005). Conclusion:The immune status in NDMM patients achieving deep response is closely related to survival. Persistent severe immunoparesis indicates early progression of the disease.

Research progress of salivary glands injury secondary to 225Ac/ 177Lu-PSMA-617 in the treatment of prostate cancer and its protection / 中华核医学与分子影像杂志

Prostate specific membrane antigen (PSMA) radioligand therapy (RLT) is effective in metastatic castration-resistant prostate cancer (mCRPC). However, PSMA RLT can cause radiation damage to salivary glands, especially 225Ac/ 177Lu-PSMA-617. Radiation-related salivary glands damage can cause xerostomia, reduce the quality of life, and even limit the dose of radiopharmaceuticals and reduce the efficacy of tumor treatment. At present, there are few literatures on PSMA RLT related salivary glands damage in China. In this article, radiation-related salivary glands damage and the related protective measures during 225Ac/ 177Lu-PSMA-617 RLT are reviewed based on domestic and foreign studies.

Aretrospective cohort study of pregnancy after kidney transplantation / 中华器官移植杂志

Objective:To evaluate the safety of pregnancy after kidney transplantation and summarize the optimal timing of pregnancy and the experience in the management during pregnancy and peripartum.Methods:A total of 25 kidney transplant recipients were pregnant during March 2013 to February 2020. A matched cohort of 75 general pregnant women wasincluded as control.Results:Twenty-five women successfully delivered healthy babies in the transplant group. The mean age at kidney transplantationwas (25.6 ±3.2) years old, and the mean interval between transplantation and conception was (54.0±23.1) months. 92% (23 / 25) of recipients had cesarean surgery and all infants were singletons.During pregnancy, the incidence of preeclampsia was significantly higher in the transplant group(20.0%VS. 1.3%, P=0.001)compared with matched control. Compared with pre-pregnancy, the serum creatinine levels of the recipients decreased in the second trimester( P<0.001)and increased in the third trimester( P=0.019), which was similar with the control group. In the third trimester, 40%(10/25)of recipients in the transplant group had proteinuria, which decreased to negative(5/10) or 1+ (4/10) within 6 months after delivery. No rejection occurred in all patients during pregnancy and 6 months after delivery. A higher dose of tacrolimus was needed to maintain the normal trough level after pregnancy, which returned to routine dose postpartum. Conclusions:Although the risk of pregnancy was higher in kidney transplant recipients than that in non-transplant women, the overall risk was acceptable. Strict screening of patients preparing for pregnancy, adjustment of immunosuppressive drugs, and multi-disciplinary collaboration are important for safe pregnancy and delivery.

Effect of E54 mutation of human secreted phospholipase A2 GIIE on substrate selectivity / 生物工程学报

Human secreted phospholipase A2 GIIE (hGIIE) is involved in inflammation and lipid metabolism due to its ability of hydrolyzing phospholipids. To reveal the mechanism of substrate head-group selectivity, we analyzed the effect of mutation of hGIIE on its activity and selectivity. hGIIE structural analysis showed that E54 might be related to its substrate head-group selectivity. According to the sequence alignment, E54 was mutated to alanine, phenylalanine, and lysine. Mutated genes were cloned and expressed in Pichia pastoris X33, and the enzymes with mutations were purified with 90% purity by ion exchange and molecular size exclusion chromatography. The enzymatic activities were determined by isothermal microthermal titration method. The Km of mutant E54K towards 1,2-dihexyl phosphate glycerol decreased by 0.39-fold compared with that of wild type hGIIE (WT), and the Km of E54F towards 1,2-dihexanoyl-sn-glycero-3-phosphocholine increased by 1.93-fold than that of WT. The affinity of mutant proteins with phospholipid substrate was significantly changed, indicating that E54 plays an important role in the substrate head-group selectivity of hGIIE.

Preparation and preliminary biological evaluation of domestic 177Lu-PSMA-617 / 中华核医学与分子影像杂志

Objective:To synthesize 177Lu-prostate-specific membrane antigen (PSMA)-617 with domestic 177Lu (made in China), and explore its optimal labeling condition, biodistribution, stability, and safety. Methods:177Lu-PSMA-617 was prepared with domestic 177Lu by a manual method. The optimal labeling condition, radiochemical purity, stability ( in vivo and in vitro), lipid-water partition coefficient, and plasma protein binding rate were determined. The uptake rate of 177Lu-PSMA-617 was evaluated by using 22RV1 cells. Biodistribution and SPECT/CT imaging were performed on normal mice with imported 177Lu-PSMA-617 as control group. The blood routine test was performed to evaluate the safety. Results:The best labeling result of domestic 177Lu-PSMA-617 can be obtained under the following conditions: pH=4.5, 100 ℃ for 30 min. And the radiochemical purity was ≥99%. The product was stable in vivo and in vitro, with the radiochemical purity >95% in 72 h. The plasma protein binding rate was (35.3±5.3)%, the lipid-water partition coefficient was -2.27±0.06, and the specific uptake rate of domestic 177Lu-PSMA-617 by 22RV1 cells reached the highest in 1 h ((7.58±0.84)%), which was slightly lower than the imported 177Lu-PSMA-617 ((7.86±0.96)%), but there was no significant difference between them ( t=-0.439, P>0.05). The distribution and SPECT/CT imaging of normal mice showed that domestic and imported 177Lu-PSMA-617 in blood were cleared quite fast, and both of them were excreted mainly through the kidneys. No obvious adverse reactions were found in the toxicity test of domestic and imported 177Lu-PSMA-617. There was no obvious abnormality in blood routine and liver and kidney metabolism. Conclusion:The domestic 177Lu-PSMA-617 has many advantages, such as qualified quality control, good biological properties and safety, which support its potential application value in diagnosis of prostatic neoplasms.

Centralized blood screening across the regions of Hubei province: a retrospective survey / 中国输血杂志

【Objective】 To retrospectively analyse the quality status and annual trend of centralized blood screening across the regions of Hubei province, and discuss the effect and advantages of the application of centralized blood screening across blood establishment. 【Methods】 Blood screening results of five blood establishment across Hubei province from 2005 to 2019 were statistically analyzed. The sample size, overall rate of qualified blood donations, overall and annual rate of positive testing items were compared among regions. 【Results】 There were differences in blood quality among different regions of Hubei province. In Wuhan, Ezhou, Xiantao, Tianmen and Qianjiang, the overall rate of qualified blood donations was 97.1%(2 466 396/2 538 871), 96.5%(85 405/88 547), 95.2%(59 087/62 047), 95.5%(68 920/72 146) and 94.7%(34 274/36 188), respectively; the overall deferral rate of ALT was 1.472% (37 374/2 538 871), 2.024% (1 792/88 547), 2.840% (1 762/62 047), 2.476% (1 786/72 146) and 3.777% (1 367/36 188), with significant differences across regions; the overall positive rate of HBsAg was 0.587% (14 897/2 538 871), 0.664% (588/88 547), 1.094% (679/62 047), 1.282% (925/72 146) and 0.862% (312/36 188), with significant differences across regions. The deferral rate of ALT showed a downward trend by year in these five regions from 2005 to 2019.An decreasing trend in the seroprevalence of HBV was noticed in Wuhan, Tianmen, and Qianjiang, HCV in Wuhan, Ezhou, and Tianmen, as well as syphilis infections in Wuhan. 【Conclusion】 Centralized blood screening can optimize the allocation of testing resources, reveal problems during blood collection and supply and improve the ability to guarantee blood safety. Future efforts are needed to expand the scope of centralized blood screening and seek for a centralized screening mode suitable for local situation.

Research progress on diagnosis and treatment of HPV-positive oropharyngeal cancer / 中华放射肿瘤学杂志

The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer is growing year by year. Compared with the other head and neck squamous cell carcinoma, HPV-positive oropharyngeal cancer has unique biological characteristics and better prognosis. According to the 8 th edition TNM staging of UICC/AJCC, HPV-positive and HPV-negative oropharyngeal cancer have been classified separately. In 2018, College of American Pathologists and American Society of Clinical Oncology released the guidelines on the HPV testing in head and neck cancer. Several published clinical trials have demonstrated that de-intensified chemoradiation might be efficacious treatment of HPV-positive oropharyngeal cancer.

The diagnostic value of HPV detection in squamous cell carcinoma of cervical lymph node metastasis from an unknown primary site (with report of 6 cases) / 中华放射肿瘤学杂志

Objective:To evaluate the diagnostic value of HPV detection in squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site.Methods:Clinical data of 6 patients who were initially diagnosed with squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site and eventually diagnosed with HPV-related oropharyngeal squamous cell carcinoma were collected, and the process of diagnosis was analyzed.Results:Upon the initial admission, all patients were diagnosed with squamous cell carcinoma of the cervical lymph node metastasis with positive p16 expression, positive HPV-16 subtype and negative EBER expression. No obvious primary lesion was found after comprehensive examination. Subsequently, four of them underwent ipsilateral tonsollar blind biopsy ( n=2) and ipsilateral tonsillectomy ( n=2). All these four patients were pathologically diagnosed with tonsillar squamous cell carcinoma. For the other two cases, MRI detected the thickening complicated with enhancement of ipsilateral wall of oropharynx and tongue root after follow-up for D149 and D545 , respectively. Biopsy confirmed the diagnosis of squamous cell carcinoma of the tonsil and tongue root, respectively. Conclusion:For patients with HPV-positive squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site, the possibility that the primary lesion originates from the oropharyngeal site, especially the tonsil and tongue root, should be highly suspected.

Influence of childhood trauma and impulsivity traits on symptom dimensions in obsessive compulsive disorder / 中华行为医学与脑科学杂志

Objective:To explore the effect of childhood traumatic experience and impulsive traits on symptom dimensions in patients with obsessive-compulsive disorder(OCD).Methods:A cross-sectional study was performed to enroll 134 patients with obsessive-compulsive disorder diagnosed by DSM-Ⅳ and 82 healthy controls to match. The obsessive compulsive inventory-revised(OCI-R) questionnaire, and the Barratt impulsiveness scale (BIS-11) and Childhood trauma questionnaire-short form(CTQ-SF) were used to assess the symptom dimensions, impulsive traits, and childhood trauma levels of two groups.The Yale-Brown Obsessive-compulsive Scale (Y-BOCS) was used to assess severity of disease in OCD patients. The scores of each dimension of obsessive-compulsive symptoms were used as dependent variables. The impulse characteristics of different components and childhood trauma scores were independent variables. Multivariate regression analysis was used to explore the influence of impulsive traits and childhood trauma on obsessive-compulsive symptoms.Results:The scores of OCD patients in nonplanning impulsivity (26.80±4.57), attentional impulsivity(18.96±3.51), emotional abuse(6 (5, 9)), physical abuse (5(5, 6)), emotional neglect (11 (9, 14)) were higher than those in healthy controls ((24.39±4.15), (16.18±2.76), 6 (5, 7), 5 (5, 5), (10.00±3.42) respectively) ( P<0.05, P<0.01). Each subscore of OCI-R in patients with OCD was significantly higher than those in healthy controls (all P<0.01). Multiple regression analysis indicated that the ordering scores of obsessive-compulsive patients was affected by attentional impulsivity and physical neglect ( B=0.191, P=0.011; B=0.273, P=0.005). The emotional abuse was the major impact factor of the hoarding symptom ( B=0.204, P=0.002). The score of obsessions was affected by attentional impulsivity and emotional abuse ( B=0.499, P<0.01; B=0.175, P=0.008). The scores of neutralizing were influenced by attentional impulsivity and physical neglect ( B=0.365, P<0.01; B=0.199, P=0.034). Conclusion:Childhood trauma and attentional impulsivity of OCD patients have different effects on different obsessive-compulsive symptoms.

Construction standard of Europe′s breast cancer centers and its enlightenment to China / 中华医院管理杂志

Breast cancer centers in European countries operate under a complete set of industry standards, which feature multi-disciplinary teamwork and offer " one package services" for patients, not only conducive to elevating treatment outcomes but also sizably downsizing the time consumption and expenditure of patients in seeking medical services. The authors systematically analyzed the basic standards, organizational structure, and management requirements for core team departments and doctors in breast cancer diagnosis and treatment centers in Europe, and came up with recommendations for the current situation and defects of breast cancer diagnosis and treatment in China.

The relationship between dietary pattern and serum C-reactive protein concentration / 中华预防医学杂志

In order to explore the relationship between dietary pattern and C-reactive protein (CRP) in Xiamen residents, 2 904 subjects from 3 districts of Xiamen City were selected by a multi-stage stratified random sampling method. The food frequency questionnaire was used for dietary survey and serum CRP concentration was determined simultaneously. The dietary model was established by factor analysis and the relationship between different dietary patterns and serum CRP concentration was analyzed. Five dietary patterns were obtained by the factor analysis. After the adjustment of gender, age, occupation, education, marriage status, income, smoking, drinking and body mass index, the healthy dietary pattern was negative associated with the serum CRP concentration [OR(95%CI):0.62(0.42-0.90)]. The Serum CRP concentration of residents with a healthy dietary pattern is lower.

Acute promyelocytic leukemia with t(2;17;15): report of one case and review of literature / 白血病·淋巴瘤

Objective@#To explore the clinical and laboratory characteristics and therapeutic effect of acute promyelocytic leukemia (APL) with t(2;17;15).@*Methods@#The G-banding technique was used for karyotypic analysis in a female patient with APL who was admitted to the First Affiliated Hospital of Zhengzhou University in December 2018. PML-RARα fusion gene was quickly detected by fluorescence in situ hybridization (FISH). The real-time quantitative polymerase chain reaction (RT-PCR) was used to detection 43 kinds of fusion gene, and the gene mutations were detected by next generation sequencing (NGS). The induction therapy was given with oral retinoic acid+ intravenous infusion of arsenic trioxide, followed by 3 courses of retinoic acid+ arsenic trioxide consolidation therapy.@*Results@#The G-banding karyotypic analysis demonstrated 46, XX, t(2;17;15) (q31;q21;q22)[8]/46, XX[2]. FISH results indicated that 62.0% of analyzed cells were positive for the PML-RARα fusion gene. RT-PCR further revealed the positive PML-RARα fusion gene transcript. NGS detection of gene mutations showed no obvious abnormalities. After 39 days of induction therapy with retinoic acid and arsenic trioxide, the patient achieved complete remission (CR). The karyotype was 46XX[20], and PML-RARα/ABL was 0/100. Then, the patient was treated with 3 courses of consolidation therapy, and the results remained in CR.@*Conclusions@#APL with complex t(2;17;15) (q31;q21;q22) is rare, and the morphological characteristics are not typical, but it is still associated with the formation of PML-RARα fusion gene. Retinoic acid+ arsenic trioxide has a good therapeutic effect, and the long-term efficacy still needs follow-up.