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This paper reported a case of severe COVID-19 in the recovery stage with acute lymphoblastic leukemia treated by integrated traditional Chinese and western medicine， with the intention of shedding light on the clinical diagnosis and treatment of similar conditions. The patient， who had acute lymphoblastic leukemia， developed COVID-19 infection during the bone marrow suppression period after chemotherapy. Treatment with western medicine was mainly anti-infection， symptomatic management， and supportive care. During the recovery stage， considering the patient's chemotherapy history and disease progression， the overall syndrome was identified as deficiency of both qi and yin and binding of phlegm and blood. Based on the “state-target” combined treatment strategy， herbal prescriptions were selected and modified to address the “deficiency state”， “disease target”， and “symptom target”. In addition to western medicine， the patient was administered with Shengmai Powder （生脉散） and Compound Zhebei Granules （复方浙贝颗粒） in its modifications to boost qi， nourish yin， and reinforce healthy qi， nourish and cool the blood， ultimately achieving satisfactory therapeutic effects.
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“Cold-dampness entering ying （营）” is the key to the worsening of cold-dampness epidemic， and is more common in the elderly or critically ill cases of cold-dampness epidemic with pathogen exuberance and healthy qi deficiency. This paper reported a case of critically ill COVID-19 combined with multiple organ dysfunction treated by integrative traditional Chinese and western medicine based on “cold-dampness entering ying” theory. The patient did not have high fever after being infected with SARS-Cov-2， but D-dimer continued to increase， and she developed multiple thrombosis throughout the body and multiple organ dysfunctions such as pulmonary embolism， edema， oliguria， and shock. The patient were with enlarged and dusky tongue， with yellow， thick and greasy coating， and sublingual blood stasis， and thready， rapid and rough pulse. All these were characteristic manifestations of “cold-dampness entering ying”， and was differentiated as cold-dampness stasis. For the treatment， symptomatic and supportive western medicine of improving heart function， anti-infection， relieving asthma， stopping cough and reducing phlegm was given as the basic therapy， and additionally， traditional Chinese medicine to open the constraint and the blocked， save from collapse and restore yang， boost qi and relieve collapse， invigorate blood and drain water was used， usually with Modified Poge Zilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤加减）， which was in accordance with the pathogenesis and thus achieving good effect.
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This article highlighted the invaluable expertise of Academician TONG Xiaolin in managing severe cases of COVID-19， thereby providing ideas for the treatment of severe and critically ill patients with SARS-CoV-2 infection by integrating traditional Chinese and western medicine. It is believed that COVID-19 belongs to the “cold dampness epidemic” in traditional Chinese medicine， which is caused by pathogenic qi of cold and dampness. The course of the disease can be divided into four stages： constraint， block， collapse， and deficiency， and the severe cases are mainly in the block and collapse stages. The pathogenesis at the block stage is described as epidemic toxins blocking the lung， which should be treated by diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals. The primary formula used is Zilong Xuanbai Chengqi Decoction （子龙宣白承气汤） with modifications based on individual condition. The pathogenesis at the collapse stage is described as internal block and external collapse， which should be treated by restoring yang to save from collapse， boosting qi to relieve collapse， diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals， usually with the formula Poge Zilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications.
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We reported a case of a patient dignosed as tuberculosis and severe malnutrition with coronavirus disease 2019 （critical type） treated with a combination of Chinese medicine and Western medicine. Through the retrospective analysis of the diagnosis and treatment process of this patient， on the basis of Chinese medicine's understanding of the etiology and pathogenesis of “old state” and “deficient state”， the critical coronavirus pneumonia combined with pulmonary tuberculosis and severe malnutrition was mostly due to the physical condition and the invasion of epidemic toxin， resulting in dysfunctions of the internal organs such as the lungs， spleens， kidneys and other organs. Based on the understanding of the cause and mechanism of the coronavirus disease， the treatment combined Chinese and Western medical therapies was given. The western medicine was used with the main treatments of oxygen therapy， anti-viral， intestinal nutritional support， and anti-coagulation， while the Chinese medicine was used by tonifying qi， blood， yin， and yang， warming yang and dissipating cold， and clearing heat and dampness， then tonifying qi， nourishing yin and eliminating heat， in which tonifying middle and replenishing qi ran through the whole process. The integrated treatment eventually improved the patient's symptoms and accelerated the negative conversion of nucleic acid of the coronavirus.
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We report a case of a long-term survivor of heart transplant who developed severe COVID-19 and was treated with a traditional Chinese medicine combined with conventional medicine. Throughout the treatment， the patient received active conventional medical treatment， and traditional Chinese medicine interventions included tonifying qi， invigorating the spleen and transforming phlegm， promoting yang and eliminating stagnation， resolving dampness and dissipating phlegm， and promoting blood circulation and eliminating stasis. The main therapeutic principles adopted were to recuperating depleted yang and rescuing the patient from collapse and to resolve phlegm and promote water. Pogezilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications was administered. In summary， it is crucial to the timely adjust the immunosuppressive regimen， combine use of various anti-infective agents with a focus on COVID-19， to protect of cardiac and renal function， and to integrate traditional Chinese medicine in the entire treatment process. As this case is rare， the diagnostic and therapeutic methods in traditional Chinese medicine， the use of immunosuppressive agents， and follow-up monitoring strategies can be a valuable reference.
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Objective:To investigate the surgical treatment strategies of mesh infection after tension-free repair of inguinal hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 88 patients with mesh infection after tension-free inguinal hernia repair who were admitted to Beijing Chaoyang Hospital Affiliated to Capital Medical University from March 2013 to May 2018 were collected. There were 85 males and 3 females, aged from 14-84 years, with an average age of 58 years. All patients underwent debridement. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect wound healing, recurrence of inguinal hernia, postoperative pain and reinfection after operation up to July 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Count data was described as absolute numbers. Results:(1) Surgical and postoperative situations: 88 patients underwent debridement successfully. Of the 88 patients, 71 cases underwent laparoscopic exploration before undergoing debridement, and 17 cases underwent open debridement directly. Of the 71 patients who underwent laparoscopic exploration, 63 cases had intact peritoneum with no infection observed in intestine and bladder after laparoscopic abdominal exploration, and then were transferred to open debridement. Four cases with small bowel fistula confirmed by laparoscopic exploration were transferred to open debridement combined with small bowel resection and anastomosis after separating tissue adhesion. Three cases with mesh infection confirmed by laparoscopic exploration underwent the treatment of opening peritoneum and removing the infection mesh through posterior approach under laparoscopy. One case with bladder fistula confirmed by laparoscopic exploration underwent bladder repair after removing infection mesh under laparoscopy. Of the 88 patients, 82 cases had mesh infection including 31 cases with mesh completely removed, 51 cases with the infected part of mesh removed; 28 cases had the sutures co-infected removed. Six of the 88 patients who only suffered from superficial infection underwent the treatment of removal of infected sinus tract. Of the 84 patients who underwent open debridement, 65 cases underwent primary suture after indwelling drainage tube, 19 cases kept incision opening including 13 cases undergoing continuous drainage with vacuum sealing drainage device after postoperative dressing change and 6 cases undergoing the treatment of dressing change. The operation time, volume of intraoperative blood loss and duration of postoperative hospital stay of 88 patients were 60 minutes(range, 15-175 minutes), 14 mL(range, 2-200 mL) and 22 days (range, 1-101 days), respectively. All patients underwent postoperative extubation successfully. There were 56 cases of class A healing, 15 cases of class B healing and 17 cases of class C healing in 88 patients. Seventy-one of 88 patients underwent bacterial culture examination of intraoperative pyogenic fluid and sutures, of which 27 cases had negative results, 32 cases had staphylococcus aureus infection, 5 cases had staphylococcus haemolyticus infection, 5 cases had pseudomonas aeruginosa infection, 5 cases had enterococcus faecium infection, 4 cases had staphylococcus hominis subsp infection, 3 cases had proteus mirabilis infection, 2 cases had serratia marcescens infection, 2 cases had streptococcus agalactiae infection, 2 cases had escherichia coli infection and 1 case had achromobacter xylose oxidation subsp infection. There were some cases undergoing more than 2 kinds of bacterial infection. (2) Follow-up: 88 patients underwent postoperative follow-up for 14 to 76 months, with a media follow-up time of 32 months. Of the 88 patients, 5 cases underwent postoperative recurrence of inguinal hernia including 3 undergoing transabdominal preperitoneal inguinal hernia repair, 1 undergoing open preperitoneal inguinal hernia repair and 1 undergoing partial extraperitoneal inguinal hernia repair. One case had postoperative pain with the visual simulation score of 2-4 and received no special treatment. Seventeen cases had postoperative reinfection, in which 3 achieved wound healing after dressing change and 14 achieved wound healing after surgical removal of the infected tissue completely including 7 cases with residual mesh infection and 2 cases with residual suture infection.Conclusions:Surgical strategy of mesh infection after tension-free repair of inguinal hernia is complicated. Removal of the infected mesh by surgery is an effective treatment.
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Objective:To investigate the application value of different types of acellular matrix graft biological meshes in inguinal hernia repair of adolescents.Methods:The retrospective cohort study was conducted. The clinical data of 159 adolescent patients with inguinal hernia who were admitted to Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2013 to June 2018 were collected. There were 155 males and 4 females, aged from 13.0 to 18.0 years, with a median age of 15.0 years. Of the 159 patients, 42 undergoing traditional high ligation of hernia sac were divided into traditional operation group, 61 undergoing Lichtenstein hernia repair using domestic cross-linked acellular matrix graft biological meshes were divided into domestic biological mesh group, and 56 undergoing Lichtenstein hernia repair using imported non cross-linked acellular matrix graft biological meshes were divided into imported biological mesh group. Observation indicators: (1) surgical situations; (2) postoperative recovery; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detected postoperative recovery and complications of patients up to June 2019. Measurement data with skewed distribution were represented as M (range), comparison between multiple groups was analyzed using the Kruskal-Wallis H test, and paired comparison between groups was analyzed using the Nemenyi test. Count data were described as absolute numbers, comparison between multiple groups was analyzed using the chi-square test or Fisher exact probability, and paired comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison between groups was corrected using the Bonferroni method. Results:(1) Surgical situations: all the 3 groups underwent inguinal hernia repair successfully. The operation time of the traditional operation group, domestic biological mesh group and imported biological mesh group was 20 minutes(range, 10-25 minutes), 35 minutes (range, 30-40 minutes) and 35 minutes (range, 30-40 minutes), respectively, showing a significant difference among the three groups ( χ2=91.640, P<0.05). There were significant differences in the operation time between the traditional operation group and the domestic biological mesh group or between the traditional operation group and the imported biological mesh group ( P<0.016 7). There was no significant difference in the operation time between the domestic biological mesh group and the imported biological mesh group( P>0.05). (2) Postoperative recovery: the postoperative recurrence rate of hernia of the traditional operation group, domestic biological mesh group and imported biological mesh group was 7.1%(3/42), 0, 0, respectively, showing a significant difference among the three groups ( χ2=8.150, P<0.05). There were significant differences in the postoperative recurrence rate of hernia between the traditional operation group and the domestic biological mesh group or between the traditional operation group and the imported biological mesh group ( P<0.016 7). There was no significant difference in the postoperative recurrence rate of hernia between the domestic biological mesh group and the imported biological mesh group( P>0.05). The incidence of seroma of the traditional operation group, domestic biological mesh group and imported biological mesh group was 0, 3.3%(2/61), 17.9%(10/56), respectively, showing a significant difference among the three groups ( χ2=14.929, P<0.05). There were significant differences in the incidence of seroma between the imported biological mesh group and the traditional operation group or between the imported biological mesh group and the domestic biological mesh group ( χ2=6.517, 6.741, P<0.016 7). There was no significant difference in the incidence of seroma between the traditional operation group and the domestic biological mesh group ( P>0.05). The incidence of fat liquefaction of incision of the traditional operation group, domestic biological mesh group and imported biological mesh group was 0, 3.3%(2/61), 1.8%(1/56), respectively, showing no significant difference among the three groups ( P>0.05). Patients with fat liquefaction of incision were cured after the treatment of dressing change. The duration of hospital stay of the traditional operation group, domestic biological mesh group and imported biological mesh group were 3.0 days(range, 2.0-5.0 days), 3.0 days(range, 1.0-5.0 days), 2.5 days(range, 1.0-5.0 days), respectively, showing no significant difference among the three groups ( χ2=0.907, P>0.05). (3) Follow-up: all the 155 patients were followed up for 12-77 months, with a median time of 41 months. None of patients was observed with chronic pain, foreign body sensation or infection during the follow-up. Conclusions:It is safe and effective to repair adolescent inguinal hernia with biological mesh. There was no significant difference in the clinical efficacy between the two different types of acellular matrix graft biological meshes, both of which can be used in repair of adolescent inguinal hernia.
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Objective@#To evaluate treatment experience for mesh infection after inguinal hernia repair.@*Methods@#392 cases underwent surgery for mesh infection after inguinal hernia repair in Beijing Chaoyang Hospital from Jan 2007 to Jun 2018. For mesh infection after open inguinal hernia repair, infected mesh and tissue were removed by open operation, while laparoscopic operation was adopted for mesh infection after laparoscopic inguinal hernia repair. Time of infection, type of bacteria, and hernia recurrence were evaluated.@*Results@#369 cases suffered mesh infection after open inguinal hernia repair and 23 cases were after laparoscopic inguinal hernia repair. 61 cases suffered mesh infection within 3 months, 258 cases were from 3 months to 1 year and 73 cases were after one year. During follow up of 6 to 36 months after operation, 29 cases suffered hernia recurrence in 24 to 34 months after removal of mesh. Bacterial culture were positive in 193 cases, including 126 cases of staphylococcus aureus, 18 cases of escherichia coli and 15 cases of pseudomonas aeruginosa.@*Conclusion@#Individualized treatment policy based on original mesh placement is safe and effective for mesh infection after inguinal hemiorrhaphy.
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Objective To evaluate treatment experience for mesh infection after inguinal hernia repair.Methods 392 cases underwent surgery for mesh infection after inguinal hernia repair in Beijing Chaoyang Hospital from Jan 2007 to Jun 2018.For mesh infection after open inguinal hernia repair,infected mesh and tissue were removed by open operation,while laparoscopic operation was adopted for mesh infection after laparoscopic inguinal hernia repair.Time of infection,type of bacteria,and hernia recurrence were evaluated.Results 369 cases suffered mesh infection after open inguinal hernia repair and 23 cases were after laparoscopic inguinal hernia repair.61 cases suffered mesh infection within 3 months,258 cases were from 3 months to 1 year and 73 cases were after one year.During follow up of 6 to 36 months after operation,29 cases suffered hernia recurrence in 24 to 34 months after removal of mesh.Bacterial culture were positive in 193 cases,including 126 cases of staphylococcus aureus,18 cases of escherichia coli and 15 cases of pseudomonas aeruginosa.Conclusion Individualized treatment policy based on original mesh placement is safe and effective for mesh infection after inguinal hemiorrhaphy.
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According to the three steps of teaching design, teaching practice and teaching reflection, the research group organized and implemented WeChat public platform to assist the teaching of the battlefield first aid course. Teaching design focused on three aspects: teaching content setting, learning process development and learning effect evaluation. Content setting highlighted the relevance of key content and knowledge points. The learning process emphasized two steps:teaching before class and internalizing in class . A variety of evaluation methods were used in teaching effect evaluation . Through investigation , interview and analysis of test results, it was shown that this new teaching method was generally accepted by experimental class students. Students in this class have generally improved their three core abilities and their test scores were also higher than those of the control class. This research provides fresh ideas and a useful example for the implementing WeChat public platform as an assist in the teaching of other courses in the military medical university. In addition, the research group believe that in-depth research and discussions are still needed on how to effectively deal with such problems as the lack of diversification of contents in WeChat public platform.
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Objective To explore the relationship between WT1 and prognosis of patients with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), and to evaluate the possibility of WT1 as a potential marker for monitoring the minimal residual disease (MRD). Methods Bone marrow mononuclear cells from 58 patients with primary AML, 32 patients with primary ALL, 40 patients with AML-complete remission (CR), 28 patients with ALL-CR and 31 patients with trilineage hyperplasia (control group) were collected. Real-time fluorescent quantitative PCR method was used to detect the expression of WT1 in all patients. The expression threshold of WT1 in each group was established. WT1 copy number/ABL copy number ratio×100%denotes the relative expression level of WT1 gene. Results Median relative expression level of WT1 in the control patients was much lower than that in primary AML patients [0.026%(0-0.240%) vs. 20.880 % (3.550 %-48.500 %), Z=-7.74, P20.880 %) was 60.7 % (17/28), while the CR rate was 76.7 % (23/30) in those with lower WT1 expression. WT1 expression was increased dramatically in recurrent AML patients. Relative expression level of WT1 was significantly higher in primary ALL patients [0.350 % (0.021 %-10.780 %)] compared with that in the control group Z=-2.58, P<0.05. There was no significant difference in relative expression level of WT1 between ALL and ALL-CR patients [0.038 % (0-2.800 %), P=0.065]. Conclusion WT1 expression level in AML patients is relatively high, which could be used as an effective index of prognosis evaluation and MRD monitoring for AML patients, but not for ALL patients.
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Objective To investigate the coverage rate of iodized salt and the nutritional status of schoolaged children before and after adjustment of salt iodine concentration in Haishu District,Ningbo City.Methods The observation period (2010-2016) was divided into three sub-periods:before the adjustment (2010,2011),adjustment period (2012-2014) and after the adjustment (2015,2016).Household salt samples and urine samples of school-aged children aged 8-10 were collected during the 3 periods in Haishu District,Ningbo City,and the iodized salt coverage rate,qualified iodized salt consumption rate,urinary iodine concentration were determined.Results Totally 600,900 and 615 household salt samples were collected in the 3 periods,respectively.The medians of salt iodine in the 3 periods were 27.30,23.50 and 23.10 mg/kg;while the iodized salt coverage rates were 97.83％ (587/600),94.67％ (852/900) and 84.72％ (521/615),and the qualified iodized salt consumption rates were 96.50％ (579/600),92.11％ (829/900) and 74.63％ (459/615),respectively.There were significant differences in the iodized salt coverage rates and qualified iodized salt consumption rates among the 3 periods (x2 =86.13,162.57,P ＜ 0.01);and significant decreases of the iodized salt coverage rates and qualified iodized salt consumption rates were observed in the 3 periods (x2trend =77.34,141.11,P ＜ 0.01).The median urinary iodine concentration of the school-aged children in the 3 periods were 171.18,161.95 and 186.07 μg/L;the differences of urinary iodine were statistically significant among the 3 periods (H =11.81,P ＜ 0.01).Conclusions In Haishu District,significant decreases of the iodized salt coverage rates and qualified iodized salt consumption rates are observed after the adjustment of salt iodine concentration.However,the iodine nutrition is adequate in school-aged children.
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Objective To investigate the prevalence of thyroid nodules among residents of Ningbo City and to explore the risk factors for thyroid nodules.Methods Totally 3 596 residents aged 6-70 were selected by multistage stratified cluster random sampling in Ningbo City,2011.Thyroid ultrasound examination was performed in all participants,while salt iodine and urinary iodine were measured.Possible risk factors for thyroid nodules were analyzed by single factor and multi-factor logistic regression.Results The prevalence rate of thyroid nodules in residents of Ningbo City was 22.66％ (815/3 596),with standardized prevalence rate of 17.69％.Female [(odds ratio (OR) =2.06,95％ confidence interval (CI) =1.74-2.43],groups of aged 18-(OR =3.42,95％ CI =1.22-9.61),aged 40-(OR =13.06,95％ CI =4.80-35.51),aged 65-(OR =16.67,95％ CI =5.97-46.54) and occasional consumption of seafood habits (less than twice per week,OR =1.23,95％ CI =1.02-1.49) were significant associated with thyroid nodules.Conclusions There is no link Letween iodine nutrition and thyroid nodules.It is demonstrated that female and aged ≥ 18 groups have higher risk of thyroid nodules; frequent consumption of seafood seems to be a protective factor.
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Objective To investigate the effect of bone marrow stem cells (BMSCs) transplantation combined with body weight supported treadmill training on neural functional recovery of rats with spinal cord injury.Methods T11 complete spinal cord injury (SCI) was introduced into 40 Sprague-Dawley male rats using an improved simple device,imitating the Allen method.The rats were randomly divided into a stem cell transplantation group,a body weight support treadmill training group,a combined treatment group and a control group,each of 10 assigned according to a random number table.One week after the SCI operation,stem cell transplantation was performed on the rats in the stem cell transplantation group and the combined treatment group.One day before their transplantation,the third passage BMSCs were labeled with 5-ethynyl-2'-deoxyuridine (Edu).The rats in body weight support treadmill training group and combined treatment group were received body weight support treadmill training,while the other two groups were not given any training.At the 1 st,2nd,3rd,4th and 5th week after SCI modeling,Basso-Beattie-Bresnahan (BBB) movement function score was used to evaluate the motor function recovery of all rats.At the 5 th week after SCI,immunohistochemical staining and immunofluorescence staining was applied to detect neural specific markers including the neuron specific enolase (NSE),microtubule associated protein (MAP-1 β) and vimentin (VIM).The survival and differentiation of the transplanted cells,as well as the nerve fiber recovery in the lesion were also observed.Results The average BBB score of the combined treatment group was (6.60 ± 0.97) at the 2nd week after SCI operation,significantly higher than the other 3 groups,while that of the stem cell transplantation group and the body weight support treadmill training group was (5.00 ± 0.67) and (4.80 ± 0.63) respectively,both higher than that of the control group but without significant differences (P ＞ 0.05).In the third week after modeling,however,the value of the stem cell transplantation group rose to (8.00 ± 0.67),significantly higher than that of the body weight support treadmill training group (6.80 ± 0.79).The immuohistochemical staining showed that a variable degree of neural specific markers (NSE,MAP-1 β,VIM) positive cells were observed in the SCI tissues of all groups,with those in the combined treatment group significantly higher than the other 3 groups.The immunofluorescence also found significantly higher fluorescence expression of neural specific protein markers including NSE,MAP-1 βand VIM in the combined treatment group than the rest group,with obvious proliferation and differentiation of nerve fibers.Conclusions Stem cell transplantation combined with partial body weight supported treadmill training can effectively promote the recovery of neural function of rats with spinal cord injury,and the effect is better than solely stem cell transplantation or the weight loss training.
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Objective To investigate the iodine nutritional status,thyroid function and the prevalence of thyroid nodules of residents using non-iodized salt in Ningbo City,Zhejiang Province.Methods In 2011,using typical sampling method,6 villages/communities consumption of non-iodized salt were selected as study fields and residents aged 6-70 were selected as study subjects in Ningbo.Urinary iodine detection,thyroid ultrasound examination and tests of thyroid function [free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb)] were performed in all participants.Urinary iodine concentration (UIC) was determined by arsenic cerium catalytic spectrophotometry,and thyroid function was monitored by chemiluminescence method.Results A total of 1 177 residents agreed to participate in the study,482 were male,and 695 were female (including 2 pregnant women).The participants' mean age was (48.54 ± 13.98) years.The median UIC in all participants was 90.36 μg/L,and the proportions with a UIC ＜ 100μg/L was 56.07％ (660/1 177).Furthermore,the median UIC in male was 97.05 μg/L and in female was 83.84 μg/L,there was a significant difference in UICs between male and female (Z =-2.99,P ＜ 0.05).Similarly,significant difference in UICs was observed among age groups (x2 =99.34,P ＜ 0.01).Among the participants,19.88％ had thyroid nodules,with standardized prevalence rate of 13.95％.Furthermore,in male,11.83％ had thyroid nodules,with standardized prevalence rate of 8.11％,and in female was 25.47％,with standardized prevalence rate of 19.83％,there was a significant difference in the detection rate of thyroid nodules between male and female (x2 =33.25,P ＜ 0.01).Likewise,significant difference in the detection rate of thyroid nodules was observed among age groups (x2=49.65,P＜ 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (x2trend =44.22,P ＜ 0.01).Conclusions The residents who using non-iodized salt in Ningbo City are in the status of iodine deficiency.The detection rate of thyroid nodules is higher in female than in male and it has increased with age.
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Objective Estahlished the method to detect different transcripts of EVI1 gene expression with quantitative PCR and study the expression patterns of EVI1 gene in different leukemia groups to investigate the association between EVI1 gene expression and the incidence and prognosis of leukemia.Methods 60 cases acute myeloid leukemia (AML) and 9 cases normal control were detected in the study,37 cases were male and 32 cases were female,age 10-70 years,median age 42 years,M3 36 cases,M2 16 cases and M4 8 cases according to FAB classification criteria,control samples of nine cases were normal healthy people.Using the quantitative PCR (Taq Man probe) to detect the expression of different transcripts of EVI1 gene.The t test was used to detect the expression difference among different leukemia groups.Results ABL gene was used as internal reference,relative changes of EVI1 gene expression level were detected by EVI1/ABL.In all the control patients,EVI1 gene of different transcription of this expression were detected,expression level of EVI1 gene different transcription was significant with the difference (P ＜ 0.05),transcription 2 and 5 (the same primers) were the lowest,followed for transcription 1 and 6,expression of transcription 3 was the highest.The expression levels of transcripts 2 and 5,1,6,3 were nagative,0.005,0.050 and 0.512 respectively in healthy control samples.In addition,the EVI1 gene expression was negatively correlated with expression of the fusion gene AML-ETO and CBFB-MYH11 in AML.Conclusion The study established a stable,fast and accurate method to detect the expression of EVI1 gene.
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Objective To delineate the potency of YC-1 on the proliferation,apoptosis,cell cycle and the protein expression of Caspase-3,-8,-9 in U937 and THP-1 leukemia cell lines.Methods MTT assay was performed to detect proliferation.Flow cytometry was used to measure the apoptosis and cell cycle.The expression of Caspase-3,-8 and-9 were detected by Western blot.Results The MTT assay showed that cell proliferation was inhibited in a concentration-dependent manner in 1.0,3.0,10.0 μmol/L YC-l-treated U937 and THP-1 cells.The survival rates for YC-1 after 24 h in U937 cells were (76.5±4.4) ％,(68.7±6.8) ％,(60.9±13.2) ％ respectively and (94.1±1.4) ％,(81.4±2.0) ％,(72.7±3.0) ％ respectively in THP-1 cell,compared with the control group (100 ％),there were significant differences (F =15.870,126.629,P ＜ 0.01).The apoptosis rates for 1.0,3.0,10.0 μmol/L YC-1 after 24 h were (40.7±1.0) ％,(55.6±2.3) ％,(71.8±1.5) ％respectively in U937 cells and (34.6±2.0) ％,(50.3±3.5) ％,(59.6±4.6) ％ respectively in THP-1 cells.With the control group (4.7±1.4) ％,(1.8±1.0) ％,there were significant difference (F =937.229,200.447,P ＜ 0.01).However,there was no significant difference for cell cycle.In addition,Cleaved Caspase-8 and Cleaved Caspase-3 expression after 1.0,3.0,10.0 μmol/L YC-1 treated for 24 h were significantly higher than control,but the expression of Caspase-9 did not appear significant change in U937 cells.As the same concentration and time point,Cleaved Caspase-3 expression increased with no change of Caspase-9 or Caspase-8 in THP-1 cells.Conclusion YC-1 effectively suppress the proliferation with little effect on cell cycle,but induce the apoptosis,have no effect on cell cycle,and the mechanism of apoptosis may be related to the Caspase activation in U937 and THP-1 cell lines.
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Objective To investigate the effect of arsenic trioxide (ATO) on the growth inhibition of bcr-abl mutant cell lines in vitro and to explore its potential mechanism. Methods The growth inhibition of ATO on bcr-abl wild type cell lines (K562, KBM5 and 32Dp210) and imatinib(IM)-resistant cell lines (K562R, KBM5R, 32Dp210T315I, 32Dp210Q252H, 32Dp210Y253H, 32Dp210M351T and 32Dp210E255K) were measured by trypan blue exclusion. Apoptosis was assayed by AnnexinV and PI staining. Glutathione (CSH) levels were detected by DTNB colorimetry of Glutathione Assay Kit. Results ATO inhibited cell growth in both bcr-abl wild type and IM-resistant mutant type cells in a dose dependent manner. ATO significantly inhibited growth of bcr-abl point mutant cells compared with the corresponding wild type cells, and the IC50 of ATO in mutant cells was lower than that in wild type, while the IC50 in no point mutant cells K562R was not different compared with that in wild type cells K562. The GSH levels in bcr-abl point mutant cells were lower than that in the corresponding wild type cells(P =0.00106-0.0358) , but that in K562 was quite similar with K562R cells(P = 0.315). After depletion of intracellular GSH by using BSO, the growth inhibition of ATO in both bcr-abl point mutant cells and wild type cells was significantly enhanced. Conclusion The growth inhibition of ATO on bcr-abl point mutant cells is remarkably more effective than that on wild type cells, which may be related with intracellular GSH. ATO would be a potential therapeutic select against CML with bcr-abl point mutation including the T315I mutation.
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Objective To detect the PML-RARα fusion gene expression of APL patients with FISH and fluorescent quantitative PCR and discuss the sensitivity and specificity of two techniques. Methods The detection of the PML-RARα fusion gene expression of 75 APL patients with FISH and fluorescent quantitative PCR were carried out simultaneously. Results Eighty eight patients of primary and relapse or remission phases were examinated and total conformity rate was 96.59 %. Fourteen primary patients were detected and conformity rate was 100 %. Seventy four relapse or remission patients were detected and conformity rate was 95.95 %. Stem cell essays were detected for six times and conformity rate was 100 %. Conclusion The sensitivity of FISH and fluorescent quantitative PCR is identical for primary APL patients and FISH is more sensitive. But the sensitivity of FISH is weaker than that of fluorescent quantitative PCR for detection of residue disease.