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Objective:To explore the differences and current situation of scientific research background and occupational cognition of enrollees in MD-PhD programs.Methods:A questionnaire survey was conducted among 158 students (40 males and 118 females) who were enrolled in MD-PhD programs in a medical college during 2017 to 2020. SPSS 24.0 and Fisher’s exact test were used for statistical analysis.Results:Over 50% of enrollees in 2019 and 2020 had at least 2-year experience in basic medical research before enrollment. The research background of MD-PhD program enrollees was continuously improving from 2018 to 2020, and Fisher's exact chi-square P value was 0.02. Since 2018, the proportion of enrollees who planned to seek for administrative or education-related jobs in medical institutions had reduced year by year ( P=0.01). Conclusion:In view of the scientific research problems and professional cognitive tendencies of the new students of the MD-PhD programs, certain relevant guidance suggestions are put forward in this study.
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Long non-coding RNA (lncRNA) and circular RNA (circRNA) are two important types of non-coding RNA that can regulate gene expression by directly interacting with DNA, RNA or protein. A large number of studies have shown that lncRNA and circRNA can not only predict the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after radiotherapy and chemotherapy, but also affect the sensitivity of ESCC to radiotherapy and chemotherapy through competing endogenous RNA mechanisms, regulating PI3K/Akt/mTOR and Wnt/β-catenin signaling pathways, participating in DNA and protein modification, regulating the cell cycle and other pathways. In-depth research on the mechanism of lncRNA and circRNA regulating the sensitivity of ESCC to radiotherapy and chemotherapy will improve the effect of radiotherapy and chemotherapy in ESCC patients.
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Objective:To analyze the effectiveness of antiviral therapy on adolescents and adults with infectious mononucleosis (IM).Methods:The clinical data of patients aged≥16 years old with IM who were hospitalized in Peking University First Hospital from January 1, 2005 to December 31, 2018 were analyzed retrospectively, and the patients were divided into antiviral treatment group and non-antiviral treatment group. The duration of hospitalization day, fever duration, ratio of lymphocytes and duration for normalization of Epstein-Barr virus (EBV) markers were compared between the two groups through single factor and propensity score matching analysis. Statistical analysis was conducted by independent sample t test, Mann-Whitney U test, chi-square test or Fisher exact probability method. Results:A total of 274 cases were enrolled and 176 cases (64.23%) were divided into antiviral treatment group and 98 cases (35.77%) into non-antiviral treatment group. The proportion of male (56.25%(99/176) vs 56.12%(55/98)), age (21.0(18.0, 26.0) years old vs 21.0(18.0, 27.0) years old), the ratio of fever (98.30%(173/176) vs 93.88%(92/98)), sore throat (90.34%(159/176) vs 88.78%(87/98)), lymphocyte ratio (0.648(0.568, 0.707) vs 0.663(0.581, 0.711)), atypical lymphocyte ratio (0.150(0.100, 0.235) vs 0.135(0.060, 0.250)) and serum EBV DNA level (2.71(2.70, 3.47) lg copies/mL vs 2.70(2.70, 3.28) lg copies/mL) were comparable between two groups at admission, and the differences were all not statistically significant(all P>0.05). The durations of hospitalization and fever in antiviral treatment group were 14.0(10.0, 18.0) d and (14.91±7.24) d, respectively, which were both significantly longer than those in non-antiviral treatment group (11.0(7.0, 15.0) d and (9.95±5.67) d, respectively). The differences were both statistically significant ( Z=-3.294 and t=-5.035, respectively, both P<0.01). Twenty-six patients each in the antiviral treatment group and non-antiviral treatment group were included in the propensity score matching assessment. The fever days of the two groups were 15.0(10.0, 18.0) d and 7.5(5.0, 12.5) d, respectively, and the hospitalization days were (15.4±5.5) d and (12.0±5.7) d, respectively. The differences were both statistically significant ( Z=-3.781 and t=-2.187, respectively, both P<0.05). However, there were no significant differences in the time required for the ratio of lymphocytes returning to normal, the time required for the ratio of atypical lymphocytes decreasing to <0.100, and the time required for serum EBV DNA becoming negative(all P>0.05). Conclusion:The antiviral treatment could not improve the prognosis of adolescent and adult IM patients.
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Objective:To investigate the status quo and influencing factors of tutors' guidance satisfaction of medical postgraduates.Methods:Te satisfaction of tutors' guidance of 149 medical postgraduates from a class Ⅲ teaching hospital in Beijing who would graduate were investigated with questionnaires and statistically analyzed. SPSS 22.0 software was used for data statistical.Results:The rate of satisfaction of tutors' guidance was 92.62%. The satisfaction with the training of ideological ethics and academic integrity was relatively higher (94.97%), and the satisfaction with career planning guidance was lower (89.71%). The tutors' guiding frequency and contents, tutor's attention to postgraduates and the relationship between them, and so on had certain influence on the tutors' guidance satisfaction.Conclusion:The mechanism of tutor management should be strengthened and the management level of postgraduate should be improved.
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ObjectiveTo investigate the features of liver injury and related influencing factors in adolescents and adults with infectious mononucleosis (IM). MethodsA retrospective analysis was performed to investigate the features of liver injury in adolescents and adults with IM who were hospitalized in Peking University First Hospital from January 2005 to December 31 2018, and the patients were divided into subgroups based on age, Epstein-Barr virus (EBV) DNA level, and presence or absence of jaundice or infection with cytomegalovirus or hepatitis E virus (HEV). The t-test was used for comparison of continuous data meeting analytical conditions between two groups, and the Mann-Whitney U test was used for comparison of continuous data which did not meet analytical conditions between two groups; the chi-square test was used for comparison of categorical data between two groups, and the Fisher’s exact test was used for comparison of categorical data which did not meet the analytical conditions of the chi-square test. A logistic regression analysis was used for multivariate analysis. ResultsA total of 274 patients were enrolled, with 154 male patients (56.2%) and 120 female patients (43.8%), and the mean age of onset was 22.3±67 years. The incidence rate of liver injury ［defined as alanine aminotransferase (ALT) ＞50 U/L and/or aspartate aminotransferase (AST)＞40 U/L］ was 97.4% (267/274), and that of jaundice was 27.6% (74/268). The patients, aged ≥20 years, tended to have a higher level of gamma-glutamyl transpeptidase (GGT) (Z=2.070, P=0.038). Serum EBV DNA was measured for 167 patients, among whom 90 had positive results and 77 had negative results. The positive serum EBV DNA group had significantly higher levels of GGT (Z=3.005, P=0.003) and lactate dehydrogenase (Z=2.162, P=0.031) than the negative serum EBV DNA group. The patients with cytomegalovirus infection tended to have a higher level of alkaline phosphatase (Z=2.351, P=0.019), and the patients with HEV infection presented with a higher level of GGT (Z=1.988, P=0.047). AST (odds ratio ［OR］=1.006, 95% confidence interval ［CI］: 1.002-1.010, P=0.005) and ALP (OR=1.012, 95%CI: 1.005-1.020, P=0.001) were independent risk factors for jaundice. ConclusionThere is a high incidence rate of liver injury in adolescents and adults with IM, and the patients with an older age or positive serum EBV DNA tend to have more severe liver injury.
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Objective:To investigate the normal range of exhaled nitric oxide (FeNO) in 6-18-year-old children in China, so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods:A multi-center study was conducted on 5 949 children aged 6-18 (3 101 males and 2 848 females) in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association, FeNO was measured, and the relationship of FeNO with the sex, age, height, weight, body mass index and region was discussed.Results:The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb, and its 95% confidence interval (skewness distribution) was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb, respectively, and their 95% confidence intervals (skewness distribution) were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old, FeNO decreased with age, with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11, and FeNO of children aged 12-18 was significantly correlated with the gender, height, and region(all P<0.01). Conclusions:FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18, 16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old, the influence of age on FeNO should be considered, and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.
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During the severe epidemic of coronavirus disease 2019 (COVID-19) in China, some patients with chronic viral hepatitis have difficulties in attending the hospital and getting medical treatment. This article introduces the management strategies for patients with chronic viral hepatitis in medical institutions, including long prescription to improve patients’ compliance, long-distance online outpatient service, participation of community health service centers in management, medication guidance for patients by pharmacists, and nurses’ participation in improving patients’ self-management ability. At the same time, patients should also strengthen the self-management of life style and take protective measures when going out. With the efforts of both doctors and patients, proper management of patients with chronic viral hepatitis will be achieved during this special period.
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Objective:To study the anti-tumor efficacy of endostar microbubble combined with focused ultrasound radiation in colon cancer liver metastases.Method:29 mice with colon cancer liver metastasis were randomly divided into four groups. Group 1(8 mice), as the control group. Group 2(7 mice) were treated only with ultrasonic radiation. Group 3 (7 mice) treated with the ultrasonic radiation combined with SonoVue microbubbles without carrying any medicine. Group 4(7 mice), treated with the ultrasonic radiation combined with microbubbles carrying endostar. The mice were sacrificed and the tumor specimens were weighted on the 12 days after ultrasound radiation. Immunohistochemistry was used to assess CD34 expression within the metastatic tumor.Results:The tumor weight in group 4 (0.79±0.49)g was significantly lower than that in group 1 (2.67±0.61)g, group 2 (2.60±0.60)g and group 3 (1.74±0.33)g ( F=20.629, P<0.01). The liver metastatic tumor weight in group 4(0.55±0.16) g was much lower than that in group 1 (1.47±0.22)g, group 2(1.42±0.28) g and group 3 (0.95±0.27)g ( F=23.758, P<0.01). There was no obvious difference among the four groups in the number of nodules of metastatic tumor in liver ( F=0.167, P=0.918). The level of CD34 in group 4 were (8 037±1 708) , significantly lower than that in any other group, ( F=15.779, P<0.01). Conclusion:Endostar microbubble combined with focused ultrasound radiation decreases tumor angiogenesis in liver metastasis, and inhibits the growth of both primary and metastatic tumor.
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Objective@#To explore the safety and feasibility of colonoscopy - assisted transanal minimally invasive surgery via glove port (CA-TAMIS-GP) in the treatment of early rectal tumors.@*Methods@#A total of 67 patients evaluated as early rectal tumors (adenoma limited within mucosal layer) with diameter ≤4.0 cm at Department of Anal-Colorectal Surgery, Hangzhou Third People′s Hospital from July 2013 to March 2017 were prospectively enrolled in the study. Benign tumors were diagnosed by preoperative imaging in all the patients with the distance to anal edge of 4 to 20 cm. Patients were randomly divided into treatment group and the control group according to the random number table. The treatment group (n=32) underwent CA-TAMIS-GP, including 19 males and 13 females with mean age of (55.6±11.2) years and mean tumor size of (3.3±0.4) cm, while the control group (n=35) underwent endoscopic submucosal dissection (ESD, control group), including 20 males and 15 females with mean age of (52.9±12.3) years and mean tumor size of (3.4±0.5) cm. Differences of baseline data between two groups were not significant (all P>0.05). The specific method of CA-TAMIS-GP was as follows: a surgical rubber glove sleeve (No.6) was passed through the anal device; the glove was fixed at the anvil device; after fully expanding the anus, the anal sac was placed into the anus with the fingers outside; then, the cuff and the anal sac were sutured and fixed to the perianal; a well-tight glove path was established; the ultrasonic scalpel, grasper and the colonoscopy lens connected to the host platform and the electric negative pressure suction were inserted into the three finger sleeves respectively and fixed by rubber band or silk thread; the laparoscopic instruments such as the grasper and the ultrasonic scalpel were used for pulling, grasping, cutting, electrocoagulation, suturing and other operations to complete the resection of rectal lesions. Efficacy, postoperative complication and operative cost, etc. between two groups were compared using the student′s t test, chi-square tests, and Fisher′s exact test.@*Results@#Operations of two groups were completed successfully without conversion to laparotomy. Histopathologic examination showed all specimens had negative margins with the surgical resection of the layer to the submucosa, and showed no significant differences between two groups (P>0.05). Compared to the control group, the operation time was shorter [(49.5±14.6) minutes vs.(66.1±17.6) minutes, t=-4.235, P<0.001], and the intraoperative hemorrhage was less [(4.2±1.6) ml vs. (6.2±2.1) ml, t=-4.349, P<0.001] in the treatment group with significant differences. In the treatment group, 6 patients had mild anal pain or discomfort after operation, and 1 patient in the control group showed anal foreign body sensation. The difference was statistically significant [18.8% (6/32) vs. 2.9% (1/35), P=0.048]. The incidence of postoperative hematochezia in the treatment group was lower than that in the control group [9.4% (3/32) vs. 20.0% (7/35), P=0.310] without significant difference. The cost of consumables in the treatment group was (1586.9±204.4) yuan, which was lower than (7694.4±1123.2) yuan in control group, and the difference was statistically significant (t=-30.880, P<0.001). All the patients were followed up for 6 to 36 months after operation, and no recurrence or long-term complication occurred in the treatment group, while 1 case developed local recurrence in the control group.@*Conclusion@#CA-TAMIS-GP is a safe and effective method for early rectal tumors with simple and economical characteristics, which broadens the application of colonoscopy.
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Objective@#To explore the related influencing factors of high frequency hearing loss (HFHL) in workers exposed to noise and establish a prediction nomogram for HFHL.@*Methods@#A total of 822 workers exposed to noise from 46 enterprises were included. A questionnaire survey and a pure-tone hearing test were conducted for the workers. The data of noise level of the workers exposed was also collected. After single factor analysis of related influencing factors, the multivariate Logistic regression analysis was performed to identify the final independent influencing factors of HFHL. Finally, a nomogram model was established by R software to achieve individual prediction of HFHL.@*Results@#Among the 822 workers exposed to noise, 166 (20.2%) workers had HFHL. In multivariate Logistic regression analysis, increasing age, men, increasing wearing earphone time, less wearing earplugs, and high noise level were the independent risk factors for HFHL. The C-index of the nomogram model for predicting HFHL was 0.834 (95%CI: 0.748~0.903) . The area under the predictive power curve of nomogram model was 0.834 (95%CI: 0.799~0.869, P<0.001) .@*Conclusion@#Age, sex, wearing earphone time, wearing earplugs, and noise level are independent influence factors for HFHL. The nomogram model is successfully established as a accurate and visible tool for individually predicting the HFHL risk in workers exposed to noise.
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Objective To investigate the effects of immediate exercise training in acute myocardial infarction(MI)patients treated by radial artery coronary intervention.Methods Totally 120 patients with acute MI that received radial artery coronary intervention were randomized into two groups:60 cases in the control group and 60 cases in the experimental group.The experimental group started immediate exercise training right after the radial artery coronary intervention.The control group received routine exercise training,which started one week after the radial artery coronary intervention.The Activity of Daily Living Scale (ADL),left ventricular ejection fraction(LVEF),and length of hospital stay were compared in both groups before the intervention and 7 days after the start of the intervention.The patients' quality of life and the incidence of adverse cardiac events were investigated 6 months after the intervention.Interviews of the patients were conducted to have a comprehensive evaluation on the results.Results One week after the start of the intervention,the LVEF in the experimental group was significantly higher than that in the control group(P＜0.01),and the ADL was significantly higher in the experimental group(P＜0.01).The length of hospital stay in the experimental group was shorter than that in the control group (P＜0.01).The follow-up results after 6 months showed that the experimental group had better quality of life(P＜0.01),but lower incidence of angina and arrhythmia (P＜0.05).There were no differences in heart failure and coronary artery in-stent restenosis between two groups (P＞0.05).Results of the interviews showed that the patients were satisfied with the improved comfort through immediate exercise training and expressed willingness to cooperate.Conclusion Immediate exercise training improved the LVEF in patients with acute myocardial infarction after emergent coronary artery intervention,shortened the length of hospital stay,improved patients' quality of life as well as reduced the incidence of angina and arrhythmia.
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Objective To explore the possible associations between EBV capsid antigen-immunoglobulin M antibody (EBV-VCA-IgM ) ,serum EBV DNA load and clinical severity ,laboratory results in adolescent and adult patients with infectious mononucleosis (IM ).Methods Clinical data of 250 adolescent and adult IM patients were retrospectively analyzed .Patients were divided into two groups by EBV-VCA-IgM titer (＞160 U/mL or≤160 U/mL) and serum EBV DNA level (＞3 .38 lg copies/mL or ＜3.38 lg copies/mL) ,respectively . Clinical data were compared between the two groups ,respectively .The t test was used for intergroup comparison and the Mann-Whitney U test was used for non-normally distributed data .Results Compared with those with lower VCA-IgM antibody titer (≤160 U/mL) ,sore throat (83.0%[122/147] vs 67.2%[43/64] ,χ2＝ 6.534 ,P＝0 .011) ,pharynx secretion (59 .9%[88/147] vs 40 .6%[26/64] ,χ2＝6.645 , P＝0 .010) ,and swollen tonsils (78 .9%[116/147] vs 59.4%[38/64] ,χ2＝8.631 , P＝0.003) were more common in those with higher VCA-IgM antibody titer (＞160 U/mL).ALT level was higher as well in those with higher VCA-IgM antibody titer (290 .5 [168.0 ,460.5] U/L vs 221 .0[113 .0 ,440.5] U/L ,Z＝ －2.251 ,P＝0.024).The peak body temperature ([39.2 ± 0.7]°C vs [38.7 ± 0 .7]°C ,t＝ －3 .150 ,P＝0.002) ,maximum WBC counts (16 .2 [12 .2 ,20.4]×109/L vs 13.4[11 .1 ,17.3]×109/L ,Z＝ －2 .098 , P＝0.036) ,maximum percentage of lymphocyte ([72.0 ± 7.8]% vs [68.2 ± 7 .0]%,t＝ －2.238 ,P＝0.028) ,and lymphocyte EBV DNA load ([5 .5 ± 0.9] lg copies/mL vs [4 .8 ± 1 .0] lg copies/mL ,t＝ －2 .602 ,P＝0.012)in those with higher serum EBV DNA load ＞3 .38 lg copies/mL were higher than those with serum EBV DNA load ＜3.38 lg copies/mL . Regression analysis showed that serum EBV DNA load was associated with the peak body temperature (regression coefficient 0.368 , P＝0.003) and lymphocyte EBV DNA load (regression coefficient 0.389 , P＝0.002).Conclusions In adolescents and adults ,EBV-VCA-IgM antibody titer and serum EBV DNA load are associated with severity of patients with infectious mononucleosis .
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<p><b>OBJECTIVE</b>To evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors.</p><p><b>METHODS</b>Eight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a "glove TEM port" from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator (CAD), standard surgical glove, colonoscopy instruments and straight laparoscopic instruments.</p><p><b>RESULTS</b>Procedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6(1.5-3.5) cm, the median (range) operative time was 55.6(30-110) min. Postoperative pathology included villous adenomas (n=3), tubular adenomas (n=2), tubulovillous adenomas (n=2), serrated adenoma (n=1), low-grade intraepithelial neoplasia (n=2), and high-grade intraepithelial neoplasia (n=1). All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months.</p><p><b>CONCLUSION</b>Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Colonoscopy , Methods , Follow-Up Studies , Microsurgery , Methods , Rectal Neoplasms , General Surgery , Treatment OutcomeABSTRACT
ObejectiveTo evaluate the efficacyofacupointthread embedding in easing painafterMilligan-Morgan(M-M)for mixed hemorrhoids.MethodSixty patients undergone M-M for mixed hemorrhoids were randomized into a treatment group of 30 cases and a control group of 30 cases. After M-M, patients in the treatment group received thread embedding at Changqiang (GV1) and bilateral Zhibian (BL54), while the control groupdidn’treceive any intervention. The onset time of post-operative pain, average pain index within a week, and pain index after defecation, electromyogram (EMG), change of anal canal pressure, patients’ satisfaction, and adverse-event rate were observed.ResultThe average pain index and pain index after defecation in the treatment group were significantly lower than that in the control group (P0.05). According to the motor unit potential (MUP) analysis, there were significant differences in comparing the amplitude (Ampl) and Ar/Am of the restingphase between the two groups (P0.05). There were significant differences in comparing the patients’satisfaction, adverse-event rate, and use of analgesics between the two groups (P<0.05). ConclusionAcupoint thread embedding can produce a content analgesic effect, and it’s safe and reliable.
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Objective To observe the effects of extracorporeal shock wave therapy (ESWT) on spasticity of biceps brachii after stroke. Methods 12 patients with spasticity of biceps brachii after stroke were divided into control group (n=6) and ESWT group (n=6). The ESWT group received a session of ESWT and the control group received placebo treatment. All patients were assessed before and immediately after treatment, including integrated electromyogram (iEMG) and co-contraction ratio during maximum isometric voluntary contraction (MIVC) of elbow extension with surface electromyography, the modified Ashworth Scale (MAS) and content of shoulder and elbow of Fugl-Meyer Assessment (FMA). Results The scores of MAS and FMA, the iEMG and the cocontraction ratio of biceps brachii improved in the ESWT group after the treatment (P<0.05), and improved more than those in the control group (P<0.05). Conclusion ESWT can immediately re-lieve the spasticity of biceps brachii, inhibit the cocontraction of biceps brachii during elbow extension and improve the motor function of upper limb in patients post stroke.
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Objective To evaluate the clinical significance of serum procalcitonin (PCT)in early diagnosis of pul-monary tuberculosis (PTB)complicated with pulmonary infection.Methods Clinical data of active PTB patients admitted to a hospital between August and December 2013 were collected,patients were divided into bacterial infec-tion group(n=104),fungal infection group(n=37)and control group (n=95)according to whether patients were associated with bacterial infection,fungal infection,and without infection,serum PCT concentrations in three groups were compared,receiver operating characteristic (ROC)curve analysis was conducted.Results The median PCT concentrations in bacterial infection and fungal infection group was 0.44ng/mL and 0.30ng/mL respectively, which was significantly higher than 0.16ng/mL of control group(Z =9.49,3.51 respectively,both P <0.001 ).The area under curve (AUC)was 0.89(0.84-0.93)and 0.69(0.61 -0.77)respectively;cut-off point was 0.31 ng/mL and 0.27 ng/mL respectively;sensitivity was 79.81%(70.57%-86.80%)and 59.46%(42.19%-74.80%)respectively;specificity was 83.16%(73.79%-89.78%)and 73.68%(63.48%-81.95%)respectively.Conclusion PCT level is a valuable predictor for early diagnosis of PTB complicated with pulmonary infection,and can provide reference for the rational use of antimicrobial agents.
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ObjectiveTo observe the efficiency of hematopoietic stem cell transplantation to the treatment of hematological malignancies and explore prevention and treatment of the complications correlated with HSCT. Methods110 patients with hematological malignancies which were treated by HSCT were recruited. 61 patients were treated with autologous peripheral blood hematopoietic stem cell transplantation (auto-PBSCT), 49 patients were treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT).Among them,there were 28 patients were used by all HLA-identical sibling allo-PBSCT,20 patients were used by haploid allogeneic bone marrow and peripheral blood stem cell transplantation, one case of acute lymphoblastic leukemia in children were treated with cord blood stem cell transplantation.Results109(99.1％) patients acquired hemopoietic reconstruction. The median time of neutrophils≥0.5×109/L, and platelets≥20×109/L were 10 days and 12 days in auto-PBSCT,and were 12 days and 15 days in allo-PBSCT.The incidence of Ⅰ-Ⅲ degree of acute GVHD (aGVHD) in allogeneic transplantation was 28.6 ％(14/49),however,the incidence of chronic GVHD (cGVHD) was 32.6 ％(16/49).The median follow-up time was 36 (1～60) months.84 patients (76.4 ％) were disease-free.Among them,73.8 ％(45/61) were in auto-PBSCT group,(79.6 ％)39/49 were in allo-HSCT group.26 patients (23.6 ％) were died.There were 26.2 ％(16/61) who were in auto-PBSCT group died of disease relapse,3.3 ％(2/61) had disease relapse.There was no transplant-related deaths.18.4 ％(9/49) who were in allo-HSCT group died of disease relapse, 6.1％(3/49)had disease relapse, 2.0 ％(1/49)died of transplant-related deaths. ConclusionHematopoietic stem cell transplantation is a safe and effective way for the treatment of malignant hematopathy patients,also an important mean for treatment of blood diseases.
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ObjectiveTo immunoscreen the mimic peptides of Mycobacterium tuberculosis antigen from phage displayed 12-mer peptide library.MethodsSpecific IgG was purified from sera of patients with TB and used as the target to immunoscreen a phage random peptide library of 12 amino acids.Positive clones which were obtained after three rounds of biopanning were detected by ELISA and sequenced.The diagnostic value of the high frequent positive clones were observed by ELISA.Results After 3 rounds of immunoscreening,the eluted phages were enriched effectively.Six kinds of animo acid sequence were obtained from twelve positive phage clones.Sensitivity of the two high frequent positive clones were 71.4％ (A2)and 55.4％ (A7) respectively.ConclusionThe antigen-mimic peptide was successfully screened from 12 random phage peptide library and the peptides can be recognized by tuberculosis patients' polyclonal antibodies.
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Objective To compare the efficacy and safety of Iamivudine-interferon sequential therapy and lamivudine monotherapy in HBeAg-positive chronic hepatitis B (CHB) patients.MethodsA total of 172 patients with HBeAg-positive CHB were randomized to sequential group (n=83) or lamivudine group (n=89).Sequential group were administrated with lamivudine 100 mg/d and 5 million units interferon alpha 2b subcutaneous injection every other day for 24 weeks were added since week 25 of treatment.Lamivudine group were administrated with lamivudine 100 mg/d for 48 weeks.All subjects were followed up for 24 weeks after drug withdrawal.Measurement data with homogeneity of variance were analyzed by using t test and data with heterogeneity of variance were analyzed by using rank sum test.The comparison of rates was done by chi square test or Fisher exact test.ResultsThe baseline hepatitis B virus (HBV) DNA levels of patients in sequential group and lamivudine group were (7.8±1.0) and (7.9±1.1) lg copy/mL,respectively (P＞0.05),and the baseline alanine aminotransferase (ALT) levels were (210.5 ± 150.1 ) and (211.9 ± 160.9) U/L,respectively (P＞0.05).At the end of treatment,higher ALT levels [(78.4±146.1) vs (36.1±32.4) U/L,P＜0.05)] and HBV DNA levels [(4.5±1.5) vs (3.8±1.3) lg copy/mL,P＜0.05)] levels,lower response rates (65.8％ vs 83.5％,P＜0.05),and similar HBeAg loss rates (31.6％ vs 22.2％,P＞0.05) and HBeAg seroconversion rates (27.6％ vs 16.0％,P＞0.05) were found in sequential group compared with lamivudine group.At the end of follow-up,higher ALT levels [(126.0±143.1) vs (82.7±83.0) U/L,P＜0.05)],similar HBV DNA levels [(5.3±1.5) vs (5.0±1.5) lg copy/mL,P＞0.05)],similar HBeAg loss rates (25.0％ vs 32.3％,P＞0.05) and HBeAg seroconversion rates (25.0 ％ vs 26.2 ％,P＞0.05) were found in sequential group compared with lamivudine group.YMDD motif mutation rate in sequential group was lower than lamivudine group at week 48 of treatment (10.5％ vs 26.9％,P＜0.05).ConclusionsLamivudine-interferon sequential therapy and lamivudine monotherapy are both effective in HBeAg-positive CHB patients,while HBV mutations are reduced in patients with sequential therapy.