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【Objective】 To investigate the knowledge acquisition status for blood transfusion of transfusion related medical staff in underdeveloped cities in western China and explore its influencing factors. 【Methods】 A questionnaire consisted of blood transfusion laws and regulations, clinical blood transfusion theory and blood transfusion technology was designed, randomly distributed to medical staff and blood transfusion departmenttechnicians of 17 secondary/tertiary hospitals in Wuwei and then collected on the spot. The knowledge acquisition of blood transfusion of each group was compared using statistical description method, and its influencing factors were analyzed by multivariate logistic regression analysis. 【Results】 A total of 507 questionnaires were issued, and 498 valid questionnaires (98.22%) were collected. The scores of transfusion related laws and regulations, blood transfusion theory and blood transfusion technology of doctor group(n=158), nurse group(n=239) and transfusion technician group(n=101)were 4.56-5.97(5.06±0.73)(P<0.01) vs 4.23-5.87(4.98±1.24)(P<0.01) vs 3.71-0.78 (4.15±1.34), 3.67-5.02(4.27±1.02) vs 3.76-5.12(4.06±0.75) vs 4.71-5.98(5.16±0.64)(P<0.01) and 3.41-5.76(3.82±0.56) vs 3.78-5.24(4.01±0.56) vs 3.77-5.46(3.82±0.59). Among the seven departments, blood transfusion department(n=51) won the highest score of above three types of knowledge [4.91-5.97(5.28±0.43) vs 5.03-5.92(5.36±0.59) vs 4.39-5.77(4.97±0.79)(P<0.01) ]. Univariate logistic regression analysis showed that age, occupation, professional titles, training times and hospital grade had an impact on the degree (score) of blood transfusion knowledge acquisition (P<0.05), and multivariate unconditional logistic regression analysis indicated that training times was an important influencing factor(P<0.01). 【Conclusion】 This survey revealed that the level of knowledge acquisition for blood transfusion among medical staff in Wuwei is generally low, and there is a significant difference between staff from hospitals of different grade and different departments. It is urgent to strengthen the training of blood transfusion for medical staff in western China.
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Objective:To explore the correlation between the expression of signaling lymphocyte activation molecule family 6 (SLAMF6) on peripheral blood CD8 +T cells and perforin and granzyme B and the clinical significance in patients with newly diagnosed severe aplastic anemia(SAA). Methods:The indicators of blood routine and bone marrow and peripheral blood samples of 32 newly diagnosed SAA patients admitted to Henan Provincial People′s Hospital from January 2016 to June 2019 were collected for retrospective analysis. Flow cytometry was used to detect the expression of SLAMF6, perforin and granzyme B on samples CD8 +T cell before therapy and 6 months after therapy (11 cases received transplantation, 21 cases received immunosuppressive therapy [IST]). Spearman correlation analysis was performed to determine the association between clinical indicators and laboratory test results. The expression of SLAMF6, perforin and granzyme B was also detected in 10 healthy people (normal group) and 13 myelodysplastic syndromes/paroxysmal nocturnal hemoglobinuria (MDS/PNH) patients (MDS/PNH group). Results:(1) At diagnosis: the expression of SLAMF6 was significantly lower in the SAA group than that in the normal group and the MDS/PNH group ([56.40±6.37]% vs [84.34±5.81]% and [82.24±4.98]% (both P<0.001]). The expression of perforin was significantly higher in the SAA group (32.73±8.46) than that in the normal control group (23.75%±5.10%), and the MDS/PNH group (26.12%±5.53%) (both P<0.05). The expression of granzyme B was also significantly higher in the SAA group (36.23%±7.94%) than that in the normal control group (21.67%±5.05%) and the MDS/PNH group (21.79%±5.10%) (both P<0.001). The expression of SLAMF6 was positively correlated with the hemoglobin ( r=0.804), and reticulocyte absolute values ( r=0.656) in peripheral blood, percentage of granulocytes ( r=0.643) and erythrocytes ( r=0.622) in bone marrow of SAA patients (all P<0.05). Expression of SLAMF6 was negatively correlated with perforin ( r=-0.792) and granzyme B ( r=-0.908) on CD8 +T cells in patients with SAA (both P<0.001). (2) After treatment: the expression of SLAMF6 in peripheral blood CD8 +T cells of 30 surviving patients was higher than pre-treatment ([79.19±12.69]% vs [56.40±6.37]%, P<0.001). The expressions of perforin and granzyme B were lower than pre-treatment level (both P<0.05). The expression of SLAMF6 on CD8 +T cells in 11 transplanted patients was higher than before transplantation ([86.54±3.75]% vs [56.40±7.35]%, P<0.001). The expressions of perforin and granzyme B were lower than before transplantation (both P<0.05). The expression of SLAMF6 on CD8 +T cells in 12 IST-respond patients was higher than that before treatment, while the perforin and granzyme B levels were lower than pre-treatment (all P<0.05). The post-treatment expressions of SLAMF6, perforin and granzyme B were similar as before treatment levels in 7 IST-unrespond patients (all P>0.05). Conclusion:SLAMF6 is significantly down-regulated on CD8 +T cells in newly diagnosed SAA, negatively correlated with the effective factors of CD8 +T cells, which might participate in the immune regulatory of CD8 +T cells as a negative regulatory factor in patients with SAA. The SLAMF6 is significantly up-regulated after hematopoietic recovery, while there is no significant change in treatment-unrespond patients, which could thus serve as an useful diagnostic and therapeutic index of patients with SAA.
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Objective:To examine a nomogram model for individualized prediction of the risk for recurrence of early gastric cancer(EGC)in elderly patients undergoing endoscopic submucosal dissection(ESD).Methods:This was a retrospective cohort study, with a total of 3 987 elderly EGC patients who underwent ESD treatment between January 2000 and December 2016 after admission to the gastroenterology department of our hospital.Twenty-eight relapsed patients with complete clinicopathological data and follow-up data were selected as the relapse group, and 276 non-relapsed patients were selected as the control group.General data of all patients were collected and a logistic regression analysis was performed to analyze independent risk factors for the recurrence of EGC in patients after ESD.A corresponding nomogram risk prediction model was established by using the R software.Results:Among the 3 987 elderly EGC patients, 29 relapsed after an average follow-up of 2.7 years, and the recurrence rate was 0.73%(29/3 987). The differences in baseline data such as age(≥75 years old), lesion size(≥3 mm), T stage and lymph node metastasis between the recurrence group and the control group were statistically significant(11 cases or 39.3% vs.171 cases or 62.0%, 19 cases or 67.9% vs.111 cases or 40.0%, 9 cases or 32.1% vs.153 cases or 55.4%, 19 cases or 67.9% vs.102 cases or 39.0%, P<0.05). Logistic regression analysis showed that age over 75 years( OR=2.128, 95% CI: 1.373-3.624), T stage( OR=1.763, 95% CI: 1.079-2.934), lesion size≥3 mm( OR=2.604, 95% CI: 1.363-4.217), and lymph node metastasis( OR=2.871, 95% CI: 1.425-5.639)were independent risk factors for the recurrence after ESD in EGC patients( P<0.05). The nomogram model was established based on the above risk factors, and the validation results showed that the predicted value was basically the same as the actual measured value and had good predictive performance.The internal validation results showed that the consistency index was 0.817(95% CI: 0.722-0.941), suggesting that the model had a high accuracy and discrimination. Conclusions:Before ESD for elderly EGC patients is performed, factors such as age, tumor size, T stage and lymph node metastasis should be fully considered to comprehensively evaluate the recurrence rate of EGC after the procedure.This predictive model can improve the diagnostic efficacy of postoperative recurrence and has high clinical value.
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Objective To establish a blast injury experimental model using a shock tube at lateral lying position of C57BL/6 mice, investigate biomechanical responses of macrophages/microglia cells in the heart, lung and brain tissues to mechanical damage by shock wave within 24 hours. Methods Shock tube was employed to generate a shock wave to C57BL/6 mice. Firstly, the weight changes of mice were measured at different time points after the shock. Then the cardiac, pulmonary and whole brain tissue samples were dissected after anesthesia. Pathological sections were stained with HE staining to detect structural damage; the TUNEL staining method was used to mark and count the proportion of dead cells in each tissue. Microglial cells were labeled with fluorescent antibody, while responses and changes of macrophages/microglia after shock loading were analyzed. Results The shock tube exerted 179 kPa overpressure shock wave upon sideway of the mouse, and lethal rate of the mouse was 3.33%. Compared with normal control group, the mice in experimental group had a significant weight loss within 24 hours after loading shock. Pathological sections showed rupture of lung tissues after shock, accompanied by alveolar protein deposition, pulmonary bulla and other diseases. Fluorescence staining showed that lung tissue was recruited and activated in a large amount within 24 hours. The proportion of dead cells cleared rebounded to normal level within 24 hours. The heart was highly tolerant to shock, and macrophages appeared near the large blood vessels. The brain showed unilateral aggregation of microglia due to the impact posture, mainly due to prolonged inflammation and a higher proportion of dead cells at the junction of gray and white matter. Conclusions A blast shock model at lateral lying position of the mouse was established. Within 24 hours, macrophages/microglia were recruited quickly to the injury site after being impacted, which mediated strong immune stress, and might participate in the immune response to trigger a second long-term inflammatory injury. The results of the study provide experimental basis for the evaluation of primary impact injury, such as dose-effect relationship and tissue damage difference.
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Objective@#To reveal the related factors of inhibitors and differences ofhemorrhage and joint disease before and after the production of inhibitors in children with hemophilia A (HA) .@*Methods@#Retrospective analyses of the clinical data of 381 children with HA under the age of 16 registered in the Registration Management Center of Hemophilia in Henan Provincial from January 2015 to August 2018.@*Results@#A total of the 381 children were enrolled with 116 (30.4%) mild, 196 (51.4%) moderate, and 69 (18.1%) severe cases; 54 patients (14.2%) had inhibitors, including 22 high and 32 low titer inhibitors. Positive family history was positively associated with inhibitors[P<0.001, OR=3.299 (95%CI 1.743-5.983) ], and high-intensity exposure was associated with inhibitors[P=0.002, OR=2.587 (95%CI 1.414-4.731) ]. High-intensity exposure was associated with high titer inhibitor production[P=0.001, OR=8.689 (95%CI 2.464-30.638) ], and high-intensity exposure increased the risk of high titer inhibitors in HA patients. After inhibitors occurred in 54 patients with HA, the rates of overall joint annual bleeding (z=-3.440, P=0.001) and traumatic annual bleeding (z=-2.232, P=0.026) increased, but the rates of the annual joint bleeding (z=-1.342, P=0.180) and spontaneous annual bleeding (z=-1.414, P=0.157) remained to be not statistically significant. The joint ultrasound score did not change significantly after the inhibitor information (z=-0.632, P=0.527) .@*Conclusions@#Positive family history and high-intensity exposure could increase the risk of F Ⅷ inhibitors in HA patients, and high-intensity exposure increased the risk of high titer inhibitors. The rates of the overall joint annual bleeding and traumatic annual bleeding increased after the inhibitor information.
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Objective To compare the tumor characteristics and survival between postoperative incidentally discovered gallbladder cancer (ID-GBC) and preoperatively suspected gallbladder cancer (PS-GBC).Methods The data of 276 GBC patients who underwent surgical resection with curative intent between January 2004 and December 2014 at the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed.Results The 1-,3-,and 5-year cumulative survival rates of the ID-GBC group (88.8％,52.2％,and 33.0％,respectively) were significantly better than those in the PS-GBC group (57.5％,25.7％,and 16.6％,P ＜ 0.05).In the ID-GBC group,multivariate analysis revealed that T staging,hepatic invasion and time interval from cholecystectomy to re-operation were independent prognostic factors.The overall survival (OS) in the group with the time interval within 2 weeks was significantly better than those in the other two groups (both P ＜ 0.05).However,there were no significant differences in OS between the groups with the time interval of 2 weeks to 1 month and more than 1 month (P ＞ 0.05).Conclusions Postoperative ID-GBC had significantly better survival outcomes than PS-GBC.Reoperation within two weeks in patients with ID-GBC is a good strategy.
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Objective@#To analyze the percentage of myeloperoxidase (MPO)-positive acute myeloid leukemia (AML) blast cells, and to explore the correlation of MPO expression with the clinical features, gene alterations, therapeutic response and prognosis of AML.@*Methods@#The expressions of MPO in BM blasts cells of 233 newly diagnosed AML were retrospectived analyzed, they were divided into two groups using the percentage of MPO-positive blast [low (≤70%) and high (>70%)], clinical features, gene alterations, chemotherapy efficacy and prognosis were compared between the two groups.@*Results@#①Of the 233 patients, 121(51.9%) were in the low MPO group, and the rest 112(48.1%) in the high MPO group. Favorable-risk group according NCCN guidelines of AML was always MPO-high (χ2=32.773, P<0.001), while MPO-low was closely related to poor-risk (χ2=7.078, P=0.008); ②DNMT3A mutation (χ2=6.905, P=0.009), spliceosome genes mutation (SF3B1/SRSF2/U2AF1) (χ2=5.246, P=0.022), RUNX1 mutation (χ2=4.577, P=0.032), ASXL1 mutation (χ2=7.951, P=0.005) and TP53 mutation (P=0.004) were more likely to be seen in the low MPO group, while C-KIT mutation (χ2=8.936, P=0.003) and CEBPA mutation (χ2=12.340, P<0.001) were more frequent in the high MPO group, especially CEBPA double mutation; ③The rates of first complete remission in the low MPO group were significantly lower than that in the high MPO group (38.8% vs 68.1%, χ2=15.197, P<0.001). Multivariate analysis showed that low MPO positivity significantly affected the CR1 unfavourably. ④The overall survival (OS) and the progression-free survival (PFS) were significantly worse in the low MPO group (18.0% vs 89.4% for OS, and 11.5% vs 56.7% for PFS, P<0.001). Multivariate analysis disclosed that the low number of MPO was significantly unfavourable prognostic factor. ⑤The low MPO group still showed a worse survival even when restricted to the patients with normal karyotype, the OS and the PFS were 31.1% and 18.8% respectively.@*Conclusions@#AML with different MPO expression percentage had a unique gene mutation spectrum. Low expression of MPO was an independent risk factor for CR1, OS and PFS in AML patients, which may be a simple and highly significant factor for AML patients when evaluating the therapeutic efficacy and prognosis.
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As a new noninvasive molecular biomarker, plasma cell-free DNA (cfDNA) has potential value in early diagnosis, prognosis evaluation, therapeutic monitoring. Now lots of methods can be used to detect cfDNA including SSCP-PCR, RFLP-PCR, sequencing, and digital PCR. Different methods could be applied in screening of unknown mutations, analysis of genetic polymorphism, and anlysis of specific mutations. cfDNA can be applied in early screening and evaluation in cancers, prenatal test, cardiovascular diseases, and transplantation. This manuscript reviewed the detective value of cfDNA on different diseases.
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Various genetic switches have been developed to let engineered cells perform designed functions. However, a sustained input is often needed to maintain the on/off state, which is energy-consuming and sensitive to perturbation. Therefore, we developed a set of transcriptional switches for cell states control that were constructed by the inversion effect of site-specific recombinases on terminators. Such a switch could respond to a pulse signal and maintain the new state by itself until the next input. With a bottom-up design principle, we first characterized the terminators and recombinases. Then the mutual interference was studied to select compatible pairs, which were used to achieve one-time and two-time state transitions. Finally, we constructed a biological seven-segment display as a demonstration to prove such switch's immense potential for application.
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Recombinases , MetabolismABSTRACT
Triple-negative breast cancer,which lacks estrogen receptor,progesterone receptor,and human epidermal growth factor receptor 2,accounts for about 15％-20％ of breast cancers,and is the most aggressive breast cancer subtype.It displays poor prognosis from traditional therapies,therefore,there is an urgent need to find new treatments.This paper mainly describes the characteristics of protein and gene expression,such as PIM1,MYC,CDK4,TGF-β,TP53,MYOF,FOSB,MENA,and the latest research of therapeutic approaches of triplenegative breast cancer about PARP,PI3K/Akt/mTOR,EGFR,Hedgehog,Met,etc..
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As a kind of common autoimmune diseases,rheumatoid arthritis (RA) affected the health of human beings seriously.In the past,serological diagnosis of RA solely relied on the detection of rheumatoid factor (RF),but its specificity was not satisfactory.Lately,people found that anti-cyclic citrullinated peptide (CCP) antibody was a serological indicator of RA.Now,there have been a series of kits for the detection of anti-CCP antibodies to diagnose RA.The sensitivity and specificity of anti-CCP antibody detection are better than those of RF detection.This paper reviews the significance and value of anti-CCP antibody detection used for clinical diagnosis in the recent years,while systematically compares the sensitivities and specificities between several common commercial kits and methods of anti-CCP antibodies detection.
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Objective To explore the establishing methods and differences of rat models of spleen deficiency and spleen deficiency liver cancer using the traditional Chinese medicine Dachengqi and Xiaochengqi decoctions .Methods Spleen-deficiency rat models were developed by multifactor methods:bitter-cold purgation ( Dachengqi or Xiaochengqi de-coction), cold-wet environment, tiredness, and fasting on alternate days for 30 days.Seven days after spleen-deficiency modeled,liver cancer in the spleen-deficiency rats and normal rats was developed by subcutaneously inoculation of Walker -256 carcinoma cell line in nude mice and then transplanted into rat livers .Liver cancer models were observed for 35 days. Sixty 3-week old male Wistar rats were randomly distributed into 4 groups: normal group , liver cancer model group , and Dachengqi and Xiaochengqi decoction groups .Degree of spleen deficiency , changes of the body-weight, survival time and tumor formation were recorded .Results Spleen deficiency rat models were successfully established .The weight gain of rats in the spleen-deficiency groups was significantly inhibited (P<0.01), and during the first 20 days (but not later) the average body weight of the Dachengqi decoction group was significantly higher than that of the Xiaochengqi decoction group (P<0.05).Spleen-deficiency scores of rats in the Xiaochengqi and Dachengqi groups were higher than those in the blank tumor group, especially in the Xiaochengqi group (P<0.01).The total tumor formation rate was 91.1%and 80%in the blank tumor groups , and 93.3%in both Xiaochengqi and Dachengqi groups , respectively .The average survival time of Xi-aochengqi group was lower than that of the blank tumor and Dachengqi groups ( P<0.01 and P<0.05 ) .The cumulative survival rate of the Xiaochengqi group and rats with a higher spleen-deficiency score was lower than that of the other groups (P<0.05).Conclusions Xiaochengqi decoction may induce spleen deficiency more seriously than Dachengqi decoction , and spleen deficiency may be an important unfavorable prognostic factor for rat models of liver cancer .
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Objective To introduce the laboratory and clinical characteristics of acute lymphoblastic leukemia accompanied by the karyotypic abnormality of 5q-.Methods Report the diagnosis and treatment of one case of acute lymphoblastic leukemia with 5q- and review the relevant literatures.Results The patient came to the hospital because of bellyache and ostalgia.The blood routine showed a high WBC count and reduced platelets.Bone marrow aspirates examination indicated acute leukemia and by peroxidase staining and flow cytometry test,acute pro-T lymphoblastic leukemia was diagnosed.The karyotype and fluorescence in situ hybridization analysis showed 5q-.The hyper-CVAD regimen induced a temporary remission but it did not work anymore after the relapse nor did the MEA regimen.From the literatures ever reported,the kyryotypic abnormality of 5q- was rarely seen in acute lymphoblastic leukemia.In such cases,the minimal deletion region overlaped between marks of D5S410 and D5S436 corresponding to chromosomal location 5q31-33.Conclusion 5q- is rare in acute lymphoblastic leukemia and more features are still to be found about the kind of disorder.
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Using method of orthogonal design we observed that low K+,high Ca2+ & low Mg2+ in perfusate produced the peak incidence of reperf-usion-indaced ventricular fibrillation & introduction of K+ & Ca2+ significantly affected the incidence & pnset of it, The appropriate prop-ortion of K+, ea2+ & Mg2+ in perfusate is the important effecting factor of reperfusion-induced arrhythmias in Langendorff heart of rats.