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Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.
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Objective:To investigate the risk factors of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients in plain-sand areas and loess hilly areas of Gansu province.Methods:A total of 1 599 T2DM patients who participated in chronic disease and risk factors monitoring and basic public health service management were selected by multi-stage stratified random sampling method in the sandy plain areas and loess hilly areas of Gansu province. Questionnaire survey, physical measurement and laboratory tests were performed. Multivariate binary logistic model was used to analyze the influencing factors.Results:The prevalence of DKD was 22.1% (174/787) among T2DM patients in the sandy plain areas and 19.1%(155/812) in the loess hilly area, respectively. Hypertension ( OR=3.022), hyperuricemia ( OR=2.114) and HbA1c≥7%( OR=2.231) were the risk factors for DKD in the plain-sand areas, and the risk of DKD increased with age. In the loess hilly areas, female sex ( OR=0.379) was the protective factor for DKD; while duration of disease≥10 years ( OR=2.476), hyperuricemia ( OR=1.907), HbA1c≥7% ( OR=1.927) were the risk factors for DKD; and the risk of DKD increased with the increase of age, and decreased with the increase of per capita monthly income. Conclusions:The prevalence of DKD and its influencing factors are different between sandy plain areas and loess hilly areas in Gansu province. The prevention and treatment of hypertension should be given more attention in sandy plain areas. In addition, the screening of DKD should be conducted among T2DM patients, particularly for those with old age, hyperuricemia and HbA1c≥7% in both areas of the province.
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Objective:To test the practicality and effectiveness of Evaluation system of Hunan Medical Science and Technology Awards by empirical data.Methods:The empirical data of this paper is based on the 48 award-winning projects of the 2018 Hunan Medical Science and Technology Award. The actual evaluation process was simulated and peer experts were invited to grade the researching samples by index system to collect measured data. Use AMOS and SPSS as tools to test the reliability, validity and the correlation of the Evaluation system.Results:The internal consistency reliability of Cronbach α is 0.820, which shows this evaluation system with good reliability; sample data of confirmatory factor analysis matches the theoretical model, which shows this evaluation system with good validity; The results of analysis of variance showed that the differences among the three winning groups were statistically significant( P<0.05); The correlation coefficient of spearman rank correlation analysis is 0.335( P<0.05), which shows the positive correlation between the theoretical results and the actual evaluation results. Conclusions:The evaluation system of Hunan Medical Science and Technology Awards performs well and possesses strong applicability and practicality. The higher the score of the project measured by this indicator, the higher the quality of the project, and the higher the order of rewards that can actually be obtained. It could be used as an objective reference for the evaluation of Hunan Medical Science and Technology Award.
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Objective:To establish an evaluation index system for Hunan Medical Science and Technology Award.Methods:Based on the literature review and expert demonstration, combined with the previous review experiences of Hunan Medical Science and Technology Award, a review system framework was initially developed. Delphi method was used for expert consultation, outcome analysis were also adopted for the modification and reconstruction of this index system.Results:The standard evaluating system was set up with four first-level indicators, fifteen second-level indicators and their scoring standards.Conclusions:The evaluation index system established has the characteristics of scientific, systematic, pertinent, practical, simple and operable, also provides a reference and basis for scientific, objective and accurate evaluation of Medical Science and Technology Awards.
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Objective To explore the milk production and its regularity in mothers with preterm infants hospitalized in NICU during periods of mother-infant separation,and to analyze the associating factors.Methods Totally 122 mothers with preterm infants hospitalized in NICU were recruited from February to December,2017.Continuous measurements of daily breast milk production were performed.The maternal lactation related comprehensive questionnaire and Edinburgh Postnatal Depression Scale (EPDS) were used.The Pearson correlation analysis and multiple linear regression analysis were conducted using the Statistical Analysis Systems (version 9.2).Results The milk volumes for the first 14 days postpartum showed a trend of rising among mothers.The mean milk volume on day 14 postpartum was (535.43±256.97) ml.The mean initiation time of lactogenesis stage Ⅱ was (68.23±26.42) h.The correlation coefficient of lactation between day 4 and day 14 was 0.707 0(P＜0.01).The multiple linear regression analysis revealed that the pregnancy induced hypertension syndrome,initiation time of lactogenesis stage Ⅱ,EPDS score,gestational age,maternal age were the influencing factors of milk volume for mothers during periods of mother-infant separation.Conclusion The milk volume of mothers with preterm infants was relatively lower compared with mothers with full-term infants during the early stage postpartum,and the onset of lactogenesis stage Ⅱ was later.In clinical nursing work,healthcare providers should pay special attention to mothers with older maternal age,smaller gestational age,pregnancy induced hypertension syndrome,higher EPDS score,and later initiation time of lactogenesis stage Ⅱ.
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OBJECTIVE:To provide reference for improving the service quality of PIVAS in our hospital. METHODS:Satis-faction questionnaire was designed by us. The survey was conducted among clinical nurses from 40 wards of our hospital about their satisfactory degree to pharmaceutical care of PIVAS and related influential factors. The survey data were analyzed statistically. RESULTS:A total of 280 questionnaires were sent out,and 271 effective questionnaires were collected with effective recovery of 96.79%. The overall satisfaction degree of nurses to PIVAS services was higher [(4.31±0.89)points]. The top 3 items were"drug admixture correction rate""infusion order rationality"and"drug packing quantitative accuracy rate rate",scored (4.57 ± 0.70), (4.56 ± 0.73) and (4.50 ± 0.76),respectively;the last 3 items of satisfaction were"timeliness of telephone answering service""timeliness of temporary medical orders'distribution"and"serviceable time for temporary medical orders'admixture",scored (3.73 ± 1.16),(3.75 ± 1.03) and (3.96 ± 1.01),respectively. The univariate analysis and multivariate analysis showed that there were statistical differences in the satisfaction score among nurses with different ages from different departments(P<0.01). The nurs-es in cardiovascular medicine department and ICU showed lowest satisfaction on service effect,and the nurses aged 20-29 years old showed highest satisfaction on service effect. There was no statistical significance in satisfactory degree among nurses with different gender,nursing ages,education background and professional titles(P>0.05). CONCLUSIONS:The overall satisfaction of clinical nurses to PIVAS service is favorable. The items of temporary medical orders-related service score the lowest,and service effect is related to nurses'departments and age. It is necessary to combine the shortage of work and the demand of clinical services to strengthen the management and promote the continuous improvement of PIVAS service quality.
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Long-term therapy should be administrated for patients with schizophrenia and the medication adherence is very important for the prognosis and outcome in these patients. In this study, we screened the literatures from various databases in accordance with our search criteria. A total of 11 literatures with the results of reliability and validity regarding the measurement of schizophrenia medication adherence were enrolled in our analysis. Based on the measurements, they were classified into subjective methods and objective ones. The objective methods include blood plasma and urine concentrations, pharmacy records, pill counts and Medication Event Monitoring System. The subjective methods include Drug Attitude Inventory, Rating of Medication Influences Scale, Brief Evaluation of Medication Influences and Beliefs, the Brief Adherence Rating Scale, Medication Adherence Rating Scale, and Morisky scales. In general, single method for measuring medication adherence in patients with schizophrenia is limited. We recommend researchers to use 2 or more methods when measuring the medication adherence in patients with schizophrenia.
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Humans , Antipsychotic Agents , Therapeutic Uses , Medication Adherence , Psychiatric Status Rating Scales , Reproducibility of Results , Schizophrenia , Drug TherapyABSTRACT
Objective To analyze the influence of the cesarean section and vaginal delivery at term pregnancy when fetal distress in labor conditions on maternal and neonatal outcomes .Methods 238 cases of fetal distress in labor when full-term pregnant were selected ,and they were randomly divided into the observation group and control group,119 cases in each group .The control group was given midwifery vaginal delivery ,while the observation group was given cesarean section .The maternal and neonatal outcomes were compared between the two groups . Results 78 cases(65.55%) of neonatal score above 7 or more points and 7 or more points of the control group were 58 cases(48.74%),the difference was significant (P<0.05).The incidence rate of neonatal complications in the observation group was 5.88%, which was significantly lower than 20.16% of the control group ( P <0.05 ). Conclusion Fetal distress in full-term pregnancy in labor , the use of cesarean section has higher neonatal score compared with vaginal delivery ,and it has low incidence rate of neonatal complications ,it is worth to be applied in clinical.
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<p><b>OBJECTIVE</b>To study the expression of tumorigenesis-related stem cell markers Lgr5 and CD44 in different pathological types of intestinal polyps and their clinical significance in predicting tumorigenesis.</p><p><b>METHODS</b>A total of 145 cases of colorectal polyps, adenomas and cancer tissues were obtained by colonoscopy biopsy. Immunohistochemistry was employed to detect the expression of Lgr5 and CD44 to analyze their relationship with the occurrence and prognosis of colon and rectal cancer.</p><p><b>RESULTS</b>The expression of CD44 in colon cancer tissue was 95.65%, significantly higher than that in normal mucosa (5%), inflammatory hyperplastic polyps (22.58%), tubular adenomatous polyps (55.26%) and villous polyps (75.76%) (P<0.05). The expression of Lgr5 in colorectal cancer was up to 95.65% while negative in normal colorectal tissue and was 16.12% in inflammatory hyperplastic tissues (P<0.05). The expression rate of Lgr5 was 86.84% in tubular adenoma and 93.94% in villous polyps, both comparable with that in colon cancer (P>0.05). Correlation analysis indicated that the expression of CD44 and Lgr5 were positively correlated with the progression of intestinal polyp tumorigenesis (rs=0.69377, P<0.0001; rs=0.81637, P<0.0001).</p><p><b>CONCLUSION</b>Lgr5 and CD44 are highly expressed in colorectal cancer tissues in close correlation with the clinical and pathological features. The expression profiles of Lgr5 and CD44 represent a distinct feature to differentiate colorectal cancer from normal intestinal mucosa. Lgr5 is more closely correlated with tumor progression of polyps than CD44. This means detecting of the expression of Lgr 5 together with CD44 is important and necessary in clinical diagnosis of patients with early stage colorectal diseases such as polyps and their canceration.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Colorectal Neoplasms , Metabolism , Pathology , Hyaluronan Receptors , Metabolism , Intestinal Polyps , Metabolism , Pathology , Prognosis , Receptors, G-Protein-Coupled , MetabolismABSTRACT
The transcriptional repressor RE1 silencer transcription factor(NRSF/REST) is an important factor that restricts some neuronal traits in neurons.Since these traits are also present in pancreatic islet cells,NRSF-regulated genes involved in islet function are searched.A NRSE-like motif was analysed in human insulin promoter.The role of NRSE was evaluated by generating a model of insulin-secreting cells that firmly express NRSF.The presence of NRSF led to a decrease in activity of human insulin promoter by stable or transient transfection with human insulin-promoter luciferase.The predicted NRSE-like motif also confers NRSF-dependent transcriptional repression in the context of a surrogate gene promoter.Specific binding activity of NRSF/REST to the NRSE-like motif was confirmed by EMSA.Moreover,the binding activity is competed by consensus NRSE sequence.These data showed that human insulin promoter is regulated by the transcriptional repressor NRSF/REST via the NRSE-like motif.
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Wnt signaling is implicated in the control of cell growth and differentiation during neural stem cell(CNS) development.Wnt3a, one of wnt gene family members, has effect on regeneration neurospheres and differentiation into neurons.Wnt3a inhibits regeneration of neurospheres, and promotes its differentiation. In vitro neurosphere was cultured in a serum-free defined medium DMEM/F12 supplemented with bFGF and EGF. Dissociated cells were plated onto poly-d-lysine-coated coverslips and propagated in medium containing recombined Wnt3a-adenovirus. Plenty of Nurr1 were detected by RT-PCR after 3 days. Wnt3a combined AA would improve NSC differentiation into dopaminergic (DA) neuron. The quantity of DA neuron is obviously more than the AA alone group's. Moreover, the expression of TH mRNA is 1.86 fold in Wnt3a combined AA group. Induced cells were immunostained for TH and DAT. The proportion of TH-positive was (37.42 ? 2.54) % (P
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Current therapies for myocardial infarction and congestive heart failure are limited in efficacy or in applicability. The plasticity of adult stem cells and cellular transplantation offer a novel therapeutic approach to improve cardiac function. This review describes the latest progress in research, summarizes recent studies of adult stem cells and their application in myocardial regenerative medicine in China and abroad, and discusses the future directions of cell transplantation as a new therapy to repair injured hearts. (J Geriatr Cardiol 2004;1(2) :77-82. )
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A Human blood type antigen P1 with very high activity was separated from sheep hydatid cyst fluid. Determination of the antigen by ultraviolet spectrum, polyacrylamide electrophoresis, gel filtration, and determination of its carbohydrate content and aminoacid residue had indicated that the substance was a glycoprotein, its total carbohydrate content was 80％ about one-fifth of which was hexosamine, and other carbohydrate components were glucqse, galactose and glucosamine. Its protein consisted of 14 aminoacids, and its molecular weight was about 30000 Daltons. By immunizing the animals with this substance, the anti-P1 serum of high titer could be obtained. The successful extraction of this substance P1 with high activity would provide the abundant resource for reseach on human blood type antigen and its immunochemistry, and create the good conditions for studies in preparation and application of anti-P1 serum or monoclonal antibody toward P1.
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Objective To construct adenovirus vector harboring CTLA4Ig-IRES-CTLA4 gene, and to express the gene in bone marrow mesenchymal stem cells (BMMSCs). Methods The cDNA fragments of CTLA4, and the extracellular domains of CTLA4 and IgGFc were cloned to pT-Easy vectors by RT-PCR from the activated splenocytes of Wistar rats. Recombinant adenovirus vector harboring CTLA4Ig-IRES-CTLA4 was produced from AdeasyTM Adenoviral Vector System by homologous recombination between the Adtrack vector (pAdtrack-GFP-CTLA4Ig-IRES-CTLA4) and the plasmid pAdEasy-1 containing most of the human adenovirus serotype 5 (Ad5) genome in E. coli BJ5183 strain, and then packaged and propagated in 293 cells. BMMSCs were infected with the recombinant adenovirus, and the co-expression of both CTLA4Ig and CTLA4 was then detected by RT-PCR and Western blotting. The immunosuppression function of the transfected BMMSCs was investigated by mixed lymphocyte response (MLR). Results Fusion gene CTLA4Ig was constructed successfully, and the recombinant CTLA4Ig-IRES-CTLA4 adenovirus was then generated by homologous recombination and packaged in 293 cells. The transduction efficiency of recombinant adenovirus in BMMSCs was elevated up to 98.67% determined by flow cytometry using a GFP as marker. CTLA4Ig and CTLA4 were expressed at the same time in BMMSCs detected by RT-PCR and Western blot, and the transfected stem cells showed stronger immunosuppression function than that of BMMSCs or BMMSCs transduced by Ad-CTLA4Ig. Conclusion The BMMSCs transfected by the recombinant adenovirus can co-express CTLA4Ig and CTLA4, which improved the immunosuppression function of BMMSCs in the way of costimulatory pathway blockade.