ABSTRACT
Objective: To explore the related factors of negative conversion time (NCT) of nucleic acid in children with COVID-19. Methods: A retrospective cohort study was conducted. A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3rd to May 31st 2022 were enrolled in the study. The infection age, gender, viral load, basic disease, clinical symptoms and information of accompanying caregivers were retrospectively analyzed. According to age, the children were divided into<3 years of age group and 3-<18 years of age group. According to the viral nucleic acid test results, the children were divided into positive accompanying caregiver group and negative accompanying caregiver group. Comparisons between groups were performed using Mann-Whitney U test or Chi-square test. Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19. Results: Among the 225 patients (120 boys and 105 girls) of age 2.8 (1.3, 6.2) years, 119 children <3 years and 106 children 3-<18 years of age, 19 cases were diagnosed with moderate COVID-19, and the other 206 cases were diagnosed with mild COVID-19. There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT (5 (3, 7) vs.7 (4, 9) d, Z=-4.17, P<0.001) compared with patients <3 years of age. Patients in the negative accompanying caregiver group had a shorter NCT (5 (3, 7) vs.6 (4, 9) d,Z=-2.89,P=0.004) compared with patients in the positive accompanying caregiver group. Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid (OR=3.74,95%CI 1.69-8.31, P=0.001). Conclusion: Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid, and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Young Adult , China/epidemiology , COVID-19/genetics , Nucleic Acids , Retrospective StudiesABSTRACT
OBJECTIVES@#To explore the difference in CT values between pulmonary thromboembolism and postmortem clot in postmortem CT pulmonary angiography (CTPA) to further improve the application value of virtual autopsy.@*METHODS@#Postmortem CTPA data with the definite cause of death from 2016 to 2019 were collected and divided into pulmonary thromboembolism group (n=4), postmortem clot group (n=5), and control group (n=5). CT values of pulmonary trunk and left and right pulmonary artery contents in each group were measured and analyzed statistically.@*RESULTS@#The average CT value in the pulmonary thromboembolism group and postmortem clot group were (168.4±53.8) Hu and (282.7±78.0) Hu, respectively, which were lower than those of the control group (1 193.0±82.9) Hu (P<0.05). The average CT value of the postmortem clot group was higher than that of the pulmonary thromboembolism group (P<0.05).@*CONCLUSIONS@#CT value is reliable and feasible as a relatively objective quantitative index to distinguish pulmonary thromboembolism and postmortem clot in postmortem CTPA. At the same time, it can provide a scientific basis to a certain extent for ruling out pulmonary thromboembolism deaths.
Subject(s)
Humans , Autopsy , Thrombosis , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed , Angiography , CadaverABSTRACT
OBJECTIVES@#Fourier transform infrared spectroscopy (FTIR) was used to analyze myocardial infarction tissues at different stages of pathological change to achieve the forensic pathology diagnosis of acute and old myocardial infarction.@*METHODS@#FTIR spectra data of early ischemic myocardium, necrotic myocardium, and myocardial fibrous tissue in the left ventricular anterior wall of the sudden death group of atherosclerotic heart disease and the myocardium of the normal control group were collected using hematoxylin-eosin (HE) and immunohistochemistry (IHC) staining as a reference, and the data were analyzed using multivariate statistical analysis.@*RESULTS@#The mean normalized spectra of control myocardium, early ischemic myocardium and necrotic myocardium were relatively similar, but the mean second derivative spectra were significantly different. The peak intensity of secondary structure of proteins in early ischemic myocardium was significantly higher than in other types of myocardium, and the peak intensity of the α-helix in necrotic myocardium was the lowest. The peaks of amide Ⅰ and amide Ⅱ in the mean normalized spectra of myocardial fibrous tissue significantly shifted towards higher wave numbers, the peak intensities of amide Ⅱ and amide Ⅲ were higher than those of other types of myocardium, and the peak intensities at 1 338, 1 284, 1 238 and 1 204 cm-1 in the mean second derivative spectra were significantly enhanced. Principal component analysis (PCA) and partial least square-discriminant analysis (PLS-DA) showed that FTIR could distinguish different types of myocardium.@*CONCLUSIONS@#FTIR technique has the potential to diagnose acute and old myocardial infarction, and provides a new basis for the analysis of the causes of sudden cardiac death.
Subject(s)
Humans , Amides , Death, Sudden, Cardiac , Myocardial Infarction/pathology , Myocardium/pathology , Spectroscopy, Fourier Transform Infrared/methods , Forensic PathologyABSTRACT
OBJECTIVE@#To analyze the clinical characteristics of venous thromboembolism (VTE) in patients with multiple myeloma (MM) and to identify the risk factors of VTE in MM patients.@*METHODS@#179 newly diagnosed MM (NDMM) patients admitted to The Second Hospital of Shanxi Medical University from January 2014 to December 2020 who were followed up for more than 6 months were collected, and they were divided into VTE group and control group according to whether combined with VTE. The clinical and laboratory data were compared between the two groups. Mann-whitney U test was used for inter-group comparison of measurement data, Chi-square test or Fisher's exact test was used for inter-group comparison of count data, and multivariate logistic regression analysis was performed to explore the risk factors of VTE in MM patients.@*RESULTS@#Compared with control group, the serum albumin (ALB) level in VTE group was significantly lower (P =0.033), the fibrinogen (FIB) level was significantly higher (P =0.016), and the proportion of patients with D-dimer≥2 000 ng/ml was significantly higher than that in the control group (26.3% vs 4.4%, P =0.002). There was a significant difference in M-component type between the two groups (P =0.028), and the proportion of IgG type in VTE group was higher. There were no statistically significant differences between two groups in age, sex, body mass index (BMI), the proportions of patients with hypertension, diabetes, coronary heart disease and cerebral infarction, white blood cell (WBC) count, platelet (PLT) count, liver and kidney function, plasma cells ratio in bone marrow, serum globulin (GLO), lactate dehydrogenase (LDH), β2-microglobulin (β2-MG) level, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), prothrombin time (PT), activated partial thromboplastin time (APTT), disease stage, thrombosis prevention and the use of immunomodulators (P >0.05). Multivariate logistic regression analysis showed that FIB level (OR=1.578, 95%CI:1.035-2.407, P =0.034), D-dimer≥2 000 ng/ml (OR=5.467, 95%CI:1.265-23.621, P =0.023) and IgG type (OR=4.780, 95%CI: 1.221-18.712, P =0.025) were independent risk factors for VTE in MM patients.@*CONCLUSION@#MM patients are prone to VTE, and FIB level, D-dimer≥2 000 ng/ ml and IgG type are independent risk factors for VTE in MM patients.
Subject(s)
Humans , Venous Thromboembolism , Multiple Myeloma/complications , Risk Factors , Anticoagulants , Immunoglobulin G , Retrospective StudiesABSTRACT
Diatom test is the main laboratory test method in the diagnosis of drowning in forensic medicine. It plays an important role in differentiating the antemortem drowning from the postmortem drowning and inferring drowning site. Artificial intelligence (AI) automatic diatom test is a technological innovation in forensic drowning diagnosis which is based on morphological characteristics of diatom, the application of AI algorithm to automatic identification and classification of diatom in tissues and organs. This paper discusses the morphological diatom test methods and reviews the research progress of automatic diatom recognition and classification involving AI algorithms. AI deep learning algorithm can assist diatom testing to obtain objective, accurate, and efficient qualitative and quantitative analysis results, which is expected to become a new direction of diatom testing research in the drowning of forensic medicine in the future.
Subject(s)
Humans , Artificial Intelligence , Autopsy , Diatoms , Drowning/diagnosis , LungABSTRACT
OBJECTIVES@#To select four algorithms with relatively balanced complexity and accuracy among deep learning image classification algorithms for automatic diatom recognition, and to explore the most suitable classification algorithm for diatom recognition to provide data reference for automatic diatom testing research in forensic medicine.@*METHODS@#The "diatom" and "background" small sample size data set (20 000 images) of digestive fluid smear of corpse lung tissue in water were built to train, validate and test four convolutional neural network (CNN) models, including VGG16, ResNet50, InceptionV3 and Inception-ResNet-V2. The receiver operating characteristic curve (ROC) of subjects and confusion matrixes were drawn, recall rate, precision rate, specificity, accuracy rate and F1 score were calculated, and the performance of each model was systematically evaluated.@*RESULTS@#The InceptionV3 model achieved much better results than the other three models with a balanced recall rate of 89.80%, a precision rate of 92.58%. The VGG16 and Inception-ResNet-V2 had similar diatom recognition performance. Although the performance of diatom recall and precision detection could not be balanced, the recognition ability was acceptable. ResNet50 had the lowest diatom recognition performance, with a recall rate of 55.35%. In terms of feature extraction, the four models all extracted the features of diatom and background and mainly focused on diatom region as the main identification basis.@*CONCLUSIONS@#Including the Inception-dependent model, which has stronger directivity and targeting in feature extraction of diatom. The InceptionV3 achieved the best performance on diatom identification and feature extraction compared to the other three models. The InceptionV3 is more suitable for daily forensic diatom examination.
Subject(s)
Humans , Algorithms , Deep Learning , Diatoms , Neural Networks, Computer , ROC CurveABSTRACT
OBJECTIVES@#To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning.@*METHODS@#In this study, 7 corpses were selected as the research objects. The image data of corpses were collected by computed tomography (CT) before conventional autopsy. The characteristics of corpses were observed through image reading, combined with virtual measurement indexes, and compared with 15 non-drowned corpses.@*RESULTS@#The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning, and ground-glass opacities in the lung. The statistical volume of fluid in the sinus (maxillary sinus and sphenoid sinus) was (10.24±4.70) mL in drowning cases and (2.02±2.45) mL in non-drowning cases. The average CT value of fluid in the sinus, left atrial blood and gastric contents in drowning cases were (15.91±17.20), (52.57±9.24) and (10.33±12.81) HU, respectively, which were lower than those in non-drowning cases (P<0.05).@*CONCLUSIONS@#The comprehensive consideration of multiple characteristic image manifestations and the virtual measurement indexes are helpful to the forensic pathological diagnosis of drowning. Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.
Subject(s)
Humans , Autopsy/methods , Cadaver , Drowning/diagnostic imaging , Forensic Pathology/methods , Tomography, X-Ray Computed/methodsABSTRACT
Objective:To compare the chemical constituents of Puerariae Flos from three different varieties of <italic>Pueraria montana</italic> var. <italic>lobata</italic>, <italic>P. montana</italic> var. <italic>thomsonii</italic> and <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic>. Method:Ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS) was used with the mobile phase of 0.1% formic acid aqueous solution (A)-acetonitrile (B) for gradient elution (0-20 min, 10%-30%B; 20-30 min, 30%-55%B; 30-35 min, 55%-95%B; 35-37 min, 95%B; 37-40 min, 95%-10%B), the flow rate was 0.25 mL·min<sup>-1</sup>. Electrospray ionization (ESI) was used to scan and collect MS data in positive and negative ion modes with scanning range of <italic>m</italic>/<italic>z</italic> 50-1 500. The chemical components from different sources of Puerariae Flos were identified in combination with the chemical composition database and literature information. After the obtained data were normalized by MarkerView<sup>TM</sup> 1.2.1, they were imported into SICMA-P 14.1 software for principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) to select the main differentiated components among the three different varieties. Result:A total of 35 compounds were identified from three different varieties of Puerariae Flos, including 22 isoflavones, 6 flavonoids and 7 saponins. The flowers of <italic>P</italic>. <italic>lobata</italic>, <italic>P. montana</italic> var. <italic>thomsonii</italic> and <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic> contained 32, 35, 33 compounds, respectively. And 18 differential compounds were screened under the positive and negative ion modes, including kakkalide, tectoridin, 6″-<italic>O</italic>-xylosyl-tectoridin, 4'-methyltectorigenin-7-glucoside, glycitin, 6″-<italic>O</italic>-xylosyl-glycitin, irisolidone, kaikasaponin Ⅲ, 6″-<italic>O</italic>-malonylglycitin, kakkalidone, tectorigenin, rutin, soyasaponin BB, vitexin, biochanin A, genistin, kakkatin, azukisaponin Ⅱ. Conclusion:This research is the first to systematically study the chemical constituents of the flower of <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic>, although the flower of <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic> is used as adulterants, it has high contents of tectoridin and 6″-<italic>O</italic>-xylosyl-tectoridin, which has great potential for development. The efficacy components such as kakkalide and tectoridin in Puerariae Flos from the three sources of varieties are obviously different, and it is necessary to carefully consider the application of these three varieties as Puerariae Flos.
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OBJECTIVE@#To investigate the molecular mechanism in stable cell strains expressing Mini-hF9 gene with nonsense mutation.@*METHODS@#Mini-hF9 gene and its nonsense mutants were transfected into HeLa cells independently, and stable cell strains were obtained after G418 resistance screening and monoclonal transformation. The altered splicing and protein expression of mRNA in Mini-hF9 gene in stable cell strains were detected by using RT-PCR and Western blot.@*RESULTS@#The wild type and nonsense mutated human coagulation factor IX stable cell strains were constructed successfully, which were named HeLa-F9-WT, HeLa-F9-M1 and HeLa-F9-M2. Only normal splicing Norm was detected in the wild-type cell strain HeLa-F9-WT; Norm and Alt-S1 splicing were detected in HeLa-F9-M1; while Norm, Alt-S1 and Alt-S2 splicing were detected in HeLa-F9-M2.@*CONCLUSION@#The nonsense associated altered splicing (NAS) pathway, which generated alternately spliced transcripts, might be triggered in coagulation factor IX gene with nonsense mutation.
Subject(s)
Humans , Codon, Nonsense , Factor IX/metabolism , HeLa Cells , Mutation , RNA Splicing , RNA, Messenger/metabolismABSTRACT
Objective To study the mechanism of rib fracture caused by landing on different parts of the trunk using finite element method, and to provide some new techniques and new ideas for the reconstruction of the whole process of falls from height. Methods The finite element method was used to study the rib fracture of human security model THUMS4.0 caused by landing on different parts of the trunk. Then the model was compared with actual cases and the mechanism of rib fracture caused by falls from height was analyzed from a biomechanical point of view. Results There were some differences in the stress and strain distribution as well as the rib fracture sites when different parts touched the ground. Ribs on both sides of the body were fractured when the front of the trunk touched the ground, and the fractures were mainly located in the junction of the ribs and costal cartilage and the midaxillary line area. When the right anterior part of the trunk touched the ground, rib fracture occurred first on the side that touched the ground, and rib fractures were mainly located in the area from the right midaxillary line to the posterior axillary line, and junction of ribs on both sides and costal cartilage. When the back of the trunk touched the ground, the fracture sites were mainly located on the back of the ribs on both sides. When the right posterior part of the trunk touched the ground, multiple rib fractures were likely to occur in the parts that touched the ground. The plastic strains were mainly concentrated at the fracture sites, while the von Mises stresses were not only concentrated at the fracture sites, but also at other sites. Conclusion There are some differences in rib fracture location sites and injury mechanisms when different parts of the trunk touch the ground.
Subject(s)
Humans , Accidental Falls , Biomechanical Phenomena , Finite Element Analysis , Rib Fractures/etiology , Ribs , TorsoABSTRACT
Objective To discuss the application of artificial intelligence automatic diatom identification system in practical cases, to provide reference for quantitative diatom analysis using the system and to validate the deep learning model incorporated into the system. Methods Organs from 10 corpses in water were collected and digested with diatom nitric acid; then the smears were digitally scanned using a digital slide scanner and the diatoms were tested qualitatively and quantitatively by artificial intelligence automatic diatom identification system. Results The area under the curve (AUC) of the receiver operator characteristic (ROC) curve of the deep learning model incorporated into the artificial intelligence automatic diatom identification system, reached 98.22% and the precision of diatom identification reached 92.45%. Conclusion The artificial intelligence automatic diatom identification system is able to automatically identify diatoms, and can be used as an auxiliary tool in diatom testing in practical cases, to provide reference to drowning diagnosis.
Subject(s)
Humans , Artificial Intelligence , Cadaver , Diatoms , Drowning , LungABSTRACT
OBJECTIVE@#To evaluate the diagnostic value of 18F-FDG PET/CT and tumor markers (CEA,CA19-9,CA24-2) in detection for recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma.@*METHODS@#Fifty-five patients were enrolled in this study. All of the patients were tested with serum CEA within 2 weeks when they underwent 18F-FDG PET/CT scan, and some patients were tested with serum CA19-9 and CA24-2 simultaneously. According to the pathology and clinical results of their follow-up, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT and tumor markers were calculated based on different divided groups, respectively.@*RESULTS@#According to the pathology and the results of their clinical follow-up, the sensitivity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 68.09%, 28.57%, 40.00% and 74.47%, respectively. The specificity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 50.00%, 66.67%, 71.43% and 50.00%, respectively. The positive predictive valueof 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 88.89%, 85.71%, 88.89% and 89.74%, respectively. The negative predictive value of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 26.67%, 11.42%, 17.24%, 25.00%, respectively. The accuracy of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 92.73%, 65.47%, 32.65%, 44.68% and 70.91%, respectively. There were 2 cases of false positive and 2 cases of false negative in 18F-FDG PET/CT.@*CONCLUSION@#18F-FDG PET/CT has high value in detecting recurrence and metastasis of postoperative colorectal carcinoma. Tumor markers have the positive value to imply the recurrence and metastasis of postoperative colorectal carcinoma and are useful to indicate when to perform the 18F-FDG PET/CT. The combination of tumor markers could improve the diagnostic efficiency to some extent.
Subject(s)
Humans , Adenocarcinoma/diagnosis , Biomarkers, Tumor , CA-19-9 Antigen , Carcinoembryonic Antigen , Colorectal Neoplasms/diagnosis , Fluorodeoxyglucose F18 , Neoplasm Recurrence, Local , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , RecurrenceABSTRACT
Objective To discuss the causes and precautionary measures of the risks of relevant medical disputes by analyzing 22 cases of death from otolaryngology diseases. Methods A retrospective analysis of 22 judicial expertise cases of medical disputes related to death from otolaryngology diseases accepted by Chongqing Zhengding Judicial Appraisal Institute and Academy of Forensic Science during 2008-2018 were made. Results Of the 22 cases, the male to female ratio was 3.4∶1. The age of death was from 1.3 to 76 years old, with an average age of 45.3 years. There were 28 medical institutions involved, of which 71.4% were tertiary medical institutions. Statistics for death causes showed that respiratory asphyxia accounted for 50%. Conclusion Forensic identification provides an important scientific basis for medical disputes cases related to otolaryngology diseases. It also has an important reference value for medical institutions to optimize the work procedure of diagnosis and treatment of otolaryngology diseases and improve the quality of diagnosis and treatment.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Cause of Death , Death , Dissent and Disputes , Otorhinolaryngologic Diseases , Retrospective StudiesABSTRACT
Postmortem changes on corpses appear immediately after death, and can transform the original structure characteristics of the corpse to different degrees as well as show specific changes on computed tomography (CT) images, sometimes with false positives and false negatives, influencing the identification of injuries or diseases. This paper systematically summarizes the postmortem changes of computed tomography imaging characteristics on corpses, to further expand the application of virtopsy in the practices of forensic pathology identification, and provide reference for the identification of injuries, diseases and changes after normal death.
Subject(s)
Humans , Autopsy , Cadaver , Forensic Pathology/instrumentation , Postmortem Changes , Research/trends , Tomography, X-Ray ComputedABSTRACT
Objective · To provide theoretical guidance for the design of molecules with high activity by building the quantitative structure-activity relationship (QSAR) model for tropane compounds as muscarinic M3 receptor antagonists. Methods · Six compounds (J1-J6) were prepared with3α-hydroxy-tropane (J0) as the starting material by modifying the structure in C-3α position of the tropane skeleton. The antagonistic activity of new tropane compounds to muscarinic M3 receptors on tracheal rings of guinea pigs was evaluated by functional assays in vitro. The antagonistic parameters (pA2) of new tropane compounds prepared in this paper and former studies were applied to construct the QSAR model. The information about structural optimization was acquired by analyzing the effect of steric field and electrostatic field of model on activity of tropane compounds. Results · The six new tropane compounds showed obvious antagonistic activity against M3 receptors. Among them, J4 had the greatest activity (pA2=7.992). The cross-validation correlation coefficient squared (q2) and the non-cross-validated correlation coefficient squared (r2) of the QSAR model were 0.585 and 0.993, respectively.Conclusion · The antagonistic activity to muscarinic M3 receptors can be obviously improved, when the conjugating extent of π-bonds is large and O or N atoms participate in conjugation on the rings in the R-substituting group at C-3α position of the compounds.
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OBJECTIVE@#To investigate the safety and efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) using modified BU/CY conditioning regimen for young AML patients of low and middle risk in the first complete remission (CR1).@*METHODS@#Ten young AML patients of low and middle risk who did not want to accept allogeneic hematopoietic stem cell transplantation(allo-HSCT)and underwent auto-PBHSCT in CR1 during May 2013 to December 2016 were retrospectively analyzed. From 3 months after auto-PBHSCT, the maintenance therapy with interleukin-2 (IL-2) or IL-2 combined with histamine dihydrochloride was performed for these patients in the next 18 months. The side effects of the conditioning regimen, hematopoietic recovery time, transplant-related mortality (TRM) within 100 days and 1 year after auto-PBHSCT, relapse rate, leukemia-free survival (LFS) rate at 2 years and 3 years, overall survival (OS) were evaluated at 3 years and 4 years.@*RESULTS@#Gastrointestinal side effects were the major non-hematologic toxicity reaction, among which, 7 cases relatively mild and 3 cases displayed moderate, just one case suffered from severe reaction. In 4 cases, the mild liver damage occurred, but no hemorrhagic cystitis occurred. All the patients experienced different kinds of infection, including 5 cases of bloodstream infection, 2 cases of gastrointestinal infection, 3 cases of crissum infection and 2 cases of oral infection. The myeloablative effect occurred in all ten patients. The median times for absolute neutrophil count (ANC)0.5×10/L at 10 to 19 days, median was 13 days after auto-PBHSCT. The patients achieved platelet count >20×10/L at 10 to 72 days; median was 32 days after auto-PBHSCT. The TRM within 100 days and 1 year after transplantation was 0. The relapse occurred in 2 cases at 6 and 14 months after auto-PBHSCT raspectively. The median follow-up time was 48.1 months, and the median survival time was 54.7 months after transplantation. The 2-year and 3-year LFS were 100% (10 cases) and 80% (8 cases), respectively. The 3-year and 4-year OS were 80% (8 cases) and 70% (7 cases), respectively.@*CONCLUSION@#Modified BU/CY as conditioning regimen for auto-PBHSCT can achieve the myeloablative effect without raising TRM and obtain good LFS and OS. As for young AML patients without high risk, it is a valuable therapeutic option, especially for those lacking the chance of allo-HSCT.
Subject(s)
Humans , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Retrospective Studies , Transplantation Conditioning , Transplantation, Autologous , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate the clinical manifestations pathologic features, treatment options and prognosis of patients with bone lymphoma.@*METHODS@#The clinical characteristics, pathologic features, treatment and prognosis of 34 BL patients diagnosed by histopathologic method or/and PET-CT and treated in first hospital of peking university from January 2004 to April 2018 were analyzed retrospectively.@*RESULTS@#The median age of 34 BL patients was 56 years old, the male and female ratio was 1.43∶1 (24 /10). Among 34 patients, the patients with primary bone lymphoma(PBL) were 8 cases, the patients with secondary bone lymphoma(SBL) was 26 cases, the PBL and SBL ratio was 0.31∶1. Bone lymphoma lacks typical systemic symptoms, and its onset began mostly from bone pain and pathologic bone fracture. The most frequent pathological type of bone lymphoma in our study was diffuse large B-cell lymphoma (DLBCL), accounting for 55.88%. At present, the conventional treatment for bone lymphoma includes chemotherapy, or chemotherapy combined with radiotherapy and surgery, as well as hematopoietic stem cell transplantation. The average and median OS time of BL patients were 349 years and 3 years respectively, meanwhile the OS rate for three years and two years were 56.25% and 78.16%, respectively. Factors that affect survival of BL patients were PBL and SBL classification, pathological type, blood LDH level, and treatment methods.@*CONCLUSION@#Bone lymphoma is usually concealed onset,an adequate and adequate combination therapy can improve the survival rate and transplantation therapy plays an important role. Primary bone lymphoma is rare, the prognosis of patients with primary bone lymphoma is good, whereas the prognosis of patients with secondary bone lymphoma is poor.
Subject(s)
Female , Humans , Male , Middle Aged , Bone Neoplasms , Hematopoietic Stem Cell Transplantation , Lymphoma, Large B-Cell, Diffuse , Positron Emission Tomography Computed Tomography , Prognosis , Retrospective StudiesABSTRACT
In order to straighten out the primary and secondary relationships that affect the harmony between doctors and patients in China and explore the factors that have a great influence on the harmony between doctors and patients,this paper through literature review,established 29 types of problems that affect the harmony between doc-tors and patients and builds the hierarchy of problems according to the macro-Model, and expert argumentation, the use of analytic hierarchy process to calculate the importance index of the problem,and the use of K-means clustering method to classify the problem,and finally come to the order of the importance of the problem. Through this study,it was found that there are seven important issues that affect the harmony between doctors and patients in China,and the most important one is"the Crisis of Social Trust and the lack of trust between doctors and patients". The importance index is 0.0784,belonging to the external sub-model. This is in line with the current background of declining credi-bility of the current society as a whole. Therefore,the restoration of the trust between doctors and patients should be the key direction of current governance, and the state should proceed from the macro level and rebuild social trust throughout the system.
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This study was designed to investigate the effects of icariin on bone metabolism in osteoprotic mice induced by iron overload, the model of iron overload mice was established by intraperitoneal injection of iron dextran (100 mg·kg-1). Sixty 2-month-old C57/BL6 male mice were randomly divided into six groups, including normal control group, model group, N-acetyl-L-cysteine (NAC)-treated group, icariin (50, 100 and 200 mg·kg-1)-treated group. Except for the mice in control group, the mice were intraperitoneal injected weekly with iron dextran (100 mg·kg-1) to establish the model of iron overload mice. The NAC and icariin were suspended in 0.5% CMC-Na solution, and administered orally for six times one week according to body weight. The mice in normal group and model group were given the same volume of 0.5% CMC-Na solution. Three months later, the organs, serum and femurs of mice were collected. Serum biochemical parameters were detected with an ELISA kit, the distal femur bone density and trabecular bone microstructure were analyzed by Micro-CT, and the mechanical properties of femur were measured by universal mechanical analyzer. Compared with the normal control group, iron overload decreased the bone mineral density and deteriorated the micro-architecture structure and bone mechanical properties in femur of mice, increased the level of iron, phosphorus and activity of tartrate resistant acid phosphatase-5b (TRACP-5b), reduced the level of osteocalcin (OCN) in serum, decreased the activity of superoxide dismutase (SOD) of liver tissues, increased the content of malondialdehyde (MDA) of liver tissues. Icariin increased bone mineral density, improved the micro-architecture and mechanical properties of bone tissue, reduced the levels of iron and phosphorus, decreased the activity of TRACP-5b and enhanced the levels of OCN in serum, and also decreased the activity of MDA in liver tissue of iron overload mice. These results suggest that icariin is able to reduce bone loss and improve bone microstructure and mechanical properties in iron overload mice through regulation of bone metabolism via anti-oxidation.
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Objective To explore the effect of antiosteoporotic active fraction from Er-Xian Decoction (EXD) on retinoic acid-induced osteoporosis in rats. Methods Sixty female SD rats were randomly divided into normal control group, model group, estradiol valerate (0.2 mg/kg) group and antiosteoporotic active fraction from EXD low-, middle- and high-dose groups (50, 100, 200 mg/kg). Except for the rats of normal group, the others were intragastrically treated with 70 mg/(kg • d) of retinoic acid for 14 days to induce osteoporosis. Then the rats were treated with estradiol valeratse or antiosteoporotic active fraction from EXD (10 mL/kg) for 28 days. The biochemical parameters in serum and urine of rats were detected by ELISA. The bone mineral density and trabecular bone microstructure of distal femur were analyzed with micro-CT. Results The antiosteoporotic active fraction from EXD significantly decreased calcium content in urine and activities of alkaline phosphatase and tartratse-resistant acid phosphatase in the sera of retinoic acid-induced osteoporotic rats (P0.05, P0.01). High-dose of antiosteoporotic active fraction from EXD significantly increased bone mineral density of distal femur (P0.05). And the antiosteoporotic active fraction from EXD improved the trabecular bone microstructure of distal femur in retinoic acid-induced osteoporotic rats. Conclusion Antiosteoporotic active fraction from EXD can reduce bone loss and deterioration of bone microstructure in retinoic acid-induced osteoporotic rats.