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1.
Article in Chinese | WPRIM | ID: wpr-870592

ABSTRACT

Objective:To explore immune cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT)by using mathematical function models.Methods:From June 2011 to May 2015, 65 patients with malignant hematological disorders were retrospectively analyzed. Immune cell frequencies and absolute counts were detected at day 14/28/42 and month 2/3/6/9/12/18/24 post-allo-HSCT. The immune cells included CD3 + T, CD4 + helper T, CD8 + effector T, regulatory T, CD19 + B, CD3 -CD56 + NK and CD3 + CD56 + NKT. Kinetic curve models and mathematical equations were established by utilizing curve model estimation. Results:Cubic curve models were observed for the changes of immune cell frequencies. Except for CD3 + T, CD8 + T and NK cells, the changes of absolute counts of immune cells conformed to cubic curve models. The reconstructed kinetic models of CD8 + T and NK cells after allo-HSCT were associated with relapse. Conclusions:Immune cell reconstitution after allo-HSCT conforms to certain mathematical function curve models. It may provide a new strategy for in-depth studies of immune reconstitution after allo-HSCT.

2.
Article in Chinese | WPRIM | ID: wpr-870590

ABSTRACT

Objective:To explore the incidence rates, clinical features, risk factors and its impacts on survival of central nervous system complications (CNSC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:From June 2011 to October 2018, 237 consecutive patients undergoing allo-HSCT were retrospectively analyzed.Results:The incidence of CNSC was 10.5%(25/237) and the median time 82(-4 - 810) days post-transplantation. The most common instances of CNSC were drug-associated encephalopathy (n=6), CNS infection (n=5), unexplained convulsions (n=4), metabolic encephalopathy (n=3), immune-related encephalopathy (n=3), primary central relapse (n=3) and cerebrovasculopathy (n=1). The most common clinical symptom was epileptic seizure (n=11). CsA-related encephalopathy was manifested mainly as posterior reversible encephalopathy syndrome on brain MRI. Metabolic encephalopathy is mostly demyelination. Most hippocampal lesions were caused by immune-related encephalopathy or CNS infection. Analysis of risk factors indicated that umbilical cord blood transplantation, HLA incompatible transplantation and delayed platelet implantation were high risk factors for post-transplantation occurrence of CNSC. Survival analysis suggested that non-relapse mortality rate (42.9%, 9/21) in group with CNSC of malignant hemoblastosis was higher than that in group without CNSC (15.3%, 27/176) and inter-group difference was statistically significant ( χ2=9.511, P=0.005). The 1/3-year OS rates in group with CNSC were lower than those in group without CNSC (56.6% vs 77.8%; 37.1% vs 65.7%). And the difference was statistically significant ( P=0.022). Conclusions:With a complex etiology, CNSC is one of serious complications after allo-HSCT and it significantly reduces the overall survival rate of patients. Umbilical cord blood transplantation, HLA incompatible transplantation and delayed platelet implantation are high-risk groups for CNSC.

3.
Chinese Journal of Oncology ; (12): 580-586, 2019.
Article in Chinese | WPRIM | ID: wpr-805784

ABSTRACT

Objective@#To investigate the effect of down-regulation of insulin-like growth factor 2 (IGF2) gene on the biological characteristics of HCT116 colon cancer stem cells (CSCs).@*Methods@#Flow cytometry sorting technology was used to isolate CSCs from colon cancer cell line HCT116 by a monoclonal antibody against CD133; serum free floating culture assay was used for the enrichment of CSCs. The proportion of CD133+ cells was analyzed by flow cytometry; CSCs were identified by sphere culturing, immunofluorescence analysis and soft agar clone formation. RT-qPCR method was used to examine transcriptional level of IGF2 gene in CSCs. Western blotting was used to examine IGF2 protein expression in CSCs. siRNA was used to establish IGF2 transient knock down model in CSCs. Cell proliferation array, cell cycle and apoptosis analysis, cell invasion array and colony forming assay were used to further examine the role of IGF2 on the biological characteristics of colon CSCs.@*Results@#CSCs were successfully isolated from HCT116 cell lines, which were cultured to form cell spheres in serum-free stem cell culture medium. We found that the morphology of sphere-forming-like cells after several passages maintained the same characteristics as that of the first passage. The results of immunofluorescence showed that CSC markers including CD133 and ALDH continued positively expressing on the cell surface of CSCs, and flow cytometry analysis showed that more than 90% of the spheroid cells remained CD133 positive. The clone formation rate of non-CSCs group and CSCs group were (28.10±2.66)% and (43.73±2.30)% respectively, with significant difference (P<0.01). The RT-qPCR results showed that the transcriptional level IGF2 gene in non-CSCs group and CSCs group were (1.06±0.24) and (2.17±0.51) respectively, with significant difference (P<0.05). The western blot results showed that the protein expression of IGF2 in CSCs group and non-CSCs group were (1.10±0.55) and (2.14±0.23) respectively, with significant difference (P<0.05). Knockdown of IGF2 significantly decreased the percentage of CD133+ cells in CSCs and cell proliferation (P<0.01). Knockdown of IGF2 increased the percentage of G2/M phase (23.46% of siNC group vs 60.14% of siIGF2 group) and cell apoptosis (2.80% of siNC group vs 40.70% of siIGF2 group), while decreased the percentage of G0/G1 phase (40.77% of siNC group vs 17.73% of siIGF2 group). The invasion results showed that the number of cells penetrating into the basement surface in siNC group and siIGF2 group was (109.00±16.37) and (54.00±8.19) respectively, with significant difference (P<0.01). The rate of sphere-forming of colon CSCs in siNC group and siIGF2 group were (51.70±7.42)% and (21.27±2.35)% respectively, with significant difference (P<0.01). The clone formation rate of siNC group and siIGF2 group were (37.20±3.87)% and (18.23±2.25)% respectively, with significant difference (P<0.01).@*Conclusion@#IGF2 gene plays an important role in maintaining the biological characteristics of colon cancer stem cells and promoting self-renewal and stemness of colon CSCs.

4.
Article in Chinese | WPRIM | ID: wpr-710699

ABSTRACT

Objective To analyze the effect of haploidentical hematopoietic stem cell transplantation (HID-HSCT) on high-risk acute lymphoblastic leukemia (ALL),and to explore the influence of minimal residual disease (MRD) before transplant on the outcomes.Methods A retrospective analysis was performed on 39 high risk ALL patients receiving HID-HSCT in our hospital from Jan.2013 to Jan.2018.The clinical features,stem cell engraftment,complications,survival and recurrence were compared between patients with pretransplant MRD + and MRD-.Results All the 39 patients presented with successful engraftment.The overall survival (OS) was 54.67%;the disease free survival (DFS) was 40.96%;the incidence rate of acute graft versus host disease (aGVHD) was 53.8%,including 23.1% Ⅱ-Ⅳ degree aGVHD and 2.6% Ⅲ-Ⅳ degree aGVHD.There was no significant difference in stem cell engraftment,GVHD,cytomegalovirus infection and hemorrhagic cystitis between MRD + and MRD-patients.DFS and OS in MRD + patients were significantly lower than those in MRD-patients;the cumulative RR rate increased significantly,and there was no significant difference in cumulative TRM.Conclusion HID-HSCT was an effective method to treat high-risk ALL,but MRD + patients had high recurrence rate and poor prognosis.Strategy adjustment should be considered to reduce tumor residual and the transplantation strategy should be optimized for these kinds of high risk patients,so as to improve long-term outcomes.

5.
Chinese Journal of Hematology ; (12): 408-413, 2018.
Article in Chinese | WPRIM | ID: wpr-809977

ABSTRACT

Objective@#To investigate the effect of 1q21 amplification (1q) on the therapeutic response and prognosis of bortezomib(Btz) in the treatment of newly diagnosed multiple myeloma (MM) patients.@*Methods@#A total of 180 newly diagnosed MM were included for analyses of clinical characteristics, cytogenetics, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS), retrospectively. Gene expression profiling (GEP) was analyzed using publicly available R2 platform.@*Results@#① In 180 patients, 1q was found in 51.1% cases. Of them, 174 patients had complete follow-up data, including 88 cases with 1q and 86 without 1q (non-1q). ②Incidence of 1q was positively associated with percentage of IGH rearrangement (72.2%, P=0.017) and 1p deletion (1p) (27.8%, P=0.040). ③ The median PFS was 15.0 and 20.3 months for the 1q group and non-1q group, and the median OS was 29.4 and 44.0 months, respectively. Both PFS and OS of 1q group was significantly shorter than those of the non-1q group (P=0.029 and 0.038, respectively). Multivariate analysis further revealed that 1q was an independent prognostic factor for both PFS (HR=1.910, 95% CI 1.105-3.303, P=0.020) and OS (HR=2.353, 95% CI 1.090-5.078, P=0.029). ④ In 91 evaluable cases with 1q, very good partial remission (VGPR) rate was higher after treatment with Btz than those without Btz (62.1% vs 40.0%, P=0.032). Of note, the patients with 1q who received auto-HSCT after induction with Btz had significantly longer PFS than those without auto-HSCT (19 months vs 13 months, P=0.048). ⑤GEP analysis revealed that 1q21 amplification predominantly up-regulated expression of >50% genes within 1q21 region, and also altered expression of 28% genes in chromosome 1 and 10% genes in whole genome, particularly related to DNA repair and cell cycle.@*Conclusions@#1q is an independent adverse prognostic factor in patients with newly diagnosed MM. It is often associated with 1p deletion and IGH rearrangement. Patients with 1q respond well to Btz-based regimen, but they fail to gain long-term benefit from this treatment itself. However, auto-HSCT following Btz induction might improve survival of patients with 1q, suggesting a potential strategy to treat this high-risk subset of MM. GEP analysis warrants further attention in understanding the mechanisms underlying the high-risk of 1q.

6.
Article in Chinese | WPRIM | ID: wpr-618643

ABSTRACT

Objective To study the immune re-constitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with hematological malignancies.Methods From June 2011 to May 2015,65 patients with hematological malignancies were analyzed retrospectively.Lymphocyte subsets were determined by flow cytometry (FCM),including total T lymphocytes (CD3+),helper T cells (CD3+ CD4+),cytotoxic T cells (CD3+ CD8+),CD4/CD8 ratio,nature killer (NK) cells (CD3-CD56+),NKT cells (CD3+ CD56+),B lymphocytes (CD19+),naive T cells (CD3+ HLA-DR+),static T cells (CD3+ HLA-DR-),and regulatory T cells (CD4+ CD25high Foxp3+) on the day 14,28 and 42,and on the month 2,3,6,9,12,15,18 and 24 after allo-HSCT.Results The percentage of CD3+ T cells located normal range after hematological recovery,and its absolute number recovered to normal range at + 15 months.The percentage of CD3+ CD4+ T cells recovered to normal range at + 24 months.However,the absolute number of CD3+ CD4+ T cells did not recover to normal range until 24 months after allo-HSCT.The percentage of CD3+ CD8+ T cells was higher than normal range at + 42 day,and its absolute number was greater than normal range at + 3 months.Hence,low CD4/CD8 ratio was observed for a long period.The re-constitution time points of the percentage and absolute number of CD3+ HLA-DR+ T cells were + 3 months and + 24 months respectively.The re-constitution time points of the percentage and absolute number of CD3 + HLA-DR-T cells were + 2 months and + 15 months respectively.The re-constitution time points of the percentage and absolute number of regulatory T cells were + 12 months and + 15 months respectively.The percentage of NKT cells located in normal range after hematological recovery,and its absolute number retumed to normal range at + 12 months.The re-constitution time points of the percentage and absolute number of B cells were + 9 months and + 18 months respectively.The percentage of NK cells located in normal range after hematological recovery,and its absolute number returned nearly to normal range at + 3 months.Conditioning regimen containing ATG,source of stem cells,CD34+ cell number,GVHD,and CMV reactivation were all associated with immune re-constitution after allo-HSCT.Conclusion Different immune cells showed different re-constitution models after allo-HSCT,and the percentage recovered faster than absolute number for a certain kind of immune cells.Studying immune re-constitution and its associated factors may offer beneficial information for insight into transplantation immunology and improve the management of allo-HSCT.

7.
Article in Chinese | WPRIM | ID: wpr-610478

ABSTRACT

Objective · To isolate phages which can fight against extended-spectrum β-lactamase (ESBLs)-producing Escherichia coli (E. coli), and provide basic research for establishment of E. coli phage library and treatment of bacterial infection. Methods · Samples collected from sewage were co-cultured with 93 ESBLs-producing E. coli strains. A phage named JDEC001 was isolated by double agar overlay plaque assay. The biological characteristics, complete genome sequence and comparative genome analyses of JDEC001 were studied respectively. Results · JDEC001 belongs to the lytic phage as a member of the Caudovirales order, Podoviridae family. It has high activity at pH from 5 to 11 and with temperature from 0 to 39 ℃ .Whole-genome sequencing of JDEC001 demonstrated double-stranded DNA genome of 38745 bp with GC content of 49.93%, which encoded 46 open reading frames. The comparative genomics also showed that there was no virulent genes or antibiotic resistant genes in its genome. Conclusion · The phage JDEC001 against ESBLs-producing E. coli was isolated and purified, with good stability in a broad range of pH and temperature.

8.
Chinese Critical Care Medicine ; (12): 332-336, 2017.
Article in Chinese | WPRIM | ID: wpr-511302

ABSTRACT

Objective To reveal the pathophysiological changes of sepsis, the plasma metabonomics of septic rats was determined and differential metabolites were determined by gas chromatography-mass spectrometry (GC-MS). Methods Male Spraguee-Dawley (SD) rats about 8 weeks were randomly divided into sham group (n = 18) and sepsis group (n = 24). Cecal ligation and puncture (CLP) was used to build sepsis model, while cecum was kept intact only in the sham group. 6 hours after the operation, rats were anesthetized, and blood was harvested through heart thoracotomy. Then the plasma metabonomics was detected by GC-MS and metabolic profile analysis was performed to find the relative differential metabolites.Results Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) showed that the metabolic profiling of the sepsis group was significantly different from the sham group. 259 kinds of metabolites were got by GC-MS, and 69 kinds of differential metabolites were found between sham group and sepsis group, in which 23 differential metabolites were related to amino acid metabolism. Compared with sham group, the contents of putrescine, N-glutamic acid, hydroxynorvaline, 3-cyanuric acid, D-alanyl-D-alanine and urea in the plasma of septic rats increased significantly, which ratios of sepsis/sham group were 10.876, 6.394, 2.800, 2.226, 1.323, 1.203, respectively (allP < 0.05). On the other hand, the contents of oxygen generation of proline, citrulline, glutamine, su-beta-hydroxy aspartic acid, citric acid, N-methyl-DL-alanine, serine, lysine, threonine, N-formyl-L-methionine, methionine, alanine, nicotinuric acid, N-methyl-L-glutamic acid, trans-4-hydroxy-L-proline, proline, L-glutamic acid in the plasma of septic rats decreased significantly, which ratios of sepsis/sham group were 0.858, 0.853, 0.834, 0.816, 0.816, 0.814, 0.813, 0.801, 0.793, 0.792, 0.774, 0.766, 0.748, 0.727, 0.716, 0.674, 0.603, respectively (allP < 0.05).Conclusions Through the GC-MS analysis of plasma metabonomics of septic rats, we found abnormal energy metabolism changes. The content of amino acid in plasma might be a method to evaluate the energy metabolism status of sepsis.

9.
China Pharmacy ; (12): 4559-4564, 2017.
Article in Chinese | WPRIM | ID: wpr-704462

ABSTRACT

OBJECTIVE:To provide reference for improving the process quality of antibiotics management.METHODS:Based on the international Antibiotics Stewardship(AMS) strategy goal,according to process quality evaluation method of "structure-process-result" medical quality evaluation model,antibiotics management intervention of a tertiary general hospital during 2011-2016 was analyzed statistically in respects of general information,department involved,intervention types,intervention reasons,drug types involved,etc.The proportion of antibiotics in outpatients,emergency patients and inpatients,the proportion of antibiotics for prophylactic use in type Ⅰ incision surgery patients were evaluated before (2011) and after intervention (2014).RESULTS:A total of 2 137 intervention records were collected.The department involved in the intervention was mainly surgical department,including 12 surgical departments as gynecology department,otolaryngology department and orthopedics department (55.97%).In the type of intervention,the intervention of used drug type was relatively high (44.77%).The main reasons for intervention included inappropriate usage and dosage,improvement of treatment effect,unreasonable amount of solvent,incomplete clinical diagnosis or clinical diagnosis deletion in prescriptions,inappropriate indication,and repeated administration (90.55%).The drugs involved were mainly β-lactam (including carbapenems) and enzyme inhibitor (62.43%).After intervention,the utilization rates of antibiotics in outpatients,emergency patients and inpatients decreased from 27.70%,49.42%,60.42% to 17.57%,38.65%,47.21%,respectively.The proportion of antibiotics for prophylactic use decreased from 85.75% to 30.33% in type Ⅰ incision surgery patients.The proportion of surgery with antibiotics for prophylactic use <24 h in total cases of antibiotics for prophylactic use increased from 54.52% to 68.84% (all P<0.05).Average antibiotics cost of outpatients and inpatients decreased from (30.12 ± 10.19),(727.36 ± 120.45) yuan to (30.03 ± 1.34),(609.32 ± 48.83) yuan,respectively.There still were some problems,including lacking of economic intervention for drug use,lacking of multi-disciplinary collaborative management,imperfect information system,etc.,which delayed the promotion of professional antibiotics management.CONCLUSIONS:Referring to AMS strategy,the hospital should establish multidisciplinary management mechanismto strengthen the process management of antibiotics use.The role of information system in the management of antibiotics use should be given full play,and the intervention of antibiotics use economy should be increased so as to realize the specialization of antibiotics management process.

10.
Article in Chinese | WPRIM | ID: wpr-515505

ABSTRACT

Objective To explore the long-term outcomes and complications of patients with hematological malignancies (HM) after haploidentical donor transplantation (HDT) or siblingidentical donor transplantation (SDT).Methods From June,2011 to July,2016,89 patients with HM receiving allo-HSCT were retrospectively analyzed,including 57 patients undergoing HDT and 32 cases undergoing SDT.Results The median time to achieve neutrophil engraftment was 2 days shorter after HDT than SDT,whereas that of platelet engraftment was 3 days longer after HDT than SDT.The cumulative incidence for 3 to 4 grade acute graft-versus-host disease (GVHD) was not obviously different between HDT and SDT (8.77% versus 12.5% respectively;x2 =0.313,P =0.576).The cumulative incidence for chronic GVHD was not significantly different between HDT and SDT (45.6% versus 37.5%;~ =0.551,P =0.458).Cytomegalovirus (CMV) reactivity was significantly higher in patients after HDT (77.19%) than those after SDT (21.88%) (x2 =25.633,P<0.001).The occurrence of hemorrhagic cystitis was also obviously higher in patients after HDT (26.32%)than those after SDT (3.85%) (x2 =5.340,P =0.021).The 1-,2-,and 3-year relapse-free survival rate of patients receiving HDT and SDT was 63.9%,55.4%,44.3% and 71.2%,58.3%,51.8%,respectively (P =0.541).The 1-,2-,and 3-year overall survival rate of patients receiving HDT and SDT was 75.3%,65.3%,52.3% and 76.9%,62.9%,62.9%,respectively (P =0.777).Conclusion Considering similar incidence of severe GVHD and long-term outcomes,haploidentical donors should be recommended as a potential alternative donor source when an identical donor is lacking for patients with HM.

11.
Chinese Journal of Immunology ; (12): 1809-1814, 2016.
Article in Chinese | WPRIM | ID: wpr-506627

ABSTRACT

Objective:To investigate the expression and prognostic significance of CD19 in patients with Acute myelogenous leukemia with AML1-ETO positive. Methods: Clinical data of 66 patients AML with AML1-ETO positive who were newly diagnosed from Jan 2010 to Dec 2015 were collected. To retrospectively analyze the relationship between clinical characteristics and expression of CD19,so dose the prognosis. Results:The positive rate of CD19 expressing in AML with AML1-ETO positive was 50. 0%. There were no statistically significant differences in terms of age,gender,hemoglobin,platelet,percentage of bone marrow blasts,accompanied with chromosome ,gene mutations between patients with and without CD19 expression(P>0. 05). The white blood cell count(WBC) of the CD19 negative group was higher than CD19 positive group,while showed significant difference(P=0. 027). Although the relapse-free survival (RFS) of patients with CD19 expression was higher than those without,no significant difference was calculated (P=0. 105). Patients with CD19 expression had superior overall survival ( OS ) compared to those without CD19 expression ( P = 0. 030 ) . Multivariable analysis for OS identified CD19 positivity as an independent predictor associated with better prognosis. Conclusion: The expression of CD19 in AML with AML1-ETO positive may be an indicator associated with better prognosis.

13.
Article in Chinese | WPRIM | ID: wpr-494814

ABSTRACT

Objective To analyze the distribution characteristics and drug resistance change of acinetobacter baumannii in prima‐ry hospital during 2005-2014 to provide reference for clinical rational drug use .Methods The infection characteristics of acineto‐bacter baumannii in primary hospital during 10 years and its resistance to 10 kinds of common antibacterial drugs was analyzed .Re‐sults A total of 576 strains of acinetobacter baumannii were isolated during 2005-2014 ,accounting for 31 .44% of all Gram nega‐tive bacteria ,which was significantly higher than that of Escherichia coli ,pseudomonas aeruginosa and klebsiella pneumonia bacillus (P<0 .05);446 strains were mainly originated from the sputum specimens (77 .43% ) and 290 strains(50 .35% ) from ICU ;the re‐sistant rate was 44 .44% for CSL ,62 .24% for MIN and more than 70 .00% for 8 kinds of antibacterial drugs of IPM ,MEM ,etc .;which to IPM ,CAZ ,SXT showed the declining trend year by year ,while which to MEM ,AMK ,LEV ,MIN showed the rising trend year by year .Conclusion The isolated acinetobacter baumannii strains in primary hospital are rised year by year ,and generally have resistance to commonly used antibacterial drugs ,the clinical doctors should rationally select antibacterial drugs according to the drug susceptibility test results for preventing the occurrence of acinetobacter baumannii infection .

14.
China Pharmacy ; (12): 2746-2751,2752, 2016.
Article in Chinese | WPRIM | ID: wpr-605699

ABSTRACT

OBJECTIVE:To provide reference for rational use of respiratory inhalants. METHODS:The utilization of respiratory inhalants in 34 hospitals from Nanjing area during 2012-2014 was analyzed by SPSS13.0 software in respects of DDDs,consumption sum,DDC,health insurance and self-paying cost and so on. RESULTS:Respiratory inhalants involved 4 kinds of drugs, 5 kinds of dosage forms,12 kinds of general name and 38 kinds of trade name(specification)in 34 hospitals from Nanjing area during 2012-2014. The total DDDs and total consumption sum of respiratory inhalants increased from 10 827.46×103 and 71,006, 500 yuan in 2012 and 14 627.25×103 and 99,137,100 yuan in 2014,there was no statistical significance(P>0.05). 4 categories of respiratory inhalants in the list of DDDs were anticholinergic agents,compound preparations,glucocorticoid and β2 receptor agonists; DDDs of each type increased year by year,but only that of anticholinergic agents had statistical significance(P0.05). 5 kinds of inhalants in the list of DDDs were aerosol preparation,power aerosols,atomizing solution,nasal spray and clickhaler. DDDs of aerosol preparation and power aerosols increased year by year,with statistical significance(P<0.05). Top one in the list of consumption sum was power aerosols during 2012-2013 and atomizing solution in 2014;power aerosols took up the first place in the list of total consumption in 3 years. Among 12 kinds of general name inhalants,top 4 inhalants in the list of DDDs were ipratropium bromide,salmeterol and fluticasone, albuterol and budesonide,and the constituent ratio of their total DDDs in 3 years were 40.16% ,16.71% ,13.51% and 13.39%,respectively;the sum of constituent ratio of total DDDs in 3 years was more than 80%. Top 3 inhalants in the list of consumption sum were budesonide,salmeterol and fluticasone, budesonide and formoterol,and the sum of constituent ratio of their total consumption sum in 3 years were 39.59%,20.81% and 12.50% ,respectively;the sum of constituent ratio was more than 70% . DDC of salbutamol was the lowest. Among 38 kinds of trade name(specification)inhalants,the type and cost of health insurance accounted for 92.11% and 95.02% .Pulmicort atomization suspension and Symbicort Turbuhaler(160 μg)took up the first place in the list of health insurance cost and self-paying cost respectively,and they were B directory of health insurance. CONCLUSIONS:The utilization of respiratory inhalants was basically reasonable in 34 hospitals from Nanjing during 2012-2014.

15.
Practical Oncology Journal ; (6): 221-224, 2015.
Article in Chinese | WPRIM | ID: wpr-499387

ABSTRACT

Objecitive Under the fluorescent microscope ,we used fluorescein sodium fluorescence to determine glioma boundary ,thus gliomas removed through surgery more thoroughly .Mtehods We randomly se-lected 14 patients who were admitted in the First Hospital of JiLin University as the research objects ,patients with glioma were diagnosed as glioma according to the physical signs ,physical examination a,nd imaging findings before surgery.Diagnosed with glioma,intraoperative application of fluorescein sodium yellow fluorescence was deter -mined the tumor boundary ,and removal of the tumor ,according to the fluorescence intensity strength is different . The pathological diagnosis was to determine the boundary of fluorescent was accurate .Postoperative examined MRI was performed in order to make clear the excision of the tumor ,and the neurological condition of postoperative was observed.Results Glioma could be inspired by yellow fluorescence under fluorescent microscope .The normal brain tissue was not light .Postoperative pathological results showed that the fluorescent yellow area contained a lot of glioma cells,pale yellow fluorescence area found a small amount of glioma cells .Postoperative enhanced MRI scan had confirmed that application of fluorescein sodium could be more thoroughly resection of glioma ,postopera-tive dysfunction was reduced .Conclusion This method is prior to tumor boundary observasion without fluoresent staining and reducing the recurrence of the tumor and reducing the normal brain tissue damage ,and therefore,im-proving the quality of postoperative survival of patients .

16.
Article in Chinese | WPRIM | ID: wpr-288019

ABSTRACT

OBJECTIVE To assess the value of quantitative fluorescence PCR (QF-PCR) for the prenatal diagnosis of common fetal chromosomal aneuploidies. METHODS A total of 2436 amniotic fluid samples were collected at 18 to 22 gestational weeks. Multiplex QF-PCR was performed with fluorescence-labeled primers specific for 32 polymorphic short tandem repeat (STR) sites on chromosomes 21, 18, 13, X and Y. The PCR products were assayed by capillary electrophoresis. All samples were also assayed by karyotyping. RESULTS Seventy-six (3.12%) samples were diagnosed as chromosomal aneuploidies by QF-PCR, among which 51 were trisomy 21, 12 were trisomy 18, 2 were trisomy 13, and 1 was triploidy. The results were all consistent with those of karyotyping. Ten samples were suspected as sex chromosomal aneuploidies, among which 9 were confirmed, except for 1 case with X structural abnormality. In addition, karyotyping has diagnosed 24 (0.99%) cases of structural abnormalities, only one of which was suspected by QF-PCR with partial abnormal STR results. Two (0.08%) samples were found to be mosaic by karyotyping, one of which was suggested by QF-PCR with cut-off ratios of STR markers. CONCLUSION QF-PCR is reliable for the diagnosis of numerical abnormalities of chromosomes 21, 18, 13, X and Y. The method can serve as an effective technique for rapid prenatal screening of common chromosome aneuploidies in fetus.


Subject(s)
Aneuploidy , Female , Fluorescence , Humans , Microsatellite Repeats , Polymerase Chain Reaction , Methods , Pregnancy , Prenatal Diagnosis , Methods
17.
Chinese Medical Journal ; (24): 290-293, 2014.
Article in English | WPRIM | ID: wpr-317998

ABSTRACT

<p><b>BACKGROUND</b>Rapid clearance of peripheral blood blasts (PBBs) predicts complete remission (CR) and survival in patients with acute myeloid leukemia (AML). We aimed to explore the correlation between induction therapy response, outcome, and the PBB percentage.</p><p><b>METHODS</b>Forty-six consecutive patients with de novo AML (excluding acute promyelocytic leukemia) were enrolled in this study. Flow cytometry was performed to identify cells with a leukemia-associated aberrant immunophenotype in the initial bone marrow aspirate and in peripheral blood on day 7 of induction therapy.</p><p><b>RESULTS</b>The PBB percentage on day 7 (D7PBBP) was significantly lower in patients who achieved CR (0.03% (0.0%, 0.45%)) than in those who did not (10.85% (1.13%, 19.38%); u = -3.92, P < 0.001). The CR rate was significantly higher among patients with a D7PBBP of <0.945% (84.62%, 22/26) than among those with a D7PBBP of = 0.945% (25.0%, 5/20; χ2 = 16.571, P < 0.001). D7PBBP was significantly correlated with overall survival (OS; r = -0.437, P = 0.003) and relapsefree survival (RFS; r = -0.388, P = 0.007). OS and RFS were significantly higher in patients with a D7PBBP of <0.43% than in those with a D7PBBP of ≥ 0.43% (P < 0.001 and P = 0.039, respectively). D7PBBP was also found to be an independent prognostic indicator in multivariate analysis for both OS (P = 0.036) and RFS (P = 0.035).</p><p><b>CONCLUSION</b>D7PBBP may be an important risk factor for the achievement of complete remission, for overall survival, and for relapse-free survival.</p>


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Antineoplastic Agents , Antineoplastic Combined Chemotherapy Protocols , Blast Crisis , Drug Therapy , Child , Cytarabine , Therapeutic Uses , Female , Flow Cytometry , Humans , Idarubicin , Therapeutic Uses , Immunophenotyping , Induction Chemotherapy , Leukemia, Myeloid, Acute , Drug Therapy , Mortality , Male , Middle Aged , Neoplasm Recurrence, Local , Drug Therapy , Young Adult
18.
Article in Chinese | WPRIM | ID: wpr-291777

ABSTRACT

<p><b>OBJECTIVE</b>To assess the value of multiplex ligation-dependent probe amplification (MLPA) for the genetic and prenatal diagnosis of Duchenne/Becker muscular dystrophy (DMD/BMD).</p><p><b>METHODS</b>Forty seven patients clinically diagnosed or suspected with DMD/BMD were recruited. Deletion or duplication of the 79 exons of the DMD gene were detected by MLPA. PCR and sequencing were used to detect single exon deletion. MLPA was also used for identifying carriers. For cases requesting prenatal diagnosis, short tandem repeat (STR) capillary electrophoresis, linkage analysis and MLPA were applied to determine fetal DMD gene.</p><p><b>RESULTS</b>Among the 47 patients, deletions and duplications encompassing one or more exons were identified in 31 and 7 cases with MLPA, respectively. Seven patients had single exon deletions. However, one of which was actually a point mutation in the probe-conjugated region and was confirmed by PCR and sequencing. Of the 23 mothers with MLPA positive sons, 13 were found to carry either deletions or duplications. Prenatal diagnosis has identified 2 male affected fetuses and 3 female carrier fetuses in the 13 cases examined, which was in conformity with linkage analysis.</p><p><b>CONCLUSION</b>Our data demonstrated that MLPA is a rapid, direct and reliable method for detecting deletions or duplications of the DMD gene. It can also indicate small changes within the sequences detected by the probe. Combing MLPA with PCR, sequencing and linkage analysis could make the genetic diagnosis of DMD/BMD more accurate.</p>


Subject(s)
Adolescent , Base Sequence , Child , Child, Preschool , Exons , Female , Fetal Diseases , Diagnosis , Genetics , Gene Deletion , Genetic Testing , Methods , Humans , Infant , Infant, Newborn , Male , Molecular Sequence Data , Multiplex Polymerase Chain Reaction , Methods , Muscular Dystrophy, Duchenne , Diagnosis , Embryology , Genetics , Mutation , Pregnancy , Prenatal Diagnosis , Methods , Young Adult
19.
Article in Chinese | WPRIM | ID: wpr-424534

ABSTRACT

ObjectiveTo investigate the variation of peripheral blood CD34+ cells during the hematopoietic stem cell mobilization,and its influence on the collecting timing and results.Methods Twenty-seven cases of peripheral blood hematopoietic stem cell mobilization and collection from April 2010 to December 2011 were analyzed,including 13 autologous cases mobilized with chemotherapy combined with granulocyte colony-stimulating factor (G-CSF,10 μg· kg-1 · d-1) and 14 cases of healthy donors mobilized with only G-SCF (7.5 μg · kg- 1 · d- 1 ).The number of peripheral blood CD34+ cells was counted,and its correlation with the yield of mononuclear cells (MNCs) and CD34+cells was analyzed.ResultsMNCs (5.84 ± 1.48) × 108/kg and CD34+ cells (3.93 ± 2.16) × 106/kg were obtained in healthy donors,and (6.58 ± 3.72) × 108/kg MNCs and (3.98 ± 3.06) × 106/kg CD34+ cells were obtained in autologous cases,respectively.There was only 1 failure in autologous cases.The peak of peripheral blood CD34+ cells in autologous cases appeared at day 4 after the treatment of G-CSF,and in healthy donors the number of peripheral blood CD34+ cells at day 5 was still in ascendant phase.The CD34+ cells/kg in the collection products were positively correlated with the percentage and absolute value of peripheral blood CD34+ cells.The cases ratio of CD34+ cells≥2× 106/kg in the products of single collection was up to 76.2% (16/21) in the cases with peripheral blood CD34+ cells absolute value greater than 20/μl.ConclusionThe number of peripheral blood CD34+ cells was an important monitoring indicator in hematopoietic stem cell mobilization and collection,CD34+ cell absolute value ≥20/μl could be used as collection threshold.

20.
Article in Chinese | WPRIM | ID: wpr-385089

ABSTRACT

Objective To evaluate the protective effect of Ulinastatin on pathological changes of lung induced by paraquat (PQ) intoxication in rats. Method Sixty female SD rats were randomly and equally divided into three groups ( n = 20 in each group). On the experimental day, the rats of group A (control group) received 1 mL of saline intragastrically; the rats of group B (PQ, group) received 1 mL of PQ intragastrically (40 mg/kg diluted in saline) and then treated with saline injected intraperitoneally once a day, and the rats of group Group C (Ulinastatin treatment group) received 1 mL of PQ intragastrically (40 mg/kg,diluted in saline) and then treated with 1 mL of Ulinastatin ( 120 000 IU/kg) intraperitoneally twice a day. The rats ( n = 5 in each subgroup) were sacrificed on the 7th, 14th, 21st, and 28th day for observing the histopathological changes of the lung stained with hematoxylin-eosin stain (HE) and Masson's trichrome stain. Data were semi-quantitatively analyzed by SPSS10.0 software. Hierarchical data were analyzed by rank and inspection. The data that have significance analyzed by comparison test (Bonferroni methods). Results Paraquat intoxication resulted in significant alveolitis and lung fibrosis. Ulinastatin treatment alleviated lung edema, hemorrhage, inflammatory cell infiltration, and fiber aggregation. Conclusions These data demonstrated the Ulinastatin exerted protective effects against PQ-induced lung injury. Ulinastatin could to be used in clinical management for PQ intoxication.

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