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1.
Article in Chinese | WPRIM | ID: wpr-912836

ABSTRACT

Objective:To investigate the health status, health-related behaviors and health needs of elderlies in eastern, central and western China and to understand their health experience, for exploring an efficient medical service model, and optimizing allocation of medical resources.Methods:This study used the 2008-2018 database from Chinese longitudinal healthy longevity survey organized by Peking University. It described the concentration trend of medical distance by median, compared the health status, health-related behaviors and health needs of the elderly in eastern, central and western China by χ2 tests, and analyzed time-distribution trends of the poor health status, negative health behaviors and health needs by linear relation test. Results:Among 49 611 subjects included in the study, 7 881 of them self-evaluated their health status as poor, 19 445 evaluated their recent health status as deteriorated, while 14 954 lack routine physical examination, 35 141 lack physical exercise, 8 178 smoked, 7 859 drunk, 35 814 had no access to health education services in their communities, 35 676 expressed their health education needs, and 2 637 lack adequate medical services. The difference of distribution of health status, health-related behaviors and health needs of the elderly in eastern, central and western China was statistically significant ( P<0.05). The health status, negative health behaviors and health needs of the elderly in 2008-2018 presented a linear time distribution trend( P<0.05), while the overall medical distance in eastern, central and western China was 1.02 km, 1.00 km and 1.56 km respectively, and the medical distance in the rural area further than that in the urban areas. Conclusions:The health status of the elderly in China needed to be further improved, the proportion of negative health behaviors was high, and the health needs of the elderly in central and western China were large. Promoting an active medical service mode in central and western China, strengthening the interactions between medical institutions and residential communities will contribute to health needs fulfillment and medical resource utilization.

2.
Article in Chinese | WPRIM | ID: wpr-912456

ABSTRACT

Detection of serum biomarkers is an important strategy for the diagnosis of cardiovascular diseases. The roles of serum biomarker detection have become increasingly valuable in the baseline risk stratification among cancer patients in recent years. The Cardio-oncology Study Group of the Heart Failure Association and the Cardio-Oncology Council of the European Society of Cardiology newly proposed the “role of serum biomarkers in cancer patients receiving cardiotoxic cancer therapies”. By evaluating the characteristics of cardiac biomarkers in cancer patients receiving cardiotoxic cancer therapy, this statement discussed the mechanism, clinical application, value on monitoring and prognosis of the two main biomarkers,cardiac troponin and natriuretic peptide on chemotherapy induced cardiac toxic responses. The purpose of this statement is to help establish the multidisciplinary collaborative diagnosis and treatment strategies and provide a clinical framework, and guide clinicians to select appropriate serum biomarker monitoring programs based on risk stratification to prevent cardiovascular disease in cancer patients.

3.
Article in Chinese | WPRIM | ID: wpr-911438

ABSTRACT

To analyze the prognostic factors of extramedullary relapse (EMR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute lymphoblastic leukemia (ALL).The clinical data of 33 relapsed patients in 95 ALL patients receiving allo-HSCT were analyzed retrospectively. The median time of relapse was 5.7 (0.7-52.3) months. Extramedullary relapse was recorded in 10 cases (10.5%), bone marrow relapse in 15 cases (15.8%), and both extramedullary and marrow relapse were seen in 8 cases (8.4%). The median time of EMR was 7.4(0.7-52.3) months. The most commonly involved organ was central nervous system, followed by testis and bone. The 3-year OS rate in EMR patients was (33.3±11.1) %. Univariate analysis showed that disease state before transplantation ( P=0.026), extramedullary infiltration before transplantation ( P=0.005), conditioning regimens ( P=0.033) and acute graft-versus-host disease(aGVHD) ( P=0.013) were significantly correlated with EMR. Multivariate analysis suggested that extramedullary infiltration ( RR=5.067, 95 %CI1.542-16.645, P=0.007) and aGVHD( RR=3.585, 95 %CI1.245-10.320, P=0.018) were independent predictive factors of EMR in ALL patients after allo-HSCT.

4.
Article in Chinese | WPRIM | ID: wpr-885138

ABSTRACT

Objective:To evaluate risk factors and available treatments of extramedullary relapse (EMR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myeloid leukemia.Methods:A total of 280 patients were retrospectively analyzed from January 2008 to December 2018 in Affiliated Cancer Hospital of Zhengzhou University. Clinical data were collected including disease patterns, pre-transplantation status, chromosome karyotype, conditioning regimen, types of donor, extramedullary disease before transplantation and graft-versus-host disease (GVHD). The log-rank test and Cox proportional hazard model were uesd for univariate analysis and multivariate analysis, respectively.Results:Twenty patients developed EMR (7.14%). The median time of EMR was 7.5 (1-123) months after allo-HSCT. The mortality of EMR was 80% (16/20). Univariate analysis identified disease patterns, second complete remission (CR2) or progressive disease before transplantation, extramedullary disease, abnormal karyotype and conditioning regimen without total body radiation as significant factors correlated to EMR ( P<0.05). Multi-variable analysis revealed that CR2 or progressive disease ( RR=3.468,95% CI 2.189-7.786), abnormal karyotype ( RR=1.494,95% CI 1.020-2.189) and extramedullary disease before transplantation ( RR=8.627,95% CI 3.921-18.452) were independent risk factors of EMR. Conclusions:The clinical outcome of EMR after allo-HSCT is poor.It is crucial to comprehensively assess and identify EMR as early as possible.

5.
Article in Chinese | WPRIM | ID: wpr-883572

ABSTRACT

Phased national medical licensing examination requires clinical students to have the ability to apply basic medical knowledge to solve comprehensive clinical problems. But the traditional teaching patterns of Medical Microbiology experiments can no longer meet requirements of actual education effect. In order to accommodate new situation, we have integrated medical licensing examination with microbiology experimental teaching syllabus and contents. We have also comprehensively applied a variety of teaching methods and curriculum formative assessment in class. These reforming methods have efficiently improved classroom teaching effect and greatly inspired the enthusiasm of students, and effectively improved early clinical thinking ability and innovation ability of students.

6.
Article in Chinese | WPRIM | ID: wpr-876477

ABSTRACT

Objective To investigate the epidemiological characteristics of acute myocardial infarction (AMI) in Yichang City in the last 5 years, and to provide a basis for targeted prevention and treatment. Methods The annual estimated percentage was used to evaluate the trend of morbidity and mortality of AMI by using the monitoring data from 2015 to 2019 from the health big data platform of Yichang. Results There were 1 976 new cases of AMI in Yichang from 2015 to 2019, with a crude morbidity of 41.96/100 000, and standardized morbidity of 87.52/100 000. Among them the crude incidence rate in males was 57.69/100 000, and 29.84/100 000 in females. The difference was statistically significant (χ2=15.76, P2=45.65, P<0.001). The morbidity and mortality of males and females were increased with age. Conclusion From 2015 to 2019, the morbidity of AMI in Yichang was at a moderately low level in China, but the mortality was higher than the national average. The morbidity showed an upward trend, with men and elderly people aged ≥60 being more serious. Appropriate intervention measures should be taken for different groups of people to reduce the incidence of AMI.

7.
Journal of Chinese Physician ; (12): 1524-1528, 2020.
Article in Chinese | WPRIM | ID: wpr-867434

ABSTRACT

Objective:To analyze the pathological features of facioscapulohumeral muscular dystrophy (FSHD). For better characterization of inflammatory response in FSHD, we performed histochemical morphological analysis for FSHD and polymyositis (PM) muscle biopsies.In order to provide a reference for guide targeted therapeutic interventions.Methods:The clinical and myopathological data of 30 patients with FSHD from January 2006 to January 2019 in the Sixth Hospital of Shanxi Medical University and the first hospital of Jilin University were retrospectively analyzed. The patients were divided into non-inflammatory infiltration group (16 cases) and inflammatory infiltration group (14 cases) according to the presence or absence of inflammatory cell infiltration. For better characterization of inflammatory response in FSHD, we performed histochemical morphological analysis for two groups of muscles: FSHD and PM muscle biopsies, using Image-Pro plus bioanalytical software.Results:In 30 cases of FSHD, 14 cases showed intramuscular and interstitial inflammatory cell infiltration, especially around the blood vessels. Immunohistochemical staining confirmed that the infiltration of inflammatory cells was mainly CD4 + T lymphocytes. Morphometric analysis showed that there were no significant differences in muscle fiber surface area, density, diameter, inflammatory cell infiltration, regeneration and necrosis between FSHD patients and PM patients ( P>0.05). The total area of myointerstitium in FSHD group was significantly larger than that in PM group ( P=0.03). Conclusions:The pathological morphometric analysis showed that the proliferation of interstitial connective tissue in FSHD inflammatory cell infiltration group was significantly more than that in PM group. Clinicians can identify the two from pathology and provide help for clinical practice.

8.
Article in Chinese | WPRIM | ID: wpr-864285

ABSTRACT

Objective:To investigate the normal range of exhaled nitric oxide (FeNO) in 6-18-year-old children in China, so as to provide a data base for the establishment of FeNO standards for Chinese children.Methods:A multi-center study was conducted on 5 949 children aged 6-18 (3 101 males and 2 848 females) in 16 pro-vinces of 7 administrative districts in China.According to the technical standard recommended by American Thoracic Society/European Respiratory Association, FeNO was measured, and the relationship of FeNO with the sex, age, height, weight, body mass index and region was discussed.Results:The geometric mean FeNO value of Chinese children aged 6-18 was 14.1 ppb, and its 95% confidence interval (skewness distribution) was 1.0-38.2 ppb.The geometric mean FeNO values of children aged 6-11 and 12-18 were 13.1 ppb and 15.7 ppb, respectively, and their 95% confidence intervals (skewness distribution) were 1.0-38.1 ppb and 2.0-38.2 ppb.For children at and under 11 years old, FeNO decreased with age, with a mean decline of 1 ppb per year.The multiple linear regression results suggested that there was a significant correlation between FeNO and age for children aged 6-11, and FeNO of children aged 12-18 was significantly correlated with the gender, height, and region(all P<0.01). Conclusions:FeNO values of Chinese children and adolescents in this study are higher than those obtained by the previous study conducted from 2010 to 2012.For children aged 12-18, 16 ppb is recommended as the clinical cut-off point.For children at or under 11 years old, the influence of age on FeNO should be considered, and the cut-off point of FeNO decreases by 1 ppb as the age is reduced by one year.

9.
Article in Chinese | WPRIM | ID: wpr-863619

ABSTRACT

Objective:To evaluate the clinical effect of Changzhi-Xiaoyuan Decoction auxiliary nasal endoscopic surgery for radioactive sinusitis. Methods:A total of 90 patients with radioactive sinusitis included inour hospital from May 2016 to June 2018 were divided into two group according to the random number table method, 45 in each group. The control group was treated with nasal endoscopic surgery, nasopharyngeal flushing after the surgery andoral clarithromycin. The observation group was treated with Changzhi-Xiaoyuan Decoction on the basis of the control group. Both groups were treated for 2 months, following up for 12 months. Before and after the treatment, for clinical symptom scores, using the modified Lund Mackay Postoperative Endoscopic Score (MLMES) respectively from bilateral maxillary sinus, Ethmoid sinus, frontalsinus, sphenoidsinus, olfactory cleft state of mucous membrane inflammation and mucus secretion and purulent secretion evaluation; tested the cilia transmission rateand clinical efficacy were evaluated. Results:The total effective rate of observation group was 91.1% (41/45), and the control group was 64.4% (29/45). There was statistically significant difference between two groups ( χ2=7.779, P=0.005). After the treatment, stuffy nose, turbinate swelling, nasal secretions, hyposmia, headaches scores of the observation group were significantly lower than those of the control group ( t value were 3.558, 5.582, 5.367, 7.442, 7.115, respectively, all Ps<0.01), the MLMES score was significantly lower than that of the control group ( t=4.762, P<0.01). After the treatment, cilia transmission rate (4.42 ± 0.51 mm/min vs. 3.87 ± 0.38 mm/min, t=5.801) of the observation group was significantly higher than that of the control group ( P<0.01). Conclusions:The Changzhi-Xiaoyuan Decoction combined with auxiliary nasal endoscopic surgery can reduce symptoms of radioactive sinusitis patients with sinus, restore the function of nasal mucosa, and enhance the clinical curative effect.

10.
Chinese Journal of Dermatology ; (12): 519-524, 2020.
Article in Chinese | WPRIM | ID: wpr-870315

ABSTRACT

Objective:To investigate the physiological role of F1Fo-ATP synthase α-subunit encoding gene (ATP1) in promoting Candida albicans ( C. albicans) to escape from macrophage killing through eliminating intracellular reactive oxygen species (ROS) by using a reverse genetics approach. Methods:An ATP1 deletion strain and a parental strain of C. albicans were cultured on the YPD media, and the number of formed colonies on the plates was counted to evaluate in vitro viability of C. albicans. To evaluate their in vivo viability, the ATP1 deletion strain and parental strain of C. albicans were inoculated into mice through the caudal vein, kidney tissues were taken out from the mice 1-7 days after the infection, and inoculated onto the YPD medium followed by numeration of colonies after 48 hours of culture. After co-culture of overnight-cultured C. albicans suspensions with macrophages, some of the C. albicans suspensions were inoculated onto the YPD solid medium followed by numeration of colonies and determination of survival rate, and some culture supernatants were inoculated into the 96-well plate for detection of the level of lactate dehydrogenase (LDH) released by macrophages by LDH release assay. A model mimicking oxidative stress in macrophages was established by using hydrogen peroxide. After treatment with hydrogen peroxide, the number of colonies was counted to compare the viability of the C. albicans strains. DCFH-DA staining was conducted to detect the intracellular ROS level in C. albicans after co-culture with macrophages or treatment with hydrogen peroxide, and real-time fluorescence-based quantitative PCR to measure mRNA expression of catalase 1 (CAT1) , superoxide dismutase 4 (SOD4) and SOD5 genes in C. albicans after treatment with hydrogen peroxide. Statistical analysis was carried out by using two-way analysis of variance or Student t test. Results:In vitro, the colony number in both the parental strain group and ATP1 deletion strain group gradually increased over time; after 24 hours, the colony number of the ATP1 deletion strain group was only 10% of that in the parental strain group ( F = 481.84, P < 0.001) . The number of colony formed by the parental strain-infected mouse kidney tissues gradually increased over time, but that by the ATP1 deletion strain-infected mouse kidney tissues gradually decreased, and there was a significant difference between the two groups ( F = 78.27, P = 0.001) . After in vitro co-culture of C. albicans with macrophages, the survival rate in the ATP1 deletion strain group (62.67% ± 3.51%) was significantly lower than that in the parental strain group (82.33% ± 2.52%, t = 7.88, P = 0.001) , and the percentage of LDH released by macrophages was also significantly lower in the ATP1 deletion strain group (27.80% ± 3.54%) than in the parental strain group (87.78% ± 0.17%, t = 33.89, P < 0.001) , which were consistent with the in vivo results. In the model mimicking oxidative stress, the viability of the ATP1 deletion strain group was significantly lower than that of the parental strain group ( F = 3 440.65, P < 0.001) . Both in the co-culture model with macrophages and in the model mimicking oxidative stress in macrophages, the intracellular ROS levels were significantly higher in the ATP1 deletion strain group than in the parental strain group (both P < 0.001) . Furthermore, the mRNA expression of CAT1, SOD4 and SOD5 genes was significantly lower in the ATP1 deletion strain group than in the parental strain group after treatment with hydrogen peroxide (all P < 0.001) . Conclusion:ATP1 deletion may reduce the capabilities of C. albicans to counteract oxidative stress and eliminate ROS, likely by down-regulating the expression of oxidative stress- and ROS clearance-related genes respectively, which may prevent C. albicans from escaping from the macrophage killing and lead it to be eliminated by the host ultimately.

11.
Article in Chinese | WPRIM | ID: wpr-872347

ABSTRACT

Objective:To conduct data mining on hospital accreditation results for inspirations and clues in hospital management.Methods:The Apriori function contained in the arules package of R software was used to extract the association rules. This practice aimed to analyze association rules of the accreditation results of 56 tertiary hospitals which were made based on tertiary hospital accreditation standard(2011)and Detailed Rules from 2017 to 2019; to explore the correlation between the clauses, and analyze the inspirations for hospital management.Results:A total of 6 566 138 and 247 rules were generated for all clauses and core clauses, receptively. The top 10 rules sorted by lift were selected as strong association rules. Among them, the minimum lift of all clauses and core clauses was 1.41 and 1.53, respectively. There was a strong correlation between the establishment of a quality and safety management team in the hospital and the development & implementation of relevant regulations by the hospital. There were strong correlations among emergency service procedure and regulations, patient rights to know, responsibility system by the first one to receive a complaint, medical safety(adverse)event reporting, development & implementation of antimicrobial management system, as well as training for prevention of multi-drug resistance infection measures, and multi-drug resistance infection hospital infection control system.Conclusions:This study suggested that hospital management should highlight the correlation between regulations development and staffing, that between indicator systems and monitoring feedback systems, and that between indicators in different sectors in the medical process. These correlations can be used as management clues and inspirations for hospital management.

12.
Article in Chinese | WPRIM | ID: wpr-800764

ABSTRACT

Objective@#To investigate the influence of additional clonal chromosome abnormalities in Ph negative cells (CCA/Ph-) on the efficacy of chronic myeloid leukemia (CML) after tyrosine kinase inhibitors (TKI) treatment.@*Methods@#The clinical data of 28 CML patients with CCA/Ph- treated in Henan Cancer Hospital from July 2014 to December 2017 were analyzed retrospectively. The univariate analysis was carried out by Kaplan-Meier method. Multivariate analysis was done by Cox proportional risk model.@*Results@#A total of 28 CCA/Ph-patients were recruited including 17 males and 11 females with median age of 42.5 years old. The most common CCA/Ph-were trisomy 8 (60.7%), monosomy 7 (14.3%). 64.3% CCA/Ph-were transient and 35.7% recurrent (more than 2 times). Cytopenia in two or three lineages of peripheral blood was seen in 42.9% patients. As to the efficacy, 89.3% patients achieved major cytogenetic response (MCyR), 25% with major molecular response (MMR). The median follow-up time was 26.5 months. Treatment failure (TF) of TKI occurred in 32.1% patients with median duration of response 8 (1-41) months. Univariate analysis showed that TF rate was significantly correlated with the frequency of CCA/Ph-and cytopenia (all P<0.05). The MMR rate was also significantly correlated with cytopenia (P<0.05). Cytopenia of two lineages or pancytopenia was an independent risk factor related to MMR rate (RR=3.868, 95%CI 1.216-12.298, P=0.022) .@*Conclusions@#Cytopenia in CCA/Ph-appears to be an independent risk factor of MMR in CML patients with TKI treatment. The recurrent CCA/Ph-may link to higher treatment failure rate. Drug withdrawal or alternative strategy should be considered according to response and the ABL kinase mutations.

13.
Chinese Journal of Hematology ; (12): 986-989, 2019.
Article in Chinese | WPRIM | ID: wpr-800483

ABSTRACT

Objective@#To observe the pregnancy outcome among patients with chronic myeloid leukemia (CML) treated with Nilotinib (NIL) .@*Methods@#Clinical data of pregnancy delivery in CML patients treated with NIL from March 2015 to January 2019 were retrospectively collected.@*Results@#A total of 11 patients were recruited with median pregnancy age 28 (25-40) years. The median duration of NIL treatment before pregnancy was 34 (3-48) months. There were 12 pregnancies, included 2 planned ones and 10 (83.3%) unplanned. In the 10 unplanned patients, 9 (90.0%) received NIL 600 mg/d. The median exposure time were 4 (4-7) weeks. In eight patients with delivery outcomes, 5 cases had well-developed babies, 2 had spontaneous abortion and 1 case with an baby of syndactyly deformity, whose mother was exposed to NIL 600 mg/d for 7 weeks in the early trimester of pregnancy. Seven infants were 4 boys and 3 girls with the median height at birth 50 (41-54) cm and median weight 3.2 (3.0-4.6) kg. They all grew with a normal pattern and well developed. Now the median age is 19 (4-41) months. The disease status during 12 pregnancies included 3 cases in CMR, 2 cases in MR4.0, 3 cases in MMR, 4 cases not acquiring MMR. The median time of drug discontinuation was 35 (15-36) weeks during pregnancy. No patient lost CHR during this period.@*Conclusions@#Female CML patients exposed to NIL 600 mg/d for 4 weeks in early pregnancy can give birth to normal babies, but there is still a risk of spontaneous abortion and congenital malformations.

14.
Chinese Journal of Hematology ; (12): 738-743, 2019.
Article in Chinese | WPRIM | ID: wpr-797983

ABSTRACT

Objective@#To explore the clinical efficacy and prognostic factors of first-generation and second-generation tyrosine kinase inhibitors (TKI) based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia (ALL) .@*Methods@#Retrospectively analyze the clinical characteristics and prognostic factors of 89 patients with BCR-ABL positive ALL from April 2012 to June 2018 in our hospital, the clinical efficacy of first-generation and second-generation TKI was compared.@*Results@#60 patients were classified into the first-generation TKI (imatinib) group, and 29 patients were in the second-generation TKI (dasatinib) group. There were no significant differences in gender, age, WBC, hemoglobin concentration, PLT, chromosomal karyotype, the types of fusion genes, allogeneic hematopoietic stem cell transplantation (allo-HSCT) and TKI initiation time between the two groups. The first-generation and second-generation TKI groups, for which the complete remission (CR) rate at the fourth week of induction therapy was 83.3% and 89.7% (P=0.637) , respectively, and the complete molecular remission (CMR) was 48.3%and 58.6% (P=0.363) , respectively, the difference was not statistically significant. The 2-year overall survival (OS) rate of first-generation and second-generation TKI group was 34.9% and 64.0% (χ2=4.743, P=0.029) , the 2-year relapse free survival (RFS) rate was 17.2% and 55.0% (χ2=8.801, P=0.003) , respectively. Multivariate analysis showed that complete molecular remission (HR=0.281, 95%CI 0.151-0.523, P<0.001) was independent favorable prognostic factor for overall survival (OS) , complete molecular remission (HR=0.209, 95%CI 0.112-0.390, P<0.001) and second-generation TKI (HR=0.318, 95%CI 0.158-0.641, P=0.001) were independent favorable prognostic factors for RFS.@*Conclusion@#For TKI-based regimen of BCR-ABL positive ALL, second-generation TKI is superior to first-generation TKI in OS and RFS time.

15.
Article in Chinese | WPRIM | ID: wpr-755908

ABSTRACT

Objective To evaluate the efficacy of unrelated donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for leukemic children .Methods Clinical data of 54 leukemic children undergoing allo-HSCT were retrospectively analyzed from May 2006 to March 2018 .According to the source of donor ,they were divided into matched sibling donor allo-HSCT group (MSD ,n = 27 ) and unrelated donor group (URD ,n= 27) .The clinical outcomes of leukemic children receiving URD allo- HSCT were assessed and those in MSD allo-HSCT group were enrolled as control .Results One patient with refractory AML was not implanted in URD group and the remaining 53 cases were successful in hematopoietic reconstitution .The time of neutrophil and platelet ,the incidence of acute graft-versus-host disease (aGVHD ) , chronic GVHD (cGVHD ) , generalized cGVHD and their transplant-related complications including pulmonary complications ,hemorrhagic cystitis between two groups were not statistically different (P> 0 .05) .The incidence of serious aGVHD ,cytomegalovirus (CMV) and EB virus (EBV) infection was significantly higher in URD group than that in MSD group (P< 0 .05) .The proportion of non-recurrent deaths in URD and MSD groups was 80% and 31 .3% respectively and the difference between two groups was statistically significant ( P = 0 .041) .The 3- year disease-free survival rate (DFS) of URD group and MSD group was (52 .9 ± 9 .8 )% ,(38 .5 ± 8 .7 )% and the overall 3-year survival rate (OS) was (57 .9 ± 9 .5)% and (46 .5 ± 9 .7)% respectively . The inter-group difference was not statistically significant ( P > 0 .05 ) .Conclusions In leukemic children ,although the incidence of complications post URD allo-HSCT is significantly increased , the prognosis is comparable to MSD allo-HSCT .It is a good choice when there is no suitable sibling donor .

16.
Article in Chinese | WPRIM | ID: wpr-755723

ABSTRACT

Objective To analyze the clinical features,efficacy and outcomes in patients with transplantation associated thrombotic microangiopathy (TA-TMA).Methods The clinical data of 9 patients who developed TA-TMA after allogeneic hematopoietic stem cell transplantation (allo-HSCT) were retrospectively analyzed from January 2011 to August 2018 in Affiliated Tumor Hospital of Zhengzhou University.Results There were 6 male and 3 female patiens with a median age of 31 (12-38) years.The median time from transplantation to TA-TMA was 76 (24-155) days.The baseline blood and biochemical parameters at diagnosis of TA-TMA included median hemoglobin (Hb) 66 (58-77) g/L,platelet (PLT) count 22 (4-38) × 109/L,serum lactic dehydrogenase (LDH) 655 (305-4 238) U/L,blood urine nitrogen (BUN)level 15.9 (4.8-26.2) mmol/L,blood creatinine (Cr) level 118 (24-380) μmol/L.The proportion of median peripheral blood schistocytes was 2.6%(1.2%-9%).All patients had positive urinary occult blood tests,and urinary protein was seen in 4 patients.Three patients had mental symptoms.Coombs tests were all negative.The main treatments of TA-TMA composed of reduction and withdrawal of calcineurin inhibitor,steroids and plasma exchange.Response was seen in 4 patients.Patients who did not response to the treatment had a higher proportion of schistocytes,more severe acute graft-versus-host disease (aGVHD),more elevated serum LDH and other transplant-related complications.Conclusions TA-TMA after allo-HSCT is a serious complication with high mortality rate.The proportion of schistocytes in peripheral blood,serum LDH level and comorbidities are prognostic factors of clinical outcome.

17.
Article in Chinese | WPRIM | ID: wpr-743655

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Objective To describe and compare the attitude and actual participation of decision-making regarding nursing care of patients with breast cancer, and to identify the related factors. Methods To investigate 480 cases of inpatients with breast cancer in 3 Grade ⅢA hospitals in Wuhan through questionnaire and self-designed general information questionnaire. Results There were significant differences (χ2=28.3, P<0.01) between the attitude and actual participation of decision making regarding of nursing care. The results of Logistic regression analysis showed that patients with higher education level (B=1.574, P=0.002), less children (B=-2.716, P<0.01) and higher income (B=0.323, P<0.01) , had a more active attitude to participate decision making; patients who were younger (B=-6.001, P=0.015), with higher education level (B=1.643, P=0.000), shorter duration of disease (B=-2.413, P=0.022), and lower degree of TNM stage (B=0.618, P=0.012), actually participated more often in decision making. Conclusions The actual participation was inconsistent with the attitude of decision-making regarding nursing care among patients with breast cancer. And patients′ demographic characters were related to their participation of decision making, which suggested that nurses should make a comprehensive assessment of willingness and capacity of patients′decision-making participation, identify the facilitators and barriers, and take measures to support patients to take an active part in the decision making to improve the quality of nursing care.

18.
Experimental Neurobiology ; : 104-118, 2019.
Article in English | WPRIM | ID: wpr-739527

ABSTRACT

Subarachnoid hemorrhage (SAH) is a devastating cerebrovascular event that often is followed by permanent brain impairments. It is necessary to explore the pathogenesis of secondary pathological damages in order to find effective interventions for improving the prognosis of SAH. Blockage of brain lymphatic drainage has been shown to worsen cerebral ischemia and edema after acute SAH. However, whether or not there is persistent dysfunction of cerebral lymphatic drainage following SAH remains unclear. In this study, autologous blood was injected into the cisterna magna of mice to establish SAH model. One week after surgery, SAH mice showed decreases in fluorescent tracer drainage to the deep cervical lymph nodes (dcLNs) and influx into the brain parenchyma after injection into the cisterna magna. Moreover, SAH impaired polarization of astrocyte aquaporin-4 (AQP4) that is a functional marker of glymphatic clearance and resulted in accumulations of Tau proteins as well as CD3⁺, CD4⁺, and CD8⁺ cells in the brain. In addition, pathological changes, including microvascular spasm, activation of glial cells, neuroinflammation, and neuronal apoptosis were observed in the hippocampus of SAH mice. Present results demonstrate persistent malfunction of glymphatic and meningeal lymphatic drainage and related neuropathological damages after SAH. Targeting improvement of brain lymphatic clearance potentially serves as a new strategy for the treatment of SAH.


Subject(s)
Animals , Apoptosis , Aquaporin 4 , Astrocytes , Brain , Brain Ischemia , Cisterna Magna , Drainage , Edema , Hippocampus , Lymph Nodes , Mice , Neuroglia , Neurons , Prognosis , Spasm , Subarachnoid Hemorrhage , tau Proteins
19.
Article in Chinese | WPRIM | ID: wpr-732683

ABSTRACT

Objective To observe regular monitoring in patients with chronic myeloid leukemia (CML) who received tyrosine kinase inhibitor (TKI), and to analyze its influencing factors. Methods A total of 857 patients with CML in Henan Tumor Hospital from October 2012 to October 2016 were collected. Patients were told to receive regular monitoring after receiving TKI treatment, including blood routine, bone marrow, BCR-ABL fusion gene and chromosomes. All patients were divided into good and poor compliance groups according to regular monitoring. Chi-square test was used to compare ABL kinase domain mutations rate and mortality between two groups. TKI species, level of education, duration from diagnosis to treatment, teaching times, sites of follow-up, convenience of transportation, annual income and gender were recorded respectively, and the factors affecting regular monitoring were analyzed by using single and multiple factor analysis. Results There were 390 and 467 patients in good and poor compliance groups respectively. Treatment failure rate was 19.49% (76/390) and 25.91% (121/467) in good and poor compliance groups respectively, the mutation rate was 28.95% (22/76) and 7.44% (9/121) respectively. The difference of ABL kinase domain mutation in patients with treatment failure of both groups was statistically significant (χ 2 =16.287, P < 0.01). The mortality was 0.77% (3/390) in good compliance group, and 2.78% (13/467) in poor compliance group, and the difference was statistically significant (χ 2 = 4.543, P = 0.033). The single factors analysis showed that TKI species, level of education, duration from diagnosis to treatment, teaching times, sites of follow-up, convenience of traffic and annual income were related with regular monitoring (all P < 0.05). Multiple-factor analysis showed that inconvenient transportation (β = 1.56, 95% CI 1.74-3.74, P = 0.014), low education level (β = 1.67, 95% CI 0.81-3.12, P = 0.041) and low income (β = 2.87, 95% CI 1.31-4.51, 95%CI 1.74-3.74, P = 0.011) were independent factors for poor compliance in regular monitoring. In the result detection, 56 fusion genes fluctuated. Conclusions CML patients who received regular monitoring have a low treatment failure rate and mortality. Inconvenient transportation, low education level and low outcome are independent risk factors for regular monitoring. The single monitoring result can not prompt treatment effect, and thus it needs to review and monitor for many times.

20.
Article in Chinese | WPRIM | ID: wpr-804931

ABSTRACT

Objective@#To explore the health status of the workers who were leaving their posts from small-scaled coal mines, and to provide evidence for coal workers’ pneumoconiosis prevention and safeguard measures.@*Methods@#In 2017, 1008 workers from the coal mine in a town were monitored for occupational health, and the effects of working type, age were analyzed and evaluated.@*Results@#The health monitoring of the mine workers in this town showed high rate of the abnormal detection of respiratory system and cardiovascular system, the incidence rate of pneumoconiosis was up to 34.82%. The incidence of pneumoconiosis in different types of work was not the same (P<0.05) , and the incidence of tunneling workers' pneumoconiosis was the highest. Pneumoconiosis detection rate increased with age (P<0.05) . The difference of pneumoconiosis detection rate among workers of different ages was statistically significant (P<0.05) , among which the pneumoconiosis detection rate was the highest in the group of 40 years old.@*Conclusion@#The pneumoconiosis is serious in small coal mines in this town. It should strengthen the prevention of diseases such as respiratory system and cardiovascular system of coal mine workers, and pay attention to their health management and prolong the life of patients with pneumoconiosis.

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