Genetic characteristics and survival analysis of 27 cases of juvenile myelomonocytic leukemia / 中华儿科杂志

Objective: To investigate the genetic and genomic profiling of juvenile myelomonocytic leukemia (JMML) and factors affecting its survival rate. Methods: Clinical characteristics, cytogenetics, molecular biology results and survival status of children with 27 JMML cases admitted to the Hematology Department of Children's Hospital, Capital Institute of Pediatrics from December 2012 to December 2021 were analyzed retrospectively, and the outcomes of the children were followed up. Kaplan-Meier method was used for survival analysis. Univariate analysis was used for analyzing factors affecting the overall survival (OS) rates of patients who received hematopoietic stem cell transplantation (HSCT). Log-Rank test was used for comparison of survival curves. Results: Among 27 JMML cases, there were 11 males and 16 females. The age of disease onset was 28 (11,52) months. There are 20 cases of normal karyotype, 4 cases of monosomy 7, 1 case of trisomy 8,1 case of 11q23 rearrangement and 1 case of complex karyotype. A total of 39 somatic mutations were detected.Those involved in RAS signal pathway were the highest (64%(25/39)), among which PTPN11 mutation was the most frequent (44% (11/25)). A total of 17 cases (63%) received HSCT, 8 cases (30%) did not receive HSCT, and 2 cases (7%) lost follow-up. For children receiving transplantation, the follow-up time after transplantation was 47 (11,57) months. The 1-year OS rate of high-risk transplantation group (17 cases) and high-risk non transplantation group (6 cases) was (88±8)% and (50±20)% respectively, with a statistically significant difference (χ2=5.01, P=0.025). The 5-year OS rate of the high-risk transplantation group was (75±11)%. The survival time of those who relapsed or progressed to acute myeloid leukemia after transplantation was significantly shorter than that of those who did not relapse (χ2=6.80, P=0.009). The OS rate of patients with or without PTPN11 mutation was (81±12) % and (67±19)% respectively (χ2=0.85, P=0.356). Conclusions: The main pathogenesis involved in JMML is gene mutation related to RAS signaling pathway, and the most common driver gene of mutation is PTPN11. Allogeneic HSCT can significantly improve the survival rate of high-risk JMML patients. The recurrence or progression after transplantation was related to poor prognosis.

Comparison of effect between internal fixation and total hip replacement in the treatment of displaced femoral neck fracture in middle age patients / 中国骨伤

OBJECTIVE@#To analyze and compare the clinical efficacy of internal fixation and total hip replacement in the treatment of displaced femoral neck fracture from 55 to 65 years.@*METHODS@#From September 2016 to August 2020, 86 patients with Garden type Ⅲ or Ⅳ femoral neck fracture were divided into two groups according to different surgical methods. Among them, 38 patients were treated with lag screws for internal fixation, there were 26 males and 12 females, aged 55 to 64 years old with an average of(60.2±3.1) years;the other 48 patients were treated with total hip replacement, including 28 males and 20 females, aged from 57 to 65 years old with an average of(61.3±3.8) years. The time from injury to operation ranged from 1 to 3 days. The reoperation rate, incidence of deep infection, Harris score of hip joint function, visual analogue scale(VAS) of pain and patients reported outcome scores(European five-dimensional Health Questionnaire, EQ-5D) were compared between two groups.@*RESULTS@#All patients were followed up for 24 to 54 months with an average of (35.8±10.3) months. There was significant difference in reoperation rate between two groups (P<0.05). There was no significant difference on the incidence of deep infection, hip Harris score and VAS between two groups(P>0.05) . The postoperative EQ-5D score of patients with internal fixation was lower than that of total hip replacement, and the difference was statistically significant(P<0.05).@*CONCLUSION@#Both the surgery of internal fixation and total hip replacement have similar effect in short-and medium term among the patients aged 55 to 65 years old. However, for the reoperation rate, the group of internal fixation was higher than that of total hip replacement. For the subjective functional score of patients, the group of internal fixation was lower than that of total hip replacement.

Review of closed reduction techniques for femoral neck fracture / 中国骨伤

For patients with femoral neck fractures who plan to undergo internal fixation, satisfied alignment of fracture ends is an important prerequisite for internal fixation stability and fracture healing. There are many reports on the reduction methods of displaced femoral neck fractures, which can be summarized into three categories:First, the solely longitudinal traction of lower limbs, supplemented by other manipulations such as rotation and compression; Second, the resultant force formed by the longitudinal traction of lower limbs and the lateral traction;the third is accomplished by vertical traction in the axis of femur with hip joint flexed. Each reduction method has its own advantages, but no single method can be applied to all fracture displacement. In this paper, some classical reduction techniques in the literatures are briefly reviewed. It is hoped that clinicians will not be limited to a certain reduction method, they should analyze the injury mechanism and fracture displacement process according to the morphology features and flexibly select targeted reduction methods to improve the success rate of closed reduction of femoral neck fracture.

Assessment of the local blood supply when femoral neck fracture occurs:advances in the anatomy research and its clinical application / 中国骨伤

The stability of internal fixation of femoral neck fractures can be obtained through surgical techniques, the configuration of screws and bone grafting, etc. However, the blood supply injury caused by fractures could not be completely reversed by the current medical management. Hence, the comprehensive evaluation of the residual blood supply of the femoral neck, to perioperatively avoid further iatrogenic injury, has become a hotspot. The anatomy of the extraosseous blood supply of the femoral neck has been widely reported, while its clinical application mostly involved the assessment of the medial circumflex femoral artery and retinacular arteries. However, further studies are needed to explore the prognosis of patients with these artery injuries, with different degrees, caused by femoral neck fractures. Direct observations of nutrient foramina in vivo are not possible with current clinical technologies, but it is possible to make reasonable preoperative planning to avoid subsequent femoral head necrosis based on the distribution features of nutrient foramina. The anatomy and clinical application studies of the intraosseous blood supply focused on the junction area of the femoral head and neck to probe the mechanism of femoral head necrosis. Thus, the intraosseous blood supply of other regions in the femoral neck remains to be further investigated. In addition, a blood supply evaluation system based on a three-level structure, extraosseous blood vessels, nutrient foramina, and intraosseous vascular network, could be explored to assist in the treatment of femoral neck fractures.

Comparison of diagnostic criteria for acute kidney injury in critically ill children / 中华儿科杂志

Objective: The kidney disease: improving global outcome (KDIGO) and pediatric reference change value optimized for acute kidney injury (pROCK) criteria were used to evaluate the incidence, stages and mortality of acute kidney injury (AKI). The differences between the 2 criteria were compared for exploring the value of pROCK criteria in diagnosing pediatric AKI and predicting adverse outcomes. Methods: In the multicenter prospective clinical cohort study, we collected general data and clinical data such as serum creatinine values from 1 120 children admitted to 4 PICUs of Children's Hospital of Soochow University, Children's Hospital of Fudan University, Anhui Provincial Children's Hospital, and Xuzhou Children's Hospital from September 2019 to February 2021. AKI was defined and staged according to the KDIGO and pROCK criteria. The incidence of AKI, the consistency of AKI definite diagnosis and stages, and the mortality in PICU were compared between the 2 groups. The chi-square test or Fisher's exact test was applied for comparison between 2 groups. The Cohen's Kappa and Weighted Kappa analyses were used for evaluating diagnostic consistency. The Cox regression analysis was used to evaluate the correlation between AKI and mortality. Results: A total of 1 120 critically ill children were included, with an age of 33 (10, 84) months. There are 668 boys and 452 girls. The incidence of AKI defined by the KDIGO guideline was higher than that defined by pROCK criteria (27.2%(305/1 120), 14.7%(165/1 120), χ2=52.78, P<0.001). The concordance rates of the 2 criteria for the diagnosis of AKI and AKI staging were 87.0% (κ=0.62) and 79.7% (κ=0.58), respectively. Totally 63 infants with AKI stage 1 defined by the KDIGO guideline were redefined as non-AKI by following the pROCK criteria. The PICU mortality rate of these infants was similar to patients without AKI defined by KDIGO guideline(P=0.761). After adjusting for confounders, AKI defined by KDIGO or pROCK criteria was an independent risk factor of death in PICU (AHR=2.04, 2.73,95%CI 1.27-3.29, 1.74-4.28, both P<0.01), and the risk of death was higher when using the pROCK compared with the KDIGO criteria. As for the KDIGO criteria, mild AKI was not associated with the mortality in PICU (P=0.702), while severe AKI was associated with increased mortality (P<0.001). As for the pROCK criteria, both mild and severe AKI were risk factors of PICU death in children (HR=3.51, 6.70, 95%CI 1.94-6.34, 4.30-10.44, both P<0.001). In addition, The AKI severity was positively associated with the mortality. Conclusions: The AKI incidence and staging varied depending on the used diagnostic criteria. The KDIGO definition is more sensitive, while the pROCK-defined AKI is more strongly associated with high mortality rate.

Clinical Efficacy of Haplo-HSCT of ATG Combined with PTCy for Children with Myelodysplastic Syndrome / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and safety of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in combination of ATG and post-transplant cyclophosphamide (PTCy) -induced immune tolerance after transplantation in treatment of childhood myelodysplastic syndromes(MDS）.@*METHODS@#From July 2016 to November 2020, a total of 8 children with MDS receiving the haploidentical allo-HSCT combined with ATG and PTCy-induced immune tolerance after transplantation in our hospital were enrolled, whose clinical data were retrospected and analyzed.@*RESULTS@#Median age at diagnosis of the 8 children (1 male and 7 females) was 6.4 (range, 10 months to 15 years) years old. The median medical history of MDS was 2.7 years (range, 3 months to 8 years). Among the 8 patients, 7 cases were diagnosed with refractory cytopenia of childhood and one with refractory anemia with excess of blasts. The HSC donors were father, mother or brother of patients and HLA matching in 6-9/12 loci were identical. All the donors were healthy and didn't carry the same pathogenic genes as the recipients. The median age of donors was 36.4 (range, 25 to 49) years old. The median mononuclear cell (MNC) number of the graft was 19.8, ranging in (13.2-47.3)×108/kg, and the median CD34+ cell number was 11.8×106/kg, ranging in (5.0-18.3)×106/kg. Graft-versus-host disease prophylactic regimen was started on day 3 and 4 after transplantation, in which cyclophosphamide (50 mg/kg·d) was administered by intravenous infusion. From day 5 after transplantation, low-dose tacrolimus was administered by intravenous infusion and mycophenolate mofetil was administered orally. The median time of neutrophil and platelet engraftment was 12.6 (rang, 11 to 15) days and 13.3 (rang, 11 to 18) days, respectively. All the patients achieved full donor chimerism on neutrophil engraftment after transplantation. The median follow-up time was 1 032 (rang, 747 to 1 536) days. Both overall survival rate and disease-free survival rate were 100%.@*CONCLUSION@#Haplo-HSCT combined with ATG and PTCy-induced immune tolerance after transplantation is a safe and effective treatment for children with MDS.

Molecular mechanism of airway epithelial cells involved in airway remodeling through epithelial mesenchymal transition in asthma / 国际儿科学杂志

Airway remodeling is one of the main pathological features of bronchial asthma.Airway remodeling may lead to increased airway hyperresponsiveness and pulmonary function decline in asthmatic patients.Some studies suggest that airway epithelial cells may play an important role in the development of airway remodeling in asthma, and they can differentiate into mesenchymal cells through epithelial-mesenchymal transition.This article reviews the signaling pathways involved in epithelial-mesenchymal transition, such as TGF-β 1 signaling pathways, Wnt/β-catanin signaling pathway and sonic hedgehog signaling pathway, to further elucidate the molecular mechanisms in airway remodeling in asthma.It provides a new perspective for the study of the pathogenesis of asthma and the development of new, effective and safe targeted therapy.

Prevalence and influencing factors of depression and anxiety symptoms in disabled people in Guang'an during the post-pandemic period / 四川精神卫生

ObjectiveTo investigate the prevalence rate and influencing factors of depression and anxiety in disabled people in Guang'an during the post-pandemic period， so as to provide references for promoting mental health of disabled people. MethodsFrom April to May 2021， the disabled people dwelling in low-risk areas for coronavirus infections in Guang'an for half a year and met the criteria outlined in Classification and Grading Criteria of Disability （GB/T26341-2010） were selected as the survey subjects， and their depression and anxiety symptoms were evaluated via the Patients' Health Questionnaire Depression Scale-9 item （PHQ-9） and the Generalized Anxiety Disorder Scale （GAD-7） through Wenjuanxing platform. Then binary Logistic regression analysis was performed to screen the risk and protective factors for depression and anxiety in disabled people. ResultsThe detection rates of moderate-to-severe and severe depressive symptoms were 9.05% and 8.35%， and the detection rates of moderate and severe anxiety symptoms were 9.40% and 11.25%. Regression analysis denoted that being laid-off and job-waiting were risk factors for depression and anxiety in disabled people （OR=2.354， 2.353， P<0.01）. Being unmarried （OR=0.418）， married （OR=0.414）， visual disability （OR=0.254）， limb disability （OR=0.460）， good family function （OR=0.241）， moderate family dysfunction （OR=0.288）， complete self-care （OR=0.062） and partial self-care （OR=0.416） were protective factors for depression in disabled people （P<0.05 or 0.01）. Visual disability（OR=0.382）， hearing disability（OR=0.143）， limb disability（OR=0.432）， good family function （OR=0.246）， moderate family dysfunction （OR=0.402）， complete self-care （OR=0.093） and partial self-care （OR=0.378） were protective factors for anxiety in disabled people （P<0.05 or 0.01）. ConclusionThe disabled people in Guang'an during the post-pandemic period suffer a high detection rate of depression and anxiety， and the detection rate is even higher among those being laid-off or job-waiting， while good family function and complete or partial self-care ability are conducive to protecting the mental health of the disabled.

The COMPASS Core Member Ash2l Regulates the Cell Cycle of Neural Progenitor Cells / 中国生物化学与分子生物学报

To investigate the role of Ash2l (absent, small, or homeotic 2-like, Ash2l) on the proliferation ability and cell cycle of mouse cerebral cortical neural progenitor cells (NPCs), We examined the number and distribution of NPCs, using the radial glial cell marker PAX6 and intermediate progenitor cell marker TBR2. E16. 5 mice were labeled with EdU for 30 min to detect the proliferation ability of NPCs. Conditional knockout of Ash2l resulted in a dramatic reduction in the number of NPCs and a disordered distribution. The 30 min EdU insertion experiment showed that EdU could hardly be inserted into NPCs, indicating that the proliferation ability of NPCs was severely affected. Using the mitotic cell cycle marker pH3, the distribution of dividing NPCs was observed. We then detected the expressed level of Cyclin A by Western blotting. The distribution of cell nuclei of M-phase is disordered and the expression of G

One new coumarin from seeds of Herpetospermum pedunculosum / 中国中药杂志

This paper aims to investigate the chemical constituents of the seeds of Herpetospermum pedunculosum. One new coumarin and two known lignans were isolated from the ethanolic extract of the seeds of H. pedunculosum with thin layer chromatography(TLC), silica gel column chromatography, Sephedax LH-20 chromatography, Semi-preparative high performance liquid chromatography and recrystallization, etc. Their structures were elucidated as herpetolide H(1), phyllanglaucin B(2), and buddlenol E(3) by analysis of their physicochemical properties and spectral data. Among them, compound 1 was a new compound, and compounds 2 and 3 were isolated from this genus for the first time. In vitro anti-inflammatory activity test showed that herpetolide H had certain NO inhibitory activity for LPS-induced RAW 264.7 cells, with its IC_(50) value of(46.57±3.28) μmol·L~(-1).

Value of near-infrared spectroscopy in monitoring intestinal tissue oxygen saturation in preterm infants with hemodynamically significant patent ductus arteriosus: a prospective research / 中国当代儿科杂志

OBJECTIVES@#To study the change in regional oxygen saturation (rSO@*METHODS@#The preterm infants with patent ductus arteriosus (PDA) who had gestational age <32 weeks and/or birth weight <1 500 g were prospectively enrolled, who were admitted to the Department of Neonatology, Shenzhen Longgang Central Hospital from October 2017 to October 2020.According to the diagnostic criteria for hsPDA, the preterm infants with patent ductus arteriosus (PDA) were divided into two groups: hsPDA and non-hsPDA. According to closure of the ductus arteriosus after oral administration of ibuprofen, the preterm infants in the hsPDA group were subdivided into two groups: hsPDA closure and hsPDA non-closure. Hemodynamic parameters were measured at diagnosis of PDA and after treatment, and the level of intestinal tissue rSO@*RESULTS@#A total of 241 preterm infants with PDA were enrolled, with 55 infants (22.8%) in the hsPDA group and 186 infants (77.2%) in the non-hsPDA group. There were 36 infants (65%) in the hsPDA closure group and 19 infants (35%) in the hsPDA non-closure group. Compared with the non-hsPDA group, the hsPDA group had a significantly higher left atrial diameter/aortic root diameter ratio and significantly lower left ventricular ejection fraction and fractional shortening (@*CONCLUSIONS@#hsPDA has an impact on intestinal tissue oxygenation in preterm infants, and continuous monitoring of intestinal tissue rSO

FLASH Binds p53 and Enhances its Transcriptional Activity / 中国生物化学与分子生物学报

As an important transcription factor, the tumor suppressor protein p53 is involved in multiple biological processes such as cell cycle regulation, cell division, cell senescence and DNA repair The functional roles of p53 under various physiological conditions are inseparable from the assistance of many cofactors, which can regulate the protein modification, cellular sub-localization, and protein stability of p53 Therefore, the identification of p53-binding protein(s) has important biological significance for further understanding the signal transduction network of p53 in vivo. In the present study, a novel p53-binding protein, FADD-like interleukin-1β-converting enzyme associated huge protein (FLASH) was identified through a yeast two-hybrid screen The protein-protein interaction and the structural basis of the interaction between FLASH and p53 was also confirmed by co-immunoprecipitation analysis These studies have shown that p53 can simultaneously interact with both FLASH-N1 (aa 1 ~ 200) and FLASH-C1 (aa 1 534 ~ 1 780) In addition, both of FLASH-N and FLASH-C can interact with the same region of p53 (aa 293 ~ 393) Transcription analysis has revealed that the full length of FLASH and FLASH-M (aa 921 ~ 1533) can enhance the transcription activity of p53 In summary, FLASH can bind to p53 and enhance its transcriptional activity

Clinical outcome of tibiotalocalcaneal fusion using cannulated screw and humeral proximal locking plate inverted fixation through a lateral transfibular approach / 中国骨伤

OBJECTIVE@#To evaluate the clinical outcome of tibiotalocalcaneal fusion using cannulated screw and humeral proximal locking plate inverted fixation through a lateral transfibular approach.@*METHODS@#From June 2015 to December 2018, 15 patients underwent a tibiotalocalcaneal fusion operation using cannulated screw and inverted proximal humerus locking plate through a transfibular approach. There were 10 males and 5 females with the age ranging from 45 to 72 (58.9±6.1) years, and the course of disease ranged from 2 to 35 (11.9±7.9)years. Preoperative diagnosis included 8 cases of post traumatic arthritis, 2 cases of Charcot arthritis, 2 cases of Charcot-Marie -Tooth (CMT), 1 case of ankle tuberculosis, 1 case of talar necrosis, and 1 case of pigmented villonnodular synovitis. Among them, 8 patients were combined with simple varus deformity, 4 patients with simple valgus deformity, 2 patients with equinovarus deformity, 1 patient with equinovarus deformity, 2 patients with adduction and internal rotation of middle and forefoot. American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and the visual analogue scale (VAS) score were used to evaluate the clinical outcome at the last follow up.@*RESULTS@#One lost follow up and remaining fourteen patients were followed up. The follow up time ranged from 10 to 25(16.6±4.3) months. All the 15 patients had primary healing. Fusion time ranged from 15 to 24 (16.8 ± 2.4) weeks after operation. One patient with diabetes experienced delayed union and was successfully treated with secondary bone grafting combined with Platelet-Rich Plasma (PRP) injection. The AOFAS score increased from 38.7±3.3 to 84.5±2.6 (@*CONCLUSION@#Tibiotalocalcaneal fusion used cannulated screw and humeral proximal locking plate inverted fixation through a lateral transfibular approach has the advantages of relatively simple technique, high fusion rate, especially for patients with posterior foot deformity, which has satisfactory short term effects.

Effects of the injectable glycol-chitosan based hydrogel on the proliferation and differentiation of human dental pulp cells / 北京大学学报(医学版)

OBJECTIVE@#To prepare glycol-chitosan (GC)-based single/dual-network hydrogels with different composition ratios (GC31, DN3131 and DN6262) and to investigate the effects of hydrogel scaffolds on biological behavior of human dental pulp cell (hDPC) encapsulated.@*METHODS@#GC-based single-network hydrogels (GC31) and GC-based dual-network hydrogels (DN3131, DN6262) with different composition ratios were prepared. The injectability was defined as the average time needed to expel a certain volume of hydrogel under a constant force. The degradation of the hydrogel was determined by the weight loss with time. The fracture stress was measured using a universal testing machine. The proliferation of hDPCs in hydrogels was detected using the cell counting kit-8 (CCK-8) method and CalceinAM/PI Live/Dead assay. After 14 days of odontoblastic induction, the expression of alkaline phosphatase (ALP), dentin sialophosphoprotein (DSPP) and dentin matrix protein-1 (DMP-1) was detected by real-time quantitative reverse transcription PCR (real-time RT-PCR) and the mineralized nodules was observed by Von Kossa staining.@*RESULTS@#The injectability of all three groups of hydrogels was acceptable. The time of injection of GC31 was the shortest, and that of DN6262 was longer than DN3131 (P<0.05). The degradation rate of GC31 hydrogel in vitro was significantly faster than that of the dual-network hydrogel groups (P<0.05). There was no significant difference between DN3131 and DN6262 (P>0.05). The compressive resistance failure point of GC31 group was 1.10 kPa, while it was 7.33 kPa and 43.30 kPa for DN3131 and DN6262. The compressive strength of dual-network hydrogel was significantly enhanced compared with single-network hydrogel. hDPCs were in continuous proliferation in all the three groups, and the GC31 group showed a higher proliferation rate (P<0.05). The expression levels of DSPP, DMP-1 and ALP in the dual-network hydrogel groups (DN3131, DN6262) were significantly higher than that of GC31 after culturing for 14 days (P<0.05), there was no difference in the expression levels of DMP-1 and ALP between DN3131 and DN6262 (P>0.05); Von Kossa staining showed that more mineralization deposition and mass-shaped mineralized nodules formed in DN3131 and DN6262, while only light brown calcium deposition staining was observed in GC31 group, which was scattered in granular forms.@*CONCLUSION@#GC-based single/dual network hydrogels with different composition ratios met the injectable requirements. GC31 group had a lower mechanical properties, in which hDPCs exhibited a higher proliferation rate. dual-network hydrogels had slower degradation rate and higher mechanical properties, in which hDPCs exhibited better odontoblastic differentiation potential and mineralization potential.

Umbilical therapy combined with moxibustion for autumn diarrhea in children / 中国针灸

OBJECTIVE@#To observe the efficacy differences between moxibustion combined with umbilical therapy and oral administration of montmorillonite powder (smecta) on diarrhea symptoms in children of different ages.@*METHODS@#A total of 120 children were randomly divided into an observation group and a control group, 60 cases in each group. In the observation group, the children aged under 3 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12) and Tianshu (ST 25), and each acupoint was treated for less than 3 min, and the total treatment duration was no more than 10 min; the children aged between 3 to 7 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Dachangshu (BL 25), each acupoint was treated for less than 3 min, and the total treatment duration was no more than 20 min. After moxibustion, traditional Chinese medicine patch (clove, cinnamon, rhizoma zingiberis, fructus evodiae, hawthorn, rhizoma atractylodis) was applied at Shenque (CV 8). For the children under 1 year old, the medical bag with 30 g powder was heated to 50 ℃ and used for about 30 min; for children over 1 year old, 2-5 g powder was mixed with vinegar and used for 4-8 h each time. The treatment was given once a day, three times as a course of treatment, and a total of one course of treatment was given. The children in the control group were treated with oral administration of montmorillonite powder, 3 g per day for children under 1 year old, 3-6 g per day for children aged 1-2 years old and 6-9 g per day for children over 2 years old. The montmorillonite powder was taken three times a day for 3 days. The diarrhea symptom scores before and after treatment were observed and the clinical efficacy was evaluated. From the first treatment, the recovery cases and recovery time in the two groups were recorded, the recovery cases and recovery time in acute and chronic stages were compared between different age groups. The recurrence was observed 3 months after treatment.@*RESULTS@#Compared before treatment, the diarrhea symptom score after treatment was decreased in the observation group (0.05). After treatment, the score of diarrhea symptoms in the observation group was lower than that in the control group (0.05). The recovery time of different age stages and average recovery time in the observation group were shorter than those in the control group (1 year old and ≤5 years old and average recovery time in the observation group were shorter than those in the control group (<0.05), while the average recovery time of children in chronic stage in the observation group was shorter than that in the control group (<0.05). Three months after treatment, the recurrence rate was 0% (0/36) in acute phase and 4.8% (1/21) in chronic phase in the observation group, which were superior to 9.7% (3/31) in acute phase and 46.7% (7/15) in chronic phase in the control group (<0.05).@*CONCLUSION@#The umbilical therapy combined with moxibustion could improve the symptoms of diarrhea and shorten the recovery time in children of different ages with autumn diarrhea, which have better efficacy than montmorillonite powder.

Therapeutic dosingtiming and efficacy of bortezomib for antibody-mediated kidney transplant rejection / 中华器官移植杂志

Objective To explore whether therapeutic dosing timing of proteasome inhibitor bortezomib(BZ) would impact its clinical efficacy .Methods From 2012 to 2018 ,35 biopsy-confirmed cases of acute antibody-mediated kidney transplant rejection (AMR) were collected .They received intravenous immunoglobulin (IVIG) plus sirolimus (Sir) plus bortezomib (BZ) .Three groups were assigned according to dosing timing of BZ .After a diagnosis of AMR ,ET (early treatment ) group began BZ dosing within 7 days (n=16) while DT (delayed treatment) group within 8-14 days (n=11) and LT (late treatment) group > 14 days (n= 8).Their clinical parameters and incidence of complications were analyzed .Results DSA reversal rate of ET ,DT and LT groups was 87 .5％ , 45 .5％ and 25 .0％ (P=0 .006) while DSA declining rate 93 .8％ ,90 .9％ and 50％ respectively (P=0 .019);recurrent rate of AMR was lower in ET/DT group than LT group (6 .6％ vs 10％ vs 75％ , P=0 .042) .No significant differences existed in blood perfusion score of allograft at 1 month post-dosing among three groups .In three groups ,creatinine (Cr) of ET group was lower than DT group at month 1/3/12 while DT group was lower than LT group .No significant difference existed in the incidence of adverse reactions among 3 groups .Conclusions More likely to enter the window period , early dosing of BZ is more effective for treating acute AMR .An earlier intervention yields a better efficacy .

Analysis of CDSS Experimental Indexes in 333 Cases of Newly Diagnosed Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analyze the 5 experimental indexes of CDSS in the patients with acute leukemia (AL) so as to provide the laboratorial basis for the early diagnosis and treatment of the secondary DIC in AL.@*METHODS@#Three hundred and thirty three patients with AL were divided into 7 groups, such as AML-M1-M5, other AML and ALL. The experimental indexes and CDSS scores of all AL groups were compared and analyzed in pairs, meanwhile 100 healthy persons were taken in the control group. Clinical events such as early death in all cases were also analyzed.@*RESULTS@#The highest positive rate of Platelet was 59.76%, among the 5 experimental indexes, followed by D-D (30.93%), and the lowest APTT with only 2.70%. Compared with the control group, the differences of remaining indexes were statistically significant (P＜0.01), except APTT in group AML-M3 and FIB in the other AML groups. The score of laboratory index was (1.50±1.51) in all AL patients, and the positive rate of overt DIC ( score≥4) was 14.11% ( 47 cases). The highest score of CDSS was (3.34 ±1.71) in group AML-M3. The difference in the incidence of early death and cerebral (pulmonary) hemorrhage in DIC patients were statistically significant (P＜0.05 and P＜0.01).@*CONCLUSION@#The application of quantitative integral method of experimental indexes in CDSS is objective and feasible, which is of great significance for early diagnosis and early treatment of acute leukemia complicated with DIC.

New records of medicinal plants in Tibet / 中国中药杂志

By the fourth survey of Chinese medicinal resources, new medicinal plants records of 2 genera and 5 species were reported in Tibet. They are two genera Rhynchoglossum and Asteropyrum, and five species including Rh. obliquum, A. peltatum, Urena repanda, Schefflera khasiana and Mimulus tenellus. All the voucher specimens are preserved in Herbarium of Tibet Agriculture and Animal Husbandry University.

Molecular cloning and characterization of CMK from Artemisia annua / 中国中药杂志

Artemisinin is a preferred medicine in the treatment of malaria. In this study, AaCMK, a key gene involved in the upstream pathway of artemisinin biosynthesis, was cloned and characterized from Artemisia annua for the first time. The full-length cDNA of AaCMK was 1 462 bp and contained an ORF of 1 197 bp that encoded a 399-anomo-acid polypeptide. Tissue expression pattern analysis showed that AaCMK was expressed in leaves, flowers, roots and stems, but with higher expression level in glandular secretory trichomes. In addition, the expression of AaCMK was markedly increased after MeJA treatment. Subcellular localization showed that the protein encoded by AaCMK was localized in chloroplast. Overexpression of AaCMK in Arabidopsis increased the contents of chlorophyll a, chlorophyll b and carotenoids. These results suggest that AaCMK plays an important role in the biosynthesis of terpenoids in A. annua and this research provids a candidate gene that could be used for engineering the artemisinin biosynthesis.

Morphology of intervertebral disc in Chinese adults evaluated using computer tomography three-dimensional imaging / 中国组织工程研究

BACKGROUND: The artificial disc requires a height, a width, and a shape as much as possible to be similar to the original intervertebral disc in order to perfectly distribute the load. At present, most of the data are from foreign countries or measured using X-ray and magnetic resonance imaging, but there are some shortcomings. OBJECTIVE: To diagnose the spinal disease and provide data for the design of a native lumbar disc device by measuring the normal lumbar intervertebral disc using computer tomography (CT). METHODS: A total of 2 235 patients who underwent lumbar CT examination in Liuzhou Worker's Hospital from January 2012 to May 2017 were collected and analyzed. There were 62 cases, including 45 males and 17 females, after being strictly met the inclusion and exclusion criteria. From the age of 20, they were divided into four groups: 20-30, 31-40, 41-50 and more than 50 years old. The range was from L1to S1. The measurement index include intervertebral disc anteroposterior diameter, transerverse diameter, disc volume, sagittal anterior, middle and posterior height, coronal left and right height, and interverterbral angle. RESULTS AND CONCLUSION: (1) In terms of age, there was a statistically significant difference in measurement indexes between L1/2, L2/3 and L3/4(P < 0.05). Therefore, the factor of age should be taken into account. However, there was no statistically significant difference between L4/5and L5/S1segments (P > 0.05). (2) There was a statistical difference between the anterior and middle height of the sagittal position in L4/5and L5/S1(P < 0.05). (3) There were statistical differences between the angles of L2/3, L3/4, L4/5, L5/S1intervertebral space (P <0.05), but the difference of angle between L4/5and L5/S1was the most. (4) There was no statistical difference in the height between the left and right sides of the coronal position (P > 0.05). (5) There was statistical difference between the anteroposterior and transverse diameters of the disc on the adjacent cross section (P < 0.05). (6) The results showed that the lower the segment, the smaller the statistical difference between each group. It is indicated that the age difference should be considered on the L1/2, L2/3, and L3/4segments in the design of lumbar disc or interbody fusion. The lumbar artificial intervertebral disc can be placed in the middle or side. The artificial disc should be designed into the wedge shape instead of a rectangle. These will provide a good anatomical basis for the design of domestic lumbar artificial intervertebral discs.