Analysis of Correlation of Immune T Cell Subsets, TNF-α, IFN-γ and sFas levels with Severity and Prognosis in Aplastic Anemia Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the correlation of immune T cell subsets and expression levels of TNF-α, IFN-γ and sFas with the severity and prognosis of aplastic anemia(AA) patients.</p><p><b>METHODS</b>Ninety-five patients with aplastic anemia treated in our hospital were selected and enrolled in AA group, 43 cases of which were included in the acute group and 52 cases in the chronic group according to the disease status of patient's. Then, 50 cases of healthy volunteers in the same period were enrolled in the control group, and the changes of immune T cell subsets, and sFas serum TNF-α, IFN-γ and levels of the 3 groups were compared. The ROC curve was used to analyze the value of each index for evaluating the severity of the disease, 95 patients with aplastic anemia were followed up and the Kaplan-Miere survival curve was used to analyze the effect of different index levels on the progression-free survival of the patients.</p><p><b>RESULTS</b>the serum level of CD4 level and CD4 /CD8 ratio in AA group were significantly lower than those in the control group (P<0.05), and the CD8 level in AA group was significantly higher than that in the control group (P<0.05). The CD4 level and CD4 /CD8 ratio in the acute group was significantly lower than those in the chronic group (P<0.05), and the CD8 level in the acute group was significantly higher than that in the chronic group (P<0.05). The serum level of TNF-α and IFN-γ of the patients in AA group was significantly higher than those in the control group (P<0.05), and the level of sFas in AA group was significantly lower than those in the control group (P<0.05). The levels of serum TNF-α and IFN-γ in the acute group were significantly higher than that in the chronic group (P<0.05), and the level of sFas was significantly lower than that in the chronic group (P<0.05). The analysis of each index value for predicting the severity of AA by ROC showed that the area under curve of CD4 /CD8 , TNF-α, IFN-γ and sFas for predicting the patients' condition was 0.954, 0.763, 0.853 and 0.857, respectively. Kaplan-Miere survival curve analysis showed that CD4 /CD8 ratio had a significant effect on progression-free survival (P<0.05), the TNF-α, IFN-γ and sFas levels had no significant effect on progression-free survival (P>0.05).</p><p><b>CONCLUSION</b>The patients with aplastic anemia have significantly abnormal T lymphocyte subsets, there is a certain correlation between the serum TNF-α, IFN-γ and sFas levels with aplastic anemia, each index can reflect the disease severity, and the changes of T lymphocyte subsets has important influence on the clinical prognosis of the patients.</p>

Assessment of the characteristics of echocardiography in pediatric patients with total anomalous pulmonary venous connection / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To assess the accuracy of echocardiography in diagnosis of total anomalous pulmonary venous connection (TAPVC).</p><p><b>METHODS</b>A combination of suprasternal, parasternal, subcostal and apical views were employed to diagnose TAPVC and to trace the course of the anomalous pulmonary venous connection, the direction of the inter-atrial shunt, enlargement of right atrium (RA) and right ventricle (RV), superior and inferior vena cava. All pediatric patients underwent surgical repair. The results of echocardiography were compared with surgical findings.</p><p><b>RESULT</b>A total of 28 consecutive pediatric patients with suspected TAPVC were included in this study. The TAPVC diagnosis was confirmed in 26 cases after surgery, partial anomalous pulmonary venous connection (PAPVC) in one case, and Cor Triatriatum and possible TAPVC in another. The diagnostic accuracy of TAPVC by echocardiography in the study was 92.86%. There were 17 supracardiac TAPVC, 11 intracardiac TAPVC. In all patients, enlargement of the RA and RV, inter-atrial right-to-left shunt via atrial septal defects were documented in parasternal and subcostal views. Common pulmonary vein or four pulmonary vein direct to RA or via coronary sinus to RA were the draining sites of intracardiac TAPVC. The enlargement of left innominate vein-right superior vena cava draining to RA was seen in supracardiac TAPVC.</p><p><b>CONCLUSION</b>A combination of suprasternal and subcostal multi-views in echocardiography can increase the diagnostic accuracy of TAPVC in pediatric patients.</p>

Study on the status and quality of sleep-related influencing factors in medical college students / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the status and influencing factors on sleep quality in some medical college students.</p><p><b>METHODS</b>Stratified sampling, pittsburgh sleep quality index (PSQI), self-evaluation depression scale (SDS), self-evaluation anxiety scale (SAS) and self-developed questionnaire of influencing factors on the quality of sleep in medical college students were used. Cumulative odds logistic model was performed to analyze the related factors on the quality of sleep.</p><p><b>RESULTS</b>19.17 percent of the medical college students showed poor quality of sleep and the difference between genders was not statistically significant (P > 0.05). Statistically significant (P < 0.05) difference was seen among different years of students and correlation was found between sleep quality and depression or anxiety (P < 0.0001). Factors influencing on the quality of sleep in medical college students would include: worry of sleep, irregular work/rest, worry on examination, stress, relationship with classmates, self-evaluated health condition, environments of the dormitory and late to bed.</p><p><b>CONCLUSION</b>Influencing factors were identified and comprehensive measures should be taken to improve the quality of sleep.</p>