Evaluation of continuous metabolic syndrome score as a screening tool for metabolic syndrome in Xinjiang urban population aged 15-18 years / 中国学校卫生

Objective@#The purpose of the present study was to evaluate of continuous metabolic syndrome score (cMetS) in screening metabolic syndrome (MetS) and to determine the cut-off values in a representative sample of Xinjiang population aged 15 to 18 years old.@*Methods@#A stratified cluster sampling was used to select participants aged 15-18 years from 13 cities in Xinjiang. cMetS was calculated by summing up the Zscores of standardized waist circumference, mean arterial pressure, high-density lipoprotein, triglyceride, and fasting blood glucose by age and gender.@*Results@#Totally 16.3% of subjects were overweight, and 5.2% were obese. The proportion of overweight and obesity in males was significantly higher than that in females (18.1% vs 13.8%)(6.0% vs. 4.1%)(χ2=15.36，7.89，P<0.05). The prevalence of total MetS was 6.1%, with 6.6% and 5.4% for men and women, respectively. There was a correlation between cMetS and MetS components, and the average cMetS value increased with increasing MetS component(P<0.05). The total cut-off value of cMetS was 0.99 (sensitivity 68.0%, specificity 80.7%), and the area under the ROC curve was 84.9%. The cMetS scores for boys and girls were 0.80 and 1.48, respectively.@*Conclusion@#Compared with MetS, cMetS shows more accuracy in screening MetS among youth aged 15-18 years in both gender.

An analysis of epidemiological and clinical features of 46 patients with hemorrhagic fever with renal syndrome in Shenzhen City / 中华地方病学杂志

Objective@#To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen, and to accumulate experience in the diagnosis and treatment of HFRS in this area.@*Methods@#A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018. The demographic characteristics, epidemiological, clinical manifestations, examinations, treatments and prognosis, and other characteristics were analyzed.@*Results@#All the 46 patients with HFRS were residens in Shenzhen, with a male-to-female ratio of 6.67∶1.00(40∶6), aged (40.18 ± 15.63) years old, and 38 patients (82.61%) aged 23-45 years old. There were 41 patients (89.13%) with a history of HFRS epidemiology, and there were mice in their houses or workplaces. The houses of 39 patients (84.78%) were rented, and 34 patients(87.18%) rented their houses in urban villages. There were morbidity throughout the year, and 33 patients (71.74%) were ill from January to June. In clinical classification, 44 cases (95.65%) were mild, 2 cases (4.35%) were medium, and there were no severe or critical cases. The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia. Thirty-nine patients (84.78%) were presented with systemic aches, headaches, low back pain and eyelid pain, and 28 patients (60.87%) had skin and mucous membrane hyperemia flushing. Clinical stages showed that all patients had pyretogenesis stage and polyuria stage, including pyretogenesis stage [(7.34 ± 6.82) d], polyuria stage [(9.94 ± 5.77) d], only 4.35% (2/46) patients with hypotension shock stage, all patients did not have oliguric stage. On the next day of admission, the number of white blood cells in 46 patients was (8.17 ± 3.19) × 109/L, and 38 cases (82.61%) in the normal range; platelet was (61.92 ± 32.53) × 109/L, and 42 cases (91.30%) were decreased; the procalcitonin was (1.62 ± 0.38) ng/ml, and 41 cases (89.13%) were increased; C-reactive protein was (74.33 ± 30.48) mg/L, and 46 patients (100.00%) were elevated; creatinine was (176.25 ± 55.15) μmol/L, and 19 cases (41.30%) were increased. Abnormal liver function was manifested by increased enzymology, alanine aminotransferase was (137.58 ± 46.76) U/L, and aspartate aminotransferase was (129.82 ± 40.29) U/L. All patients were positive for Hantavirus IgM. B-ultrasound results showed that in 58.70% (27/46) patients, both kidneys were plump and the parenchymal echo was enhanced. Liver injury occurred in 39 patients (84.78%) and sinus bradycardia in 2 patients (4.35%). All the 46 patients were clinically cured.@*Conclusion@#The epidemiological characteristics of patients with HFRS in Shenzhen are typical, the clinical manifestations are mild, and the curative effect and prognosis are good.

An analysis of epidemiological and clinical features of 46 patients with hemorrhagic fever with renal syndrome in Shenzhen City / 中华地方病学杂志

Objective To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen,and to accumulate experience in the diagnosis and treatment of HFRS in this area.Methods A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018.The demographic characteristics,epidemiological,clinical manifestations,examinations,treatments and prognosis,and other characteristics were analyzed.Results All the 46 patients with HFRS were residens in Shenzhen,with a male-to-female ratio of 6.67:1.00 (40:6),aged (40.18 ± 15.63) years old,and 38 patients (82.61％) aged 23-45 years old.There were 41 patients (89.13％) with a history of HFRS epidemiology,and there were mice in their houses or workplaces.The houses of 39 patients (84.78％) were rented,and 34 patients (87.18％) rented their houses in urban villages.There were morbidity throughout the year,and 33 patients (71.74％) were ill from January to June.In clinical classification,44 cases (95.65％) were mild,2 cases (4.35％) were medium,and there were no severe or critical cases.The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia.Thirty-nine patients (84.78％) were presented with systemic aches,headaches,low back pain and eyelid pain,and 28 patients (60.87％) had skin and mucous membrane hyperemia flushing.Clinical stages showed that all patients had pyretogenesis stage and polyuria stage,including pyretogenesis stage [(7.34 ± 6.82) d],polyuria stage [(9.94 ± 5.77) d],only 4.35％ (2/46) patients with hypotension shock stage,all patients did not have oliguric stage.On the next day of admission,the number of white blood cells in 46 patients was (8.17 ± 3.19) × 109/L,and 38 cases (82.61％) in the normal range;platelet was (61.92 ±32.53) × 109/L,and 42 cases (91.30％) were decreased;the procalcitonin was (1.62 ± 0.38) ng/ml,and 41 cases (89.13％) were increased;C-reactive protein was (74.33 ± 30.48) mg/L,and 46 patients (100.00％) were elevated;creatinine was (176.25 ± 55.15) μmol/L,and 19 cases (41.30％) were increased.Abnormal liver function was manifested by increased enzymology,alanine aminotransferase was (137.58 ± 46.76) U/L,and aspartate aminotransferase was (129.82 ± 40.29) U/L.All patients were positive for Hantavirus IgM.B-ultrasound results showed that in 58.70％ (27/46) patients,both kidneys were plump and the parenchymal echo was enhanced.Liver injury occurred in 39 patients (84.78％) and sinus bradycardia in 2 patients (4.35％).All the 46 patients were clinically cured.Conclusion The epidemiological characteristics of patients with HFRS in Shenzhen are typical,the clinical manifestations are mild,and the curative effect and prognosis are good.

Management of cytokine release syndrome related to CAR-T cell therapy / 医学前沿

Chimeric antigen receptor T (CAR-T) cell therapy is a novel cellular immunotherapy that is widely used to treat hematological malignancies, including acute leukemia, lymphoma, and multiple myeloma. Despite its remarkable clinical effects, this therapy has side effects that cannot be underestimated. Cytokine release syndrome (CRS) is one of the most clinically important and potentially life-threatening toxicities. This syndrome is a systemic immune storm that involves the mass cytokines releasing by activated immune cells. This phenomenon causes multisystem damages and sometimes even death. In this study, we reported the management of a patient with recurrent and refractory multiple myeloma and three patients with acute lymphocytic leukemia who suffered CRS during CAR-T treatment. The early application of tocilizumab, an anti-IL-6 receptor antibody, according to toxicity grading and clinical manifestation is recommended especially for patients who suffer continuous hyperpyrexia, hypotensive shock, acute respiratory failure, and whose CRS toxicities deteriorated rapidly. Moreover, low doses of dexamethasone (5-10 mg/day) were used for refractory CRS not responding to tocilizumab. The effective management of the toxicities associated with CRS will bring additional survival opportunities and improve the quality of life for patients with cancer.

Impact of electroacupuncture on the life quality in patients of female mixed urinary incontinence / 中国针灸

<p><b>OBJECTIVE</b>To observe the impact of electroacupuncture (EA) on the quality of life in the patients of female mixed urinary incontinence (MUI) and evaluate its clinical efficacy.</p><p><b>METHODS</b>EA was adopted in 25 cases of MUI at Zhongliao (BL 33) and Huiyang (BL 35), needle retaining for 30 min each time. The treatment was given once every two days, three treatments a week, totally for 12 weeks of treatment. The incontinence quality of life questionnaire (I-QOL), the incontinence impact questionnaire-7 (IIQ-7), the urogenital distress inventory short form (UDI-SF) and the visual analogue scale (VAS) were adopted in the comparison before and after treatment. The efficacy was evaluated.</p><p><b>RESULTS</b>The curative rate was 52.0% (13/25) and the total effective rate was 96.0% (24/25) in 25 cases. In comparison before and after treatment, in I-QOL, the score of limiting behaviors was increased up to (30.32 ± 3.39) from (11.52 ± 2.45), the score of psychosocial impacts was up to (36.48 ± 2.90) from (13.52 ± 2.25) and the score of social isolation was up to (21.52 ± 1.61) from (9.84 ± 2.23). The score of IIQ-7 was decreased, down to (2.48 ± 1.36) from (11.96 ± 3.45), the score of UDI-SF was down to (2.92 ± 0.95) from (8.84 ± 2.58) and VAS score was down to (1.40 ± 0.91) from (6.96 ± 1.65). The differences were all significant statistically in comparison (all P < 0.05).</p><p><b>CONCLUSION</b>EA improves effectively the quality of life in MUI patients and the clinical efficacy is apparent.</p>

The enantioselective pharmacokinetic study of desvenlafaxine sustained release tablet in Chinese healthy male volunteers after oral administration / 药学学报

A chiral LC-MS/MS method for the simultaneous analysis of desvenlafaxine (DVS) enantiomers in human plasma was developed and applied to a pharmacokinetic study on 12 Chinese healthy volunteers. d6-Desvenlafaxine was used as internal standard (IS). Chromatographic separation was performed on the Astec Chirobiotic V chiral column (150 mm x 4.6 mm, 5 μm). The assay was linear over the concentration range of 0.500-150 ng x mL(-1) for both enantiomers (r2 > 0.99). The method was successfully applied to a stereoselective pharmacokinetic study of 100 mg desvenlafaxine sustained release tablets on 12 Chinese healthy volunteers under fasting conditions. The results showed that the pharmacokinetic parameters were similar to both enantiomers in Chinese healthy volunteers. The AUC(0-t), and C(max) of the two enantiomers were about 1.5 times higher than those of blacks and whites reported in the literature.

Expression of WT1 gene in acute leukemia and its clinical significance / 白血病·淋巴瘤

Objective To investigate the expression level and clinical significance of WT1 gene in acute luekemia (AL) patients.Methods WT1 gene level was detected by real time quantitative-polymerase chain reaction in acute myelogenous leukemia (AML) and in acute lymphocytic leukemia (ALL) patients.Then the expression levels of WT1 gene in different subtypes of AML were compared,and the correlation between gene expression and disease courses and prognosis were observed.Moreover,the relationship between disease courses and WT1 expression in patiens after receiving haemopoietic stem cell transplantation were analyzed.Results Among 66 cases,WT1 expression positive rate was 87.5 ％ (14/16) in AML and 76.0 ％ (38/50) in ALL.In AML,the expression level in M3 showed the lowest than that in any other subtypes (compared with M1,M2,M4,M5,P value was 0.040,0.007,0.006 and 0.01,respectively).The expression level of WT1 was closely correlated with leukemia disease courses.The expression level in complete remission (CR) group showed a significant lower expression level than that in non-remission group (P =0.018) and relapse group (P =0.003),and the re-increase of WT1 expression level could predict relapse as early as 1.5 months.Moreover,WT1 expression also showed an close relationship with prognosis of patients receiving haemopoietic stem cell transplantation.Patients whose WT1 was undetectable had a better prognosis than those with persistent expression,and increase again after becoming undetectable.Conclusion WT1 has a high expression level in AL,which can represent minimal residual disease.The expression level in M3 was lowest than that in different AML subtypes,and its expression level has a close correlation with clinical disease course and prognosis of AL.

Allogeneic peripheral blood stem cell transplantation using a low toxicity conditioning regimen with fludarabine and busulfan for 13 patients with hematological malignancies / 白血病·淋巴瘤

[Objective]To discuss the clinical effect of fludarabine and busulfan (Bu+Flu) as a low toxicity myeloablative conditioning regimen for allogeneic peripheral blood stem cell transplantation (allo-HSCT)in leukemia patients.[Methods]Clinical data of 13 patients with hematological malignancies receiving conditioning regimen with Bu+Flu for allo-HSCT were analyzed retrospectively.Conditioning regimen was Bu+Flu,compalriot mismatched and unrelated transplantation combined with rabbit anti-human thymocytes immune globulin (ATG).CsA+short course of methotrexate or CsA + mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD).DNA sequencing of short tandem repeat (STR)polymorphism analysis method was performed for identification of donor stem cells implantation.[Results]13 patients all tolerated with this conditioning regimen well,no serious complications occurred.Neutrophil engraftment was at 9-15 days (median 11 days),platelet engraftment at 8-25 days (median 13 days).10 patients achieved hematopoiesis reconstitution with their full donor chimerisms confirmed by STR-DNA analysis.Acute GVHD occurred in 5 cases,accounting for 38.5％.Chronic GVHD occurred in 4 cases of 10 patients could be assessed,accounting for 40.0％.Severe GVHD more than Ⅱ degree did not happen.1-39 months (median time 11 months)of follow-up revealed the overall survival rate of 76.9％(10/13),disease-free survival of 61.5％ (8/13).The causes for death were relapse in all.[Conclusion]The conditioning regimen with Bu+Flu has low toxicity,well tolerance and better effect.

Clinical study on MEAD regimens for relapsed or refractory adult patients with acute lymphocyte leukemia / 白血病·淋巴瘤

Objective To study the clinic effect and safety of MEAD chemotherapy regimen for adult patients with relapsed or refractory acute lymphocyte leukemia. Methods Between July 2006 and July 2009,twenty-two adult patients with relapsed or refractory acute lymphocyte leukemia received MEAD regimen (mitoxantrone 6 mg/d dl-3 iv drip,cytarabine 100 mg/d dl-5 iv drip,etoposide 100 mg/d dl-5 iv drip,dexmethasone 10 mg/d dl-8 iv drip). Results The complete remission (CR) rate of adult patients with relapsed or refractory acute lymphocyte leukemia was 31.8 %,the partial remission(PR) rate was 22.7 % and the overall response (OR) rate 54.5 %. The cumulitive CR rate was 50.0 %,and the PR rate 40.9 % after two times MEAD chemotherapy regimen. The main adverse effect was different level of myelosuppression,and other toxicity of vital organ was mild. Conclusion MEAD regimen is effective and can be tolerated for adult patients with relapsed or refractory acute lymphocyte leukemia,and its side effect is mild.

Construction and characterization of hGM-CSF-expressing K-562 cell line / 药物分析学报

Objective The whole process of vaccine preparation is time-consuming and technically challenging. Here the hGM-CSF-engineered K-562 cell line was constructed to simplify tumor vaccine preparation process. Methods The eukaryocyte expressing plasmid pcDNA3.1/GM-CSF was first constructed and its accuracy was verified through sequencing. The pcDNA3.1/GM-CSF was transfected into COS-7 cells to verify GM-CSF expression and cytokine activity using TF-1 cell line. Then the plasmid was transfected into K-562 cell line using liposome method, and was selected under G-418 and sub-cloned by limiting dilution. GM-CSF product from the monoclone GM-CSF-K-562 cell lines was quantified using ELISA method. Results We successfully constructed the hGM-CSF eukaryocyte expressing plasmid and hGM-CSF expressing K-562 cell line. Conclusion The construction of K-562/GM-CSF line will simplify the preparation of tumor vaccine, thus facilitating the application of tumor vaccination therapy in clinical application.

Construction and characterization of hGM-CSF-expressing K-562 cell line / 西安交通大学学报·英文版

Objective: The whole process of vaccine preparation is time-consuming and technically challenging. Here the hGM-CSF-engineered K-562 cell line was constructed to simplify tumor vaccine preparation process. Methods: The eukaryocyte expressing plasmid pcDNA3.1/GM-CSF was first constructed and its accuracy was verified through sequencing. The pcDNA3. 1/GM-CSF was transfected into COS-7 cells to verify GM-CSF expression and cytokine activity using TF-1 cell line. Then the plasmid was transfected into K-562 cell line using liposome method, and was selected under G-418 and sub-cloned by limiting dilution. GM-CSF product from the monoclone GM-CSF-K-562 cell lines was quantified using ELISA method. Results: We successfully constructed the hGM-CSF eukaryocyte expressing plasmid and hGM-CSF expressing K-562 cell line. Conclusion: The construction of K-562/GM-CSF line will simplify the preparation of tumor vaccine, thus facilitating the application of tumor vaccination therapy in clinical application.

OBSERVATION OF CURATIVE EFFECT OF HA IN 23 CASES WITH CML / 西安交通大学学报(医学版)

The 23 cases with chronic myelogenousleukemia (CML) were treated with program ofharringtonine and ara-c (HA) and the results werethat the 13 cases got complete remission and 10cases got partial remission. Comparing with thecontrol group the patients of which were treatedwith busulfan, the authors found that the spendedtime of decreased WBC in blood (WBC decreasedto 10. 0 ? 10~9/L) and reduced spleen (reduced tosmallest status of spleen) and improvement of self-sensation symptoms in the group treated with HAwere better than those in control group. The HAprogram for cases who recured CML again and re-ceived maintenance cure after remission of CMLwas still effective. The time of maintenance cureand interval should be individualized.