Analysis of the Prognostic Value and Risk Factors of Early Relapse for Newly Diagnosed Multiple Myeloma Patients in the Era of Novel Agents / 中国实验血液学杂志

OBJECTIVE@#To investigate the influece of early relapse in the era of novel drugs on the prognosis of the patients with newly diagnosed multiple myeloma（NDMM） and risk factors, and to provide the basis for the early identification of the high-risk patients and guiding the treatment.@*METHODS@#The clinical data of the patients with NDMM admitted to our hospital from November 2011 to May 2022 were retrospectively analyzed. According to whether the progression free survival（PFS） was more than 12 months, they were divided into early relapse group（≤12 months） and late relapse group（＞12 months）. The high-risk factors of the patients in two groups were analyzed, including age, anemia, renal insufficiency, hypercalcemia, increasing of lactate dehydrogenase（LDH） level, Extramedullary disease (EMD), International Staging System（ISS） stage, Revised International Staging System （R-ISS） stage, cytogenetic abnormalities(CA) detected by fluorescence in situ hybridization（FISH）, and treatment efficacy. The meaningful clinical indicators were screened, and multivariate analysis was used to explore the high-risk factors of early relapse.@*RESULTS@#170 patients with NDMM were collected, including 25 cases in early relapse group and 145 cases in late relapse group. The median OS time of the patients in early death group was 20 months, and 140 months in late relapse group by the end of follow-up, there was significant difference in OS of the patients between two groups（P<0.001）. Fifteen patients（56.0％）in early relapse group obtained ≥VGPR, and 113（77.9%） patients in late relapse group, the difference was statistically significant（P=0.011）. Survival outcomes remained poor among early relapse patients irrespective of depth of response to initial therapy. Multivariate analysis showed that the EMD and high-risk CA predicted early relapse.@*CONCLUSION@#The prognosis of patients with early relapse in NDMM is poor. EMD and high-risk CA is an independent prognostic factor of early relapse.

Influencing Factors of HIV/ AIDS Death Based on Bayesian Cox Proportional Hazard Regression Model / 中山大学学报(医学科学版)

ObjectiveTo understand the composition of related characteristics of HIV/AIDS cases in Lanzhou and analyze the influencing factors of AIDS-related deaths. MethodsThe information of HIV/AIDS cases reported in Lanzhou from 2011 to 2019 was collected， the method of survival was used analysis and Bayesian Cox Proportional Hazard Regression Model was constructed to analyze the related factors of death. ResultsA total of 2 312 HIV/AIDS patients were selected in this study， including 45 AIDS-related deaths. The results of multivariate regression showed that the older the patients were， the higher the risk of death was； the risk of death of AIDS patients at the time of diagnosis was 13.91 times higher than that of HIV-infected patients； Patients who received CD4 testing had a lower risk of death than those who did not； The risk of death was 0.22 times higher among those who received antiretroviral therapy than those who did not receive antiretroviral therapy. ConclusionsAge at diagnosis， course of disease， antiviral therapy were the influencing factors of AIDS-related death in HIV/AIDS patients in Lanzhou. Therefore， it is necessary to strengthen health education for AIDS-related groups， advocate early detection， early diagnosis， and early treatment， expand the coverage of AIDS testing and treatment， prolong the survival time of AIDS patients.

Evaluation of Renal Impairment in Patients with Diabetic Kidney Disease by Integrated Chinese and Western Medicine / 中国结合医学杂志

OBJECTIVE@#To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine.@*METHODS@#Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients.@*RESULTS@#Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD.@*CONCLUSIONS@#Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).

Study of tooth drifts after orthodontic extractions in cases of interruption / 口腔疾病防治

Objective @# To compare the tooth drift differences between different types of patients after orthodontic extraction for 1.5 months (45 days) without return to the clinic on time for some reasons.@*Methods@#This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. A total of 84 patients had bilateral premolars extracted but were not bonded the bracket for some reasons. The upper and lower jaw dental models were cast, scanned, and reconstructed in 3D. Patients were divided into 12 groups based on extraction positions (first premolar or second premolar), jaw types (maxilla or mandible) and vertical facial types (average angle, high angle, or low angle). Multivariate analysis of variance was used to analyze the changes in the following five indicators in different types of patients who were interrupted for 1.5 months after extraction: anterior tooth crowding, width between canines, width between first molars, tooth extraction space, and overbite of anterior teeth. @*Results @#The tooth extraction position, jaw type and vertical facial type had an effect on the reduction in tooth extraction space and anterior tooth crowding before and after the sudden emergent state (1.5 months after tooth extraction) (P<0.001), and the tooth extraction position and vertical facial type had an effect on the increase in anterior tooth overbite (P<0.001). The drift of bilateral adjacent teeth was greater in patients with first premolars extracted than in those with second premolars extracted (P<0.001), and the drift of bilateral adjacent teeth in the maxilla was larger than that of the mandible (P<0.001). The drift of bilateral adjacent teeth in patients with high angles was more obvious than that of patients with average angles and low angles (P<0.001). @* Conclusion@# For orthodontic patients who have maxillary tooth extraction, first premolar extraction, and even high angles in the vertical facial type, the bilateral adjacent teeth are easier to drift, orthodontic treatment should be carried out soon after extraction, and attention should be given to anchorage control.

MicroRNA-125b Accelerates and Promotes PML-RARa-driven Murine Acute Promyelocytic Leukemia / 生物医学与环境科学（英文）

Objective@#Most acute promyelocytic leukemia cases are characterized by the PML-RARa fusion oncogene and low white cell counts in peripheral blood.@*Methods@#Based on the frequent overexpression of miR-125-family miRNAs in acute promyelocytic leukemia, we examined the consequence of this phenomenon by using an inducible mouse model overexpressing human miR-125b.@*Results@#MiR-125b expression significantly accelerates PML-RARa-induced leukemogenesis, with the resultant induced leukemia being partially dependent on continued miR-125b overexpression. Interestingly, miR-125b expression led to low peripheral white cell counts to bone marrow blast percentage ratio, confirming the clinical observation in acute promyelocytic leukemia patients.@*Conclusion@#This study suggests that dysregulated miR-125b expression is actively involved in disease progression and pathophysiology of acute promyelocytic leukemia, indicating that targeting miR-125b may represent a new therapeutic option for acute promyelocytic leukemia.

Effect of SHP2 knockdown on the proliferation and osteogenic differentiation of human periodontal ligament stem cells under inflammatory environment / 口腔疾病防治

Objective @# The purpose of this study was to clarify the regulatory effect and mechanism of Src homology-2 domain containing protein tyrosine phosphatase-2 (SHP2) on human periodontal ligament stem cell (hPDLSC) proliferation and osteogenic differentiation under inflammatory environment and to provide a new target for the treatment of periodontitis. @*Methods@#SHP2 was knocked down in hPDLSCs, and the transfection efficiency of SHP2 was detected by RT-qPCR and Western blot. An in vitro inflammatory environment was created using tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). The effect of SHP2 knockdown on hPDLSC viability under normal and inflammatory conditions was detected by CCK-8, and the osteogenic capacity of hPDLSCs under normal and inflammatory conditions was detected by ALP staining, ALP activity, ARS staining, RT-qPCR and Western blot. The mechanism by which SHP2 knockdown affected the MAPK pathway and its downstream NF-κB pathway under inflammatory conditions was assessed by Western blot. @*Results@# Green fluorescence was observed after transfection for 72 h, and the titer of SHP2 shRNA recombinant lentivirus was 2.9×108 TU/mL. SHP2 expression was significantly downregulated in lentivirus-transfected cells, as demonstrated by Western blot and RT-qPCR (P<0.001). SHP2 knockdown inhibited hPDLSC proliferation to a certain extent and increased the expression of early osteogenic markers under normal conditions, including increased ALP activity and increased ALP and COL-1 expression (P<0.05). However, SHP2 knockdown exerted no effect on mineralized nodule formation. In the TNF-α- and IL-1β-induced inflammatory environment, SHP2 knockdown exerted no effect on hPDLSC proliferation (P>0.05). Osteogenic markers were upregulated (P<0.05), and mineralized nodules were significantly increased (P<0.05) after SHP2 knockdown. Western blot analysis showed that p65 phosphorylation and IκB-α degradation were reduced in SHP2-knockdown hPDLSCs in the inflammatory environment. Moreover, SHP2 knockdown significantly inhibited the expression of p-p38 and p-JNK MAPK, which represent pathways upstream of the NF-κB pathway (P<0.05). @*Conclusion @# SHP2 knockdown did not affect cell viability but promoted the osteogenic potential of hPDLSCs by inhibiting the MAPK/NF-κB-mediated signaling pathway under inflammatory environment.

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Analysis on Clinical Characteristics and Prognosis of 47 Patients with Extranodal NK/T Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical features and prognostic factors of patients with extranodal NK/T cell lymphoma (ENKTL).@*METHODS@#The clinical data of patients with ENKTL from November 2009 to November 2019 was collected and retrospectively analyzed to clarify the clinical features of ENKTL, and evaluate the factors that affected survival and prognosis.@*RESULTS@#Forty-seven patients with ENKTL were collected, median age was 40 (12-82) years old, and more common in males than females, at the ratio of 1.47∶ 1. The median follow-up was 28 (1-112) months, and 5-year overall survival (OS) rate was 49.3%. The 5-year OS rates of the subjects with ECOG performance stage 0-1 and ≥2 were 51.6% and 0 (P=0.001), respectively. The 5-year OS rates of International Prognostic Index (IPI) score 0-1 and ≥2 were 60.0% and 40.6% (P=0.027), respectively. The 5-year OS rates of Ann Arbor staging Ⅰ/Ⅱ and stage Ⅲ/Ⅳ were 61.3% and 31.7% (P=0.005), respectively. The 5-year OS rates of the patients with presentation of B symptoms and without presentation of B symptoms were 79.0% and 30.1% (P=0.013), respectively. The 5-year OS rates of plasma EBV-DNA level < 5×10@*CONCLUSION@#ECOG score, B symptoms, the copy number of EBV-DNA, and treatment regimens are independent prognostic factors for OS of patients with ENKTL.

Effect of warm needling therapy on nerve conduction in patients with occupational hand-arm vibration disease / 中国职业医学

OBJECTIVE: To investigate the effect of warm needling therapy on the conduction of hand-arm motor nerve and sensory nerve in patients with occupational hand-arm vibration disease(HAVD). METHODS: Male occupational HAVD patients were divided into control group(39 cases) and experimental group(36 cases) by random number table method. The control group received routine therapy, while the experimental group was treated with routine therapy plus warm needling therapy five times a week for four consecutive weeks. The changes on the conduction of motor nerve and sensory nerve in these two groups before and after treatment were compared. RESULTS: Before treatment, the motor nerve conduction velocity(MCV), distal motor latency(DML), compound muscle action potential amplitude(CMAP), sensory nerve conduction velocity(SCV) and sensory nerve action potential amplitude(SNAP) of the median nerve and ulnar nerve in the two groups were compared, and there was no statistically significant difference(all P>0.05). After treatment, the MCV and SCV of median nerve and ulnar nerve in the experimental group were accelerated(all P<0.05), the DML of median nerve and ulnar nerve were shortened(all P<0.01), and the CMAP of median nerve increased compared with the control group(P<0.01). However, there was no significant difference in the CMAP of ulnar nerve and SNAP of median nerve and ulnar nerve(all P>0.05). CONCLUSION: Warm needling therapy can improve the conduction of motor nerve and sensory nerve. Warm needling therapy might be able to promote the repair of injury in axons and myelin sheaths.

Analysis of the on-site quality inspection results of occupational medical examination institutions in Guangdong Province in 2020 / 中国职业医学

OBJECTIVE: To analyze the problems existing in the on-site quality inspection of occupational medical examination(OME) institutions in Guangdong Province. METHODS: A total of 96 OME institutions in Guangdong Province were selected as the research subjects using the random number table method. On-site quality inspections were carried out and the results were analyzed. RESULTS: The OME institutions participating in the on-site quality inspection in 2020 accounted for 49.0%(96/196) of total OME institutions in Guangdong Province. Among them, occupational disease prevention and control hospitals/institutions, Centers for Disease Control and Prevention(CDC), public hospitals, and private hospitals accounted for 8.3%, 9.4%, 42.7% and 39.6%, respectively. They were distributed in 17 prefecture-level cities. The registered OME qualifications include dust, chemical factors, physical factors, radiological factors and other categories. Some institutions have registered two or more OME qualifications. The non-qualified rate of the on-site quality inspections in six assessment modules of the 96 OME institutions from high to low were quality management work, equipment(instruments and vehicles) allocation, quality management system, medical and health technical personnel allocation, information report, and on-site professional assessment module, with the non-qualified rate of 24.1%, 22.4%, 20.7%, 15.9%, 15.6% and 1.1% respectively(P<0.01). The problems were mostly concentrated in the CDC, public and private hospitals, and rarely in occupational disease prevention and treatment hospitals/institutes. In addition to the on-site professional assessment module, a total of 696 non-qualified items were detected in the remaining five modules of the 96 OME institutions, with an average of seven items per institution. Occupational disease prevention and treatment hospitals/institutions, CDC, public hospitals, and private hospitals had an average of 2, 9, 8, 7 non-qualified items respectively. CONCLUSION: In the on-site quality assessment of OME institutions in Guangdong Province, there are relatively few problems in all aspects of occupational disease prevention and treatment hospitals/institutes. CDC has certain inadequacies. The public and private hospitals have more prominent problems in aspects of equipment(instruments and vehicles) allocation, quality management system and quality management work.

Clinical Characteristics and Prognosis Affecting-Factors of the Patients with Burkitt Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics and treatment outcome of patients with Burkitt lymphoma.@*METHODS@#The clinical data of 27 patients with Burkitt Lymphoma were collected and retrospectively analyzed, the clinical characteristics, laboratory data, survival and the factors affecting the prognosis were also analyzed.@*RESULTS@#Among the 27 patients (mainly for adults), the median age was 30 (15-83) years old, the ratio of male and female was 3.5∶1. There was no EB virus infection in all the patients, 92.6% of the patients showed extranodal organs involvement, 40.7% of them were leukemic stage, 85.2% patients belonged to Ⅲ and Ⅳ stage, 74.1% patients belonged to high/high-middle risk according to IPI index. In the terms of molecular biology, five patients were treated with next-generation sequencing test, and the MYC gene mutations were detected out in alt the patients, and the most common mutations were CCND3, ID3 and TP53. The overall response rate (ORR) for all the patients was 85.2%, the complete response (CR) rate was 63.0%, and the partial response rate was 22.2%, the 5-year progression-free survival rate and overall survival rate of the patients was 76.6% and 76.6%, respectively, which showed that the efficacy of the patients in high-dose methotrexate treatment group was higher than that in the non-high high-dose methotrexate treatment group. For the patients treated with LMB89 chemotherapy, the CR was 78.6%, ORR was 100%, the 5-year survival rate was 92.9%, which was superior to the patients treated with other regimens. Auto-hematopoietic stem cell transplantation as consolidation treatment could improve the prognosis for those patients who could not tolerate high-dose chemotherapy. Univariate analysis showed that ECOG score, the level of LDH>500 U/L, WBC level, CNS involvement, short-term effect and LMB89 regimen were the risk factors affecting the prognosis of the patients.@*CONCLUSION@#The adult Burkitt lymphoma are highly aggressive. For the patients in high-dose methotrexate treatment group, especially LMB89 regimen can improve the survival of the patients, and to choose HSCT as a consolidation treatment can be a choice for those patients who could not tolerate high-dose chemotherapy.

Genetic Polymorphism of 17 STR Loci in Uygur Population of Akesu in Xinjiang / 法医学杂志

OBJECTIVES@#To investigate the genetic polymorphisms of 17 STR loci in Uygur population of Akesu in Xinjiang Uygur Autonomous Region.@*METHODS@#Blood samples from 10 094 unrelated individuals of Uygur population of Akesu in Xinjiang were amplified by using the 17+1 PCR amplification kit, and 17 STR loci typing were detected. Allele distribution and population genetic parameters of each locus were calculated, and compared with those of Chinese Han population, and Uygur population of Yili, Hotan and Turpan regions.@*RESULTS@#In the 10 094 unrelated Uygur individuals, 252 alleles were detected. All loci meet the Hardy-Weinberg equilibrium using a chi-square goodness-of-fit test expectation except vWA loci. Fourteen out of the 17 STR loci, including D13S317, showed high power of discrimination. A significant difference on the allele distribution of all the 17 STR loci was observed between Uygur population of Akesu and Chinese Han population, and the difference of some loci existed between Uygur population of Akesu and the other three Uygur populations.@*CONCLUSIONS@#The 17 STR loci are highly polymorphic genetic markers, and the polymorphic information could serve as reference data for forensic individual identification and paternity identification in Akesu.

Dual pitch titanium-coated pedicle screws improve initial and early fixation in a polyetheretherketone rod semi-rigid fixation system in sheep / 中华医学杂志(英文版)

Background@#Reports on the efficacy of modifications to the thread design of pedicle screws are scarce. The aim of the study was to investigate initial and early fixation of pedicle screws with a plasma-sprayed titanium coating and dual pitch in the pedicle region (dual pitch titanium-coated pedicle screw [DPTCPS]) in a polyetheretherketone (PEEK) rod semi-rigid fixation system.@*Methods@#Fifty-four sheep spine specimens and 64 sheep were used to investigate initial ( "0-week" controls) and early (postoperative 6 months) fixation, respectively. Sheep were divided into dual pitch pedicle screw (DPPS), standard pitch pedicle screw (SPPS), DPTCPS, and standard pitch titanium-coated pedicle screw (SPTCPS) groups. Specimens/sheep were instrumented with four screws and two rods. Biomechanical evaluations were performed, and histology at the implant-bone interface was investigated.@*Results@#At 0-week, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (557.0 ± 25.2 vs. 459.1 ± 19.1 N, t = 3.61, P < 0.05; 622.6 ± 25.2 vs. 459.1 ± 19.1 N, t = 3.43, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (343.4 ± 16.5 vs. 237.5 ± 12.9 N, t = 3.52, P < 0.05; 343.4 ± 16.5 vs. 289.9 ± 12.8 N, t = 3.12, P < 0.05; 124.7 ± 13.5 vs. 41.9 ± 4.3 cycles, t = 2.18, P < 0.05; 124.7 ± 13.5 vs.79.5 ± 11.8 cycles, t = 2.76, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (1.8 ± 0.13 vs. 3.76 ± 0.19 mm, t = 2.29, P < 0.05; 1.8 ± 0.13 vs. 2.46 ± 10.20 mm, t = 2.69, P < 0.05). At post-operative 6 months, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (908.4 ± 33.6 vs. 646.5 ± 59.4 N, t = 3.34, P < 0.05; 925.9 ± 53.9 vs. 646.5 ± 59.4 N, t = 3.37, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (496.9 ± 17.9 vs. 370.3 ± 16.4 N, t = 2.86, P < 0.05; 496.9 ± 17.9 vs. 414.1 ± 12.8 N, t = 2.74, P < 0.05; 249.1 ± 11.0 vs.149.9 ± 11.1 cycles, t = 2.54, P < 0.05; 249.1 ± 11.0 vs.199.8 ± 7.2 cycles, t = 2.61, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (0.96 ± 0.11 vs. 2.39 ± 0.14 mm, t = 2.57, P < 0.05; 0.96 ± 0.11 vs. 1.82 ± 0.12 mm, t = 2.73, P < 0.05). Resistance to toggle testing (370.3 ± 16.4 vs. 414.1 ± 12.8 N, t = 3.29, P < 0.05; 149.9 ± 11.1 vs.199.8 ± 7.2 cycles, t = 2.97, P < 0.05) was significantly lower and maximum displacement in cyclic loading (2.39 ± 0.14 vs.1.82 ± 0.12 mm; t = 3.06, P < 0.05) was significantly higher for the SPTCPS than the DPTCPS. Bone-to-implant contact was significantly increased for the DPTCPS compared to the SPPS (58.3% ± 7.0% vs. 36.5% ± 4.4%, t = 2.74, P < 0.05); there was no inflammatory reaction or degradation of coated particles.@*Conclusion@#DPTCPSs might have stronger initial and early fixation in a PEEK rod semi-rigid fixation system.

Sepsis-related acute kidney injury after traumatic injury / 解放军医学杂志

The mechanisms of traumatic injury-induced acute kidney injury (AKI) are very complicated. Among these mechanisms, sepsis-related AKI is the most harmful and the most difficult to treat. The medical community gave a high priority on this disease, dedicated to raise the level of awareness and treatment through its pathogenesis, early diagnosis ideas and biomarkers, and standardization of treatment. There has been some consensus on the classification of sepsis, AKI, and treatments of antiinfection, fluid resuscitation, renal replacement therapy. A series articles and guidelines have also been published and the survival status of patients have been improved, but many basic and clinical issues are still controversial and need to be answered by further trails. This article focuses on the progress of pathogenesis, diagnosis and treatment about sepsis-related AKI, and tries to raise the understanding level of early diagnosis and standardized treatment of it.

Analysis of HIV/AIDS epidemic characteristics and spatiotemporal aggregation in Lanzhou City from 2011 to 2018 / 中华疾病控制杂志

Objective To detect the characteristics of acquired immune deficiency syndrom (AIDS) epidemic in Lanzhou City from 2011 to 2018 and the spatiotemporal aggregation of human immunodeficiency virus (HIV) infection and AIDS patients at county level, and to provide scientific reference for prevention and control of HIV/AIDS in Lanzhou City. Methods The space-time scanning and measurement method was used to detect, test, and analyze the spatiotemporal aggregation of HIV/AIDS reports. The aggregation characteristics of the AIDS epidemic in time and space were obtained, and the detection results were visualized by ArcGIS 10.3. Results From 2011 to 2018, there were four statistically significant high spatial and temporal aggregation areas in HIV/AIDS in Lanzhou City. One type of gathering area was Chengguan District, Anning District and Gaolan County. The gathering time was from 2015 to 2018 (LLR=108.63,RR=2.02, P<0.001); The second type of aggregation area was the Qilihe area, which gathered from 2015 to 2018 (LLR=60.93,RR=2.11, P<0.001). It was detected that the Qilihe District had a type Ⅰ aggregation of heterosexual transmission from 2014 to 2017, and Gaolan County, Anning District and Chengguan District had a type II aggregation of heterosexual transmission from 2015 to 2018; It was detected that Gaolan County, Anning District and Chengguan District had a type of gathering of same-sex transmission from 2015 to 2018; In the Qilihe District, there was a second category of same-sex communication between 2017 and 2018. Conclusion The HIV/AIDS epidemic in Lanzhou City has spatiotemporal aggregation regardless of the number of reports or different transmission routes. The prevention and control situation is still severe and should be highly valued by the relevant local departments.

Analysis of transmission rate of hand-foot-mouth disease in different provinces in China / 中华疾病控制杂志

Objective To understand the periodicity of the incidence of hand, foot and mouth disease (HFMD) in representative provinces from different climatic zones in China, and to analyze the seasonality and the factors influencing the HFMD transmission rate, to provide a scientific reference for the prevention and treatment of HFMD. Methods Five climate-representative provinces including Hainan, Hunan, Shandong, Qinghai and Inner Mongolia were selected as research objects. Wavelet analysis was used to analyze the cyclic pattern of HFMD incidence. Time series susceptible infected recovered (TSIR) model was established to examine the HFMD transmission rate of the five provinces and of the entire country. The parameters in the TSIR model were estimated by markov chain monte carlo (MCMC). Linear regression model was used to analyze the effects of climate factors, school terms and the Spring Festival travel rush on the transmission rate of HFMD. Results (1) HFMD incidence in the provinces and the entire country exhibited annual or semi-annual cycles and the transmission rates in all provinces showed obvious seasonality with similar patterns. February to May was the peak period of HFMD transmission rate. (2) The transmission rate of HFMD was affected by the climate or the contact rate, depending on which factor was dominant. Conclusions The transmission rate of HFMD had obvious seasonality, which had increased significantly in February, and it was necessary to strengthen its prevention and control during the Spring Festival.

Dual pitch titanium-coated pedicle screws improve initial and early fixation in a polyetheretherketone rod semi-rigid fixation system in sheep / 中华医学杂志(英文版)

BACKGROUND@#Reports on the efficacy of modifications to the thread design of pedicle screws are scarce. The aim of the study was to investigate initial and early fixation of pedicle screws with a plasma-sprayed titanium coating and dual pitch in the pedicle region (dual pitch titanium-coated pedicle screw [DPTCPS]) in a polyetheretherketone (PEEK) rod semi-rigid fixation system.@*METHODS@#Fifty-four sheep spine specimens and 64 sheep were used to investigate initial ("0-week" controls) and early (post-operative 6 months) fixation, respectively. Sheep were divided into dual pitch pedicle screw (DPPS), standard pitch pedicle screw (SPPS), DPTCPS, and standard pitch titanium-coated pedicle screw (SPTCPS) groups. Specimens/sheep were instrumented with four screws and two rods. Biomechanical evaluations were performed, and histology at the implant-bone interface was investigated.@*RESULTS@#At 0-week, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (557.0 ± 25.2 vs. 459.1 ± 19.1 N, t = 3.61, P < 0.05; 622.6 ± 25.2 vs. 459.1 ± 19.1 N, t = 3.43, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (343.4 ± 16.5 vs. 237.5 ± 12.9 N, t = 3.52, P < 0.05; 343.4 ± 16.5 vs. 289.9 ± 12.8 N, t = 3.12, P < 0.05; 124.7 ± 13.5 vs. 41.9 ± 4.3 cycles, t = 2.18, P < 0.05; 124.7 ± 13.5 vs.79.5 ± 11.8 cycles, t = 2.76, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (1.8 ± 0.13 vs. 3.76 ± 0.19 mm, t = 2.29, P < 0.05; 1.8 ± 0.13 vs. 2.46 ± 10.20 mm, t = 2.69, P < 0.05). At post-operative 6 months, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (908.4 ± 33.6 vs. 646.5 ± 59.4 N, t = 3.34, P < 0.05; 925.9 ± 53.9 vs. 646.5 ± 59.4 N, t = 3.37, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (496.9 ± 17.9 vs. 370.3 ± 16.4 N, t = 2.86, P < 0.05; 496.9 ± 17.9 vs. 414.1 ± 12.8 N, t = 2.74, P < 0.05; 249.1 ± 11.0 vs.149.9 ± 11.1 cycles, t = 2.54, P < 0.05; 249.1 ± 11.0 vs.199.8 ± 7.2 cycles, t = 2.61, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (0.96 ± 0.11 vs. 2.39 ± 0.14 mm, t = 2.57, P < 0.05; 0.96 ± 0.11 vs. 1.82 ± 0.12 mm, t = 2.73, P < 0.05). Resistance to toggle testing (370.3 ± 16.4 vs. 414.1 ± 12.8 N, t = 3.29, P < 0.05; 149.9 ± 11.1 vs.199.8 ± 7.2 cycles, t = 2.97, P < 0.05) was significantly lower and maximum displacement in cyclic loading (2.39 ± 0.14 vs.1.82 ± 0.12 mm; t = 3.06, P < 0.05) was significantly higher for the SPTCPS than the DPTCPS. Bone-to-implant contact was significantly increased for the DPTCPS compared to the SPPS (58.3% ± 7.0% vs. 36.5% ± 4.4%, t = 2.74, P < 0.05); there was no inflammatory reaction or degradation of coated particles.@*CONCLUSION@#DPTCPSs might have stronger initial and early fixation in a PEEK rod semi-rigid fixation system.

Advances in indole alkaloids from traditional Chinese medicine of Uncariae Ramulus Cum Uncis documented in Chinese Pharmacopoeia / 中国中药杂志

Uncaria genus( Rubiaceae) contains 34 species all over the world,of which 11 species and one variant are present in China. Five species,namely U. rhynchophylla,U. macrophylla,U. hirsuta,U. sinensis and U. sessilifructus,are documented in Chinese Pharmacopoeia as the raw materials of Uncariae Ramulus Cum Uncis. Indole alkaloids are the characteristic constituents of Uncaria plants,in addition to triterpenes,lignans and flavones. This paper reviews the progress of indole alkaloids and their distribution within the five Uncaria species documented in Chinese Pharmacopoeia for better understanding the active constituents of Uncariae Ramulus Cum Uncis.

Clinical Characteristics and Prognosis of Acute Myeloid Leukemia with FLT3-ITD Mutation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of acute myeloid leukemia(AML) patients with FLT3-ITD(Fms-like tyrosine kinase3, intenal tandem duplication) mutation and their response to treatment.</p><p><b>METHODS</b>Retrospective analysis of 128 newly diagnosed AML (except type M3) patients was performed between January 2014 and July 2017. Patients were divided into FLT3-ITD mutated group and non-mutated group. Mutation detection was carried out by using polymerase chain reaction(PCR) and gene sequencing analysis. Standard 3 + 7 or CAG regimen were taken as the first induction chemotherapy, 4 cases received sorafenib, overall survival (OS) was calculated by Kaplan-Meier.</p><p><b>RESULTS</b>Ninety-seven patients can be evaluable for clinical data available; 4 patients were FLT3-TKD mutated, which accounted for 4.1%; 19 patients were FLT3-ITD mutated, which accounted for 19.59%(19/97). Median white blood cell count (WBC), percentage of peripheral blasts and LDH value were significantly higher in FLT3-ITD group than those in non-mutated group [64.65(1.07-587.92)×10/L vs 39.68 (0.45-203.81) ×10/L](P<0.01), [69.62(16-99)% vs 36.35(0-92) %](P<0.01 ) and [LDH 526(124-2 729)U/L vs 265(20-1977)U/L](P<0.05), respectively. The frequency of coexisting NPM1 mutation was higher in FLT3-ITD group than that in non-mutated group [36.8(7/19)% vs 6.8 (5/74) %](P<0.01). The CR+PR was lower in FLT3-ITD group than that in non-mutated group [31.6(6/19)% vs 64.9 (48/74)%](P<0.05). OS in FLT3-ITD group was significantly shorter than that in non-mutated group (5 vs 18 months)(P<0.05). There is no significant difference in OS between FLT3-ITD concomitant with and without NPM1 mutation groups(5 vs 5 months)(P>0.05). The median OS was 13 months for the FLT3-ITD patients taking sorafenib.</p><p><b>CONCLUSION</b>The FLT3-ITD is a common mutation in AML, FLT3-ITD mutated AML is more likely concomitant with NPM1 mutation with higher number of WBC, percentage of peripheral blasts and LDH value, thus CR is low after the 1st treatment and survival is poor.</p>