Research and development strategies of new Chinese medicines based on new regulations / 中国中药杂志

In recent years, only a small number of new Chinese medicines have been approved for marketing, which has embodied the bottleneck in the development of the Chinese medicine industry. To tackle this problem, the National Medical Products Administration has issued a series of regulations and technical requirements. In the context of new regulations, this study deeply explored the research and development strategies of new Chinese medicines under the guidance of the new classification of drug registration, and discussed the key technical issues in the research and development.

Relationship between SUVmax in 18F-FDG PET/CT and PD-L1 expression in invasive lung adenocarcinoma / 中国胸心血管外科临床杂志

@#Objective    To investigate the relationship between the expression of programmed cell death ligand-1 (PD-L1) and the maximal standardized uptake value (SUVmax) in 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and the correlation of clinical factors between SUVmax values and PD-L1. Methods    The clinical data of 84 patients with invasive lung adenocarcinoma diagnosed pathologically in West China Hospital, Sichuan University from August 2016 to November 2018 were analyzed retrospectively, including 38 males and 46 females, aged 60 (32-85) years. The tumor was acinar-predominant in 37 patients, papillary in 20, lepidic in 19, solid in 5 and micropapillary in 3. Multivariate analysis of the relationship between SUVmax value and other clinicopathological features was performed by linear regression. Logistic regression analysis was used to analyze the relationship between PD-L1 protein expression and other pathological features. Results    The SUVmax of the PD-L1 expression group was significantly higher than that of the non-PD-L1 expression group in the whole invasive lung adenocarcinoma group (P=0.002) and intermediate-grade histologic subtype (P=0.016). The SUVmax cut-off value of PD-L1 expression in the whole invasive lung adenocarcinoma group and intermediate-grade histologic subtype was 5.34 (AUC: 0.732, P=0.002) and 5.34 (AUC: 0.720, P=0.017), respectively. Multivariate analysis showed that pleura involvement, vascular tumor thrombus and the increase of tumor diameter could cause the increase of the SUVmax value, while the SUVmax value decreased in the moderately differentiated tumor compared with the poorly differentiated tumor. The SUVmax cut-off value between low-grade histologic subtype and intermediate-grade histologic subtype, intermediate-grade histologic subtype and high-grade histologic subtypes was 1.54 (AUC: 0.854, P<0.001) and 5.79 (AUC: 0.889, P<0.001), respectively. Multivariate analysis of PD-L1 expression showed pleura involvement (P=0.021, OR=0.022, 95%CI 0.001 to 0.558) and moderate differentiation (opposite to poor differentiation) (P=0.004, OR=0.053, 95%CI 0.007 to 0.042) decreased the expression of PD-L1. Conclusion    The SUVmax of the PD-L1 expression group is significantly higher than that of the non-PD-L1 expression group in the whole invasive lung adenocarcinoma group and intermediate-grade histologic subtype. The level of SUVmax and the expression of PD-L1 in invasive lung adenocarcinoma are related to many clinical factors.

Expression of EphrinA1, vascular endothelial growth factor and microRNA-210 after hydronephrosis / 中国医师杂志

Objective To investigate the difference and correlations of the EphrinA1,vascular endothelial growth factor (VEGF) expression and microRNA (miRNA)-210 in the kidney tissue of rats in the unilateral ureteral obstruction (UUO) model.And to understand the regulation mechanism of the three factors in the occurrence of renal tissue injury in rats.Methods Using unilateral ureteral ligation to establish a model of hydronephrosis in mice (except for the NC group),and they wrere randomly divided into an acute hydronephrosis group (UUO group) and a false surgical control group (NC group).The UUO group was divided into four groups (UUO 2 d group,UUO 5 d group,UUO 9 d group,and UUO 14 d group),and eight mice in each group.The pathological changes of renal tissue were observed by hematoxylin-eosin (HE) staining.Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression of EphrinA1,VEGF and miRNA-210;Western blot was used to detect the protein expression of EphrinA1 and VEGF.Resulsts Hydronephrosis was not shown in the NC group,and hydronephrosis and inflammatory cell infiltration were observed in the UUO group.Compared with NC group,the mRNA expression of EphrinA1,VEGF and miRNA-210 were up-regulated in UUO 2 d group (P ＜0.05).With the extension of the time of hydronephrosis,the expressions of all three factors were down-regulated in 9 d and 14 d groups compared with 2 d and 5 d groups,and reached the lowest point at 14 d (P ＜0.05);Western blot result indicated that the expression of EphrinA1 and VEGF in renal tissue of UUO 2 d and 5 d group was increased compared with NC group (P ＜ 0.05).Conclusions The UUO mouse model verified that miRNR-210 participated in hydronephrosis.The consistency of EphrinA1,VEGF,and miRNA-210 indicated that the three factors played an important role in the occurrence and development of UUO.

Expression of EphrinA1, vascular endothelial growth factor and microRNA-210 after hydronephrosis / 中国医师杂志

Objective@#To investigate the difference and correlations of the EphrinA1, vascular endothelial growth factor (VEGF) expression and microRNA (miRNA)-210 in the kidney tissue of rats in the unilateral ureteral obstruction (UUO) model. And to understand the regulation mechanism of the three factors in the occurrence of renal tissue injury in rats.@*Methods@#Using unilateral ureteral ligation to establish a model of hydronephrosis in mice (except for the NC group), and they wrere randomly divided into an acute hydronephrosis group (UUO group) and a false surgical control group (NC group). The UUO group was divided into four groups (UUO 2 d group, UUO 5 d group, UUO 9 d group, and UUO 14 d group), and eight mice in each group. The pathological changes of renal tissue were observed by hematoxylin-eosin (HE) staining. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression of EphrinA1, VEGF and miRNA-210; Western blot was used to detect the protein expression of EphrinA1 and VEGF.@*Resulsts@#Hydronephrosis was not shown in the NC group, and hydronephrosis and inflammatory cell infiltration were observed in the UUO group. Compared with NC group, the mRNA expression of EphrinA1 , VEGF and miRNA-210 were up-regulated in UUO 2 d group (P<0.05). With the extension of the time of hydronephrosis, the expressions of all three factors were down-regulated in 9 d and 14 d groups compared with 2 d and 5 d groups, and reached the lowest point at 14 d (P<0.05); Western blot result indicated that the expression of EphrinA1 and VEGF in renal tissue of UUO 2 d and 5 d group was increased compared with NC group (P<0.05).@*Conclusions@#The UUO mouse model verified that miRNR-210 participated in hydronephrosis. The consistency of EphrinA1, VEGF, and miRNA-210 indicated that the three factors played an important role in the occurrence and development of UUO.

'Outbreak Gold Standard'Selection to Provide Optimized Threshold for Infectious Diseases Early-alert Based on China Infectious Disease Automated-alert and Response System / 华中科技大学学报（医学）（英德文版）

The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008.The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China.In the CIDARS,thresholds are determined using the'Mean+2SD'in the early stage which have limitations.This study compared the performance of optimized thresholds defined using the'Mean +2SD'method to the performance of 5 novel algorithms to select optimal 'Outbreak Gold Standard (OGS)'and corresponding thresholds for outbreak detection.Data for infectious disease were organized by calendar week and year.The'Mean+2SD',C1,C2,moving average (MA),seasonal model (SM),and cumulative sum (CUSUM) algorithms were applied.Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window.When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week,this Px was then defined as the optimized threshold for that algorithm.In this study,six infectious diseases were selected and classified into TYPE A (chickenpox and mumps),TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever].Optimized thresholds for chickenpox (P55),mumps (P50),influenza (P40,P55,and P75),rubella (P45 and P75),HFMD (P65 and P70),and scarlet fever (P75 and Ps0) were identified.The C1,C2,CUSUM,SM,and MA algorithms were appropriate for TYPE A.All 6 algorithms were appropriate for TYPE B.C1 and CUSUM algorithms were appropriate for TYPE C.It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

The effect of Nd：YAG lasers used in root canal therapy： a Meta-analysis / 口腔疾病防治

Objective @#Meta-analysis was used to assess the effect of Nd: YAG Lasers used in root canal therapy. @*Methods @# A search of literatures about clinical effect of Nd:YAG lasers in root canal therapy in PubMed, Embase, Cochrane Library, CMCC, CNKI, VIP, Wanfang databases was conducted from 1997 to 2015. The quality of included studies was stringently evaluated and data was analyzed by the RevMan 5.3 software.@*Results@#8 studies were included in the Meta-analysis. Meta-analysis results showed that the ratio of the occurrence of endodontic interappointment emergencies (EIAE) of 24 ~ 48 hours and 1 week after the therapy was significantly lower in the Nd: YAG lasers group compared with the control group (24 h: OR = 0.27, 95％CI = 0.15 ~ 0.48; 1week: OR = 0.26, 95％CI = 0.13 ~ 0.54). The six months to one year failure rate of root canal therapy was lower in Nd:YAG lasers group compared with the control group, the differences were statistically significant (OR = 0.24, 95％CI = 0.06 ~ 1.00). @*Conclusion@# The use of Nd: YAG laser in root canal therapy relieves post-treatment pain response after the therapy and also reduces the long-term failure rate of root canal treatment.

Retrospective analysis of emergent endoscopic management of foreign bodies in the upper gastrointestinal tract / 中国内镜杂志

Objective To present novel measures in endoscopic removal of foreign bodies in the upper gastrointestinal tract. Methods The clinical trial performed a retrospective analysis of emergency endoscopic management of 251 cases of foreign bodies in the upper gastrointestinal tract from January 2013 to November 2016. The patients underwent gastric endoscopic examinations under local pharyngeal anesthesia or general intravenous anesthesia. Flexible endoscopes and retrieval accessories such as rat-tooth and alligator forceps, polyp snares, polyp graspers, dormia basket, lithotripter or grasping forceps or rubber gloves were used for the endoscopic procedures. We reviewed of patients' general data (age, sex, type of foreign body), type of anaesthesia, foreign bodies' locations, type of accessory, complications, success rate. Results A total of 251 foreign bodies were definitely diagnosed through endoscopy, 248 foreign bodies were successfully removed with compatible devices according to the foreign bodies' location, nature, and size, and 3 cases failed. At the same time, 192 cases had little mucosal laceration and bleeding, and 45 cases were found to have underlying diseases. 1cases had esophageal surgery and 1cases had laryngeal surgery. 1 cases refuse to remove the foreign body because no symptoms and therapheutic risks. Conclusion Emergency endoscopic management is the foremost option for foreign bodies in the upper gastrointestinal tract, for its obvious advantages in safety, efficiency, low cost, and minimal invasion. Endoscopic intervention can also diagnose early underlying digestive diseases. Innovative measures can increase the successful rate of removing foreign bodies with gastric endoscopy.

Suggestions on improving administration of local crude drug quality standards / 中国中药杂志

To improve the administration of local crude drug quality standard, the administration history, and current administration situation of local crude drugs were reviewed, the legal orientation and positive effect of local crude drugs were analyzed, and the existing problems were summarized. It was found that many problems existed in the administration of local crude drug quality standards, especially the phenomenon of homonym and synonym on their names. The suggestions on improving the administration of local crude drug quality standards were proposed. First of all, the construction of legal system should be strengthened to improve the administration methods. Secondly, the coordination mechanism should be developed to solve the outstanding problems. Thirdly, the basic research should be enhanced to resolve the general technical problems. Lastly, the channels to transfer the local crude drugs into pharmacopeia standards should be developed to achieve dynamic administration.

Detection of sex hormone levels in children with hypospadias / 中国医师杂志

Objective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.

Research on application status of Chinese herbal decoction pieces based on clinical survey / 中国中药杂志

Chinese herbal decoction pieces are the basic approaches for clinical traditional Chinese medicine (TCM), reflecting the features and advantages of TCM. In order to investigate the clinical application status and features of Chinese herbal decoction pieces, the questionnaire on application of commonly used Chinese herbal decoction pieces was designed in this study for analysis of the application situations of Chinese herbal decoction pieces from 56 medical institutions in 10 provinces. The results showed 549 varieties of Chinese herbs and 801 varieties of decoction pieces were used on clinic. They can be classified into 19 categories according to their effects. The varieties of Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), Dihuang (Rehmanniae Radix), Chuanxiong (Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephale Rhizima), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinenses Radix), Baishao (Paeoniae Radix Alba) and Maidong (Ophiopogonis Radix) were most common ones; the application of Chinese herbal decoction pieces from different medical institutions was differentiated from areas to areas. The survey results reflected the general situation about application of decoction pieces, providing the basic data for recording and completing Chinese herbal decoction pieces in essential drug system, with certain reference significance for the production of Chinese medicinal materials and the allocation of the varieties of Chinese herbal decoction pieces.

HPLC combined with PCA technology for analysis of five gingerol compounds in different processing degrees of ginger charcoal / 中国中药杂志

To establish a new method for simultaneously determining the content of five gingerol compounds in different processing degrees of ginger charcoal and PCA principal component analysis was conducted for analysis. Samples were analyzed on Ultimate TM XB-C18 column (4.6 mm x 250 mm, 5 μm) , with acetonitrile (A) -0.1% phosphoric acid solution (B) as mobile phase for gradient elution. Detection wavelength was set at 280 nm. The flow rate was 0.6 mL x min(-1) and the column temperature was 30 degrees C. The five compounds were separated well and showed good linearity (r ≥ 0.999 7) within the concentration ranges tested. The average value for recoveries was between 98.86% - 101.5% (RSD 1.4% - 2.9%). The contents of five compounds showed difference among different processing degrees of ginger charcoal. Zingiberone had the highest content in the standard carbon, and the content of gingerol was decreased as the deepening of processing degree. Different processing degrees of ginger charcoal were classified into three groups with PCA, and provided scientific basis for establishing the quality standards of ginger charcoal.

Meta-analysis of selective serotonin reuptake inhibitors [SSRIs] compared to tricyclic antidepressants [TCAs] in the efficacy and safety of anti-depression therapy in Parkinson's disease[PD] patients

To assess the efficacy and safety of selective serotonin reuptake inhibitors[SSRIs] and tricyclic antidepressants[TCAs] in treatment of Parkinsonian depression. A computer-based search was conducted in the databases of PUBMED, MEDLINE, EMBASE and CochraneControlled Trails Register up to December 2011. The random controlled clinic trials about SSRIs and TCAs in treatment of Parkinsonian depression were collected. Statistical analysis was completed using Review Manager, version 5.0. Five clinic controlled trials were identified for this meta-analysis. There was no significant statistical difference in the response rate of treatment [RR 0.95, 95%CI [0.78, 1.16]] and Hamilton depression score [RR -2.54, 95%CI [-5.35, 0.26]] between two groups. In term of complications, no statistical difference was observed in the insomnia rate between two groups [RR 0.82, 95%CI [0.24, 2.84]]. Moreover, the incidence rate of xerostomia [RR 0.21, 95%CI [0.07, 0.65]] and constipation [RR 0.12, 95%CI[0.02, 0.63]] was lower in SSRIs group rather than those in TCAs group. In general, SSRIs and TCAs have comparable efficacy and equal acceptability in treatment of Parkinson's disease-induced depression. However, SSRIs are superior to TCAs in the terms of xerostomia and constipation

Application of traditional Chinese medicine reference standards in quality control of Chinese herbal pieces / 中国中药杂志

Traditional Chinese medicine (TCM) reference standards plays an important role in the quality control of Chinese herbal pieces. This paper overviewed the development of TCM reference standards. By analyzing the 2010 edition of Chinese pharmacopoeia, the application of TCM reference standards in the quality control of Chinese herbal pieces was summarized, and the problems exiting in the system were put forward. In the process of improving the quality control level of Chinese herbal pieces, various kinds of advanced methods and technology should be used to research the characteristic reference standards of Chinese herbal pieces, more and more reasonable reference standards should be introduced in the quality control system of Chinese herbal pieces. This article discussed the solutions in the aspect of TCM reference standards, and future development of quality control on Chinese herbal pieces is prospected.

Preliminary study on general regulations for processing of different processing procedures of prepared slices of Chinese crude drugs in China / 中国中药杂志

General regulations for the processing are the important part of processing procedures of prepared slices of Chinese crude drugs. It has an important significance on enhancing the operability of actual production, regulating production of prepared slices of Chinese crude drugs, improving quality and establishing drug safety. The article could provides suggestions and reference for future compilation work on "National processing procedures of prepared slices of Chinese crude drugs" by comparative analysis and summary on general regulations for the processing of different processing procedures of prepared slices of Chinese crude drugs in China.

Immunophenotype analysis of leukemic mantle cell lymphoma / 中国实验血液学杂志

Mantle cell lymphoma (MCL) is a kind of mature B-cell neoplasms with significantly poor prognosis and is usually misdiagnosed. With the development of flow cytometry and cytogenetic technique, most patients were at leukemic phase when diagnosed. This study was purposed to investigate the immunophenotypes of MCL, the immunophenotype information of 22 leukemic MCL patients was analyzed retrospectively. All the patients were conformed t(11;14) translocation by fluorescence in situ hybridization. Immunophenotypes were detected by a four-color flow cytometry including CD3, CD4, CD5, CD8, CD10, CD19, CD20, CD22, CD23, CD25, CD38, CD103, CD148, CD200, FMC7, ZAP-70, κ, λ. The results showed that CD19, CD5, CD20 and monoclonal sIg expressed in all 22 patients with CD20 high expression; CD22 expressed weakly in 17 patients; CD23 expressed in 6 patients including 2 cases highly expressed; FMC7 expressed in 12 patients. 5 patients were 4-point score and 17 patients had a score less than 4 according to CLL scoring system. CD148 and CD200 were detected in 18 patients, in which CD200 expressed negatively in 11 patients, CD200 expressed weakly in 7 patients with median fluorescence intensity (MFI) 25.8 (6.6 - 254.26); CD148 expressed positively in all 18 patients with median MFI: 337 (73.4 - 1341.9). It is concluded that the atypical immunophenotype is common in leukemia MCL, thereby the diagnosis of MCL needs comprehensively analyze with morphocytology, immunophenotype and cytogenetic, CD200 and CD148 as new bio-markers can differentiate MCL from chronic B cell lymphoproliferative disease.

Application of pressure of end-tidal carbon dioxide concentration in polysomnography / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The purpose of this study was to investigate the end-tidal carbon dioxide concentration (PETCO2) monitoring coupling in polysomnography for patients with obstructive sleep apnea hypopnea syndrome (OSAHS) during sleep.</p><p><b>METHODS</b>PETCO2 was sampled through a Oral-Nasal Cannula and measured using micro-stream capnometer. Capnometer was calibrated according to the manufacturer instructions and integrated into the standard polysomnographic recordings. Thirty-eight consecutive patients underwent overnight polysomnography (PSG) were synchronously monitored PETCO2. All variables were recorded continuously and transferred to a computer for analysis.</p><p><b>RESULTS</b>PETCO2 numeric values and waveform were displayed in real time on the PSG epoch. The mean PETCO2 of wake, non-rapid eye movement, rapid eye movement and TST(?) were negatively correlated with apnea-hypopnea index and arousal index (r were -0.458 ∼ -0.688, P < 0.01), were positively correlated with mean arterial oxygen saturation (SaO2) and lowest SaO2, (r were 0.604 ∼ 0.674, P < 0.01).</p><p><b>CONCLUSIONS</b>The study provides preliminary data showing that PETCO2 potentially can be used in continuous monitoring of OSAHS patients. And PETCO2 can indicate the severity of OSAHS.</p>

Dynamic analysis on impacting during baseball batting / 医用生物力学

Objective By a thorough analysis of the baseball batting to provide a theoretical instruction for baseball players with a simple and efficient dynamic model. Method Based on the moment of impulse theory, the closed form linear equations were derived by the dynamic analysis of the hinged multi-rigid body model. The numerical results would be obtained after solving the equations. Results (1) The batting speeds have been obtained by the numerical calculation under various conditions of different initial speeds of the baseball and bat; (2) The knockout speeds of wood bats are much smaller than the aluminum ones; (3) The coefficient of restitution has the significant effect on the batting speeds, and has no effects on sweet spot and center of position. Conclusions The numerical results are consistent with the data of experiments in reference. The calculating procedure is easy for baseball coaches and players to understand and can be applied in the training of baseball batting directly.

Experimental study of the effect of liposome-mediated vascular endothelial growth factor gene on the flap survival in rats / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of VEGF gene on the random flap survival after pedicle division at different time in rats.</p><p><b>METHODS</b>The random-pattern flaps were formed on the back of the 120 SD rats. PcDNAVEGF165 (gene) wrapped with liposome was injected into the flaps in experimental group (n = 40). The flaps in the two control groups were injected with PcDNA (n = 40) or saline (n = 40). 1, 3, 5, 7 days after injection, 10 rats in each group were randomly selected to performed pedicle division. 7 days after pedicle division, the rats were killed to measure the flap survival rate. The microvessels was studied by histologic examination. The expression of VEGF was assessed by immunohistochemical staining. The flaps were also examined under the electron ultrastructure microscopy.</p><p><b>RESULTS</b>1) Flap survival rate after pedicle division in experimental group at 1 day, 3 days, 5 days, 7 days after injection, were (45.45 +/- 12.24)%, (82.95 +/- 3.81)%, (85.00 +/- 3.38)%, (85.96 +/- 3.25)%, respectively. The flap survival rates were significant different between experimental group and the control groups at 3, 5, 7 days after injection (P < 0.05), but not at 1 days after injection (P > 0.05). 2) The average microvascular diameter and number in experimental group were significantly higher than those in control groups (P < 0.05). 3) The expression of VEGF in experimental group was significantly higher than that in the two control groups (P < 0.05). 4) Ultrastructure study showed more angiogenesis in experimental group.</p><p><b>CONCLUSIONS</b>Subcutaneous injection of liposome-mediated VEGF gene can increase the survival rate of flap with early pedicle division. It is a simple, efficient, economic, and the relatively safe gene therapy.</p>

Analysis of NPM1 gene mutations in acute myeloid leukemia / 中国实验血液学杂志

The aim of this study was to evaluate the nucleophosmin (NPM1) gene exon 12 mutation in patients with acute myelogenous leukemia (AML) and its clinical characteristics. Genomic DNAs from 33 AML patients were amplified by PCR and sequencing for NPM1 mutations. The results showed that the NPM1 exon 12 mutations were found is 8 patients from 33 AML patients (24.2%) including 1 of M(1), 3 of M(2), 1 of M(4) and 3 of M(5). The NPM1 gene mutations were found in 7 out of 19 patients with normal karyotype and their incidence was significantly higher than that in patients with karyotype abnormalities (1/14, 7.1%, p < 0.005). The proportion of bone marrow blast cells and the count of peripheral white blood cells in patients with NPMI exon 12 mutation were higher than that in patients with wild type NPMI gene. It is concluded that the occurrence of NPM1 exon 12 mutations is observed more in AML patients with normal karyotype. NPM1 mutant cases are associated with more high amount of boon marrow blast cells and peripheral white blood cell count.

Value of pulse transit time in detecting respiratory drive / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To assess the accuracy of pulse transit time (PTT) in classification of apnea events, and collect data for clinical application reference.</p><p><b>METHODS</b>Thirty-two obstructive sleep apnea-hypopnea syndrome (OSAHS) patients included in the research had Polysomnography (PSG), and 10 305 apnea events were recorded. All the events were analyzed by PTT and esophageal pressure (Pes) respectively. The results were analyzed to assess the accuracy of PTT and compare the accuracy of pulse transit time between REM stage and NREM stage, and analyze the correlation between age, body mass index (BMI), apnea hypopnea index (AHI) and concordance rate in every patient.</p><p><b>RESULTS</b>The total concordance rate between PTT and Pes in classification of apnea was 96.7% (9970/10305). The sensitivities of PTT in detecting central, mixed and obstructive apnea were 88.0%, 91.3% and 97.8% respectively and the specificities were 99.8%, 97.8% and 92.8% respectively. The false determinations of apnea events mainly concentrated on the false determinations between the obstructive and mixed apnea. There was no statistical significant between the accuracy of PTT in different sleep stages. There was a negative relationship between the age, BMI, Lowest SaO2, AHI and the concordance rate.</p><p><b>CONCLUSIONS</b>There was good concordance between PTT and Pes in classification of apnea. PTT had very high sensitivity and specificity in detecting all kinds of apnea. This study showed that PTT can detect respiratory drive noninvasively with high accuracy.</p>