Prognostic influencing factors analysis of patients with estrogen receptor-positive de novo stage Ⅳbreast cancer / 肿瘤研究与临床

Objective:To investigate the factors influencing the prognosis of patients with estrogen receptor (ER)-positive de novo stage Ⅳ breast cancer.Methods:The clinical data of 339 patients with ER-positive de novo stage Ⅳ breast cancer treated in Tianjin Medical University Cancer Hospital and Cangzhou Hospital of Integrated TCM-WM from February 2010 to December 2017 were retrospectively analyzed. Related factors such as age, time of chief complaint, the clinical T/N stage, site of metastasis, expressions of molecular markers and treatment mode were included. Univariate log-rank test and multivariate Cox regression model were used to analyze the effects of prognostic factors on patients' overall survival (OS).Results:Univariate analysis showed that there were statistically significant differences in the OS of patients stratified by clinical N stage at first diagnosis, metastasis sites at first diagnosis, ER expression, progesterone receptor (PR) expression, Ki-67 positive index and p53 expression, endocrine therapy, chemotherapy at first diagnosis, surgery and radiotherapy of the primary lesions (all P < 0.01). Multivariate Cox regression analysis results showed that metastasis sites at first diagnosis, Ki-67 positive index, surgery and radiotherapy of the primary lesions were all independent influencing factors of OS for breast cancer patients (all P < 0.01). Conclusions:Patients with ER-positive de novo stage Ⅳ breast cancer have a good prognosis when they have oligometastasis, Ki-67 positive index ≤ 20%, and they receive surgery and radiotherapy of the primary lesions.

Application of scenario simulation teaching based on PBL in communication ability training of Pediatric Hematology Department / 中华医学教育探索杂志

Objective:To explore the application of scenario simulation teaching based on PBL in communication skills training of hematology students in Children's Hospital.Methods:The training of doctor-patient communication skills was conducted among trainees who had the standardized residency training at the Department of Hematology of the Children's Hospital of Soochow University. All the residents were randomized into the control group and observation group by lottery, with 24 residents in each group. The control group adopted the traditional narrative teaching method, and the observation group adopted PBL combined with scenario simulation teaching method. The Liverpool communication skills assessment scale (LCSAS) was used to compare the differences between the two groups before and after training, and the differences between the two groups after training. Then the degree of residents' recognition of these two teaching methods was investigated. Finally, the examination results were used to evaluate knowledge mastery of doctors in department of hematology. SPSS 20.0 was used for Chi-square test and t-test. Results:LCSAS scores of the two groups before training were respectively (11.61±2.21) and (11.95±2.22), with no statistically significant difference ( P >0.05). After PBL-based scenario simulation teaching and training in the observation group, the LCSAS score of the observation group (27.41±2.53) was higher than that of the control group (23.30±1.81), and the difference between the two groups was statistically significant ( P<0.05). Questionnaire survey results showed that the favorable rating rate of PBL-based scenario simulation teaching was 91.67% (22/24), higher than that of the traditional narrative teaching method [62.50% (15/24)], and the difference was statistically significant ( P<0.05). The examination of students' mastery of professional knowledge showed that after the PBL-based scenario simulation teaching and training, the trainees had a better grasp of knowledge and a higher score, with excellence rate of 91.67% (22/24）, which was higher than 66.67% (16/24) of the control group, with a statistically significant difference ( P<0.05). Conclusion:The scenario simulation teaching based on PBL could improve the communication ability and professional knowledge of trainees taking standardized residency training in the department of hematology, and the trainees are highly satisfied with this teaching method.

Role of Oxidative Stress in Osteoporosis and Treatment by Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Osteoporosis （OP） is a systemic metabolic bone disease. Amid population aging， OP has become a major health problem for the middle-aged and the elderly in China. Aging， iron load， and estrogen deficiency break the balance between oxidation and antioxidant systems， and the increase of reactive oxygen species mediates oxidative stress to damage DNA， lipids， proteins and other macromolecules， thus accelerating cell apoptosis and inducing OP， obesity， and neurodegenerative disorders. It has been found that oxidative stress is of great significance in the pathogenesis of OP. Oxidative stress regulates the signaling pathways， cytokines， and proteins related to the mesenchymal stem cells， osteoblasts， and osteoclasts， thereby weakening the osteogenic differentiation of mesenchymal stem cells， inhibiting osteoblast mineralization， and promoting the activation， proliferation， and maturation of osteoclasts. As a result， the dynamic imbalance between bone resorption and bone formation occurs， influencing bone remodeling and promoting the progression of OP. At the moment， anti-bone resorption drugs， bone formation-promoting drugs， and hormones are mainly used in clinical settings in western medicine. However， due to the long treatment cycle and the occurrence of serious gastrointestinal reactions， hypocalcemia， osteonecrosis， and others， patients show poor compliance and thus the effect is not as expected. Traditional Chinese medicine （TCM） demonstrates remarkable effect on OP attributing to the multi-pathway and multi-target characteristics. With low price and few adverse reactions， TCM is widely applied in clinical practice in comparison with western medicine. TCM has unique advantages in the treatment of OP by regulating oxidative stress. It exerts the therapeutic effect on OP by modulating different signaling pathways， providing new mindset for the treatment of this disease. Therefore， through literature research， this study summarized the research on mechanism of oxidative stress in OP and the treatment by TCM， which is expected to lay a foundation for further research.

Research on clinical application of manual therapy to tumor-related adverse reactions / 针灸推拿医学（英文版）

Objective: To analyze the clinical application of manual therapy (MT) to tumor-related adverse reactions via summarizing the research at home and abroad, in order to provide more theoretical evidence for the clinical promotion of MT. Methods: We searched 7 Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Excerpta Medica Database (EMBASE), Ovid and EBSCO. The publication date was between the establishment date of the database and December 31, 2020. We screened the literature according to the inclusion and exclusion criteria, and then sorted and analyzed the selected information. Results: A total of 46 papers were analyzed. Most studies focused on the adverse reactions in breast cancer patients. MT interventions demonstrated the best efficacy for fatigue, followed by pain, depression and anxiety. In different MT interventions, Tuina (Chinese therapeutic massage) was mainly adopted for fatigue, pain, anxiety, depression, and limb dysfunctions. Acupoint pressing was mainly adopted for gastrointestinal and psychological problems such as abdominal bloating, insomnia, depression and anxiety. The application of reflexotherapy was similar to that of Tuina. Conclusion: MT can alleviate various adverse reactions by effectively relieving patients' somatic symptoms and improving their psychological states and overall functions. It can be popularized as a significant non-drug therapy. Currently, however, the clinical application of MT is neither extensive nor has sufficient basic research. Consequently, we should attach importance to this application.

The risk factors for hemophagocytic syndrome in childhood Epstein-Barr virus-associated infectious mononucleosis / 中国医师进修杂志

Objective:To explore the risk factors for hemophagocytic syndrome (HPS) in childhood Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM).Methods:From January 2013 to December 2017, the medical charts of all children who were diagnosed with EBV-associated IM and HPS in Children′s Hospital of Soochow University were analyzed retrospectively. Statistical analyses were performed using SPSS version 22.0.Results:A total of 316 IM and 59 HPS were enrolled. The age was (4.26 ± 2.95) years old with a male-to-female ratio of 1.2∶1. In addition to the diagnostic criteria of HPS, there were significantly lower rates of fever >10 d, hepatomegaly, jaundice, alanine aminotransferase >500 U/L, aspartate aminotransferase >500 U/L, LDH >1 000 U/L, C-reactive protein >50 mg/L and hypoalbuminemia in children with EBV-associated IM compared to those with HPS, and the differences were statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that fever >10 d, eyelid edema, lymphadenopathy and purulent tonsils were independent predictors of HPS in children with EBV-associated IM ( P<0.05). Hepatomegaly and fever >10 d were risk factors ( OR = 16.079 and 12.138, 95% CI 2.788 to 92.744 and 2.878 to 51.180). Eyelid edema, lymphadenopathy and purulent tonsils were protective factors ( OR = 0.087, 0.006 and 0.031; 95% CI 0.010 to 0.723, 0.001 to 0.058 and 0.007 to 0.146). Conclusions:Hepatomegaly and fever >10 d are the risk factors for hemophagocytic syndrome in childhood EBV-associated infectious mononucleosis.

Analysis of curative effect of hematoma removal and minimally invasive puncture drainage in hypertensive intracerebral hemorrhage under neuroendoscope / 中国医师杂志

Objective:To compare the curative effect of hematoma removal and minimally invasive puncture drainage in hypertensive intracerebral hemorrhage (HICH) under neuroendoscope.Methods:The clinical data of 118 patients with HICH admitted to our hospital from February 2017 to November 2019 were retrospectively analyzed. According to the different surgical methods, the patients were divided into group A ( n=59, minimally invasive puncture and drainage) and group B ( n=59, neuroendoscopic hematoma removal). The perioperative indexes, complications and neurological function indexes [neuron specific enolase (NSE), neurotrophic factor (NGF), substance P (SP)], inflammatory factor index [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] and related scale scores [National Institutes of Health Stroke Scale (NIHSS), modified Barthel Index (mBI)] were compared between the two groups. Results:The operation time, cerebrospinal fluid recovery time, hematoma removal time and hospitalization time of group B were shorter than those of group A ( P<0.05). On the 7th day after operation, the NSE, SP, IL-6, TNF-α in the two groups were decreased, and the levels of NSE, SP, IL-6 and TNF-α in group B were lower than those in group A ( P<0.05); on the 7th day after operation, the levels of NGF in two groups were increased, and those in group B were higher than those in group A ( P<0.05). 6 months after operation, the NIHSS decreased and mBI increased in both groups ( P<0.05), and NIHSS in group B was lower than that in group A, but mBI was higher than that in group A ( P<0.05). There was no difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Compared with minimally invasive puncture and drainage, neuroendoscope hematoma removal for HICH patients can effectively improve perioperative indicators, reduce neurological damage and body inflammatory stimulation, and improve the self-care ability of patients, which is safe and reliable.

The role of Mycoplasma pneumoniae in children with community-acquired pneumonia / 中国医师进修杂志

Objective:To explore the role of Mycoplasma pneumoniae (MP) in hospitalized children with community-acquired pneumonia (CAP) in Suzhou.Methods:Pathogen data of 2 367 patients with bronchiolitis, bronchopneumonia, lobar pneumonia, and interstitial pneumonia were retrospectively analyzed from January 2017 to December 2018 in Children′s Hospital of Soochow University. The detected pathogens were MP, respiratory syncytial virus (RSV), adenovirus (Adv), influenza A, B, parainfluenza virus (PIV) 1, 2 and 3, human metapneumovirus (hMPV), boca virus (HBoV) and bacteria.Results:The most common pathogen of bronchiolitis was RSV (34.9%, 249/713), followed by MP (15.8%, 113/713) and hMPV (11.4%, 85/713). The most common pathogen of bronchial pneumonia was Streptococcus pneumoniae (Sp, 14.8%, 180/1 220), followed by RSV (13.1%, 160/1 220) and MP (10.2%, 124/1 220). The most common pathogen of lobar pneumonia was MP (47.8%, 141/295), followed by Sp(12.9%, 38/295). The most common pathogen of interstitial pneumonia was MP (35.3%, 49/139), followed by RSV (23.0%, 32/139) and Adv (6.5%, 9/139). Compared with non-MP infections, children with MP infections were older, and had higher percentage of fever and less shortness of breath. The adjusted OR(95% CI) was 2.4 (1.1-3.5), 5.1 (3.2-10.4) and 0.2 (0.0-0.4), respectively. Conclusions:MP is the most common pathogen of lobar pneumonia and interstitial pneumonia and the second most common cause of bronchiolitis. MP infections are usually associated with older age, higher percentage of fever and less shortness of breath.

Clinicopathological features and prognostic analysis of initially diagnosed stage Ⅳ breast cancer bone metastasis / 中国肿瘤临床

Objective: To examine the relationship of clinicopathological features and treatment strategies with the prognosis of patients with initially diagnosed stageⅣbreast cancer bone metastasis (IDBCBM). Methods: Clinical data from 74 patients with IDBCBM who were treated at Tianjin Medical University Cancer Institute and Hospital between March 2007 and November 2016 were analyzed retrospectively. A univariate analysis of prognosis was conducted using a Log-rank test, and the subsequent multivariate analysis was conducted using a Cox regression model. Results: The median age of the patients was 53.3 years. The median total survival duration (overall survival, OS) was 34.3 months, and the 3-and 5-year survival rates were 37.8% and 12.2%, respectively. Patients for whom the first distant metastasis was bone metastasis only had a better prognosis, with a median survival duration of 41.7 months and overall 3-and 5-year survival rates of 54.5% and 20.4%, respectively. In the univariate analysis, molecular subtype, hormonal receptor status, HER-2 expression levels, nodal status, Ki-67 index, number of bone metastases (NBM), initial mode of metastasis, mode of therapy, and locoregional treatment showed an association with prognosis. Further, multivariate analysis demonstrated that Ki-67 index, NBM, mode of therapy, and initial mode of metastasis were independent factors affecting OS (P<0.05). Conclusions: A high Ki-67 index, single mode therapy, the presence of multiple bone metastases, and accompanying visceral metastasis were associated with a poor prognosis. However, it remains unclear whether locoregional treatment, including surgery and radiotherapy treatment of the primary tumor, is beneficial.

Treatment of four cases of Fanconi anemia by allogeneic hematopoietic stem cell transplantation with low intensity conditional regimen / 中华血液学杂志

Objective@#To evaluate the efficiency and safety of low intensity conditional regimen for children with Fanconi anemia (FA) receiving allogenic hematopoietic stem cells transplantation (allo-HSCT).@*Methods@#Four patients diagnosed as Fanconi anemia were enrolled in this study. One patient received HLA-identical sibling donor hematopoietic stem cell transplantation, two patients underwent unrelated donor matched (UD) HSCT, and one patient received unrelated cord blood transplantation. The conditional regimen consisted of Busulfan with low dose of cyclophosphamide.@*Results@#All 4 cases succeeded in allo-HSCT. The median time for neutrophils engraftment was 11(9-15) day, median time to platelets (PLT) engraftment was 12 (8-28) day. One case occurred with grade I of aGVHD, 1 case with hemorrhagic cystitis. No patient happened with hepatic veno-occlusive disease (VOD).@*Conclusion@#Low intensity of conditional regimen is efficient and safe which should be recommended for FA patients with HSCT.

The value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma / 中华普通外科杂志

Objective To explore the clinical value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma (PTC).Methods A total of 1 408 PTC patients who met the inclusion criteria and received initial thyroidectomy at our department from January 2006 to December 2011 were enrolled in this study.Results After a median follow-up time of 7.8 years,distant metastases developed in 46 patients.Patients with lateral neck lymph node metastasis ≥7,individual size of lateral neck lymph node metastasis ≥ 1.15 cm and the total number of cervical lymph node metastasis ≥9 were prone to higher risk of distant metastasis;the high risk group had a lower 10-year distant metastasisfree survival (78.7％ vs.98％,x2 =122.941,P ＜0.01) and a shorter distant metastasis-free survival time (99.2 M vs.122.5 M,x2 =122.941,P ＜ 0.01).Conclusions Lateral lymph node metastasis is an independent risk factor for distant metastasis in PTC patients.

The safety of decitabine as bridging pretreatment regimen before hematopoietic stem cell transplantation in pediatric hematological malignancies / 中华内科杂志

The safety of decitabine as bridging treatment before allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with refractory hematological malignancies was evaluated.All 11 cases succeeded in hematopoietic reconstitution.The main adverse reaction was hematological toxicity.Neither did infections occur,nor drug-induced liver damage and renal impairment during decitabine administration.Most cases showed grade Ⅰ-Ⅱ gastrointestinal adverse events.One case was diagnosed as severe acute graft versus host disease and died of intracranial hemorrhage on day 61 after allo-HSCT.The other 10 patients survived.Decitabine bridge is a safe regimen before allo-HSCT in children with refractory hematological malignancies.

Clinical efficacy of recombinant activated factor Ⅶ a for 16 hematonosis with moderate or severe bleeding / 中华血液学杂志

Objective@#To analyze the efficacy of recombinant activated factor Ⅶ a (rF Ⅶ a) on hematonosis with moderate or severe bleeding signs.@*Methods@#Of total 16 cases with rF Ⅶ a treatment from May 2013 to May 2016, 8 cases received allogeneic hematopoietic stem cells transplantation (allo-HSCT) and the other were non-transplantation patients. In two groups, there was no significant difference on rF Ⅶ a usage and dosage. 15 patients with acute graft-versus-host disease (aGVHD) after allo-HSCT were control group (without rF Ⅶ a) .@*Results@#①The total response rate was 75.0% (6/8) in non-transplantation group and 37.5% (3/8) in transplantation group, respectively. Median interval for hemorrhage stop was 38.5 hours in non-transplantation group and 63.0 hours in transplantation group. The median overall survival (OS) was 201.0 and 29.0 days for non-transplantation group and transplantation group, respectively, and the OS rate was 50.0% (4/8) and 25.0% (2/8) , respectively. The bleeding-related mortality rate was 50.0% (2/4) and 83.3% (5/6) , respectively. ②Of the 16 cases, 9 showed response to rF Ⅶ a treatment and the other 7 cases’bleeding signs did not alleviate. The median OS was 268.0 in 9 cases with response and 24.0 days in 7 cases without response, respectively. ③In patients with intestinal aGVHD complicated with intestinal hemorrhage, the median OS of observation group (n=6) and control group (n=15) were 25.5 days and 20.0 days, respectively.@*Conclusion@#Patients with hematological diseases, especially patients after allo-HSCT, had high bleeding-related mortality, and rFⅦa therapy had a obvious hemostatic efficacy. The survival rate of patients with response was higher than that of cases without response. The causes of poor hemostasis efficacy of rF Ⅶ a therapy were associated with unsatisfactory control of complications in patients with intestinal bleeding after allo-HSCT.

Analysis of children with acute promyelocytic leukemia by using 2010-protocol in China: an experience from single center / 中华实用儿科临床杂志

Objective To explore the clinical efficacy and adverse reactions of children with acute promyelocytic leukemia (APL) by adopting Chinese children APL-2010-protocol in single center.Methods Forty-seven children with newly diagnosed APL in Soochow University Affiliated Children's Hospital from October 2010 to September 2015 were selected,including 30 boys and 17 girls with the median age of 7 years (1.2-14.0 years).The patients were divided into 3 groups,including 11 cases in the low-risk group,20 cases in the intermediate-risk group and 16 cases in the high-risk group.Their clinical features and therapeutic prognosis were analyzed retrospectively and the clinical efficacies were compared in low-risk group[white blood cell(WBC) ≤ 10 × 109/L,platelets (PLT) ＜ 40 × 109/L],intermediate-risk group (WBC ≤ 10 × 109/L,PLT ≤40 × 109/L) and high-risk group (WBC ＞ 10 × 109/L).Five-year event-free survival (EFS) rate and overall survival (OS) rate of each group were analyzed by using Kaplan-Meier curve method.Results The peak comparative difference of peripheral blood WBC among 3 groups was statisticallysignificant(x2 =7.618,P =0.002).The occurrence rate of disseminated intravascular coagulation (DIC) was 68.8％ and the occurrence rate in the high-risk group was higher compared with low-risk group and intermediate-risk group (x2 =8.217,P =0.016).Arsenic trioxide related side effects including abnormal liver tests,electrocardiogram and anaphylactic reaction were invertible after supportive therapy.Hematologic complete response (HCR) rate in the high-risk group was 93.7％,HCR time was (39.3 ± 2.7) days and molecular complete remission (MCR) time was(71.0 ± 9.7) days.HCR rate in the intermediate-risk group was 95.0％,HCR time was (44.6 ± 3.1) days and MCR time was (80.0 ± 8.2) days.HCR rate in the low-risk group was 100.0％,HCR time was (32.4 ±2.3) days and MCR's time was (71.5 ± 12.0) days.HCR time among 3 groups had statistical significance (F =3.652,P =0.034),but HCR rate and MCR time among 3 groups showed no statistical significance (F =0.318,P =0.729).In the high-risk group,EFS rate was (93.3 ± 6.4) ％,5-year OS rate was (86.7-± 8.8) ％.Meanwhile,5-year OS rate and EFS rate were 100.0％ in other 2 groups.Conclusions Treating patients with APL by using 2010 protocol according to the risk stratification in our center has achieved high long-time survival.The higher the risk,the higher the incidence of DIC in induction period,but eventually achieve a very high rate of 5-year EFS was achieved.No chronic arsenic toxicity or second malignancies were found during the follow-up time.

Characteristics and prognosis of parvovirus B19 infection in Pediatric leukemia patients in Suzhou / 临床儿科杂志

Objective To explore the effect of parvovirus B19 (VB19) infection on pediatric leukemia patients. Methods The pediatric leukemia patients were enrolled in the study in the Children's Hospital of Soochow University. Expression levels of VB19-DNA-PCR were detected using the polymerase chain reaction. Positive patients would be monitored and treated by conventional treatment as well until VB19 gene became negative. The data was compared according to the VB19 clearance time, clinical symptoms and blood counts to evaluate the effect. Results In the 3009 samples from 824 pediatric leukemia patients, there were 36 samples (1.2%) from 12 cases (1.5%) of pediatric leukemia paients with positive VB19 infection. Among the positive patients, 11 cases (1.9%) were from 582 with acute lymphoblastic leukemia (ALL) patients and 1 (0.45%) was from 212 with acute myeloid leukemia (AML). According to the treatment stage, 3 cases were in initially diagnosed period, 2 cases in early stage of consolidation chemotherapy, 4 cases in delayed enhanced chemotherapy period, and 3 cases in maintenance chemotherapy period. According to the treatment response, 4 cases were in continuous treatment, 2 cases were sensitive to treatment, and 3 cases were drug resistant. In the drug resistance group, 2 cases developed into the pure red cell aplastic anemia (PRCA). After treatment, one was recovered from PRCA with VB19 cleared, the other one remained PRCA with continuously positive VB19. Conclusions More VB19 virus infection in pediatric ALL happened in delayed enhanced chemotherapy period. The persistent presence of VB19 infection on pediatric leukemia patients is closely related with PRCA.

Analysis on HLA B27 results detected by real-time fluorescence PCR method and flow cytometry / 国际检验医学杂志

Objective To compare the clinical application value of the real-time fluorescence PCR method and flow cytometry method for detecting human leukocyte antigen B27(HLA-B27).Methods Blood HLA-B27 level in 225 patients with suspected ankylosing spondylitis was detected by using real-time fluorescence PCR method and flow cytometry method.The detection results were compared and analyzed between the two methods.Results The results of 95.1% sample were identical detected by two methods without statistically significant difference(P>0.05).Taken the results of flow cytometry as reference, the sensitivity of real-time fluorescence PCR for detecting HLA-B27 was 94%, the specificity was 96%.Gene sequencing was performed if results of a sample detected by two methods were different, which was identical with the result detected by real-time fluorescence PCR.Conclusion Both methods for detecting HLA-B27 all have high sensitivity and specificity.Real-time fluorescence PCR method is more superior to the flow cytometry method in the results accuracy.

Effects of Pharmaceutical Intervention after Discharge on Medication Compliance and the Prognosis of Coronary Artery Disease Patients after PCI in Primary Hospital / 中国药房

OBJECTIVE:To investigate the effects of pharmaceutical intervention after discharge on medication compliance and prognosis of patients with coronary artery disease after percutaneous coronary intervention(PCI) in primary hospital.METHODS:One hundred and eighty patients with coronary artery disease selected from our hospital after PCI during Jan.2012 to May 2015 were divided into test group and control group according to whether the patients received pharmaceutical intervention after discharge,with 90 cases in each group.Control group received conventional pharmaceutical care and discharge education.Test group additionally received pharmaceutical intervention (pharmaceutical service files,telephone follow-up,patient education,etc.) after discharge.Medication compliance and occurrence of cardiovascular events were compared between 2 groups in 1 year after discharge.RESULTS:Within 1 year after discharge,the proportion of patients showing good compliance in test group was higher than control group,the proportion of patients showing partial and non compliance in test group were lower than control group;the inci dence of heart failure and repeated revascularization,hospitalization mortality and total mortality of test group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:Pharmaceutical intervention after discharge can improve the medication compliance of coronary artery disease patients after PCI in primary hospital,reduce the occurrence of cardiovascular events and improve the clinical prognosis.

Subcritical Butane Extraction for Effective Removalof Abamectin in Fresh Tea Leaves / 分析化学

Subcritical butane technology was employed for the separation of abamectin on the fresh tea leaves surface.Under the conditions of solid-liquid ratio of 1∶10 (m/V), the experiment was designed via the response surface methodology and conducted at different temperature, various separation time and discrepant cycle number.Besides, the activity of the polyphenol oxidase (PPO) relating to the quality of the tea was determined and compared.At the same time, scanning electron microscopy (SEM) was used to observe the surface structure of fresh tea leaves before and after treatment, and the effect on physiological characteristics of the leaves by subcritical butane treatment was analyzed.The experimental results showed that the subcritical butane extraction could effectively isolate the abamectin, making the physical structure basically remained and the polyphenol oxidase activity preserved as well.Through the analysis by Design Expert software, the optimal processing parameters of separating abamectin were as follows: 45℃, 30 min, 1 cycle, and solid-liquid ratio of 1∶10 (m/V).Under the optimal conditions, the separation efficiency was over 91% and the relative PPO activity was 25.73%.The structure of fresh tea leaves changed insignificantly before and after the butane processing.This study suggested that the subcritical butane extraction technology could effectively remove pesticide residues in tea, thus provided a certain scientific basis for application of subcritical fluid removal of pesticide residue in natural plants.

Establishment of MALDI TOF-MS Technique Platform for Detecting Cytochrome P4 5 0 Gene Polymorphism / 现代检验医学杂志

Objective To establish the MALDI-TOF-MS technique platform for detecting Cytochrome P450 gene polymor-phismfrom of patients.Methods Collected 53 EDTA anticoagulation peripheral blood samples from October 2013 to June 2014 in Peking Union Medical College Hospital.The whole genomic DNA was extracted from patients’peripheral blood. Used MALDI-TOF-MS to identify the SNP polymorphism of CYP2C9*2(rs1799853),CYP2C9*3(rs1057910),CYP2C19*2(rs4244285),CYP2C19*3(rs4986893),CYP2C19*4(rs28399504),CYP2C19*5(rs56337013)and CYP2C19*17 (rs12248560).To verify the above SNP polymorphism by Sanger sequencing method.Results The MALDI-TOF-MS could perform 53 samples on two cytochrome gene and 7 SNP locus simultaneously.In all the 53 patients,25 AG,6 AA and 22 GG genotypes were identified in CYP2C19*2(rs4244285),the allele frequency of A genotype was 34.9%.4 AG and 49 GG genotypes were identified in CYP2C19*3 (rs4986893),the allele frequency of A genotype was 3.8%.5 CA and 48 AA gen-otypes were identified in CYP2C9*3 (rs1057910),the allele frequency of C genotype was 4.7%.No mutation loci were i-dentified in CYP2C9*2 (rs1799853),CYP2C19*4 (rs28399504),CYP2C19*5 (rs56337013)and CYP2C19*17 (rs12248560).All the identification data were confirmed by Sanger sequencing.The coincidence rate was 100%.Conclusion The MALDI-TOF-MS technique platform for the cytochrome enzyme SNP was established.This platform has high throughput and accurate characteristics.It has important clinical application value for the treatment of personalized medicate.

Clinical Observation of Alteplase Intravenous Thrombolysis in the Treatment of Acute Cerebral Infarction / 中国药房

OBJECTIVE:To observe the bleeding,therapeutic efficacy and ADR of patients with acute cerebral infarction (ACI) treated by alteplase intravenous thrombolysis. METHODS:140 ACI patients were randomly divided into group A and B with 70 cases in each group. Group A was give alteplase 0.6 mg/kg for intravenous thrombolytic therapy,and group B was given al-teplase 0.9 mg/kg for intravenous thrombolytic therapy. The bleeding after thrombolysis,bleeding time,therapeutic efficacy and ADR were compared between 2 groups. RESULTS:The incidence of Subcutaneous ecchymosis,gingival bleeding,bleeding of di-gestive tract and intracranial hemorrhage of group A were 4.29%,2.86%,2.86% and 2.86%;those of group B were 14.29%, 12.86%,11.43% and 11.43%;the bleeding time of those symptomsin 2 groups were(6.04±0.75)and(7.22±0.56)h、(24.63± 10.24)and(35.22±9.87)min、(3.04±0.11)and(4.08±0.25)h、(3.12±0.48)和(4.53±0.66)h respectirely,with statistical signifi-cance(P0.05). CONCLUSIONS:The bleeding should be monitored strictly when ACI patients receive alteplase intravenous thrombolysis,and low-dose alteplase thrombolysis can ultimately reduce the incidence of bleeding.

The significance of Treg and T lymphocyte subsets in acute myelocytic leukemia / 安徽医科大学学报

Objective To explore the alterations, relationship and clinical significance of CD4 +CD25 +CD127 low/ - regulatory T cells ( Treg ) and lymphocyte subsets in peripheral blood of patients with acute myelocytic leukemia ( AML) . Methods The level of peripheral blood lymphocyte subsets and Treg of untreated AML patients and com-plete remission( CR) patients were tested by flow cytometry,and were compared with that of 30 normal controls. Re-sults The proportions of Treg were much higher in untreated AML patients and CR patients than in normal con-trols, while the mean proportion of Treg in untreated AML patients was higher than that in CR patients(P<0. 05). The proportions of NK( CD3 -CD16 +CD56 +) cells in untreated AML patients and CR patients were both decreased compared with normal controls,and the mean proportion of NK cells in untreated AML patients was lower than that in CR patients(P<0. 05). Compared with the normal controls,the proportions of CD3 +T cell, CD4 +T cell,and the ratio of CD4 +/CD8 + decreased in untreated AML patients ( P <0. 05 ) , but the proportions of CD8 +T cell was higher than in normal controls;the proportions of CD3 +T cell, CD4 + T cell, CD8 +T cell and the ratio of CD4 +/CD8 + in CR patients were close to the proportions in normal controls, but there was significant difference between CR patients and untreated AML patients(P<0. 05). Conclusion The increase of Treg, CD8 +T cell and decrease of NK cells, CD3 +T cell, CD4 +T cell, and the ratio of CD4 +/CD8 + in peripheral blood of patients with AML in-dicate that the immune function of patients with AML is depressed. Treg control the immune response of CD8 +T cells,at the same time inhibit the natural immune response of NK cells, playing a major role in the disorders of CD4 +T cells and CD8 +T cell balance,and closely relate with the development of AML. The immune treatment of patients with AML will be optimised by reducing the amount of Treg or removing the suppression function.