A nomogram for individualized prediction of the probability of hemorrhagic transformation in patients with acute ischemic stroke after endovascular treatment based on 4-dimensional CT angiography factors / 中华放射学杂志

Objective:To assess the value of 4-dimensional CT angiography (4D CTA) to predict hemorrhagic transformation (HT) with a new nomogram model in acute ischemic stroke (AIS) patients after endovascular treatment (EVT).Methods:Imaging and clinical data of 101 AIS patients with internal carotid artery and/or middle cerebral artery occlusion who underwent "one-stop" CTA-CT perfusion and EVT in green channel of Beijing Hospital from March 2016 to November 2020 were analyzed retrospectively. The patients were divided into HT group (45 patients) and non-HT group (56 patients). Multivariate logistic regression analysis was used to select relevant clinical and imaging variables, such as age, initial National Institute of Health stroke scale (NIHSS) score, 4D CTA collateral circulation score, Alberta stroke program early CT score (ASPECTS), clot burden score, and a predictive nomogram model were developed. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the efficacy of predictive nomogram model for diagnosing HT.Results:Univariate analysis showed that there were significant difference of age[79.00(68.00, 85.00) years, 73.00(62.75, 80.00) years, Z=-2.20, P=0.028], NIHSS score [16.00(12.00, 21.00), 9.50(6.00, 14.00), Z=-4.44, P<0.001], ASPECTS score [5.00(3.00, 8.00), 8.00(7.00, 9.00), Z=-4.23, P<0.001], 4D CTA collateral circulation score [2.00(0, 3.00), 3.00(3.00, 4.00), Z=-5.39, P<0.001], clot burden score [4.00(1.00, 7.00), 7.50(6.00, 9.00), Z=-3.42, P=0.001], location of the occlusion(internal carotid artery/middle cerebral artery occlusion was 23/22, 11/45 cases, χ2=9.70, P=0.002), and atrial fibrillation (27 and 19 cases respectively, χ2=5.83, P=0.016) between HT group and non-HT group. Multivariate logistic regression analysis showed that ASPECTS score (OR=0.64, 95%CI 0.47-0.87), NIHSS score (OR=1.13, 95%CI 1.01-1.26), 4D CTA collateral circulation score (OR=0.40,95%CI 0.22-0.76) were independent predictors of HT in AIS patients ( P<0.05). The AUC of the nomogram based on the ASPECTS score, NIHSS score and 4D CTA collateral circulation score to predict HT of AIS patients was 0.876 (95%CI 0.807-0.945), with a sensitivity of 77.8% and specificity of 87.5%. Conclusions:Patients with low ASPECTS score, high NIHSS score and low 4D CTA collateral circulation score have a higher risk of HT after EVT. The nomogram model may predict the probability of HT of AIS patients and provide effective assistance for clinical decision-making.

Risk factors for prognosis of primary intussusception treated by enema reduction in children based on propensity score matching analysis / 国际外科学杂志

Objective:To evaluate the risk factors for prognosis of primary intussusception treated by enema reduction in children.Methods:A retrospective analysis of 519 patients with primary intussusception in Anhui Provincial Children′s Hospital from January 2017 to December 2020 was performed. Among the 519 patients, there were 346 males and 173 females. The median age was 15 months, with a range of 3 to 69 months, some basic information was collected. Patients were divided into bad prognosis group ( n=71) and good prognosis group ( n=448) according to prognosis.Propensity score matching (PSM) was conducted to reduce confounding bias between the groups. Conditional logistic regression were used to analysis the risk factors of primary intussusception treated by enema reduction. Results:There were 71 cases of poor prognosis among 519 primary intussusception patients, incidence was 13.7%.Before PSM, there was significant difference in 6 covariates, including gender, age, duration of symptoms, bloody stool, diarrhoea and fever between two group ( P<0.05). There was no significant difference in abdominal pain and vomit between two group ( P>0.05). With propensity score matching, 69 pairs of patients were sucessfully matched. After PSM, distribution of the above covariates reached equilibrium between two groups ( P>0.05). There were statistically significant differences in enema reduction, mass location, seroperitoneum, lactic acid and overweight/obese between the two groups ( P<0.05). Conditional logistic regression analysis confirmed that enema reduction( OR=3.478, 95% CI: 1.150-10.517, P=0.027), mass location ( OR=6.596, 95% CI: 1.669-26.056, P=0.007), lactic acid( OR=1.012, 95% CI: 1.003-1.021, P=0.010), overweight/obese ( OR=6.085, 95% CI: 1.650-22.436, P=0.007) were independent factors for predicting prognosis of primary intussusception treated by enema reduction. Conclusions:AER, mass located left hemicolon, elevated lactic acid and overweight/obese were independent risk factors for poor prognosis of primary intussusception treated by enema reduction.

Clinical experience summary of gastroinstinal injury caused by magnets ingestion in children / 国际外科学杂志

Objective:To explore the clinical characteristic, pathogenesis, diagnosis and treatment strategies of gastroinstinal injury caused by magnets ingestion in children.Methods:A retrospective analysis of 46 patients with gastrointestinal tract magnets ingestion in Anhui Provincial Children′s Hospital from October 2017 to September 2021 was performed. Patients were divided into different groups according to gastroinstinal perforation. Some basic information was collected, including gender, age, duration of swallow foreign bodies, quantity of foreign bodies, symptoms, white blood cell, neutrophil, C-reactive protein, therapeutic method, gastroinstinal injury and follow up. Logistic regression. Univariate analysis and multivariate Logistic regression were used to analysis the risk factors of gastroinstinal perforation. Continuous parametric data were summarized using median and interquartile range, differences were evaluated using Wilcoxon Mann-Whitney test.Noncontinuous data were analyzed using chi-square test or corrected chi-square test.Results:Among the 46 patients, there were 33 males and 13 females. The median age was 3 years, with a range of 8 months to 11years. 34 cases had a history of ingesting magnets. The common number of ingested magnets was 2-10 (25 cases). Vomiting (18 cases) and abdominal pain (13 cases)were the commonest complaint. 6 cases tend to pass through the gastrointestinal tract uneventfully, and the remaining cases were successfully extracted by endoscopy (5 cases) and surgery(35 cases). Gastroinstinal perforation was found in 28 cases, and the majority of perforation was located in the ileum (18 cases). Univariate analysis showed that symptom, white blood cell, neutrophil, and CRP were associated with gastroinstinal perforation ( P<0.05). Multivariate Logistic regression analysis showed that symptom( OR=4.715, 95% CI: 1.074-20.696, P=0.040) and CRP( OR=11.605, 95% CI: 1.132-118.981, P=0.039) were independent factors for gastroinstinal perforation. There was no significant correlation between the number of magnets and gastroinstinal perforation ( r=0.276, P>0.05). Conclusions:The ingestion of magnetic foreign bodies in children often requires urgent management.When magnets are located within the prepyloric part of the GI tract, retrieval by endoscopy is recommended.The surgical intervention is required as soon as possible due to the failure of endoscopic treatment.

The experience of diagnosis and treatment of complications related to abdominal lymphangioma in children / 中国医师进修杂志

Objective:To summarize the diagnosis and treatment of complications related to abdominal lymphangioma in children.Methods:The clinical data of 18 children with complications related to abdominal lymphangioma in Anhui Provincial Children′s Hospital from January 2016 to January 2020 were collected. The clinical manifestations, radiological characteristics, diagnosis, treatment and prognosis were retrospectively analyzed.Results:Among the 18 children, there were 4 cases with secondary infection, 3 cases with hemorrhage, 2 cases with rupture and 9 cases with intestinal obstruction. The ultrasonic diagnosis was accurately in 13 cases, and CT diagnosis was accurately in 16 cases. Conservative treatment was performed first for 2 cases with secondary infection and 1 case with rupture, and then radical operation was performed after the condition was stable. One case with macrosis lymphangioma of transverse colon complicated with infection underwent cyst external drainage in emergency first, and surgical resection of the tumor was carried out after 2 months. The other 14 cases were treated with one-stage radical operation, and the operation was successfully. There were 8 cases with single port laparoscopic assisted operation and 10 cases with open operation. Postoperative recovery was satisfactory and no complications such as chylous leakage occurred. The hospital stays after operation was (6.6 ± 1.8) d, among which the hospital stays after operation of single port laparoscopic assisted operation was (5.4 ± 1.4) d, and open operation was (7.6 ± 1.6) d. All children were followed up for 3 months to 2 years, and no single case recurred.Conclusions:Complications of abdominal lymphangioma in children are rare. Abdominal ultrasound and CT can be used as routine examination to evaluate the condition of the disease. The operation is a safe and effective procedure in clinical practice. The individualized treatment measures should be chosen according to the clinical condition.

Advance in Assessment of Speech Intelligibility in Adults with Dysarthria (review) / 中国康复理论与实践

Dysarthria is a group of nerological speech disorder, which occurred in about 20%-30% after stroke, or 10%-60% after traumatic brain injury. The assessment of speech intelligibility is a necessary part of the evaluation of dysarthria, which can be used to communicate the patients' condition with their relations, and also in treatment planning, evaluating the communication performance and the treatment effects. The methods used to assess intelligibility can be divided into two groups: scaling methods and item identification methods. They are also divided into non-standard and standard methods based on whether a standard assessment or not. Scaling methods include interval scales, Direct Magnitude Estimation (DME), Speech Sample Pairs Scaling, Percentage Estimates, and Visual Analogue Scale (VAS), etc. The item identification methods mainly include: Word Intelligibility Test, Chinese Speech Intelligibility Test, Chinese Speech Intelligibility Test Character List, Chinese Articulation Ability Test Word List, Sentence Intelligibility Test, Assessment of Intelligibility in Dysarthric Speakers (AIDS) and Speech Intelligibility Test (SIT) software. Among them, AIDS and SIT softwares are comprehensively standardized assessments. There are few methods can be used in China. The literatures on intelligibility assessment in the past ten years were reviewed.

Clinical analysis of hemorrhagic cystitis in children and adolescents with hematological diseases post haplo-hematopoietic stem cell transplantation / 中华血液学杂志

Objective: To investigate the incidence and clinical features to probe the risk factors of hemorrhagic cystitis (HC) in children and adolescents with hematological diseases post haplo-hematopoietic stem cell transplantation (haplo-HSCT) . Methods: Medical records of 62 children and 27 adolescents with hematological diseases treated with haplo-HSCT between 2015 and 2016 were analyzed. Results: Of 89 cases (56 boys and 33 girls) , 44 patients were diagnosed with ALL, 33 AML, 3 AHL and 9 MDS. HC occurred in 32 of the 89 patients with an incidence of 36%, including 6 with grade Ⅰ, 16 with grade Ⅱ, 8 with grade Ⅲ, 2 with grade Ⅳ HC, respectively. The median time of HC onset was 25 days (range 2-55 days) after haplo-HSCT with the median duration as 19 days (range 3-95 days) , all of them were cured. The incidence of HC was lower in the group of children than that in the group of adolescents (27.4% vs 55.6%, χ(2)=6.466, P<0.05) , and the incidence of HC was higher in the group of patients who were ≥5 years old than that in the group of patients who were <5 years old (0 vs 34%, χ(2)=4.043, P<0.05) . Conclusion: HC is one of common complications in children and adolescents with hematological diseases post haplo-HSCT, older age was associated with increased mortality.

Distribution characteristics of methicillin-resistant Staphylococcus aureus in a children's hospital / 中国感染控制杂志

Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.

Application of magnetic resonance enterography and ectopic gastric mucosa imaging in children with lower gastrointestinal hemorrhage / 中华实用儿科临床杂志

Objective To evaluate the diagnostic value of magnetic resonance enterography(MRE)and ectopic gastric mucosa imaging(EGMI)in children with lower gastrointestinal hemorrhage.Methods The clinical data including gender,age,amount of bleeding and preoperative minimum hemoglobin(Hb)levels of 54 children with lower gastrointestinal hemorrhage were collected,who received surgical exploration in Department of Pediatric Surgery,Anhui Provincial Children's Hospital between February 2014 and April 2016.Children were divided into lesion group and non-lesion group according to the findings of surgical exploration.Lesion group were defined as children with Meckel's diverticulum(MD)or duplication of the small intestine by surgery and postoperative pathological findings.A total of 36 cases,25 cases of boys,11 cases of girls,aged(2.86±1.59)years old.Non-lesion group were defined as children,who underwent operation with negative result or with lesions but not MD or duplication of the small intestine.A total of 18 cases,14 cases of boys,4 cases of girls,aged(3.87±1.62)years old.MRE and EGMI were performed when the children stopped bleeding,before the inspection,should fasting for 4-6 h.SPSS 13.0 software was used for statistical processing.The evaluation of EGMI,MRE and the both in diagnosing MD or duplication of the small intestine were conducted by receiver operating characteristic curve(ROC).According to the principles of biggest gain best diagnostic value by Youden index,and the degree of sensitivity and specificity was calculated at this time,P0.05).There were statistically significant differences in age,amount of bleeding and preoperative minimum hemoglobin levels(t=2.179,2.027,2.222,all P<0.05).There were statistically significant differences in classification comparison by EGMI and MRE between 2 groups(x2=15.226,29.121,all P<0.01).The optimal cut-off value of EGMI and MRE in the diagnosis of enteric malformation was more than level 3,and the suspected positive and being positive value was assigned as positive results.According to the cut-off value above,EGMI,MRE and EGMI plus MRE in series and in parallel in the diagnosis of enteric malformation,the areas under curves(AUC)were 0.809,0.917,0.750 and 0.847,respectively.The sensitivity was 61.1％,75.0％,55.6％and 80.6％,respectively.The specificity was 90.4％,94.4％,94.4％and 88.9％,respectively.The Youden's indexes were 0.515,0.694,0.500 and 0.695,respectively.The optimal cut-off value of age and preoperative minimum hemoglobin levels in the diagnosis of enteric malformation were 2.92 years and 80 g/L,respectively.The AUC was 0.761 and 0.672.The Youden's indexes were 0.515 and 0.333.There was no significant differences statistically in AUC compared with age,MRE and EGMI(all P<0.05).Conclusions The high diagnostic value in children with lower gastrointestinal hemorrhage is found by using MRE and EGMI.Then,MRE as a separate diagnosis method is also worthy of clinical application.

Distribution characteristics of methicillin-resistant Staphylococcus aureus in a children's hospital / 中国感染控制杂志

Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.

Treatment of the pediatric neck abscess and surgery scar by high negative pressure drainage system / 中南大学学报(医学版)

OBJECTIVE@#To explore the clinical significance of high negative pressure drainage system (PFM) in treatment of pediatric neck abscess and postoperative scar.@*METHODS@#The clinical data of 35 children with neck abscess from June, 2012 to January, 2014 were retrospectively analyzed. According to the site of the abscess in children, a small incision drainage combined PFM were used, and the antibiotics were used at the same time to strengthen systemic support treatment. The complications were treated by the related departments, and the application of topical silicone gel incision after operation lasted for 3-6 months.@*RESULTS@#Thirty-five children healed after the above treatment in 7-14 d. The effective cure rate was 100%. The post-operation followed up for 6 months -1 year and no surgical incision scar was found.@*CONCLUSION@#Small incision drainage combined with PFM show the superiority of minimal invasion for the treatment of postoperative abscess drainage without the needs of replacing the gauze and drainage bottle, and physiological activities are not affected in the suffering children. The method can significantly reduce the pain of children during the change of medical prescription and the physician workload. It has the advantages of faster healing, shorter hospital staying, without obvious scar and abnormalities. The method is especially useful for deep and large abscess, and it is better than the traditional treatment methods.

Clinical observation of the effect of levonorgestrel-releasing intrauterine system(LNG-IUD) on pre-venting recurrence after hysteroscopic resection of endometrial polyps / 上海预防医学

To evaluate the clinical effect of LNG-IUD on preventing recurrence after hysteroscopic resection of endometrial polyps . [ Methods] Electrical excision of endometrial polyps with the help of hysteroscopy was performed for 120 patients, who were randomly divided into trial group ( levonorgestrel-releasing intrauterine system after surgery ) and control group ( without any treatment after surgery), with 60 patients in each group.After follow-up of 4 years, the recurrence of endometrial polyps was observed in the two groups . [ Results] The recurrence rate of trial group was 1.6%,and that of control group was 15.0%.There was significant difference in recurrence between the two groups ( P<0. 05 ) . [ Conclusion] The hysteroscopy can be used for more definite diagnosis and treatment of endome-trial polyps .And there has been a significantly positive effect of LNG-IUD proved on preventing recurrence after hysteroscopic resection of endometrial polyps .

Association between single nucleotide polymorphism of rs4753426 of melatonin receptor 1B gene and gestational diabetes mellitus / 中华妇产科杂志

Objective To investigate the genotypic and allele frequency differences of melatonin receptor 1B (MTNR1B)-rs4753426 between gestational diabetes mellitus (GDM) pregnancies and normal pregnancies , and to explore the association between single nucleotide polymorphism ( SNP ) of rs4753426 and gestational diabetes mellitus.Methods Totally 93 GDM pregnancies and 165 normal pregnancies were recruited from the Affiliated Hospital of Qingdao University.The age, gestational weeks, height, early pregnant weight , and the levels of fasting plasma glucose ( FPG) , fasting insulin ( FIN) were determined in every participants.By using PCR and DNA sequencing , we detected the distribution of the rs 4753426 genotypes and alleles in all individuals.The homeostasis model assessment-insulin resistance ( HOMA-IR) and the homeostasis model assessment-βcell function ( HOMA-β) were calculated.The allele and genotype frequencies and the FPG , FIN, body mass index ( BMI) , HOMA-IR, HOMA-βlevels between GDM group and control group were compared.Results (1) The genotype frequencies in the GDM group and the control group of rs4753426-CC, CT, TT were 72.0% (67/93), 21.5% (20/93), 6.5% (6/93), and 53.9%(89/165), 40.0% (66/165), 6.1% (10/165) respectively.The allele frequencies in the GDM group and the control group of T and C were 17.2% ( 32/186 ) , 82.8% ( 154/186 ) and 26.1% ( 86/330 ) , 73.9% ( 244/330 ) respectively.There were statistical differences in genotype frequencies and allele frequencies between two groups ( all P<0.05 ).( 2 ) The levels of FPG , FIN and HOMA-IR in the GDM group were obviously higher than those in the control group (P<0.05).The level of HOMA-βwas lower in the GDM group than that of the control group (P<0.05).(3)The FPG of CC and CT genotypes was higher than that of TT genotype in the GDM group (P<0.05), while the level of HOMA-βwas lower than that of TT genotype (P<0.05).Conclusions The MTNR1B-rs4753426 SNP is associated with the pathogenesis of GDM, and rs4753426 is the predisposing locus of GDM.The C-allele is the susceptibility allele of GDM.

Temporal regulation of transcription factor Mef2c by histone acetylases during cardiogenesis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To observe the temporal modification of transcription factor Mef2c by histone acetylases (HATs) P300, PCAF, and SRC1 during cardiogenesis and to provide a basis for investigating the pathogenesis of congenital heart disease.</p><p><b>METHODS</b>The normal heart tissues from embryonic mice (embryonic days 14.5 and 16.5) and neonatal mice (postnatal days 0.5 and 7) were collected. The binding of P300, PCAF, and SRC1 to Mef2c gene and level of histone H3 acetylation in the promoter region of Mef2c were evaluated by chromatin immunoprecipitation assays. Meanwhile, real-time PCR was used to measure the mRNA expression of Mef2c.</p><p><b>RESULTS</b>P300, PCAF, SRC1 were involved in histone acetylation in the promoter region of Mef2c during cardiogenesis in mice, and binding of P300, PCAF, and SRC1 to the promoter of Mef2c varied significantly in different stages of cardiogenesis (P<0.01). The level of histone H3 acetylation and mRNA expression of Mef2c in the promoter region of Mef2c also varied significantly in different stages of cardiac development (P<0.01). The levels of acetylated H3, Mef2c mRNA, and HATs (P300, PCAF, SRC1) changed over time. They were highest on embryonic day 14.5 (P<0.01), decreased gradually with cardiac development, and were maintained at low levels after birth.</p><p><b>CONCLUSIONS</b>The mRNA expression of Mef2c varies during cardiogenesis in mice, which indicates that Mef2c plays an important role in the process of cardiac development. Meanwhile, histone acetylation in the promoter region of Mef2c is regulated temporally by HATs P300, PCAF, and SRC1.</p>

Association between single nucleotide polymorphism of macrophage migration inhibitory factorrs1007888 and the pathogenesis of gestational diabetes mellitus / 中华妇产科杂志

Objective To investigate the association between single nucleotide polymorphism (SNP) of macrophage migration inhibitory factor (MIF) gene-rs1007888 and the pathogenesis of gestational diabetes mellitus (GDM).Methods A total of 120 GDM pregnant women (GDM group) and 165 healthy pregnant women (control group) from Affiliated Hospital of Medical College,Qingdao University were recruited from June 2011 to July 2012.Their age,gestational week,height and weight were recorded.The levels of fasting blood glucose (FBG) and fasting insulin (FIN) were determined.Body mass index (BMI),the hemeostasis model assessment-insulin resistance (HOMA-IR) and hemeostasis model assessment-β cell function (HOMA-β) were calculated.DNA was extracted from fasting blood samples.SNP of MIFrs1007888G/A was determined by DNA sequencing.The FBG,FIN,HOMA-IR and HOMA-β were compared between GDM group and the control group.They were also compared among pregnancies withdifferent genotypes.Results (1) GDM group had higher FBG,FIN and HOMA-IR levels,but lower HOMA-β than the control group (all P ＜ 0.05).(2) MIF-rs1007888 SNP genotype frequencies of GG,GA and AA were 37.5％,45.8％ and 16.7％,and the allelic frequencies of G and A were 60.4％,39.6％ in GDM group; However,in the control group,the frequencies of GG,GA and AA were 26.1％,54.5％ and 19.4％,and the allelic frequencies of G and A were 53.3％,46.7％,respectively.The distributions of MIF genotypes in GDM patients were significantly different from the healthy subjects (P ＜ 0.05).No significant difference of MIF-rs1007888 allele distributions was observed between GDM group and the control group (P ＞0.05).(3) The FBG,FIN and HOMA-IR in pregnant women with GG genotype were statistically higher than those with GA or AA genotypes,while HOMA-β was lower in women with GG genotype (all P ＜0.05).Conclusions The SNP of MIF rs-1007888 was related to the insulin resistance and pancreatic β cell function of pregnant women.GG genotype of MIF-rsl007888 might be a genetic susceptible factor in the pathogenesis of GDM.

Salvaged allogeneic hematopoietic stem cell transplantation for refractory/recurrent acute myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of salvaged allogeneic hematopoietic stem cell transplantation (allo-HSCT) for refractory/recurrent acute myeloid leukemia (AML).</p><p><b>METHODS</b>A total of 45 patients with refractory/recurrent AML were enrolled from September 2006 to April 2010. The median blasts in bone marrow (BM) were 36% (20% to 92%) before conditioning. The donors were identical siblings (6) or unrelated ones (9) or haploidentical family members (30). Conditioning regiments were individualized according to patients' status, the regimen with high-dose cytarabine plus BuCy/CY was mostly used (20). The patients with impaired organ function received above regimen except using fludarabine instead of cyclophosphamide (16). FLAG followed by reduced-intensified BuCy was employed for the recipients with more than 40% blasts in BM (6) to reduce leukemia burden. TBI/CY or TBI/Fludarabine was used for the recipients with extramedullary infiltration of leukemia or multidrug resistant leukemia. G-CSF, MTX, NVT, Vm26, Acla or Thaltipa was added into conditioning regiments according to leukemia character.</p><p><b>RESULTS</b>All but 2 patients attained durable engraftment. The incidence of grade II to IV aGVHD and cGVHD were 34%, 59.1%, respectively. With median follow-up 30 (0.5 - 57) months, the relapse rate was 29.2%. Twenty-nine of 45 (60.2%) patients remained in complete remission since salvaged HSCT. Three-years disease-free survival and overall survival were 60.2% and 62.6%, respectively.</p><p><b>CONCLUSION</b>Our results indicated that the combination of salvaged HSCT with prophylactic immunotherapy might be a promising modality for treatment of refractory/recurrent AML, even with high leukemia burden.</p>

Flow cytometric monitoring of minimal residual diseases in patients with acute leukemia after allogeneic hemapoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the significance of flow cytometric monitoring minimal residual diseases (MRD) in patients with acute leukemia (AL) after allogeneic hemapoietic stem cell transplantation (HSCT).</p><p><b>METHODS</b>From January 2007 and January 2008 MRD were detected by flow cytometry (FCM) in 402 bone marrow (BM) in 102 AL patients without leukemic gene and chromosomal changes at first diagnosis after HSCT (1, 2, 3, 6,12 months after HSCT; adding detection frequency in part of high risk patients), The relationship between the MRD results and clinical prognosis were observed. Patients with significantly higher MRD were treated and the effectiveness was monitored by FCM (MRD > 0.01% considered as positive).</p><p><b>RESULTS</b>(1) 71 cases were persistently negative for MRD after HSCT and all them were in hematologic complete remission (CR). Only 3 cases had extramedullary relapse. The disease free survival (DFS) and overall survival (OS) were 66.2% and 90.1%, respectively. (2) Of 27 MRD(+) cases 11 converted to MRD negativity after chemotherapy plus donor lymphocyte infusion (DLI), CIK, NK cells. The DFS and OS were 63.6% and 72.7%, respectively. Other 16 cases had hematologic relapse. The DFS and OS were 11.1% and 25.0%, respectively. The median time from MRD increasing to hematologic relapse was 48 days (7-69 day). (3) Four cases had hematologic relapse after HSCT and died in the end.</p><p><b>CONCLUSIONS</b>(1) The DFS and the OS in MRD(-) cases are significantly higher than those of MRD(+) cases. (2)MRD(+) patients after HSCT coveted to MRD(-) after intervention. Therapy, whose DFS and the OS are still significantly higher than those of MRD(+) cases. (3) Patients with hematologic relapse after HSCT have the worst prognosis and the DFS and OS are significantly low. FCM monitoring of MRD in patients after HSCT is a sensitive, specific, quick and simple method. It can indicate recurrent state in time, facilitates early intervention, reduces the hematologic relapse risk and improves DFS.</p>

Efficacy of allogeneic hematopoietic stem cell transplantation in treatment of childhood myelogenous leukemia: the observation of 24 cases / 中华儿科杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on childhood chronic myelogenous leukemia (CML).</p><p><b>METHOD</b>Of the 24 consecutive cases, 16 were boys and 8 were girls. The median age of patients was 12 (3 - 16) years old; 16 cases were in chronic phase (CP) of CML, 1 case in accelerated phase (AP) and 5 cases in blastic phase (BP). Allo-HSCT from HLA identical siblings were performed for 5 cases, HLA haplotype was performed for 14 cases and unrelated allo-HSCT for 5 cases. Twenty-four cases underwent allo-HSCT with conditioning regimen of BUCY. Prophylaxis of graft versus host disease (GVHD) included CsA + MTX plus MMF. The average follow-up was 36 months.</p><p><b>RESULT</b>All of patients were successfully engrafted. The 5-year overall survival (OS) of the 24 cases was 81%. Four patients died after allo-HSCT including 3 cases in BP from haploidentical donors and 1 case in CP from HLA identical sibling. The 5 cases who received unrelated allo-HSCT have been alive. Among the 10 cases who survived over 5 years, 3 had chronic GVHD.</p><p><b>CONCLUSION</b>Children with CML could be treated effectively with allo-HSCT. There were no significant differences among different donors. Transplantation to children with CML should be performed as early as possible. Preparative regimen adjustment before transplantation, the transplantation of associated comorbidities and effective prevention and treatment for CML patients after prolonged graft survival of high quality have important significance.</p>

Inhibitory effect of icariin on acetylcholinesterase / 药学学报

Acetylcholinesterase (AChE) inhibitors are mainly used in the treatment of Alzheimer's disease (AD). The inhibitory effect of icariin on the activity of AChE was investigated by inhibition kinetics. The binding interaction and binding sites between icariin and AChE were also studied by using fluorimetry and molecular docking, respectively. The results showed that icariin could potently inhibit the activity of AChE, the IC50 value was determined to be 3.50 x 10(-8) mol x L(-1), and the determined IC50 value to tacrine was 0.75 x 10(-8) mol x L(-1). Kinetic analyses showed that icariin is a reversible and mixed type AChE inhibitor. The inhibition constants K1 and K(IS) were determined to be 2.67 x 10(-8) and 4.43 x 10(-8) mol x L(-1), respectively. Icariin binds selectively to the AChE peripheral anionic site via hydrogen bonds and Van der Waals forces.

CT characteristic findings of Meckel's diverticulum and its complications in children / 中华放射学杂志

Objective To investigate the CT manifestations of Meckel's diverticulum and its complications in children. Methods Retrospective analysis of Clinical and CT findings in 25 cases with pathologically proved Meckel's diverticulum. The unenhanced and contrast-enhanced CT were obtained in all patients. Results (1)The direct signs: the diverticulum cannot be shown in 5 cases; the diverticulums were found around the navel or in lower right abdomen in 20 cases. The blind-ending fluid-filled or gas-filled structures were found in 9 cases, with heterogeneous ring-enhancement. The tubercle-like structures were detected in 11 cases, which showed no enhancement in 4 cases, and homogeneous enhancement in 3 cases,and heterogeneous enhancement in 4 cases. (2) The indirect signs included intestine obstruction in 8 cases,swelling fat layer surrounding the diverticulum in 9 cases, free gas around the diverticulum in 3 cases,thickened mesentery in 8 cases, ascites in 4 cases, and intussusception due to inverted Meckel's diverticulum with "target sign" in 1 case. (3) CT classification: with diverticulitis or diverticular bleeding in 20 eases; with intestine obstruction or intussusception in 8 cases; bands-caused obstruction in 7 cases;intussusception in 1 case; with perforation in 3 cases. Conclusion Meckel's diverticulum and its complications have typical CT findings, and CT can clearly demonstrate diverticulum's shape, margin,internal components and surroundiug tissues.

Alcohol-induced proliferation of neurons in mouse hippocampal dentate gyrus: a possible role of ceramide / 生理学报

To investigate the role and mechanism of ceramide (Cer) regulation in alcohol-induced neuronal proliferation and the newborn neurons formation, we used sphingomyelin synthase 2 (predominant enzyme of Cer metabolism) knockout (SMS2(-/-)) and wild type (WT) female mice to establish the model of prenatal alcohol exposure. In 24 h after being given birth (postnatal day 0, P0), the offspring of model mice received blood sphingomyelin (SM) measurement with enzymatic method. On P0, P7, P14 and P30, the proliferation of granule cells in the dentate gyrus and newborn neurons were investigated with immunofluorescent labeling. The expression of protein kinase Cα (PKCα) in the hippocampus was tested with Western blot analysis. The results showed that the SM level of blood in SMS2(-/-) pups was significantly lower than that in WT pups. No matter in SMS2(-/-) or WT mice, the prenatal alcohol exposure down-regulated the SM levels in pups with dose-dependency. In both SMS2(-/-) and WT pups, the number of proliferative neurons and newborn neurons in the dentate gyrus gradually decreased with the growing age. Compared with the WT pups, SMS2(-/-) pups showed significantly more proliferative neurons and newborn neurons in the dentate gyrus. Notably, prenatal alcohol exposure dose-dependently increased proliferative neurons and newborn neurons in the dentate gyrus in both WT and SMS2(-/-) pups. The hippocampal expression of PKCα protein in SMS2(-/-) mice was lower than that in WT mice, and prenatal alcohol exposure could up-regulate the PKCα protein expression in both WT and SMS2(-/-) mice with dose dependency. These results suggest that alcohol exposure during pregnancy can induce the compensatory neural cell proliferation and the production of newborn neurons in offspring, and the Cer-ceramide-1-phosphate (C1P) pathway is involved in alcohol-induced neural cell proliferation. The activation of PKCα may be a key step to start the Cer-C1P pathway and up-regulate the alcohol-induced neural cell proliferation and the newborn neurons formation.