Efficacy and safety of flumatinib in treatment of imatinib-resistant or imatinib-intolerant patients with chronic myeloid leukemia / 白血病·淋巴瘤

Objective:To investigate the efficacy and safety of flumatinib in the treatment of imatinib-resistant or imatinib-intolerant patients with chronic phase chronic myelogenous leukemia (CML-CP).Methods:The clinical data of 9 CML-CP patients who received flumatinib after imatinib resistance or intolerance in Jining No. 1 People's Hospital from April 2020 to May 2021 were retrospectively analyzed. Patients were evaluated for the hematologic, cytogenetic and molecular responses, progression-free survival (PFS), event-free survival (EFS), and adverse reactions.Results:Among 9 CML-CP patients, there were 4 imatinib-resistant patients and 5 imatinib-intolerant patients. The median duration of flumatinib exposure was 17 months (1-25 months). Except for 1 case who discontinued flumatinib early due to grade 4 thrombocytopenia and other adverse reactions, 7 of the remaining 8 cases achieved the best response at 3, 6 and 12 months of flumatinib therapy. By the end of follow-up in April 2022, 7, 7 and 6 patients achieved complete cytogenetic response (CCyR), major molecular response (MMR) and molecular response 4.5 (MR4.5), respectively. The median time to achieving CCyR, MMR and MR4.5 was 4.5 months (3-6 months), 12 months (3-12 months) and 15 months (3-21 months), respectively. Within 17 months (11-25 months) of follow-up, 7 of the 9 patients had EFS and 8 patients with continuous flumatinib had PFS. Among 9 patients treated with flumatinib, hematologic adverse reactions were observed in 6 cases, and grade 3-4 hematologic adverse reactions occurred in 2 cases. Non-hematologic reactions events mainly included diarrhea (4 cases), muscle ache (2 cases), fatigue (2 cases) and liver damage (2 cases), which were all grade 1-2.Conclusions:Flumatinib is effective and well tolerated in the treatment of imatinib-resistant or imatinib-intolerant CML-CP patients.

Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand / 中华烧伤杂志

Objective@#To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand.@*Methods@#Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n=18) and comprehensive training group (CT, n=28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test.@*Results@#(1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups (t=0.834, P>0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in group CT, with no statistical differences between them (χ2=2.140, P>0.05). After treatment, the ratio of excellent and good results according to TAM in patients of group CT (6/7) was higher than that in group RT (5/9, χ2=0.023, P=0.038). The ratios of excellent and good results according to TAM in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.023 and -4.780, P values below 0.05). (3) The improved score of hand function in patients of group CT was (26±12) points, which was higher than (15±7) points in group RT (t=3.278, P=0.002). The score of hand function in patients of groups RT and CT after treatment was significantly higher than that before treatment (with t values respectively 2.628 and 6.125, P values below 0.05). There were no significant differences in grades of hand function of patients between the two groups before treatment (Z=-0.286, P>0.05). After treatment, the grade of hand function in patients of group CT was higher than that in group RT(Z=-1.993, P=0.046). The grades of hand function in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.717 and -4.998, P values below 0.01).@*Conclusions@#For patients with scar contracture after burn injury of dorsal hand, early functional training combined with hand flexing training band can improve the range of motion of hand joints and functional recovery of hand, and the result was better than functional training alone.

The association between plasma TGF-α levels and EGFR-TKI treatment sensitivity and prognosis in NSCLC patients with EGFR mutation / 中国癌症杂志

Background and purpose: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is of advantage in treating non-small cell lung cancer (NSCLC) patients with EGFR mutations. However, their clinical effects vary individually. This study aimed to evaluate whether the EGFR ligand, plasma transforming growth factor α (TGF-α), could act as a predictor for the EGFR-TKI treatment e?ciency in NSCLC patients with EGFR mutations and the association between TGF-α and prognosis in these patients. Methods: Seventy-five NSCLC patients with EGFR gene positive mutation were included in the current study from May 2012 to Jul. 2014 in Ruikang Hospital A?liated to Guangxi University of Chinese Medicine. Plasma TGF-α was measured using enzyme-linked immunosorbent assay (ELISA) in all of the patients before EGFR-TKI treatment. The radiographic evaluation was performed 2 months after the therapy. The association between TGF-α and clinical outcome and its prediction e?ciency were determined, followed by the further analysis of the association between TGF-α and overall survival (OS) as well as progression-free survival (PFS). Results: After EGFR-TKI treatment, there were 20 patients with partial response (PR), 25 with stable disease (SD) and 30 with progression disease (PD) in all 75 NSCLC patients harboring EGFR positive mutation. The disease control (DC) rate reached 60%. Patients in PD group presented statistically significant higher plasma TGF-αthan patients in the DC group (P<0.01). Multivariate COX model indicated that smoking status, lymph node metastasis and plasma TGF-α levels were independent risk factors for prognosis in these patients. The ROC analysis revealed that baseline plasma TGF-α showed good prediction e?ciency [area under the curve (AUC)=0.926] and the cut-off point of TGF-α was 16.75 pg/mL. Higher level of TGF-α (≥16.75 pg/mL) was associated with smoking history, clinical stage, lymph node metastasis and clinical outcome of the patients (P<0.05). In comparison to patients with low TGF-α, the patients with high TGF-α concentration presented significantly reduced median OS and PFS (log-rank P<0.05). Conclusion: Higher plasma TGF-α (≥16.75 pg/mL) had a predictive role in EGFR-TKI resistance and poor prognosis.

Effects of early treatment with ultrashort wave combined with sequential pressure on functional recovery of deeply burned hands / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effects of ultrashort wave combined with sequential pressure treatment on the functional recovery of deeply burned hands in the early stage of healed wounds in hands.</p><p><b>METHODS</b>Sixty-five patients with burn of unilateral hand were hospitalized from July 2012 to June 2013 in our center. Injured hands of 35 patients were treated with active movement, ultrashort wave, sequential pressure therapy, and pressure gloves, and the other 30 patients were treated with active movement and pressure gloves 10-31 days after the wounds were healed according to the will of patients. The former 35 patients were regarded as comprehensive treatment (CT) group, and the latter 30 patients were regarded as routine treatment (RT) group. Before treatment and 4 weeks after treatment, the appearance of injured hands was observed; the circumference of the proximal segment of thumb, index, and middle fingers and that of the palmar crease and wrist crease were measured to evaluate swelling of injured hand; score and grade of function of injured hands were evaluated with a Carroll Upper Extremity Functional Test. Data were processed with t test and rank sum test.</p><p><b>RESULTS</b>(1) Four weeks after treatment, appearance of 30 injured hands in group CT was improved, which was close to that of the normal hand of each patient, while contracture deformity of metacarpophalangeal joints and interphalangeal joints was observed in the other 5 injured hands. Four weeks after treatment, no obvious change in the appearance of 17 injured hands in group RT was observed compared with that before treatment, while hyperextension of metacarpophalangeal joints, flexion of interphalangeal joints, and adduction deformity of thumb were observed in the other 13 hands. (2) Four weeks after treatment, the circumferential values of the proximal segment of thumb, index, and middle fingers and the palmar crease and wrist crease of injured hands in group CT were respectively lower than those before treatment (with t values 3.26-4.24, P values below 0.01), and the circumferential values of the proximal segment of thumb and middle fingers and the wrist crease of injured hands in group RT were respectively lower than those before treatment (with t values 2.02-2.44, P values below 0.05). The difference values of circumference values of the proximal segment of thumb, index, and middle fingers and the palmar crease and wrist crease of injured hands between before treatment and 4 weeks after treatment were respectively (0.491 ± 0.022), (0.583 ± 0.089), (0.486 ± 0.021), (1.100 ± 0.076), (0.751 ± 0.053) cm in group CT, which were significantly higher than those in group RT [(0.306 ± 0.021), (0.277 ± 0.022), (0.320 ± 0.027), (0.700 ± 0.052), (0.483 ± 0.048) cm, with t values respectively 5.94, 3.11, 5.02, 4.22, 3.68, P values below 0.01]. (3) Four weeks after treatment, scores of function of injured hands in groups CT and RT were respectively higher than those before treatment (with t values respectively 14.40 and 4.00, P values below 0.001), and the grades of function of injured hands were respectively improved (with u values respectively 6.93 and 3.29, P values below 0.01). The difference value of scores of function of injured hands between before treatment and 4 weeks after treatment was (51.1 ± 2.2) points in group CT, which was significantly higher than that of group RT [(32.5 ± 4.8) points, t = 3.52, P < 0.001].</p><p><b>CONCLUSIONS</b>Ultrashort wave combined with sequential pressure and routine rehabilitation treatment of deeply burned hands in the early stage after wounds in hands are healed can obviously reduce the swelling of injured hands, which provides a favorable condition for active movements and systematic rehabilitation treatment later.</p>

Effects of group psychological counseling on self-confidence and social adaptation of burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the effects of group psychological counseling on the self-confidence and social adaptation of burn patients during the course of rehabilitation.</p><p><b>METHODS</b>Sixty-four burn patients conforming to the inclusion criteria and hospitalized from January 2012 to January 2014 in Xijing Hospital were divided into trial group and control group according to the method of rehabilitation, with 32 cases in each group. Patients in the two groups were given ordinary rehabilitation training for 8 weeks, and the patients in trial group were given a course of group psychological counseling in addition. The Rosenberg's Self-Esteem Scale was used to evaluate the changes in self-confidence levels, and the number of patients with inferiority complex, normal feeling, self-confidence, and over self-confidence were counted before and after treatment. The Abbreviated Burn-Specific Health Scale was used to evaluate physical function, psychological function, social relationship, health condition, and general condition before and after treatment to evaluate the social adaptation of patients. Data were processed with t test, chi-square test, Mann-Whitney U test, and Wilcoxon test.</p><p><b>RESULTS</b>(1) After treatment, the self-confidence levels of patients in trial group were significantly higher than those in control group (Z = -2.573, P < 0.05). Among trial group, the number of patients with inferiority complex was 17 (53.1%) before treatment, which was decreased to 6 (18.8%) after treatment; the number of patients with normal feeling and that of self-confidence were 8 (25.0%) and 4 (12.5%) before treatment, which were respectively increased to 13 (40.6%) and 10 (31.3%) after treatment. The overall difference in trial group was obvious between before and after treatment (Z = -4.123, P < 0.01) . There was no obvious difference in self-confidence level of patients in control group between before and after treatment (Z = -1.000, P > 0.05). (2) After treatment, the scores of psychological function, social relationship, health condition, and general condition were (87 ± 3), (47.8 ± 3.6), (49 ± 3), and (239 ± 10) points in trial group, which were significantly higher than those in control group [(79 ± 4), (38.3 ± 5.6), (46 ± 4), and (231 ± 9) points, with t values respectively -8.635, -8.125, -3.352, -3.609, P values below 0.01]. After treatment, the scores of physical function, psychological function, social relationship, health condition, and general condition in trial group were significantly higher than those before treatment (with t values from -33.282 to -19.515, P values below 0.05). The scores of physical function, psychological function, health condition, and general condition in control group after treatment were significantly higher than those before treatment (with t values from -27.137 to -17.790, P values below 0.05).</p><p><b>CONCLUSIONS</b>Group psychological counseling combined with ordinary rehabilitation training give rise to significant effects on self-confidence level and social adaptation for burn patients.</p>

Changes and significance of insulin-like growth factor-1 in infant myocarditis / 中国基层医药

Objective To investigate insulin-like growth factor-1(IGF-1) on the protective effect of infant myocarditis.Methods The serum levels of IGF-1 was detected by two-site enzyme-linked immunosorbent assy ( ELISA) and CK-MB by electrochemiluminescence at the acute and convalescent in 50 infant with myocarditis,and 50 normal healthy children as the controls.Results The serum levels of IGF-1 in acute myocarditis was significantly lower than those of healthy children and the convalescen[(22.90 ±9.30) mg/L vs (45.69 ±10.95) mg/L, (38.99 ±9.06)mg/L,all P<0.01],while the CK-MB was significantly higher than those of the control group and the convalescent[(77.48 ±8.71)mg/L vs (14.99 ±7.62)mg/L,(17.99 ±6.31)mg/L,all P<0.01.IGF-1 and CK-MB was negative correlation (r=-0.62,P<0.01).Conclusion IGF-1 is involved in the repair process of myocardial injury in myocarditis infant,and play some protective role in the mechanism.

Application of high-frequency color Doppler in the diagnosis of acute appendicitis / 中国基层医药

Objective To explore the application value of high frequency probes in ultrasonic diagnosis of acute appendicitis.Methods Using high frequency probe to detect 356 patients with right lower quadrant abdominal ultrasound,and the results were analyzed.281 cases were confirmed by operation and pathology.Results 240 cases of 356 patients were detected low frequency transducer,and the detection rate was 67.4％.Application of high frequency probe were detected in 322 cases,and the detection rate was 90.4％.Pathological progress of appendicitis with appendicitis,display rates have increased,there was a significant correlation between the two.Conclusion The use of high frequency color ultrasound imaging for suspected acute appendicitis in patients has definite diagnosis and differential diagnosis.

Application of color Doppler ultrasound in diagnosis for neck lymph node metastatic tumor / 中国基层医药

Objective To evaluate the applicated value of color Doppler ultrasound in diagnosis for neck lymph node metastatic tumor.Methods A retrospective analysis of 53 cases with metastatic tumors in cervical lymph nodes of two-dimensional and color Doppler ultrasonography features was taken out.Results The color Doppler ultrasound on cervical lymph node metastasis tumor location,shape,size and internal structural characteristics were observed,it is found that the characteristic change,provide reliable evidence for the clinical diagnosis.Conclusion The color Doppler ultrasound to cervical lymph node metastatic tumor has a high diagnostic value,can be used as the cervical lymph node metastatic tumor imaging examination of choice.

Advance of the relationship between Th17 and autoimmune diseases / 国际儿科学杂志

Th17 is a CD4+ T cell subset that is a new member of Th1 and tH2.Recent studies have shown that it products IL-17A,IL-17F,IL-21 and IL-22,which play an imoortant role in rheumatoid arthritis.systemic lupus erythematosus,systemic sclerosis,inflammatory howel disease.autoimmune myocarditis and other autoimmune diseases.Deepen the understanding of Th17 and Th17 production in the advancement of autoimmune diseases will provide a new basis for future diagnosis.Th17 will become a new target for the treatment of human autoimmune diseases.

Study on the contrast of diagnosis value of two-dimensional and three-dimensional sonography on the fetal facial structure / 中国基层医药

Objective Study on the clinic value of the application of two-dimensional and three-dimensional sonography on observing the fetal facial structure. Methods Applying Voluson 730 three-dimensional probe surface imaging mode and two-dimensional probe to make sonography on 16～48 weeks fetus in 1805 cases, emphasized on observing the fetal facial structure, saving the image information, making three-dimensional reconstruction and comparing the result of post partum and the result after induction of labor. Results In 1805 cases, applying two-dimensional and three-dimensional sonography to observe the facial structure of the fetus of 23～35 weeks, the display rate is 93.1% and 95.1% respectively, and there is no obvious difference between the two modes. The three-dimensional is higher than two-dimensional for the fetus less than 23 weeks, with the display rate 69.6% and 84.8% respectively, and the two-dimensional is a bit higher than three-dimensional for the fetus more than 35 weeks, with the display rate 90.4% and 88.7% respectively. One cleft lip case is excluded. Conclusion As long as mastering the optimum examination time and operation skill, there is no obvious difference between the display rate of two-dimensional and three-dimensional sonography on observing the fetal facial structure, the two modes can be complementary in the work to improve the accuracy of the diagnosis and be favorable for the prepotency.

AN IMPROVED TECHNIQUE ON NUTIONAL GB NUTRIENT AGAR FOR COUNTING BACTERIA RIENT AGAR FOR COUNTING BACTERIA / 微生物学通报

Both Chinese GB nutrient agar and American FDA standard method agar are commonly used for counting bacteria in food inspection. A number of our experiments showed that the count of bacteria by FDA standard method agar is 23.9% higher than that by GB nutrient agar. The present C8 medium is an improved medium based on the composition of the two media mentioned above The result of our comparison experiment showed that the C8 medium used for counting bacteria was 35.8% higher than that by GB nutrient agar and 9.5% higher than that by FDA standard method agar respectively.