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OBJECTIVE To systema tically evaluate the efficacy and safety of blinatumomab for acute lymphoblastic leukemia （ALL）in order to provide evidence-based reference for clinical use. METHODS Retrieved from PubMed ，Embase，Web of Science，the Cochrane Library ，CNKI，Wanfang database and CBM during the inception to February 3，2022，randomized controlled trials （RCTs）and cohort studies of blinatumomab （experimental group ） versus conventional chemotherapy （control group ）in the treatment of ALL were collected. After literature screening and data extraction ，the quality of RCTs was evaluated by the risk bias evaluation tool recommended by Cochrane handbook 5.1.0，and the quality of cohort studies was evaluated by the Newcastle-Ottawa scale （NOS）. Meta-analysis was performed by RevMan 5.4 software. GRADE grading system was used to evaluate the evidence quality of outcomes. The publication bias was analyzed by inverted funnel plot. RESULTS A total of 8 studies were included ，involving 3 RCTs and 5 cohort studies ，with a total of 2 841 patients. Results of Meta-analysis showed that the overall survival rate more than one year [RR ＝1.30，95％CI（1.14，1.48），P＜0.000 1]，relapse-free survival rate [RR ＝1.78，95％CI（1.50，2.12），P＜0.000 01]，complete remission rate [RR ＝1.42，95％CI（1.11，1.82），P＝0.006]，the incidence of tremor [RR ＝16.98，95％CI（2.17，133.12），P＝0.007]，and the incidence of cytokine release syndrome [RR ＝14.11， 95％CI（3.43，58.01），P＝0.000 2] in trial group were all significantly higher than control group ，but there was no statistical significance in the incidence of headache between two groups [RR ＝1.31，95％CI（0.66，2.59），P＝0.44]. The incidence of adverse events with grade more than or equal to 3，infection，stomatitis，thrombocytopenia，febrile neutropenia ，anorexia， constipation，diarrhea，abdominal pain ，hypokalemia in trial group were significantly lower than control group （P＜0.05）. The incidence of cough ，rash and hypogamma globulinemia and fever in the trial group were significantly higher than control group （P＜0.05）. There was no statistical significance in the total incidence of adverse events ，sepsis，anemia，leucopenia，neutropenia， lymphopenia，nausea，vomiting，hyperglycemia，hypotension，hypertension，elevated transaminase or epistaxis between two groups（P＞0.05）. Results of subgroup analysis by study type showed that the overall survival rate ，relapse-free survival rate and complete response rate （except for cohort studies ）of patients in trial group were significantly higher than control group in both RCTs and cohort studies （P＜0.05）. The results of GRADE evaluation showed that the overall quality of index evidence included in this study was low. There was little possibility of publication bias in this study based on the publication bias analysis. CONCLUSIONS Blinatumomab is effective in the treatment of ALL ，with low incidence of infection and adverse events of digestive system ，but high incidence of tremor ，cough，rash，fever，hypoproglobulinemia and cytokine release syndrome. The evidence quality of the indicators included in this study is generally low .
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OBJECTIVE：To systematically evaluat e the efficacy and safety of intranasal administration of dexmedetomidine versus oral administration of chloral hydrate for programmed sedation in children. METHODS ：Retrieved from Cochrane Library ，PubMed， Embase，CBM，CNKI and Wanfang database ，randomized controlled trials （RCTs）about intranasal administration of dexmedetomidine （trial group ）versus oral administration of chloral hydrate （control group ）for programmed sedation in children were collected. Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of the included literatures after literature screening and data extraction，and Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS ：A total of 8 RCTs were included ， with a total of 1 413 children. Meta-analysis showed that the sedation success rate [RR ＝1.13，95％CI（1.02，1.25），P＝0.02]，sedation onset time [MD ＝－1.07，95％CI（－1.82，－0.31），P＝0.006]，sedation duration [MD ＝－8.25，95％CI（－14.02，－2.47），P＝ 0.005]，wake-up time [MD ＝－9.63，95％CI（－15.40，－3.86），P＝0.001]，the incidence of nausea and vomiting [RR ＝0.05，95％CI （0.02，0.14），P＜0.000 01] in the trial group were significantly better than those in control group. There was no statistical significance in the incidence of SpO 2＜95％ [RR＝0.60，95％CI（0.24，1.54），P＝0.29]，incidence of hypotension [RR ＝1.18，95％CI（0.51， 2.74），P＝0.71]，incidence of bradycardia [RR ＝1.33，95％CI（0.18，9.88），P＝0.78] between 2 groups. CONCLUSIONS ：Intranasal administration of dexmedetomidine has better efficacy than oral administration of chloral hydrate for programmed sedation in children with good safety.
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Objective To investigate the relationship between blood biochemical indicators levels (glycosylated hemoglobin and serum bilirubin) and atherosclerosis in elderly type 2 diabetic.Methods Totally 100 type 2 diabetic patients aged 62-85 years were divided into type 2 diabetes mellitus with carotid atherosclerosis group (T2DM-AS group,n=55) and type 2 diabetes mellitus group (T2DM group,n=45).Blood biochemical indicators levels (glycosylated hemoglobin and serum bilirubin) were determined and compared between the patients and the healthy controls (n=60)Results Serum levels of total cholesterol,triglyceride,low-density lipoprotein and Lp(a) were elevated in T2DM-AS group as compared with T2DM group [(5.86 ± 0.28) mmol/L vs.(4.63 ±0.32) mmol/L,(2.02±0.43) mmol/L) vs.(1.56±0.39) mmol/L,(3.74±0.76) mmol/L vs.(3.03±0.81) mmol/Land (297.3±102.2) mmol/Lvs.(203.5±110.4) mmol/L,t=20.91,5.54,4.51 and 4.40,all P＜0.05].Glycosylated hemoglobin level was higher in T2DM-AS and T2DM groups than in control group [(9.58 ± 0.47) mmol/L,(7.21 ± 0.66) mmol/L vs.(5.31 ± 0.54)mmol/L,both P＜0.05].There was a significant difference in glycosylated hemoglobin level between T2DM-AS group and T2DM group [(9.58 ± 0.47) mmol/L vs.(7.21 ± 0.66) mmol/L,t=20.9,P＜0.05].Serum bilirubin level was lower in T2DM AS group than in T2DM and control groups [(8.02±1.23)μmol/L vs.(13.72±1.64)μmol/L,(19.66±1.41)μmol/L; t=19.8,47.0,both P ＜0.05].Conclusions Glycosylated hemoglobin and serum bilirubin may promote atherosclerosis in elderly type 2 diabetic.The control of glycosylated hemoglobin and blood lipids levels may help to reduce atherosclerosis in elderly type 2 diabetic patients,which has the important clinical significance for the prevention and treatment of type 2 diabetes mellitus.
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Objective To study the mediating effect of big five personality between childhood abuse and anxiety of college students, and to provide basis to intervene their mental disorder.Methods Through stratified sampling,2374 college students in Jiangsu were investigated by the personal report of childhood abuse( PRCA),self-rating anxiety scale(SAS) and the revised NEO five-factor Inventory(NEO-FFI-R).A path analysis was applied by analysis of moment structures(AMOS) version 7.0.Results The path analysis showed that childhood abuse was directly related to anxiety of college students(Sβ=0.123, P＜0.01 ＝ ,and was directly related to 4 dimensions of the NEO-FFI-R( exclusion Openness dimension) (Sβ= -0.216 ～ -0.248,0.309; P ＜ 0.01 ＝.3 dimensions of the NEO-FFI-R( exclusion Openness and Extraversion dimensions) were directly related to anxiety of college students ( Sβ = 0.525,-0.045 ～-0.052, P ＜ 0.05 ＝.Agreeableness, conscientiousness and neuroticism of NEO-FFI-R mediate the relationship between childhood abuse and anxiety of college students.The model fit indexes were x2/df = 0.546 ＜ 3.000, P = 0.460 ＞ 0.050, RMSEA = 0.001 ＜ 0.050, GFI = 1.000, AGFI = 0.998, NFI = 1.000, RFI = 0.998, IFI = 1.000,TLI = 1.002, CFI = 1.000.Conclusion Big five personality as mediated variable mediates the relationship between childhood abuse and anxiety of college students.
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Objective To study the Mediating effect of insecurity between childhood abuse and emotional distress of medical students,and to provide basis to intervene their mental disorder.Methods Through stratified sampling,262 medical students in Jiangsu were investigated by the Personal Report of Childhood Abuse( PRCA),Self-Rating Feeling of Insecurity Scale( SRFIS),Beck Depression Inventory( BDI ),Self-rating Anxiety Scale(SAS)and Suicide Ideation Scale(SIS).A path analysis was applied by Analysis of Moment Structures(AMOS) version 7.0.Results The path analysis showed that childhood abuse was directly related to insecurity of medical students ( β =0.538,P ＜0.01 ),and was directly related to emotional distress ( β =0.435,P ＜ 0.01 ).Insecurity were directly related to emotional distress of medical students ( β =0.342,P ＜ 0.05 ).Insecurity mediated partly the relationship between childhood abuse and emotional distress of medical students.The model fit indexes were X2/df =1.365 ＜ 3.000,P =O.082 ＞ 0.05,RMSEA =0.037 ＜ 0.050,GFI =0.971,AGFI =0.940,NFI =0.943,RFI =0.902,IFI =0.984,TLI =0.972,CFI =0.984.Conclusion Insecurity as mediated variable mediates the relationship between childhood abuse and emotional distress of medical students.
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Objective To study the mediating effect of psychological defense mechanism between personality and depression or anxiety in postgraduate entrance re-examinee. Methods 496 examinee in entrance re-examination of medical postgraduate were investigated by applying Minnesota Multiphasic Personality Inventory(MMsion and anxiety(r=0. 107 ～0. 668, P＜0.05). Psychological defense mechanism was remarkably correlated with depression and anxiety(r= -0. 090 ～ -0.666, P＜0.05;r=0. 131 ～0. 663, P＜0.01). Personality was significantly correlated with psychological defense mechanism (r = - 0. 158 ～ - 0. 586, P ＜ 0.01;r = 0.125 ～ 0.532, Psion, anxiety factor, explicit anxiety, and fear (21.6%, 43.8%, 35.7%, 65.7%). Conclusion Personality is a remarkable predictor of depression and anxiety,and has indirect and direct influence on depression and anxiety through psychological defense mechanism.
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Objective To study the kindness trait of personality of pupils in grade 5 and 6,and to explore its relationship with childhood abuse. Methods 172 elementary school students were investigated by applying Female had higher scores of generosity, altruism, honesty and kindness trait than male ((41.1±4.4) vs (37.6±6.6),(19.2±3.9) vs (17.1±4.6),(17.3±3.0) vs (15.3±3.5),(77.6±8.8) vss (69.9±12.6), F=tions on kindness trait(P<0.05). Sexual abuse had not predictable functions on kindness trait (P>0.05). Con-clusion There are significant differences of kindness trait among subjects with different genders. Childhood abuse can severely impact the development of kindness trait of personality in puerile.
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Objective To investigate the effects of Pinella's ingredients on the viability of cells, morphology, microstructure, cell cycle and apoptosis in human cervical cancer cell lines. Methods The β-sitosterol and/or total protein of Pinella were incubated at different concentrations with cervical cancer cell line SiHa. The effects of β-sitosterol and/or total protein of Pinella on the viability of cells were tested by MTT assay. The effects of β-sitosterol on morphology, microstructure, cell cycle and apoptosis were studied by phase-contrast microscope, electron microscope and flowcytometry, respectively. Results β-sitosterol could obviously inhibit the viability of SiHa cells in a time-and dose-dependent manner. The total protein of Pinella had no effects on SiHa cells' viability. 20 μmol/L β-sitosterol induced the accumulation of SiHa cells in S phase in the cell cycle. And the percents of apoptosis and necrosis increased. The morphology and microstructure of SiHa cells changed significantly after treated with 20 μmol/L β-sitosterol. Conclusions The total protein of Pinella had little influence on the viability of cervical cancer cells SiHa. The viability of SiHa cells could be suppressed by β-sitosterol. β-sitosterol could induce the accumulation of cells in S phase and the percent of apoptosis and necrosis. The morphology and microstructure changed significantly after treated with β-sitosterol. Therefore, β-sitosterol might be a prospect safe and low toxicity anti-cervical cancer drug.
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OBJECTIVE To evaluate the influence of the information technique reporting on the quality of the infectious diseases reporting,and discuss the advantages and existing problems of Reporting Information System of Infectious Diseases("IDRIS").METHODS The situations of missing reports,late reports,and information quality of reporting cards before and after the application of IDRIS in the hospital were compared.RESULTS The missing report rate,late report rate,completeness rate and accuracy rate of cards after the application of IDRIS were 0.6%,2.0%,99.3% and 99.3% respectively,vs 16.5%(15.9% lower,(?2=436.997,P
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BACKGROUND: Tumor-adopted immunity and gene transduction technique are used to introduce tumor necrosis factor-α vector into carrier cells, which are then re-infused into the body so that cancer cells can be killed by tumor necrosis factor-α more directly and effectively with fewer side effects on the other tissues due to high local expression.OBJECTIVE: To study the bioactivity of in vitro cultured tumor necrosis factor-α transduced tumor-infiltrating lymphocytes as well as the inhibitory effects on cancer cells of cancer-loaded rats infused in different ways.DESIGN: A randomized controlled study based on experimental animals.SEETING: Cancer Research Institute of China Medical University.MATERIALS: This study was carried out at the Cancer Research Institute and the Experimental Animal Department, China Medical University,between January 2000 and December 2001. TJ8510 cell line (human brain glioblastoma cell line) was provided by the Neurological Research Institute of Tianjin Medical University Affiliated Hospital. The experimental animals were 36 BALB/C nude mice congenitally having no thymius.METHODS: Based on the establishment of tumor necrosis factor-α retroviral transduction system and the preparation of cartier cells tumor-infil-trating lymphocytes, the monoclonal virus cell line PLC-2 and PLJC-5available were used to introduce marked gene NeoR and targeted gene tumor necrosis factor-α into tumor-infiltrating lymphocytes, respectively.Then cell proliferation, tumor necrosis factor expression and in vitro antitumor activity were examined. After cancer cell inoculation, the 36 nude mice were randomly divided into 6 groups: local infusion control group, local tumor-infiltrating lymphocytes infusion group, local tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, venous infusion control group, venous tumor-infiltrating lymphocytes infusion group and venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, and the therapeutic effects on the cancer-loaded mice were observed.proliferation and tumor necrosis factor-α expression in tumor-infiltrating oR-tumor-infiltrating lymphocytes and tumor necrosis factor-tumor-infiltrating lymphocytes was not significantly different from each other (P ＞ 0.05).NeoR-tumor-infiltrating lymphocytes, though not significantly different (P ＞0.05), significantly differ from that of tumor necrosis factor-tumor-infiltrating lymphocytes (P ＜ 0.01); moreover, tumor necrosis factor-tumor-infiltrating lymphocytes were found to express higher tumor necrosis factor-α conactivity did not significantly differ between tumor-infiltrating lymphocytes and NeoR-tumor-infiltrating lymphocytes (P ＞ 0.05), but obviously increased come of the animal experiment: 40 days after tumor necrosis factor-tumorinfiltrating lymphocytes infusion, cancer size in local tumor necrosis factortumor-infiltrating lymphocytes infusion group was found smaller than that in local infusion control group [(307±42) and (2 048±278) mm3, P ＜ 0.01],and it was also smaller in venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group than that in venous control group [(954±195)and (1 989±305) mm3 , P ＜ 0.05].CONCLUSION: Tumor necrosis factor-α gene transduced tumor-infiltrating lymphocytes could effectively express tumor necrosis factor, exerting higher and in vivo anti-tumor effects than tumor-infiltrating lymphocytes in cancer-loaded nude mice. No obvious inhibitory effects on the growth of subcutaneous solid carcinoma could be observed in nude mice after venous infusion of human brain glioblastoma tumor-infiltrating lymphocytes, but the inhibitory effects became obvious due to venous infusion of tumor necrosis factor-tumor-infiltrating lymphocytes and significant due to local tumor necrosis factor-tumor-infiltrating lymphocytes infusion, indicating that local infusion is the preferable way in the treatment of glioblastoma by immuno-gene therapy.
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Objective To study the effect of cumulus cell apoptosis on the structure of human oocyte cultured in vitro and to probe into the reason why cumulus cell apoptosis rate can be used clinically to predict the developmental potential of oocyte. Methods Cumulus-enclosed oocyte complexes (COCs) at the GV stage were cultured in vitro. The apoptosis rate of cumulus cells for every COC was evaluated with HE staining, DAPI staining and TUNEL labeling methods. Oocytes were divided into two groups according to their cumulus cell apoptosis rate. Structure of oocytes was observed under light microscope and transmission electron microscope. Mature oocytes at MⅡ stage were fertilized and cultured in vitro for two days. Then the embryos were evaluated according to their morphology under light microscope.Results The oocytes with low cumulus cell apoptosis rate had a normal structure and a promising developmental potential, while the oocytes with high cumulus cell apoptosis rate had deformed structures and a poor developmental potential. Some deformed oocytes had uneven perivitelline space. For oocytes with a small perivitelline space, the organelle development was slow compared with those with a large perivitelline space. Some had unevenly piled organelles. Secondary lysosomes and large space probably caused by the decopmounding of lysosomes were found in the ooplasm of these oocytes. The deformed oocytes appeared to have lots of swollen mitochondria with blurred cristae and membrane. Some of these oocytes had fractured first polar bodies and abnormally thick or thin zona pellucida. The cell junctions and microvilli of cumulus cells reduced as well. Conclusion The effect of cumulus cell apoptosis on the structure of oocyte cultured in vitro was revealed. The reason why cumulus cell apoptosis rate prognosticated the developmental potential of oocyte was demonstrated in the aspect of oocyte structure.
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Objective To study the ultrastructure of human oocytes cultured in vitro.Methods Ultrastructure of oocytes at different stages and of different quality were observed under transmission electron microscope(TEM).Immature oocytes at germinal vesicle(GV) stage and at MI stage after germinal vesicle break-down before and after being cultured in vitro,as well as mature oocytes at MⅡ stage after being cultured were evaluated according to their morphology under light microscope,and then studied by TEM. Results At GV stage the microvilli on oocyte surface were rare and shorter.Nucleus with a dense nucleolus was located in the periphery of oocyte.After culture the oocyte microvilli became denser and increased in number.There were rich ooplasm with organelles,such as large numbers of secretion vesicles,mitochondria and lipid droplets in the GV oocyte.The end of cumulus cell expanded and penetrated into the oocyte zone,forming gap junctions with oocyte microvilli.Functional connection of the adjacent cumulus cells was by desmosomes. In mature oocytes the rough endoplasmic reticulum and Golgi apparatus decreased while the smooth endoplasmic reticulum increased in number.Mitochondria degenerated and lipid droplets fused to form bigger ones.Cortical granules were distributed beneath the cytoplasm membrane in a line manner.The cell junctions between oocytes and cumulus cells were interrupted.There were various organelles in the first polar body.The mature oocytes with lower quality appeared to have lots of swollen mitochondria with blurred cristae and membrane.Some of these oocytes had fractured first polar bodies and deformed zona pellucida.Their surrounding cumulus cells showed higher frequency of cell apoptosis.Conclusion The ultrastructure of human oocytes at different stages and of different quality cultured in vitro was revealed.
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3 systems) underlying diseases.One hundred and five cases with respiratory tract infections ranked on top of distribution of infected tissues,59 cases happened in ICU wards.CONCLUSIONS The predisposing factors of hospital infections are aging,long hospitalization,inappropriate use of antibiotics,invasive operations and serious underlying diseases.Hospital infections happen highly in ICU,department of neurology,and organ transplantation departments.The most infected site is respiratory tract.
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AIM: To assay fatty acids in Hericium Erinaceus polysaccharide by GC for establishing a method for quantitative determination of fatty acids. METHODS: The kinds of fatty acids were detected by GC-MS. The fatty acids contents were determined by GC: The sample was dissolved in sulphuric acid-methanol (1∶20) containing 0.5 mg heptadecanoic acid methyl ester and kept at 80?C for 3 hr. Then, the solution was extracted by hexamethylene four times and diluted to 1 mL. The extraction (0.4 ?L) was injected on a DB-1 column, using nitrogen as the carrier gas. The temperature was raised from 60?C to 200?C at the rate of 10?C?min -1 , and subsequently sustained for 30 min. The injection port and detector temperature were both at 250?C. RESULTS: The fatty acids were separated completely. The linear ranges were 0.4-3.6 mg?mL -1 . RSD97%. CONCLUSION: The fatty acids can be determined accurately by this method.
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AIM: To develop a new method based on phenol-sulfuric reaction for the determination of hetero-polysaccharide. METHODS: The proportion of sugars in the hetero-polysaccharide was determined by GC. According to standard solution obtained, Heteropolysaccharide can be determined through the standard curve. ( RESULTS:)The linear relationship of standard solution of mixed sugars was at the range of 8.56-38.52 mg/L~(-1). CONCLUSION: GC and phenol-sulfuric acid method can be used to determine the heteropolysaccharide accurately.