The Uptake and Distribution Evidence of Nano- and Microplastics in vivo after a Single High Dose of Oral Exposure / 生物医学与环境科学（英文）

OBJECTIVE@#Tissue uptake and distribution of nano-/microplastics was studied at a single high dose by gavage in vivo.@*METHODS@#Fluorescent microspheres (100 nm, 3 μm, and 10 μm) were given once at a dose of 200 mg/(kg∙body weight). The fluorescence intensity (FI) in observed organs was measured using the IVIS Spectrum at 0.5, 1, 2, and 4 h after administration. Histopathology was performed to corroborate these findings.@*RESULTS@#In the 100 nm group, the FI of the stomach and small intestine were highest at 0.5 h, and the FI of the large intestine, excrement, lung, kidney, liver, and skeletal muscles were highest at 4 h compared with the control group ( P < 0.05). In the 3 μm group, the FI only increased in the lung at 2 h ( P < 0.05). In the 10 μm group, the FI increased in the large intestine and excrement at 2 h, and in the kidney at 4 h ( P < 0.05). The presence of nano-/microplastics in tissues was further verified by histopathology. The peak time of nanoplastic absorption in blood was confirmed.@*CONCLUSION@#Nanoplastics translocated rapidly to observed organs/tissues through blood circulation; however, only small amounts of MPs could penetrate the organs.

Sanitary inspection results of drinking water quality in stations along Hexi Corridor Railway in 2018 -2020 / 公共卫生与预防医学

Objective To understand the sanitary status of drinking water quality in stations along Hexi Corridor Railway from 2018 to 2020. Methods Among of 270 samples of drinking water collected by a railway CDC from 2018 to 2020 were detected and analyzed. Results A total of 270 water samples were detected from 2018 to 2020. Among them, 90 water samples were detected in train water supply stations, and 89 were qualified, with a qualified rate of 98.89%. 180 water samples were detected in non-train water supply stations, and 119 samples were qualified, with a qualified rate of 66.11%. The qualified rate of water quality test items in train water supply stations was significantly higher than that in non-train water supply stations (χ2=36.44, P＜0.05). There was no significant difference in the qualified rate of water quality test items in different years (χ2=2.4,3.01, 0.04, P＞0.05). Conclusion The drinking water source of each station along the Hexi Corridor Railway is supplied by deep groundwater. Without adding disinfectant, the total bacterial count, coliform group, Escherichia coli and other indicators of drinking water in all stations meet GB5749-2006 “sanitary standard for drinking water”. This raises a question on the necessity to add disinfectant when deep groundwater is used as drinking water source. However, the train water supply station, which is used as the source of secondary water supply, provides drinking water for railway train passengers. The free residual chlorine in the water after chlorination can continuously kill microorganisms in the water. Therefore, it is necessary to add disinfectant to the source water of the train water supply station.

The correlations between influenza and meteorological factors in 15 cities of northern China, 2008-2020 / 中华流行病学杂志

Objective: To understand the influence of meteorological factors on the morbidity of influenza in northern cities of China and explore the differences in the influence of meteorological factors on the morbidity of influenza in 15 cities. Methods: The monthly reported morbidity of influenza and monthly meteorological data from 2008 to 2020 were collected in 15 provincial capital cities, including Xi 'an, Lanzhou, Xining, Yinchuan and Urumqi (5 northwestern cities), Beijing, Tianjin, Shijiazhuang, Taiyuan, Hohhot, Ji'nan, Zhengzhou (7 northern cities), Shenyang, Changchun and Harbin (3 northeastern cities). The panel data regression model was applied to conduct quantitative analyze on the influence of meteorological factors on influenza morbidity. Results: The univariate and multivariate panel regression analysis showed that after controlling the population density and other meteorological factors, for each 5 ℃ drop of monthly average temperature, the morbidity change percentage (MCP) of influenza was 11.35%, 34.04% and 25.04% in the 3 northeastern cities, 7 northern cities and 5 northwestern cities, respectively, and the best lag period months was 1, 0 and 1 month; When the monthly average relative humidity decreased by 10%, the MCP was 15.84% in 3 cities in northeastern China and 14.80% in 7 cities in northern China respectively, and the best lag period months was 2 and 1 months respectively; The MCP of 5 cities in northwestern China was 4.50% for each 10 mm reduction of monthly accumulated precipitation, and the best lag period months was 1 month; The MCPs of 3 cities in northeastern China and 5 cities in northwestern China were 4.19% and 5.97% respectively when the accumulated sunshine duration of each month decreased by 10 hours, the best lag period months was 1 month. Conclusions: In northern cities of China from 2008 to 2020, the temperature, relative humidity, precipitation and sunshine duration all had negatively impact on the morbidity of influenza, and temperature and relative humidity were the main sensitive meteorological factors. Temperature had a strong direct impact on the morbidity of influenza in 7 cities in northern China, and relative humidity had a strong lag effect on the morbidity of influenza in 3 cities in northeastern China. The duration of sunshine in 5 cities in northwestern China had a greater impact on the morbidity of influenza compared with 3 cities in northeastern China.

Chemical constituents from stems and leaves of Cratoxylum cochinchinense and their inhibitory effects on proliferation of synoviocytes in vitro / 中国中药杂志

The chemical constituents from the stems and leaves of Cratoxylum cochinchinense were isolated and purified using silica gel, ODS gel, and Sephadex LH-20 gel column chromatography, as well as preparative HPLC. The chemical structures of all isolated compounds were identified on the basis of their physicochemical properties, spectroscopic analyses, and the comparison of their physicochemical and spectroscopic data with the reported data in literature. As a result, 21 compounds were isolated from the 90% ethanol extract of the stems and leaves of C. cochinchinense, which were identified as cratocochine(1), 1-hydroxy-3,7-dimethoxyxanthone(2), 1-hydroxy-5,6,7-trimethoxyxanthone(3), ferrxanthone(4), 3,6-dihydroxy-1,5-dimethoxyxanthone(5), 3,6-dihydroxy-1,7-dimethoxyxanthone(6), 1,2,5-trihydroxy-6,8-dimethoxyxanthone(7), securixanthone G(8), gentisein(9), 3,7-dihydroxy-1-methoxyxanthone(10), pancixanthone B(11), garcimangosxanthone A(12), pruniflorone L(13), 9-hydroxy alabaxanthone(14), cochinchinone A(15), luteolin(16), 3,5'-dimethoxy-4',7-epoxy-8,3'-neolignane-5,9,9'-triol(17), N-benzyl-9-oxo-10E,12E-octadecadienamide(18), 15-hydroxy-7,13E-labdadiene(19), stigmasta-4,22-dien-3-one(20), and stigmast-5-en-3β-ol(21). Among these isolates, compound 1 was a new xanthone, compounds 2-5, 7, 8, 12, and 16-21 were isolated from the Cratoxylum plant for the first time, and compounds 11 and 13 were obtained from C. cochinchinense for the first time. Furthermore, all isolated compounds 1-21 were appraised for their anti-rheumatoid arthritis activities by MTS method through measuring their anti-proliferative effect on synoviocytes in vitro. As a result, xanthones 1-15 displayed notable anti-rheumatoid arthritis activities, which showed inhibitory effects on the proliferation of MH7A synoviocytes with the IC_(50) values ranging from(8.98±0.12) to(228.68±0.32) μmol·L~(-1).

Long-term impact of mild traumatic brain injury on oculomotor parameters / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the long-term impact of mild traumatic brain injury(mTBI)on oculomotor parameters.METHODS: Prospective study. A total of 46 patients from 6 to 12mo after mTBI who visited Tianjin Eye Hospital from February to August 2021 were collected. According to the score of the Brain Injury Vision Sympton Survey(BIVSS)Questionnaire, they were divided into the symptomatic group of mTBI(BIVSS total score ≥32, n=24)and the asymptomatic group of mTBI(BIVSS total score &#x0026;#x003C;32, n=22). In addition, healthy people without mTBI were selected as the control group(n=23). All of the subjects accepted test of oculomotor parameters to evaluate binocular vision.RESULTS: Monocular accommodation amplitude, monocular accommodation facility, the absolute value of phoria at near, BI recovery point of fusional range at near and saccades were different among the three groups(P&#x0026;#x003C;0.05); There were no significant differences in near point of convergence, the absolute value of distance phoria, BI blur, BO blur and recovery of fusional range at near among the three groups(P&#x0026;#x003E;0.05). The incidence of accommodative abnormality, convergence abnormality, and saccadic dysfunction were different among the three groups(P&#x0026;#x003C;0.01). The incidence of accommodative abnormality in the symptomatic group was significantly higher than that in the asymptomatic and control groups(all P&#x0026;#x003C;0.0167); the incidence of convergence dysfunction in the symptomatic and the asymptomatic groups were higher than that in the control group(all P&#x0026;#x003C;0.0167); the incidence of saccadic dysfunction in the symptomatic group was significantly higher than that in the asymptomatic and control groups(all P&#x0026;#x003C;0.0167).CONCLUSION: Accommodation, convergence, and saccades functions in the mTBI symptomatic group were lower, and some of the binocular vision in the asymptomatic group was also affected. It is suggested that mTBI has a long-term impact on oculomotor parameters, and comprehensive oculomotor assessment is necessary for mTBI patients.

Efficacy of CLAE Chemotherapy Regimen Followed by Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Relapsed/Refractory Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To observe the efficacy and safety of CLAE intensive chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with relapsed/refractory acute leukemia (R/R AL).@*METHODS@#CLAE regimen [cladribine 5 mg/(m2·d), d 1-5; cytarabine 1.5 g/(m2·d), d 1-5; etoposide 100 mg/(m2·d), d 3-5] followed by allo-HSCT was used to treat 3 R/R AL patients. The patients received CLAE chemotherapy in relapsed or refractory status and underwent bone marrow puncture to judge myelodysplastic state. After an interval of 3 to 5 days, followed by preconditioning regimen for allo-HSCT [fludarabine 30 mg/(m2·d), d -7 to d -3; busulfan 0.8 mg/kg q6h, d -6 to d -3 or d -5 to d -2. If the bone marrow hyperplasia was not active and the blasts were less than 10%, busulfan should be used for 3 days. If the bone marrow hyperplasia was active and the blasts were more than 10%, busulfan should be used for 4 days]. Cyclosporin A, mycophenolate mofetil and short-term methotrexate were used for graft-versus-host disease (GVHD) prevention. After transplantation, the status of minimal residual disease (MRD) and bone marrow chimerism were regularly monitored in all 3 patients, and demethylation drugs or dasatinib were used to prevent recurrence 3 months after transplantation.@*RESULTS@#2 patients with t(11;19) translocation and relapse/refractory acute myeloid leukemia recurred within 6 months after induction of remission, and received intensive chemotherapy with CLAE regimen followed by haploidentical allo-HSCT and unrelated donor allo-HSCT, respectively. The two patients both relapsed 6 months after transplantation, then achieved complete remission by donor lymphocyte infusion, interferon, interleukin-2 and other methods, and disease-free survival was 2 years after transplantation. The other patient was chronic myelogenous leukemia who developed acute lymphoblastic leukemia during oral administration of tyrosine kinase inhibitor, accompanied by T315I and E255K mutations in ABL1 kinase region and additional chromosomal abnormalities. After morphological remission by induction chemotherapy, central nervous system leukemia was complicated. Intensive chemotherapy with CLAE regimen followed by sibling allo-HSCT was performed in the positive state of MRD. The patient relapsed 3 months after transplantation, and achieved remission after chimeric antigen receptor T-cell (CAR-T) therapy, however, he died 5 months after transplantation because of severe cytokine release syndrome (CRS) and GVHD.@*CONCLUSION@#CLAE regimen followed by allo-HSCT may be an effective salvage treatment option for R/R AL patients to prolong the overall survival.

Assessment of intensity of seasonal influenza activity in Beijing-Tianjin-Hebei region, 2019-2021 / 中华流行病学杂志

Objective: To explore the feasibility of moving epidemic method (MEM) in the assessment of seasonal influenza (influenza) activity intensity from the perspective of urban agglomeration, assess influenza activity intensity in the Beijing-Tianjin-Hebei region from 2019 to 2021 and evaluate the reliability of surveillance data and the effectiveness of the MEM model application. Methods: The weekly reported incidence rate (IR) of influenza and the percentage of influenza-like illness (ILI%) from 2011-2021 in Beijing-Tianjin-Hebei region were collected to establish MEM models respectively. The model fitting effect and the reliability of the two data were evaluated for the purpose of establishing an optimal model to assess the influenza activity intensity in Beijing-Tianjin-Hebei region from 2019-2021. A cross-validation procedure was used to evaluate the performance of the models by calculating the Youden's index, sensitivity and specificity. Results: The MEM model fitted with weekly ILI% had a higher Youden's index compared with the model fitted with weekly IR at both Beijing-Tianjin-Hebei region level and provincial level. The MEM model based on ILI% showed that the epidemic threshold in Beijing-Tianjin-Hebei region during 2019-2020 was 4.42%, the post-epidemic threshold was 4.66%, with medium, high and very high intensity thresholds as 5.38%, 7.22% and 7.84%, respectively. The influenza season during 2019-2020 had 10 weeks (week 50 of 2019 to week 7 of 2020). The influenza season started in week 50 of 2019, and the intensity fluctuated above and below medium epidemic level for six consecutive weeks. The high intensity was observed in week 4 of 2020, the threshold of very high intensity was excessed in week 5, and the intensity gradually declined and became lower than the threshold at the end of the influenza season in week 8. The epidemic threshold was 4.29% and the post-epidemic threshold was 4.35% during 2020-2021. Influenza activity level never excessed the epidemic threshold throughout the year, and no epidemic period emerged. Conclusions: The MEM model could be applied in the assessment of influenza activity intensity in Beijing-Tianjin-Hebei region, and the use of ILI% to assess influenza activity intensity in this region was more reliable than IR data. Influenza activity intensity in Beijing-Tianjin-Hebei region was higher during 2019-2020 but significantly lower in 2020-2021.

Effects of modified Zhujing pill on retinal autophagy in mice with form deprivation myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of modified Zhujing pill on retinal autophagy in mice with form deprivation myopia.METHODS: Thirty C57BL/6 mice were randomly divided into a negative control group, a myopia model group and a traditional Chinese medicine intervention group, with 10 mice in each group. Except for the negative control group, all mice in the myopia model group and the traditional Chinese medicine intervention group used translucent EP tubes to cover their right eyes to make a form deprivation myopia(FDM)model; The traditional Chinese medicine intervention group gavage Zhujing pill modified suspension 0.546g/(kg·d)(0.15mL/d), the negative control group and the myopia model group were given an equal amount of normal saline(0.15mL/d)for 4wk. At the beginning and the end of the experiment respectively, the right eye diopter of the mouse was measured with a strip retinoscope, measurement of the axial length of the right eye of mouse by A-ultrasound. At the end of the experiment, the right eyes of all mice were taken for detection, and immunofluorescence method was used to locate and detect the activity and migration of the retinal microglia marker(Iba1); Transmission electron microscope observation of autophagosome formation in retinal pigment epithelial cells; Western Blot, real-time fluorescent quantitative PCR(q-PCR)to detect the autophagy marker LC3Ⅱ and p62 protein quantitative and gene expression in retinal tissues.RESULTS: At the end of the experiment, the refractive power of the right eyes of mice showed that the myopia model group and the traditional Chinese medicine intervention group formed relative myopia, the myopia model group and the traditional Chinese medicine intervention group were significantly lower than those of the negative control group(all P&#x003C;0.01). At the end of the experiment, the axial length of the myopia model group and the Chinese medicine intervention group were significantly increased compared with the negative control group(P&#x003C;0.01). Immunofluorescence method for locating and detecting Iba1 showed that the average optical density of Iba1 in the retina of the myopia model group increased the most obviously, followed by the increase in the negative control group, and the decrease in the traditional Chinese medicine intervention group. Compared with the negative control group, the myopia model group increased significantly(P&#x003C;0.05), and the traditional Chinese medicine intervention group was significantly lower than the myopia model group(P&#x003C;0.05). It was found that Iba1 migrated to the ganglion cell layer in the myopia model group and the traditional Chinese medicine intervention group. Transmission electron microscopy showed that autophagosomes were observed in the retinal pigment epithelial cells of the myopia model group and the Chinese medicine intervention group. The results of Western Blot and q-PCR showed that the expression of LC3Ⅱ and p62 increased most obviously in the traditional Chinese medicine intervention group, followed by the myopia model group, and the negative control group was the lowest.CONCLUSION: The results of the study show that modified Zhujing pill may enhance retinal autophagy in mice with FDM by inhibiting the activation of microglia.

Progress in the practice of surveillance and early warning of infectious diseases in major countries and regions / 中华流行病学杂志

The COVID-19 pandemic is yet another reminder that the threat of infectious disease has never really gone away. As the cornerstone of preventing and controlling infectious diseases, effective surveillance and early warning are of great significance in understanding the outbreak and epidemic of specific infectious diseases and putting forward effective prevention and control measures. Therefore, we must continue strengthening the construction of infectious disease surveillance and early warning system. We reviewed the surveillance and early warning practices of infectious diseases in major countries and regions, then discussed the development direction in the field of surveillance and early warning of infectious diseases to provide the reference for strengthening the construction and capacity of infectious disease surveillance and early warning system in China.

Monitoring and analysis of secondary water supply quality of passenger train in a certain district / 公共卫生与预防医学

Objectives To investigate the sanitary condition of the secondary water supply for passenger trains in the administration area, to evaluate the influencing factors of the secondary water supply system for passenger trains, and to put forward suggestions for improving the water quality of the secondary water supply for passenger trains. Methods The water quality of secondary water supply of 48 trains of 24 pairs of CRH type passenger trains and 160 trains of 10 pairs of type 22 passenger trains and 30 pairs of type 25 passenger trains in Lanzhou Railway Bureau in 2019 was analyzed and compared. Results The qualification rate of 208 samples tested was 73.08%. The qualification rate of secondary water supply quality of type 22 and 25 passenger trains was 62.50% and 66.67%, respectively, and the difference was not statistically significant（χ2=0.23 ，P＞0.05）. The qualification rate of secondary water supply of CRH passenger train was 97.92%, which was statistically significantly different compared with that of type 22 and 25 passenger trains（χ2=18.40, 18.15, P2=0.056, 0.054, 0.056, 0.22, 0, and 0.22, P>0.05). The total number of bacterial colonies, total coliform, turbidity and iron in the secondary water supply of type 22 and 25 passenger trains did not meet the standard, while only one water sample for the secondary water supply of CRH passenger trains did not meet the standard. Conclusion The quality of secondary water supply of CRH passenger train is obviously better than that of type 22 and 25 passenger trains. Changing the position of defecation port and water injection pipe of type 22 and 25 passenger trains, selecting non direct train defecation collection system, or adding appropriate amount of chlorine disinfectant into the water supply hose can significantly improve the qualification rate of bacteriological indexes of secondary water supply of passenger trains.

A prospective multicenter cohort study comparing vNOTES and laparoscopic sentinel lymph node mapping for endometrial cancer / 부인종양

Objective@#To determine the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in hysterectomy and sentinel lymph node (SLN) mapping for endometrial cancer by comparing its SLN detection rate and perioperative outcomes with those of laparoscopic staging. @*Methods@#In this multicenter prospective cohort study, 68 patients with early endometrial cancer between 2020 and 2021 in 2 tertiary referral centers in China were grouped to vNOTES (n=33) or laparoscopy (n=35). All the patients underwent hysterectomy with SLN mapping. @*Results@#The total successful SLN detection was 97.0% in the vNOTES group and 91.4% in the laparoscopy group (p=0.32), whereas the bilateral success rates were 81.8% and 80.0%, respectively (p=0.84). There was no difference in SLN detection observed between the 2 groups regarding the side-specific mapping efficacy quotient (89.4% vs 85.7%; p=0.05). The number of harvested SLNs, the location of SLNs, operative time, estimated blood loss, intraoperative and postoperative complications and hospital cost in the 2 groups were similar (p>0.05), but there were differences in the 2 groups; the one was postoperative exhaust time that was 18 vs. 21 hours (p=0.01), the other was median postoperative hospital stay which was 4 vs. 5 days (p=0.05). @*Conclusion@#This study suggests that lymph node mapping can be completed through the vNOTES procedure. It can ensure effective surgical staging and show the advantages of a fast recovery and good cosmetic effect.

Research progress of gene therapy for retinitis pigmentosa / 国际眼科杂志(Guoji Yanke Zazhi)

@#Retinitis pigmentosa(RP)is a hereditary retinal disease characterized by degeneration of retina rods and cones photoreceptor cells and degeneration of retinal pigment epithelial cells. The age of onset and progression of RP are genetically related and influenced by the environment. Gene therapy uses vectors in delivering therapeutic genes to genetically modify target cells, so as to correct or replace the disease-causing RP genes. This article introduces the research progress of vectors in RP gene therapy, and review the efficacy and safety of gene therapy on five common genotypes(RHO, PDE6B, MERTK, RLBP1, RPGR).

Efficacy of Micro-Transplantation Consolidation Therapy for Patients with Acute Myeloid Leukemia after Complete Remission / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and safety of micro-transplantation in acute myeloid leukemia (AML).@*METHODS@#The clinical data of 13 adult AML patients who received micro-transplantation as consolidation therapy from July 2014 to October 2019 was retrospectively analyzed, and the adverse reactions and efficacy of micro-transplantation were followed up.@*RESULTS@#Eight patients received micro-transpantation were still in complete remission, 5 patients relapsed after micro-transplantation, 1 of them received umbilical cord blood micro-transplantation after remission by reinduction, and all of the 13 patients have survived till now. The median overall survival time was 13 months, and the median relapse-free survival time was 12 months. All 13 patients developed grade 2-4 hematological adverse reactions. The median recovery time of neutrophils and platesets was 13 (11-15) and 15 (13-17) days, respectively. None of the 13 patients developed acute or chronic graft versus host disease. Twelve patients suffered from different infections, however, there were no serious organ function injury complications happened.@*CONCLUSION@#The micro-transplomtation of HLA-incompatible stem cells derived from peripheral blood or umbilical and blood is an effective regimen for the consolidation therapy of AML, especially for the patients suffered from low and moderate risk of AML or the aged AML patients.

Meta-analysis of effect of Jinqi Jiangtang Tablets on treating insulin resistance in type 2 diabetes / 中国中药杂志

To systematically assess the efficacy and safety of Jinqi Jiangtang Tablets for patients with insulin resistance in type 2 diabetes, literatures were retrieved in 7 databases: PubMed, EMbase, Cochrane Library, Chinese National Knowledge Infrastructure(CNKI), WanFang database, Chinese BioMedical Database(CBM), VIP Chinese Science and Technique Journals Database, from the date of its inception up to November 2018. Review Manager 5.3 software was used for risk bias assessment, data synthesis and subgroup analysis. Begg's and Egger's tests were performed for assessing symmetries of funnel plot by software Stata 14.0. GRADE system was used to assess the quality of evidence. A total of 10 trials involving 797 participants were eligible. Compared with Western medicine alone, Jinqi Jiangtang Tablets showed a statistical significance in FBG(WMD=-0.63, 95%CI[-1.00,-0.26]). Jinqi Jiangtang Tablets showed a significant decrease in 2 h BG combined with Western medicine compared with Western medicine alone(WMD=-1.46, 95%CI[-1.71,-1.21], P<0.000 01). Jinqi Jiangtang Tablets combined with Western medicine showed a significant decrease in HbA1 c(WMD=-0.75, 95%CI[-0.97,-0.53], P<0.000 01), FINS(WMD=-0.65, 95%CI[-0.80,-0.50], P<0.000 01), 2 h INS(SMD=-1.67, 95%CI[-2.26,-1.09], P<0.000 01) and HOMA-IR(WMD=-1.22, 95%CI[-1.67,-0.76], P<0.000 01). Jinqi Jiangtang Tablets combined with Western medicine was beneficial for ISI(WMD=1.00, 95%CI[0.84, 1.17], P<0.000 01). Egger's and Begg's test showed no publication bias(P=0.379). Sensitivity analysis showed no impact on the overall results. The GRADE quality of the evidence was low. Despite of the apparently positive results, we cannot draw a rational conclusion that Jinqi Jiangtang Tablets has a positive effect in patients with IR, because of the low evidence grade.

Significance of Targeted Sequencing Assay for Patients with Suspected Myeloid Malignancies / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical significance of the targeted next-generation sequencing assay for patients with suspected myeloid malignancies.@*METHODS@#A total of 39 hematopenia patients with suspected myeloid malignamies in Department of Hematology of The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from January 2018 to April 2019 were treated, 20 hot spot genes of myelodysplastic syndrome (MDS) were detected.@*RESULTS@#Regarding the diagnostic type, there were 7 cases of idiopathic cytopenia of undetermined significance (ICUS), 8 cases of clonal cytopenias of undetermined significance (CCUS) and 24 cases of myeloid myeloid malignancies which included 18 cases of MDS, 4 cases of myelodysplastic/myeloproliferative neoplasms (MDS/MPN) and 2 cases of acute myeloid leukemia. Positive mutation was detected in 70.8% (17/24) of myeloid malignancy patients , and 72.7% (16/22) in MDS and MDS/MPN patients. The main mutation types were ASXL1, TET2 and RUNX1. Compared with gene negative group, there were no significant differences in sex, age (＜60 years old or ≥60 years old), proportion of bone marrow blast cells (＜5% or≥5%) and cytogenetics (good, medium and poor) (P＞0.05). Furthermore, all 8 CCUS patients showed positive mutation, and the incidence of double or multiple mutation in CCUS group was significantly lower than that of the MDS and MDS/MPN group (37.5% vs 54.5%) (P=0.002). The mutation types between the two groups were similar, and there was no significant difference in variant allele frequency (P＞0.05).@*CONCLUSION@#Our results suggest that there are high rates of double or multiple mutations in myeloid malignancies, especially in patients with MDS and MDS/MPN. Targeted sequencing assay can improve the diagnosis of myeloid malignancies, and guide clinical treatment.

Characteristic Changes and 3D Virtual Measurement of Lung CT Image Parameters in the Drowning Rabbit Model / 法医学杂志

OBJECTIVES@#To use virtual anatomy technique in the analysis of post-mortem characteristic changes of CT images in the experimental drowning rabbit model and the related parameters in 3D virtual model, so as to explore its application value in the diagnosis of drowning in forensic pathology.@*METHODS@#A model of drowning rabbits was established, with animal models of hemorrhagic shock and mechanical asphyxia as the controls. CT scan was performed on the experimental animals, and the differences in imaging features between the groups were compared by morphological reading of the tomographic images. CT data were imported into Mimics 14.0 software for 3D modeling. The CT values and lung volumes were calculated by the software, and the differences on CT values and lung volumes brought by different causes of death were analyzed.@*RESULTS@#The CT images of lungs in the drowning group showed characteristic ground-glass opacity （diffuse and uniform density increase）. There were no obvious abnormalities in hemorrhagic shock group, and only a few similar changes were found in the mechanical asphyxia group. Compared with the controls, the CT values and the lung volumes in the drowning group were significantly increased P<0.05.@*CONCLUSIONS@#Based on post-mortem lung imaging, the combination of CT value and lung volume changes can effectively reflect the virtual anatomical features in drowning, and provide a diagnostic basis for the forensic identification of drowning.

Therapeutic Response and Prognosis of Adult Acute Myeloid Leukemia with Chromosome Karyotype Abnormalities / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and prognosis of acute myeloid leukemia (AML) patients with chromosome karyotype abnormalities.@*METHODS@#The clinical features and treatment responses of 91 patients with AML were collected and analyzed retrospectively. The efficacy and survival rate of the AML patients with normal and abnormal chromosome karyotype were compared.@*RESULTS@#Chromosome translocations and monosomal karyotypes were the main heterogeneity of AML. There was no significant difference in complete remission rate and overall response rate between the normal and abnormal karyotype groups, but the recurrence rate was higher in abnormal karyotype group. There was no significant difference in response of AML patients received the standard "3+7 regimen" and pre-excitation chemotherapy in the treatment of normal and abnormal karyotype groups. The relapse free survival time (RFS) was longer in the normal karyotype group, but there was no significant difference in overall survival time (OS).@*CONCLUSION@#The abnormal karyotype of AML is an independent prognostic factor, monosomal karyotype shows a poor prognosis, and the recurrence rate in AML patients with monosomal karyotype is higher.

Clinical Efficacy of Endoscopic Tympanoplasty for Large Tympanic Membrane Perforation / 中山大学学报(医学科学版)

@#【Objective】To investigate the clinical efficacy of endoscopic tympanoplasty for chronic suppurative otitis with large tympanic membrane perforation.【Methods】A total of 110 cases（115 ears）which were diagnosed as chronic suppurative otitis with large tympanic membrane perforation were retrospectively collected from May 2017 to Jan 2019. All cases were performed endoscopic tympanoplasty；including removing tympanic lesions，reconstruction of ossicular chain， and myringoplasty with cartilage and perichondrium complex by underlay technique. At the same time of tympanoplasty ， balloon eustachian tuboplasty（BET）was performed in patients who were diagnosed with eustachian tube dysfunction. The graft success rate，pure tone threshold average（PTA）of speech frequency and the air-bone gap（ABG）were assessed at 3 months after surgery.【Results】The primary graft success rate was 95.7%，and the PTA and ABG were（25.7±11.8）dB HL and（13.8 ± 6.9）dB HL，respectively，which showed significant differences compared with pre- operation conditions （P < 0.001）. Furthermore，29 ears which were diagnosed with eustachian tube dysfunction were treated with BET at the same time of tympanoplasty. Compared with simply tympanoplasty （86 ears），no difference was found in primary graft success rate ，PTA and ABG post-operation（P > 0.05）.【Conclusions】 Endoscopic tympanoplasty is an effective surgery，and the cartilage and perichondrium complex is a reliable repair material for large tympanic membrane perforation ，which are both worthy of clinical promotion. Furthermore ，BET at the same time of tympanoplasty could ensure clinical efficacy for the patients with eustachian tube dysfunction.

Effect of alprostadil on microcirculation after the resuscitation in patients with septic shock / 解放军医学杂志

Objective To evaluate the effect of alprostadil on the microcirculation and mortality after the fluid resuscitation in patients with septic shock.Methods The patients who met the criteria of septic shock admitted to our hospital from March 2015 to September 2016 were selected as the subjects.After the shock resuscitation reached the standard,they were randomly divided into control group and alprostadil group.Control group was given a standard treatment.On the basis of standard treatment,alprostadil group was given alprostadil 10μg/d plus tube.The heart rate,mean arterial pressure (MAP),central venous pressure (CVP),lactic acid (Lac) and urine volume were recorded at 0,1,3 and 7 days.The microcirculation index under the tongue including small vessel density (TvDs),perfused small microvessel density (PvDs),small vessel perfusion ratio (PPVs),microvascular flow index (MFI) and heterogeneity index (HI) were recorded at 0,6,24 and 72h.The patients' hospitalization time in ICU,total hospitalization time and mortality rate of follow-up 28 days were recorded.Results Forty-eight patients were enrolled in this study,of which 23 were in control group and 25 in alprostadil group.The heart rate and MAP had no significant changes in alprostadil group,but the CVP decreased significantly compared with control group (P＜0.05) at 1,3,7 days after the treatment,and urine volume increased at 3 and 7 days in the alprostadil group (P＜0.05);but TvDs did not increase at 6 and 24h in the two groups,while PvDs,PPVs,MFI,HI increased at 6,24 and 72h in the two groups,with a higher value at 24 and 72h than the 6h.The 72-h indexes were significantly higher in alprostadil group than in control group (P＜0.05).The mechanical ventilation (MV) was significantly lower in alprostadil group than in control group (P＜0.05);ICU hospitalization time and total hospitalization time was significantly shorter in alprostadil group than in control group (P＜0.05).The hospital mortality and 28-day mortality were lower in alprostadil group than in control group (P＜0.05).Conclusions Alprostadil could significantly improve the microcirculation and urine volume in the patients after resuscitation for septic shock,with little effect on systemic circulation,effectively improve the prognosis of patients,and shortening the mechanical ventilation time,ICU stay time and total hospitalization time,thus reducing the mortality rate.

Application of PDCA cycle management method in prevention and control of multidrug-resistant organisms / 中国感染控制杂志

Objective To evaluate the effect of plan-do-check-act (PDCA) cycle management method on improving multidrug-resistant organisms (MDROs) prevention and control measures.Methods PDCA cycle management method was applied to improve the management system and management process of a hospital,prevention and control efficacy of MDROs in clinic departments between July-December 2014 (before PDCA implementation) and January-June 2015 (after PDCA implementation) was compared.Results After half a year implementation of PDCA cycle management,the total implementation rate of MDROs prevention and control measures increased from 57.14％ (360/630) to 79.69％ (510/640),difference was statistically significant(P＜0.05);implementation rate of recording by doctors during the disease course,recording by nurses during the nursing process,registration and reporting of MDROs,as well as posting isolation signs were all improved,difference was statistically significant (all P＜0.05).The total isolation rate of MDROs declined from 30.65％ (347/1 132)before PDCA implementation to 22.61％ (236/1 044) after PDCA implementation,difference was statistically significant (x2 =10.393,P＜0.05).Conclusion Application of PDCA cycle can improve the prevention and control measures of MDROs.