Systematic review on the characteristics of acute gastroenteritis outbreaks caused by sapovirus / 中华流行病学杂志

Objective To understand the epidemiological and etiological characteristics of outbreaks on acute gastroenteritis caused by sapovirus (SaⅤ) worldwide.Methods Literature about the outbreaks on acute gastroenteritis caused by SaⅤ were retrieved from the databases including WanFang,CNKI,PubMed and Web of Science after evaluation.Time,geography,setting and population distributions of outbreaks,transmission mode,SaⅤ genotype and clinical characteristics of the patients were analyzed.Results A total of 34 papers about SaⅤ were included,involving 146 outbreaks occurred between October 1976 and April 2016.In these papers,138 outbreaks were reported on the related months.All these outbreaks occurred in northern hemisphere.SaⅤ outbreaks occurred all year around,but mainly in cold season,the incidence was highest in December (25 outbreaks) and lowest in in August (2 outbreaks).Most outbreaks were reported by Japan,followed by Canada,the United States of America and the Netherlands.There were 141 outbreaks for which the occurring settings were reported,child-care settings were most commonly reported setting (48/141,34.04％),followed by long-term care facility (41/141,29.08％) and hospital (16/141,11.35％).Clinical symptoms of 1 704 cases in 31 outbreaks were reported,with the most common symptom was diarrhea (1 331/1 704,78.12％),followed by nausea (829/1 198,69.20％),abdominal pain (840/1 328,63.25％),vomiting (824/1 704,48.36％) and fever (529/1 531,34.53％).Genotypes of SaⅤ were determined for 119 outbreaks.GⅠ (51/119,42.86％) and GⅣ (45/119,37.82％) were predominant.The outbreaks of G Ⅳ SaⅤ increased suddenly in 2007,and the outbreaks of G Ⅰ SaⅤ mainly occurred in 2008 and during 2011-2013.Conclusions SaⅤ outbreaks were reported mainly by developed countries,with most outbreaks occurred in cold season,in child-care settings and long term care facility.G Ⅰ and GⅣ were the most common genotypes of SaⅤ.Prevention and control of SaⅤ outbreak in China seemed relatively weak,and it is necessary to conduct related training and to strengthen the SaⅤ outbreak surveillance in areas where service is in need.

Systematic review on the characteristics of acute gastroenteritis outbreaks caused by sapovirus / 中华流行病学杂志

Objective To understand the epidemiological and etiological characteristics of outbreaks on acute gastroenteritis caused by sapovirus (SaⅤ) worldwide.Methods Literature about the outbreaks on acute gastroenteritis caused by SaⅤ were retrieved from the databases including WanFang,CNKI,PubMed and Web of Science after evaluation.Time,geography,setting and population distributions of outbreaks,transmission mode,SaⅤ genotype and clinical characteristics of the patients were analyzed.Results A total of 34 papers about SaⅤ were included,involving 146 outbreaks occurred between October 1976 and April 2016.In these papers,138 outbreaks were reported on the related months.All these outbreaks occurred in northern hemisphere.SaⅤ outbreaks occurred all year around,but mainly in cold season,the incidence was highest in December (25 outbreaks) and lowest in in August (2 outbreaks).Most outbreaks were reported by Japan,followed by Canada,the United States of America and the Netherlands.There were 141 outbreaks for which the occurring settings were reported,child-care settings were most commonly reported setting (48/141,34.04％),followed by long-term care facility (41/141,29.08％) and hospital (16/141,11.35％).Clinical symptoms of 1 704 cases in 31 outbreaks were reported,with the most common symptom was diarrhea (1 331/1 704,78.12％),followed by nausea (829/1 198,69.20％),abdominal pain (840/1 328,63.25％),vomiting (824/1 704,48.36％) and fever (529/1 531,34.53％).Genotypes of SaⅤ were determined for 119 outbreaks.GⅠ (51/119,42.86％) and GⅣ (45/119,37.82％) were predominant.The outbreaks of G Ⅳ SaⅤ increased suddenly in 2007,and the outbreaks of G Ⅰ SaⅤ mainly occurred in 2008 and during 2011-2013.Conclusions SaⅤ outbreaks were reported mainly by developed countries,with most outbreaks occurred in cold season,in child-care settings and long term care facility.G Ⅰ and GⅣ were the most common genotypes of SaⅤ.Prevention and control of SaⅤ outbreak in China seemed relatively weak,and it is necessary to conduct related training and to strengthen the SaⅤ outbreak surveillance in areas where service is in need.

Value of combined detection of urine NGAL and KIM-1 in the early diagnosis of contrast-induced nephropathy / 国际检验医学杂志

Objective To explore and analyze the effect and value of combined detection of urine neutrophil gelatin-associated apolipoprotein (NGAL) and kidney injury molecule 1 (KIM-1) in the early diagnosis of contrast-induced nephropathy.Methods The clinical data of 116 patients with coronary heart disease who received coronary intervention treatment in our hospital in 2017 were collected with forward-looking research methods.The patients were divided into the non-contrast-induced nephropathy group (control group, n=90) and the contrast-induced nephropathy group (observation group, n=26) according to the occurrence of contrast-induced nephropathy.The levels of serum creatinine, serum urea nitrogen, urine NGAL and KIM-1 were compared at different time points between the two groups.Results From 2 days after surgery, the serum creatinine levels were increased significantly (P＜0.05).The serum creatinine levels at 2 days after surgery (102.43±20.31) μmol/L and 3 days after surgery (107.22±25.13) μmol/L in the observation group were significantly higher than those in the control group[ (92.89±16.74) μmol/L, (91.97±15.38) μmol/L];The serum urea nitrogen levels in the observation group were increased significantly from 12 hafter surgery (P＜0.05);the serum urea nitrogen levels of the observation group at 12 h, 1 d, 2 dand 3 dafter surgery were significantly higher than those of the control group (P＜0.05);The urine NGAL levels at 4 and 12 hour and 1 and 2 days after surgery in the observation group were significantly higher than those in the control group;The KIM-1 levels at 1 day after surgery (5.14±0.96) μg/L and 2 days after surgery (5.58±1.33) μg/L in the observation group were significantly higher than those in the control group [ (3.58±1.23) μg/L, (3.64±1.15) μg/L], and the differences were statistically significant (P＜0.05).Pearson correlation analysis showed that there was a positive correlation between urinary NGAL at 4 hours postoperatively and serum creatinine at2 days postoperatively (r=0.784, P=0.000), and positively correlated with serum urea nitrogen level at 1 day postoperatively (r=0.811, P=0.000).The KIM-1 level at 1 day postoperatively was positively correlated with the serum creatinine level at 2 days postoperatively (r=0.596, P=0.000), and positively correlated with the serum urea nitrogen level at 2 days postoperatively (r=0.644, P=0.000).ROC curve analysis showed that the area under curve (AUC) of urine NGAL was 0.917[95％confidence interval (CI) :0.884-0.951], the sensitivity was 86.74％, and the specificity was 93.92％;AUC of KIM-1 was 0.842 (95％CI:0.755-0.901), the sensitivity was 81.16％, and the specificity was 83.47％.Conclusion Urine NGAL and KIM-1 are biochemical markers that can early react to the impairment of renal function, and have positive value in the early diagnosis of contrast-induced nephropathy.

Analysis on influencing factors for acute gastroenteritis outbreaks caused by norovirus in Beijing, 2014-2018 / 中华流行病学杂志

Objective@#To analyze the influencing factors of acute gastroenteritis outbreaks caused by norovirus in Beijing from 2014 to 2018.@*Methods@#Data of acute gastroenteritis events caused by norovirus in Beijing from April 2014 to March 2018 were collected. Unconditional logistic regression model was conducted to identify the risk factors of the outbreaks.@*Results@#A total of 765 acute gastroenteritis epidemics caused by norovirus were reported in Beijing, in which 85.88% (657/765) were cluster events and 14.12% (108/765) were outbreaks. Among the outbreaks, 70.37% (76/108) were reported in 2017; 84.26% (91/108) were reported in winter and spring; 88.89% (96/108) were reported in kindergartens, primary or secondary schools; 81.48% (88/108) were through person-to-person transmission; 93.52% (101/108) were caused by norovirus GⅡ infection. The risk of outbreaks in suburban and out suburb area were 1.84 times (95%CI: 1.13-3.02) and 3.78 times (95%CI: 1.62-8.82) as high as that in urban area, respectively. The risks of outbreaks in primary, secondary schools and other institutions were 6.26 times (95%CI: 3.53-11.10), 14.98 times (95%CI: 6.23-36.01) and 8.71 times (95%CI: 3.07-24.71) as high as that in kindergartens, respectively. The risk of outbreak in which patients having lower hospital visiting rate than the median rate of all events was 2.29 times than that in the context of having higher hospital visiting rate (95%CI:1.42-3.68). The risk of foodborne outbreak was 14.55 times as high as that transmitted through person-to-person (95%CI: 3.15-67.07).@*Conclusion@#Measures such as strengthening the prevention and control of norovirus outbreaks in suburbs, primary schools, secondary schools and other institutions, promoting patients to visit the hospital actively, improving the management of foodborne events and kitchen workers should be taken to reduce the incidence of acute gastroenteritis outbreaks caused by norovirus.

Causes and management for male urethral stricture / 中南大学学报(医学版)

Objective:To explore the etiology of male urethral stricture,analyze the therapeutic strategies of urethral stricture,and summarize the complicated cases.Methods:The data of 183 patients with urethral stricture were retrospectively analyzed,including etiology,obstruction site,stricture length,therapeutic strategy,and related complications.Results:The mean age was 49.7 years,the average course was 64.7 months,and the constituent ratio of51 to 65 years old patients was 38.8％ (71/183).The traumatic injury of patients accounted for 52.4％ (96/183),in which the pelvic fracture accounted for 35.5％ (65/183) and the straddle injury accounted for 16.9％ (31/183).There were 54 cases of iatrogenic injury (29.5％).The posterior urethral stricture accounted for 45.9％ (84/183),followed by the anterior urethral stricture (44.8％,82/183) and the stenosis (6.6％,12/183).A total of 99 patients (54.1％) received the end to end anastomosis,and 40 (21.9％) were treated with intracavitary surgery,such as endoscopic holmium laser,cold knife incision,endoscopic electroknife scar removal,balloon dilation,and urethral dilation.In the patients over 65-years old,the urethral stricture rate was 14.8％ and the complication rate (70.4％) for transurethral resection of the prostate (TURP) was significantly higher than that of all samples (P＜ 0.01).Conclusion:Both the etiology of male urethral stricture and the treatment strategy have changed and the incidence of traumatic and iatrogenic urethral stricture has increased in recent 3 years.The main treatment of urethral stricture has been transformed from endoscopic surgery into urethroplasty.

Seasonality of clustering of fever and diarrhea in Beijing, 2009-2015 / 中华流行病学杂志

Objective To understand the seasonal distribution of the clustering of fever and diarrhea.Methods Concentration degree and circular distribution methods were used to analyze the seasonal distribution of the clustering of fever and diarrhea in Beijing from 2009 to 2015.The information were collected from the Infectious Disease Surveillance Information System of Beijing.Results The M values of the clustering of fever and diarrhea were 0.57 and 0.47.Circular distribution results showed that the clustering of fever and diarrhea angle dispersion index R values were 0.57 and 0.46 respectively,the sample average angle of Rayleigh's test Z values were 414.14,148.09 respectively (all P＜0.01).The clustering of fever and diarrhea had seasonality.The incidence peak of fever was on October 13,and the epidemic period was during August 13-December 14.The incidence peak of diarrhea was on July 31,and the epidemic period was during May 20-October 11.Conclusion The clustering of fever had obvious seasonality in Beijing,which mainly occurred in auttmn and winter.The cluster of diarrhea had certain seasonality,which mainly occurred in summer and autumn.

Seasonality of clustering of fever and diarrhea in Beijing, 2009-2015 / 中华流行病学杂志

Objective To understand the seasonal distribution of the clustering of fever and diarrhea.Methods Concentration degree and circular distribution methods were used to analyze the seasonal distribution of the clustering of fever and diarrhea in Beijing from 2009 to 2015.The information were collected from the Infectious Disease Surveillance Information System of Beijing.Results The M values of the clustering of fever and diarrhea were 0.57 and 0.47.Circular distribution results showed that the clustering of fever and diarrhea angle dispersion index R values were 0.57 and 0.46 respectively,the sample average angle of Rayleigh's test Z values were 414.14,148.09 respectively (all P＜0.01).The clustering of fever and diarrhea had seasonality.The incidence peak of fever was on October 13,and the epidemic period was during August 13-December 14.The incidence peak of diarrhea was on July 31,and the epidemic period was during May 20-October 11.Conclusion The clustering of fever had obvious seasonality in Beijing,which mainly occurred in auttmn and winter.The cluster of diarrhea had certain seasonality,which mainly occurred in summer and autumn.

Infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses / 中华实验和临床病毒学杂志

Objective@#To analyze the infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses.@*Methods@#Between April 2014 and March 2016, the clinical data and samples were collected from the patients in acute gastroenteritis outbreaks caused by noroviruses in Beijing. Noroviruses were detected and genotyped using real time RT-PCR, and the infection characteristics of norovirus gastroenteritis were analyzed using the descriptive epidemiological method.@*Results@#A total of 1743 clinical diagnosed cases of norovirus gastroenteritis were collected, and children under 12 years old accounted for 77.68% (1354/1743). The detection rate of noroviruses was 73.98% (509/688). The detection rates of noroviruses in fecal, swab and vomitus samples were gradually decreased (χ2=67.798, P<0.001). Among these clinical diagnosed cases, vomiting was the most common symptom (93.98%), followed by abdominal pain (40.34%), diarrhea (30.35%) and fever (27.94%). The most common symptom of patients under 6 years old was vomiting(98.14%), whereas diarrhea was most common among over 18 years old patients (68.12%). With the increase of age of the patients, the incidence of vomiting was gradually decreased (χ2=100.913, P<0.001), whereas the incidence of diarrhea was gradually increased (χ2=261.164, P<0.001). There was no statistical difference in vomiting, diarrhea and abdominal pain symptoms between patients infected with genogroup Ⅰ and Ⅱ noroviruses, and patients infected with genogroup Ⅱ (34.49%, 149/432) had the higher incidence rate of fever than that of genogroup Ⅰ (18.18%, 14/77) (χ2=7.985, P<0.01).@*Conclusions@#Noroviruses mainly infected children under 12 years old in acute gastroentertis outbreaks. The most common symptom of patients with acute gastroenteritis caused by noroviruses was vomiting, and the incidences of vomiting and diarrhea were significantly correlated with age of the patients. Patients infected with genogroup Ⅱ had the higher incidence rate of fever than genogroup Ⅰ infection.

Estimation of excess numbers of viral diarrheal cases among children aged ＜5 years in Beijing with adjusted Serfling regression model / 中华流行病学杂志

Objective To estimate the excess numbers of viral diarrheal cases among children aged ＜5 years in Beijing from 1 January 2011 to 23 May 2015.Methods The excess numbers of diarrheal cases among the children aged ＜5 years were estimated by using weekly outpatient visit data from two children' s hospital in Beijing and adjusted Serfling regression model.Results The incidence peaks of viral diarrhea were during 8th-10th week and 40th-42nd week in 2011,40th-4th week in 2012,43rd-49th week in 2013 and 45th week in 2014 to 11th week in 2015 respectively.The excess numbers of viral diarrheal cases among children aged ＜5 years in the two children's hospital were 911(95％CI:261-1 561),1 998(95％CI:1 250-2 746),1 645 (95％CI:891-2 397),2 806(95％CI:1 938-3 674) and 1 822(95％ CI:614-3 031) respectively,accounting for 40.38％ (95％ CI:11.57％-69.19％),44.21％(95％CI:27.66％-60.77％),45.08％(95％CI:24.42％-65.69％),60.87％ (95％CI:42.04％-79.70％) and 66.62％ (95％CI:22.45％-110.82％) of total outpatient visits due to diarrhea during 2011-2015,respectively.Totally,the excess number of viral diarrheal cases among children aged ＜5 years in Beijing was estimated to be 18 731(95％CI:10 106-27 354) from 2011 to 23 May 2015.Conclusions Winter is the season of viral diarrhea for children aged ＜5 years.The adjusted Serfling regression model analysis suggested that close attention should be paid to the etiologic variation of viruses causing acute gastroenteritis,especially the etiologic variation of norovirus.

Comparison of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients ;undergoing laparoscopic cholecystectomy operation / 实用医学杂志

Objective To compare the effects of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC) operation. Methods Sixty patients of both sexes , aged 18-65 yr , weighing 46-85 kg , scheduled for LC operation , were randomly divided into 2 groups (n = 30). Patient-controlled intravenous analgesia (PCIA) pump (oxycodone hydrochloride injection 20 mg or sufentanil 100 μg with physiological saline to 100 ml ) was used for postoperative analgesia five minutes before the end of operation. The first dose and bolus dose were both 5 ml , background infusion was 2 ml/h,lockout interval was 5 minute. The NRS score of rest and during movement at 1 ,6 and 24 h after operation,total oxycodone or sufentanil consumption in 24 h, requirement for rescue analgesic, the level of patient′s satisfaction , the adverse events were recorded. Results There was no significant difference in the NRS scores at rest and during movement , total oxycodone or sufentanil consumption in 24 h and postoperative nausea and vomiting (PONV) between the two groups. The patient’s satisfaction were significantly higher (P < 0.05), and the incidence of dizziness were significantly lower (P = 0.026) in group Q than in group S. Both groups were no requirement for rescue analgesic , no sleepiness , no itch , no retention of urine and other adverse reaction. Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after LC operation, however the incidence of dizziness is lower and the level of patient’s satisfaction is higher with oxycodone hydrochloride than with sufentanil.

Observation of the effect of posterior fossa operation analgesia with tramadol compound dexmedetomidine / 重庆医学

Objective To investigate the effects of posterior fossa operation analgesia with tramadol compound dexmedetomi‐dine ,and the feasibility of reducing the dosage of tramadol .Methods Forty cases undergoing posterior fossa operation were ran‐domly divided into dexmedetomidine group (group A) and control group (group B) .Patients in group A with tramadol compound dexmedetomidine intravenous infusion analgesia ,reducing the dosage of tramadol .Group B with tramadol intravenous infusion anal‐gesia .To observe two groups of patients with preoperative ,postoperative 1 ,6 ,12 ,24 ,48 hVAS score ,Ramsay score ,heart rate , blood pressure ,respiratory rate ,SpO2 ,the postoperative complications such as nausea and vomiting ,and carries on statistics analy‐sis ,the two groups of patients with postoperative analgesic and sedative effect evaluation .Results VAS score :postoperative at each time point ,there was no significant difference between groups (P>0 .05) .Ramsay score :after operation and postoperative at each time point ,the experimental group were significantly higher than those in the control group (P<0 .05);the incidence of nausea and vomiting ,restlessness complications ,the experimental group was significantly lower than that of the control group (P<0 .05) .Con‐clusion Posterior fossa operation patients with tramadol and dexmedetomidine postoperative to analgesia could reduce the dosage of tramadol ,reduce nausea and vomiting ,restlessness and other complications ,and the analgesic effect is ideal .It was favorable to ob‐serve the postoperative condition .

Etiological analysis of diarrhea patients visiting enteric disease clinics in Beijing / 中华传染病杂志

Objective To investigate the etiological characteristics of diarrhea patients visiting enteric disease clinics in Beijing .Methods A total of 595 stool samples were collected among outpatients with diarrhea vistiting enteric disease clinics at two sentinel hospitals from July 2013 to June 2014 . Diarrheagenic Escherichia coli (E . coli) , Vibrio parahemolyticus , O1 or O139 Vibrio cholerae , Salmonella and Shigella were isolated according to standard methods . And rotavirus , norovirus , astrovirus and enteric adenovirus were identified by molecular techniques .The characteristics of population and temporal distribution , and serotypes of these pathogens were analyzed using descriptive epidemiological method .Chi‐square test was used for comparison between groups .Results Totally 128 bacterial strains were isolated from 595 samples ,and the detection rate was 21 .5% .Diarrheagenic E .coli was most common pathogenic bacteria (11 .4% ,68/595) ,followed by Vibrio parahemolyticus (6 .9% , 41/595) ,Salmonella (2 .4% ,14/595) and Shigella (2 .2% ,13/595) .No V ibrio cholerae was detected . One hundred and twelve viral strains were detected from all samples ,and the positive rate was 18 .8% . Norovirus was most common viral pathogen (9 .1% ,54/595) ,followed by rotavirus (8 .7% ,52/595) , astrovirus (1 .8% , 11/595 ) and enteric adenovirus (0 .7% , 4/595) . Enteropathogenic E .coli , enterotoxigenic E .coli and enteroadhesive E .coli were the most common types of diarrheagenic E .coli . The most common serotype of Vibrio parahaemolyticus was O4∶K8 .The detection rate of bacterial pathogens reached the peak from June to September ,while the highest detection rate of viral pathogens was found from November to the next March .Conclusion Norovirus and rotavirus are also the main pathogens of the diarnhea patients visiting enteric clinics ,which should be paid enough attention .

Epidemiological and clinical features of norovirus infection among diarrhea patients from the enteric clinics in Beijing, 2013-2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological and clinical characteristics of norovirus infection on diarrhea patients from the enteric clinics in Beijing.</p><p><b>METHODS</b>From April 2013 to March 2014, 1 892 fecal specimens and related epidemiological information were collected among diarrhea patients visiting the enteric clinics in Beijing. Norovirus was detected by real time RT-PCR, and data was analyzed under the descriptive epidemiological method.</p><p><b>RESULTS</b>A total of 269 positive cases were found among 1 892 diarrhea patients, with a positive rate as 14.2%. Norovirus caused diarrhea mainly occurred in seasons with lower temperature. Higher positive rates of norovirus were found in northwest mountainous area. Norovirus diarrhea was more commonly seen in children between 6 month and 5 years old, with differences between the two groups statistically significant (P = 0.006). Compared with other occupation, a higher infection rate was identified in children, with differences between the two groups statistically significant (P = 0.025). Nausea and vomiting appeared more common in diarrhea patients with norovirus infection, with differences between the two groups statistically significant (P < 0.05).</p><p><b>CONCLUSION</b>Norovirus was an important pathogen which causing diarrhea in patients visiting the enteric clinics in Beijing. The virus was seen more in patients aged between 6 months and 5 years old. Nausea and vomiting were the common symptoms seen in patients with norovirus diarrhea.</p>

Diagnosis and treatment of traumatic renal infarction / 中华创伤杂志

Objective To investigate the diagnosis and treatment methods of traumatic renal infarction.Methods A retrospective analysis was performed on 6 cases of traumatic renal infarction treated between September 2008 and February 2013.There were 5 males and 1 female,at age of 5-65 years (average,36.2 years).Causes of injury included vehicle collisions in 4 cases and high falls in 2.Out of 6 cases,segmental renal infarction was identified in 2 and total infarction in 4.According to American Association for the surgery of trauma renal trauma grading system,2 cases were classified to grade Ⅳ and 4 to grade Ⅴ.Results Three cases were managed conservatively,which showed segmental infarction in 1 case and total infarction in 2.Three cases underwent surgical exploration,followed by partial nephrectomy in 1 case,left kidney removal plus partial pancreectomy in 1 and right kidney removal in 1.There were no major complications intraoperatively or postoperatively and no cases received blood transfusion.Period of follow-up was 3-34 months.In conservative management,there were no renal atrophies in segmental renal infarction cases and some degree of atrophies in total renal infarction cases,but none presented with arterial hypertension.Conclusions Enhanced CT is the preferred diagnostic tool for evaluation of traumatic renal infarction.Conservative therapy is the optimal option for most cases,but nephrectomy is reserved for cases of infection or renal hypertension.

Application of support vector machine in the detection of early cancer / 生物医学工程学杂志

Support Vector Machine (SVM) is an efficient novel method originated from the statistical learning theory. It is powerful in machine learning to solve problems with finite samples. Due to the deficiency of cancer cells, character of patient and noise in the raw data, it is very difficult to diagnose early cancer accurately. In this paper, SVM is employed in detecting early cancer and the results are encouraged compared with conventional methods. The accuracy of Non-linear SVM classifier is especially high in all kinds of classifiers, which indicates the potential application of SVM in early cancer detection.

Implementation of mutual information based medical image registration methods / 生物医学工程学杂志

Image registration methods based on mutual information, including mutual information and normalized mutual information, have been accepted as the most accurate and efficient methods. But there are many fluctuations in the registration functions that hinder the optimization procedure and lead to registration failure in intra-modal registration. We found that besides the interpolation artifacts, the uncertainty of the changing of entropy with the changing of overlap also contributes to the fluctuations. The effect of interpolation artifacts can be eliminated, but it is difficult to eliminate the effect of uncertainty of entropy. Luckily, this effect is not significant in normalized mutual information. Normalized mutual information is more stable and robust than standard mutual information and its better performance and wider application can be expected.

An improved anti-leukemic effect achieved with donor progenitor cell infusion for relapse patients after allogeneic bone marrow transplantation / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To observe the antileukemic effect in relapse patients by infusion of donor immunocompetent cells with or without granulocyte colony-stimulating factor (G-CSF) mobilization.</p><p><b>METHODS</b>Twenty patients with leukemia in relapse after allogeneic bone marrow transplantation (allo-BMT) were treated with chemotherapy followed by donor-derived lymphocytes (DDL) without G-CSF mobilization (Group A, n = 11), or donor peripheral blood progenitor cells (PBPCs) with G-CSF mobilization (Group B, n = 9).</p><p><b>RESULTS</b>Five patients in Group A were in hematologic relapse. After DDL infusion, 3 of 5 patients had a temporary complete remission (CR) and relapsed after 3, 7 and 10 months, respectively. One achieved partial remission and died of interstitial pneumonia; and the other one showed no response. Another 6 patients in Group A were in cytogenetic relapse or central nerve system (CNS) leukemia, and all achieved CR and remained in disease free survival (DFS) for 10 to 98 months after DDL infusion. All 9 patients in group B were in hematologic relapse. Three patients with chronic myeloid leukemia (CML) had cytogenetic and molecular remission for 16, 35 and 51 months, respectively after PBPC infusion; and 5 patients with acute lymphoid leukemia (ALL) had CR and were still in CR for 10 to 18 months except 1 patient relapsed soon. And the other one with AML showed no response to the therapy.</p><p><b>CONCLUSION</b>Donor immunocompetent cells infusion is an effective therapy for relapsed leukemia after allo-BMT, especially for the patients with early (molecular and cytogenetic) or CNS relapse. Infusion of donor PBPC mobilized by G-CSF seems to have more potentiated graft-versus-leukemia (GVL) effect than DDL infusion.</p>