Clinical observation of decitabine combined with low-dose cytarabine in treatment of high-risk myelodysplastic syndrome / 白血病·淋巴瘤

Objective:To observe the clinical efficacy and safety of decitabine combined with low-dose cytarabine in treatment of high-risk myelodysplastic syndrome.Methods:The data of 47 newly treated MDS patients who had high-risk or above scores according to revised international prognostic scoring system (IPSS-R) in the Affiliated Hospital of Qingdao University from January 2016 to September 2018 were retrospectively analyzed. The patients were divided into decitabine combined with low-dose cytarabine group (15 cases) and decitabine group (32 cases). The clinical efficacy and adverse reactions in two groups were compared.Results:After 4 courses of treatment, the bone marrow remission rate, partial remission rate and hematologic remission rate was 20.0% (3/15), 6.7% (1/15), and 13.3% (2/15), respectively in decitabine combined with low-dose cytarabine group, and was 28.1% (9/32), 3.1% (1/32), and 9.4% (3/32), respectively in decitabine group, and there were no statistically differences of both groups (both P > 0.05). The overall response rate in decitabine combined with low-dose cytarabine group was higher than that in decitabine group [93.3% (14/15) vs. 62.5% (20/32), P = 0.037], and the complete remission rate in decitabine combined with low-dose cytarabine group was higher than that in decitabine group [53.3% (8/15) vs. 21.9% (7/32), P = 0.046]. The 1-year overall survival (OS) rate of decitabine combined with low-dose cytarabine group was 86%; and the median OS time of decitabine combined with low-dose cytarabine group was 24 months (95% CI 15.5-32.5 months), which was higher than that of decitabine group (20 months), but there was no statistically significant difference ( χ2 = 0.058, P = 0.810). The incidence of grade Ⅲ-Ⅳ bone marrow suppression and infection in decitabine combined with low-dose cytarabine group was higher than that in decitabine group, but there were no statistically significant differences of both groups (both P > 0.05). Grade Ⅲ-Ⅳ bone marrow suppression and infection were commonly found within the first 2 courses of treatment in decitabine combined with low-dose cytarabine group, and the adverse reactions gradually decreased in the subsequent treatment. Conclusions:Decitabine combined with low-dose cytarabine can achieve better remission rate and prolong survival time for MDS patients with high-risk and above. There is no significant increase in the incidence of grade Ⅲ-Ⅳ bone marrow suppression and infection. For high-risk MDS patients who are not suitable or unable to receive hematopoietic stem cell transplantation, it can be the preferred option.

Comparison of single-bundle and double-bundle autografts in anterior cruciate ligament reconstruction / 中国组织工程研究

BACKGROUND:Different weaving methods of autologous tendon lead to various treatment efficacies on cruciate ligament rupture, but the preferred method is stil controversial. OBJECTIVE:To comparatively analyze the clinical efficacy of single-bundle and double-bundle autografts on anterior cruciate ligament reconstruction. METHODS:A retrospective analysis of 48 cases of anterior cruciate ligament rupture was performed. According to the composition of graft beam, these 48 patients were divided into two groups:double-bundle group (n=24) and single-bundle group (n=24). Al surgical patients underwent autologous anterior cruciate ligament reconstruction by arthroscopy, and were fol owed up for at least 6 months. The function of knee joint after operation was comprehensively analyzed through IKDC and Lysholm scores. RESULTS AND CONCLUSION:Al of the patients (n=48) exhibited no joint complications postoperatively, such as intra-articular infection, joint effusion and incision inflammation. The IKDC scores and Lysholm scores in the double-bundle group were better than those in the single-bundle group, but there was no statistical y significant difference (P>0.05). This study demonstrated that single-bundle and double-bundle autografts both have good curative effects on anterior cruciate ligament reconstruction by arthroscopy. But in contrast, the curative effects of double-bundle autografts are better.

Mutation of Notch1 gene and its protein expression in T-cell lymphoma / 白血病·淋巴瘤

Objective To investigate the effect of the expression of Notch1 protein and the mutation of Notch1 gene in.T-cell lymphoma (TCL).Methods Immunohistochemistry was used to detect the expression of Notch1 protein,and PCR amplification and DNA sequencing were used to detect the mutation of Notch1 gene in the 26th and 27th HD domain and the 34th PEST domain in 30 cases.10 cases of reactive hyperplasia tissues of lymph node were as the control.Results The positive rates of Notch1 protein expression and Notch1 gene mutation were 70.0 ％ (21/30) and 56.7 ％ (17/30).8 cases of Notch1 mutations were detected in the HD domain,6 cases in the PEST domain,and 3 case in both HD and PEST domains.Inscrtion,deletion,nonsense mutation and missense mutation were included in Notch 1 mutations.Conclusion Notch1 gene mutation may play an important role in the expression of Notch1 protein.The occur of TCL is related to the expression of Notch1 protein and the mutation of Notch1 gene.

Awareness of knowledge about iron deficiency anemia in patients with it / 中华全科医师杂志

Objective To investigate awareness of knowledge about iron deficiency anemia (IDA)in patients with it.Methods Patients diagnosed as IDA at their initial visits to Affiliated Hospital of Qingdao University Medical School were randomly selected for the study during January 2008 to January 2009 with self-designed questionnaire to investigate their awareness of knowledge about IDA.Results Among 199 patients with IDA investigated, their awareness was lower in general, five percent about its etiologies, 34.2 percent about its clinical manifestations, 18.1 percent about its hazard to health, and two percent about food abundant of iron.For preventive measures of IDA, 50.7 percent (101/199) of them knew that daily diet should be diversified and 43.7 percent (87/199) knew that meals should be prepared with ferric cooking pot.Awareness of knowledge about other preventive measures of IDA was lower in them.No significant difference in awareness of IDA-related knowledge between them at varied ages was found, except for knowledge about etiology and hazard of IDA.Awareness of etiology of IDA differed between them at varied ages (P ＜0.05), and about 75.3 percent (64/85)of patients with IDA aged 30 -45 years were caused by chronic blood loss.There was no significant difference in awareness of IDA-related knowledge between patients with IDA caused by varied etiologies (P ＞ 0.05).Conclusions In general, awareness of IDA-related knowledge was lower in patients with IDA.It is necessary to strengthen its popularization, with varied focuses in preventive measures for IDA patients with different etiologies.

Experimental teaching exploration of practice of bone marrow cytomorphology / 中华医学教育探索杂志

The experimental teaching of morphlogy of bone marrow cytomorphology is the important content in the medical laboratory science.By conducting a series of reforms such as renewing teaching concept,consummating teaching condition,reforming teaching link,recombinating teaching content,establishing examination system about the experimental teaching of bone marrow cytomorphology may remarkably enhance student’s comprehensive ability and teacher’s anthusiasm and build the new type of relationship between teachers and students,which plays an important role in the cultivation of medical laboratory science specialized talents.