Differential Subsampling with Cartesian Ordering Contrast-Enhanced Magnetic Resonance Angiography for the Preoperative Assessment of Anterolateral Thigh Flap

Objective@#To investigate the clinical application of differential subsampling with Cartesian ordering (DISCO) contrastenhanced (CE) magnetic resonance angiography for anterolateral thigh (ALT) flap transplantation, using operative findings as a reference. @*Materials and Methods@#Thirty patients (21 males and nine females; mean age ± standard deviation, 45.5 ± 15.6 years) who were scheduled to undergo reconstruction with ALT flaps between June 2020 and June 2021 were included in the prospective study. Before ALT flap transplantation, patients were scanned using CE-DISCO imaging. All acquired DISCO images of the 60 lower limbs (both sides from each patient) were analyzed using maximum intensity projection and volume rendering methods. Two experienced radiologists were employed to examine the patterns of the lateral circumflex femoral artery (LCFA), its branches, and perforators and their skin termini, which were compared with the operative findings. @*Results@#Using CE-DISCO, the patterns of the LCFA and its branches were clearly identified in all patients. Four different origins of the LCFA were found among the 60 blood vessels: type I (44/60, 73.3%), type II (6/60, 10.0%), type III (8/60, 13.3%), and type IV (2/60, 3.3%). Owing to a lack of perforators entering the skin, two patients did not undergo ALT flap transplantation. For the remaining 28 patients, the ALT flaps in 26 patients were successfully operated without flap reselection during the operation, while the remaining two patients underwent other surgical procedures due to the thin diameter of the perforator or injury of the perforator during the operation. The success rate of flap transplantation was 92.8% (26/28). All transplanted flaps exhibited good blood supply and achieved primary healing without infection or delayed healing. @*Conclusion@#CE-DISCO imaging can be an effective method for preoperative perforator imaging before ALT flap transplantation.

Clinical analysis of lung transplantation in eight patients with obstructive bronchiolitis syndrome after hematopoietic stem cell transplantation / 中华血液学杂志

Objective@#To investigate the efficacy and prognosis of lung transplantation (LT) for end-stage bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#The clinical data of eight cases with end-stage BOS after allo-HSCT who were treated by LT in our hospital were retrospectively analyzed.@*Results@#Eight patients with hematological malignancy underwent allo-HSCT, and the median age was 23 (12-40) years. The donors are parents or siblings. Severe BOS occurred in 8 patients after allo-HSCT, the median age for LT was 27.5 (13-47) years. The median interval between allo-HSCT and LT was 69 (21-132) months. The median follow-up time for 8 patients after LT was 15 (6-63) months, 7 patients survived, 1 patient died of pulmonary hemorrhage 15 months after LT treatment. Of the survivors, three had BOS again, and one of them received reduplicated lung transplantation.@*Conclusion@#LT is an effective treatment for patients with severe BOS after HSCT.

Distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015: results from a multicenter, retrospective study / 中华血液学杂志

Objective@#To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment.@*Methods@#Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed.@*Results@#The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) .@*Conclusions@#Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Protective effect of glucagon-like peptide-1 analogue on cardiomyocytes injury induced by hypoxia/reoxygenation / 中华内科杂志

Objective To investigate the effect of glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide on hypoxia/reoxygenation (H/R)-induced cardiomyocytes death under high glucose condition and the potential mechanisms.Methods H9C2 cardiomyocytes were divided into 4 groups:normal glucose (N,5 mmol/L),high glucose (G,20 mmol/L),high glucose in combination with liraglutide (L,100 nmol/L),high glucose in combination with liraglutide and wortmannin (W,25 nmol/L).The apoptosis of H9C2 was detected by TUNEL assay.Nitric oxide synthetase(eNOS),nitric oxide (NO) and reactive oxygen(ROS) in supernatants were measured by enzymatic analysis,p-PI3K,PI3K,p-Akt,Akt,Bcl-2,caspase-3 were examined by western blotting.Results Compared with cells in N group,the apoptosis of H9C2 cells induced by H/R was markedly increased [(15.79 ± 3.92) ％ vs (9.74 ± 1.14) ％,P =0.028] in G group.The same was true for ROS [(489.63 ±21.01) U/ml vs (338.50 ±43.60) U/ml,P ＜0.001] and caspase-3 levels (1.87 ±0.03 vs 1.15 ±0.04,P ＜0.001),but not for Bcl-2 protein expression (1.79 ± 0.06 vs 1.89 ±0.03,P =0.047).Pretreatment of cells with liraglutide (100 nmol/L) prevented the cell death induced by high glucose and H/R together with decrease of ROS and caspase-3 levels and increase of Bcl-1 expression.Moreover,treatment of cells with liraglutide also significantly increased phosphorylation of PI3K and Akt (p-PI3K/PI3K:0.87 ± 0.07 vs 0.59 ± 0.09,P =0.002;p-Akt/Akt:0.34 ± 0.01 vs 0.08 ± 0.01,P＜0.001),eNOS[(41.29 ±0.56) μmpl/L vs (37.20 ±0.52)μxmpl/L,P ＜0.001]and NO [(31.24 ±0.40) μmpl/L vs (26.66 ±0.53) μmpl/L,P ＜0.001] levels.Furthermore,addition of PI3K/Akt inhibitor wortmanin markedly inhibited the expression of p-PI3K/PI3K,p-Akt/Akt,reversed the changes of eNOS,NO,caspase-3 and Bcl-2 by liraglutide,and abolished the protective effect of liraglutide on cell apoptosis.Conclusions GLP-1 receptor agonist liraglutide treatment could alleviate cardiomyoeytes apoptosis induced by high glucose and H/R through the activation of PI3K-Akt-eNOS-NO signaling pathway and inhibition of oxidative stress.

Study on the Relationship between Severity of Coronary Artery Lesion and the Level Cystatin C,Nitric Oxide and Superoxide Dismutase of Serum / 现代检验医学杂志

Objective To study the correlation between coronary lesion and Cystatin C (CyC),Nitric Oxide (NO)and Super oxide dismutase,accumulate the clinical experience in prevention and diagnose of Coronary Heart Disease (CHD)by analy-zing the contents of serum Cystatin C (CyC),Nitric Oxide and Superoxide Dismutase in patients with coronary lesion.Meth-ods According to their severity of coronary artery lesion,all cases were divided into four groups:Normal compared group (40 cases);Simple branch pathological group (44 cases);Double branch pathological group (43 cases):Multi-branch patho-logical group (35 cases).All cases were tested CyC,NO,SOD and hs-CRP in serum.Results The level of CyC and hs-CRP were increased gradually from normal group to multi-branch group.The level of NO and SOD were decreased gradually from normal group to multi-branch group.There were significant differences the levels of CyC,NO,SOD and hs-CRP among the four groups.Coronary lesion Gensini in the CHD patients had significant positive relationship to the level of CyC or hs-CRP respectively (r=0.473,0.429),had significant negative relationship to the level of NO or SOD respectively (r=-0.356, 0.384)(P<0.05).CyC in the CHD patients had significant positive relationship to the level of hs-CRP (r=0.458),had sig-nificant negative relationship to the level of NO or SOD respectively (r=-0.426,0.484,P<0.05).Conclusion By aggra-vation of coronary artery lesion,the level of CyC increased,reduced the contents of NO,SOD,aroused endothelial dysfunc-tion,induced occurrence and aggravation of coronary artery lesion.CyC,NO and SOD play important mark in the assistant diagnosis of the disease.

Clinical and genetics characteristics of patients with monosomal karyotype acute myeloid leukemia patients / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the clinical and genetics characteristics of patients with monosomal karyotype acute myeloid leukemia (MK-AML).</p><p><b>METHODS</b>The karyotypes of 3743 patients with newly-diagnosed de novo AML were analyzed, which had identified 153 cases with MK-AML, for whom the clinical and genetics characteristics were analyzed.</p><p><b>RESULTS</b>There were 2056 patients (54.9%) among all patients. A total of 153 patients fulfilling the criteria for MK-AML were identified, which comprised 93 males and 60 females, with a median age of 54. The median white blood cell count on presentation was 4.4×10 (9)/L. One hundred and forty-five cases (94.8%) have fulfilled the criteria for complex karyotype (≥ 3 chromosomal abnormalities). Although the monosomy could be found with all autosomes, chromosome 7 has been most frequently involved (38.56%, 59/153).</p><p><b>CONCLUSION</b>MK-AML is a distinct cytogenetic subtype of AML. Monosomy 7 is frequently detected among MK-AML patients. The monosomal karyotype is common among elder patients with AML.</p>

Clinical significance of the detection of serum iNOS and SOD in patients with chronic hepatitis B / 国际检验医学杂志

Objective To explore the relationship between the HBV‐DNA ,ALT ,AST and NO ,iNOS ,SOD levels in serum of patients with chronic hepatitis B(CHB) .Methods 24 patients with mild CHB ,30 patients with moderate CHB ,18 patients with se‐vere CHB and 30 healthy individuals were selected and set in group A ,B ,C and D ,respectively .The serum levels of HBV‐DNA , ALT ,AST ,NO ,iNOS ,and SOD were detected by FQ‐PCR and chemical analysis respectively .Results There were significant difference in the levels of ALT ,AST ,NO ,iNOS and SOD between group D and group A ,B and C (P<0 .05) .The serum level of ALT was positive relative to the levels of NO and iNOS(r=0 .487 ,0 .521 ,P<0 .05) ,and was negative relative to the level of SOD (r= -0 .574 ,P<0 .05) .The serum level of AST was positive relative to the levels of NO and iNOS(r=0 .453 ,0 .545 ,P<0 .05) , and was negative relative to the level of SOD(r= -0 .484 ,P<0 .05) .Conclusion With the increase of ALT and AST levels ,the levels of NO and iNOS increase ,and the level of SOD decreases simultaneously in CHB patients .It is suggested hepatocellular inju‐ry .

The correlation between chronic infection of microorganism and the severity of coronary artery disease / 国际检验医学杂志

Objective To study the correlation between chronic infection of three microorganism and coronary artery lesion by detecting their antibodies and high-sensitivity C-reactive protein(hs-CRP) .Methods According to their severity of coronary artery lesion ,patients enrolled in the study were divided into 4 groups ,including normal control group(n=37) ,single-branch lesion group (n=36) ,double-branch lesion group(n= 30) and multi-branch lesion group(n= 29) .Serum Chlamydia pneumonia IgG(CPN-IgG) ,Helicobacter pylori IgG(HP-IgG) ,human cytomegalo virus IgG (HCMV-IgG) and hs-CRP tests were performed .Results CPN-IgG ,HP-IgG ,HCMV-IgG positive rates and the mixed infection positive rates increased sequentially from normal group to multi-branch group .There were significant differences of CPN-IgG ,HP-IgG ,HCMV-IgG and hs-CRP contents among the 4 groups (P<0 .05) .Logistic analysis showed that CPN-IgG ,HP-IgG and HCMV-IgG were dangerous factors to coronary artery lesion . Conclusion Chronic infections of three microorganism might affect the development of coronary artery lesion .

FcγRIII a polymorphisms and efficacy of Rituximab combined chemotherapy for diffuse large B-cell lymphoma in Chinese patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the impact of Fc gamma receptor IIIa (FcγR IIIa) polymorphisms on the efficacy of rituximab (RTX) combined chemotherapy for patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>FcγRIIIa polymorphisms were analyzed by PCR in 122 patients and 100 healthy controls. All patients received 8(4-12) cycles of RTX combined chemotherapy.</p><p><b>RESULTS</b>78(63.93%) patients with F/F, 5(4.10%) with V/V, and 39(31.97%) with V/F were identified, which were not different compared to controls. Patients with different FcγRIIIa genotypes did not have any difference in terms of gender, age, molecular subtypes, lactate dehydrogenase (LDH) or international prognostic index (IPI). The overall response rate (ORR) was 89.35% with a complete response (CR) of 80.33% and a partial response (PR) of 9.02%. The ORR was 83.33%, 100.00% and 100.00% in F/F, V/V and V/F, respectively. A higher response rate was observed in V/V and V/F as compared with F/F (P<0.05). With a median follow-up of 35 months (range: 12-62 months), 46(37.71%) patients had relapsed and 40 (32.79%) cases progressed and ended in death. The 3-year progress-free survival (PFS) rate was 41.03%, 100.00%, 100.00% in F/F, V/V and V/F, respectively. The 3-year overall survival (OS) rate was 48.72%, 100.00% and 100.00% in patients with three genotypes. The PFS and OS rate were significantly higher in V/V and V/F as compared with F/F (P<0.05).</p><p><b>CONCLUSION</b>FcγR III a polymorphisms could predict response and prognosis of RTX combined chemotherapy for patients with DLBCL.</p>

Distribution of lymphomas subtypes in Jiangsu Province: a multicenter analysis of 5 147 cases / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of lymphoma in Jiangsu province.</p><p><b>METHODS</b>A total of 5 147 consecutive lymphoma samples collected from 18 hospitals in Jiangsu province from January 2007 to December 2013 and diagnosed according to the WHO classification were enrolled in this study. Basic epidemiological information including age, gender and lymphoma subtypes was analyzed.</p><p><b>RESULTS</b>The median age of all lymphoma cases was 59(2-96) years, and gender ratio (M/F) was 1.6:1. The subtypes distribution analysis revealed that Hodgkin lymphoma (HL) accounted for 5.19% (n=241), whereas non-Hodgkin's lymphoma (NHL) accounted for 94.81% (n=4 400). Further analysis displayed B-NHL formed 75.44% (n=3 501) of all cases and T/NK-NHL 16.51% (n=766), diffuse large B-cell lymphoma and NK/T-cell lymphoma were the major subtypes of B-NHL and T/NK-NHL (53.50%, 1 873/3 501 and 31.85%, 244/766), respectively.</p><p><b>CONCLUSION</b>Unique epidemiological characteristics of lymphoma in Jiangsu province was different from other regions in China and western country, which can provide strong theoretical basis for public health, clinical and basic research.</p>

Genetic analysis of a congenital nephrogenic diabetes insipidus pedigree / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As an X-linked recessive way, arginine vasopressin receptor 2 (AVPR2) gene mutation resulted in a hereditary disease - congenital nephrogenic diabetes insipidus (CNDI). We found a suspect clinical CNDI pedigree. In order to identify the genetic etiology, we performed the genetic analysis.</p><p><b>METHODS</b>The clinical features of the proband and his family members were recorded. The laboratory tests and imaging inspections were analyzed. The water deprivation and pituitrin loading test were performed in the proband and his brother. The genomic DNA of all the members of the pedigree was extracted and then PCR amplification on AVPR2 gene was carried out. Sequencing in both directions was performed to identify mutation on AVPR2 gene.</p><p><b>RESULTS</b>Both the proband and his brother were diagnosed as CNDI, meanwhile the other members of this pedigree were normal. No severe biochemical abnormality was found in the two CNDI patients. Both the patients had moderate urinary retention, severe megaloureter and hydronephrosis, and mild renal insufficiency. Two mutations of AVPR2 gene were discovered in the 3rd exon in the patients, a silent mutation L309L and a nonsense mutation R337X. The AVPR2 gene R337X mutation was co-segregated with CNDI. R337X mutation was not a reported mutation in the mainland of China.</p><p><b>CONCLUSION</b>The AVPR2 gene R337X mutation was also a genetic etiology of CNDI patients in the mainland of China.</p>

A study of tracking the superparamagnetic iron oxide and enhanced green fluorescent protein labeled miniature porcine bone marrow stem cells by in vitro MRI / 中华内科杂志

Objectives To track bone marrow stem cells (BMSCs) labeled by enhanced green fluorescent protein (EGFP) and superparamagnetic iron oxide ( SPIO ) -poly-L-lysine (PLL) compound by MRI in vitro for autotransplantation into pancreas of type 1 diabetes miniature pigs. Methods The BMSCs were isolated by density gradient centrifugation and attachment culture from type 1 diabetes minipigs' bone marrow. Expressional intensity of EGFP in BMSCs transfected lentivirus-EGFP with a multiplicity of infection Different magnetic resonance scanning protocols were carried out on various density BMSCs labeled by different concentration of SPIO in various time-point in vitro. Results When SPIO concentration was 25mg/L (count in Fe3 + ), the positive Fe3+ -labeling rate of BMSCs was 93. 1%. Most of SPIO particles in BMSCs' cytoplasm were observed in secondary lysosomes, but they were not detected in important organelle as cell nucleus. Comparing with gelatin the MRI of BMSCs labeled with SPIO in the condition with 1 ×104/ml cells density and 25 mg/L Fe3+ concentration in vitro, the signal intensity changes (△SI) after BMSCs labeled with SPIO 3 weeks and 6 weeks in TSE T1WI, TSE T2WI and FLASH T2 * WI sequences were 12%, 41%, 63% and 7%, 28%, 46% respectively (P ＜ 0.01 and P ＜ 0.05, respectively).Conclusions The data showed that the porcine BMSCs labeled with SPIO and EGFP could be traced successfully in vitro by MRI in the suitable sequences.

Identification of a novel glucokinase-E339K mutation in a Chinese maturity onset diabetes of the young 2 pedigree / 中华内科杂志

ovel GCK-E339K mutation might be linked to this MODY2 pedigree.

Screening for Mutations of MODY 1-5 Genes in Chinese Families with Early-onset Type 2 Diabetes / 中山大学学报(医学科学版)

[Objective] The aim of our study was to seek the mutations in MODY1～5 genes in Chinese population by direct sequencing in probands from families with early-onset type 2 diabetes.[Methods] Variants screening in MODY 1-5 genes were performed by PCR and direct sequencing in 19 probands from early-onset type 2 diabetes families.[Results] We found no mutation but many polymorphisms.There were 6,5,15,1,and 1 variants in MODY 1-5 genes respectively.[Conclusion] Our negative results in MODY genes suggest the genetic heterogeneity of different populations.Mutations in MODY 1-5 genes might not be the cause of diabetes in those 19 families.

Abnormalities of chromosome 17 in myeloid malignancies with complex chromosomal abnormalities / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of the abnormalities of chromosome 17 in myeloid malignancies with complex chromosomal abnormalities (CCAs).</p><p><b>METHODS</b>Abnormalities of chromosome 17 were analyzed in 73 patients with myeloid malignancies with CCAs showed by R banding and conventional karyotyping, including 21 acute myeloid leukemia (AML), 36 chronic myeloid leukemia (CML) and 16 myelodysplastic syndrome (MDS). All CCAs were further analyzed by multiplex fluorescence in situ hybridization (M-FISH).</p><p><b>RESULTS</b>Among the 73 myeloid malignancies with CCAs, chromosome 17 was the most frequently involved chromosome. It was found in 46.5% (34/73) of all cases, including 12 AML, 13 CML in blast crisis (BC) and 9 MDS. However, it was not found in the 9 CML cases in chronic phase (CP). The majority of changes were structural rearrangements which were identified in 43.8%(32/73)of all cases, among them the frequency was 52.4% (11/21), 33.3% (12/36) and 56.3% (9/16) in AML, CML and MDS, respectively. Numerical abnormalities were detected in 15.1% (11/73) cases, all were monosomy 17, and the frequency was 25.0% (3/12), 38.5% (5/13) and 33.3% (3/9) in AML, CML and MDS, respectively. Both numerical and structural abnormalities of chromosome 17 were found in 9 cases. Unbalanced translocations involving chromosome 17 were much more frequent than balanced ones. In the 3 groups, 16, 15 and 8 unbalanced translocations were found respectively. Only two kind of balanced translocations including t(15;17) in AML and t(15;17;22) in CML were found. All chromosomes were involved except chromosomes 5, 6 and 22 as partner chromosomes, the most common one was chromosome 15 (8.2%), followed by chromosome 2 (5.4%). Five of the 6 cases with translocation of chromosomes 15 and 17 were acute promyelocytic leukemia, the other case was CML-BC.</p><p><b>CONCLUSION</b>Abnormalities of chromosome 17 were the most frequently involved chromosomal aberrations in myeloid malignancies, and structural rearrangements were more common. All the numerical abnormalities were monosomy 17, unbalanced translocations were much more frequent than balanced ones.</p>

Effects of Fluvastatin on microalbuminuria of type 2 diabetes mellitus patients / 中国综合临床

Objective To observe the effect of fluvastatin on urinary albumin excretion rate(UAER)of microalbuminuria in type 2 diabetes patients.Methods Type 2 diabetes patients with mieroalbuminuria were randomly divided into fluvastatin goup(n=126)and control group(n=129).Fluvastatin group was given fluvastatin 40 mg each night.Follow up was conducted for 1.5 years.The UAER and glomerular filtration rate(GFR)as well as blood lipid level before and after therapy were compared.Results UAER in fluvastatin group was significantly lower than that in control group[(59.6±10.5)vs(87.5±12.3)mg/min,P＜0.05]before therapy[(104.4±25.2)vs(110.6±19.7)mg/min,P＜0.05],which was independent of its lowering-lipid effect.But GFR had no signifimicroalbuminuria which is independent of lowering-lipid effect in type 2 diabetic nephropathy patients and delay the progress of diabetic nephropathy.