Meta-analysis of efficacies of dasatinib and imatinib for patients with chronic myeloid leukemia-chronic phase / 白血病·淋巴瘤

Objective To compare the efficiencies of imatinib and dasatinib in patients with chronic myeloid leukemia-chronic phase (CML-CP).Methods The databases were retrieved,including Cochrane Library,OVID,Embase,PubMed,China National Knowledge Infrastructure (CNKI),WanFang database and VIP database,besides,references of articles were further to search.The quality of randomized controlled trials (RCTs) was assessed by the Cochrane collaboration' s risk tool.Meta-analysis was performed by RevMan 5.1 software.Results A total of 5 articles involved 2 031 patients with CML-CP were included.Meta-analysis showed that the rate of complete cytogenetic response (CCyR) at the 12th month in dasatinib group was higher than that in imatinib group [83.6 ％ (478/572) vs 70.6 ％ (406/575),OR =2.11,95 ％ CI 1.59-2.80,P＜ 0.05],and the rate of major molecular response (MMR) at the 12th month in dasatinib group was higher than that in imatinib group [49.3 ％ (296/600) vs 30.6 ％ (185/605),OR =2.22,95 ％ CI 1.75-2.82,P ＜ 0.05].Conclusion Dasatinib can improve CCyR and MMR rate at the 12th month in CML-CP patients.

[Mutation and clinical relevance in a large cohort of unrelated Chinese patients with hypertrophic cardiomyopathy].

OBJECTIVE: To explore the genetic basis and phenotypic correlation with disease severity in a large cohort of Chinese patients with hypertrophic cardiomyopathy (HCM). METHODS: A total of 179 unrelated Chinese HCM patients admitted to our department from 2002 to 2011 were enrolled in this study. Direct gene sequencing of ß-myosin heavy chain (MYH7), myosin binding protein-C ( MYBPC3), and cardiac troponin T (TNNT2) were performed and clinical data were obtained in these patients. RESULTS: A total of 34 mutations were identified in 40 patients (22.3%), 79.4% (27/34) mutations occurred only once and a possible hot spot, A26 in MYH7, was found. Distribution of mutations was 52.9% (18/34) (MYBPC3), 35.3% (12/34) ( MYH7) and 11.8% (4/34) (TNNT2) respectively. Double mutations were identified in 2.2% (4/179) patients. Genotype-positive patients were associated with an earlier symptom onset, severer left ventricular hypertrophy, a higher incidence of syncope, and were more likely to have positive family history of HCM or sudden cardiac death (SCD) , and were more likely to progress into heart failure (24.2% vs. 5.0%, P = 0.002) and at a higher risk of SCD (9.1% vs. 0, P = 0.009) during the 6.5-year follow-up. No statistical difference in any clinical parameters and outcomes was found between patients carrying MYBPC3 and MYH7 mutations. Double mutations were associated with malignant clinical progression in this cohort. Different phenotype severity could be seen in HCM patients with same genotype (e. g. MYH7-1736T, TNNT2-R92W). CONCLUSION: MYBPC3 is the most predominant gene mutation in this HCM cohort. The presence of a sarcomere mutation in patients with HCM is associated with poor clinical outcome, although no specific genes or mutations can exactly predict the severity of clinical phenotypes.

Prevalence Survey of Pre-excitation and Wolff-Parkinson-White Syndrome in Adolescents in Beijing Area / 中国循环杂志

Objective:To study the prevalence of pre-excitation and Wolff-Parkinson-White (WPW) syndrome in adolescents in Beijing area. Methods: A total of 19 484 adolescents at the age of (15-20) years from Xicheng district of Beijing and the freshmen from Peking University were enrolled for our survey; 12-lead electrocardiography (ECG) screening was conducted and the diagnosis, classification of pre-excitation, WPW syndrome were recorded. The follow-up study was performed in relevant patients. Results: There were 19 389 qualiifed ECG obtained, among them, 30 (0.15%) patients with ventricular pre-excitation and WPW syndrome identiifed including 17 male (0.17%) and 13 (0.13%) female, the prevalence between male and female was similar (χ2=0.495,P>0.05). There were 6/19389 (0.03%) patients with palpitation and 2 (0.01%) documented by super-ventricular tachycardia. There were 16/30 (53.33%) patients with type A and 14(46.7%) with type B ventricular pre-excitation, the prevalence between male and female was similar (χ2=4.693,P>0.05). The patients were followed-up at the mean of 2.5 (1.5-3) years and no malignant arrhythmia events occurred. Conclusion: In this cohort survey, prevalence of pre-excitation and WPW syndrome is about 0.15% in adolescents from (15-20) years in Beijing area; the prevalence is similar between male and female subjects.

Research progress on the relationship between leukemia and thyroid function / 白血病·淋巴瘤

It had been found that there was the relationship between leukemia and thyroid function.Treatment of leukemia and hematopoietic stem cell transplantation affect thyroid function,induce thyroid disease syndrome and secondary thyroid lesion.Leukemia is relate to family autoimmune thyroid diseases.Thyroid hormone may affect the bone marrow hematopoietic function.Current studies reviewed the relationship between leukemia and thyroid function.

Assessment of the anesthesia effect of etomidate combined with remifentanil in elderly patients / 中国基层医药

ObjectiveTo study the anesthesia effect,safety and reliability of etomidate combined with remifentanil in elderly patients. Methods40 patients scheduled for abdominal operation were divided into two groups with 20 cases each: etomidate group(group A)and propofol group(group B).Anesthesia induction: midazolam 0.04mg/kg,remifentanil 1.5 μg/kg(time＞60s),atracurium 0.6mg/kg,group A to etomidate 0.2mg/kg(30 ～ 60s),(T1),1 min before trachea intubation(T2),1 min after trachea intubation(T3),5 min after cutting skin(T4),5 min after exploration(T5),5min after cutting ill focus(T6),3min after tracheal extubation(T7),30min after operation(T8).At the same time,observed analepsia condition. ResultsIn group B,SBP and DBP were lower than those in group A at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than those in group A at T6 and HR was lower than those in group A at T3 and T7(all P＜0.05).In group B,SBP and DBP were lower than before anesthesia at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than before anesthesia at T6 and HR was lower than before anesthesia at T2(all P＜0.05).In group A,HR was faster than before anesthesia at T7(P＜0.05).The time of openingeyes,remove-tracheal tube in B group was less than those in A group(all P＜0.05).Both groups without memory about operation,anesthesia was content. ConclusionEtomidate combined with remifentanil anesthesia was milder than propofol group to elderly patients ardiovascular effects.It was better than propofol group for elderly patients.

Clinical analysis of laryngeal mask airway anesthesia and endotracheal intubation anesthesia / 中国基层医药

Objective To study the safety and efficacy of laryngeal mask airway(LMA) used in breast cancer general anesthesia. Methods Forty ASA Ⅰ or Ⅱ patients with breast cancer scheduled for selective radical mastectomy under general anesthesia were allocated randomly to either laryngeal mask airway group(group A,n =20) or tracheal tube group(group B, n = 20). SBP, DBP, HR, SpO2 of patients before anesthesia(To)/after intubation immediately (T1) and 5 minutes(T2) after intubation tracheal tube or laryngeal mask intubation/after extubation immediately (T3) and 5 minutes(T4) of after extubation tracheal tube or laryngeal mask were recorded. The different incidence of anesthetic complications and side effect were observed in both groups because intubation and extubation. Results In group B, SBP, DBP and HR were significantly higher than those in group A at T1 and T3 (P ＜ 0.05). Agitation, bucking and pharyngodynia incidence rate in group B were significantly higher than group A(P ＜ 0.05). Conclusion Ventilation with LMA in patients underwent breast cancer radical correction was better than endotracheal intubation general anesthesia in keeping stable hemodynamics and producing less anesthetic complications.

Effect assessment of controlled hypotension of remifentanil in endoscopic sinus surgery / 中国基层医药

Objective To investigate the effects,safety,controlling of controlled hypotension induced by remifentanil during endoscopic sinus surgery.Methods Forty patients with ASA grade Ⅰ～Ⅱ undergoing selective endoscopic sinus surgery,were randomly assigned into remifentanil group(A group)and nitroglycerin group(B group).After routine inducing,controlled hypotension was induced before the main procedure of surgery.A group was given remifentanil(1μg/kg)by intravenous injection,then remifentanil(0.3～0.8μg·kg~(-1)·min~(-1))was used in group A to keep mean arterial pressure between(MAP)60 and 80 mm Hg.B group was given fentanyl(0.03～0.08 μg·kg~(-1)·min~(-1))and nitroglycerin(2～5 μg·kg~(-1)·min~(-1))to keep mean arterial pressure(MAP)between 60 to 80 mm Hg till the main procedure of surgery was finished.Observing MAP and HR change before controlled hypotension,during controlled hypoteusion and after stopping controlled hypotension.Observing the time of opening-eyes,remove-tracheal tube and surgical field quality.Results The two groups were comparable with regard to the surgical field rating(P＞0.05).MAP in two groups during controlled hypotension were lower than those before controlled hypotension(P＜0.05),in A group,MAP were comparable with those in B group during controlled hypotension(P＞0.05).In B group there was rellexible tachycardia during controlled hypotension.HR in A group during controlled hypotension was lower than those before controlled hypotension(P＜0.05).HR during controlled hypotension in A group was lower than those in B group(P＜0.01).The time of opening-eyes,remove-tracheal tube in A group was less than those in B group(P＜0.01).ConclusionRemifentanil cound induce and sustain controlled hypoteusion.It was safe and feasible.It was better than nitroglycerin group for controlled hypotension in endoscopic sinus surgery.

The thickness measurement of alive human skull based on CT image / 生物医学工程学杂志

This study sought to measure accurately the thickness of the frontal, parietal and occipital bones of the alive human skull based on CT images. The images were treated with a series of processes by coding into a program: image segmentation and binary coding; eliminating edge interference; rectifying image deviation and clarifying boundary edge; redrawing the boundary and reference point fixing; and finally thickness measurement. The new method can measure not only the different points in one CT image but also the same point in massive CT images. The measurement results are of great practical value in the fields of anatomy, clinical medicine, biomechanics study, head injury analysis, etc.

A new exploration of the applicability of the head injury criterion / 生物医学工程学杂志

Head injury criterion (HIC) is a widely accepted injury criterion in assessing the injury potential of the human head under external loads. It has been used in vehicle safety regulations worldwide and helmet design. However, controversy about its applicability exists. In this study, two human head models of different size and mass were created to explore the applicability of HIC. Under three different impact loadings, the principal stresses of the two brains of the two different head models were calculated and compared with the corresponding HIC values. The influences on the application of HIC in head injury assessment were investigated. This study provides some new insights and leads new conclusions towards human head injury assessment.

Association of genetic polymorphisms in the fibrinogen and platelet glycoprotein genes with unstable angina in Chinese patients.

BACKGROUND: Inherited predisposition has been associated with coronary artery disease (CAD) in the white population. HYPOTHESIS: The objective of this study was to investigate the association between the risk of unstable angina (UA) and genetic factors believed to be associated with an increased tendency toward thrombosis (the variable number of tandem repeats [VNTR] polymorphism of the platelet glycoprotein [GP] Ib alpha gene, Pl(A1/A2) of the platelet GP IIIa gene, 448G/A of the Bbeta fibrinogen gene and Thr312Ala of the Aalpha fibrinogen gene) in Chinese patients with UA. METHODS: We performed a case/control study evaluating 69 Chinese patients (43 men, 26 women) with UA and 69 control subjects without CAD, individually matched for age and gender. The restriction fragment length polymorphism (RFLP) method was used to determine the genetic polymorphisms. RESULTS: The frequencies of GP Ib alpha C/B genotype and Bbeta fibrinogen 448A allele were higher in patients with UA (46.4 vs. 30.4%, odds ratio [OR] 1.977, 95% confidence interval [CI] 0.98-3.97, p = 0.054, and 49.3 vs. 20.3%, OR 3.816, 95% CI 1.797-8.103, p = 0.000, respectively). Only four subjects (two cases, two controls) with GP IIIa Pl(A2) allele were found, and there was no association between Aalpha fibrinogen Thr312Ala polymorphism and UA. CONCLUSIONS: Chinese patients with UA had increased frequencies of GP Ib alpha C/B genotype and Bbeta fibrinogen 448A allele. These data suggest that some genetic factors may influence the development of UA.

Mutation analysis of potassium channel genes KCNQ1 and KCNH2 in patients with long QT syndrome / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To determine mutations of two common potassium channel subunit genes KCNQ1, KCNH2 causing long QT syndrome (LQTS) in the Chinese.</p><p><b>METHODS</b>Thirty-one Chinese LQTS pedigrees were characterized for mutations in the two LQTS genes, KCNQ1 and KCNH2, by sequencing.</p><p><b>RESULTS</b>Two novel KCNQ1 mutations, S277L in the S5 domain and G306V in the channel pore, and two novel KCNH2 mutations, L413P in the transmembrane domain S1 and L559H in the transmembrane domain S5 were identified. The triggering factors for cardiac events developed in these mutation carriers included physical exercise and excitation. Mutation L413P in KCNH2 was associated with the notched T wave on ECGs. Mutation L559H in KCNH2 was associated with the typical bifid T wave on ECGs. Mutation S277L in KCNQ1 was associated with a high-amplitude T wave and G306V was associated with a low-amplitude T wave. Two likely polymorphisms, IVS11 + 18C > T in KCNQ1 and L520V in KCNH2 were also identified in two LQTS patients.</p><p><b>CONCLUSIONS</b>The mutation rates for both KCNQ1 (6.4%) and KCNH2 (6.4%) are lower in the Chinese population than those from North America or Europe.</p>

Application of transgenic animal in hypertrophic cardiomyopathy / 北京大学学报(医学版)

Hypertrophic cardiomyopathy is an autosomal-dominant disease.Disease-causing mutations have been found in genes encoding structural components of the thick and thin filament systems of cardiac myocyte;it has therefore been named as a disease of sarcomere.Many approaches have been used to characterize the pathogenesis of the desease.Transgenic animal models have been created to gain further insight into the pathogenesis of this disease.Most of these models has been made in mice;however,recently a transgenic rabbit model has been created.In addition,there are several natural-occurring forms of HCM in animals.The discovery of responsible genes and the elucidation of the molecular mechanisms of pathogenesis through the use of animal models promise improved and early diagnosis and the potential for mechanism-based therapeutics.

Familial Wolff-Parkinson-White syndrome is linked to the loci on chromosome 7q3 / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>Wolff-Parkinson-White syndrome (WPW) is considered to be an autosomal dominant hereditary disease, but the gene is not identified. The objective of this study was to localize the genetic loci of Wolff-Parkinson-White syndrome.</p><p><b>METHODS</b>Linkage analysis between the disease of Wolff-Parkinson-White syndrome and 3 STR (short tandem repeats) markers on 7q3 (D7S505, D7S688, and D7S483) was tested in 3 kindreds of the Wolff-Parkinson-White syndrome (101 numbers in total) by genotyping.</p><p><b>RESULTS</b>Wolff-Parkinson-White syndrome was linked to the loci above. The maximum two-point Lod score detected at D7S505 was 6.4 at a recombination fraction (theta) of 0.1; the Lod score of D7S688, D7S483 was 5.3 vs 2.5.</p><p><b>CONCLUSION</b>The gene of Wolff-Parkinson-White syndrome is located at 7q3.</p>

THE CHANGES OF THE EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH FACTOR DURING RAT LIVER REGENERATION / 解剖学报

Objective Detecting the changes of the expression of vascular endothelial growth factor(VEGF) during rat liver regeneration so as to study the role of VEGF in the course of liver regeneration. Methods Three hundred adult SD rats were randomly divided into three groups:control group,sham operated group and test group.After taking out liver tissue and isolating hepatocytes at different phases after 2/3 rat hepatectomy,the change of VEGF expression was detected by both immunocytochemistry and Western blotting. Results The results of immunocytochemistry showed that VEGF positive cells were little in normal liver.The amounts of immunoreaction positive cells began to increase after 24 h of partial hepatectomy(P