Introduction of 15D Instrument Application / 中国卫生经济

It systematically summarized Finland's 15D instrument's development,content and its application status in health eco-nomic evaluation field,so as to provide references for implementing economic evaluation research in China,especially for health utilitymeasurement and cost-utility analysis.

Evaluation methods of vascular remodeling / 基础医学与临床

Until now,the evaluation methods of vascular remodeling mainly included the related enzymes and bio-chemical markers,imaging feature,pulse conduction velocity measurement,etc.

Effect of electric acupuncture on the expression of NgR in the cerebral cortex, the medulla oblongata, and the spinal cord of hypertensive rats after cerebral infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of electric acupuncture (EA) on the Nogo receptors (NgR) protein expression in the cerebral cortex, the medulla oblongata, and the spinal cord of cerebral ischemia-reperfusion (I/R) stroke-prone renovascular hypertensive rats (RHRSP) with middle cerebral artery occlusion (MCAO) at different time points, and to investigate its possible mechanisms for remote-organ injury of acute cerebral infarction (ACI).</p><p><b>METHODS</b>The RHRSP model was duplicated in male SPF grade SD rats. Then the MCAO model was prepared by a thread stringing method. Rats were divided into the hypertension group,the sham-operation group, the MCAO group, the EA group, and the sham-acupoint group by random number table method, 60 in each group. Rats in the MCAO group only received MCAO reperfusion treatment. Those in the sham-operation group only received surgical trauma. Baihui (DU20) and Dazhui (DU14) were needled in the EA group, once daily for a total of 28 days.The needles were acupunctured at the skin one cun distant from Baihui (DU20) and Dazhui (DU14) and then the same EA treatment was performed in the sham-acupoint group. At day 1, 7, 14, 28 after treatment, six rats were executed from each group, and their right cortex and medulla oblongata, and the left spinal cord were isolated. The infarct volume was detected by Nissl's staining method. The NgR expression was detect by Western blot.</p><p><b>RESULTS</b>(1) In the cortex area: compared with the hypertension group,the NgR expression increased in the MCAO group at day 1,7,14,and 28 after MCAO (P < 0.05). Compared with the MCAO group, the NgR expression of the EA group and the sham-acupoint group were equivalent at 1 day af ter MCAO (P > 0.05). At day 7, 14,and 28 after MCAO, the NgR expression decreased in the EA group (P < 0.05), it was quite similar to that in the sham-acupoint group (P > 0.05). (2) In the medulla oblongata area: compared with the hypertension group, the NgR expression was equivalent in the sham-operation group. the MCAO group,the EA group, and the sham-acupoint group at 1 day after MCAO (P > 0.05). At day 7.14, and 28 after MCAO, the NgR expression increased in the MCAO group (P < 0.05). Compared with the MCAO group,the NgR expression decreased in the EA group at day 7, 14, and 28 after MCAO (P < 0.05), whereas it was similar in the sham-acupoint group (P > 0.05). (3) In the spinal cord area: compared with the hypertension group, the NgR expression was equivalent in the sham-operation group, the MCAO group,the EA group, and the sham-acupoint group at day 1 and 7 after MCAO (P > 0.05). At day 14 and 28 after MCAO, the NgR expression increased in the MCAO group (P < 0.05). Compared with the MCAO group, the NgR expression decreased in the EA group at day 14 and 28 after MCAO (P < 0.05), whereas it was equivalent in the sham-acupoint group (P > 0.05).</p><p><b>CONCLUSIONS</b>Increased NgR expression in the cerebral cortex, the medulla oblongata, and the spinal cord of cerebral infarct rats was an important reason for involving remote-organ injury of ACI. The protective effect of EA on hypertensive I/R cerebral injury rats might be closely related to down-regulating central nervous system myelin growth inhibition mediated factors Nogo-A receptor NgR protein expression.</p>

Pathogenesis and management of hemorrhage and thrombosis in plasma cell dyscrasias / 中国实验血液学杂志

Unexpectedly high rates of venous thromboembolic events (VTE) induced by highly effective immune modulating drugs thalidomide and lenalidomide for treatment of multiple myeloma have focused attention on the incidence and underlying pathophysiology of VTE in patients with plasma cell dyscrasias, and on thromboprophylaxis approaches. While bleeding complications are relatively uncommon in the patients with lymphoproliferative disorders, acquired von Willebrand syndrome, typically occurring in the patients with monoclonal gammopathy of unknown significance, and acquired coagulopathies associated with primary amyloidosis can present with haemorrhagic complications and both are challenges to the management. This review highlights these important haemostasis-related complications of plasma cell dyscrasias and provides an overview of other uncommon bleeding and thrombotic events that can affect diagnosis and therapeutic management of clonal plasma cell disorders. Due to the infrequency of most these haemostasis complications, available information is typically based on retrospective cases or series analysis.

Treatment of primary systemic amyloidosis with the combination of bortezomib and dexamethasone / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and feasibility of bortezomib plus dexamethasone (BD) in patients with primary systemic (AL) amyloidosis.</p><p><b>METHODS</b>Eleven AL amyloidosis patients, including four relapsed or progressed after previous therapies and 7 newly diagnosed were treated with BD. Ten patients had two or more organs involved. Precursor protein analysis showed that 1 was κ light chain, 9 λ light chain; 5 patients with positive immunofixation including 1 IgG κ, 3 IgG λ and 1 IgA λ. BD was administered according to standard two-week schedule.</p><p><b>RESULTS</b>Eight patients were evaluable, the median number of treatment cycles was 3 (range 1 - 6). Median follow-up duration was 6 months. At least one affected organ response was observed in six patients and median time to organ response was 2 months. Three patients progressed and two of them died. Toxicities were mainly diarrhea, thrombocytopenia, peripheral neuropathy, fatigue and herpes zoster, and 7 evaluable patients who had toxicities were adjusted dosage and 2 of them interrupted therapy. Epilepsia, paralytic ileus, acute cardiac dysfunction, and postural hypotention were occurred in 3 inevaluble patients.</p><p><b>CONCLUSION</b>Bortezomib plus dexamethasone is effective in AL amyloidosis. Adverse events are common, and in some patients are severe.</p>

Clinical significance of monoclonal gammopathy with undetermined significance--review / 中国实验血液学杂志

Monoclonal gammopathy with undetermined significance (MGUS) is the most common plasma cell disorder, MGUS is an asymptomatic premalignant disorder, which is markedly underdiagnosed in the general population. The risk frequency of progression to multiple myeloma or a closely related plasma cell disorder was developed at a rate of 1.5% per year, indicating that the condition is not entirely benign. The cumulative probability of progression is 10% at 10 years, 21% at 20 years, and 26% at 25 years. As compared with control populations, the progression rate of MGUS into multiple myeloma, Waldenstr m's macroglobulinemia, AL amyloidosis and lymphoma were increased by 25, 46, 8.4 and 2.4 times respectively. Numerous reports suggest an association of MGUS with a wide variety of other malignant and nonmalignant diseases. The determining highest risk factors of progression, delaying or preventing the progression of MGUS, targeting at the highest risk of progression and improving overall quality of life, all of them are the current hot topics to be explored and summarized in this review.

Investigation on distribution of HBV genotype and serotype from Tibetan in Tongde, Qinghai / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the distribution of HBV genotype and serotype from Tibetan in Tongde, Qinghai.</p><p><b>METHODS</b>Nested polymerase chain reaction (nPCR) was used for amplification of S gene and C gene of HBV from sera carried by Tibetan chronic HBV carrier in Tongde, Qinghai, then the HBV DNA positive products were sequenced by direct sequencing. Genotype and serotype were identified by analysis of sequence result.</p><p><b>RESULTS</b>271, which come from 311 sera samples with positive HBsAg randomly selected from natural community, were amplified and sequenced in both S gene and C gene successfully, 10 (3.7%), 261 (96.3%) out of them were identified as genotype C, recombinant between genotypes C and D respectively; 259 (95.6%), 10 (3.7%), 2 (0.7%) belonged to serotype ayw2, adr, adw2 respectively.</p><p><b>CONCLUSION</b>The recombinant between genotypes C and D was the main genotype in Tibetan chronic carrier with hepatitis Bin Tongde, Qinghai; the serotype of this areas was consisted largely of ayw2.</p>

Haplotypes of DXS10011 and DXS8377 in Guangdong Han individuals / 法医学杂志

OBJECTIVE@#To investigate genetic polymorphism of two X chromosome specific STR: DXS10011 and DXS8377 in male samples from Guangdong Han population.@*METHODS@#The DNA samples were amplified by PCR and analyzed by polyacrylamide gel electrophoresis followed by silver staining.@*RESULTS@#Among 113 samples, 20 alleles were found for DXS1011 and 12 alleles for DXS8377. Also, 72 DXS10011-DXS8377 haplotypes were shown. The most common haplotypes only occurred three times. When only female children were tested in motherless case, the exclusion probability of paternity was 0.9588 for DXS10011-DXS8377 haplotypes. Investigations in 83 family trios with female children and 29 pedigrees with two children suggested a co-dominant X-linked inheritance; mutations were not found.@*CONCLUSION@#Our data indicate that DXS10011 and DXS8377 are highly informative X chromosome markers for complicated kinship analysis.

Intravascular malignant lymphomatosis and Asian variant / 医学研究生学报

Because absence of lymphoadenopathy, and often associated with haemophagocytic syndrome, the intravascular malignant lymphoma(IVL) is easy mistaken as malignant histiocytosis or connective tissue disease or vasculitis, the diagnosis was difficult while patients were alive. The clinical course of this disorder (IVL)was aggressive and carried a poor prognosis. The cases of this disorder are not too rare to be seen in our country. To enhance one′s ability to differentiate disorder in unknown fever diseases are extremely necessary.

Clinical significance of ADAMTS13 activity in thrombotic thrombocytopenic purpura patients / 医学研究生学报

A deficient of plasma VW factor-cleaving protease (ADAMTS13) and appearance of unusually large multimers induced platelets aggregation in capillaries and arterioles. It was critical pathogenesis of thrombotic thrombocytopenia purpura (TTP). ADAMTS13 activity has been measured over 1000patients of TTP and hemolysis uremia syndrome (HUS) since 1997. Diagnostic sensitivity and specificity,as well as clinical significance of ADAMTS13 deficiency for TTP patients were evaluated,and synthetical diagnosis basis of TTP were raised.