Validating the accuracy of a multifunctional smartwatch sphygmomanometer to monitor blood pressure.

BACKGROUND: Hypertension is the most modifiable factor associated with cardiovascular events and complications. The conventional blood pressure (BP) meter method is simple but is limited in terms of real-time monitoring abnormal BP. Therefore, the development of a multifunction smartwatch (HUAWEI WATCH D) sphygmomanometer could significantly improve integrated BP monitoring. METHODS: We enrolled 361 subjects from Chinese PLA General Hospital, Beijing, China to validate the accuracy of the smartwatch versatile sphygmomanometer using ISO 81060-2:2018. Resting and ambulatory BP accuracy of the smartwatch were compared with gold standard clinical sphygmomanometers using ISO 81060-2:2018 guidelines, the accuracy of 24 h systolic blood pressure (SBP) circadian rhythm monitoring, and diurnal high SBP alert for this smartwatch were assessed using a confusion matrix approach. Additionally, we analyzed online users of different ages for compliance. RESULTS: Eighty-five subjects underwent resting BP measurements; the mean resting BP differences between two devices were -0.683 ± 6.203 mmHg (SBP) (P = 0.723) and 1.628 ± 5.028 mmHg (diastolic blood pressure, DBP) (P = 0.183). In 35 subjects' ambulatory BP measurements, the mean differences of ambulatory BP were -1.943 ± 5.475 mmHg (SBP) (P = 0.923) and 3.195 ± 5.862 mmHg (DBP) (P = 0.065). All data complied with ISO 81060-2:2018 guidelines (mean ≤ ±5 mmHg and standard deviation ≤ ±8 mmHg) with no significant differences. Positive predictive values (PPV) of resting SBP and DBP were 0.635 and 0.671, respectively. The PPV of ambulatory SBP and DBP were 0.686. Also, 24 h SBP circadian rhythm monitoring was performed in 107 subjects: accuracy = 0.850, specificity = 0.864, precision/PPV = 0.833, sensitivity = 0.833, and F1-measure (F1) = 0.833. The accuracy, specificity, precision, sensitivity, and F1 values in 85 subjects undergoing diurnal high SBP alerting were 0.858, 0.876, 0.706, 0.809, and 0.754, respectively. CONCLUSIONS: When compared with the gold standard clinical sphygmomanometer, smartwatch results were consistent and accurate. Online user feedback showed that elderly individuals cared more about BP monitoring accuracy, with better compliance.

Pretreatment of nucleus pulposus mesenchymal stem cells with appropriate concentration of H2O2 enhances their ability to treat intervertebral disc degeneration.

BACKGROUND: Nucleus pulposus mesenchymal stem cells (NPMSCs) transplantation is a promising treatment for intervertebral disc degeneration (IVDD). However, the transplanted NPMSCs exhibited weak cell proliferation, high cell apoptosis, and a low ability to resist the harsh microenvironment of the degenerated intervertebral disc. There is an urgent need to explore feasible methods to enhance the therapeutic efficacy of NPMSCs transplantation. OBJECTIVE: To identify the optimal concentration for NPMSCs pretreatment with hydrogen peroxide (H2O2) and explore the therapeutic efficacy of NPMSCs transplantation using H2O2 pretreatment in IVDD. METHODS: Rat NPMSCs were pretreated with different concentrations (range from 25 to 300 µM) of H2O2. The proliferation, reactive oxygen species (ROS) level, and apoptosis of NPMSCs were detected by cell counting kit-8 (CCK-8) assay, 5-ethynyl-2'-deoxyuridine (EdU) staining, and flow cytometry in vitro. The underlying signalling pathways were explored utilizing Western blotting. A rat needle puncture-stimulated IVDD model was established. X-ray, histological staining, and a multimode small animal live imaging system were used to evaluate the therapeutic effect of H2O2-pretreated NPMSCs in vivo. RESULTS: NPMSCs pretreated with 75 µM H2O2 demonstrated the strongest elevated cell proliferation by inhibiting the Hippo pathway (P < 0.01). Meanwhile, 75 µM H2O2-pretreated NPMSCs exhibited significantly enhanced antioxidative stress ability (P < 0.01), which is related to downregulated Brd4 and Keap1 and upregulated Nrf2. NPMSCs pretreated with 75 µM H2O2 also exhibited distinctly decreased apoptosis (P < 0.01). In vivo experiments verified that 75 µM H2O2-pretreated NPMSCs-transplanted rats exhibited an enhanced disc height index (DHI% = 90.00 ± 4.55, P < 0.01) and better histological morphology (histological score = 13.5 ± 0.5, P < 0.01), which means 75 µM H2O2-pretreated NPMSCs can better adapt to the environment of degenerative intervertebral discs and promote the repair of IVDD. CONCLUSIONS: Pretreatment with 75 µM H2O2 was the optimal concentration to improve the proliferation, antioxidative stress, and antiapoptotic ability of transplanted NPMSCs, which is expected to provide a new feasible method to improve the stem cell therapy efficacy of IVDD.

[Clinical Significance of EBV-DNA Copy Number in EBV Positive Lymphoma Patients].

OBJECTIVE: To investigate the effect of EBV-DNA copy number on the prognosis of patients with EBV positive lymphoma. METHODS: Clinical data of 109 patients diagnosed as EBV positive lymphoma in Tianjin Medical University Cancer Institute and Hospital from January 2010 to January 2020 were enrolled and analyzed retrospectively. Kaplan-Meier analysis was used for survival analysis, Log-rank was used to compare the clinical characteristics between the patients in different groups, and Cox regression was used for multivariate analysis. RESULTS: Among the 109 patients with EBV-positive lymphoma, the medium age were 56 (range 15 to 83) years old. 29 patients at Ann Arbor stage I-II while 80 patients at stage III-IV. The average value of EBV-DNA was 1 023 510 IU/ml, 7 patients were higher than the average value, while 102 patients were lower. KM survival analysis showed that OS and PFS in patients with EBV-DNA above average level were shorter than those in patients with EBV-DNA below average level (OS: P=0.048, PFS: P=0.001), EBV-DNA copy number was a factor affecting the prognosis of patients. In addition, LDH level showed positive correlation with EBV-DNA copy number (r=0.650), which was also one of the factors affecting OS (P=0.053). CONCLUSION: EBV-DNA copy number and LDH level can influence the prognosis of EBV positive lymphoma patients. Therefore, detection of EBV-DNA copy number in peripheral blood is important for evaluate the prognosis the patients.

The biological effect of cobalt chloride mimetic-hypoxia on nucleus pulposus cells and the comparability with physical hypoxia in vitro.

Objective: Nucleus pulposus cells (NPCs) are cells extracted from the intervertebral disc and are important for research into intervertebral disc degeneration (IVDD). NPCs live in an avascular and relatively hypoxic environment. Cobalt chloride (CoCl2) has been used in many cell studies to mimic hypoxia. The objective of this study was to explore the possibility of using CoCl2 to induce mimetic-hypoxia for NPCs and the comparison with hypoxia (1% O2) in vitro. Materials and methods: Rat nucleus pulposus cells of Passage 3-5 were used in this research. Cell viability, rate of cell apoptosis, ROS (reactive oxygen species) generation, cell migration, extracellular pH and extracellular matrix metabolism were determined to compare the influence of hypoxia (1% O2) and CoCl2 on NPCs. Results: We found that the effects of CoCl2 on NPCs was dose-dependent. At the proper concentration, CoCl2 could be used to elicit chemical hypoxia for nucleus pulposus cells in vitro and many biological effects, analogous to physical hypoxia (1% O2), could be achieved such as enhanced cell viability, decreased apoptosis and activated extracellular matrix metabolism. On the other hand, CoCl2 mimetic-hypoxia did not affect NPCs glycolysis and migration compared to physical hypoxia. In addition, high concentration of CoCl2 (>200 µM) is harmful to NPCs with high rates of apoptosis and ECM (extracellular matrix) degradation. Conclusions: It is feasible and convenient to use CoCl2 to induce chemical mimetic hypoxia for culturing NPCs on the premise of appropriate concentration. But in aspects of cell migration and glycolysis, CoCl2 could not achieve similar results with physical hypoxia. This study may provide a convenient method and enlightenment to induce mimetic-hypoxia for researchers studying NPCs and IVVD.

[Clinical Analysis of B-Cell Non-Hodgkin Lymphoma Treated with Modified Conditioning Regimen].

OBJECTIVE: To investigate the efficacy, safety and prognosis of auto-HSCT between classical and modified conditioning regimen in patients with B-cell non-Hodgkin lymphoma. METHODS: 36 patients diagnosed as B-cell non-Hodgkin lymphoma treated with autologous hematopoietic stem cell transplantation from January 2015 to June 2018 in Tianjin Cancer Hospital were retrospectively analyzed. The patients were divided into two groups: Idarubicin group and non-Idarubicin group. The overall survival (OS), progression-free survival (PFS), adverse reactions and hematopoietic reconstitution time between the two groups were compared. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox regression was used for multivariate analysis. RESULTS: The median follow-up time was 29 months. Among these 36 patients with B-cell non-Hodgkin lymphoma before transplantation, 21 patients achieved CR and 15 patients achieved PR. The reconstitution time of neutrophil (P>0.05) and platelet (P>0.05) was not significantly different between Idarubicin and non-Idarubicin group. Also, the adverse reactions were not significantly different between two groups. The addition of idarubicin showed not aggravate the adverse reactions of patients. The OS and PFS of patients with idarubicin was longer than that of patients without idarubicin. The multivariate analysis showed that, the modified conditioning regimen and the remission state before transplantation were closely associated with prognosis. CONCLUSION: The above-mentioned results indicated that the combination of modified conditioning regimen with idarubicin can lengthen the OS and PFS of the patients significantly, and show not aggravate of bone marrow inhibition, moreover, the hematopoietic reconsititution time show not lengthen, which means that it can be a safe and effective choice for autologous HSCT in the patients with B cell non-Hodgkin lymphoma.

[Reaserch Advances in Immunotherapy for Acute Myeloid Leukemia--Review].

Acute myeloid leukemia (AML) is a malignant tumor with abnormal myelocyte differentiation. With the development of immunological technology, great importance has been attached to the immunotherapy of AML patients, which may become an effective treatment strategy for AML, and providing a new means for the prognosis and survival. In this review, the advanced research of immunotherapy for AML, such as antibody-dependent drugs, chimeric antigen receptor T cell therapy, and checkpoint inhibitors, the bastest reaserch advanves of clinical experiment for immunotherapy was summarized briefly.

Exosomes derived from stem cells as an emerging therapeutic strategy for intervertebral disc degeneration.

Intervertebral disc (IVD) degenerative diseases are a common problem in the world, and they cause substantial social and economic burdens for people. The current methods for treating IVD degenerative diseases mainly include surgery and conservative treatment, which cannot fundamentally restore the normal structure of the disc. With continuous research on the mechanism of degeneration and the development of regenerative medicine, rapid progress has been made in the field of regenerative medicine regarding the use of stem cell-derived exosomes, which are active biological substances used in intercellular communication, because they show a strong effect in promoting tissue regeneration. The study of exosomes in the field of IVD degeneration has just begun, and many surprising achievements have been made. This paper mainly reviews the biological characteristics of exosomes and highlights the current status of exosomes in the field of IVD degeneration, as well as future developments regarding exosomes.

[Clinical Characteristics of 219 Patients with Primary Gastrointestinal Non-Hodgkin's Lymphoma].

OBJECTIVE: To analyze the clinical and pathological characteristics of primary gastrointestinal non-Hodgkin's lymphoma (PGI-NHL) patients, and to explore the factors affecting the patients' survival and prognosis. METHODS: The clinical data of 219 patients with PGI-NHL diagnosed in our hospital from March 2009 to April 2016 was collected and retrospectively analyzed. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison among the groups, and Cox regression was used for multivariate analysis. RESULTS: Among the 219 patients with PGI-NHL, 126 patients were males and 93 patients were females. 182 patients were IPI 0 to 2 and 37 patients were IPI 3 to 5. There were 205 cases (93.6%) of B cell phenotype and 14 cases (6.4%) of T cell phenotype. 140 patients (63.9%) were patients with primary gastric NHL, including 85 DLBCL and 19 MALT. 79 cases (36.1%) were patients with primary intestinal NHL, including 46 DLBCL, 4 MALT, 7 FL, 3 MCL and 4 Burkitt lymphoma. 23 cases were HP positive and received anti-HP therapy. 57 cases and 32 cases received surgery and chemotherapy respectively. 84 cases received combination treatment of surgery and chemotherapy and 11 cases received combination treatment of radiotherapy and chemotherapy. Overall survival (OS) of indolent B-cell non-Hodgkin's lymphoma was longer than that of invasive B-cell non-Hodgkin's lymphoma, which shows better prognose. Kaplan-Meier analysis showed that there was no difference between progression-free survival (PFS) and OS in the patients with different origin sites, age and sex. There was no significant difference in PFS between B-cell and T-cell-derived patients, whereas OS of B-cell-derived PGI-NHL patients was longer than that of T-cell-derived PGI-NHL patients. The OS and PFS of patients with IPI 0-2 were longer than those of patients with IPI 3-5. According to Lugano and Ann Arbor staging systems, there was no difference in prognosis of patients between phase I/II and III/IV. The prognosis of patients treated with surgery alone was worse than that of patients treated with combination therapy, and the prognosis of patients with surgery combined with chemotherapy was not significantly different from that of patients with chemotherapy alone. CONCLUSION: B-cell phenotype, indolent and low IPI score lymphoma indicate better prognosis, while that of different origin site, sex and age shows no different in prognosis. Surgery is used only for emergency case or pathological materials, and these patients should be treated with chemotherapy-based combined treatment.

[Characteristics and Source Apportionment of Carbon Components in Road Dust PM2.5 and PM10 During Spring in Tianjin Derived by Using the Quadrat Sampling Method].

In order to study the characteristics and sources of carbon fractions in PM2.5 and PM10 of road dust in Tianjin, samples of road dust were collected by the quadrat sampling method in April 2015 in Tianjin, and samples were re-suspended on filters by using a NK-ZXF sampler. A Thermal Optical Carbon Analyzer (IMPROVE-TOR) was employed to measure the concentrations of organic carbon (OC) and elemental carbon (EC), and the pollution characteristics and sources were investigated by non-parametric tests and OC/EC ratio, correlation, and cluster analyses. The results showed that ω(total carbon, TC) in PM2.5 of road dust amounted to 4.89% (secondary road) -18.83% (expressway), ω(OC) amounted to 3.57% (secondary road) -15.39% (expressway), and ω(EC) amounted to 1.32% (secondary road) -3.44% (expressway); meanwhile, ω(TC) in PM10 of road dust was 8.14% (secondary road) -19.71% (expressway), ω(OC) was 5.91% (secondary road) -16.28% (expressway), and ω(EC) was 1.96% (main road) -3.43% (expressway). The mass fraction of each carbon component for the expressway was relatively high, and that for the secondary trunk road was relatively low, which may have been due to the large traffic volume on the expressway and corresponding large amounts of exhaust emissions from motor vehicles, whereas there were fewer vehicles on the secondary trunk road. Additionally, ω(OC) was significantly larger than ω(EC) for all types of roads, and ω(EC) did not vary much among the different road types. The non-parametric tests of two related samples showed that there was no significant difference in the mass fraction of each carbon component between PM2.5 and PM10. The correlation analysis showed that the sources of OC and EC in road dust were roughly the same. The OC/EC ratio analysis and cluster analysis showed that the main sources of the carbon components in the dust of roads in Tianjin in spring were coal combustion, motor vehicle exhaust, and biomass burning.

Evaluation of intra-operative imaging during scarf osteotomy - an unnecessary cost or an essential prerequisite?

Scarf osteotomy is an effective surgical treatment option for hallux valgus. It can manipulate alignment in three planes, allowing accurate anatomical correction. The potential benefit of intra-operative image intensification (II) to gauge deformity correction during surgery however, has not been quantitatively reported. This study aims to compare the correction of hallux valgus by scarf osteotomy with and without intra-operative imaging. Retrospective analysis of a consecutive series of scarf osteotomy in 2 groups. Group A had intra-operative radiographic assessment and group B did not. Patient and surgical data was collected with a mean follow-up of 14 months. Of 99 scarf osteotomies there was no significant difference in age, gender or pre-operative deformity between the groups (p<0.05). No statistical difference was found between the radiographic corrections of the two groups (p<0.05), although operating time was less in group B. This series shows that intra-operative imaging does not improve accuracy of deformity correction, or implant position in scarf osteotomy. We suggest it is not required routinely during scarf osteotomy.

[Research Progress on Diagnosis and Treatment of B Cell Chronic Lymphoproliferative Disease--Review].

The 2016 world health organization (WHO) classification of B cell chronic lymphoproliferative disease (B-CLPD) includes chronic lymphocytic leukemia (CLL), B prolymphocytic leukemia, (B-PLL), hairy cell leukemia (HCL), marginal zone lymphoma (MZL), follicular lymphoma (FL), mantle cell lymphoma (MCL), Waldenstrom macroglobulinemia (LPL/WM). All the above-mentioned diseases are partially similar in cell morphology, immunophenotype and molecular genetics, but significantly different in treatment and prognosis. Currently, many new drugs targeted at cell cycle and apoptosis pathway, such as proteasome inhibitor immune modulators and histone deacetylase inhibitors, have achieved encouraging results in B-CLPD, which bring new hope for patients with B-CLPD. The review will discuss the progress in diagnosis and treatment of B-CLPD in recent years.

[Advances of Targeting Therapy in Acute Myeloid Leukemia--Review].

Although the application of combined chemotherapy has made a great progress in treatment of adult acute myeloid leukemia (AML), the overall survival rate is still not high, mainly because of high recurrence rate and drug resistance. The treatment regimen for relapsed/refractory AML is always strong. Due to the chemotherapy drugs lacking of specific identification of tumor cells, significant adverse reactions often come out and sometimes even endanger the life of patients. In order to improve the life quality and survival rate, the new treatment strategy is urgently needed. With the deepening of research, the new molecular targets of tumor cells including the abnormal expression of cell surface morecules, gene mutation and abnormal gene methylation has been found. Targeted drugs for these abnormal changes could improve the prognosis of AML patients, providing a new way for AML treatment. This review summarizas the progress of molecular targeted therapy of AML.

[Characteristics and Sources of Carbon Components in PM2.5 During Autumn and Winter in Panjin City].

In order to study the pollution characteristics and sources of carbon in Panjin City during autumn and winter, PM2.5 samples were collected at three monitoring points in October 2016 and January 2017. Pollution characteristics and sources of carbon components in PM2.5 were analyzed by the OC/EC ratio method, EC tracer method, and principal component analysis method. The results showed that the PM2.5 concentration exceeded the ambient air quality standard (GB 3095-2012) and that the average concentrations of OC and EC were 10.02 µg·m-3 and 3.91 µg·m-3 in autumn, respectively, and 16.04 µg·m-3 and 5.62 µg·m-3 in winter. According to the OC/EC ratio method, the OC/EC ratios were more than 2.0 during the sampling periods, indicating that there was secondary pollution in autumn and winter. Spearman correlation analysis and linear fitting indicated that the OC and EC sources were complex in development zones and that secondary school and cultural park areas may have similar sources during autumn and winter. SOC was quantitatively estimated by the EC tracer method, with concentrations of 7.21 µg·m-3 and 23.07 µg·m-3 in autumn and winter, respectively. The absolute and relative errors of SOC uncertainty were 0.98 µg·m-3 and 14.00% in autumn, respectively, and 1.87 µg·m-3 and 8.21% in winter. Based on the method of principal component analysis, the carbon components in autumn and winter were mainly derived from coal combustion, biomass burning, and vehicle exhaust.

[Characteristics and Source Apportionment of Water-soluble Inorganic Ions in Road Dust PM2.5 During Spring in Tianjin Using the Quadrat Sampling Method].

In order to collect comprehensive information regarding the characteristics and sources of the water-soluble inorganic ions in road dust (RD) PM2.5 in Tianjin, samples of road dust were collected in April 2015 in Tianjin, and then re-suspended on filters using a NK-ZXF sampler. The concentrations of the major water-soluble inorganic ions were analyzed by ion chromatography. A correlation analysis, ratio method, and principal component analysis were used to analyze the sources of RD PM2.5. The results showed that the total water-soluble inorganic ion concentration in Tianjin accounted for 6.13%±2.32%, varying with different road types. Na+, K+, Mg2+, and Ca2+ showed high homology. NO3-/SO42- revealed that the main source of PM2.5 was mostly attributed to fixed sources. The principal component analysis showed that the main sources of RD PM2.5 in Tianjin were coal combustion, mobile sources, biomass burning, and construction dust.

[Characteristics and Source Apportionment of Water-soluble Ions in PM2.5 During Winter in Panjin].

In order to study the characteristics and source of water-soluble ions in PM2.5 in Panjin, PM2.5 samples were collected at three sites in January of 2017, and the levels of eight ions (Na+, Mg2+, Ca2+, K+, NH4+, SO42-, Cl-, and NO3-) were determined by ICS-900 ion chromatograph. The characteristics of PM2.5, the water-soluble ion concentration, SOR and NOR calculation, and ion balance calculation were investigated, and a principal component analysis was conducted. The results showed that the concentration of PM2.5 and water-soluble ions followed a descending sequence of park > development zone > the second middle school. SO42-, NO3-, and NH4+ were the major components of the water-soluble ions at the three sampling sites. SOR and NOR values were all higher than 0.10, indicating that SO42- and NO3- were mainly converted from SO2 and NOx. The ion balance calculation demonstrated that the cationic and anion equivalents in Panjin had great correlation in winter. Further study showed that the atmosphere in the development zone presented as neutral and that in the cultural park and the second middle school presented as partially alkaline. The principal component analysis further indicated that the water-soluble ions were mainly derived from fuel combustion, biomass burning, secondary particles, and re-suspended dust in winter.