Duodenal perforation caused by imatinib mesylate during adjuvant treatment of gastric stromal tumor: Case report.

Imatinib, a tyrosine kinase inhibitor, is frequently used to treat unresectable or metastatic gastrointestinal stromal tumors. The application of this medication is considered an adjuvant treatment of gastrointestinal stromal tumors. It can reduce the postoperative recurrence of the tumors. During the treatment with imatinib, there can be various gastrointestinal adverse reactions, which are mild and can be alleviated following a reduction in the dose. It is rare that perforation of the digestive tract happens after the employment of this medication. This study reported that imatinib mesylate caused bowel perforation in one patient with gastric stromal tumors after its use for 3 months.

[Anti-A/B Antibody Titers in Group O Healthy Donors in Hainan Province Area].

OBJECTIVE: To detect the IgM anti-A (B) and IgG anti-A (B) antibody titers of group O healthy donors in Hainan province area, to understand the distribution of O-type blood donor IgM and IgG antibody titers and to analyze the relationship between antibody titers, so as to provide experimental evidences for the safety and feasibility of urgent transfusion of uncrossmatched group O RBCs. METHODS: Group O whole blood sample was collected from 80 volunteers blood donors. IgM antibody titrations was performed using the immediate spin (IS) tube, and IgG antibody titration were performed using the column agglutination technique with anti-human globulin (AHG). Using two-way ANOVA, paired t-test and correlation analysis, the different types of antibodies were compared. RESULTS: The IgM antibody titers distributed in 4-1 024, IgG antibody titer distributed in 2-2 048. Anti-A antibody titers of IgG were significantly higher than that of IgM anti-B, IgG anti-B and IgM anti-A titers (P < 0.05). There was a positive correlation bewteen IgM anti-A and anti-B, IgM anti-B and IgG anti-B, IgG anti-A and anti-B (P < 0.05). CONCLUSION: Group O blood donors have high antibody titers in Hainan province area, type O RBC suspensions should be first screened through screening the anti-A titer of IgG, so that can significantly improve the pass rate of O-type universal blood and reduce testing costs.

[Serological characteristics and transfusion efficacy evaluation in 61 cases of autoimmune hemolytic anemia].

This study was aimed to analyze the serological characteristics, efficacy and safety of incompatible RBC transfusion in patients with autoimmune hemolytic anemia (AIHA). The patients with idiopathic or secondary AIHA were analyzed retrospectively, then the serological characteristics and the incidence of adverse transfusion reactions were investigated, and the efficacy and safety of incompatible RBC transfusion were evaluated according to the different autoantibody type and infused different RBC components. The results showed that out of 61 cases of AIHA, 21 cases were idiopathic, and 40 cases were secondary. 8 cases (13.1%) had IgM cold autoantibody, 50 cases (82.0%) had IgG warm autoantibody, and 3 cases (4.9%) had IgM and IgG autoantibodies simultaneously. There were 18 cases (29.5%) combined with alloantibodies. After the exclusion of alloantibodies interference, 113 incompatible RBC transfusions were performed for 36 patients with AIHA, total efficiency rate, total partial efficiency rate and total inefficiency rate were 56.6%, 15.1% and 28.3%, respectively. Incompatible RBC transfusions were divided into non-washed RBC group and washed RBC group. The efficiency rate, partial efficiency rate and inefficiency rate in non-washed RBC group were 57.6%, 13.0% and 29.4%, respectively. The efficiency rate, partial efficiency rate and inefficiency rate in washed RBC group were 53.6%, 21.4% and 25.0%, respectively. There was no significant difference of transfusion efficacy (P > 0.05) in two groups. Incompatible RBC transfusions were also divided into IgM cold autoantibody group and IgG warm autoantibody group. The efficiency rate, partial efficiency rate and inefficiency rate in IgM cold autoantibody group were 46.2%, 30.8% and 29.4%, respectively. The efficiency rate, partial efficiency rate and inefficiency rate in IgG warm autoantibody group were 56.7%, 13.4% and 29.9%, respectively. There was no significant difference of transfusion efficacy (P > 0.05 ) in two groups. Hemolytic transfusion reaction was not observed in all incompatible RBC transfusions. It is concluded that the same ABO type of non-washed RBC transfusion and O type washed RBC transfusion are all relatively safe for the AIHA patients with severe anemia after the exclusion of alloantibodies interference. There is no significant difference of transfusion efficacy in two groups. The same ABO type of non-washed RBC transfusion is more convenient and efficient than washed RBC transfusion, and excessive use of type O RBCs can also be avoided.

[A preliminary study on the measurement of (1,3)-ß-D-glucan in bronchoalveolar lavage for the diagnosis of pulmonary fungal infections].

OBJECTIVE: To explore the measurement of (1,3)-ß-D-glucan bronchoalveolar lavage fluid (BALF) for the diagnosis of pulmonary fungal infections. METHODS: A total of 135 patients in the General Hospital of Tianjin Medical University from February 2010 to February 2011 were enrolled. There were 34 cases of confirmed or clinically diagnosed pulmonary fungal infections, 53 cases of bacterial pneumonia, and 48 cases of non-infection diseases. All patients underwent BAL and the BALF samples were obtained. (1,3)-ß-D-glucan content (G test), in BALF and plasma were tested and the data were analyzed statistically by Mann-Whitney while the receiver operating characteristic curve (ROC curve) was established, from which the best threshold of the 2 G tests was derived. RESULTS: The median of BALF G test in the fungal infection group, pneumonia group and non-infection group was 281, 28 and 10 ng/L, respectively; the level in the fungal infection group being significantly higher than those of the other 2 groups (P < 0.001), but no significant difference being observed between the pneumonia group and the non-infection group (P > 0.05). The median of plasma G tests in the fungal infection group, the pneumonia group and the non-infection group was 27, 10, and 5 ng/L, respectively; the level in the fungal infection group being significantly higher than those in the other 2 groups (P < 0.001), but there was no significant difference between the pneumonia group and the non-infection group (P > 0.05). The best threshold of BALF G test was 67 ng/L, while the best threshold of G test of plasma was 17 ng/L. CONCLUSION: As compared to G test of plasma, G test of BALF may be more accurate, and have a higher clinical value for the earlier diagnosis of pulmonary fungal infections.

[A study on the endogenous cannabinoid system synthetic and catabolic enzyme levels in patients with obstructive sleep apnea].

OBJECTIVE: To observe the differences of endogenous cannabinoid system (ECS) synthetic and catabolic enzyme levels between the obstructive sleep apnea syndrome (OSA) patients and the control subjects. METHODS: Patients with OSA confirmed by PSG in our Sleep Center were randomly recruited from July to December, 2009. Peripheral blood was obtained to isolate mononuclear cells and the mRNA levels of anandamide (AEA) synthase N-acylphosphatidylethanolamine hydrolyzing phospholipase D (NAPE), fatty acid amide hydrolase (FAAH) and 2-arachidonoylglycerol (2-AG) synthase diacylglycerol lipase (DAGL) and hydrolase monoacylglycerol lipase (MAGL) were measured by real-time polymerase chain reaction. The association between the severity of OSA and the enzyme levels were explored. RESULTS: There was a significant difference in both the NAPE and MAGL levels between patients with OSA and the control subjects. The level of MAGL was related to some indices of severity of OSA, including the longest apnea time, lowest blood oxygen saturation and the micro-arousal index (r = 0.31, 0.24, 0.34, respectively, all P < 0.05). Compared with patients with OSA alone, patients with OSA complicated by hypertension showed a different level of FAAH (P < 0.05). CONCLUSION: OSA altered the expression of the ECS synthetic and catabolic enzymes, leading to an increase in endogenous cannabinoid substances.