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With the progress of high-throughput sequencing technologies and bioinformatics,and deepening understanding of immune system,immunomics has evolved from initially deciphering gene sequences of B cell receptor(BCR)and T cell receptor(TCR)to unraveling and mapping interactions between host immune system and antigens,as well as panorama of host immune system response mechanisms,which now encompasses various research areas,such as antigen epitopeomics,immunogenomics,immunopro-teomics,antibodyomics and immunoinformatics.Based on a large amount of immunological research data,immunological databases such as ImmPort,VDJdb and IEDB have been established to accelerate discovery of new antigen epitopes and study of immune response mechanisms.Immunomics has revealed the association between immune system and diseases,promoted the development of novel vac-cines and immunotherapeutic strategies,and effectively drove the development of personalized medicine and precision medicine.In recent years,integration of immunome with exposome and fusion it with artificial intelligence will have a significant impact on compre-hensively understanding immune system's response and regulatory mechanisms to environmental factors,as well as deciphering molecular mechanisms underlying disease occurrence and progression.
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Objective:To investigate the clinical and imaging characteristics of patients with cryptogenic stroke with different right-to-left shunt (RLS) and possible mechanisms.Methods:Acute ischemic stroke patients aged 18-65 years, who admitted to the Department of Neurology, the First Affiliated Hospital of Fujian Medical University from April 2012 to July 2022, were etiologically classified according to the TOAST criteria. Cryptogenic stroke patients further underwent contrast-enhanced transcranial Doppler (cTCD) examination. Patients with RLS (RLS grade Ⅰ-Ⅳ) were divided into large shunt group (RLS grade Ⅲ-Ⅳ, under normal breathing or after Valsalva manoeuvre) and small shunt group (RLS grade Ⅰ-Ⅱ, under normal breathing or after Valsalva manoeuvre). The chi-square test,Fisher's exact probability method and one-way analysis of variance were used to compare clinical and neuroimaging data between the 2 groups. And the RLS related factors as well as mechanisms of RLS-related stroke were further discussed through Spearman correlation and multiple Logistic regression analysis.Results:A total of 167 cryptogenic stroke patients with RLS were included in this study. The male to female ratio was 88∶79. The onest age was (45.27±9.02) years. In the large shunt group, there were 92 patients (55.1%) with onset age of (45.61±9.32) years. In this group, 35 patients (38.0%) were males, 9 (9.8%) had hypertension, and 18 (19.6%) had smoking history; the Risk of Paradoxical Embolism (RoPE) score was 7.08±0.12. In the small shunt group, there were 75 patients (44.9%) with onest age of (44.85±8.68) years. In this group, 53 patients (70.7%) were males, 29 (38.7%) had hypertension, and 31 (41.3%) had smoking history; the RoPE score was 6.20±0.14. Males (χ 2=17.640, P<0.001) as well as hypertension (χ 2=19.611, P<0.001) and smoking history (χ 2=9.443, P<0.01) were significantly less common in the large shunt group than in the small shunt group, while the RoPE score in the large shunt group was higher than that in the small shunt group ( F=21.580, P<0.001). All 6 pulmonary arteriovenous fistula cases (6.5%, 6/92) belonged to the large shunt group. There was no pulmonary arteriovenous fistula patient in the small shunt group ( P<0.05). There were no statistically significant differences in age of onset, hyperlipidemia, diabetes, previous stroke/transient ischemic attack, or family history of stroke between the 2 groups (all P>0.05). Multiple Logistic regression analysis showed that female ( OR=2.848, 95 %CI 1.223-6.632, P<0.05) and no history of hypertension ( OR=3.937, 95 %CI 1.593-9.727, P<0.01) were significantly associated with large shunt. The neuroimaging features were analyzed through comparing offending vessels as well as spatial distribution of lesions between the 2 groups. Results:showed that infarct location of 54 cases (58.7%) was in the unilateral anterior circulation area, 34 cases (37.0%) in the posterior circulation area, no case in the bilateral anterior circulation area, and both of anterior and posterior circulation areas were involved in 4 cases (4.3%) in the large shunt group. Of all the large shunt group patients, 31 (33.7%) had cortical infarcts, 9 (9.8%) had subcortical infarcts, 36 (39.1%) had deep infarcts, and 16 (17.4%) had mixed multiple infarcts. In the small shunt group, infarct location of 36 cases (48.0%) was in the unilateral anterior circulation area, 29 cases (38.7%) in the posterior circulation area, 4 cases (5.3%) in the bilateral anterior circulation area, and both of anterior and posterior circulation areas were involved in 7 cases (9.3%). Of all the small shunt group patients, 7 (9.3%) had cortical infarcts, 8 (10.7%) had subcortical infarcts, 39 (52.0%) had deep infarcts, and 21 (28.0%) had mixed multiple infarcts. Logistic regression analysis showed that cortical infarction was associated with large shunt ( OR=5.981,95 %CI 1.882-19.007, P<0.01), and there was no statistically significant difference in other types of infarction distribution between the 2 groups (all P>0.05). Conclusions:Among cryptogenic stroke patients with RLS, large shunt was more common in females, patients with no history of hypertension, and those with higher RoPE score as well as more cortical infarction, suggesting that there was a strong link between stroke and large RLS, which revealed the underlying mechanism of embolism in patients with stroke and large RLS. In the small shunt group, there were more males and hypertensive patients, suggesting atherosclerosis was more likely involved in pathogenic mechanism of stroke patients with small RLS.
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OBJECTIVE To explore the effect of volatile oil of Ligusticum chuanxiong on the transdermal properties and cytotoxicity of triptolide in vitro. METHODS The chemical constituents of the volatile oil of L. chuanxiong were analyzed by gas chromatography-mass spectrometry. The lower abdominal skin of KM mice was separated and divided into triptolide group， triptolide in compatibility with volatile oil of L. chuanxiong groups at 1∶10， 1∶50， 1∶100 （hereinafter referred to as “compatibility 1∶10”“compatibility 1∶50”“compatibility 1∶100” groups）. After the skin of mice in each group was fully exposed to 0.2 g of the corresponding cream for 24 h， the cumulative transdermal dose （Qn） of triptolide in the receiving solution of each group was determined by high-performance liquid chromatography， and the transdermal absorption rate （Jss） was calculated. Human immortalized keratinocytes （HaCat） were used as a model， the CCK-8 method was used to detect the cell survival rate of different concentrations of the volatile oil of L. chuanxiong and triptolide before and after compatibility. RESULTS A total of 62 chemical constituents of the volatile oil of L. chuanxiong were identified， including Z-ligustilide， senkyunolide， and β-selinene. The Qn （P＜ 0.01） and Jss of triptolide increased within 24 h in the compatibility 1∶10 and 1∶50 groups， while the Qn （P＜0.05） and Jss decreased in the compatibility 1∶100 group as compared with the triptolide group. Compared with the triptolide group， the cell survival rate of HaCat was significantly increased in the compatibility 1∶10 and 1∶50 groups when the triptolide concentrations were 36， 72 and 144 ng/mL （P＜0.05 or P＜0.01）； while the cell survival rate of HaCat was decreased in the compatibility 1∶100 group， but the difference was not statistically significant （P＞0.05）. CONCLUSIONS When the compatibility ratio of triptolide and volatile oil of L. chuanxiong was 1∶10 or 1∶50， it can promote the transdermal absorption of triptolide and reduce the cytotoxicity of triptolide to HaCat.
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OBJECTIVE To study the extraction technology of Sophora flavescens-Phellodendron chinense drug pair and provide a reference for the development of new drugs for the treatment of anorectal diseases. METHODS Using the contents of total alkaloids of S. flavescens （matrine+oxymatrine）， berberine hydrochloride and total flavonoid， and extract yield as evaluation indicators， analytic hierarchy process-entropy weight method was used to calculate the weight coefficient of each indicator， and was combined with Box-Behnken design-response surface method to study the extraction technology of S. flavescens-P. chinense drug pair and verify it. RESULTS The optimal extraction technology of S. flavescens-P. chinense drug pair was immersed in 12-fold amount of 58% ethanol for 30 minutes and extracted twice， each time for 120 minutes. The relative error between the verification experimental results and the predicted value was 1.88%. CONCLUSIONS The obtained extraction technology is stable and feasible and can provide reference for the application of S. flavescens-P. chinense drug pair and development of new drugs.
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Objective To analyze the epidemiological characteristics of school varicella and varicella public health emergency event (PHEE) in Yunnan Province, and to provide a scientific basis for the prevention and control of varicella in schools. Methods The descriptive epidemiological method was used to analyze the reported PHEE of varicella in students and varicella in schools in Yunnan Province from 2018 to 2020. Results From 2018 to 2020, a total of 69,391 cases of varicella were reported in students in Yunnan Province, accounting for 71.48% (69 391 / 97 080) of the total cases in the province, and the annual average reported incidence rate was 255.56/100 000 (69 391/27.1522 million). The time distribution of the incidence showed double peaks, which were from May to July (26.48%) and October to January of the following year (53.88%). The incidence rates of different schools from high to low were 301.74/100 000 for primary schools (34 816/11.538 3 million), 250.43/100 000 for kindergarten (11 526/4.6024 million), 202.74/100 000 for middle school (16 779/8.276 1 million), and 119.07/100 000 for others (3 257/2.735 4 million). The age distribution was mainly concentrated in 5-9 years old, accounting for 39.81% (27 625/69 391). Varicella PHEE accounted for 25.64% (180/702）of the province's PHEE in the same period, school varicella PHEE accounted for 100% of varicella PHEE, and the attack rate was 3.38% (6 566/194 260). The sources of reported varicella PHEE were hospitals 45.40% (58/123), epidemic analysis 36.78% (44/123), schools 13.22% (15/123), and others 4.60% (6/123). Conclusion The incidence of varicella in schools in Yunnan Province is high, which is harmful to students. PHEE reported in rural schools are relatively lagging behind. On the basis of doing two doses of varicella vaccination, emergency prevention should be focused on epidemic seasons, lower grade schools and rural schools. The source of infection shall be controlled and managed in time to prevent the outbreak of the epidemic. It is recommended that varicella should be included in the management of Class C infectious diseases.
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CD226 is an activated receptor on the surface of natural killer (NK) cells. It competes with TIGIT and CD96 to bind to ligands such as CD155 on the surface of tumor cells and mediates the killing function of NK cells. Although TIGIT and CD96 have other binding ligands in the tumor microenvironment, they compete to bind CD115 ligands with higher affinity and inhibit the activity of NK cells, which allows tumor cells to evade killing. Therefore, studying the expression patterns of these three NK cell surface receptors in different tumors and monitoring their binding ability with ligands will help us to explore new tumor treatment strategies. This article reviews the role and mechanism of CD226, TIGIT, CD96 and other NK cell receptor molecules in regulating NK cell function in anti-tumor immune response.
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Ligands , Receptors, Immunologic , Receptors, Natural Killer Cell , Killer Cells, Natural , Antigens, CDالملخص
Objective@#To understand the status and associated factors of knowledge, attitude and practice (KAP) about myopia prevention and control among young children s parents in Guangzhou, so as to provide reference for family health education on myopia prevention and control.@*Methods@#During January to February 2023, 4 584 parents of children from kindergarten and primary school (grade 1-3) were recruited. Two to three kindergartens and 2 primary schools were selected from each of the 3 urban districts and 2 suburb districts of Guangzhou by stratified cluster random sampling method. Parents of children were administered with online questionnaire survey on KAP about myopia prevention and control. Descriptive analyses and multivariate Logistic regression models were used.@*Results@#The proportion of parents reaching standard of KAP about myopia prevention and control was 61.54%, the knowledge awareness rate was 57.30%, the positive attitude holding rate was 76.98% and the health practice formation rate was 63.31 %. Internet (70.35%) and lectures on school health education/health education materials (66.14%) were the most common ways for obtaining knowledge for parents. Multivariate Logistic regression analysis showed that urban area, higher education ( college /undergraduate or above), annual household income 50 000-90 000, 100 000-290 000, 300 000-490 000, 500 000- 590 000 , and ≥600 000 Yuan, being aware of vision status (normal/poor) of their children, one or both parents with myopia, both parents with non myopia, acquiring knowledge by multi ways(2, 3, ≥4) were associated with higher KAP about myopia prev ention and control ( OR =1.23, 1.34, 1.36, 1.25，1.49, 1.93, 2.34, 1.64, 1.66, 1.89, 3.48, 3.09, 2.42, 1.65, 2.29, 3.22, P ＜ 0.05).@*Conclusion@#Knowledge and practice about myopia prevention and control among young children s parents in Guangzhou are insufficient, yet the attitude was satisfactory. It is necessary to carry out targeted education for parents, especially those living in suburb area, with low education and income level.
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Objective@#To investigate the epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021, so as to provide insights into the prevention and control of overseas imported arthropod-borne infectious diseases.@*Methods@#The data pertaining to imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 were collected from the Chinese Disease Prevention and Control Information System, and the temporal distribution, regional distribution, population distribution, sources, diagnosis and treatment of imported dengue fever and malaria cases were descriptively analyzed.@*Results@#Totally 4 332 overseas imported dengue fever cases and 2 011 overseas imported malaria cases were reported in Yunnan Province form 2015 to 2021, which accounted for 30.09% of all reported dengue fever cases and 98.53% of all reported malaria cases. The number of overseas imported dengue fever and malaria cases peaked from August to November (83.13% of all imported dengue fever cases) and from April to July (59.08% of all imported malaria cases), and the cases were predominantly reported in Dehong Prefecture (50.99% and 58.88%), with farmers as the predominant occupation (40.21% and 67.93%). The dengue fever and malaria cases were mainly imported from Southeast Asia (99.04% and 88.21%), and the proportions of definitive diagnosis of dengue fever and malaria were 88.33% and 97.80% at township hospitals, respectively.@*Conclusions@#The number of overseas imported dengue fever and malaria cases peaked from August to November and from April to July in Yunnan Province from 2015 to 2021, and the cases were predominantly reported in Dehong Prefecture and imported from Southeast Asia, with farmers as the predominant occupation.
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The concept of "ntigen"is a relative one. The narrow concept of it condenses the process of activation of adaptive immune response and re-recognition of the same antigen, revealing the protective mechanism of vaccines with great significance for research and development of vaccines. However, the narrow concept involves adaptive immune system members: B cells, T cells and their effector products, which is difficult for beginners to understand the inherent meaning. Meanwhile, antigen classification fully summarizes the immune response process, so a variety of classification approach increases the difficulty in learning. Our teaching team analyzes the difficulties of this chapter in depth, and we implements the strategy that takes antibody structure and function as the breakthrough point and simplified adaptive immune response process as the core in teaching. A mind map that includes the main contents of this chapter is made during the process, which promotes the effectiveness of classroom teaching greatly.
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Learning , Vaccines , Antibodiesالملخص
Objective:To explore the consistency of MRI fast field echo resembling a CT using restricted echo-spacing (FRACTURE) and CT in the evaluation of knee and ankle bone changes.Methods:From November 2020 to November 2021, seventeen patients who underwent CT and MRI FRACTURE examinations of knee joint or ankle joint in the First Affiliated Hospital of Dalian Medical University were retrospectively collected, including 14 patients with knee joint examinations and 3 patients with ankle joint examinations. According to the number of joint components, 80 components were included, including 14 for femur and patella, 17 for tibia and fibula, and 3 for talus, scaphoid, medial cuneiform, medial cuneiform, lateral cuneiform and calcaneus, respectively. The fracture, hyperosteogeny, and bone destruction of the joint bones were evaluated by two observers using CT and FRACTURE images, respectively. Kappa test was used to analyze the consistency of CT and FRACTURE images between observers in the evaluation of joint bone lesions.Results:The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by CT and FRACTURE images were 0.925 (0.823-1.027), 0.905 (0.799-1.011) and 0.895(0.752-1.038) respectively for observer 1, and were 0.963 (0.892-1.034), 0.933 (0.843-1.023) and 0.886 (0.731-1.041) respectively for observer 2. The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by observers 1 and 2 via CT images were 1.000 (1.000-1.000), 0.937(0.851-1.023) and 0.945 (0.839-1.051) respectively, and that by FRACTURE images were 0.962 (0.888-1.036), 0.966 (0.899-1.033) and 0.836 (0.656-1.016) respectively.Conclusion:For the evaluation of fracture, hyperosteogeny, and bone destruction of knee joint and ankle joint, MRI FRACTURE sequence is highly consistent with CT.
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Osteoporosis， as a systemic bone disease with high incidence rate and high disability rate， has become a research hotspot in recent years. The daidzein in soybean isoflavones can bind with estrogen receptors， simulating the prevention and treatment of osteoporosis with estrogen-like effect. Its mechanism of action includes promoting osteoblast formation and differentiation by activating the Wnt signaling pathway， increasing bone density， and improving bone tissue health； inhibiting osteoclast differentiation and slowing down bone resorption by reducing receptor activator of nuclear factors κB ligand/ osteoprotegerin ratio， downregulating the expression of macrophage colony-stimulating factor （M-CSF）； collaborating antioxidant and immune regulation to achieve the goal of preventing and treating osteoporosis. In addition， different doses of daidzein have different effects on bone density and osteoporosis， which may be related to factors such as study design， sample selection， and individual differences.
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Objective@#To understand the changing trend of the teaching environment of the elementary and secondary schools in Zhengzhou, and to provide data for further improving the teaching environment of the elementary and secondary schools.@*Methods@#A survey of teaching facilities and teaching aids in 534 secondary and primary schools in Zhengzhou was conducted from 2014 to 2018 by using a stratified random sampling method.@*Results@#Teaching facilities: the qualified rate of the railings in the outer corridor of the teaching building was 88.8% (474), the qualified rate of classroom lighting was 79.6% (425), the qualified rate of the light desk distance was 82.8% (442), and the qualified rate of black plate lights 86.1% (460), the qualified rate of each year was statistically significant ( χ 2=9.97, 23.74, 80.10, 53.33, P <0.05); the qualified rate of classroom area per capita was 52.8% (282), the qualified rate of the outer corridor width of the teaching building was 64.0% (342), the qualified rate of each year showed no statistical difference( χ 2=7.38, 8.71, P >0.05). Teaching ancillary facilities: the proportion of centralized water supply was 65.0% (347), toilet with hand washing facilities was 81.6% (436), these two indicators showed an increasing trend, hand washing facilities in campus was 70.6% (377), showed a decreasing trend, the rate of each year differed significantly( χ 2=88.62, 42.71 , 123.53, P <0.05).@*Conclusion@#The overall situation of teaching environment in Zhengzhou primary and secondary schools is relatively good, the qualified rate of most indicators of teaching facilities increased from 2014 to 2018. However, there are still some indicators to be strengthened.
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Objective:To investigate the clinical characteristics, treatments and prognosis of pulmonary arteriovenous fistula (PAVF) related ischemic stroke, as well as summarize the diagnosis and treatment process to screen and confirm PAVF related ischemic stroke.Methods:The clinical data of six PAVF related ischemic stroke patients in the First Affiliated Hospital of Fujian Medical University from January 2015 to January 2019, including clinical manifestations, brain magnetic resonance imaging, risk of paradoxical embolism (RoPE) score, contrast-enhanced transcranial Doppler (cTCD), contrast transesophageal echocardiography (cTEE), chest CT and pulmonary arteriography, were analyzed. PAVF patients were treated with interventional catheter embolization or conservative medication. All patients were followed up for 1.5 to 5.5 years.Results:All the six PAVF related ischemic stroke patients were young and middle-aged. The ratio of men to women was 1∶2. RoPE scores ranged from 6 to 7 points. Recurrent stroke was seen in five patients, and only one patient had primary stroke. Both anterior and posterior cerebral circulation could be involved. Hereditary hemorrhagic telangiectasia (HHT) was common in PAVF patients. Of the six patients, two had definite HHT with PAVF, two had suspicious HHT with PAVF, and the other two had sporadic PAVF. In all the six cases, a grade Ⅳright-to-left shunt (RLS) was observed on cTCD, and a mass of delayed microbubbles in the left atrium appeared on cTEE. One patient was diagnosed with patent foramen ovale (PFO). Lung enhanced CT was applied in all the patients. In three cases, PAVF was found located in left lower lobe. And in other three cases, lesions were located in left upper lobe, right lower lobe and right middle lung, separately. All cases were confirmed with simple type PAVF. Transcatheter embolization was performed to resolve PAVF in five patients. Of five post-operative patients, four cases showed no sign of RLS on cTCD. One patient combined with PFO still remained a small amount of potential RLS after embolization. One patient chose aspirin for conservative medication. All patients had no recurrence of ischemic stroke during the 1.5 to 5.5-year follow-up.Conclusions:PAVF related ischemic stroke patients have a high recurrence rate of ischemic stroke. PAVF related ischemic stroke has no specific brain imaging characteristics. cTCD is recommended for cryptogenic stroke patients with a high RoPE score (≥ 6 points) to detect RLS. If a patient turns out to be positive for RLS, cTEE could help differentiate intracardiac shunt from extracardiac shunt. For patients with cTEE suggesting extracardiac shunt, lung enhanced CT scan is necessary to confirm PAVF diagnosis. Patients who are diagnosed as PAVF can choose transcatheter embolization or surgical resection. cTCD could be used to evaluate the treatment effect.
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sequential treatment of advanced prostate cancer is a current research hotspot. One patient with advanced prostate cancer with multiple metastases at initial diagnosis in our institution was sequentially treated with endocrine, abiraterone, polymerase inhibitor, and enzalutamide with an overall survival of 35 months.
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Objective:To compare the effect of age on clinical outcome of laparoscopic sleeve gastrectomy (LSG) in the obese patients.Methods:A total of 113 patients who underwent LSG due to obesity and metabolic disorders between 2013 and 2018 at Fudan University Pudong Hospital, and completed the scheduled follow-up (1, 3, 6, and 12 months after surgery) were included for the retrospective analysis. The patients were divided into three groups based upon pre-operative age, including 15 to 30 year-old group ( n=58), 31 to 45 year-old group ( n=32), and 45 to 65 year-old group ( n=23). The body weight related parameters, glycemic and metabolic related parameters, lipid panel as well as arterial blood pressure were compared at pre-operative baseline, 1, 3, 6, and 12 months after surgery. The quantitative data were analyzed by repeated measurement ANOVA, and the P value was corrected by Bonferroni method. And the categorical variables were analyzed by chi square test. Results:The preoperative baseline data showed that with the increase of age, the preoperative body mass index gradually decreased, which were (40.1±5.9) kg/m 2, (37.1±6.6) kg/m 2 and (35.3±7.4) kg/m 2 in 16 to 30, 31 to 45 and 46 to 65 year-old groups, respectively. Otherwise, other metabolic related parameters were comparable. At 12 months after LSG, there was no significant difference in the amount of weight loss among the groups, but the percentage of total weight loss (% TWL) and the percentage of total BMI loss (%TBMIL) decreased significantly with age increasing. The %TBMIL in 16 to 30, 31 to 45 and 46 to 65 year-old groups were 32.3±7.5%, 28.4±8.4% ( P<005 compared with 16 to 30 year-old group) and 25.7±8.2% (compared with 16 to 30 year-old group P<0.001), respectively. In the patients with preoperative HbA1c>7%, HbA1c reduction in the three groups at 12 months after operation were 3.20% (compared with 46-65 year-old group P<0.001), 2.64% (compared with 46-65 year-old group P<0.05) and 1.34%, respectively. The proportions of patients with HbA1c < 6.5% were 95.8%, 88.9% and 50.0%, respectively. LDL, triglyceride and arterial blood pressure in all groups decreased and HDL increased rapidly within 3 months after operation, but there was no significant difference among the three groups. Conclusions:The improvement of blood glucose metabolism and the remission rate of type 2 diabetes mellitus (T2DM) in the patients with older age were worse than those in the younger patients, and the T2DM in the younger patients tends to obtain better clinical remission after LSG; in terms of weight loss, with the increase of age, %TWL and %TBMIL also showed a decreasing trend; however, the improvement of blood lipid and blood pressure after LSG was not affected by the factor of age. This study implies that patients who meet the indications of metabolic and bariatric surgery should be suggested to receive surgical treatment early in order to achieve better clinical outcomes.
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AIM: The DNA plasmid lipidosome (LP) vaccine based VEGFR2 extracellular region (exVEGFR2) was prepared in order to provide a new approach for cancer active immunotherapy. METHODS: High fidelity PCR was used to amplify the target sequence of exVEGFR2 with two restriction site of Kpn and Xba. The plasmid of pCMV/exVEGFR2 was constructed by connected exVEGFR2 with pCMV empty plasmid. The activity of immune activation was detected by ELISA. CTLs mediated cytotoxic activity was analyzed by
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Objective:To investigate the clinical characteristics of acute myeloid leukemia with BCR-ABL p210 fusion gene-positive.Methods:The clinical characteristics of a patient diagnosed in the Second Hospital of Jiaxing were analyzed and the related literature was reviewed.Results:BCR-ABL p210 fusion gene and Philadelphia chromosome (Ph) were detected by reverse transcription-polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH). Imatinib associated with multi-drug intravenous chemotherapy resulted in poor efficacy.Conclusions:Patient with Ph +/BCR-ABL + acute myeloid leukemia is rare with a very poor prognosis. There is no unified standard treatment and the efficacy of tyrosine kinase inhibitors is unclear. Intravenous chemotherapy combined with hematopoietic stem cell transplantation is expected to change the prognosis.
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Objective:To describe the long-term outcomes of intensive care unit (ICU) survivors of mechanical ventilation, and investigate the views of survivors on ICU rehabilitation clinics.Methods:A single-center cross-sectional descriptive study was designed. ICU survivors of mechanical ventilation admitted to the First Affiliated Hospital of Guangzhou Medical University from January to December 2016 were enrolled. Data were collected from August 2017 to March 2018. The general information questionnaire, Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and ICU rehabilitation clinics questionnaire were used to evaluate ICU survivors social-demographic factors, social and economic outcomes, clinical data, quality of life and the views on ICU rehabilitation clinics.Results:A total of 248 ICU survivors of mechanical ventilation were included in the study, 130 (52.4%) of them were followed up successfully. The mean time from ICU discharge to follow-up day was (19.64±3.20) months. The average age of the survivors was (60.09±15.42) years old, and 55.4% of them were over 60 years old. Among 130 ICU survivors, severe pneumonia was the dominant ICU admission diagnosis (23.1%), followed by surgical operations (cardiac surgery 16.9%, other surgical operations 20.8%), lung transplantation (13.1%), and acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 12.3%), etc. The first APACHEⅡ score after ICU admission was 16.88±7.37, the mechanical ventilation time was (12.52±12.34) days, and the length of ICU stay was (16.71±15.11) days. In terms of social and economic outcomes, the proportion of having full-time or part-time jobs decreased from 32.3% (42/130) before ICU admission to 25.4% (33/130) by the date of follow-up, while the unemployed rate increased from 6.9% (9/130) to 18.5% (24/130). Only 45.1% (23/51) of the ICU survivors returned to the post before ICU admission. 36.2% (47/130) of the ICU survivors reported that they needed care from others, and 86.9% (113/130) reported that their treatment experiences in ICU had an impact on their lives. In terms of quality of life, physiological function dimension, which was 34.62±33.15, scored the lowest and suffered the most. The physical pain dimension and mental health dimension suffered the least, and the scores were 90.19±16.98 and 75.28±15.15, respectively. Furthermore, physical component summary (PCS) score was 61.12±17.09, and mental component summary (MCS) score was 65.97±21.85. In terms of the views of ICU rehabilitation clinics, 68.5% (89/130) of the subjects believed that the establishment of ICU rehabilitation clinics was very helpful or helpful.Conclusions:The long-term outcomes of ICU survivors of mechanical ventilation are not optimistic. Their quality of life is lower than that of general people. It is necessary to set up ICU rehabilitation clinics.
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The clinical manifestation, laboratory findings, and imaging examination of a baby with familial glucocorticoid deficiency were summarized. The patient presented achypnea, cyanosis, and pigmentation of the whole body skin, no convulsion and hypoglycemia found. Laboratory findings revealed low blood cortisol and high blood ACTH levels. A 1-bp homozygous deletion(c.106+ 1delG) in intron 3 of melanocortin 2 receptor accessory protein(MRAP) gene in the patient was found. His parents were found to be heterozygous carrier for the same mutation, without any clinical manifestation.
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Objective:To explore the clinical and genetic characteristics of a Chinese baby with perinatal hypophosphatasia (HPP) and his parents for better understanding of the disease.Methods:The clinical data of the patient with HPP was carefully collected. The laboratory and radiographic examination data were taken for this baby patient. Sequencing for all the twelve tissue-nonspecific alkaline phosphatase(ALPL) exons and the flanking exon-intron junctions were performed in the proband and his parents with their genomic DNA from peripheral blood.Results:The blood level of alkaline phosphatase was decreased in this patient while serum calcium level was increased. His bone revealed chondrodysplasia-like change. Compound heterozygous mutations were found in the proband, with c. 346G>A(p.A116T) in exon 5 and c. 1171C>T(p.R391C) in exon 10. His father and mother were without clinical manifestation while respectively carried c. 346G>A(p.A116T and c. 1171C>T(p.R391C) missense mutations, suggesting an autosomal recessive inheritance in this family.Conclusion:Perinatal HPP has a high mortality rate. Skeletal deformities, hypercalcemia, and low level of ALP are important in the differential diagnosis of perinatal HPP.