A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological malignancies / 中华血液学杂志

Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.

In vitro skin retention and drug permeation study of Tongluo-Qutong rubber plaster by UPLC/UV/MS/MS

Abstract Tongluo-Qutong rubber plaster (TQRP), a typical Chinese patent medicine that contains 13 different herbal remedies, is widely used in clinical practice for the treatment of cervical spondylosis and osteoarthritis. However, due to a lack of in vitro transdermal studies, the active ingredients of TQRP have not been fully elucidated. This presents a huge obstacle for quality evaluation, pharmacokinetic studies and clinical safety assessment of TQRP. In this work, a UPLC/UV/MS/MS method was established and validated to evaluate five analytes in TQRP. The validation demonstrated linearity (r > 0.99), specificity (no co-eluting peaks at the retention times of the analytes), and precision (RSD < 15%) within acceptable parameters. A skin permeation study was performed to determine the concentrations of drugs delivered to the dermis. The 24-hour cumulative permeation of ferulic acid, aleo-emodin, emodin and piperine were 303.68, 709.31, 671.06 and 25561.01 ng/cm2, respectively. According to the fitting data of the TQRP active components, skin permeation was mainly due to a combination of passive diffusion and drug release after matrix erosion

Influence of FLT3-ITD Mutation and ITD Length on the Outcome on Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the influence of FLT3-ITD mutation and ITD length on the overall survival (OS) and relapse free survival(RFS) in patients with non-M3 acute myeloid leukemia.</p><p><b>METHODS</b>Clinical features and therapeutic effect were retrospectively analyzed in 75 AML patients with FLT3-ITD mutation and 76 FLT3-ITD AML patients with a normal karotype from June 2011 to April 2016. Genomic DNA was amplified by PCR, and FLT3-ITD mutation length was analyzed by DNA sequencing in 40 patients.</p><p><b>RESULTS</b>AML patients with FLT3-ITD mutation had higher WBC count and the ratio of BM blast cells at initial diagnosis was also higher than those in AML patients without FLT3-ITD mutation (95.13 vs 10.85)(P<0.01); 72% vs 59%(P<0.01). The CR rates in AML patients with FLT3-ITD mutation less than those in AML patients without FLT3-ITD mutation(70.42% vs 94.7%)(P<0.01). OS (P<0.01) and RFS (P<0.01) were significantly increased in patients with AML who received allo-HSCT as compared with the patients who received consolidation chemotherapy and similar to AML patients without FLT3-ITD mutation who received HSCT. Patients with maintenance sorafenib after HSCT had longer OS (P<0.05) and RFS (P<0.05) than controls. ITDs exceeding 60 bp in length were associated with decreasing OS as compared with shorter ITD in AML patients with FLT3-ITD mutation (P<0.05). OS and RFS were similar among the 2 groups receiving consolidation chemotherapy. Besides, the patients with allo-HSCT had shorter ITDs and longer OS than ITDs exceeding 60 bp (P<0.05) and similar to AML patients without FLT3-ITD mutation.</p><p><b>CONCLUSION</b>AML patients with FLT3-ITD mutation has poorer outcome, among which the prognosis was worse in patients with ITD exceeding 60 bp, and the chemotherapy alone can not improve the prognosis of FLT3-ITD. Allo-HSCT is an effective treatment for AML patients with FLT3-ITD mutation; Sorafenib appears to be an effective maintenance therapy after allo-HSCT in FLT3-ITD AML.</p>

Influence of ulinastatin on the proliferation of vascular endothelial cells and IL-6 and TNF-α release under heat stress / 解放军医学杂志

Objective To explore the influence of ulinastatin on the proliferation of vascular endothelial cells and release of IL-6 and TNF-α under heat stress. Methods-HUVEC cells were divided into control, and ulinastatin of different dosage groups (1000, 2000, 3000, 4000, 5000, 6000, 7000U/ml), and CCK-8 assay was used to investigate the influence of ulinastatin on the proliferation of vascular endothelial cells. HUVEC cells were also divided into control, 43℃ heat stress, and 43°C heat stress plus ulinastatin groups. ELISA assay was used to determine the effect of ulinastatin on the release of IL-6 and TNF-α. Results-All the above mentioned doses of ulinastatin showed no significant inhibitory effect on proliferation of HUVEC cells (P>0.05). ELISA results showed that, compared with control group and 43°C heat-stress group, both the IL-6 and TNF-α releases were decreased at 0h in treatment group with ulinastatin (P<0.05). The IL-6 and TNF-α releases were much lower at 6h in the treatment group with ulinastatin than those undergoing 43℃ heat-stress only group (P<0.05). Conclusions-Various doses of ulinastatin have no effect on proliferation of endothelial cells. However, it can inhibit the IL-6 and TNF-α releases from HUEVC cells under heat stress.

Clinical significance of monitoring BK polyomavirus in patients after hematopoietic stem cell transplantation / 中国实验血液学杂志

This study was aimed to establish a method for rapid detecting BK polyomavirus (BKV) and to investigate the feasibility and value used in leukemia patients undergoing hematopoietic stem cell transplantation. Primers were designed according to BKV gene sequence; the quantitative standards for BKV and a real-time fluorescent quantitative PCR for BKV were established. The BKV level in urine samples from 36 patients after hematopoietic stem cell transplantation were detected by established method. The results showed that the standard of reconstructed plasmid and real time fluorescent quantitative PCR method were successfully established, its good specificity, sensitivity and stability were confirmed by experiments. BKV was found in 55.56% of urine samples, and the BKV load in urine was 2.46 × 10(4) - 7.8 × 10(9) copy/ml. It is concluded that the establishment of real-time fluorescent quantitative PCR for BKV detection provides a method for early diagnosis of the patients with hemorrhagic cystitis after hematopoietic stem cell transplantation.

The outcome and safety of mesenchymal stem cells from bone marrow of a third party donor in treatment of secondary poor graft function following allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of bone marrow-derived mesenchymal stem cells (MSC) from a third party donor for secondary poor graft function (PGF) following allogeneic hematopoietic stem cell transplantation(allo-HSCT).</p><p><b>METHODS</b>Five patients with secondary PGF were treated with MSC at a dose of 1 x 10(6)/kg body weight at a median of 47 days (35 to 61) after secondary PGF. MSC were derived from bone marrow (BM) of HLA-disparate third party donors, cultured in vitro and infused without HSC. If absolute neutrophil cell (ANC) and platelet counts (PLT) did not reach the standardization of > 1.5 x 10(9)/L and > 50.0 x 10(9)/L, respectively, within 28-30 days after the first MSC treatment, a second MSC treatment was required.</p><p><b>RESULTS</b>MSC were infused once in one patient and twice in four patients with an interval of 28 to 30 days. All patients obtained ANC and PLT recovery at a median of 34 (25 to 49) days and 47 (26 to 54) days, respectively, without toxic side effects within follow-up periods of median 761 (204-1491) days. Three patients developed Epstein-Barr virus (EBV) reactivation at 42, 48, 108 days after MSC infusion, respectively and two of the three coverted to posttransplant lymphoproliferative disorders (PTLD).</p><p><b>CONCLUSION</b>MSC from a third party donor are effective to patients with secondary PGF following allo-HSCT, whether it might increase the risk of EBV reactivation and EBV-associated PTLD need further observation.</p>

Limb preservation surgery combined with perioperative rehabilitation for the treatment of 7 patients with stage II to III giant cell tumor of bone in the proximal humerus / 中国骨伤

<p><b>OBJECTIVE</b>To study the effects of the extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation for the treatment of stage II to III giant cell tumor of bone in the proximal humerus.</p><p><b>METHODS</b>From March 2007 to March 2010, 7 patients with stage II to III giant cell tumor of bone in the proximal humerus were treated. Among the patients, 3 patients were male and 4 patients were female with a mean age of 34.6 years (ranged, 18 to 49 years). The mean course of disease was 19 months (ranged, 6 to 35 months). All the patients were confirmed to suffer stage II to III giant cell tumor of bone in the proximal humerus by pathology and X-ray examinations. Clinical manifestations of the patients included persistence aggravated pain of the shoulder, swelling in the proximate arm with obviously tenderness, activity limited of the joint. All the patients were treated with extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation. CMS and OSIS score system were used to evaluate shoulder function and shoulder stability.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 14 to 35 months, with an average of 17 months. There were no serious complications or recurrence in all cases. One year after the surgery CMS and OSIS score system were 70.7 scores (ranged,63 to 82 scores) and 25.1 scores (ranged, 18 to 29 scores) respectively. According to evaluation for shoulder function, 2 patients got an excellent result and 5 good. According to evaluation of shoulder stability, 1 patient got an excellent result and 6 good.</p><p><b>CONCLUSION</b>Extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation for the treatment of stage II to III giant cell tumor of bone in the proximal humerus would not only preserve the upper extremity but also preserve the function of upper extremity.</p>

Clinical features and prognosis in 49 patients with Castleman's disease / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the clinical features and prognosis of patients with Castleman's disease (CD).</p><p><b>METHODS</b>Clinical and pathological data of 49 patients with CD diagnosed in Peking Union Medical College Hospital from January 1990 to December 2007 were retrospectively analyzed.</p><p><b>RESULTS</b>In patients with uni-centric CD (UCD), hyaline vascular type had the highest percentage (88.2%, 15/17), which was significantly higher than that of either plasma cell type (5.9%, 1/17) or mixed cell type (5.9%, 1/17) (P < 0.05). In patients with multicentric CD (MCD), there were no significant differences among the percentages of different histopathologic types. In contrast to patients with UCD, patients with MCD were relatively older and had more typical clinical features, more frequent complications, and more frequent abnormal laboratory results. Twenty patients with UCD achieved complete remission (CR) after surgery, and their complications also disappeared one month later. Twenty-three out of 29 patients with MCD were treated with chemotherapy; only 6 patients achieved CR and 9 achieved partial remission (PR), and the overall response rate was 65.2%. Two patients who initially did not responded to chemotherapy achieved CR after the addition of rituximab.</p><p><b>CONCLUSIONS</b>The clinical features of CD are multifarious and nonspecific, and diagnosis is exclusively depended on histopathology. UCD has a good prognosis after surgery, while MCD often poorly responds to chemotherapy and has a relatively poor prognosis. New drugs and clinical trials are needed to improve the outcome of MCD.</p>

A study on individual mandibular prostheses according to 3D reconstruction of CT images and CNC simulation method / 中国医疗器械杂志

The new method of manufacturing individual mandibular prostheses, in combination with CT data and CNC technique, can duplicate bone tissues accurately, and can have the individual mandibular prosthesis made to order, and repair the mandibular defect (especially the lager mandibular segmental defect).

Five Years Follow-Up in Children with Secundum Artrial Septal Defect Using Amplatzer Occluder Device / 实用儿科临床杂志

Objective To evaluate the efficiency of transcatheter closure of secundum artrial septal defect (ASD) using Amplatzer occluder device in 5 years.Methods There were 18 children with ASD.Each ASD was occluded using Amplatzer occluder device through the percutaneous procedure.The closure procedure was guided by fluoroscopy and transthoracic echocardiography.All patients were followed up by physical examination,color flow echocardiography,chest radition,electrocardiography at 48 h,1month,3 month,6 month,one year,two years,three years,four years and five years.Results Cardiac murmur disappeared or lightened.Arrhythmia and right heart volume in all patients were improved after the procedure.A case revealed a trival shunt of short duration and vanished after one month color flow echo.A case has “spring′s beat” in heart when she goes to bed in three years after the procedure.Another patient had serious headach after closure and recoved after heparin therapy.Conclusions Transcatheter closure of secundum ASD using amplatzer occluder device is safe and efficient by follow-up.In order to prevent cerebral embolism,heparin should be injected in vein in two days.

Changes of Matrix Metalloproteinase in Serum and Cerebrospinal Fluid of Children with Purulent Meningitis and Those Clinical Significances / 实用儿科临床杂志

0.05,respectively).But most inte-restingly,the MMP-9 showed a positive relevance(r=0.686,P