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Objective:To explore the application of venetoclax in transplantation of patients with refractory acute myeloid leukemia (AML).Methods:The diagnosis and treatment process of a patient with refractory AML who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) under venetoclax and hypomethylating agents bridging myeloablative preconditioning regimen after induction therapy failure in the First Affiliated Hospital of Soochow University in March 2020 were retrospectively analyzed.Results:The patient was a 28-year-old female who was diagnosed with refractory AML. The patient was initially given induction chemotherapy with IA (idarubicin+cytarabine) (3+7) regimen, but the disease did not relieve, then the induction chemotherapy with CLAG (cladribine+cytarabine+granulocyte colony stimulating factor) regimen was given, but the disease still did not relieve. After chemotherapy with venetoclax and hypomethylating agents bridging myeloablative preconditioning regimen, salvage haploid allo-HSCT was performed. Re-examination of bone marrow showed remission, and implantation was successful. The patient was followed up for 100 days and had sustained remission, and no transplantation complications occurred.Conclusion:For refractory AML patients who have failed primary induction therapy, the use of venetoclax and hypomethylating agents bridging myeloablative preconditioning regimen can be used as a preferred solution for salvage allo-HSCT.
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Sancai and Zhonghe are important parts of Chinese traditional culture. Their enriched connotation continues to influence Chinese ancient science and the development of TCM. Sancai-Zhonghe-TCM is a complex relationship, and this article focused on the relationship among the three. This article pointed out that the Zhongheand Sky and Earth form Sancai; Zhonghe and human corresponding reflects the overall concept of TCM, and is further enrichment of the unique theoretical system of TCM between man and universe correspondence. Zhonghe and qi corresponding has an important influence on the TCM essence, qi and spirit theory, supplemented by charts to describe.
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Objective To investigate the expression alteration and significance of long non-coding RNA (lncRNA)by GWAS(Genome-wide association study)between Esophageal squamous cell carcinoma(ESCC)and its adjacent normal esophageal tissues. Methods lncRNA and mRNA differential expression in 6 pairs of ESCC and matched non-cancerous tissues were screened by microarray assay. The target genes were predicted. Finally , GO(Gene Ontology)and Pathway analysis was used for the further research of lncRNA. Results A total of 680 lncRNA and 1472mRNA were differentially expressed at more than two-fold change(P ≤ 0.05,with 161lncRNA and 653mRNA up-regulated,519lncRNA and 819mRNA down-regulated between ESCC and its adjacent normal esophageal tissues. Gene ontology and pathway analysis results suggested that the differentially expressed genes were involved in 11 pathways.Theyare potentially associated with esophageal squamous cell carcinoma ,including post-translational protein modification ,mucin type O-Glycan biosynthesis and sphingolipid metabolism pathways , which mainly related to the changes of molecular function ,cellular components and biological processes. Through cis and trans analysis,a total of 15 differentially expressed lncRNA had cis-and/or trans-regulated target genes in the database,with 13 lncRNA had cis-regulated target genes,3 lncRNA had trans-regulated target genes,and 1 lncRNA had both cis- and trans-regulated target genes. Conclusion Compared with adjacent normal tissues ,a large number of lncRNA were expressed differentially in ESCC in Xinjiang Han people.Aberrantly expressed lncRNA may play important roles in ESCC development and progression through some signaling pathways ,which are of great significance for further search of new targets for the diagnosis and treatment of ESCC.
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One of the effective methods to resolve the conflict between the ever-increasing medical demands and relatively limited medical resources is to improve the work efficiency of the medical institutions as well as to effectively control their operating cost through continuous reforms and improvements of the management modes in the medical industry.The Lean Management and Six Sigma Management theories which have been applied in manufacturing industry and service industry are now gradually being introduced to clinical medicine.This article systematically describes the Lean Management and Six Sigma Management theories and illustrates some examples of its application in health management renovation and the effects achieved.
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Objective To explore current situation of hospital outpatient injection room infection and to discusse relevant countermeasures of infection control .Methods A retrospective analysis was conducted in 245 patients admitted and got infected in our hospital outpatient department injection room from October 2012‐to October 2013 .By analyzing its infection type ,treatment time ,age ,etc .,and in winter and items ,air ,medical staff hand in spring and summer and fall of hospital respectively we understand the hospital infection and the seasonal relationship ,the related factors of hospital infection ,and develop targeted and effective inter‐vention measures .Results The outpatient injection room infection were mainly occurred in respiratory system and digestive sys‐tem ,the occurrence rates were 54 .29% (133/245) ,25 .31% (62/245) ,respectively .The infection rate of treatment time> 7 d (2 .74% ) apparently higher than < 7 d (1 .09% ) (χ2 = 56 .246 ,P= 0 .000) .The infection rate of people whose age over 40 (1 .91% )apparently higher than age < 40 (1 .13% ) (χ2 = 12 .316 ,P= 0 .000) .The qualified rate of atmosphere in Winter and Spring (68 .46% ) was significantly lower than summer and autumn (89 .23% ) (P<0 .05) ,the qualified rates of surfaces and hands of medical staffs (84 .62% ,82 .31% ) were significantly higher than summer and autumn(63 .08% ,66 .15% ) .Conclusion The out‐patient injection room infections were related to a variety of factors ,we could carry on the comprehensive analysis and formulate specific interventions to reduce hospital infection .
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Substituting the value-added tax for business tax was one of the main content of the current implementation of structural tax cutting.As the policy fully implemented,it put forward how to strengthen the management of public hospital in tax and accounting cohesion measures around the public hospital tax changes and the resulting effects.
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Since the State Council approved and issued the law of The People's Republic of China Government Procurement Regulations(Draft),from the perspective of internal control,regarding internal control environment,risk assessment and evaluation,internal control supervision and other elements,it explored and analyzed the existing problems and improvement measurement for government procurement business in public hospitals,summarized the highlights and deficiencies to provide enlightenment for improving internal control level of public hospitals.
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Objective To investigate the incidence of subclinical hypothyroidism (SCH) during the third trimester of pregnancy and its effects on pregnancy outcomes and neonatal hypothyroidism.Methods A total of 10 695 women in the third trimester of pregnancy (28-42 weeks of gestation) who labored from January 1,to December 31,2012 in Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University were enrolled.The levels of thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) of the mothers were quantified by electrochemical immunoassay.The time-resolved fluorescence immunoassay was used to detect neonatal thyroid hormone levels.Using t test or x2test,the incidence of adverse pregnancy outcomes was compared between SCH group and euthyroid group and between SCH women with positive (n=40) or negative TPOAb (n=176).Results The incidence of SCH was 2.02％ (216/10 695) and the positive rate of TPOAb in SCH women was 18.5％ (40/216).No neonatal thyroid dysfunction was found.According to the age matched,222 cases were randomly selected as controls from 7 757 euthyroid women.Compared with the controls,SCH women had a higher incidence of premature rupture of membranes [28.7％ (62/216) vs 14.9％ (33/222),x2=12.34],anemia [11.6％ (25/216) vs 4.1％ (9/222),x2=8.65],pregnancy-induced hypertension [9.7％ (21/216) vs 4.5％ (10/222),x2=4.53],premature labor [8.8％ (19/216) vs 3.6％ (8/222),x2=5.10] and intrahepatic cholestasis of pregnancy [8.3％(18/216) vs 2.3％ (5/222),x2=8.14] (all P＜0.05).The overall incidence of adverse pregnancy outcomes was also higher in SCH group than in the controls [69.4％ (150/216) vs 49.5％ (110/222),x2=17.96,P＜0.01].The incidence of fetal growth restriction and still birth in SCH mothers with positive TPOAb was higher than in those with negative TPOAb [7.5％ (3/40) vs 0.0％ (0/176),x2=13.32,P＜0.01; 2.5％ (1/40) vs 0.0％ (0/176),x2=4.40,P＜0.05],but there was no significant difference in the overall incidence of adverse pregnancy outcomes compared with TPOAb-negative mothers [65.0％ (26/40) vs 70.5％ (124/176),x2=0.46,P=0.50].Conclusions SCH diagnosed in the third trimester may lead to adverse pregnancy outcomes.Early screening for thyroid dysfunction is necessary.
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Neuropsychiatric systemic lupus erythematosus (NP-SLE) is more common in young woman but not yet in people over 75 years old.We report a case of NP-SLE in an old woman,who complained of tremor,hypermyotonia and gatism.The lab examinations showed strong positive (1∶3200) ANA,decreased levels of CH50,C3,C4,WBC,RBC,PLT,anti-ds-DNA(+),anti-Sm(+),SSA(+),PO(+),RO-52(+),urine blood (+) and protein (+).The proteins,MBPand IgGin CSF were increased.Head MRI scan showed many demyelination in bilateral intra ventricular and multiple patchy irregular long T1 and T2 signal under right parietal subcortical.The patient was immediately given methylprednisolone hormone therapy,combined with gamma globulin and hydroxychloroquine.After 4 days of treatment,most symptoms such as tremor and hypermyotonia disappeared.Laboratory tests showed that all immune markers changed better in three weeks.The patient was discharged in 4 weeks.it must be identified with cerebrovascular disease,Parkinson's disease and other common diseases in elderly people.It can be improved if the diagnosis and treatment of NP-SLE is immediately and the illness is well controlled.
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Echinomycin is a small-molecule inhibitor of hypoxia-inducible factor-1 DNA-binding activity, which plays a crucial role in ovarian ovulation in mammalians. The present study was designed to test the hypothesis that hypoxia-inducible factor (HIF)-1alpha-mediated endothelin (ET)-2 expressions contributed to ovarian ovulation in response to human chorionic gonadotropin (hCG) during gonadotropin-induced superuvulation. By real-time RT-PCR analysis, ET-2 mRNA level was found to significantly decrease in the ovaries after echinomycin treatment, while HIF-1alpha mRNA and protein expression was not obviously changed. Further analysis also showed that these changes of ET-2 mRNA were consistent with HIF-1 activity in the ovaires, which is similar with HIF-1alpha and ET-2 expression in the granulosa cells with gonadotropin and echinomycin treatments. The results of HIF-1alpha and ET-2 expression in the granulosa cells transfected with cis-element oligodeoxynucleotide (dsODN) under gonadotropin treatment further indicated HIF-1alpha directly mediated the transcriptional activation of ET-2 during gonadotropin-induced superuvulation. Taken together, these results demonstrated that HIF-1alpha-mediated ET-2 transcriptional activation is one of the important mechanisms regulating gonadotropin-induced mammalian ovulatory precess in vivo.
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Animals , Female , Humans , Rats , Cells, Cultured , Chorionic Gonadotropin/pharmacology , Echinomycin/pharmacology , Endothelin-2/genetics , Gonadotropins, Equine/pharmacology , Granulosa Cells/drug effects , Hypoxia-Inducible Factor 1, alpha Subunit/antagonists & inhibitors , Oligonucleotides/genetics , Ovary/cytology , Rats, Sprague-Dawley , Superovulation/drug effects , Transcriptional ActivationABSTRACT
Objective To evaluate the effect of Ganoderma lucidum on drug resistance of the cisplantin-resistant ovarian cancer cell line(A2780CP).Methods The A2780CP cells were randomly divided into control group and test group.The cells in control group and test group were incubated in culture media alone and in culture media containing Ganoderma lucidum 0.5 mg/ml for 48 h respectively.The resistance index(RI) of A2780CP was determined by WST-1 assay.The expression of Akt,Bcl-2 and p53 protein was measured by Western blot.Results The RI was significantly deeressed,the expression of Akt and Bcl-2 protein was down-regulated,while p53 protein expression was up-regulated in test group as compared with control group(P<0.05).Conclusion Ganoderma lueidum can reduce the resistance of A2780 CP cells to cisplantin by down-regulating the expression of Akt and Bcl-2 and up-regulating p53 expression in A2780CP cells.
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@#Objective To investigate the effects of recombinant tissue-type plasminogen activator (rt-PA) combined with mild hypothermia on the hemorrhagic transformation after cerebral ischemia-reperfusion within or out of the therapeutic time window in rats.Methods The focal cerebral ischemia-reperfusion 3 and 4 hours models of rats were established by middle cerebral artery occlusion (MCAO) 3 or 4 hours. The rats were randomly divided into the normal saline group (group NS), normothermia rt-PA group (group rt-PA), rt-PA combined with hypothermia group (group rt-PA +HT), and sham-operation group. Brain mild hypothermia was achieved after ischemia reperfusion and maintained 3 hours. Rats were sacrificed 24 h after ischemia reperfusion, and the amount of bleeding was measured.Results The amount of bleeding significantly reduced in the group rt-PA+HT compared with group rt-PA, which obviously increased in the group rt-PA compared with group NS ( P<0.05); there was a significant difference between rt-PA groups MCAO 3 hours and 4 hours ( P<0.05).Conclusion rt-PA can increase hemorrhagic transformation volume; hemorrhagic transformation volume is higher if treated by rt-PA within 3 h therapeutic time window than treated beyond the time window; mild hypothermia should possibly prevent the development of hemorrhagic transformation and prolong the therapeutic time window of thrombolytic intervention in ischemic stroke.