Study of the association of lncRNA-GAS5 gene polymorphisms with systemic lupus erythematosus in Guangxi population / 中华医学遗传学杂志

OBJECTIVE@#To assess the association of rs55829688 and rs75315904 polymorphisms of the lncRNA-GAS5 gene with susceptibility to systemic lupus erythematosus (SLE) in Guangxi population.@*METHODS@#Peripheral venous blood samples were collected from the SLE group and control group. Following extraction of genomic DNA, SNPscan and Sanger sequencing were carried out to determine the genotypes for the rs55829688 and rs75315904 loci of the lncRNA-GAS5 gene.@*RESULTS@#No difference was found between the two groups with regard to the genotypic frequencies for rs55829688 and rs75315904 (P > 0.05). However, the frequencies of C allele of rs55829688 between the two groups was significantly different (P < 0.05). In the SLE group, the frequencies of C allele and CT+CC genotype for rs55829688 among SLE patients with nephritis were significantly lower than those of SLE patients without nephritis (P < 0.05). In addition, haplotype analysis showed that the frequency of rs55829688 C/rs75315904 A allele in the SLE group was lower than that of the control group (P < 0.05).@*CONCLUSION@#In Guangxi population, the carrier status of rs55829688 C allele of the lncRNA-GAS5 gene may reduce the risk of SLE and its complicated nephritis, and the rs55829688 C/rs75315904 A haplotype may reduce the risk for SLE.

Analysis of Epstein-Barr virus activity and clinical characteristics in patients with hemorrhagic fever with renal syndrome / 中华地方病学杂志

Objective:To study the Epstein-Barr virus (EBV) activity and its clinical characteristics in patients with hemorrhagic fever with renal syndrome (HFRS). Methods:From January 2016 to August 2017, patients with HFRS who were hospitalized in the First Affiliated Hospital of Harbin Medical University were routinely tested by EBV serology, and were divided into two groups according to their presence or absence of EBV infection, namely EBV active group and non-EBV active group. The clinical data between the two groups were compared and analyzed by SPSS 18.0.Results:A total of 188 HFRS patients were enrolled, including 73 cases in EBV active group and 115 cases in non-EBV active group. The EBV active rate of HFRS patients was 38.83% (73/188). The incidences of lumbago [57.53% (42/73) vs 42.61% (49/115)], abdominal pain [42.47% (31/73) vs 20.00% (23/115)], skin and mucosa congestion [57.53% (42/73) vs 39.13% (45/115)], and conjunctiva edema [50.68% (37/73) vs 28.70% (33/115)] in EBV active group were significantly higher than those in non-EBV active group (χ 2 = 3.983, 11.008, 6.083, 9.239, P < 0.05). There were 10, 7 and 43 patients with acute kidney injury (AKI) stage 1, 2 and 3 in EBV active group and 5, 13 and 53 patients in non-EBV active group. Degree of AKI in EBV active group was higher than that in non-EBV active group, and the difference was statistically significant (χ 2 = 12.615, P < 0.05). In EBV active group, the proportion of patients whose renal function recovery over 15 days [23.29% (17/73)] and white blood cell count [11.26 (3.39 ~ 54.23) × 10 9/L] were significantly higher than those in non-EBV active group [6.96% (8/115), 10.03 (2.91 ~ 66.99) × 10 9/L], and the differences were statistically significant (χ 2 = 10.330, Z = - 2.003, P < 0.05). Conclusion:HFRS patients may cause latent EBV activity, complicate their clinical features, cause severe renal damage and prolong the recovery time of renal function.

Effect of different asparaginase on the incidence of drug-induced diabetes in children with acute lymphoblastic leukemia during combined chemotherapy / 中国基层医药

Objective:To observe the effect of different asparaginase on the incidence of drug-induced diabetes in children with acute lymphoblastic leukemia(ALL) during combined chemotherapy.Methods:A total of 100 ALL children hospitalized in Zhucheng People's Hospital from January 2016 to December 2018 were selected in this study.According to the difference of asparaginase, 67 cases were divided into L-asparaginase group, and 33 cases were divided into pegaspargase group.The demographic, clinical indicators and remission after chemotherapy were compared between the two groups, and logistic regression model was used to analyze the influencing factors of diabetes mellitus during treatment.Results:There were statistically significant differences in random blood glucose ( t=2.515, P=0.014), albumin ( t=2.407, P=0.018), serum C-peptide ( t=2.030, P=0.045) and diabetes mellitus ( t=5.380, P=0.002) between the two groups after chemotherapy ( P<0.05). During chemotherapy, drug-induced diabetes mellitus had the highest incidence in induction remission period.The incidence of the L-asparaginase group (31.3%, 21/67) was higher than that of the pegaspargase group (12.1%, 4/33) (χ 2=4.357, P=0.037). Age (χ 2=7.748, P=0.005), risk stratification (χ 2=10.500, P=0.005) and types of chemotherapeutic drugs (χ 2=7.752, P=0.005) were independent influencing factors for the occurrence of drug-induced diabetes in children with ALL during chemotherapy ( P<0.05). The older the age, the greater the risk of diabetes mellitus during chemotherapy.The risk of drug-induced diabetes mellitus in pegaspargase group was 0.107 times higher than that in L-asparaginase group.The risk of drug-induced diabetes in high-risk children was 9.916 times higher than that in low-risk children. Conclusion:Drug-induced diabetes mellitus in ALL children treated with asparaginase combined with chemotherapy mainly occurs in the early stage of chemotherapy.The risk of drug-induced diabetes mellitus in ALL children treated with L-asparaginase combined with chemotherapy is higher than that of pegaspargase.Pegaspargase combined with chemotherapy in the treatment of ALL children can effectively reduce the incidence of drug-induced diabetes during chemotherapy.

Clinical value of megakaryocytes in the diagnosis and treatment of children with immune thrombocytopenic purpura / 中国基层医药

Objective@#To analyze the clinical value of megakaryocytes in the diagnosis and treatment of children with immune thrombocytopenic purpura(ITP).@*Methods@#From June 2014 to January 2018, the clinical data of 110 children with ITP diagnosed and treated in Zhucheng People's Hospital Affiliated to Weifang Medical College were analyzed and followed up for more than 1 year.The children were divided into two groups according to whether the duration of the disease was morethan 12 months(chronic group and non-chronic group). Gender, age, initial course of disease, platelet count, lymphocyte count, megakaryocyte count, white blood cell count, and initial treatment regimen were analyzed and compared between the two groups.Multivariate analysis was used to analyze the independent influencing factors of chronic ITP.The clinical value of the initial diagnosis and lymphocyte counts in evaluation of the effects of chronic ITP and initial treatment were analyzed.The clinical value of megakaryocyte in the assessment of initial treatment was analyzed.@*Results@#The initial course of disease[(5.8±2.26)d]and megakaryocyte count[(210.28±98.67)/piece] in the chronic groupwere higher than those in the non-chronic group[(3.57±2.05)d, (165.26±78.35)/piece], and the lymphocyte count[(2.87±0.90)×109/L] in the chronic groupwas lower than that in the non-chronic group[(3.66±1.12)×109/L], the differences were statistically significant(t=4.824, 2.299, 3.545, all P<0.05). Megakaryocyte count was not an independent factor of chronic ITP(P>0.05). The initial course of disease was a risk factor for chronic ITP(OR=3.826), while lymphocyte count was a protective factor(OR=0.471). The initial course of disease was evaluated as AUC=0.648 for chronic ITP, with an optimal cut-off value of 4.5 days, a sensitivity of 65.4%, and a specificity of 62.5%.Lymphocyte counts was evaluated as AUC(area under the ROC curve)=0.648 for chronic ITP, the optimal cut-off value was 3.01×109/L, the sensitivity was 59.4%, and the specificity was 78.2%.The initial course of disease and lymphocyte count had no significant value in evaluation of the treatment outcome (P<0.05). The initial treatment of patients with increased megakaryocyte counts was better than those with the normal level, and the difference was statistically significant(Z=6.051, P<0.05).@*Conclusion@#The initial course of disease and lymphocyte count can help to assess the duration of ITP in children.Patients with increased bone marrow megakaryocyte counts can achieve better results at initial treatment.

Application of mind mapping in the training of general residents / 中华医学教育探索杂志

Objective To explore the application method and value of mind mapping in the clinical teaching of general practitioners for the purpose of improving the teaching qualities. Methods A total of 60 GPs were divided into the test group and control group, undergoing the mind mapping teaching and tra-ditional teaching, respectively. The clinical knowledge achievements were compared in the two groups, and the results were analyzed. At the same time, a questionnaire was conducted. Results The difference between two groups in theoretical teaching was statistically significant (P<0.05), and there was no significant difference in physical examination (P>0.05). In addition, the results of the questionnaire survey showed that the test group was better than the control group in medical knowledge, self-learning ability, interpersonal communication ability, team cooperation ability and other dimensions. Conclusion Mind mapping is an effective teaching tool for general practitioners.

Effect of nucleos (t)ide analog antiviral treatment on the pathological differentiation and prognosis of ;hepatitis B virus-related hepatocellular carcinoma / 中华传染病杂志

Objective To explore the effect of nucleos(t)ide analog (NA)antiviral treatment on the pathological differentiation of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)and the prognostic factors of HCC.Methods Totally 127 patients with HBV-related HCC who were hospitalized and received partial hepatectomy in First Affiliated Hospital of Harbin Medical University from March 2007 to November 2013 were included in this study.Sixteen cases received antiviral treatment before operation and the remaining 111 cases had no history of NA treatment.The differences of histopathological grading were compared between the two groups.Twenty-nine patients received antiviral treatment for the first time after surgery,and the rest 82 patients did not.All these patients were followed up for survival and recurrence.Multivariate analysis was used to explore the prognostic factors for HCC.The categorical variables were analyzed byχ2 test or Fisher exact test.Survival rate was compared with Log-rank test. Univariate or multivariate Cox regression analysis was used to explore the related factors of survival. Results The proportions of well-,moderately- or poorly-differentiated HCC in patients with antiviral treatment before surgery were 18.75 %,68.75 % and 12.5 %,respectively.Whereas the proportions in those without treatment were 16.22%,66.67% and 17.11 %,respectively.There was no significant difference in histopathological grading of HCC between the two groups (χ2=0.224,P =0.885 ).The overall median survival time was 39 months.The 6-month,1-and 2-year survival rates were 91 .7%, 77.5 % and 59.3%,respectively.The 6-month,1- and 2-year survival rate of postoperative antiviral treatment were 96.3%,92.4% and 78.5 %,respectively,which were significantly higher than those of no antiviral treatment group (85 .9%,70.0% and 48.5 %,respectively;χ2= 6.967,P = 0.008 ). Univariate analysis showed that tumor number,size,portal vein transfer,AFP level,postoperative antiviral treatment,histopathological grading,TNM staging,BCLC staging,γ-GT and PTA were prognostic factors for postoperative HCC survival.Multivariate analysis showed that AFP level (HR=1 , 95 %CI :1 .0004—1 .002,P =0.004),postoperative antiviral treatment (HR =0.38,95 %CI :0.38—0.15 ,P =0.04)and BCLC stage (B vs A:HR=1 .55 ,95 %CI :0.76—3.18;C vs A:HR=3.63,95 %CI :1 .31 —10.09,P =0.04)were independent prognostic factors.Conclusions Preoperative antiviral treatment has no impact on the histopathological grading of HCC. BCLC stage, AFP level and postoperative antiviral treatment are independent prognostic factors for HBV-related HCC.

Application value of procalcitonin quantitative detection in diagnosis of pediatric bloodstream infection / 国际检验医学杂志

Objective To explore the application value of serum procalcitonin(PCT)quantitative detection in diagnosing pediat-ric bloodstream infection.Methods The results of 183 cases of blood culture and simultaneous PCT detection in a hospital from February to November 2013 were analyzed retrospectively.The patients were divided into the non-bloodstream infection group and the bloodstream infection group according to the blood culture results as the golden standard.The differences of serum PCT concen-tration were compared between the two groups by the Mann-Whitney U test.Results The serum PCT concentration was 0.15 (0.065-0.55)ng/mL in the non-bloodstream infection group and 1.11(0.505-8.975)ng/mL in the bloodstream infection group, the difference was statistically significant(P =0.000);with 0.50ng/mL as the cut-off value of diagnosis,the sensitivity and the spe-cificity of PCT was 77.8% and 73.3% respectively,the positive and pegative predictive value of PCT was 24.1% and 96.8% re-spectively.Conclusion The quantitative detection of PCT can assist in rapidly diagnosing or excluding bloodstream infection and provides reference for avoiding the overuse of antibiotics or conducting the early anti-infection therapy.

Correlation between platelet-associated antibody and platelet infusion effects / 中国基层医药

Objective To investigate the correlation between platelet-associated antibody and platelet infusion effects.Methods SEPSA was used to detect the platelet-associated antibody of 79 patients with multiple transfusions of platelet,the platelet count before and after platelet infusion was monitored and the corrected count increment (CCI) in lh and 24h were calculated,for those judged to be ineffective platelet infusion,the platelet cross-matching was first done and then received matching infusion again and the infusion effects were analysed. Results 47 cases were detected with platelet antibody positive in 79 patients,accounting for 59.5％ ,the CCI of lh and 24h after infusion in platelet antibody positive group were significantly lower than the negative group, the difference was statistically significant( t = 2. 462、2. 583, all P ＜ 0. 05 ) ;40 cases in positive group had the invalid with the invalid rate of 85.1％which was significantly higher than the negative group, the difference was statistically significant ( x2 = 34. 46, P ＜0. 05 ) ;the CCI of 1h and 24h after infusion in matching success group were significantly higher than the unsuccessful group, the difference was statistically significant( t = 2. 152、2. 230, all P ＜ 0. 05) ;27 cases in matching success group had the effective infusion with the effective rate of 87. 1％ ,which was significantly higher than the unsuccessful group, the difference was statistically significant ( x2 = 4. 34, P ＜ 0. 05). Conclusion The production of anti-platelet antibody was a major immune factor which lead to platelet transfusion refractoriness ,the blood platelet cooperative infusion could be a good solution for the platelet transfusion refractoriness.