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1.
Chinese Journal of Trauma ; (12): 324-330, 2023.
Article in Chinese | WPRIM | ID: wpr-992605

ABSTRACT

Objective:To investigate the factors affecting postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after severe traumatic brain injury (sTBI).Methods:A case-control study was conducted to analyze the clinical data of 55 patients with prolonged disorders of consciousness after sTBI admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University and Seventh Medical Center of PLA General Hospital from September 2021 to September 2022. There were 33 males and 22 females, with the age range of 13-68 years [(43.0±15.5)years]. All patients were assessed for the consciousness level using the coma recovery scale-revision (CRS-R) preoperatively and within 48 hours postoperatively. A total of 33 patients were observed in vegetative state and 22 in minimally conscious state preoperatively. The consciousness level was found to be improved in 26 patients (consciousness- improved group), but not improved in the remaining 29 patients (consciousness-unimproved group). Indicators were documented including gender, age, cause of injury, Glasgow coma score (GCS) on admission, course of injury, preoperative consciousness level, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade, analgesic regimen and sedation maintenance drugs. A univariate analysis was conducted first to assess those indicators′ correlation with postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI. Multivariate Logistic regression analysis was then used to determine the independent risk factors for their postoperative short-term improvement of consciousness level.Results:Univariate analysis showed that GCS on admission, course of injury, preoperative consciousness level and analgesic regimen were correlated with short-term improvement of postoperative consciousness level in patients with prolonged disorders of consciousness after sTBI (all P<0.05), whereas gender, age, cause of injury, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade and sedation maintenance drugs showed no relation to the improvement of postoperative consciousness level (all P>0.05). Multivariate Logistic regression analysis showed that the GCS ≥7 points on admission ( OR=0.06, 95% CI 0.01, 0.36, P<0.01), preoperative minimally conscious state ( OR=0.09, 95% CI 0.02, 0.40, P<0.01) and intraoperative use of Sufentanil combined with Remifentanil ( OR=0.07, 95% CI 0.01, 0.43, P<0.01) were significantly correlated with postoperative improvement of consciousness level. Conclusion:The GCS on admission (≥7 points), preoperative minimally conscious state and intraoperative use of Sufentanil combined with Remifentanil are independent risk factors affecting short-term postoperative improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI.

2.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 308-315, 2023.
Article in Chinese | WPRIM | ID: wpr-992094

ABSTRACT

Objective:To observe the lipid-lowering effect of atorvastatin on patients with acute cerebral infarction with different ATP-binding cassette subfamily B member 1(ABCB1) genotypes, and thus to provide clinical research evidence for individual application of atorvastatin in patients with acute cerebral infarction.Methods:From March 2021 to December 2021, 131 patients with acute cerebral infarction admitted to the Department of Neurology of Xuchang Central Hospital were included. The ABCB1 G2677T gene polymorphism rs2032582 of patients was detected by fluorescence staining in situ hybridization.Based on the detection results, patients were divided into GG group, GT group and TT group.All patients were given atorvastatin (20 mg/d) for lipid-lowering treatment.The levels of low density lipoprotein cholesterol(HDL-C), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC)and triglyceride(TG) in serum of patients in the three groups before and 2 months after treatment were recorded and analyzed.The adverse drug reactions in the three groups were recorded. When the serum LDL-C level was less than 1.8 mmol/L, it was considered that the lipid-lowering treatment was effective.The binary Logistic regression analysis was used to explore the influencing factors of atorvastatin lipid lowering therapy.The software of SPSS 25.0 was used for statistical analysis.Results:There were 50 (38.17%), 49 (37.40%) and 32 (24.43%) patients in GG group, GT group and TT group, respectively. The serum TC levels of patients in GG group, GT group and TT group after treatment were (3.47±0.70) mmol/L, (3.59±1.09) mmol/L and (3.48±1.02) mmol/L, respectively, which were lower than those before treatment ((4.27± 0.99) mmol/L, (4.02±0.98) mmol/L and (4.03±1.31) mmol/L), all of which were statistically significant ( t=7.652, 3.092, 5.593, all P<0.01). The serum LDL-C levels in GG group, GT group and TT group after treatment were (1.89±0.53) mmol/L, (2.07±0.92) mmol/L and (1.96±0.79) mmol/L, respectively, which were lower than those before treatment ((2.87±0.92) mmol/L, (2.56±0.89) mmol/L and (2.55±1.11) mmol/L) ( t=9.896, 4.055, 5.980, all P<0.001). The differences of serum LDL-C level before and after treatment in GG group, GT group and TT group were (-0.97±0.69) mmol/L, (-0.50±0.86) mmol/L and (-0.59±0.56) mmol/L, respectively. The difference of serum LDL-C level before and after treatment in the three groups was statistically significant ( F=5.614, P=0.005). The difference of TC, TG and HDL-C before and after treatment was not statistically significant( F=2.783, 0.490, 1.677, all P>0.05). The binary Logistic regression analysis showed that ABCB1 G2677T gene type and staying up late were independent influencing factors for atorvastatin lipid-lowering therapy. The probability of effective lipid-lowering in GT patients with ABCB1 G2677T gene was 27.9% of that in GG patients ( OR=0.279, 95% CI: 0.110-0.709, P=0.007), and the probability of TT type patients was 33.8% of GG type patients ( OR=0.338, 95% CI: 0.121-0.943, P=0.038). The probability of effective lipid-lowering in patients who had the habit of staying up late was 26.4% of the patients who did not stay up late ( OR=0.264, 95% CI: 0.118-0.591, P=0.001). There was no significant difference in the total incidence of adverse drug reactions among the three groups( χ2=0.868, P=0.648). Conclusion:The lipid-lowering effect in patients with GG type of ABCB1 G2677T is better than that of GT type and TT type when atorvastatin is used to treat patients with acute cerebral infarction.

3.
Chinese Journal of Radiological Health ; (6): 17-22, 2022.
Article in Chinese | WPRIM | ID: wpr-973571

ABSTRACT

Objective To study gross α and gross β radioactivity in environmental samples in Wuxi, China, and perfect the radioactivity data, and to discover possible radioactive contamination in time. Methods The BH1227 low-background α and β measuring instrument was used to determine gross α and gross β radioactivity in sedimentary dust, aerosol, drinking water, and food samples in Wuxi. Results Among environmental samples collected in Wuxi, 2014—2019, the mean gross α and gross β radioactivity levels were 0.01~5.98 Bq/kg and 9.47~547.86 Bq/kg in food samples, respectively, 1.2~22 mBq/L and 0.1~141 mBq/L in water samples, respectively, 39~44790 mBq/m3 and 743.1~101500 mBq/m3 in sedimentary dust samples, respectively, and 50~1125 μBq/m3 and 38~9510 μBq/m3 in aerosol samples, respectively. Conclusion We should strengthen radioactivity monitoring of environmental samples in Wuxi through increasing the scope and frequency of monitoring, to perfect baseline radioactivity data of Wuxi.

4.
Chinese Journal of Pancreatology ; (6): 278-282, 2022.
Article in Chinese | WPRIM | ID: wpr-955492

ABSTRACT

Objective:To investigate the role of caspase recruitment domain protein 9(card9) from macrophage in pancreatic acinar-to-ductal metaplasia.Methods:Card9 siRNA1, card9 siRNA2 and card9 siRNA3 were constructed; fluorescence microscopy was used to investigate the fluorescence intensity of macrophages, and real-time quantitative PCR method was performed to detect the expressed level of card9 mRNA to obtain the best transfection rate. 100 μg/ml β glucan was added into 5×10 5 macrophages in vitro culture for 12 or 24 hours, which were divided into positive group (macrophages), β glucan-stimulated positive group (β dextran+ macrophage), negative group (card9 -/- macrophage) and β glucan-stimulated negative group (β dextran+ card9 -/- macrophages). Western blotting was applied to determine the protein level of card9 in macrophages. Then, 1×10 5 macrophages and 1×10 5 pancreatic acinar cells were co-cultured in upper and lower transwell chamber in vitro for 120 hours, which were divided into positive group (macrophages+ acinar cells), 100 μg/ml and 500 μg/ml β glucan-stimulated positive group, negative group (card9 -/- macrophage+ acinar cell), 100 μg/ml and 500 μg/ml β glucan-stimulated negative group. Pancreatic acinar cells in the lower chamber were collected and immunofluorescence was applied to assay the duct metaplasia marker CK19 protein expression. Results:At 24 hours of transfection using siRNA, the intracellular fluorescence intensity in macrophages reached a peak. Card9 siRNA at the concentration of 200 nmol/l showed the highest interference efficiency. Card9 protein in positive group, β glucan-stimulated positive group, negative group, and β glucan-stimulated negative group were 0.81±0.05, 1.46±0.05, 0.42±0.06 and 0.46±0.06, respectively; card9 expression in β glucan-stimulated positive group was obviously higher than that in positive cell group, and the difference was statistically significant ( P<0.05). Finally, after 100 or 500 μg/ml β glucan stimulation, the green fluorescence in pancreatic acinar cells increased significantly compared with positive group, exhibiting β glucan concentration dependence. Conversely, CK19 protein in negative group and 100 and 500 μg/ml β glucan-stimulated negative group was obviously decreased compared with positive group. Conclusions:The expression level of card9 in macrophages can induce acinar-to-ductal metaplasia, indicating that card9 may mediate in the pathogenesis of pancreatic cancer.

5.
Journal of Environmental and Occupational Medicine ; (12): 1298-1303, 2022.
Article in Chinese | WPRIM | ID: wpr-960562

ABSTRACT

Background Acute exposure to mercury chloride (HgCl2) can cause liver damage. Whether oleanolic acid (OA) as a hepatoprotective drug can protect against liver injury induced by acute exposure to HgCl2 and related mechanism of action remain unclear. Objective To investigate the protective effect and possible mechanism of OA on liver injury in mice caused by acute exposure to HgCl2. Methods Forty SPF C57BL/6 male mice were randomly divided into four groups with 10 mice in each group according to body weight. The four groups were named control group, OA group (300 mg·kg−1), HgCl2 group (5 mg·kg−1), and OA + HgCl2 group (300 mg·kg−1 OA + 5mg·kg−1 Hgcl2). Soybean oil and OA solution were administered intragastric once a day for two consecutive days. HgCl2 solution was injected intraperitoneally 2 h after the second intragastric administration. Mice were sacrificed after 48 h, and their serum and liver were collected. Liver coefficient was calculated. The changes of liver structure and iron deposition were observed by hematoxylin-eosin (HE) staining and Prussian blue staining. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total superoxide dismutase (T-SOD), reduced glutathione (GSH), malondialdehyde (MDA), and tissue iron content were measured with commercial kits. Western blotting was used to detect nuclear factor erythroid-2 related factor 2 (Nrf2), heme oxygenase 1 (HO-1), glutathione peroxidase 4 (Gpx4), transferrin receptor 1 (TFR1,) and solute carrier family 7 member 11 (SLC7A11). Results The AST and ALT levels of the HgCl2 group were (76.447±9.695) U·g−1 and (98.563±24.673)U·g−1, respectively, which were higher than those of the control group (P<0.05). After the OA pretreatment, the liver coefficient and the above indexes were decreased to (4.769±0.237)%, (57.086±10.087) U·g−1, and (87.294±27.181)U·g−1, respectively. The liver coefficient and AST level of the OA + HgCl2 group were significantly different from those of the HgCl2 group (P<0.05). After acute exposure to HgCl2, the hepatocytes of mice were disordered, accompanied by inflammatory infiltration, positive blue particles appeared in Prussian blue staining of liver tissue, and the above changes in liver tissue were alleviated after the OA pretreatment. The iron content in the HgCl2 group was (3.646±0.238) μmol·g−1, which was higher than that in the control group, (2.948±0.308) μmol·g−1. After the OA pretreatment, the iron content decreased to (3.429±0.415) μmol·g−1. Compared with the control group, acute exposure to HgCl2 resulted in decreased levels of GSH and T-SOD, decreased protein expression levels of Nrf2, HO-1, SLC7A11, and Gpx4, increased level of MDA, and increased protein expression level of TFR1 (P<0.05). After the OA pretreatment, all indicators were improved including increased GSH level, decreased MDA level, increased Nrf2, HO-1, and SLC7A11 protein expression levels, and decreased TFR1 protein expression level; compared with the HgCl2 group, the differences were statistically significant (P<0.05). Conclusion Acute HgCl2 exposure could induce liver injury in mice, and its mechanism may involve iron overload and ferroptosis. OA may alleviate the liver injury caused by acute HgCl2 exposure by affecting iron overload and the ferroptosis-related protein expression.

6.
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6): 393-397, 2019.
Article in Chinese | WPRIM | ID: wpr-754584

ABSTRACT

Objective To observe the effects of Soyasaponins on inflammatory factors, antioxidant activity and exercise ability in rats with severe heat stroke. Methods Eighty male Sprague-Dawley (SD) rats were randomly divided into normal control group, heat shock model group, saline control group and Soyasaponin group, The rats that died during the experiment or with a low rectal temperature (< 41℃) were excluded, and finally 54 rats were included, 18 rats remaining in each group. The rats in the heat shock model group were placed in the simulated hot climate animal cabin at 30 ℃, and the temperature within 30 minutes was raised to 39 ℃ in the cabin with 65% humidity; in the mean time, the rat models of heat shock were replicated under the following situations: let the rats exercise on a treadmill with running speed set at 15 m/min, slope degree 0°, once running for 8 minutes, interval 2 minutes and the heat shock time was 90 minutes, the rats in the normal control group were fed in an environment with temperature ranging from 23-25 ℃ and relative humidity ranging from 50%-70%. After the establishment of models, the saline control group and Soyasaponin group were given daily saline and Soyasaponin (10 mg/kg) respectively by gavage for 3 consecutive months, while the heat shock model group was not given any treatment. The femoral artery blood was collected 24 hours after the rats left the cabin. The serum levels of interleukins (IL-6, IL-1β), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), malonaldehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) were measured by enzyme-linked immunosorbent (ELISA) and the contents of serum hemoglobin (Hb), serum urea (BUN), lactate dehydrogenase (LDH) and blood lactic acid (Lac) were measured by automatie biochemical analyzer. Results The levels of IL-6, IL-1β, TNF-α, IFN-γ, MDA, Hb, BUN, LDH, Lac in heat shock model group were significantly higher than those of the normal control group [IL-6 (ng/L): 86.17±4.82 vs. 12.60±3.49, IL-1β (ng/L): 83.00±5.98 vs. 15.70±3.64, TNF-α (ng/L): 72.22±6.93 vs. 13.75±2.69, IFN-γ (ng/L): 36.22±3.02 vs. 7.35±1.60, MDA (nmol/mg): 19.78±4.56 vs. 6.40±1.35, Hb (g/L): 136.22±1.93 vs. 126.75±5.84, BUN (mmol/L):21.06±3.44 vs. 5.65±1.35, LDH (μmoL·s-1·L-1): 9.65±0.83 vs. 2.12±0.17, Lac (mmol/L): 552.56±78.33 vs. 1.32±0.18, all P < 0.05], SOD and GSH-Px were significantly lower than those in normal control group [SOD (kU/L):97.89±10.57 vs. 126.65±11.35, GSH-Px (kU/L): 19.22±2.58 vs. 43.45±4.02]; however, the levels of IL-6, IL-1β, TNF-α, IFN-γ, MDA, BUN, LDH and Lac in Soyasaponin group were significantly lower than those in heat shock model group [IL-6 (ng/L): 45.28±3.54 vs. 86.17±4.82, IL-1β (ng/L): 41.61±2.93 vs. 83.00±5.98, TNF-α (ng/L):37.22±2.46 vs. 72.22±6.93, IFN-γ (ng/L): 19.22±2.60 vs. 36.22±3.02, MDA (nmol/mg): 11.28±1.74 vs. 19.78±4.56, BUN (mmol/L): 11.78±2.13 vs. 21.06±3.44, LDH (μmoL·s-1·L-1): 3.70±0.26 vs. 9.65±0.83, Lac (mmol/L): 274.56±59.08 vs. 552.56±78.33, all P < 0.01], SOD, GSH-Px and Hb were significantly higher than those of heat shock model group [SOD (kU/L): 116.11±11.28 vs. 97.89±10.57, GSH-Px (kU/L): 31.17±2.90 vs. 19.22±2.58, Hb (g/L): 141.33±3.79 vs. 136.22±1.93, all P < 0.01]; there were no significant statistical differences in above indexes between heat shock model group and saline control group (all P > 0.05). Conclusion After heat shock and exercise management, the production and release of inflammatory factors are increased, and the level of lipid peroxidation was elevated in rats. The Soyasaponin can improve the ability to withstand heat shock and strong exercise by reducing the production and release of inflammatory factors and lipid peroxidation in the rats with severe heatstroke.

7.
Chinese Critical Care Medicine ; (12): 1028-1032, 2019.
Article in Chinese | WPRIM | ID: wpr-754103

ABSTRACT

To explore the effects of different fluid replenishment methods on the internal environment, body thermal regulatory response and severe heatstroke of 5-km armed cross-country training soldiers. Methods A Special Force officers and soldiers who participated in 5-km armed cross-country training (2-3 times a week, 25-30 minutes each time for 3 weeks) during summer training from June to July in 2018 were enrolled, and they were divided into three groups according to the random number table, with 300 trainees in each group. 200 mL of drinking fluids were given to each group 15 minutes before and after each 5-km armed cross-country training: A group with boiled water, B group with purified water, and C group with beverage prepared by pharmaceutical laboratory of the 990th Hospital of PLA Joint Logistics Support Force (100 mL containing 6 g carbohydrates, 42 mg sodium, and 11 mg potassium). The venous blood was collected before and after the last training or during the onset of severe heatstroke to do the following tests: serum cardiac troponin I (cTnI, chemiluminescence), MB isoenzyme of creatine kinase (CK-MB, immunosuppressive), serum creatinine (SCr, enzymatic method), urea nitrogen (BUN, enzymatic method), alanine aminotransferase (ALT, tryptase), aspartate transaminase (AST, tryptase), and Na+, K+, Cl- (electrode method). The heart rate (HR) and core temperature (Tc, anal temperature) were monitored at the same time. The amount of sweat in training and the occurrence of severe heatstroke were also recorded. Results There was no significant difference in heart, liver, kidney function, electrolyte and body heat regulation reaction among three groups of 5-km armed cross-country trainees before training. Compared with before training, the levels of serum cTnI, CK-MB, SCr, BUN, ALT, AST, HR and Tc were significantly increased after training or during the onset of severe heatstroke in three groups, while the contents of Na+, K+, Cl- were significantly decreased, but the increase or decrease of group C was relatively smaller compared with group A and group B [cTnI (μg/L): 0.9 (0.6, 1.4) vs. 1.1 (0.7, 2.8), 1.0 (0.6, 3.3); CK-MB (U/L): 7.0 (5.0, 11.0) vs. 9.0 (6.0, 14.5), 8.0 (6.0, 15.0); SCr (μmol/L): 92.09±18.64 vs. 102.78±18.77, 103.64±20.07; BUN (mmol/L): 7 (6, 9) vs. 9 (8, 11), 10 (8, 13); ALT (U/L): 27 (22, 34) vs. 36 (30, 43), 34 (27, 43); AST (U/L): 37 (31, 48) vs. 41 (34, 50), 39 (34, 51); HR (bpm):87.01±17.07 vs. 95.88±21.06, 96.59±22.04; Tc (℃): 37.73±0.81 vs. 38.03±1.05, 38.10±1.04; Na+ (mmol/L):150.14±3.86 vs. 144.18±8.89, 144.04±9.39; K+ (mmol/L): 4.32±0.57 vs. 4.15±0.62, 4.13±0.51; Cl- (mmol/L):100.43±3.71 vs. 98.42±4.24, 98.41±4.58; all P < 0.01]. The incidence of severe heatstroke in group C was significantly lower than that in group A and group B [1.67% (5/300) vs. 5.00% (15/300), 5.33% (16/300), χ2 = 6.424, P = 0.040]. There was no significant difference in sweating volume in groups A, B, C (g: 370.47±48.71, 370.85±50.66, 370.17±50.21, F = 0.014, P = 0.986). There was no significant difference in the above indexes between group A and group B (all P > 0.05). Bi-classification Logistic regression analysis showed that the increase of HR, Tc and excessive loss of Na+, K+, Cl- were risk factors for severe heatstroke [odds ratio (OR) was 0.848, 0.138, 1.565, 17.996 and 2.328 respectively, all P < 0.01]. Conclusions Timely supplementation of carbohydrate, sodium and potassium ions can effectively change the internal environment and body heat regulation reaction of 5-km armed cross-country trainees, so as to reduce the occurrence of severe heatstroke. The increases of HR, Tc and excessive loss of Na+, K+, Cl- are risk factors for severe heatstroke.

8.
Chinese Critical Care Medicine ; (12): 890-895, 2019.
Article in Chinese | WPRIM | ID: wpr-754073

ABSTRACT

Objective To explore the relationship between training burnout, sleep quality and heat regulation response, severe heatstroke in people performed 5-km armed cross-country training. Methods 600 male officers and soldiers who participated in 5-km armed cross-country training in summer from 2017 to 2018 were enrolled. All trainees participated in 5-km armed cross-country training in environment with ambient temperature > 32 ℃ and (or) humidity > 65%. They were divided into two groups according to whether severe heatstroke occurred during 5-km armed cross-country training. The age, military age, body mass index (BMI), physical fitness score, external environment (such as ambient temperature, relative humidity, wind speed, heat index), training burnout score and Pittsburgh sleep quality index scale (PSQI) score, heart rate (HR), core temperature (Tc), sweating volume and serum Na+, K+, Cl- levels were compared between the groups. The risk factors of severe heatstroke during 5-km armed cross-country training were screened by binary multivariate Logistic regression analysis. Results There were 26 cases of severe heatstroke in 600 trainees who participated in 5-km armed cross-country training, with an incidence of 4.33%. There was no significant difference in age, military age, BMI, physical fitness score and external environment of 5-km armed cross-country training between people with or without severe heatstroke. Compared with those without severe heatstroke, the dimensions of training burnout and the total average scores of training burnout of severe heatstroke personnel before 5-km armed cross-country training were increased significantly (physical and mental exhaustion score: 12.4±2.5 vs. 9.4±3.5, training alienation score: 8.8±2.8 vs. 5.8±2.3, low sense of achievement score: 8.2±2.7 vs. 5.6±2.3, total score of training burnout: 9.8±3.2 vs. 6.9±3.2, all P < 0.01), all factors except daytime dysfunction (DD) of PSQI and total PSQI score were also increased significantly [sleep quality (SQ) score: 1.0 (1.0, 2.0) vs. 1.0 (1.0, 1.0), fall asleep time (SL) score: 2.0 (1.0, 3.0) vs. 1.0 (1.0, 1.0), sleep time (SH) score: 1.0 (0.8, 2.0) vs. 1.0 (0, 1.0), sleep efficiency (SE) score: 1.0 (0, 1.0) vs. 0 (0, 0.8), sleep disorder (SD) score: 2.0 (1.0, 3.0) vs. 1.0 (0, 2.0), total PSQI score: 1.0 (1.0, 2.0) vs. 1.0 (0, 1.0), all P < 0.01], HR was increased significantly at onset (bpm: 120.00±10.57 vs. 86.49±14.91, P < 0.01), Tc was increased significantly (℃: 41.46±0.57 vs. 37.97±0.83, P < 0.01), serum electrolyte contents were decreased significantly [Na+ (mmol/L): 130.54±5.97 vs. 143.15±10.56, K+ (mmol/L): 3.72±0.44 vs. 4.37±0.50, Cl- (mmol/L):97.58±4.80 vs. 102.10±2.39, all P < 0.01], and the amount of sweat during training was increased significantly (g: 395.81±16.16 vs. 371.88±40.76, P < 0.01). Binary multivariate Logistic regression analysis showed that total score of training burnout [odd ratio (OR) = 0.653, 95% confidence interval (95%CI) = 0.563-0.757], total PSQI score (OR =0.693, 95%CI = 0.525-0.916), HR (OR = 0.871, 95%CI = 0.838-0.908), Tc (OR = 0.088, 95%CI = 0.043-0.179), sweating volume (OR = 0.988, 95%CI = 0.979-0.997), Na+ (OR = 1.112, 95%CI = 1.069-1.158), K+ (OR = 13.900, 95%CI = 5.343-36.166), Cl- (OR = 1.393, 95%CI = 1.252-1.550) were independent risk factors for severe heatstroke during 5-km armed cross-country training (all P < 0.01). Conclusion Increase in training burnout, total PSQI score, excessive changes of body heat regulation response and excessive loss of Na+, K+, Cl- in serum are independent risk factors for severe heatstroke during 5-km armed cross-country training under the same conditions with high temperature and humidity environment.

9.
Chinese Journal of Hematology ; (12): 848-852, 2019.
Article in Chinese | WPRIM | ID: wpr-796975

ABSTRACT

Objective@#To investigate the clinic-pathological features, diagnosis and treatment of 8p11 myeloproliferative syndrome (EMS) .@*Methods@#Five patients diagnosed as EMS from Jan 2014 to May 2018 at Blood Disease Hospital, Chinese Academy of Medical Sciences were enrolled. The clinical manifestations, laboratory characteristics, treatment and outcome of these patients were summarized.@*Results@#The peripheral blood leukocyte count of 5 patients with EMS increased significantly, accompanied with an elevated absolute eosinophils value (the average as 18.89×109/L) . The hypercellularity of myeloid cells was common in bone marrow, always with the elevated proportion of eosinophils (the average as 17.24%) , but less than 5% of blast cells. The chromosome karyotype of the 5 cases differed from each other, but presenting with the same rearrangement of FGFR1 gene by fluorescence in situ hybridization technology. The average interval between onset and diagnosis was 4.8 months with a median survival of only 14 months.@*Conclusion@#EMS was a rare hematologic malignancy with poor prognosis and short survival. It was commonly to be misdiagnosed. Analysis of cytogenetics and molecular biology were helpful for early diagnosis.

10.
Chinese Journal of Endocrine Surgery ; (6): 154-158, 2019.
Article in Chinese | WPRIM | ID: wpr-743418

ABSTRACT

Objective To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin,sNGAL) and cardiovascular events in patients with chronic kidney disease(CKD).Methods 300 patients with CKD were divided into two groups according to the level of sNGAL:high sNGAL group (n=158) and low sNGAL group (n=142).The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve,and the correlation between sNGAL and cardiovascular risk factors,cardiovascular events in patients with chronic renal disease was analyzed.Influencing factors of cardiovascular events in CKD patients was analyzed.Results There were significant differences in the data about BMI,diabetes proportion,CKD staging,eGFR,hsCRP,24h proteinuria,HDL,iPTH,phosphate and blood calcium between the two groups (P<0.05).The 3-year cumulative survival rate of high sNGAL group(77.2%) was significantly lower than that of low sNGAL group(96.5%),and the 3-year incidence of cardiovascular events (37.9%) was significantly higher than that of low sNGAL group (9.8%) (P< 0.05).AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR(0.636),age (0.504),serum calcium (0.545),HDL(0.594) and LDL (0.508,all P<0.05).There was a significant correlation between sNGAL and eGFR,HDL,BMI,hs-CRP,iPTH and phosphate (P< 0.05).Both univariate and multivariate fact ors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P<0.05),((HR=1.976 and 1.588,95% CI=1.443-2.724 and 1.144-2.143,respectively,P=0.O00 and 0.000)).Conclusions The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased.sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.

11.
Chinese Journal of Biotechnology ; (12): 505-512, 2019.
Article in Chinese | WPRIM | ID: wpr-771357

ABSTRACT

Rapid reduction of postprandial blood glucose is very beneficial to diabetics. In order to shorten the onset time of recombinant insulin, the cone snail insulin G1 (cI G1) of Conus geographus was studied. First, the nucleotide sequence of recombinant cone snail proinsulin G1 (cPI G1) was designed and synthesized according to the genes of human proinsulin (hPI) and cPI G1. The codon was optimized according to Escherichia coli (E. coli) codon usage frequency. Then, the plasmid pET22b(+)-cPI G1 was constructed and the recombinant cPI G1 was expressed in E. coli BL21(DE3) host strain. The recombinant cPI G1 was then purified and cleaved specially by trypsin to generate the recombinant cI G1, and its potency is 25.9 IU/mg. Fasting blood glucose test (FBGT) and oral glucose tolerance test (OGTT) suggested that the recombinant cI G1 could rapidly reduce blood glucose in normal and streptozotocin (STZ)-induced diabetic mice, but only for a short duration. This study provides a technical reference for the development of recombinant fast-acting insulin.


Subject(s)
Animals , Humans , Mice , Conus Snail , Diabetes Mellitus, Experimental , Escherichia coli , Hypoglycemic Agents , Insulin
12.
Chinese Journal of Hematology ; (12): 889-894, 2019.
Article in Chinese | WPRIM | ID: wpr-801361

ABSTRACT

Objective@#To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison.@*Methods@#Peking University People’s Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated.@*Results@#①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories’ results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH.@*Conclusion@#The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

13.
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care ; (6): 246-249, 2018.
Article in Chinese | WPRIM | ID: wpr-706954

ABSTRACT

Objective To observe the relationship between different degree of cerebral edema and multiple organ dysfunction syndrome (MODS) of exertional heat stroke (EHS) patients. Methods The patients with EHS admitted to intensive care unit (ICU) of the 159th Hospital of PLA from June 2015 to June 2017 were enrolled. The electrical impedance perturbation coefficient (EIDC) of bilateral cerebral hemispheres were monitored at 2, 24 and 72 hours after the onset of the disease by BORN-BE non-invasive dynamic cerebral edema monitor, and the patients were divided into 9+ group, 10+ group and 11+ group according to the resistance of the measured mean impedance coefficients. Fasting venous blood of the patients were acquired after 2 hours and 72 hours of the disease, the levels of serum interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nitric oxide (NO), nitric oxide synthase (NOS), cardiac troponin I (cTnI), MB isoenzyme of creatine kinase (CK-MB), creatinine (Cr), β2-microglobulin (β2-MG), alanine aminotransferase (ALT) and aspartate transaminase (AST) were detected. The occurrence of MODS within 72 hours was recorded. Linear regression analysis of the correlation between EIDC and MODS was done. Results All 124 EHS patients were male; the age was (22.10±4.43) years. Among them, 20 in EIDC 9+ group, 61 in 10+ group, and 43 in 11+ group. There were no significant differences in the levels of IL-1β, TNF-α, NO, NOS, cTnI, CK-MB, Cr, β2-MG, ALT, AST after onset of 2 hours among different EPIC groups; all the indexes of 72 hours were significantly higher than those of 2 hours in each group; and the higher the EIDC, the more obvious increase of each index [EIDC 9+ group, 10+ group, 11+ group at 72 hours IL-1β (ng/L): 12.05±3.75, 18.49±7.94, 23.21±10.44;TNF-α (ng/L): 13.10±3.18, 18.92±7.23, 23.40±10.17; NO (μmol/L): 99.50±12.10, 111.41±17.75, 120.81±15.58;NOS (kU/L): 47.95±8.33, 56.70±12.12, 63.37±12.60; cTnI (ng/L): 92.75±20.92, 107.20±18.96, 117.30±14.53;CK-MB (U/L): 73.55±9.25, 83.23±13.19, 93.49±12.25; Cr (μmol/L): 165.30±9.41, 176.62±9.83, 180.09±10.14;β2-MG (mg/L): 16.45±2.68, 19.07±3.68, 22.05±3.93; ALT (U/L): 500.10±87.05, 563.90±91.28, 612.16±90.61, AST (U/L): 414.30±53.35, 470.51±73.83, 512.09±81.29, respectively, two-two comparison all P < 0.05], the higher of the MODS incidence [40.00 % (8/20), 65.57% (40/61), 83.72% (36/43), x2= 12.199, P = 0.002]. Linear regression analysis showed that the degree of cerebral edema was positively correlated with the incidence of MODS (R2= 0.905, P = 0.002). Conclusion The higher of the EIDC, the more severe of cerebral edema, the stronger of the inflammatory reaction, and the more severe damage of heart, liver, kidney and other organs in EHS patients within 72 hours.

14.
Chinese Critical Care Medicine ; (12): 599-602, 2018.
Article in Chinese | WPRIM | ID: wpr-703697

ABSTRACT

Objective To investigate the effects of heat acclimatization training on the inflammatory reaction and multiple organ dysfunction syndrome (MODS) in patients with exertional heat stroke (EHS). Methods 600 officers and soldiers from a special team who participated in 5 km armed wild training from June to July 2017 were selected as the research object, while 30 healthy officers and men who did not participate in armed wild training during the same period were selected as normal controls. The officers and soldiers who participated in 5 km armed wild training (ambient temperature > 35 ℃, humidity > 65%, 2-3 times a week for 3 weeks) were divided into heat acclimatization group and non-acclimatization group, with 300 in each group. The heat acclimatization group first took part in the heat acclimatization training of wild or long distance running (the initial temperature was 30 ℃, gradually transferred to the hot time of 37 ℃), 2 hours each time, twice a day, and 5 days a week, for a total of 2 weeks. Venous blood was taken before and after heat acclimatization training, before armed wild training, and after the last training or EHS onset, and the contents of serum interleukin (IL-1β, IL-10), tumor necrosis factor-α (TNF-α) and γ-interferon (IFN-γ) were detected by enzyme linked immunosorbent assay (ELISA). The occurrence of EHS and MODS in EHS patients were recorded. Results There was no significant difference in serum inflammatory factors between the officers and soldiers who participated in the training and the healthy control group before heat training or cross-country training. Compared with those before heat training, IL-1β, TNF-α, IFN-γ were significantly increased in all participants of heat acclimatization training while IL-10 was significantly decreased. For those who experienced premonitory (6 cases) and mild (2 cases) heatstroke during training, they could return to normal without severe heatstroke or EHS within 10-30 minutes after being immediately put in a cool and ventilated place and given anti- heatstroke drugs and other interventions. Compared with those before wild training, the levels of inflammatory factors in the two groups of officers and soldiers also changed after wild training, but the increase or decrease of inflammatory indexes in the heat acclimatization group were significantly smaller than those in the non-acclimatization group [IL-1β (ng/L): 10.65±5.18 vs. 12.13±7.91, TNF-α (ng/L): 14.60±5.79 vs. 16.27±8.52, IFN-γ (ng/L): 13.66±5.43 vs. 15.33±8.71, IL-10 (ng/L):8.22±2.68 vs. 7.13±2.63, all P < 0.05]. During armed wild training, a total of 27 cases of EHS occurred. The incidence of EHS in the heat acclimatization group was significantly lower than that in the non-acclimatization group [2.67% (8/300) vs. 6.33% (19/300), χ2= 4.693, P = 0.030]. In patients with EHS, IL-1β, TNF-α, IFN-γ after wild training in the heat acclimatization group were also significantly lower than those in the non-acclimatization group, and IL-10 was significantly higher [IL-1β (ng/L): 34.50±3.74 vs. 39.53±4.51, TNF-α (ng/L): 43.75±2.87 vs. 46.79±2.66, IFN-γ (ng/L): 40.25±1.75 vs. 46.58±1.92, IL-10 (ng/L): 7.50±2.45 vs. 5.42±1.80, all P < 0.01], and the incidence of MODS and organ involvement of EHS patients in the heat acclimation group were significantly lower than that in the non-acclimatization group [50.00% (4/8) vs. 89.47% (17/19), χ2= 5.075, P = 0.024; 28.13% (9/32) vs. 47.79% (65/136), χ2=4.066, P=0.044]. Conclusion Heat acclimatization training before high strength training in high temperature and humidity environment can effectively reduce the degree of inflammation reaction of EHS, protect the physiological functions of EHS organs, and reduce the incidence of MODS.

15.
Chinese Critical Care Medicine ; (12): 439-443, 2018.
Article in Chinese | WPRIM | ID: wpr-703668

ABSTRACT

Objective To observe the effect of different core temperatures (Tc) after heat strike on serum inflammatory cytokines and multiple organ dysfunction syndrome (MODS) in rat. Methods 120 male Sprague-Dawley (SD) rats were randomly divided into normal control group (n = 30) and heat strike group (n = 90). The rats in heat strike group were put into simulated thermal climate animal module after adaptive training. The module temperature was raised to 39 ℃ in 30 minutes with 65% humidity. The rats ran simultaneously at 15 m/min, on the slope of 0°, 8 minutes each time, 2 minutes interval, and the heat strike time was 90 minutes. After the rats came out of the module, rectal temperature, which was Tc value, was recorded. The rats died or Tc < 41 ℃ during the experiment were excluded, the remaining 73 rats were divided into three subgroups: 41.0-41.9 ℃ (n = 38), 42.0-42.9 ℃ (n = 26), and ≥43.0 ℃ (n = 9). The rats in the normal control group were reared at temperature of (25±2) ℃, and humidity of (55±5)%. At 0 hour and 24 hours after the rats came out of the module, femoral artery blood was collected to determine serum interleukins (IL-1α, IL-1β, IL-17), tumor necrosis factor-α(TNF-α) andγ-interferon (IFN-γ) by enzyme-linked immunosorbent assay (ELISA). The cardiac troponin I (cTnI), MB isoenzyme of creatine kinase (CK-MB), serum creatinine (SCr), blood urea nitrogen (BUN), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were determined by automatic biochemical analyzer. The incidence of MODS and the number of accumulative organs within 24 hours of the rats in different Tc of heat strike group were compared and analyzed. Results The serum inflammatory cytokines and biochemical parameters at 0 hour after heat strike were significant higher than those of the normal control group, and showed a time dependence. Further analysis showed that the inflammatory response and organ dysfunction in rats were increased gradually with the increase in Tc of rats. Compared with the normal control group, at 24 hours after heat strike, inflammatory cytokines in Tc≥43.0 ℃ rats were increased obviously [IL-1α (ng/L): 13.56±2.07 vs. 2.24±0.62, IL-1β (ng/L): 17.11±1.90 vs. 7.40±1.52, IL-17 (ng/L): 17.00±1.41 vs. 6.00±1.78, TNF-α (ng/L):16.78±1.79 vs. 7.27±1.74, IFN-γ (ng/L): 21.11±2.09 vs. 10.43±2.31], and the biochemical parameters were also increased obviously [cTnI (ng/L): 50.78±6.67 vs. 20.53±3.09, CK-MB (U/L): 62.89±3.82 vs. 22.00±3.01, SCr (μmol/L): 149.22±4.35 vs. 92.53±8.32, BUN (nmol/L): 55.22±1.99 vs. 19.10±2.02, ALT (U/L): 388.33±4.97 vs. 100.23±10.61, AST (U/L): 361.22±6.53 vs. 97.67±10.54, all P < 0.01]. The incidence of MODS within 24 hours in the heat strike group was 54.79% (40/73), and the higher the Tc, the higher the incidence of MODS, and the more insulted organs [the incidence of MODS in 41.0-41.9 ℃, 42.0-42.9 ℃, and ≥43.0 ℃ subgroups was 36.84% (14/38), 65.38% (17/26), 100.00% (9/9), and the organ involvement rate was 12.17% (37/304), 23.08% (48/208), and 48.61% (35/72), respectively, when 8 organs or systems were calculated for each rat, both P < 0.01]. Conclusion The higher the Tc of heat strike rats, the stronger the inflammatory reaction and the more serious the damage of tissue, and the more extensive damage of the organs.

16.
Chinese Critical Care Medicine ; (12): 365-368, 2018.
Article in Chinese | WPRIM | ID: wpr-703656

ABSTRACT

Objective To investigate the protective effect of mild hypothermia at different starting times on the physiological functions of the viscera of exertional heat stroke (EHS). Methods A prospective randomized controlled trial was conducted. EHS patients admitted to intensive care unit of the 159th Hospital of People's Liberation Army and the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were enrolled. The patients were divided into 2, 4, 6 hours start hypothermia treatment groups according to the random number table method, the mild hypothermia was initiated at 2, 4 and 6 hours after the disease onset respectively, and the methods were the same in each group. After treatment of 2, 12, 24 hours, the venous blood in the three groups was collected to detect serum cardiac troponin I (cTnI) with chemiluminescence method, MB isoenzyme of creatine kinase (CK-MB) with immunosuppressive method, creatinine (Cr) with creatine oxidase method, β2-microglobulin (β2-MG) with turbidimetry, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with enzyme method. Multiple organ dysfunction syndrome (MODS) within 24 hours after treatment was recorded. Linear regression analysis of the correlation between mild hypothermia start-up time and MODS was done. Results Ninety-three cases of EHS were included,with 32, 31 and 30 patients in 2, 4, 6 hours start treatment groups respectively. There were no significant differences in gender, age, core temperature, onset time to admission, Glasgow coma scale (GCS), acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ) score at admission among the three groups. There were no significant differences in the levels of serum cTnI, CK-MB, Cr, β2-MG, ALT and AST at 2 hours after treatment. But with the prolongation of the treatment time, all indicators gradually increased. And the earlier start of the mild hypothermia, the less significant of the above indexes. All indexes in 2 hours start treatment group were significantly lower than those of 2 hours and 6 hours start treatment groups at 24 hours after treatment [cTnI (ng/L): 49.53±9.25 vs. 56.52±10.05, 64.57±11.21; CK-MB (U/L):51.47±11.83 vs. 57.87±7.43, 64.40±7.93; Cr (μmol/L): 140.97±11.33 vs. 148.16±10.39,155.57±8.65; β2-MG (mg/L): 10.28±1.46 vs. 11.58±2.13, 12.93±1.98; ALT (U/L): 248.53±75.47 vs. 341.42±129.58, 425.77±101.23;AST (U/L): 197.25±42.59 vs. 292.81±58.49, 351.20±60.41, all P < 0.05]. There was significant difference in the incidence of MODS in 2, 4, 6 hours start treatment groups [43.75% (14/32), 64.52% (20/31), 80.08% (24/30), χ2= 8.761, P = 0.013]. Linear regression analysis showed that the earlier onset time of mild hypothermia, the lower incidence of MODS (R2= 0.915, P = 0.013). Conclusion The application of mild hypothermia in 2 hours can effectively protect the physiological function of EHS organs and reduce the incidence of MODS.

17.
Chinese Journal of Hematology ; (12): 724-728, 2018.
Article in Chinese | WPRIM | ID: wpr-810196

ABSTRACT

Objective@#To explore the predictive value of minimal residual disease (MRD) level in Ph-negative precursor B-acute lymphoblastic leukemia (ALL) patients.@*Methods@#De novo 193 Ph-negative B-ALL patients from Sep 2010 to Nov 2017 were involved in the study. The patients' MRD evaluation which can be performed by multiparametric flow cytometry (MFC) after 1 month, 3-month, 6-month treatment. Relapse free survival (RFS) and overall survival (OS) were compared in patients with different MRD level.@*Results@#The median follow-up was 22 months. All patients was evaluated at 497 MRD level. Patients who reach the good MRD level at 1 month (<0.1% or ≥0.1%), 3-month (negative or positive), 6-month (negative or positive) had a significantly higher probability of estimated RFS (74.5% vs 29.9%; 75.6% vs 29.7%; 74.6% vs 11.6%) and of estimated OS (67.5% vs 30.3%; 71.6% vs 27.8%; 74.0% vs 15.7%). Patients who reach the MRD negative at all 3 times had a significantly higher probability of estimated RFS (80.5% vs 30.5%) and better estimated OS (77.1% vs 29.4%) compared to patients with at least MRD failure in one time (P<0.001). Multivariable analysis showed MRD level at 3-month was an independent prognostic factor for DFS and OS.@*Conclusion@#MRD is an important prognosis factor for Ph-negative B- ALL patients.

18.
Chinese Journal of Pediatrics ; (12): 34-38, 2018.
Article in Chinese | WPRIM | ID: wpr-809763

ABSTRACT

Objective@#To investigate the clinical features and therapeutic strategies of childhood myeloid neoplasms associated with eosinophilia and platelet-derived growth factor receptor beta (PDGFRB) gene rearrangement.@*Methods@#Clinical data of myeloid neoplasms associated with eosinophilia and t (1;5) (q21;q33) chromosomal translocation of PDGFRB gene rearrangement in a child hospitalized in Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences on May 2015 was collected and analyzed. Using'eosinophilia child’and'PDGFRB’as keywords, the relevant reports in literature were searched from China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and Biomedical Literature Database (PubMed) until April 2017.@*Results@#The patient was a boy, 19 months old, who began to get sick at six months after birth, with the main clinical manifestations of high fever, diarrhea, epistaxis and hepatosplenomegaly. Peripheral blood smear showed a significant elevation in white blood cells (127×109/L) and eosinophils(20.32×109/L). Bone marrow examination showed hyperplastic marrow, increased proportion of granulocytes, apparent visible eosinophils and decreased megakaryocytes. Chromosome karyotype detection revealed t (1; 5) (q21; q33) translocation. Fluorescence in situ hybridization (FISH) examination uncovered that PDGFRB gene rearrangement was positive. The final diagnosis was myeloid neoplasms with eosinophilia and PDGFRB gene rearrangement. After treatment with oral imatinib 100 mg, once a day for 2 months, complete hematologic remission, complete cytogenetic and molecular remission were all achieved. The relevant literature was reviewed, no Chinese cases had been reported, 6 reports in English literature have complete clinical data. Four cases had t (1; 5) translocation. Four pediatric patients treated with imatinib achieved complete remission.@*Conclusion@#Myeloid neoplasms associated with eosinophilia and PDGFRB gene rearrangement is extremely rare in children. Imatinib treatment can make these patients quickly achieve complete hematologic remission, complete cytogenetic and molecular remission. Imatinib should be recommended as the first line treatment of these patients.

19.
Chinese Critical Care Medicine ; (12): 681-685, 2018.
Article in Chinese | WPRIM | ID: wpr-806821

ABSTRACT

Objective@#To explore the relationship between physiological parameters changes and severe heatstroke induced by 5-km armed cross-country training.@*Methods@#A total of 521 male officers and soldiers from a special team who participated in the summer training of 5-km armed cross-country training from year 2016 to 2017 were enrolled. All trainees participated in 5-km armed cross-country training in high temperature and humidity environment of ambient temperature > 32 ℃and (or) relative humidity > 65%. The trainees were divided into two groups according to the incidence of severe heatstroke in the course of training. The age, enlistment time, constitution score, body mass index (BMI), external environment (ambient temperature, relative humidity, wind speed, heat index) of trainees of the two groups, and the change rates of arterial blood oxygen saturation (SaO2), body temperature, pulse and blood pressure within 5 minutes after the 5-km armed cross-country training were compared between the two groups. The risk factors of severe heatstroke were screened by two classified Logistic regression analysis, and the predictive value of various risk factors of severe heatstroke was analyzed by the receiver operator characteristic curve (ROC).@*Results@#In 521 trainees of 5-km armed cross-country training, 29 trainees suffered from severe heatstroke accounting for 5.57%. There was no significant difference in the age, enlistment time, constitution score, BMI, or external environment during 5-km armed cross-country training between severe heatstroke group and non-severe heatstroke group. Compared with those without severe heatstroke, the descending rates of body temperature, pulse, blood pressure and SaO2 increased rate within 5 minutes after 5-km armed cross-country training of severe heatstroke trainees were significantly decreased [temperature descending rate: (0.67±0.30)% vs. (1.43±1.28)%, pulse descending rate: (7.53±5.21)% vs. (13.48±8.07)%, blood pressure descending rate: (9.28±6.84)% vs. (19.42±7.73)%, SaO2 increased rate: (0.51±0.39)% vs. (1.50±1.43)%, all P < 0.01]. Two classification Logistic regression analysis showed that the temperature descending rate [odds ratio (OR) = 0.485, 95% confidence interval (95%CI) = 0.289-0.817], pulse descending rate (OR = 0.903, 95%CI = 0.845-0.965), blood pressure descending rate (OR = 0.841, 95%CI = 0.790-0.896), and SaO2 increased rate (OR = 0.421, 95%CI = 0.250-0.711) were the risk factors for severe heatstroke during 5-km armed cross-country training (all P < 0.01). ROC curve analysis showed that temperature descending rate [area under ROC curve (AUC) = 0.659, 95%CI = 0.604-0.714], pulse descending rate (AUC = 0.730, 95%CI = 0.762-0.900), blood pressure descending rate (AUC = 0.831, 95%CI = 0.659-0.801), SaO2 increased rate (AUC = 0.711, 95%CI = 0.655-0.767) could be used for the incidence of severe heatstroke prediction during 5-km armed cross-country training (all P < 0.01), and the predicted value was the same.@*Conclusions@#Under the same conditions, the severe heatstroke during 5-km cross-country training is closely related to the descending rates of body temperature, pulse, and blood pressure as well as SaO2 increased rate within 5 minutes after the training, whose predictive values for severe heatstroke were the same.

20.
Chinese Journal of Hematology ; (12): 98-104, 2018.
Article in Chinese | WPRIM | ID: wpr-806125

ABSTRACT

Objective@#To investigate the spectrum of gene mutations in adult patients with B-acute lymphoblastic leukemia (B-ALL), and to analyze the influences of different gene mutations on prognosis.@*Methods@#DNA samples from 113 adult B-ALL patients who administered from June 2009 to September 2015 were collected. Target-specific next generation sequencing (NGS) approach was used to analyze the mutations of 112 genes (focused on the specific mutational hotspots) and all putative mutations were compared against multiple databases to calculate the frequency spectrum. The impact of gene mutation on the patients’ overall survival (OS) and recurrence free survival (RFS) was analyzed by the putative mutations through Kaplan-Meier, and Cox regression methods.@*Results@#Of the 113 patients, 103 (92.0%) harbored at least one mutation and 29 (25.6%) harbored more than 3 genes mutation. The five most frequently mutated genes in B-ALL are SF1, FAT1, MPL, PTPN11 and NRAS. Gene mutations are different between Ph+ B-ALL and Ph- B-ALL patients. Ph- B-ALL patients with JAK-STAT signal pathway related gene mutation, such as JAK1/JAK2 mutation showed a poor prognosis compared to the patients without mutation (OS: P=0.011, 0.001; RFS: P=0.014,<0.001). Patients with PTPN11 mutation showed better survival than those without mutation, but the difference was not statistically significant (P value > 0.05). Besides, in Ph+ B-ALL patients whose epigenetic modifications related signaling pathway genes were affected, they had a worse prognosis (OS: P=0.038; RFS: P=0.047).@*Conclusion@#Gene mutations are common in adult ALL patients, a variety of signaling pathways are involved. The frequency and spectrum are varied in different types of B-ALL. JAK family gene mutation usually indicates poor prognosis. The co-occurrence of somatic mutations in adult B-ALL patients indicate the genetic complex and instability of adult B-ALL patients.

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