Control effect of Dasatinib on the treatment of acute myeloid leukemia and adverse events of CD123 targeting CAR-T:a case report and literature review / 陆军军医大学学报

Objective To preliminarily explore the efficacy of chimeric antigen receptor T cells(CAR-T)targeting CD 123 in the treatment of acute myeloid leukemia(AML)and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.Methods Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September,2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred,40 mg orally 3 times per day,and was stopped when agranulocytosis was relieved.Changes in blood cells,CAR-T amplification,and disease control were observed.The patient was followed up for over 1 year.Results Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD 123 CAR-T cells infusion,significant expansion of CAR-T cells was observed,accompanied by granulocyte deficiency and cytokine release syndrome(CRS).After using dasatinib,inhibition of CAR-T cell expansion was observed,accompanied by blood cell recovery,and CRS symptoms were alleviated.After stop of dasatinib,CAR-T cells expanded again and blood cells decreased again.Conclusion CAR-T cells targeting CD 123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T,which can alleviate bone marrow suppression caused by CD 123 targeting CAR-T and avoid severe CRS.

Prenatal diagnosis of fetal ZTTK syndrome: a case report / 中华围产医学杂志

This article reported the prenatal diagnosis of a fetus with ZTTK syndrome. A pregnant woman underwent preimplantation genetic diagnosis because her partner carried a balanced chromosomal translocation. Chromosomal karyotype analysis and copy number variation sequencing (CNV-seq) performed on amniocytes collected at 18 + weeks of gestation revealed no abnormalities. Ultrasonography performed at 23 +5 and 26 +3 weeks of gestation revealed severe fetal growth restriction, cerebellar dysplasia, poorly visualized sacrum and coccyx, and spina bifida. MRI of the fetal brain showed that the bilateral cerebellar hemispheres of the fetus were small and the cisterna magna was large at 23 +6 weeks of gestation. Whole exome sequencing in the pedigree identified a heterozygous variant c.2092delG (p.Glu698fs*4) in the exon 3 of the fetal SON gene, which was not inherited from the parents and proved to be a de novo mutation. Mutations in the locus are pathogenic, causing ZTTK syndrome. After genetic counseling, the pregnant woman and her family chose to terminate the pregnancy.

Progress of compression therapy in treatment of venous leg ulcer / 中华全科医师杂志

Venous leg ulcer (VLU) is the most common chronic ulcer of lower extremity caused by persistent venous hypertension. Although the mortality rate is low, VLU seriously affects the quality of life of patients, and has the potential for infection, deterioration, and amputation. The compression therapy is simple and easy to implement, it can effectively reduce venous hypertension and is the most important conservative therapy for treating and preventing recurrence of VLU. There are various devices and applications of compression therapy, and this article reviews the classification of compression therapy, and its application in treatment and recurrence prevention of VLU.

Compliance and influencing factors of stretch sock pressure therapy with varicose veins of lower extremities / 中华全科医师杂志

A total of 280 patients with varicose veins of lower extremities who were prescribed stretch socks as pressure therapy in the outpatient clinic of Beijing Chaoyang Hospital from September 2019 to November 2019 were included in the study. Among 280 patients 208 were followed up for one year(74.3%), 139 cases (66.8%) gave up wearing stretch socks and 69 cases (33.2%) insisted to wear. The main reasons for giving up wearing were feeling too tight (23.1%), too much troubles (17.7%), symptom improvement (15.1%), poor effect (10.8%) and so on. The compliance of wearing stretch socks as pressure therapy in outpatients with varicose veins of lower extremities is poor with a variety of reasons, the data may provide a reference for improving clinical compliance in the future.

Compression therapy in preventing deep vein thrombosis of lower extremities / 中华全科医师杂志

Drug prophylaxis is commonly used for prevention of deep vein thrombosis (DVT), but it has deficiencies such as causing thrombocytopenia and weakening coagulation function. Compression therapy is a safe and economical physiotherapy method, which can effectively prevent the occurrence of DVT with less adverse reactions. This article reviews the clinical application and efficacy of four pressure treatment methods: graduated compression stockings, intermittent pneumatic compression, venous foot pumps and continuous enhanced circulation therapy.

Compression therapy in preventing deep vein thrombosis of lower extremities / 中华全科医师杂志

Drug prophylaxis is commonly used for prevention of deep vein thrombosis (DVT), but it has deficiencies such as causing thrombocytopenia and weakening coagulation function. Compression therapy is a safe and economical physiotherapy method, which can effectively prevent the occurrence of DVT with less adverse reactions. This article reviews the clinical application and efficacy of four pressure treatment methods: graduated compression stockings, intermittent pneumatic compression, venous foot pumps and continuous enhanced circulation therapy.

Percutaneous mechanical thrombectomy plus drug coated balloon dilation for the treatment of in-stent restenosis and arterial thrombosis of the lower extremity / 中华普通外科杂志

Objective:To evaluate the safety and efficacy of a combination of percutaneous mechanical thrombectomy (PMT) and drug coated balloon(DCB)for the treatment of in-stent restenosis(ISR) and arterial thrombosis of the lower extremity.Methods:The clinical data of 53 patients treated with PMT + DCB were analyzed retrospectively, including 38 cases of ISR and 15 cases of arterial thrombosis. 33 patients were males and the others were females , the mean age was (68.6±9.4) years . Patients were followed at 30 days, 6 months, and 12 months concerning clinical symptoms, calculation of ABIs and duplex ultrasonography.Results:Procedural success was achieved in all 53 patients. One patient died of cardiovascular event perioperatively. 6 operation-related complications occurred including 5 cases of distal embolism during the PMT managed by using 5 F angiography catheter suction and one case of artery perforation during PMT procedure, a balloon was used to cover it. 47 (88.6%) patients completed 12-month follow-up, the TLR was 10.6% (5/47). One patient had the amputation 4 months later; There were 7 cases with arterial restenosis.PMT+ DCB were performed again in 4 cases, 1 case received stent implantation and 2 cases treated by medication.Conclusion:The use of combination of PMT and DCB is a safe and effective method to treat ISR and arterial thrombosis of the lower extremity.

Effect of debulking therapy by thrombolysis in aorto-iliac artery occlusion / 中华普通外科杂志

Objective To explore the role and clinical efficacy of catheter induced thrombolysis (CDT) debulking method in the treatment of aorto-iliac artery occlusion.Methods A total of 59 patients with aorto-iliac artery occlusion who underwent endovascular treatment between June 2015 and June 2017 were enrolled.Patients were divided into PTA group and CDT group according to the treatment methods received.The PTA group received a balloon-expandable stent placement,and the CDT group underwent thrombolytic therapy for 48 to 72 hours before angiographic evaluation and further PTA treatment.Results In the CDT group,7 cases were still unable to place the stent after thrombolysis,and 20 patients successfully received stenting including 1-stent-placement in 16 patient and 2-stents-placement in 4.In PTA group 32 patients were treated with stents placement including 1-stent-placement in 19 patients,2-stents in 12,3-stents in 1.Follow-up rate was 86.3％ within 1 year,the patency rate was 84.21％ in the PTA group,and 76.92％ in the CDT group.Conclusions CDT is effective method for occlusion of the aortoiliac artery.TASC classification of aorto-iliac arterial occlusion degrades after CDT treatment,thus reducing the use of stenting.

Progress in treatment of iliac vein stenosis and chronic total occlusion / 国际外科学杂志

The anatomical structure of the iliac vein is special,the incidence of stenosis and occlusion is high.It often causes deep venous thrombosis of the lower extremities,and then causes postthrombotic syndrome.At present,with the improvement of technology and the development of endovascular treatment instruments,endovascular treatment of iliac vein stenosis has been widely recognized and is superior to conservative treatment and traditional surgery.This article reviews the advances in endovascular treatment of iliac vein stenosis and occlusion.

Progress of recurrence of venous thromboembolism in cancer patients / 肿瘤研究与临床

Cancer patients complicated with venous thromboembolism (VTE) face treatment problems, very high recurrence rate and bleeding rate. Cancer itself and the antitumor treatment plan are the important factors causing the recurrence. After the relapse, the prognosis of the patients is extremely bad, and more than 50% of the patients died within 1 year. Until now, there is no unified effective treatment plan for the relapse. This paper reviews the recurrence of VTE and the related research progress.

Advances in the in-stent restenosis of lower extremity atherosclerotic occlusive disease / 国际外科学杂志

Arteriosclerotic occlussive disease of the lower extremeties has become a common disease of aging society.Interventional technique is the main method of treating this disease,however,in-stent restenosis various and will degenerate itstherapeutic effect significantly and bring big trouble to clinicians.In the last decade,prevention and treatment techniques have emerged on the underlying mechanismofin-stent restenosis.Particularly,great improvement has been made,because of the development of related devices,such as drug coated balloons,cutting balloons,viabahn stentand bioresorbable stent,all of which could reduce the incidence of in-stent restenosisto varying degrees.In this paper,the latest progress of clinical research on the mechanism and treatment of in-stent restenosis is reviewed,particularly,the clinical effects of these newdevices are analyzed and summarized.

Progress of lower extremity arteriovenous access for haemodialysis / 国际外科学杂志

Vascular access is the dialysis patient's lifeline. Lower extremity arteriovenous accesses are a potential vascular access option in hemodialysis patients who have exhausted all upper-limb sites.The lower extremity options are including autogenous and prosthetic arteriovenous accesses.Numerous challenges including patency rates and complications are encountered in the lower extremities that are not seen in the upper extremities.In this review,we focus on the advances in lower extremity accesses.

Preparation and in vivo and in vitro biocompatibility of acellular vascular matrix / 中国组织工程研究

BACKGROUND:Acellular vascular matrix as vascular scaffold has following advantages:acellular vascular matrix possesses complicated three-dimensional structure of natural blood vessels. Growth factor and structural domain on the surface of acellular matrix helps for cell adhesion and infiltration.OBJECTIVE:To prepare acellular vascular matrix material and to evaluate its biocompatibility in vivo and in vitro.METHODS:Trypsin and Triton X-100 were used to gradually dispose pig carotid artery and to prepare acellular vascular matrix. The biocompstibility of the material was evaluated by implantation in muscle, acute toxicity experiment and cytotoxicity test in vitro.RESULTS AND CONCLUSION:The acallular vascular matrix material possessed good chemical stability and did not release harmful factors that produced destruction and dissolution in erythrocytes, without acute hemolytic reaction or toxic effects on cell growth. The acellular vascular matrix material showed lots of inflammatory cell infiltration in eady stage of implantation, and no significant inflammatory cell infiltration in late stage of observation. Fibroblasts were visible in the acellular matrix. In addition, the acellular matrix material did not exhibit toxic effects on surrounding tissues,showing wound stage I healing.Simultaneously,histological sections demonstrated that there were good compatibility of scaffold material and surrounding tissues, without rejection.These indicated that acellular matrix material presented good biocompatibility in animals.

Role of endometrial and subendometrial blood flows measured by three-dimensional power Doppler ultrasound in the prediction of endometrial receptivity during IVF-ET treatment / 中华超声影像学杂志

Objective To investigate the role of endometrial and subendometrial blood flows measured by transvaginal three-dimensional(3D) power Doppler ultrasound in the prediction of endometrial receptivity during in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods One hundred and twenty patients undergoing IVF-ET cycles were enrolled in this study. Transvaginal 3D power Doppler ultrasound examination was performed on the day of human chorionic gonadotropin injection to determine endometrial thickness,endometrial volume, vascularization index(VI), flow index(FI) and vascularization flow index (VFI) of endometrial and subendometrial regions by experienced sonograpbers. The patients were divided into pregnant group and non-pregnant group according to pregnant outcome. The data between the two groups were compared and analysed. Results There were no significant differences( P ＞0.05) between the pregnant group and non-pregnant group in endometrial thickness, endometrial volume. Endometrial and subendometrial VI,FI, VFI were higher in the pregnant group than those in the non-pregnant group, and statistical comparison had significant difference( P ＜0.05). Conclusions Endometrial and subendometrial blood flows measured by transvaginal 3D power Doppler ultrasound can be as a reliable indicator to assess endometrial receptivity and to predict the pregnancy outcome.

Experimental Study on Protective Function of Shenqi Dihuang Decoction on Diabetic Rats'Kidney / 国际中医中药杂志

Objective To study the protective function and the mechanism of Shenqi Dihuang decoction on the kidney of type 2 diabetes melltuds rats. Methods Type 2 diabetes mellitus rat models were set up by injection of small dose of streptozotocin (STZ). The SD rats were randomized into a control group, a model group and a treatment group. The treatment group was given Shenqi Dihuang decoction. The control group and the model group were given the same amount of water. After 24 weeks, renal morphology examination and biochemical indicator were examined. The levels of Ang-Ⅱ and endothelin (ET) in senum were tested by radioimmunoassay and the level of transforming growth factorβ1 (TGF-β1) in renal cortex were determined by immunohistochemistry. Results The kidney function and kidney lesions were significantly improved in the treatment group than in the model group. Ang-Ⅱ And ET levels in serum and renal cortex was reduced, and the expression of TGF-β1 in the treatment group was decreased. Conclusion Shenqi Dihuang Decoction has protective effect on the kidney of diabetic rats, the mechanism may be related to its inhibition on the over expression of Ang- Ⅱ, ET and TGF-β1.