2.Soft Environment Construction in Opening Laboratory in Key Subject
Li HAN ; Changbo LIU ; Jahong JIN ; Yongqin ZHOU ; Hongyan WU ; Changju ZHANG
Chinese Journal of Medical Education Research 2003;0(03):-
Soft environment of opening laboratory in key subject will deeply affect the construction and development of disciplines.Developing and innovative academic team;scientific and rigorous running mechanism,healthy and concordant academic atmosphere,active and positive behavior mode,all of the above are the main factors of soft environment of laboratory.From now on,we need try our best to improve human rights,design more efficient aims,constitute impellingly guarantee system and fine mechanism of consistent of regulations and environment,apply modern managing instrument scientificly and improve managing efficiency.
3.Predictive value of blood routine and blood biochemical indicators for immunotherapy combined with chemotherapy-related interstitial pneumonia in patients with diffuse large B-cell lymphoma
Fan XIA ; Qi BAO ; Jianguo ZHU ; Zhengming JIN ; Liyan MIAO ; Depei WU ; Changju QU
Journal of Leukemia & Lymphoma 2021;30(10):593-598
Objective:To investigate the predictive value of blood routine and blood biochemical indicators for immunotherapy combined with chemotherapy-related interstitial pneumonia (IP) in patients with diffuse large B-cell lymphoma (DLBCL).Methods:The data of 151 newly-diagnosed DLBCL patients treated with rituximab combined with chemotherapy in the First Affiliated Hospital of Soochow University from December 2017 to October 2020 were retrospectively analyzed. According to whether IP occurred, the patients were divided into IP group and non-IP group. The patient's clinical data and baseline laboratory test results were collected. The differences in clinicopathological features and laboratory indicators between IP group and non-IP group were analyzed. In addition, the relationship between the variety of blood routine and blood biochemical indicators and the occurrence of IP was analyzed. The receiver operating characteristic (ROC) curve of the selected indicators to predict the occurrence of IP was drawn, and the predictive performance of each indicator was analyzed.Results:The incidence of IP was 9.3% (14/151) in DLBCL patients after receiving immunotherapy combined with chemotherapy. The lymphocyte count (LYM) in IP group at the first diagnosis was higher than that in non-IP group [1.60×10 9/L (1.40×10 9/L, 2.51×10 9/L) vs. 1.28×10 9/L (0.89×10 9/L, 1.78×10 9/L), U=-2.194, P=0.028], but there was no significant difference in the levels of platelet count, neutrophil count, monocyte count, lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), serum albumin (ALB) and the proportion of patients with elevated C-reactive protein (CRP) between the two groups (all P > 0.05). Compared with the laboratory indicators in non-IP group before the 4th cycle of treatment, LYM and ALB in IP group were significantly reduced at IP onset [0.72×10 9/L (0.46×10 9/L, 0.92×10 9/L) vs. 0.93×10 9/L (0.71×10 9/L, 1.15×10 9/L), 32.9 g/L (28.6 g/L, 34.9 g/L) vs. 40.3 g/L (36.1 g/L, 43.1 g/L)], but LDH and α-HBDH increased [332 U/L (255 U/L, 396 U/L) vs. 233 U/L (200 U/L, 286 U/L), 277 U/L (206 U/L, 315 U/L) vs. 189 U/L (159 U/L, 229 U/L)], and the differences were statistically significant (all P<0.05). The proportion of patients with elevated CRP in IP group was high than that in non-IP group [100.0% (14/14) vs. 56.9% (78/137), P=0.001]. The area under ROC curve of LYM, ALB, LDH and α-HBDH alone for predicting the occurrence of IP was 0.668, 0.820, 0.789 and 0.802. The best cut-off values of ALB, LDH and α-HBDH was 34.6 g/L, 241 U/L and 199 U/L. ALB had the highest sensitivity for predicting the occurrence of IP (81.8%). The areas under ROC curve of ALB+LDH, ALB+α-HBDH, LDH+α-HBDH, ALB+LDH+α-HBDH for predicting the occurrence of IP was 0.850, 0.844, 0.777 and 0.851, respectively. LDH+α-HBDH had the highest predictive sensitivity (92.9%), but the specificity was low (53.3%). The prediction sensitivity (both 78.6%) and specificity (both 86.1%) of ALB+LDH and ALB+LDH+α-HBDH were high. Conclusions:DLBCL patients are at risk of IP during immunotherapy combined with chemotherapy. The increased LYM at initial diagnosis is a risk factor for the occurrence of IP. The variety of LYM, ALB, LDH, α-HBDH and CRP during the treatment may be related to the occurrence of IP. Among them, ALB, LDH and α-HBDH have important predictive values for the occurrence of IP.
4.Clinical diagnositic value of dynamic platelet and blood coagulation related indicators in acute pancreatitis
Mengke LI ; Sanyang CHEN ; Yanna LIU ; Yaodong SONG ; Qiaofang WANG ; Bo CHENG ; Yan ZHANG ; Zongchao CUI ; Zhongwei WU ; Changju ZHU
Chinese Journal of Emergency Medicine 2021;30(9):1113-1118
Objective:To investigate the predictive value of dynamic platelet and hemagglutination-related parameters in patients with acute pancreatitis (AP).Methods:The patients admitted to the Department of Emergency Surgery in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2020 were analyzed. According to the inclusion criteria and exclusion criteria, patients with AP were retrospectively enrolled. According to the Chinese Guidelines for the Diagnosis and Treatment of Acute Pancreatitis (Shenyang, 2019), the patients were divided into two groups: severe acute pancreatitis (SAP group) and non-severe acute pancreatitis (non-SAP group) [including mild acute pancreatitis (MAP) and moderate severe acute pancreatitis (MSAP)]. A normal distribution of the maximum and mean aggregation rates of dynamic platelets (arachiidonic acid), plateletcrit (PCT) and bedside index for severity in acute pancreatitis (BISAP) scores and other measurement data were tested by t test, while measurement data of prothrombin time (PT), fibrinogen (FIB) and D-dimer that did not conform to normal distribution were tested by Mann-Whitney U test. χ 2 test was used for the counting data such as sex, age and etiology of patients in the two groups. The prognostic value of statistically significant indicators for non-SAP group and SAP group was further analyzed by receiver operating characteristic (ROC) curve. Results:A total of 146 patients with AP were enrolled, including 50 patients in SAP group and 96 in non-SAP group. The maximum and average aggregation rates of dynamic platelet (aracidonic acid) in the SAP group were (71.76±17.62) % and (67.91±18.10) %, PT (12.02±1.33) s, FIB (4.76±2.08) g/L, D-dimer (3.75±6.04) μg/L, PCT (0.23±0.08) %, and BISAP scores (1.42±1.18), which were all significantly higher than those in the non-SAP group [the maximum and average aggregation rates of dynamic platelet (arachiidonic acid) (46.65±20.11) % and (42.50±20.71) %, PT (11.50±1.51) s and FIB (3.91±1.48) g/L, D-dimer (1.00±1.37) μg/L, PCT (0.19±0.06) %, BISAP scores (0.45±0.66)] (all P<0.05). According to area under the ROC curve, the maximum and average aggregation rates of dynamic platelets (arachiidonic acid) in serum of patients with SAP were 0.83 and 0.82, respectively, and the sensitivities were 0.56 and 0.68, respectively. The specificity was 0.99 and 0.81, respectively, which was better than PT, FIB, D-dimer, PCT and BISAP scores in predicting the severity of AP. Conclusions:The maximum and average aggregation rates of dynamic platelets (arachidonic acid), PT, FIB, D-dimer, PCT and BISAP scores can be used as predictors of the severity of acute pancreatitis. The maximum and average aggregation rates of dynamic platelets (arachiidonic acid) were the best in predicting the severity of AP.
5.Long-term Complete Remission of Decitabine-Primed Tandem CD19/CD22 CAR-T Therapy with PD-1 and BTK Inhibitors Maintenance in a Refractory Primary Central Nervous System Lymphoma Patient
Rui ZOU ; Xiao ZHOU ; Hailing LIU ; Peng WANG ; Fan XIA ; Liqing KANG ; Lei YU ; Depei WU ; Zhengming JIN ; Changju QU
Cancer Research and Treatment 2023;55(4):1363-1368
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive non-Hodgkin’s lymphoma that affects the brain, eyes, cerebrospinal fluid, or spinal cord without systemic involvement. The outcome of patients with PCNSL is worse compared to patients with systemic diffuse large B-cell lymphoma. Given potential mortality associated with severe immune effector cell-associated neurotoxicity syndrome (ICANS), patients with PCNSL have been excluded from most clinical trials involving chimeric antigen receptor T-cell (CAR-T) therapy initially. Here, we report for the first time to apply decitabine-primed tandem CD19/CD22 dual-targeted CAR-T therapy with programmed cell death-1 (PD-1) and Bruton’s tyrosine kinase (BTK) inhibitors maintenance in one patient with multiline-resistant refractory PCNSL and the patient has maintained complete remission (CR) for a 35-month follow-up period. This case represents the first successful treatment of multiline resistant refractory PCNSL with long-term CR and without inducing ICANS under tandem CD19/CD22 bispecific CAR-T therapy followed by maintenance therapy with PD-1 and BTK inhibitors. This study shows tremendous potential in the treatment of PCNSL and offers a look toward ongoing clinical studies.
6.Chinese expert consensus on emergency surgery for severe trauma and infection prevention during corona virus disease 2019 epidemic (version 2023)
Yang LI ; Yuchang WANG ; Haiwen PENG ; Xijie DONG ; Guodong LIU ; Wei WANG ; Hong YAN ; Fan YANG ; Ding LIU ; Huidan JING ; Yu XIE ; Manli TANG ; Xian CHEN ; Wei GAO ; Qingshan GUO ; Zhaohui TANG ; Hao TANG ; Bingling HE ; Qingxiang MAO ; Zhen WANG ; Xiangjun BAI ; Daqing CHEN ; Haiming CHEN ; Min DAO ; Dingyuan DU ; Haoyu FENG ; Ke FENG ; Xiang GAO ; Wubing HE ; Peiyang HU ; Xi HU ; Gang HUANG ; Guangbin HUANG ; Wei JIANG ; Hongxu JIN ; Laifa KONG ; He LI ; Lianxin LI ; Xiangmin LI ; Xinzhi LI ; Yifei LI ; Zilong LI ; Huimin LIU ; Changjian LIU ; Xiaogang MA ; Chunqiu PAN ; Xiaohua PAN ; Lei PENG ; Jifu QU ; Qiangui REN ; Xiguang SANG ; Biao SHAO ; Yin SHEN ; Mingwei SUN ; Fang WANG ; Juan WANG ; Jun WANG ; Wenlou WANG ; Zhihua WANG ; Xu WU ; Renju XIAO ; Yang XIE ; Feng XU ; Xinwen YANG ; Yuetao YANG ; Yongkun YAO ; Changlin YIN ; Yigang YU ; Ke ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Gang ZHAO ; Xiaogang ZHAO ; Xiaosong ZHU ; Yan′an ZHU ; Changju ZHU ; Zhanfei LI ; Lianyang ZHANG
Chinese Journal of Trauma 2023;39(2):97-106
During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.