With the application of chemotherapy,gestational trophoblastic neoplasia (GTN) has been the first of malignant tumors which can be cured by chemotherapy.However,the resistance and relapse still is the difficulty of treatment and the leading cause of death in patients.Approximately 20％ ～ 30％ of GTN tumor will be resistant to,or will relapse after cure.These resistant and relapsed lesions will require salvage therapy,which be treated with multi-agent chemotherapy with or without surgery and/or adjuvant radiation therapy.Various salvage regimens are used worldwide.It is unclear to determine which of the various salvage combinations,if any,was the most effect and the least toxic for the treatment of resistant or relapsed GTN.

【Objective】 To study the effect of changes in red blood cell parameters and blood donation interval on ferritin level in platelet donors with ferritin deficiency, so as to provide experimental evidence for formulating targeted blood donor care strategies. 【Methods】 100 regular male platelet apheresis donors in April 2020 were selected to test the ferritin and red blood cell parameters. Blood donors were classified according to the annual blood donation numbers: 3~10, 11~15, and 16~24, and the difference of iron deficiency rate among groups was analyzed. They also were classified according to the detection value of ferritin: iron deficiency donors versus SF normal donors, and the changes of Hb, MCV, MCH and MCHC values of them were compared. The iron deficiency donors were stratified by donation time: January to March 2019, April to June 2019, July to September 2019, October to December 2019 and January to April 2020, so as to compare the changes of Hb, MCV and MCH values among each group. The iron deficiency donors, continued the donation afterwards, were divided into interval-extended donors (minimum donation interval of 30 days) and normal ones (minimum donation interval of 14 days), and blood donation from May to December 2020 was intervened and observed. In December 2020, serum ferritin was tested again for iron deficiency donors to analyze the changes in SF between two groups. 【Results】 The incidence of iron deficiency in three groups with different donation frequency was 7.5%, 22.5% and 40.0%, respectively(P<0.05). The Hb(g/L) (144.15±9.37 vs 151.72±8.81), MCV(fl)( 87.21±4.02 vs 89.38±2.96), MCH(pg)(29.91±2.13 vs 31.01± 1.25), and MCHC (g/L)(345.85±9.08 vs 346.48±9.18) of iron deficiency donors were significantly lower than those of SF normal ones(P<0.05). The paired-comparison of Hb of iron deficiency donors was not statistically different by donation periods, except for January-April 2020 versus January-March 2019(P<0.05). MCV mean values were statistically different by donation periods, especially January-April 2020 versus January-March/April-June/July-September 2019 and October-December 2019 versus January-March 2019(P<0.05). MCH mean values were statistically different by donation periods, especially January-April 2020 versus January-March/ April-June and October-December 2019 versus January-March 2019(P<0.05). The pre-collection distribution of Hb, MCV, and MCH in iron deficiency donors and SF normal donors during 2019 and 2020 were 0.030±0.008 vs 0.025±0.004, 0.011±0.006 vs 0.007±0.002, and 0.019±0.008 vs 0.013±0.005, respectively (P<0.05). .The Hb, MCV, and MCH values of high-frequency blood donors with Hb less than 130g/L decreased significantly. The original SF (μg/L) of iron-deficiency donors without extended interval was 13.89±4.66, and the current 12.27±5.17(P>0.05), and original 13.89±4.66 vs current 35.92±5.20 in the extended ones(P<0.05). 【Conclusion】 The incidence of iron deficiency in apheresis platelet donors increased as blood donation frequency elevated. The Hb, MCV, MCH and MCHC value of iron deficiency donors decreased while the dispersion of pre-collection Hb, MCV and MCH decreased. MCV and MCH are superior to Hb in early-reflection of metabolism status of red blood cell. It is recommended that iron deficiency donors with Hb less than 130 g/L should reduce the frequency of donation. Extending the donation interval can increase the SF level of iron deficiency donors.Dynamic monitoring of ferritin and related red blood cell parameters should be carried out by blood banks to customize the donation interval.

【Objective】 To investigate the relationship between cerebrospinal fluid exosome-derived miR-630 and the function of brain microvascular endothelial cells （BMECs）. 【Methods】 The subarachnoid hemorrhage endothelial cell model was established to evaluate the effect of hemorrhagic cerebrospinal fluid （BCSF） on BMECs’ proliferation by MTT assay and cell cycle analysis. qRT-PCR and immunofluorescence staining were used to detect the expressions of endothelial cell tight junction protein （ZO-1） and adhesion molecule （ICAM-1 and VCAM-1）. Changes in NOx concentration were detected by radioimmunoassay. The cerebrospinal fluid exosomes in the experimental group （co-incubated with BCSF） and the control group （normal cerebrospinal fluid） were isolated and identified， and differences in the expressions of cerebrospinal fluid exosomal miR-630 between the two groups were compared. BMECs work changes after the intervention with miR-630 analogue were observed. 【Results】 The proliferation of BMECs was significantly inhibited in the experimental group； the mRNA and protein levels of ICAM-1， VCAM-1 and ZO-1 were significantly decreased， and the function of endothelial cells was significantly inhibited （P<0.05）. After the successful separation and identification of cerebrospinal fluid exosomes， the expression of miR-630 was significantly lower in the experimental group than in the control group （P<0.05）. The function of BMECs was significantly improved with miR-630 mimics. 【Conclusion】 The low expression of miR-630 in cerebrospinal fluid exosomes after subarachnoid hemorrhage is closely related to BMECs injury.

The isocitrate dehydrogenase (IDH) gene mutation has been recently found, which may be involved in the occurrence of leukemia. The incidence of IDH gene mutation in the patients with adult acute myeloid leukemia (AML) is high, especially in the AML patients with normal karyotype. Different subtype and molecular biology of IDH display a different effect on the AML prognosis. This gene mutation is related with treatment response, residual, recurrence of leukemia, and it could be a sign of test and a monitoring tool of minimal residual disease (MRD). The IDH gene mutation may be an index for predicting prognosis and guiding therapy. In this article, the research progress of IDH gene mutation and its correlation with acute myeloid leukemia, especially with the clinical characteristics,are reviewed.
Humans ; Isocitrate Dehydrogenase ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Mutation ; Prognosis

OBJECTIVE: To evaluate the clinical efficacy of local infiltration anesthesia of ropivacaine combined with compound betamethasone for postoperative analgesia in patients with hallux valgus. METHODS: From September 2019 to December 2020, 48 patients with hallux valgus were treated surgically. According to different postoperative analgesia methods, the patients were divided into combined local infiltration group and intravenous analgesia pump group. There were 24 cases, in the combined local infiltration group including 2 males and 22 females;the age ranged from 21 to 78 years old, with an average of (58.3±7.7) years old;soft tissue release and chevron osteotomy were performed in 15 cases and metatarsophalangeal joint fusion in 9 cases;immediately after operation, 20 ml of ropivacaine combined with compound betamethasone mixed diluent was used for local infiltration anesthesia once. There were 24 patients in intravenous analgesia pump group, including 3 males and 21 females;the age ranged from 23 to 81 years old, with an average of(56.8±8.3) years old;soft tissue release and Chevron osteotomy were performed in 17 cases and metatarsophalangeal joint fusion in 7 cases;immediately after operation, intravenous analgesia pump was used for analgesia. The basic flow was 2 ml / h;the self control dose was 0.5 ml;and the locking time was 15 min. Visual analogue scale (VAS) was recorded at 12, 24, 48 and 72 hours after operation;and the VAS was recorded at 24 hours after operation. The occurrence of adverse drug reactions at 0 to 12 hours, 12 to 24 hours and 24 to 48 hours after operation were recorded;and the healing of incision was recorded. RESULTS: All patients were followed up, and the duration ranged from 14 to 17 days, with a mean of (14.60±0.92) days. There was significantdifference in VAS at 12, 24 and 48 hours between the combined local infiltration group and the intravenous analgesia pump group( CONCLUSION Compared with intravenous analgesia pump group, ropivacaine combined with compound betamethasone can significantly reduce postoperative wound pain without increasing adverse drug reactions, and does not increase wound infection.
Adult ; Aged ; Aged, 80 and over ; Analgesia ; Anesthesia, Local ; Bunion ; Feasibility Studies ; Female ; Hallux Valgus/surgery* ; Humans ; Male ; Middle Aged ; Pain, Postoperative/drug therapy* ; Young Adult

Objective: To evaluate the effect of Notch-Hes1 signaling blockade by a γ-secretase inhibitor on the expression of γδT17 cells in a mouse model of psoriasis-like skin inflammation. Methods: Forty-five healthy specific pathogen-free (SPF) male BALB/c mice were randomly divided into control group, model group and intervention group by simple random sampling. The model group and intervention group were both topically treated with imiquimod 5% cream (62.5 mg once a day) on the shaved back, the intervention group were then intraperitoneally injected with the γ-secretase inhibitor DAPT (10 mg/kg once a day) immediately after topical application of imiquimod, and the control group were topically treated with equivalent amount of vaseline once a day. After 6-day treatment, psoriasis area and severity index (PASI) was used to evaluate changes of skin lesions. On day 7, blood samples were obtained from all the mice through heart puncture after anesthetization, and spleen and skin tissues were acquired to prepare single cell suspension. Spleen index was compared among the 3 groups. Skin tissues on the mouse back were resected and subjected to hematoxylin-eosin staining to observe histopathological changes. Flow cytometry was performed to determine the percentage of γδT17 cells in the spleen and skin tissues, real-time reverse transcription (RT) -PCR to measure the mRNA expression of Hes1 in single cell suspension of the spleen, and enzyme-linked immunosorbent assay (ELISA) to determine the serum level of interleukin (IL) -17A. Statistical analysis was carried out by using one-way analysis of variance and repeated measures analysis of variance for comparison of indices among groups, and Pearson correlation analysis for evaluating the correlation between different indices. Results: Twenty-four hours after the final treatment, the intervention group showed milder psoriasis-like skin inflammation, lower PASI score, and milder degree of epidermal thickening and dermal inflammatory cell infiltration compared with the model group. The model group showed significantly increased spleen index (12.534 ± 1.636) , proportions of γδT17 cells in the spleen (24.659% ± 4.603%) and skin tissues (22.127% ± 5.670%) , mRNA expression of Hes1 in the spleen (4.867 ± 0.543) , and serum level of IL-17A ([22.478 ± 2.776] ng/L) compared with the control group (all P < 0.01) . However, the above indices were significantly lower in the intervention group (9.449 ± 1.040, 14.966% ± 5.770%, 13.631% ± 5.946%, 2.541 ± 0.347, [18.639 ± 1.816] ng/L) than in the model group (all P < 0.01) . In the model group and intervention group, there were positive correlations between the proportions of γδT17 cells in the spleen and serum levels of IL-17A (r = 0.56, 0.53 respectively, both P < 0.05) , between the proportions of γδT17 cells in skin lesions and PASI scores (r = 0.56, 0.52 respectively, both P < 0.05) , as well as between the mRNA expression of Hes1 in the spleen and the proportions of γδT17 cells (r = 0.61, 0.58 respectively, both P < 0.05) or serum levels of IL-17A (r = 0.60, 0.54 respectively, both P < 0.05) . Conclusion Notch-Hes1 signaling blockade by γ-secretase inhibitor can markedly inhibit the expression of γδT17 cells, and effectively alleviate the severity of psoriasis-like skin inflammation in mouse models.

【Objective】 To analyze the prevalence of anemia in preschool children in Bincheng District of Binzhou city and its influencing factors, so as to provide reference for formulating new measures to prevent anemia in children. 【Methods】 The health examination results of 10 674 children aged 3~6 from multiple kindergartens in Bincheng District in 2020 were collected, and anemia prevalence was investigated by analyzing the blood routine indicators. 【Results】 The incidence of anemia in 10 674 children was 1.95%, with 1.86%(100/5 375)in boys and 2.04%(108/5 299)in girls(P>0.05), with 3.06%(44/1 439)vs 2.93%(43/1 468), 1.79%(37/2 071)vs 2.04%(43/2 107)and 1.02%(19/1 865)vs1.28%(22/1 724)in boys and girls aged 3, 4 and 5, respectively. No significant difference was noticed in anemia incidence between boys and girls in each age group(P>0.05), while significant difference laid between boys and girls among different age groups(P<0.05). The degree of anemia was mainly mild in both boys and girls, accounting for 98.6%(205/208)of the total anemia. The median Hb of preschool children in Bincheng District was 125 g/L(boys 125 g/L vs girls 124 g/L). The median Hb of 5-year-old boys was 126 g/ L, which was higher than 125 g/L of 5-year-old girls. The Hb values of boys and girls were different by age groups, with statistical significance(P<0.05). 【Conclusion】 The anemia prevalence in children in Bincheng District decreased gradually with the increase of age. The general survey of anemia in children with younger age is an important step for early detection and early intervention.

ObjectiveTo assess the level of depression， anxiety and social support among grade three senior high school students under in-school quarantine during the COVID-19 pandemic， so as to provide references for targeted psychological intervention of them. MethodsA total of 724 grade three senior high school students from three key schools in Binzhou City， Shandong Province were selected using random sampling method. Generalized Anxiety Disorder （GAD-7）， Patients' Health Questionnaire Depression Scale-9 item （PHQ-9） and Perceived Social Support Scale （PSSS） were used to survey the psychological status including anxiety， depression and the level of social support. Partial correlation analysis was adopted to discuss the correlation of PSSS score with GAD-7 and PHQ-9 scores， meantime， the multiple linear regression analysis was conducted to explore the relationship between PSSS and PHQ-9 scores. ResultsAmong grade three senior high school students， 341 （48.64%） and 383 （54.64%） were found to have symptoms of anxiety and depression， respectively. PSSS total score as well as the dimension score of family support and other support of female students were higher than those of male students， with statistical significance （t=-3.431， -3.048， -4.482， P<0.01）. GAD-7， PSSS total scores and the dimension scores of family support and other support demonstrated statistical differences among grade three senior high school students with different selections of academic subjects for college entrance examination （F=1.992， 2.660， 2.074， 3.138， P<0.05 or 0.01）. PHQ-9 score was negatively correlated with the total score and each dimension score of PSSS （r=-0.329， -0.283， -0.284， -0.284， P<0.01）. The dimension score of family support and friend support in PSSS could negatively predict the PHQ-9 score （B=-0.213， -0.308， P<0.01）. ConclusionGrade three senior high school students under in-school quarantine during the COVID-19 pandemic suffer a high prevalence rate of anxiety and depression， while students with higher perceived social support scores report fewer symptoms of depression. Hence， improving the level of social support may alleviate depression in students.

OBJECTIVETo study the hazards of demulsifier production process.

METHODSThe air of production environment was monitored, and physical examinations were conducted on 52 exposure workers and 53 non-exposure workers (control), all the medical checks including clinical, electromyography and laboratory checks.

RESULTSThe air concentration of propylene oxide was 4.6 mg/m3, and the concentration of Ethylene oxide was 4.8 mg/m3. There was significant difference between exposure group and control group in terms of the incidence of neurasthenic syndromes, lachrymation, laryngopharyngeal ache, inappetence, tired and quadriplegia (P <0.01). The incidence of Achilles's tendon reflection, knee jerk slacking up, chronic pharyngitis, coryza, acne, hair lose and pneumonia were significantly higher in study group than that in control group (P <0.01). Peripheral nerve damage of impairment incidence rate was 40.4%, significantly higher than that in control group (9.4%). No significant difference was found between groups on IgG, IgA and IgM. And also did the rate of chromosome aberrance (CA), sister chromatid exchange (SCE) and micronuclie cell (MC) of peripheral blood (P >0.05).

CONCLUSIONThe production environment of demulisier could stimulate respiratory channel and affect peripheral nerve and central nerve, but no aberrance effects were found.

Adult ; Case-Control Studies ; Epoxy Compounds ; toxicity ; Ethylene Oxide ; toxicity ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Young Adult

AIM: To explore the characteristics of refractive changes in patients with age-related cataract and shallow anterior chamber after phacoemulsification.

METHODS: A retrospective study was conducted. 96 patients(112 affected eyes)with age-related cataract who were admitted to the hospital between March 2018 and June 2019 were divided into the shallow anterior chamber group(ACD≤2.20mm, 52 patients with 62 affected eyes)and the control group(ACD between 2.21 and 2.90 mm, 44 cases with 50 affected eyes)according to the anterior chamber depth(ACD). All subjects were treated with phacoemulsification. The diopter, ACD and anterior chamber volume(ACV)were measured before surgery, at 1d and 3mo after surgery. Pearson linear correlation analysis was performed to analyze the relationship between the refractive status and anterior chamber parameters in patients with age-related cataract and shallow anterior chamber after phacoemulsification.

RESULTS: The diopter error in the shallow anterior chamber group was higher than that in the control group at 3mo after surgery(P<0.001). The variations of ACD and ACV in the shallow anterior chamber group before surgery, at 1d and 3mo after surgery were higher than those in the control group(P<0.001). In the control group, there was no obvious correlation between the diopter error at 1d, 3mo after surgery and preoperative ACD, preoperative ACV, variations of ACD or ACV at different time after surgery(P>0.05). In the shallow anterior chamber group, the diopter error at 3mo after surgery was negatively correlated with preoperative ACD(P<0.05). The diopter error of at 3mo after surgery was positively correlated with variations of ACD at 1d and 3mo after surgery(P<0.05), but there was no obvious correlation with variations of ACV(P>0.05).

CONCLUSION: There is hyperopic shift in patients with age-related cataract and shallow anterior chamber after phacoemulsification. The degree of hyperopic shift is negatively correlated with preoperative ACD and positively correlated with postoperative ACD, namely, the smaller the preoperative ACD, the larger the postoperative ACD, the severer hyperopic shift.