Asthma ; epidemiology ; Humans ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; epidemiology

Objective:To explore the clinical effect of lenalidomide combined with anti-B-cell maturation antigen chimeric antigen receptor T cell (anti-BCMA CAR-T) in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:The clinical data of a patient with RRMM who underwent lenalidomide combined with anti-BCMA CAR-T therapy in Henan Province Hospital of Traditional Chinese Medicine in January 2020 were analyzed. Clinical manifestations, diagnosis and treatment were also analyzed, and the related literature was reviewed.Results:The patient was a 51-year-old man who was diagnosed as IgD-λ multiple myeloma (MM) in October 2015. The patient achieved remission after 10 courses of chemotherapy regimens including immunomodulators and proteasome inhibitors, followed by autologous hematopoietic stem cell transplantation. MM relapsed after 14 months of transplantation. His disease continued to progress after multiple chemotherapy regimens and mouse or human-derived anti-BCMA CAR-T therapy. After a conditioning chemotherapy regimen of fludarabine and cyclophosphamide, the patient took lenalidomide on day 1 and was infused human-derived anti-BCMA CAR-T cells on the next day. Grade 3 cytokine releasing syndrome (CRS) appeared after infusion, and was resolved after symptomatic treatment. Very good partial response (VGPR) was achieved on day 14 after anti-BCMA CAR-T treatment. VGPR had been maintained for more than 3 months by press time.Conclusion:Lenalidomide combined with anti-BCMA CAR-T therapy is feasible and effective in the treatment of RRMM.

Objective To investigate whether functional Wnt-?-catenin signaling is present in activated hepatic stellate cells (HSC),and the effect of blocking this signaling on activation of HSC. Methods?-catenin expression in HSC was examined by immunocytochemistry.Wnt signalings in HSC-T6 were assessed using a T cell factor (TCF)-dependent luciferase reporter gene (pTOP- FLASH) assay.Wnt signalings in HSC-T6 were blocked by transfecting with a dominant negative TCF (dnTCF) expression plasmid,then the expression of alpha smooth muscle actin (?-SMA) and collagen typeⅠwere examined by Western blot.Results?-catenin staining was positive in the nuclei of HSC-T6.Luciferase activity in the cells transfected with pTOPFLASH was significantly higher than that in the cells transfected with pFOPFLASH (P

Humans ; Water ; Rivers ; Skull/anatomy & histology* ; Brain/diagnostic imaging* ; Forensic Medicine ; Forensic Anthropology

Objective:To investigate the role of blood ammonia in the evaluation of the prognosis of septic patients in the emergency department and to compare its value with mortality in emergency department sepsis (MEDS) score.Methods:A retrospective clinical study was conducted to septic patients who were diagnosed in the Emergency Department of West China Hospital of Sichuan University from June 2017 to May 2018, and met the diagnostic criteria established by the diagnostic criteria of the American College of Chest Physicians/Society of Critical Care Medicine in 2001. The subjects who had other diseases that affected blood ammonia level and were lost to follow-up were excluded. MEDS scores were collected, and the survival status of patients was followed up by telephone. The independent samples t test was used to compare the differences between the two groups, receiver operating characteristic (ROC) curve was used to assess the accuracy of the prediction of sepsis mortality, and the logistic regression model was used to explore the value of the combined use of blood ammonia and MEDS score.Results:Eighty subjects were finally included in the study and divided into the 1-week survival group ( n=52), 1-week death group ( n=28); 4-week survival group ( n=37), 4-week death group ( n=43); 12-week survival group ( n=33), 12-week death group ( n=47); 1-year survival group ( n=32), and 1-year death group ( n=48). There was no statistical difference in the demographic characteristics of subjects between the groups. The average blood ammonia level of all the subjects who died was higher than that of the patients who survived in the same period [(116.57 ± 85.33) μmol/L vs (77.63 ± 35.82) μmol/L, (108.53 ± 73.00) μmol/L vs (71.19 ± 32.53) μmol/L, (106.74 ± 71.59) μmol/L vs (69.21 ± 28.84) μmol/L, (105.77 ± 71.14) μmol/L vs (69.50 ± 29.25) μmol/L, P<0.05]. Based on death after one week, four weeks, twelve weeks and one year, the area under ROC curve (AUC) of blood ammonia was 0.668 (95% CI: 0.542-0.793, P=0.014), 0.706 (95% CI: 0.593-0.819, P=0.002), 0.705 (95% CI: 0.592-0.818, P=0.002), and 0.697 (95% CI: 0.582-0.811, P=0.003), respectively. Compared with the use of blood ammonia, lactic acid or MEDS score alone, the combined use of blood ammonia and MEDS score increased the accuracy of prognosis evaluation in sepstic patients ( P<0.05). Conclusions:Blood ammonia has a high value in predicting the short-term and 1-year prognosis of septic patients in the emergency department. The combined use of blood ammonia and MEDS score can further improve its predictive value.

The traditional culture methods and the molecular biology methods were used to study the rhizosphere bacterial diversity between fusarium wilt resistant and susceptible watermelon. The results showed that the diversity and the equality of cultured rhizosphere bacteria of resistant watermelon were higher than those of the susceptible watermelon. The reason was that the cultured rhizosphere bacterial di- versity index H′ and 1/D of the resistant watermelon were higher than those of the susceptible watermelon and that the cultured rhizosphere bacterial equality index E of the resistant watermelon were higher than those of the susceptible watermelon. The dominant cultured bacterial genotypes were different between re- sistant and susceptible watermelon. The genotype 1 is the dominant genotype of resistant watermelon, con- sists 51.1%. The genotype 7 is the dominant genotype of susceptible watermelon, consists 58.7%.

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

OBJECTIVETo investigate the value of MRI follow-up in pediatric patients with spinal tuberculosis.

METHODSFrom February 2004 to April 2013, MRI imaging data in 21 children with spinal tuberculosis by pathologically and clinically proven were retrospectively analysed. There were 11 males and 10 males, with an average age of 9.4 years old ranging from 2 to 14 years old. Eighteen patients were received conservative treatment, 3 patients were treated by surgical operation. The course of disease ranged from 2 months to 3 years. All cases underwent two or more MRI examinations for follow-up. MRI findings of the first and second examination were comparatively analyzed,including signal changes of vertebral body and intervertebral, paraspinal abscess and the change of kyphosis angle.

RESULTSIn the 21 cases with tuberculosis, 85 vertebral bodies were affected in total, including 10.6%(9/85), 49.4%(42/85) and 40%(34/85) vertebral bodies separately in the cervical,thoracic, lumbosacral spine. Follow-up MRI showed vertebral body shape and signal had no obvious change during or after treatment, 15 cases with vertebral bodies changed flat or cuneate, 10 cases with disc involvement,and intervertebral space became narrowing at different level. Among 13 patients with kyphosis angle greater than 0°, 7 were located on thoracic, 2, 3, 1 were on thoracolumbar, lumbar and cervical spine, respectively. Among 18 cases with conservative treatment,kyphosis angle were 0° on the first and the follow up MRI of 8 patients. One case of mild (<10°) kyphosis,follow-up MRI during therapy showed the angle slightly increased; 5 cases with moderate (10° to 30°), follow-up MRI during therapy showed no obvious change; 4 cases with severe (>30°), follow-up MRI during and after therapy showed kyphosis increased in varying degrees.

CONCLUSIONFollow-up MRI can make a big difference in the spinal tuberculosis of children; it can clearly show the change of the vertebral body and intervertebral space, paraspinal abscess and the kyphosis angle after the treatment,which can provide reference for clinical treatment and estimating prognosis.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Monitoring ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Retrospective Studies ; Spine ; diagnostic imaging ; Tuberculosis, Spinal ; diagnostic imaging ; drug therapy ; surgery

Animals ; Calcium Channel Blockers ; therapeutic use ; Dogs ; Hypothermia ; complications ; Male ; Nimodipine ; therapeutic use ; Ventricular Fibrillation ; etiology ; prevention & control

Abstract: Objective To follow up and evaluate the stability testing status of γ stereotactic radiotherapy system (hereinafter γ knife WS 582-2017 Specifications for Testing of Quality Control in X and γ referred to ) in medical institutions based on the RayStereotactic Radiotherapy System WS 582-2017 Methods (hereinafter referred to ). A total of 43 medical institutions using γ knife and 54 medical physics personnel were recruited as the research subjects by random sampling method. Based on the - - standard tracking evaluation method, we followed up the evaluation of γ knife stability testing based on WS 582 2017. Results - Only 66.7% of the 54 subjects preformed WS 582 2017 in their daily work. Only 30.2% (all were tertiary hospital) of 43 medical institutions were equipped with complete quality control and testing equipment. The implementation rate of γ knife stability test was 67.4%, and it was not carried out in strict accordance with the test events and test cycle requirements - specified in the WS 582 2017. There were incomplete test events, incomplete records or test cycles that did not meet the Conclusion standard requirements in γ knife stability test. Medical institutions did not carry out γ knife stability tests in strict - accordance with the projects and cycle required by the WS 582 2017. The reasons are related to medical institutions are not equipped with complete testing equipment, the personnel are lack of understanding of relevant national standards, the poor publicity and implementation of the standards, the lack of standardized training channels and inadequate health supervision.