AIM: To observe the local expression of nuclear factor-?B(NF-?B) in spontaneously hypertensive rat(SHR) kidney and effects of AT1 receptor contagonist valsartan.METHODS: 16 SHRs were randomly divided into two groups: SHR control group and valsartan group.Another 8 WKY rats act as normal control group.Systolic blood pressure(SBP) of SHR was measured at the beginning and the end of 2,4,6 and 8 weeks of intervention treatment.Radioimmunoassay was used to determine the activities of rennin and angiotensin II(AngII).The renal tissue NF-?B protein expression was detected by immunobiochemistry.RESULTS: SBP of SHR was remarkably decreased after valsartan intervention.However,the rennin activities and AngII level in plasma increased in valsartan group.In the renal tissue of SHR,there was remarkably increased in expression of NF-?B protein.Valsartan could significantly reduced NF-?B expression.CONCLUSION: Valsartan can depress NF-?B renal expression in protein level and might benefit hypotension renal function.

Objective To study the diagnostic value of heart fat acid binding protein (h‐FABP) in myocardial damage of children with hand‐foot‐mouth disease (HFMD) .Methods From February 2012 to December 2014 ,100 children with HFMD were chosen as study objects .All children study were divided into 2 sub‐groups according to the severity of disease:71 in ordinary HFMD sub‐group ,29 in severe HFMD sub‐group .At the same time ,100 healthy children were chosen as control group .The routine blood test , rate of abnormal electrocardiography ,rate of abnormal cTnI and rate of abnormal h‐FABP were compared among all children .The cTnI and h‐FABP at different time were compared between ordinary HFMD sub‐group and severe HFMD sub‐group .Results The WBC ,RBC and L had significant difference among different groups/sub‐groups(P<0 .05) ,the difference of PLT had no statistical significance(P>0 .05) .In ordinary HFMD sub‐group ,rate of abnormal electrocardiography was 19 .72% (14/71) ,rate of abnormal cTnI was 4 .23% (3/71)and rate of abnormal h‐FABP was16 .39% (10/71);in severe HFMD group ,rate of abnormal electrocardio‐graphy was 72 .41% (21/29) ,rate of abnormal cTnI was 82 .76% (23/29) and rate of abnormal h‐FABP was 82 .96% (23/29);in control group ,rate of abnormal electrocardiography was 1 .00% (1/100) ,rate of abnormal cTnI was 2 .00% (2/100)and rate of ab‐normal h‐FABP was 0 .00% (0/100) ,the difference had statistical significance(P<0 .05) .The cTnI and h‐FABP at different time had significant difference between ordinary HFMD sub‐group and severe HFMD sub‐group(P<0 .05) .Conclusion Heart fat acid binding protein (h‐FABP) can reflect the early myocardial damage in children with hand‐foot‐mouth disease .

Objective To compare the clinical features of cytomegalovirus (CMV) infection and CMV disease after allogeneic hematopoietic stem-cell transplantation (HSCT) from HLA haploidentical related doors vs.HLA-matched sibling donors.Methods A total of 327 patients who received allogeneic HSCT from Jan.2011 to Dec.2011 were enrolled.There were 312 patients who had complete serological data before HSCT including 216 cases of HLA haploidentical related HSCT and 96 cases of HLA-matched sibling HSCT.Monitoring of CMV antigenemia was performed by using real-time quantitative (RQ) PCR after transplantation.Risk factors were compared by univariate and multivariate analysis.Results The cumulative incidence of CMV infection and CMV disease was (80.1 ± 2.7) ％ and (8.7 ± 2.0) ％ in HLA haploiddentical HSCT group,and (21.1 ± 4.9) ％ and 0 in HLA-matched sibling HSCT group respectively,and the difference was statistically significant between the two groups (P＜0.01).Univariate analysis revealed that HLA haploidentical related HSCT,less than 20 years of age,high risk disease,CMV-IgG serum positivity in patients or donors,acute graft-versus-host disease (aGVHD),EB viremia,and hemorrhagic cystitis were the risk factors of CMV infection.HLA haploidentical related SCT and hemorrhagic cystitis were the risk factors for CMV disease.Multivariate analysis showed that patients less than 20 years of age had a significantly high incidence of CMV infection.Patients from HLA-matched sibling HSCT,low risk disease,aGVHD,hemorrhagic cystitis had a significantly low incidence of CMV infection.Conclusion Compared with patients receiving HLA-matched sibling HSCT,those who received HLA haploidentical related HSCT had significantly high incidence of CMV infection and CMV disease,which were correlated with incidence of hemorrhagic cystitis.

Objective: To investigate the impact of mycophenolate mofetil (MMF) prophylaxis duration on acute graft-versus-host disease (aGVHD) after haploidentical stem cell transplantation (haplo-HSCT) using 'Beijing Protocol’. Methods: Adult patients (≥14 years) received haplo-HSCT in Peking University Institute of Hematology from Sep, 2016 to Mar, 2017 were retrospectively reviewed if they fulfilled the criterias: ①diagnosed with hematological maligancies; ②standard-risk status at haplo-HSCT. A total of 237 patients [including 102 patients with long MMF duration (defined as started on day -9 with 100 mg/d, adjusted to 500 mg/d from day +30 and discontinued on day +45 to +60 or occurrence of CMV/EBV reactivation or late-onset hemorrhagic cytitis), and 135 patients with short MMF duration (defined as started on day -9 with 500 mg/d and discontinued on the day achieved neutrophil engraftment)] were reviewed. The incidence of aGVHD, virus infection and overall survival (OS) were compared between the two groups. Results: The median durations of MMF prophylaxis of long and short duration groups were 27(7-71) and 15(9-24) days, respectively after haplo-HSCT. There were no differences of baseline characteristics (including sex, patient age, disease, mismatched HLA loci, donor-recipient relation, donor-recipient sex and donor age) between the two groups. The incidences of the grade Ⅱ-Ⅳ and Ⅲ/Ⅳ aGVHD in long and short duration groups were 31.1% versus 17.6% (P=0.018) and 7.4% verus 7.8% (P=0.900), respectively. The duration of MMF prophylaxis was not found to be associated with gradeⅡ-Ⅳ aGVHD by the multivariate analysis. There were no significant differences in terms of CMV viremia, EBV viremia, hemorrhagic cytitis and OS between the two groups. Conclusion Prophylaxis with short duration MMF in the setting of 'Beijing protocol’ haplo-SCT was not associated with increased acute GVHD with no impact on OS, which indicated that short duration MMF might be a feasible GVHD prophylaxis regimen.

Objective:To study a classifier used to classify arrhythmia electrocardiogram (ECG) signals under the inter-patient paradigm to improve the accuracy of automatic classification and solve the limitations of manual diagnosis of arrhythmia.Methods:A SVM+XGBoost ensemble classifier with four modules including preprocessing, feature extraction, support vector machine (SVM) training and ensemble classification was constructed. ECG signal was preprocessed, and R-R interval, high-order statistics, local binary patterns and wavelet components were used as features to train independent SVM classifiers. Then, XGboost algorithm was used to integrate independent SVM classifiers and output arrhythmia classification results. The integrated classifiers were trained and tested on MIT-BIH database.Results:The overall classification accuracy of the ensemble classifier for arrhythmia was 0.867 and the average sensitivity was 0.782.Conclusions:The proposed ensemble classifier can realize automatic and accurate classification of arrhythmia ECG signals under the inter-patient paradigm, and can be used for clinical auxiliary diagnosis.

Objective To investigate the incidence and pathogenesis of fever within the first 24　hours following allogeneic peripheral stem cell transfusion and to analyze the associated risk factors.Methods Totally 114 patients received allogeneic hematopoietic stem cell transplantation(allo-HSCT)between October 2009 and August 2010 were enrolled and clinical data of febrile patients within 24 hours　following peripheral stem cell transfusion were retrospectively analyzed.Multivariate logistic regression analysis was performed to identify the risk factors for transfusion related fever.Results Thirty-two (28.1％)out of the 114 patients had a fever within 24 hours after allo-HSCT.All of them were human leukocyte antigen(HLA)mismatch transplantation.The median time of the temperature elevated was 2.5(0-18.0)hours after the infusion with a median time of the peak of 7.8(3.5-23.0)hours after the infusion.Fever was attributed to definite infection in 6 patients and no definite infection in the remaining 26 patients.None of them were hemolytic,which was attributed to transfusion related fever.Multivariate analysis showed that female donor and high count of peripheral leukocyte of donor peripheral blood were significant predictors for transfusion related fever.Conclusions Most of post-infusion fever within 24 hours after HLA mismatch related transplantation has no identifiable infectious focus.The risk factors for transfusion related fever are female donor and high number of peripheral leukocyte of donor blood.

Objective To investigate the safety and efficacy of second allogeneic hematopoietic stem cell transplantation for the relapsed hematologic malignancies. Methods The data of 25 relapsed patients received the second allogeneic transplantation as a salvage therapy in Institute of Hematology Peking University between October 1999 and March 2010 were analyzed retrospectively. Twenty-four patients relapsed at 8. 8 (1-55) months after the first transplantation, except one received the second transplantation as prophylaxis therapy. They received the second transplantation after 3(0. 3-20) months' therapy. The median time between the 2 transplants was 10. 6(0. 6-59. 0) months. Results Most of the patients were given the conditioning regimen including total body irradiation (TBI, 700-779 cGy) or modified busulfan and cyclophosphamide (BUCY, BU 12 mg). All patients survived more than 30 days and achieved sustained white blood cell engraftment. Sinus obstructive syndrome, irradiation dermatitis and acute myocardial infraction were occurred in 3 patients and recoverable. Until January 31 in 2011, with a median observation period of 9. 1 (2. 0-131. 1) months, 8 patients had been living with a overall survival (OS) of 30.9%.Twelve patients relapsed at a median 4. 4 months and 10 died of it. The other 7 patients died of transplant related complications. The non-relapsed mortality was 35. 1 %. The disease status at the 2nd transplantation was the only factor which effected the OS (P = 0. 009). Conclusions The second allogeneic transplantation is a viable option for patients relapsing after the first transplantation. Reduced intensive conditioning regimen ensures the graft engraftment and reduces transplant related toxicity.

Objective: To investigate the clinical significance of PCR detection of human herpesvirus 6 (HHV6) in gastro biopsy on the course of diarrhea in patients with severe diarrhea after allogeneic hematopoietic stem cell transplantation (HSCT) . Methods: Data from a cohort of 45 HSCT recipients (including age, sex, transplantation conditions, graft-versus-host disease, treatments, clinical signs, outcome, HHV6, and other infections) performed between 2015 and 2016 were collected. Univariate analysis was used to evaluate influences between the different parameters. Results: Of the 45 enrolled recipients, 21 patients (46.7%) presented HHV6 positive in gastro-biopsy during the analyzed period. The incidence of CMV viremia in the positive HHV6 group was comparable with that in the negative HHV6 group. But the incidence of EBV viremia in the positive HHV6 group was significantly higher than in the negative HHV6 group (P=0.028) . 44 out of 45 patients with severe diarrhea were given antiviral treatment with foscarnet and/or ganciclovir, the latter didn’t influence the course of the diarrhea. Conclusions Positive PCR results in GI tract samples didn’t necessarily reflect reactivation of HHV6. Further studies are needed to define the significance of HHV6 for GI tract symptoms after allo-HSCT.

Objective: To evaluate the impact of pre-transplant course on transplant outcomes in patients with acute myeloid leukemia (AML) . Methods: A retrospective analysis was conducted in 107 patients with AML who received allogeneic hematopoietic stem cells transplantation (allo-HSCT) in the first complete remission stage (CR₁) from January 2012 to June 2014. Results: ①46 cases received allo-HSCT within 6 months upon diagnosis, including 25 males and 21 females, with a median age of 26 (12-60) y. 61 cases received allo-HSCT after 6 months upon diagnosis, including 34 males and 27 females, with a median age of 31 (14-58) years. There is no statistical significance in patients’ age, gender, NCCN risk stratification, courses for induction, minimal residual disease (MRD) status, transplantation type and infection rates prior to transplantation. Total courses of chemotherapy before allo-HSCT were 4 (3-5) and 5 (4-10) for the two groups, respectively. ②Incidences of Grade Ⅱ-Ⅳ aGVHD were 26.09% (12/46) for the <6-month group and 24.59% (15/61) for the ≥6 months group (P=0.860) . Incidences of Grade Ⅲ/Ⅳ aGVHD were 2.17% (1/46) for the <6-month group and 14.75% (9/61) for the ≥6 months group (P=0.027) . ③ Probabilities of 2-year overall survival (OS) were (90.3±4.6) % for the <6 months group and (75.7±5.7) % for the ≥6 months group (P=0.042) . Probabilities of 2-year disease-free survival (DFS) were (90.7±4.4) % for the <6 months group and (76.3±5.5) % for the ≥6 months group (P=0.038) . ④ During the median follow-up of 863 (26-2 026) days, cumulative incidences of non-relapse mortality were (4.4±3.1) % for the <6 months group and (18.2±5.0) % for the ≥6 months group (P=0.047) . ⑤ Univariate analysis showed that age, NCCN risk stratification, MRD status before transplantation and rates of infection was not related to transplantation outcomes. Chemotherapy courses before allo-HSCT (≤4 or >4) was related to OS and DFS (P=0.044, P=0.039) , but not to NRM (P=0.079) . Conclusion AML patients who obtained CR₁ could achieve better long-term survival by receiving allo-HSCT within 6 months after diagnosis.

Objective:Donor cytomegalovirus (CMV) serological negative status may have an adverse effect on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT), while there is inadequate data for Chinese people. This study is to explore the impact of donor CMV serological status on the outcome of CMV seropositive patients receiving allo-HSCT.Methods:Our study retrospectively analyzed 16 CMV seropositive patients with hematological malignancies receiving allogeneic grafts from CMV seronegative donors (antibody IgG negative) at Peking University People′s Hospital from March 2013 to March 2020, which was defined as D -/R + group. The other 64 CMV seropositive patients receiving grafts from CMV seropositive donors at the same period of time were selected as matched controls through a propensity score with 1∶4 depending on age, disease state and donor-recipient relationship (D +/R + group). Results:Patients in D -/R + group developed CMV DNAemia later than patients in the D +/R + group (+37 days vs. +31 days after allo-HSCT, P=0.011), but the duration of CMV DNAemia in D -/R + group was longer than that of D +/R + group (99 days vs. 34 days, P=0.012). The rate of CMV reactivation 4 times or more in D -/R + group was 4/16, significantly higher than that of D +/R + group (4.7%, 3/64, P=0.01). The incidences of refractory CMV DNAemia (14/16 vs. 56.3%, P=0.021) and CMV disease (4/16 vs. 4.7%, P=0.01) in D -/R + group were both higher than those in D +/R + group. In addition, the application of CMV-CTL as the second-line antiviral treatment in D -/R + group was more than that in D +/R + group. Univariate analysis and multivariate analysis suggested that CMV serological negativity is an independent risk factor for refractory CMV DNAemia and the duration of CMV infection. The cumulative incidence of aGVHDⅡ-Ⅳ, cGVHD, 3-year probability of NRM, overall survival, and the cumulative incidence of relapse were all comparable in two groups. Conclusions:Although there is no significant effect on OS and NRM, the incidence of refractory CMV DNAemia, the frequency of virus reactivation, and the development of CMV disease in D -/R + group are higher than those in controls. Therefore, CMV seropositive donors are preferred for CMV seropositive patients.