The myelodysplastic syndromes (MDS), which are characterized by the presence of ineffective hematopoiesis and an increased risk of transformation to acute myeloid leukemia (AML), are a group of clonal disorders deriving from damage of the hematopoietic stem/progenitor cells. The 58th American Society of Hematology (ASH) Annual Meeting consists of 5 main subjects, includingchronic myelomonocytic leukemia (CMML) and MDS biology and treatment, higher risk MDS clinical studies, lower risk MDS clinical studies, predisposition and diagnosis of MDS, and prognostic and predictive utility of recurrent somatic mutations in MDS. This article will introduce some highlights of the oral reports in this meeting.

An LC-TOF /MS and LC-MS /MS method was established for the identification the related substances in ambrisentan.HPLC separation was carried out on an XBridge C18 column(4.6 mm ×150 mm,3.5 μm)with linear gradient elution using a mobile phase consists of acetonitrile,water and 0.15% formic acid.The structures of the related substances were identified by electrospray positive ESI high resolution TOF /MS and MS /MS spec-tra,and verified further through reference substances.Ambrisentan and its related substances can be separated under the established HPLC conditions.Ten related substances were detected and identified.The established method is useful for the identification of related substances in ambrisentan.The results obtained are valuable for its manufacturing process optimization and quality control.

Background: The incidence of inflammatory bowel disease (IBD) is increasing in recent years, and the etiology and pathogenesis of IBD remain unclear.Studies showed that disorder of bile acid metabolism plays an important role in the pathological process of experimental colitis.However, serum bile acid profile in IBD patients has not been reported.Aims: To investigate the changes of serum bile acid profile in patients with IBD.Methods: Seven healthy controls, 15 patients with ulcerative colitis (UC) and 16 patients with Crohn's disease (CD) at Shanghai Xin Hua Hospital were enrolled.High-performance liquid chromatography-mass spectrometry was used to determine serum bile acid profile.Results: No significant differences in serum concentrations of primary bile acid cholic acid (CA), chenodeoxycholic acid (CDCA), glycocholic acid (GCA), taurocholic acid (TCA), glycochenodeoxycholic acid (GCDCA) were found between UC or CD and controls (P>0.05).Compared with controls, serum concentration of secondary bile acid deoxycholic acid (DCA) in UC patients was significantly decreased (P<0.05), glycodeoxycholic acid (GDCA), taurodeoxycholic acid (TDCA) in CD patients were significantly decreased (P<0.05), serum concentration of lithocholic acid (LCA) in UC and CD patients was significantly decreased (P<0.05).Conclusions: The serum bile acid profile in IBD patients is significantly changed, which suggests that it may be involved in the pathological process of IBD.

Adult ; Air Pollution, Indoor ; adverse effects ; Benzene ; adverse effects ; Control Groups ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Paint

Objective To compare the clinical efficacy and angiographic outcomes of balloon dilation angioplasty,balloon-expandable stent implantation and self-expanding stent implantation in the treatment of intracranial arterial stenosis.Methods The patients with intracranial arterial stenosis who met the indications of surgical intervention treated with balloon dilatation angioplasty and stent placement were selected from Nanjing Stroke Registry Program.According to the different interventional procedures,the patients were divided into the balloon expandable stenting goup,the self-expanding stents group and the balloon dilatation angioplasty group.The success rate of surgery,the perioperative complication rate and the significant residual stenosis rate were compared among the three groups.The clinical and angiographic assessments were performed through 1-,3-,6-,12- and 24-month regular outpatient or inpatient follow-up after procedure.The incidences of ischemic stroke and/or death and restenosis within 2 years were compared.Multivariate Cox proportional hazards analysis was used to analyze the risk factors for recurrent ischemic stroke and/or death and restenosis.Results A total of 183 patients with 192 stenoses performed balloon dilatation angioplasty or stenting,in which 92 were in the balloon expandable stenting goup,42 were in the self-expanding stents goup and 49 in the balloon dilatation angioplasty group.Their preoperative stenosis rates were 80.2 ±12.8％ 、76.3 ± 11.9％ and 89.7 ± 10.2％,respectively (F =15.863,P =0.000).There were no significant differences in other baseline data.The success rates of surgery in the balloon expandable stenting group,self-expanding stents group and balloon dilatation angioplasty group were 96.7％,95.2％ and 91.8％,respectively (x2 =1.646,P =0.439).The perioperative complication rates were 6.5％,14.3％ and 10.2％,respectively (Fisher exact test,P=0.334).The imaging follow-up showed that the restenosis rate in the balloon dilatation angioplasty group was 48.5％.Although it was high than 27.7％ in the balloon expandable stenting group and 34.8％ in the self-expanding stents group,there were no significant differences (x2 =4.176,P =0.124).Multivariate Cox proportional hazards analysis showed that balloon dilatation angioplasty was an independent risk factor for restenosis after procedure (hazard ratio 2.490,95％ confidence interval 1.247- 4.969,P=0.010).Conclusions Compared to the balloon expandable stenting,the balloon dilatation angioplasty is more likely to have restenosis,but it is not associated with the risks of postoperative recurrent ischemic stroke and/or death.

Objective:To summarize acute type A aortic dissection(ATAAD) is relatively uncommon in dialysis patients, and repair outcomes are not fully understood.Methods:Between January 2014 and March 2020, 20 patients with ATAAD required dialysis for preoperative end-stage renal disease(ESRD) were treated by our group. There were 11 male and 9 female patients at mean age of(47.8±11.3) years. The mean duration of dialysis therapy in the total 20 patients before the onset of ATAAD was(4.5±3.9 )years, with 90%(18 cases) of these patients undergoing hemodialysis(rather than peritoneal dialysis). 17 patients were treated emergency surgically, surgical operation were performed under deep hypothermic circulatory arrest and perfused the cerebral selective cerebral perfusion, 5 cases with ascending aorta + arch fenestrated stent, 5 cases with ascending aorta+ hemi-arch replacement(2 cases with stent elephant trunk), 4 cases with ascending aorta+ arch replacement+ stent elephant trunk(1 case with coronary artery bypass grafting for left anterior descending coronary artery), 2 cases with aortic valvuloplasty + ascending aorta+ hemi-arch replacement, 1 case with Bentall+ arch fenestrated stent.Results:2 patients were died from aortic ruptured before operation, 1 patient treated medically was alive three months after admission. Cross-clamp, cardiopulmonary bypass, and circulatory arrest times of all the surgical patients were(233.8±84.4) min, (155.5±63.6)min and(28.2±10.8)min, respectively. The following complications occurred postoperative: 3 cases died in the hospital, 1 case of tracheotomy, 2 cases of cerebral infarction, 1 case of cerebral hemorrhage, 1 case of transient paraplegia, and 1 case of surgical site infection. After a mean follow-up of(11.6±14.5) months(rang, 3-61 months). the overall survival rate at 1 year and 5 years was 53% and 27% respectively.Conclusion:Dialysis patients with ATAAD should be operated on urgently and medical treatment carries high risks of aortic rupture, although in-hospital mortality is acceptable, long-term mortality is poor.

A.niger M1, the initial strain, was treated by UV and a mutant with 30% higher xylanase activity was obtained. Zymogram for detecting xylanase showed there are three different xylanases in the mutant mature culture, while two xylanases in initial strain. After orthogonal experiment, the optimum fermentation conditions of the mutant were obtained as follows: concentration of the major carbon resource 4 %, ratio between bran and corncob 5:5, concentration of glucose 0.1%, concentration of ammonium oxalate as supplemental nitrogen resource 2.0%, the initial pH of liquid medium 5.0, 100mL/250mL flask.

Objective:To investigate the perfection and improvement of the execution of integrative medicine therapy in severe tetanus therapy, to successfully control tetanus severe spasms, autonomic dysfunction and prevent lethal side-effect of prolong and high-dosage sedative-muscle-relaxant therapy, resulted in significant reduction of mortality of tetanus.Methods:Symptoms, treatments and outcome of tetanus patients admitted to Peking University Third Hospital from 1965 to 2020 were reviewed. Patients were classified with Ablett classification. The cases of Ablett grade Ⅲ and Ⅳ were severe tetanus. The patients were divided into two groups according to whether they were treated together with traditional Chinese medicine (TCM) simultaneously during the standard tetanus treatment; the patients in the TCM group were divided into the tetanus TCM medication group and the non tetanus TCM medication group according to the medicine provided whether was in accord with the conventional tetanus TCM prescriptions. The mortality of each group was calculated. In addition, one survived and one deceased case with severe convulsion, autonomic nerve dysfunction (Ablett grade Ⅳ) were selected, combined with the treatment methods and curative effects, the types, use methods and outcomes of Chinese and Western medicine were analyzed.Results:The 46 tetanus cases were treated with Western medicine. Twenty-two of them, TCM were applied. Fifteen of the 22 cases took the TCM prescription which was accord with the conventional tetanus prescription. The mortality of the 46 cases was 21.7% (10/46). The number of non-TCM group was 24 cases, with mortality of 20.8% (5/24); 1 case was Ablett Ⅱ, 1 was Ablett Ⅲ and 3 were Ablett Ⅳ. The number of the TCM group was 22 cases, with mortality of 22.7% (5/22), 2 cases were Ablett Ⅲ, 3 were Ablett Ⅳ. The TCM prescription of these 5 deceased cases was not directed towards tetanus. The tetanus TCM medication group was 15 cases, with no mortality. Case analyses: case 1 was intubated because of severe spasms. Autonomic dysfunction occurred on the 8th day after admission. Esmolol with increasing the dosage of the sedatives and muscle relaxant, was not effective. Tetanus TCM was applied after 2 days of autonomic dysfunction happened. Autonomic dysfunction was then under controlled on the 2nd day post-TCM. She was recovery and discharged after 4 weeks. Case 2, also was intubated because of severe spasms. Autonomic dysfunction happened on the 3rd day after admission, and failed to be controlled by large-dose sedatives, muscle relaxant, and Esmolol. After 8 days of persistent autonomic dysfunction, tetanus TCM was applied and autonomic dysfunction was under controlled on the 2nd day post-TCM administration. Large dosage of muscle-relaxant was applied continuously. After 5 days' administration of TCM, the TCM was withdrew. One day after the withdrawal of TCM, respiratory and cardiac arrest happened because of the diffused bronchiole obstruction with pulmonary secretions loading.Conclusion:Based on the precise and real-time diagnosis of the state of the disease, integrative medicine therapy with an overall analysis tetanus TCM prescription, is the key of declining tetanus mortality.

OBJECTIVE: To evaluate the significance of additional 180-degree roll test (RT) in the determination of affected side in patients with horizontal semicircular canal benign paroxysmal vertigo (HSC-BPPV). METHOD: One hundred and six patients with HSC-BPPV were performed the 90 degree RT. patients whose affected side cannot be determined by 90 degree RT were performed 180 degree roll test. RESULT: The affected side was deter- mined by the 180 degree RT in 10 cases in which the lesion side cannot be determined by the 90-degree RT. CONCLUSION The affected side of HSC BPPV was able to be determined by 180 degree RT when it not possible to be determined by 90 degree RT. 180 degree RT is an effective and simple additional method.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Movements ; Humans ; Posture ; Rotation ; Semicircular Canals ; Vertigo

OBJECTIVE: To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression. METHOD: Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS). RESULT: THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38. CONCLUSION Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.
Anxiety ; complications ; Depression ; Depressive Disorder ; Humans ; Personality Inventory ; Stress, Psychological ; Surveys and Questionnaires ; Tinnitus ; complications ; psychology