Objective To explore the differences in clinical and laboratory parameters between elderly and non-elderly patients with acute lymphoblastic leukemia (ALL).Poor prognostic factors in elderly patients were explored to guide the individualized treatment.Methods Two hundred and seventy-nine ALL patients were divided into two groups:elderly group with their age more than 60 years (60-79 years) and nonelderly group with their age less than 60 years (14-59 years).The differences in clinical and laboratory parameters,abnormal molecular genetics on related genes,including IKZF1,PAX5,NOTCH1,PHF6,SH2B3,LEF1,and JAK1,as well as the correlations with treatment response and clinical outcome were compared between the two groups.Results Males accounted for a smaller part in elderly group [42.9 ％ (21/49) vs.61.7 ％ (142/230),P =0.015].The percentage of B cell lineage ALL (B-ALL),Philadelphia chromosome positive (Ph+) and CD33 positive rate were higher in elderly group compared with those in non-elderly group [87.8 ％ (43/49) vs.70.4 ％ (162/230),P=0.009;47.8 ％ (22/49) vs.27.4 ％ (58/230),P=0.007;56.8 ％ (21/49) vs.39.0 ％ (64/230),P =0.049,respectively].While both lymphodenopathy and total complete remission (CR) rate gained the upper hand in non-elderly group [38.9 ％ (81/230) vs.20.0 ％ (9/49),P=0.016;91.3 ％ (178/195) vs.68.3 ％ (28/41),P＜ 0.001,respectively].Moreover,elderly group had lower 3-month,6-month,12-month and 24-month overall survival (OS) rates (64.6 ％ vs.84.4 ％,P=0.001;50.0 ％ vs.73.8 ％,P=0.001;29.2 ％ vs.52.4 ％,P=0.003;6.2 ％ vs.26.2 ％,P=0.003,respectively) than those of non-elderly group.No significant differences in mutation rates of PAX5,NOTCH1,PHF6,SH2B3,LEF1 and JAK1 were found (all P ＞ 0.05).Conclusions Compared with non-elderly ALL patients,elderly ones harbor their intrinsic characteristics which might give rise to inferior outcomes.As a consequence,more attention should be poured into treating this particular group of ALL patients to improve their prognosis.

Objective:To analyze the clinical features of post-pancreaticoduodenectomy hemorrhage, and explore effective and practical nursing strategies.Methods:Clinical data of 62 patients with post-pancreaticoduodenectomy hemorrhage from Jan 2014 to Dec 2019 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed. The bleeding time, location, vital signs, accompanying symptoms and surgical treatment measures and clinical outcomes were analyzed.Results:Among the 62 cases, early (within 24 h) hemorrhage occurred in 19/62 patients (30.6%), and late hemorrhage occurred in 43/62 patients (69.4%). 36/62 patients (58.1%) had arterial bleeding; And 43/62 patients (69.4%) had abdominal hemorrhage. Grade C hemorrhage occurred in 32/62 patients (51.6%). Sentinel hemorrhage occurred in 8/62 patients (12.9%). The manifestation of hemorrhage in 42 patients was bloody fluid from abdominal drainage tube (67.7%). Hemorrhage occurred in 23 patients with pancreatic fistula(37.1%), 12 patients with abdominal infection and other complications (19.4%). Shock symptoms occurred in 41 cases (66.1%) with postoperative hemorrhage. Pancreaticoduodenectomy hemorrhage were early detected in 0.3 h and last detected in 869 h, with a median time of 192.00 (14.63, 297.00) h. 30/62 cases (48.4%) of hemorrhage patients occurred 1 hour before and after nursing shift. When hemorrhage was found, emergency treatments such as blood transfusion to maintain blood volume ( n=47, 75.8%), hemostasis ( n=35, 56.5%) and vasoactive drugs to increase blood pressure ( n=32, 51.6%) were usually given immediately. 31/62 patients (50.0%) underwent emergency secondary surgery within 4 h of hemorrhage, and 45/62 patients (72.6%) were cured by emergency surgical treatment. A written treatment pre-plan for surgical nurses was established. Conclusions:Surgical nurses should be familiar with the clinical manifestations of post-pancreaticoduodenectomy hemorrhage, and improve the alarming ability of identifying the complications of post-operative hemorrhage. The establishment of an emergency pre-plan for surgical nurses could help to treat such patients timely and effectively.

OBJECTIVETo study the effect of electro-acupuncture (EA) at points along Foot Yangming Channel on metabolite of ulcerative colitis (UC) rats' cerebral cortex and to identify key metabolites by referring to Pi/Wei-brain related theory in Chinese medicine (CM).

METHODSThe UC rat model was set up by dextran sulfate sodium (DSS) method. Male SD rats were randomly divided into the model group and the EA group, 13 in each group. Another 13 rats were recruited as the blank control group. Rats in the blank control group and the model group received no EA. EA was performed at Zusanli (ST36), Shangjuxu (ST37), and Tianshu (ST25) for 5 days by using disperse-dense wave. Then all rats were sacrificed. Their recto-colon and the ileocecal junction were pathomorphologically observed by light microscope and transmission electron microscope (TEM). Cerebral cortexes were extracted. Water-soluble and lipid-soluble brain tissue metabolites were respectively extracted for metabolic research using 1H nuclear magnetic resonance (1H-NMR).

RESULTSEA could obviously improve the general condition of UC model rats, decrease the value of DAI, reduce the infiltration of inflammatory cells in the intestinal tract, stabilize structures such as mitochondria, endoplasmic reticulum and so on (P <0.05). 1HNMR analysis showed that in the model group, contents of glutamic acid, cholesterol, very low density lipoproein (VLDL) in the pallium obviously decreased, while alanine and low density lipoprotein (LDL) significantly increased. After EA, levels of lactic acid, glutamic acid, total cholesterol (TC), and VLDL all increased, and levels of alanine and LDL decreased. All indices were approximate to those of the blank control group.

CONCLUSIONEA at Foot Yangming channel was found to have some effect on metabolites in the brain tissue of UC model rats, which had specific metabonomic material basis and mechanism based on the Pi/Wei-brain related theory.

Acupuncture Points ; Animals ; Cerebral Cortex ; metabolism ; Colitis, Ulcerative ; Electroacupuncture ; Lipids ; Male ; Rats, Sprague-Dawley

In tumor immunotherapy, the study of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) provides a new approach for the comprehensive treatment of advanced lung cancer. About 20％ of patients with non-small cell lung cancer could benefit from lung cancer immunotherapy, while those with high PD-L1 expression will benefit more. At present, there are few related studies on PD-1 expression at home and abroad, and the detection of PD-1/PD-L1 expressions is mostly concentrated in tumor tissues. With the research progress of liquid biopsy technology, the convenience and accuracy of peripheral blood testing are also receiving more and more attention. However, there are still few biological indicators for predicting the efficacy of tumor immunotherapy, and the uniform standard and accuracy of testing still need more clinical practice and exploration. This article reviews the research on the expressions of PD-1 and PD-L1 in tissues and peripheral blood of patients with lung cancer, aiming to provide reference for the treatment of lung cancer with immune checkpoint blockers.

Acquired Immunodeficiency Syndrome ; Blood Donors ; China ; HIV Infections ; Humans ; Prejudice ; Rural Population

Volatile oil components and the contents and types of amino acid in spica of Prunella vulgaris were analysed by GC-MS and amino acid analyzer. Esters, fatty acids, aromatic hydrocarbon, ketone and several alcohol compounds were identified by mass spectrum comparison. In these ingredients, beta-ionone smelled aroma of cedar, raspberry, nerolidol showed weak sweet soft orange blossom flavor, neroli tasted sweet and fresh, nerolidol tasted sweet with light aroma of wood, hexadecanal showed a weak aroma of flowers and wax, alpha-sinensal had rich and fresh sweet orange flavor. To some extent, these types of aromatic substances can affect the taste of herbal tea or decoction made of Spica Prunellae. Among amino acids detected, natural amino acids accounted for a larger proportion, and those natural amino acids showed bitterness, slight bitterness, sourness (freshness), sweetness, slight sweetness, sourness (slight freshness). The results indicated that bitter and slightly bitter amino acids have the greatest impacts on the sense of Spica Prunellae.
Amino Acids ; analysis ; Gas Chromatography-Mass Spectrometry ; Oils, Volatile ; analysis ; Prunella ; chemistry ; Taste

Objective To understand the status of suicidal ideation and attitudes towards suicide among university students in Harbin as well as the influencing factors. Methods A multi-stage stratified random clustered sampling procedure was used to select university students(n=5240)who were aged 16-43 years, in Harbin. Factors associated with suicidal ideation were analyzed with logistic regression by demography characteristics and scores on the suicide acceptability scale and the social support rating scale(SSRS). Results According to our data, 9.1% of the respondents had suicidal ideation and 1% had made a suicide attempt. The influencing factors for suicidal ideation were gender, major, relationship between their parents, acceptance on thc idca of suicide attempt,the state of social support and the history of suicide attempt. Conclusion The suicidal ideation of university students in Harbin should not be neglected. Measures should be taken to improve the quality of mental health and to reduce the ratio of suicide behavior among college students.

Objective To explore into the condition of fluoride content of the drinking water and the present status of water-improving projects in the endemic fluomsis areas in Shanxi province,and to provide the evidence for making scientific and effective tactics in prevention and control.Methods In 2007,according to "The National Technical Scheme for Endemic Disease Control",screening for drinking water fluoride content was carried out in non-improving water villages of 15 counties(cities,districts).The investigation of all water-improving projects was carried out in 10 counties(cities).The fluoride content in drinking water was determined by fluoride selective ion electrode(GB/T 8538-1995).Results Screening for drinking water fluoride content was carried out in 969 non-improving water villages in 15 counties(cities,districts).Average water fluoride content was≤1.0 mg/L in 497 villages,accounting for 51.29%(497/969).Average water fluoride content was>1.0 mg/L in 472 villages.accounting for 48.71%(472/969).The overall standard drinking water fluoride content was mainlv>1.0-4.0mg/L,and the maximum average water fluoride content was 8.96 mg/L.The investigation of 290 water-improving projects was carried out in 10 counties(cities).Among 290 water-improving projects 213 water-improving projects were running normally,accounting for 73.45%(213/290);77 water-improving projects were running abnormally,accounting for 26.55%(77/290).Water fluoride content was≤1.0 mg/L in 158 projects,accounting for 54.48%(158/290).Water fluoride content was>1.0 mg/L in 132 projects,accounting for 45.52%(132/290).The maximal water fluoride content was 5.20 mg/L.Conclusions The situation of drinking water fluoride content over the national standard is serious in Shanxi province.The qualification rate was lower for the fluoride content of water-improving projects.Therefore,we should strength water-improving projects to raise the effectiveness of prevention and treatment and assure their quality.

OBJECTIVETo develop an HPLC method for determination of two polyacetylenes, lobetyolin and lobetyolinin, in Herba Lobeliae Chinensis.

METHODC18 column was used with the mobile phase consisted of acetonitrile and water. Linear gradient elution from 10% to 40% acetonitrile in 25 min was applied, at the flow rate of 1.0 mL x min(-1), the detection wavelength was at 267 nm.

RESULTLower contents of lobetyolin and lobtyolinin were found in collected samples of Herba Lobeliae Chinensis. The highest amounts of lobetyolin and lobetyolinin were found to be 0.461 and 0.436 mg x g(-1) in a sample procured from Hong Kong. However, there were no lobetyolin and lobetyolinin in some of the samples.

CONCLUSIONA simple and effective HPLC method to analyze the two polyacetylenes in Herba Lobeliae Chinensis was established. It could be applied for the quality control of this herb.

Chromatography, High Pressure Liquid ; methods ; Lobelia ; chemistry ; Molecular Structure ; Plants, Medicinal ; chemistry ; Polyacetylenes ; analysis ; chemistry ; Quality Control ; Reproducibility of Results

Objective To observe the clinical efficacy and safety of GINA regimen and GINA regimen combined with oral Huaiqihuang granule in the treatment of children with bronchial asthma.Methods A ran-domized,single blind,multicenter,parallel controlled clinical trial wascarried out.A total of 1 128 patients with bronchial asthma in children were randomized into two groups.The observation group were treated with GINA regimen combined with oral Huaiqihuang granule.The GINA regimen treatment group was treated by GINA reg-imen.Clinical assessment and C-ACT scores was observed in first month,third month,sixth month after treat-ment.Clinical assessment included the times of upper respiratory tract infection occurrence,bronchitis and pneu-monia,asthmatic attacks,application of emergency medicine,hospitalizations due to asthmatic.Drug adverse effect in the two groups was compared.Results The times of upper respiratory tract infection,bronchitis and pneumonia,asthmatic was significantly decreased(P <0.05 ),and C-ACTscores were significantly higher(P <0.05)in the first month,the third month,and the sixth month after treatment.There were 16 cases of drug relat-ed adverse reactions.Seven cases were in observation group(n ﹦7)(1.15%)and 9 cases in the GINA regimen treatment group(n ﹦9)(1.73%).There was no significant difference of adverse effect between the two groups (P >0.05).Conclusion The treatment of bronchial asthma in children with GINA regimen combined with oral Huaiqihuang granule can significantly reduce the incidence of respiratory infections and the number of asthmatic attacks dramatically and safely improve clinical curative effect,asthma control.