BACKGROUND: Previous studies have shown that HLA-identical sibling allogeneic peripheral blood hematopoietic stemcelltransplantation (allo-HSCT) provides higher disease-free and overall survival rates for patients with intermediatecytogenetic risk acute myeloid leukemia (AML) in complete remission (CR). But prognosis factors have not been fullydefined.OBJECTIVE: To evaluate the outcome of patients with intermediate cytogenetic risk AML undergoing HLA-matchedallo-HSCT in CR, and to analyze the prognostic factors.METHODS: Fifty cases of intermediate cytogenetic risk AML in CR receiving HLA-matched allo-HSCT from January2009 to January 2015 were retrospectively analyzed. Primary outcome measures of the study included overall survival(OS), relapse rate and non-relapse mortality.RESULTS AND CONCLUSION: The 4-year OS of the study population reached to 64%, and the relapse rate and NRMreached to 18% and 20% respectively. Incidence of acute graft-versus-host disease was 26%. Different prognosis wasobserved between female donor/male recipient (FDMR) combination transplant and control (4-year OS: 50% vs. 71.9%,P=0.041), between patients requiring more than one course of induction chemotherapy to achieve CR and control(4-year OS: 40% vs. 70%, P=0.038), between older age (≥ 40 years) and control (4-year OS: 44.4% vs. 68.3%,P=0.056). The 4-year OS for matched sibling donor and matched unrelated donor was 63.2% and 66.7% (P=0.427),respectively. Further analysis revealed significantly high non-relapse mortality in FDMR combination transplant (P=0.024)and older age (≥ 40 years; P=0.043). Multivariate analysis revealed three negative prognostic factors: FDMRcombination (P=0.031, RR=1.38, 95% CI: 1.03-1.95), requiring more than one course of induction chemotherapy toachieve CR (P=0.016, RR=1.46, 95% CI: 1.10-1.98) and older age (≥ 40 years; P=0.024, RR=1.63, 95% CI: 1.32-2.12).To conclude, HLA-matched allo-HSCT is a choice for the intermediate cytogenetic risk AML case in CR. FDMRcombination, requiring more than one course of induction chemotherapy to achieve CR and older age (≥ 40 years) areconfirmed as risk factors of poor prognosis for HLA-matched allo-HSCT patients with intermediate cytogenetic risk AMLin CR. To these cases, the donor-recipient sex combination is more important than the donor type in donor selection.

Objective To investigate the characteristics of plasma glucose, insulin secretion and changes of insulin resistance (IR) after a glucose load in obese children, and to predict islet β-cell function. Methods A total of 635 obese children were classified into normal glucose tolerance (NGT) group (n=483), impaired glucose regulation (IGR) group (n=112) and type 2 diabetes mellitus (DM) group (n=40) based on their glucose levels. Subjects were also divided into G1 group (23 kg/m2≤BMI<30 kg/m2, n=393) and G2 group (BMI≥30 kg/m2, n=242) based on their different BMI levels. Level of fast plasma glucose (FPG, 0.5 h-PG, 1 h-PG, 2 h-PG and 3 h-PG) and insulin (FINS, 0.5 h-INS, 1 h-INS, 2 h-INS and 3 h-INS) were measured 0 h, 0.5 h, 1 h, 2 h and 3 h after a glucose load. Insulin resistance index (HOMA-IR), whole body insulin sensitivity index (WBISI), function of pancreatic beta-cell (HOMA-β), first-phase insulin secretion index (ΔI30/ΔG30) and area under curve of insulin (AUCI) were calculated and compared between groups. Results The value of insulin at each time point was significantly higher in IGR group than that of NGT group. The values of insulin at 0.5 h, 1 h, and 2 h were significantly lower in DM group than those of IGR group, respectively (all P<0.05). Compared with NGT group, AUCI, HOMA-IR and HOMA-β increased, but WBISI and ΔI30/ΔG30 decreased in IGR group (all P<0.05). HOMA-IR increased but WBISI, HOMA-βandΔI30/ΔG30 decreased in DM group (all P<0.05). Compared with IGR group, AUCI, HOMA-βandΔI30/ΔG30 decreased in DM group (all P<0.05). Values of FINS, AUCI, HOMA-IR, 2h-PG and HOMA-βwere significantly higher in G2 group than those of G1 group, but WBISI decreased (all P<0.05). There were no significant differences in FPG and ΔI30/ΔG30 between these two groups. Conclusion From NGT, IGR to DM, the peak of insulin secretion is postponed, insulin resistance is getting heavier and the compensation of insulin secretion after a glucose load is increased first and then decreased.

Objective:To study the changes of left atrial volume and function in patients with acute myocardial infarction (AMI) by three-dimensional echocardiography (3DE) and magnetic resonance imaging (MRI).Methods:Thirty-one patients with AMI in Henan People′s Hospital from March to October 2020 were selected as AMI group and 30 healthy subjects were selected as control group.The left atrial maximum volume (LAVmax), minimum volume (LAVmin), presystolic volume (LAVpre), volume index(LAVI), emptying volume (LAEV), ejection fraction (LAEF), long axis and circumferential strain (LASr, LASr-c; LAScd, LAScd-c; LASct, LASct-c) were measured by two-dimensional echocardiography (2DE), 3DE left atrial automatic quantitative technique and CMR.The differences of left atrial indices between two groups and among 2DE, 3DE left atrial automatic quantitative and CMR techniques were compared. Pearson correlation coefficient and Bland-Altman analysis were used to compare 2DE, 3DE left atrial automatic quantitative and CMR. Intra-observer and inter-observer repeatability of 2DE, 3DE left atrial automatic quantitative technique and CMR were evaluated by intra-group correlation coefficient (ICC).Results:①Compared with the control group: LAVmax, LAVmin, LAVpre, LAVI, LASct and LASct-c by 3DE left atrial automatic quantitative increased, while LAEV, LAEF, LASr, LASr-c, LAScd and LAScd-c by 3DE left atrial automatic quantitative technique decreased in AMI group (all P<0.05). ②LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct measured by 3DE left atrial automatic quantitative were more strongly related to CMR than that measured by 2DE(all P<0.05). Compared with CMR, 2DE underestimated LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct by (8.01±4.01)ml, (9.03±4.15)ml, (7.26±2.09 )ml, (7.26±1.23)%, (5.02±1.08)%, (6.24±0.43)%(all P<0.05); 3DE left atrial automatic quantitative technique underestimated LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct by (1.67±0.62)ml, (1.95±0.90)ml, (2.52±0.76)ml, (1.97±0.59)%, (2.03±0.39)%, (1.02±0.30)% (all P>0.05); The time-consuming of 2DE and 3DE left atrial automatic quantitative technique was reduced, and the time-consuming of 3DE left atrial automatic quantitative technique was less than 2DE [(12.18±3.24)s vs (73.34±10.37)s]. ③The reproducibility of 2DE, 3DE left atrial automatic quantitative technique and CMR measurement within and between observers were good. Conclusions:3DE left atrial automatic quantitative technique can effectively evaluate the changes of left atrial volume and function in patients with AMI. Compared with 2DE and CMR, it is simple, rapid, accurate and repeatable, which provides a new and effective method for clinical study of cardiovascular diseases.

Objective:The evaluate left ventricular myocardial work in maintenance hemodialysis (MHD) patients by non-invasive left ventricular pressure strain curve.Methods:Forty-eight patients undergoing maintenance hemodialysis were selected as the MHD group, and 33 healthy subjects were selected as the control group from Apr to Oct 2019 in Henan Provincial People′s Hospital. The differences of general clinical data, basic parameters of two-dimensional ultrasound including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), stroke volume (SV), diastolic interventricular septal thickness (IVSd), left ventricular diastolic posterior wall thickness (LVPWd), left ventricular diastolic mass (LVDm), left ventricular systolic mass (LVSm), late diastolic tissue velocity (a′), early diastolic peak velocity/early diastolic tissue velocity (E/e′), A peak and cardiac output (CO), peak strain dispersion (PSD), and global work index (GWI), global work efficiency (GWE), global constructive work (GCW), global wasted work (GWW) and global long-axis strain (GLS) between two groups were compared, and the correlation between myocardial work parameters and conventional cardiac parameters was analyzed.Results:①In terms of comparison, LVDd, LVDs, LVEDV, LVESV, SV, IVSd, LVPWd, LVDm, LVSm, systolic blood pressure (SBP), diastolic blood pressure (DBP), a′, E/e′. A peak and CO of the MHD group were greater than those in the control group (all P<0.05), and e′ of the MHD group was lower ( P<0.05). ②In terms of comparison, PSD and GWW of the MHD group were greater than those of the control group (all P<0.05), while GLS and GWE of the MHD group was lower (all P<0.05). There were no statistically significant differences in GCW and GWI between two groups(all P>0.05). ③GWI was positively correlated with SBP, DBP and left ventricular ejection fraction (LVEF)( r1=0.442, P1=0.030; r2=0.477, P2=0.019; r3=0.431, P3=0.040), and negatively correlated with GLS and LVDs( r1=-0.576, P1=0.003; r2=-0.404, P2=0.050). GWW was positively correlated with GLS and PSD( r1=0.584, P1=0.003; r2=0.564, P2=0.004). GWE was positively correlated with LVEF( r=0.424, P=0.044), and negatively correlated with LVEDV, LVESV, PSD, GLS and LVDm( r1=-0.444, P1=0.034; r2=-0.490, P2=0.018; r3=-0.721, P3<0.001; r4=-0.738, P4<0.001; r5=-0.442, P5=0.035). GCW was positively correlated with LVEF and DBP( r1=0.494, P1=0.017; r2=0431, P2=0.035), and negatively correlated with GLS and LVDs( r1=-0.630, P1=0.001; r2=-0.419, P2=0.042). Conclusions:The non-invasive left ventricular pressure-strain curve combines blood pressure and strain. Compared with the GLS, it can accurately assess left ventricular myocardial work in maintenance hemodialysis patients and predict potential left ventricular function changes in maintenance hemodialysis patients.

Objective: To understand the occupational external exposure dose among radiation workers in a first-class hospital at Grade 3 of Suzhou, and to provide reference for radiological protection. Methods: The individual dose of 1156 radiation workers in the hospital from 2010 to 2017 were detected, the annual collective effective dose and per capita annual effective dose were analyzed for different years, different occupations (diagnostic radiology, radiotherapy, nuclear medicine, interventional radiology) , gender, and age. Results: From 2010 to 2017, the total annual collective effective dose was 351.40 person·mSv, the per capita annual dose was 0.30 mSv/a, and radiation workers whose annual effective dose was less than 1 mSv accounted for 94.98%. There were 5 interventional radiology workers and 1 nuclear medicine worker with annual effective dose between 2 and 4 mSv. There was no worker with annual effective dose over 4 mSv. The per capita annual effective dose of nuclear medicine workers was the highest (0.40 mSv/a) . The per capita annual effective dose was not significantly different between radiation workers with different genders and ages (P>0.05) . Conclusion Most of radiation workers have low individual dose level in the hospital. It is important to focus on nuclear medicine workers and interventional radiology workers.

This study shows a case of a patient with synovial chondromatosis of the hip misdiagnosed as rice body bursitis. The patient complained of pain and limited activity in his left hip. He was diagnosed with synovial chondromatosis of the hip by medical history, physical examination, imaging examination and postoperative pathology. Based on literature review, the characteristics and differential diagnosis of the disease in epidemiology, imaging and pathology were discussed in detail, so as to improve the understanding of the disease and avoid misdiagnosis. He was treated with hip arthroscopy and obtained satisfactory therapeutic effect. The patient was followed up for 1 year without recurrence.

Objective:To explore the changes of left atrial volume and function in patients with early diabetic nephropathy by four-dimensional auto left atrial quantification (4D Auto LAQ).Methods:Forty patients with early diabetic nephropathy (early diabetic nephropathy group), 40 patients with type 2 diabetes (diabetes group) in Henan Provincial People′s Hospital from March 2020 to April 2021 were selected, and 36 healthy volunteers (control group) were collected during the same period. The parameters of conventional echocardiography were measured, and the four-dimensional volume probe was used to obtain the complete left atrial volume image in 5 cardiac cycles. The 4D Auto LAQ software on the EchoPAC workstation was used for analysis to obtain the left atrial volume and strain indicators: left atrial (LA) maximum volume (LAVmax), left atrial minimum volume (LAVmin), pre-systolic volume (LAVpreA), left atrial volume index (LAVImax), left atrial emptying volume (LAEV), left atrial emptying fraction (LAEF), and long axis and circumferential strains in left atrial reserve phase, pipeline phase and systolic phase (LASr, LASr-c; LAScd, LAScd-c; LASct, LASct-c). The differences of these parameters among 3 groups were analyzed.Results:There were no significant differences in interventricular septum end-diastolic thickness(IVSd), left ventricular posterior wall end-diastolic thickness(LVPWd), left ventricular end-diastolic dimension(LVIDd), left ventricular ejection fraction(LVEF), and E/A (ration of early to late diastolic peak flow velocity of mitral orifice) among 3 groups (all P>0.05), and left atrial diameter(LAD), relative wall thickness(RWT), and E/e′ (ration of early diastolic peak flow velocity of mitral orifice to early diastolic velocity of lateral mitral annulus) among 3 groups were significantly different (all P<0.05). Further pairwise comparison results showed that LAD was only significantly different between the early diabetic nephropathy group and control group ( P=0.001 2), and the differences in RWT and E/e′ were statistically significant among 3 groups (all P<0.05). There were no significant differences in LAEV, LAScd-c, and LASct-c among 3 groups (all P>0.05), and LAVmin, LAVmax, LAVpreA, LAVImax, LAEF, LASr, LAScd, LASct, and LASr-c among the 3 groups were significantly different (all P<0.05). The pairwise comparison showed that, compared with the control group and the diabetes group, LAVmin, AVpreA, and LAVImax in the early diabetic nephropathy group were increased, and LAEF, LAScd, LASct, and LASr-c were decreased (all P<0.05). Compared with the control group, LAVmax, LAVImax and LASct in the diabetes group were increased, and LAEF, LAScd, and LASr-c were decreased (all P<0.05). Conclusions:4D Auto LAQ technology can quantitatively evaluate the changes in left atrium volume and function in patients with early diabetic nephropathy. Patients with early diabetic nephropathy have an increase in left atrium volume and a decrease in strain value.

Objective:To develop an ex vivo normothermic mechanical perfusion(NMP)and compare the effect of air-oxygenated NMP versus oxygen-oxygenated NMP on reducing renal injury from donor after cardiac death(DCD).Methods:All kidneys from DCD rats were subjected to 30 min in situ warm ischemia after cardiac attest.And harvested kidneys were stored for 8h under static cold preservation after NMP for 2h.In experimental groups, kidneys were subjected to either air-oxygenated NMP(group A, n=6)or oxygen-oxygenated NMP(group O, n=6). Sham operation(group C, n=6)and DCD kidneys under static cold preservation without NMP(group SCS, n=6)were employed as controls.The evaluation parameters included creatinine(Cr), aspartate amino transferase(AST)and lactate dehydrogenase(LDH)in perfusate, pathological changes by hematoxylin-eosin(HE)staining, histological criteria, expressions of myeloperoxidase and intercellular adhesion molecular-1(ICAM-1)by immunohistochemistry and Western blot, tumor necrosis factor-alpha(TNF-α)and interleukin-6(IL-6)by enzyme-linked immunoadsorbent assay and level of malondialdehyde(MDA)by thiobarbital method and activity of superoxide dismutase(SOD)by WST-8 in renal tissues.Differences between two groups were analyzed by two-tailed unpaired Student's test and differences among more than two groups by one-way ANOVA.Results:Renal arterial oxygen tensions in NMP perfusate were(576.3±68.2)mmHg with oxygen-oxygenation and(137.0±39.1)mmHg with air-oxygenation.There was significant difference( P<0.05). The pathological injury scores in groups SCS, O and A by HE staining were(7.0±0.1), (5.0±0.9)and(2.5±0.5); injury scores and the expressions of renal proximal tubular epithelial cell vacuolar degeneration in groups O and A were lower than those in group SCS( P<0.05)and injury score in group A was lower than group O( P<0.05). In perfusate, the levels of △Cr, △AST and △LDH in groups O and A were(43.9±52.8)μmol/L and(12.6±3.5)μmol/L, (532.3±52.8)U/L and(49.1±50.4)U/L and(9998.0±2014.4)U/L and(1477.0±810.4)U/L.There were significant differences( P<0.05). In perfused kidneys, the MDA level and SOD activity in groups O and A were(0.192±0.018)mmol/g, (0.162±0.023)mmol/g, (0.6±0.3)×10 3 U/g, (1.7±0.4)×10 3 U/g; TNF-α and IL-6 levels in groups O and A were(124.376±19.635)and(89.331±13.123)ng/g, and(4.038±1.026)×10 3 and(1.774±0.518)×10 3 ng/g.After air-oxygenated NMP, lower renal damage indices were characterized by a lower MDA level and a higher SOD activity, the lower levels of TNF-α and IL-6 and the lower expressions of MPO and ICAM-1 than those in oxygen-oxygenated NMP( P<0.05). Conclusions:NMP with air-oxygenation mimics renal perfusion under physiological conditions and decreases oxidative stress and inflammation injury.It may confer a better retrieval in DCD kidney against warm ischemia injury.