Objective To detect the change of CD47 on T-lymphocyte subsets marked by CD3 + CD4+ and CD3+ CD8+ in the acute graft versus host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to explore its clinical significance.Methods The peripheral blood of 30 patients was collected before and every two weeks from hematopoietic reconstitution after allo-HSCT.The expression of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ was detected by flow cytometry,and the relationship between their expression and the occurrence of aGVHD was analyzed.Results The percentage of CD3+ CD4+-and CD3+ CD8+-marked T-lymphocyte subsets showed no statistically significant difference between aGVHD group and non-aGVHDgroup [(38.95 ± 6.18)％ vs.(37.38 ± 4.6)％,and (22.35 ± 3.32)％ vs.(20.34 ±4.56) ％,respectively] (P＞0.05).The expression levels of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ was obviously increased in aGVHD group when compared to before transplantation and non-aGVHD group after transplantation,and that had no changes in non-aGVHD group when compared to before conditioning regimen after transplantation.Mean fluorescence intensity of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ [(93.70 ± 14.88) and (70.09 ± 12.51)] in aGVHD group significantly increased as compared with non-aGVHD group [(71.27-± 11.32) and (53.93 ± 8.35)] (P＜0.05).There was no significant difference in the expression of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ before and after transplantation in non-aGVHD group (P＞0.05).Moreover the expression of CD47 on T-lymphocyte subsets marked by CD3 + CD4 + and CD3 + CD8 + changed correspondingly with the outcome of aGVHD in aGVHD group.Conclusion The change of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ andCD3+ CD8+ is valuable to monitor the aGVHD after allo-HSCT,which may provide a new means for the early detection of aGVHD.

Objective To summarize the experience of improved nonmyeloablative hematopoietic stem cell transplantation(NSCT) in the treatment of severe aplastie anemia. Methods Seventeen patients with Severe Aplastic Anemia received NSCT after a nonmyeloablative conditioning.The patients were conditioned with decreased dosage of immunosuppressive agents of CTX and anti-lymphoid cell globulin or anti-thymus gland cell globulins;CsA and MMF were used to prevent the graft-versus-host disease (GVHD) after transplantation. Results 75 % of severe aplastic anemia in patients with type Ⅰ and 60 % of severe aplastic anemia in patients with type Ⅱ achieved rapid hematopoietic reconstitution, with good prognosis and implantation rate with fewer complieations and light symptoms were observed. Conclusion NSCT is an effective treatment of severe aplastic anemia.

Objective To systematically evaluate the efficacy and safety of amlodipine (A)/hydrochlorothiazide(H) versus val‐sartan(V)/hydrochlorothiazide(H) in treatment of essential hypertension .Methods Literature was retrieved online in Cochrane Li‐brary ,PubMed ,OVID ,MEDLINE ,EMBASE ,CBM ,CNKI ,VIP and Wan fang database up to November 2013 .Relevant magazines were retrieved manually .Quality of the included studies was assessed and Meta‐analysis was performed with RevMan 5 .2 software . Results Seven randomized controlled trials(RCTs) were finally included .Meta‐analyses showed that :in terms of lowering ABP ,V/H group was more effective than A/H group ,the difference was statistically significant (P<0 .05);there was no significant differ‐ence in the decreased value of clinic BP and the control rate of blood pressure between A /H group and V/H group(P>0 .05) .Ad‐verse events occurred less frequently with V/H group compared with A/H group ,the difference was statistically significant (P<0 .05) .Conclusion A/H treatment of essential hypertension is inferior to V/H ,and has more adverse events .

Objective To introduce small group learning in the course of introduction to gen-eral practice to cultivate students' ability of active learning and innovation. Methods Totally 221 students of 2008 grade A and B classes were enrolled as teaching objects and were divided into 20 groups. Introduction to general practice was used as learning materials. One week before the class, teacher gave students learning task and A and B classes carried on class discussion respectively. Re-view speaking was conducted by the representatives of groups. Effectiveness was evaluated through the observation,interview,questionnaire survey and answer scoring points. Results Overall support per-centage to small group learning was 91%. Percentages of students who believed that small group learn-ing was beneficial to cultivating the ability of active learning and innovation were 88% and 73% re-spectively. Conclusions Introducing small group learning in the course of introduction to general practice is effective and conductive to training students' ability to study and innovate.

Objective To explore the animal model of syndrome used in the study of hot flash phenomenon in women.Methods Twenty-four female SD rats were divided randomly into three groups:Con group,Ovx group,and tamoxifen group(n = 8 rats per group).Hot flashes were induced by bilateral oophorectomy and intragastric tamoxifen 10 mg/(kg·d),respectively.Open-field activity,anal temperature,and body surface infrared thermograms were detected on model days 14 and 28.The rats were then killed on day 29 and their uteruses were removed,weighed,and sectioned.Blood estradiol and catecholamine levels were determined by enzyme-linked immunosorbent assay.Gene expression levels of adrenal sex hormone synthetases(Star,Cyp11a1,Cyp17a1,Cyp19a1,Por,Hsd3b2,Hsd17b1)and catecholamine synthetases(Th,Ddc,Dbh,Pnmt)in the adrenal medulla were detected by reverse transcription-polymerase chain reaction.Results Rat body weight was significantly higher in the Ovx group compared with Con group(P<0.01),while body weight increased slowly in the tamoxifen group.The maximum body surface temperature was significantly decreased on day 28 in the Ovx group(P<0.01),the difference between the maximum and minimum abdominal temperatures was significantly increased on day 14(P<0.05),the difference between the maximum and minimum temperatures on the back was significantly increased on day 28(P<0.01),and the open-field activity was decreased(P<0.01).Compared with the sham operation group,the maximum body surface temperature in the tamoxifen group was significantly decreased(P<0.01)but the open-field activity was increased(P<0.01).The uterine index was significantly decreased in both models(P<0.01).Estradiol levels were significantly decreased(P<0.01)and NE and epinephrine were also significantly decreased in the Ovx group compared with Con group(P<0.05),and β-EP was also significantly decreased in Ovx group(P<0.05).Adrenal Cyp11a1 gene expression was significantly increased(P<0.05)while Cyp17a1 and Hsd17b1 gene expression levels were significantly decreased(P<0.05)in bilateral ovariectomized rats compared with Con group.Compared with Con group,gene expression levels of Star and Por were significantly increased(P<0.01)while Cyp17a1 gene expression was significantly decreased(P<0.01)in the tamoxifen group,and Pnmt gene expression was significantly down-regulated in Ovx group(P<0.01).Conclusions Bilateral ovariectomized rats can be used for the study of perimenopausal hot flashes,which resemble kidney Yang and Yin deficiency in traditional Chinese medicine.

Anemia, Aplastic ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans

OBJECTIVETo evaluate the relationship between dietary habits and the risk of gestational diabetes mellitus (GDM) in Cantonese women.

METHDSThis a cross-sectional study included 571 pregnant women who underwent a 75-g oral glucose challenge test at the 24th to 28th gestational week. Food frequency questionnaire (FFQ) was used by three dieticians to evaluate all the subjects' dietary habits.

RESULTS13% of the investigated subjects were identified to have GDM (GDM⁺). No significant differences were found between the GDM⁺ and GDM⁻ groups in the intake of energy, macronutrients, fibers, or cholesterol. The amount of low- and middle-GI fruits consumed daily in the two groups was not statistically different, but the GDM⁺ subjects reported a significantly greater amount of high-GI fruit intake as well as energy-dense foods than the GDM⁻ subjects (P<0.05). Multiple logistic regression analysis revealed that increased consumption of energy-dense snack foods and high glycemic-index fruits were strongly associated with the risk of GDM.

CONCLUSIONLocal dietary composition (high-GI fruit and energy-dense foods) is closely related to the risk of GDM in Cantonese women, for whom intensive health education of dietary behavior is needed to control GDM.

China ; Cross-Sectional Studies ; Diabetes, Gestational ; epidemiology ; Diet ; Female ; Glucose Tolerance Test ; Glycemic Index ; Humans ; Pregnancy ; Surveys and Questionnaires

Objective: To investigate and analyze the impact on PLT recovery of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: A retrospective analysis of Hematology Division of General Hospital of Jinan Military Command was conducted in the 85 SAA cases who treated with allo-HSCT from January 2010 to March 2017. According to the administration of medicines for platelets, 85 patients were divided into rhTPO group (n=29), rhIL-11 group (n=27) and blank group (n=29), respectively. The median time of PLT ≥20×10⁹/L, PLT ≥50×10⁹/L, and PLT ≥100×10⁹/L, the numbers of megakaryocytes in marrow smear (25±5) days after transplantation and the quantities of platelet transfusion were analyzed retrospectively. The adverse events of rhTPO and rhIL-11 groups were observed. Results: There were no significant differences in the recovery of granulocytes and PLT ≥20×10⁹/L among the three groups (P>0.05). The time of PLT ≥50×10⁹/L in rhTPO group was shorter than that in blank group [16.5 (11-39) d vs 22 (14-66) d, P<0.05], as well as the time of PLT ≥100×10⁹/L [rhTPO: 23 (12-51) d; rhIL-11: 28 (12-80) d; blank group: 35 (18-86) d, P<0.05]. Platelet transfusions were also less in rhTPO group than in rhIL-11 and blank groups [20 (10-30) U, 30 (10-50) U, 35 (10-70) U, P<0.05]. The counts of megakaryocyte in rhTPO group, rhIL-11 group and blank group were 31.5 (0-200), 12 (0-142) and 11(0-187) (P<0.05), respectively. The difference between rhTPO group and rhIL-11 group was statistically significant (P<0.05), but no difference between rhIL-11 group and blank group (P>0.05). Multivariate analysis showed that rhTPO was an independent factor for platelet recovery [HR=4.01 (95%CI 1.81-9.97), P=0.010]. The rhTPO group had no obvious adverse events. Conclusion rhTPO can promote platelet recovery of SAA patients after allo-HSCT, reduce platelet transfusion with safety.

Objective To evaluate the postoperative analgesia efficacy and clinical safety of hydro-morphone patients-controlled intravenous analgesia(PCIA)in patients with scar pregnancy after auxiliary uterine artery embolization(UAE).Methods A total of 116 patients with scar pregnancy,who received auxiliary UAE at the Fuyang Municipal People's Hospital of China between January 2021 and September 2022,were enrolled in this study.According to the intravenous self-controlled analgesic drugs used after UAE,the patients were randomly and equally divided into observation group(n=58)and control group(n=58).Ten minutes before the procedure,intravenous injection of 2 mg hydromorphone(observation group)or 2 μg/kg sufentanyl(control group)was performed,and the PCIA pump was connected.In the observation group,the mixed solution of 10 mg hydromorphone+100 mg flurbiprofen axetil+100 mL saline was put in the analgesic pump,while in the control group,the mixed solution of 2 μg/kg sufentanyl+flurbiprofen axetil 100 mg+100 mL saline was put in the analgesic pump.The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h visual analogue scale(VAS)scores,the Bruggrmann comfort scale(BCS)scores,the number of pressing analgesic pump times within postoperative 48 hours,the used dosage of analgesic drugs,the adverse reactions,and the incidence of postoperative complications were recorded.Results The difference in the post-UAE 0.5-h VAS scores between the observation group and the control group was not statistically significant(P＞0.05),while the post-UAE 4-h,8-h,12-h,24-h and 48-h VAS scores in the observation group were significantly lower than those in the control group,and the differences were statistically significant(all P＜0.05).The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h BCS scores in the observation group were significantly higher than those in the control group,and the differences were statistically significant(all P＜0.05).The number of pressing analgesic pump times and the used dosage of analgesic drugs within postoperative 48 hours in the observation group were lower than those in the control group,and the differences were statistically significant(all P＜0.05).No statistically significant differences in the complications such as drowsiness,skin itching,hypoxia,or respiratory depression,etc.existed between the two groups,while the difference in the incidence of adverse reactions between the two groups was statistically significant(P＜0.05).Conclusion Hydromorphone and sufentanil PCIA can relieve the pain in scar pregnancy patients after UAE.Hydromorphone is superior to sufentanil in reducing the number of pressing analgesic pump times within postoperative 48 hours,reducing the used dosage of analgesic drugs,and decreasing the incidence of adverse reactions,therefore,hydromorphone PCIA has a certain promotion value.(J Intervent Radiol,2024,33:240-244)