Objective To explore the value of bone marrow megakaryocyte counts in predicting clinical response of thrombocytopenia (TP) in systemic lupus erythematosus (SLE) patients. Methods Thirty-one patients of SLE with severe TP (platelet ≤50×109/L) from Peking Union Medical College Hospital during 2007 to 2014 with appreciable bone marrow aspiration results were retrospectively analyzed. Their therapeutic responses were stratified and the correlation with clinical and laboratory findings including the megakaryocyte counts in bone marrow were evaluated with logistic multivariate regression. Results Totally fifteen patients obtained complete response (CR), eight patients obtained partial response (PR) and eight no response (NR). Megakaryocyte counts in bone marrow were (101±26)/slide, (156±48)/slide and (34±15)/slide respectively with statistically significant difference (χ2=6.632, P=0.036). Those NR patients had less megakaryocytes in their bone marrow compared with those with clinical response (CR+PR) (Z=-2.438, P=0.015). By ROC curve method, we found 20/slide might be a good cutoff of megakaryocyte counts in bone marrow for determining the therapeutic response of immunotherapy with a sensitivity of 91% and a specificity of 63% and a AUC (area under the curve) of 0.793. Those with 20/slide or less megakaryocytes in bone marrows only had a clinical effective response rate of 29% verse a response rate of 88% in those with more megakaryocytes in bone marrow. Conclusion Megakaryocyte counts in bone marrow may provide predictive value for therapeutic response of severe TP in SLE patients. Those patients with equal or less than 20/slide megakaryocytes in their bone marrow tend to have poor therapeutic response.

The chemical constituents from the n-butanol fraction of ethanol extract of safflower (Carthamus tinctorius L.) were isolated and purified using chromatographic process including MCI Gel CHP-20, ODS, Sephadex LH-20 column chromatography, and semi-preparative HPLC method, and one alkyne and two phenylpropanoid derivants were obtained. Their structures were identified as (5R,E)-tetradecane-12-ene-8,10-diyne-1,5,14-triol (1), (E)-8-O-β-D-glucopyranosyl n-butyl cinnamate (2), and (7S,8S)-7-(4-hydroxy-3-methoxybenzene)-7-butyl-8,9-diol (3) by modern spectroscopy methods (1D NMR, 2D NMR, UV, IR and MS). 1-3 are all new compounds. Compounds 1-3 were screened for their anti-renal fibrosis activities in vitro, and none of them showed obvious effect.

OBJECTIVETo evaluate the effects of school entrance age on cognition and behaviors in children with attention deficit hyperactivity disorder (ADHD) using mathematical event-related potential (ERP), behavioral test, and Conners Parent Symptom Questionnaire (PSQ).

METHODSFifty-eight ADHD children aged 7-12 years were enrolled and classified into older age and younger age groups according to the school entrance age (n=29 each). The children in the older age group were admitted at an age of 6 years and 6 months to 6 years and 11 months, and those in the younger age group were admitted at an age of 6 years to 6 years and 5 months. The ERP with a mathematical task was used to detect the difference in brain electrical activity between the two groups, and the behavioral test results were compared. The children's parents were asked to complete the PSQ, and the scores on each subscale were compared.

RESULTSThe ERP detection showed that the older age group had a significantly higher P2 amplitude for wrong answers than the younger age group (10.9±5.0 μv vs 8.5±3.6 μv; P<0.05). The younger age group had a significantly shorter time of response to wrong answers than the older age group (619±340 ms vs 870±418 ms; P<0.05). The scores on the subscales of learning problems and impulse-hyperactivity of PSQ were significantly higher in the younger age group than in the older age group (P<0.05).

CONCLUSIONSSchool entrance age can affect cognition and behaviors in children with ADHD, and the ADHD children with a younger school entrance age have an obvious defect in executive function, especially the function of error detection, which leads to the prominent problems in impulse-hyperactivity and learning.

Age Factors ; Attention Deficit Disorder with Hyperactivity ; physiopathology ; psychology ; Child ; Child Behavior ; Evoked Potentials ; physiology ; Female ; Humans ; Male

XYL1 gene,which encodes xylose reductase with dual coenzyme activity from Candida tropicalis,was transformed into Pichia pastoris X-33 by expression vector pGAPZB.The recombination strain was immobilized in Ca-alginate beads and fermentation characterization is studied using corn cob hydrolysates.Fermentation conditions were as follow:initial pH value 6.0,30℃,initial cell concentration of 20%,the Liquid volume of 28%,rotation speed 130r/min.The average xylitol yield was 37.5% on the optimum condition.This result is expected to provide a new alternative method for producing xylitol on a large scale by bioconversion.

Objective To evaluate the homogeneity of the proficiency test samples to verify whether it meets the requirements of the comparison in international reference laboratory.Methods According to the Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing (CNAS-GL03),14 biochemical indexes including ALT,AST,ALP,GGT,CK,LDH,TP,T-Bil,Urea,Cr,UA,Glu,TG and TC in the past three years (from 2014 to 2016)were tested by the Roche detection system Modular P800 Biochemical analyzer.The mean ((x)),standard deviation (s)and coefficient of variation (CV)of the samples were calculated.One-way analysis of variance (ANOVA)was performed and the guideline of Ss ≤0.3σ was used to evaluate the between-bottle differences.Results The results showed that the CVs of AST in RELA 2014A and B were higher than 2.0％.The CVs of CK were over 2％ in all tests except for RELA 2016B.The results of ANOVA for RELA samples demonstrated that the F value of CK was over the critical value 4.39,which was statistically significant (P ＜ 0.05).The F values of the ALT and T-Bil in 2015B and the Cr in 2014A were also over 4.39 (P ＜ 0.05) respectively,while the F values of other measurements were less than the critical value of F,indicating there was no statistical significance (P ＞ 0.05).The CK measurement data Ss ＞ 0.3σ in all the samples by the guideline of Ss ≤ 0.3σ,suggesting that there was a between-bottle difference in CK.The other indexes were Ss ≤ 0.3σ,showing no between-bottle difference in those items.Conclusion There were significant differences between the bottles of the CK item in the past three years,and the homogeneity of all the other items in the samples could meet the requirements of Proficiency Testing for the international reference laboratory.

OBJECTIVETo investigate the cognitive characteristics in early school-age children with attention deficit hyperactivity disorder (ADHD) using event-related potential (ERP) and Achenbach Child Behavior Checklist (CBCL), as well as the correlation between ERP and behavioral problems.

METHODSA total of 22 children aged 6-7 years with ADHD and 19 healthy children matched by age were enrolled. Continue Performance Test-AX (CPT-AX) was performed for ERP test. The amplitude and latency of N2 and P3 of Go and Nogo were compared. The CBCL was completed by the parents, and the correlation between behavioral factors and ERP was analyzed.

RESULTSThe ADHD group had a significantly higher number of ERP omissions than the normal control group (10±8 vs 5±4; P<0.05), while the reaction time and number of commission errors showed no significant differences between the two groups (P>0.05). The ADHD group showed a significantly lower Go-N2 amplitude than the normal control group (-8±5 μV vs -10±4 μV; P<0.05). In the ADHD group, the detection rates of hyperactivity, attack, and discipline violation were 27%, 27% and 9% respectively. The scores on attack and discipline violation subscales were negatively correlated with the Go-N2 amplitude of ERP (r=-0.43 and -0.48 respectively; P<0.05), while the score on hyperactivity subscale was positively correlated with the latency of Go-P3 (r=0.50, P<0.05).

CONCLUSIONSThe early school-age children with ADHD show the tendency to the impairment of attention/executive function, but the inhibition function defect has not been noted. In early school-age children with ADHD, the behavioral problems such as hyperactivity, attack, and discipline violation are associated with ERP.

Attention Deficit Disorder with Hyperactivity ; physiopathology ; psychology ; Child ; Child Behavior Disorders ; etiology ; Evoked Potentials ; physiology ; Humans

This study was aimed to investigate the expression characteristics of two transcriptional factors in Ikaros family, Ikaros and Helios isoforms and their mechanism, as well as their correlation with clinical parameters, which play important roles in transcriptional regulation of hematopoiesis. Expression of Ikaros and Helios isoforms in a total of 163 patients with leukemia and correlations between Ikaros and Helios isoforms were analyzed by PCR. The results showed that different expression patters of Ikaros and Helios isoforms existed in leukemia patients, that is, Ikaros isoform (Ik-6) was predominantly expressed in acute lymphoblastic leukemia (ALL) with BCR/ABL fusion gene, while Helios isoform (He-i) was overexpressed in T-cell ALL patients. The results of cloning and sequencing demonstrated that the isoforms of Ikaros and Helios had different genetic alterations. The statistical correlation between these two isoforms not was found in this study, although interaction between Ikaros and Helios has been reported. It is concluded that although Ikaros and Helios belong to the same family with similar structure of zinc fingers, their isoforms have different expression profile, specific genetic alterations, and different clinical relevance in patients with leukemia. The connection and interaction between Ik-6 and He-i needs further research.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Gene Expression Profiling ; Humans ; Ikaros Transcription Factor ; genetics ; metabolism ; Leukemia ; genetics ; metabolism ; Male ; Middle Aged ; Protein Isoforms ; genetics ; metabolism ; Young Adult

OBJECTIVETo evaluate the technique and significance of mastoscopic axillary sentinel lymph node biopsy.

METHODSSixty-two patients with breast cancer use methylene blue to test axillary sentinel lymph node. Sentinel lymph node was moved with endoscopy, and endoscopic axillary lymph nod dissection was performed. Pathological examination of sentinel lymph node and axillary lymph node was made with HE. To evaluate detection rate and false negative rate in sentinel lymph node.

RESULTSAmong the 62 patients, 61 were confirmed by endoscopic axillary sentinel lymph nod biopsy. Detection rate was 98.4%. Thirty-five cases were no metastasis, 27 cases were metastasis, false negative rate was 0.

CONCLUSIONSMastoscopic axillary sentinel lymph node biopsy has a high detection rate, good efficiency of cosmetic and lower complications. It has higher sensitivity than traditional axillary lymph nod dissection and provide accurate lymph node stages.

Adult ; Aged ; Breast Neoplasms ; pathology ; Endoscopy ; methods ; Female ; Humans ; Lymphatic Metastasis ; diagnosis ; Middle Aged ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; methods

BACKGROUNDMyocardial tissue-level perfusion failure is associated with adverse outcomes following ST-elevation myocardial infarction (STEMI) despite successful epicardial recanalization. We have developed a new quantitative index-thrombolysis in myocardial infarction (TIMI) myocardial perfusion frame count (TMPFC)--for assessing myocardial tissue level perfusion. However, factors affecting this novel index of myocardial perfusion are currently unknown.

METHODSA total of 255 consecutive STEMI patients undergoing primary angioplasty were enrolled. Myocardial tissue level perfusion was assessed by TMPFC, which measures the filling and clearance of contrast in the myocardium using cine-angiographic frame counting. We differentiate three groups with two cut off values for TMPFC: a TMPFC of 90 frames was the upper boundary of the 95% confidence interval (CI) for the TMPFC observed in normal arteries, and a TMPFC of 130 was the 75th percentile of TMPFC.

RESULTSSTEMI patients with TMPFC > 130 frames (68 patients, 26.7%) had higher clinical and angiographic risk factor profiles as well as a higher 30-day MACE rate compared with those with TMPFC ≤ 90 frames and those with TMPFC > 90 and ≤ 130 frames. Multivariable analysis identified that the independent predictors of TMPFC > 130 frames were age ≥ 75 years (OR 2.08, 95%CI 1.21 to 3.58, P = 0.007), diabetes (OR 1.37, 95%CI 1.01 to 1.86, P = 0.042), Killip class ≥ 2 (OR 1.52, 95%CI 1.05 to 2.21, P = 0.027), and prolonged pain-to-balloon time (OR 1.73, 95%CI 1.07 to 2.79, P = 0.013). TMPFC > 130 frames was identified as the strongest independent predictor of 30-day major adverse cardiac event (MACE) (OR 2.77, 95%CI 1.21 to 6.31, P = 0.008), along with age ≥ 75 years (OR 2.19, 95%CI 1.11 to 4.33, P = 0.016), female gender (OR 1.67, 95%CI 1.03 to 2.70, P = 0.038), and Killip class ≥ 2 (OR 1.83, 95%CI 1.07 to 3.14, P = 0.021).

CONCLUSIONSSTEMI patients with poor myocardial perfusion assessed by TMPFC had higher risk factor profiles. Advanced age, diabetes, higher Killip class, and longer ischemia time were independent predictors of impaired TMPFC after primary percutaneous coronary intervention. These results emphasize that particular attention should be paid on myocardial microvascular reperfusion in STEMI patients with these risk factors.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; pathology ; therapy ; Myocardial Reperfusion ; Myocardium ; metabolism ; pathology

This study was purposed to investigate the incidence of mixed lineage leukemia (MLL) gene rearrangement and partner gene types as well as the clinical features and prognosis of acute leukemia (AL) with this rearrangement through detection in adult AL using combination of 3 techniques, and to evaluate the clinical value of this combination detection. The MLL gene rearrangement in 183 cases of adult AL was detected by combination of conventional cytogenetics, split signal FISH and multiplex nested PCR. The results showed that the incidence of MLL rearrangements in adult patients with AL was low (8.2%), and MLL-AF4 fusion gene was most common and predominant in acute lymphoblastic leukemia (ALL), while the MLL-AF6 and MLL-AF9 were most frequent in acute myeloid leukemia (AML). Extramedullary involvements were found in 40% of MLL-rearranged AL patients, and 33.3% of patients with MLL-rearranged AL reached to complete remission within 30 days during induction chemotherapy. In addition, in this cohort of MLL-rearranged adult AL patients, the 3-month relapse rate and 6-month overall survival rate were 50.0% and 50.0% respectively. It is concluded that the rate of missed diagnosis of CC technique for patients with MLL-rearranged AL reached to 60% in this study, while the combination of CC, FISH and multiplex nested PCR has been confirmed to have important significance for evaluating prognosis and conducting clinical therapy of patients with MLL-rearranged AL.
Adolescent ; Adult ; Aged ; Female ; Gene Rearrangement ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Myeloid-Lymphoid Leukemia Protein ; genetics ; Oncogene Proteins, Fusion ; genetics ; Young Adult