Objective: To evaluate the clinical characteristics and prognostic factors of patients with Philadelphia-negative myeloproliferative neoplasm-accelerated phase/blast phase (MPN-AP/BP) . Methods: A total of 67 patients with MPN-AP/BP were enrolled from February 2014 to December 2021 at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences. Their clinical features and prognostic factors were analyzed retrospectively. Results: ① Sixty-seven patients with MPN-AP/BP with a median age of 60 (range, 33-75) years, including 31 males (46.3% ) and 36 females (53.7% ) , were analyzed. Forty-eight patients progressed from primary myelofibrosis (PMF) , and 19 progressed from other myeloproliferative neoplasms (MPNs) , which included polycythemia vera, essential thrombocythemia, and MPN unclassifiable. Patients who progressed from PMF had higher lactate dehydrogenase (LDH) levels than those who progressed from other MPNs (925.95 vs. 576.2 U/L, P=0.011) , and there were higher proportions of patients who progressed from PMF with splenomegaly (81.4% vs. 57.9% , P=0.05) , a myelofibrosis grade of ≥2 (93.6% vs. 63.2% , P=0.004) , and a shorter duration from diagnosis to the transformation to AP/BP (28.7 vs. 81 months, P=0.001) . ② JAK2V617F, CALR, and MPLW515 were detected in 41 (61.2% ) , 13 (19.4% ) , and 3 (4.5% ) patients, respectively, whereas 10 (14.9% ) patients did not have any driver mutations (triple-negative) . Other than driver mutations, the most frequently mutated genes were ASXL1 (42.2% , n=27) , SRSF2 (25% , n=16) , SETBP1 (22.6% , n=15) , TET2 (20.3% , n=13) , RUNX1 (20.3% , n=13) , and TP53 (17.2% , n=11) . The ASXL1 mutation was more enriched (51.1% vs. 21.1% , P=0.03) , and the median variant allele fraction (VAF) of the SRSF2 mutation (median VAF, 48.8% vs. 39.6% ; P=0.008) was higher in patients who progressed from PMF than those who progressed from other MPNs. ③ In the multivariate analysis, the complex karyotype (hazard ratio, 2.53; 95% confidence interval, 1.06-6.05; P=0.036) was independently associated with worse overall survival (OS) . Patients who received allogeneic stem cell transplantation (allo-HSCT) (median OS, 21.3 vs. 3 months; P=0.05) or acute myeloid leukemia-like (AML-like) therapy (median OS, 13 vs. 3 months; P=0.011) had significantly better OS than those who received supportive therapy. Conclusion: The proportions of patients with PMF-AP/BP with splenomegaly, myelofibrosis grade ≥2, a higher LDH level, and a shorter duration from diagnosis to the transformation to AP/BP were higher than those of patients with other Philadelphia-negative MPN-AP/BP. The complex karyotype was an independent prognostic factor for OS. Compared with supportive therapy, AML-like therapy and allo-HSCT could prolong the OS of patients with MPN-AP/BP.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Blast Crisis/drug therapy* ; Primary Myelofibrosis/genetics* ; Prognosis ; Splenomegaly ; Retrospective Studies ; Myeloproliferative Disorders/genetics* ; Mutation ; Leukemia, Myeloid, Acute ; Janus Kinase 2/genetics*

The present study investigated the main components of fenugreek(Trigonella foenum-graecum L.) leaf flavonoids(FLFs) and their antioxidant activity. FLFs were prepared and enriched by solvent extraction, and the flavonoids were characterized by high-performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry(HPLC-Q-TOF-MS/MS). The protective effect of FLFs against H_2O_2-induced stress damage to L02 hepatocytes was also investigated. Firstly, the cell viability was measured by MTT assay. The oxidative stress injury model was induced by H_2O_2 in L02 cells. The release of lactate dehydrogenase(LDH), the content of reduced glutathione(GSH) and malondialdehyde(MDA), and the activities of superoxide dismutase(SOD) and catalase(CAT) were measured by assay kits. Hoechst fluorescence staining was performed to observe the cell apoptosis. The expression levels of c-Jun N-terminal kinase(JNK), extracellular signal-regulated kinase 1/2(ERK1/2), nuclear factor erythroid-2 related factor 2(Nrf2), heme oxygenase 1(HO-1), and their phosphorylated proteins were detected by Western blot. Based on the MS fragment ion information and data in databases, FLFs contained eight flavonoids with quercetin and kaempferol as the main aglycons. The cell viabi-lity assay revealed that as compared with the conditions in the H_2O_2 treatment group, 3.125-25 μg·mL~(-1) FLFs could increase the viability of L02 cells, reduce LDH release and MDA content in a dose-dependent manner, potentiate the activities of SOD, CAT, and GSH, decrease the phosphorylation of JNK and ERK1/2 proteins, and up-regulate the expression of Nrf2 and HO-1. The results of fluorescence staining showed that the nucleus of the H_2O_2 treatment group showed concentrated and dense strong blue fluorescence, while the blue fluorescence intensity of the FLFs group decreased significantly. FLFs showed a protective effect against H_2O_2-induced oxidative damage in L02 cells, and the underlying mechanism is associated with the enhancement of cell capability in clearing oxygen free radicals and the inhibition of apoptosis by the activation of the MAPKs/Nrf2/HO-1 signaling pathway. The antioxidant effect of fenugreek leaf is related to its rich flavonoids.
Antioxidants/pharmacology* ; Apoptosis ; Flavonoids/pharmacology* ; Hepatocytes/metabolism* ; NF-E2-Related Factor 2/metabolism* ; Oxidative Stress ; Plant Leaves/metabolism* ; Superoxide Dismutase/metabolism* ; Tandem Mass Spectrometry ; Trigonella/metabolism*

OBJECTIVETo compare the clinical effects between anterior cervical discectomy and fusion(ACDF) combined with anterior cervical corpectomy and fusion(ACCF) and cervical posterior single open-door laminoplasty with mini-titanium plate fixation in treating three-segment cervical spondylotic myelopathy.

METHODSThe clinical data of 63 patients (39 males and 24 females) with three-segment cervical spondylotic myelopathy underwent surgical treatment from March 2014 to March 2016 were retrospectively analyzed. Among them, 43 cases were treated by ACDF combined with ACCF(anterior group), and 20 cases were treated by cervical posterior single open-door laminoplasty with mini-titanium plate fixation(posterior group). Operative time, intraoperative blood loss, postoperative complications were compared between two groups. And according to JOA score to evaluate the clinical effect.

RESULTSAll the patients were follow-up from 16 to 40 months with an average of 25.8 months. Operative time of anterior group and posterior group were (123.70±6.21) min and(118.70±5.41) min, respectively, there was no significant difference between two groups(>0.05). Intraoperative blood loss of anterior group and posterior group were (85.23±7.51) ml and (107.18±9.41) ml, respectively, there was significant difference between two groups(<0.05). In anterior group, axial symptoms occurred in 6 cases, dysphagia in 1 case, and no C₅ nerve root palsy, hoarseness and choking cough were found, the incidence rate of complication was 16.3%(7/43); and in posterior group, axial symptoms occurred in 5 cases, C5 nerve root palsy in 1 case, and no dysphagia, hoarseness and choking cough were found, the incidence rate of complication was 30.0%(6/20); there was significant defference in incidence rate of complication between two group(<0.05). At 1 week after operation and final follow-up, the JOA scores of anterior group were obviously better than that of posterior group(<0.05).

CONCLUSIONSAbove-mintioned two surgical treatment for cervical spondylotic myelopathy can provide instantly stability, the method of ACDF combined with ACCF was obviously better that of the method of cervical posterior single open-door laminoplasty in intraoperative blood loss, the incidence rate of complications, clinical effect.Thus, for the treatment of three-segment cervical spondylotic myelopathy, the method of ACDF combined with ACCF would be firstly chosen.

The mechanism of metabolism of bone and cartilage are one of focus of orthopedic knowledge, and its clinical and basic study plays an important role in preventing and treating osteoporosis, degeneration of bone and joint, bone tumor. At present, the mechanism of metabolism of bone and cartilage studied from protein, signal pathway to mRNA transcription factor regulation. As a new regulatory factor for non-coding proteins, long non-coding RNA(LncRNA) participates in physiological and pathological process. In recent years, a large number of researche showed that LncRNA plays an important role in metabolism of bone and cartilage, and proved LncRNA participates in development and conversion of bone metabolism. With the exposure of function chennel and target of LncRNA, the key role of LncRNA in bone metabolism were proved constantly. The paper concluded biological characteristics of LncRNA, function and target spot of LncRNA in bone and cratilage metabolism, and in further state gene regulatory mechanism of bone and cartilage metabolism, explore diagnosis and treatment, provide new thought and treatment target for bone metabolism.
Bone and Bones ; metabolism ; Cartilage ; metabolism ; Gene Expression Regulation ; Humans ; RNA, Long Noncoding ; metabolism ; RNA, Messenger ; Signal Transduction ; Transcription Factors

Objective To investigate the clinical distribution and resistance change of pseudomonas aeruginosa (PAE) in the four hospitals of Henan province during 2012-2015,so as to provide guidance for reasonable clinical use of antibiotics.Methods By means of disk diffusion method (K-B method) or automatic instrument,the drug susceptibility testing was performed for the clinical isolated strain which collected from the 371st Central Hospital of PLA,the Third Affiliated Hospital of Xinxiang Medical University,the 150th Central Hospital of PLA and the 153rd Central Hospital of PLA during 2012-2015,then the result were interpreted according to the criteria of Clinical and Laboratory Standards Institute 2010,and the date were analyzed by using WHONET 5.6 software.Results A total of 1 796 strains of PAE had been isolated,and mainly distributed in department of critical care medicine (32.6％) and department of gastroenterology (28.7％).The specimens mainly collected from sputum (74.6％) and wound secretion (9.6％).The drug susceptibility results showed that the antibiotic sensitive rate of PAE to polymyxin B(93.5％) was the highest,followed by the piperacillin/tazobactam(78.2％) and amikacin(76.2％).Resistance rate of PAE to piperacillin(34.4％) was the highest,followed by the ticarcillin/calvulanic acid(34.1％) and aztreonam (30.7 ％).Drug-resistance of PAE to the ceftazidime,cefepime,aztreonam,amikacin,gentamicin and polymyxin B had a downward trend,respectively.Conclusion Drug-resistance of the PAE to the most commonly used antimicrobial has a downward trend.However,the drug-resistance situation of PAE is very serious and the resistance rates still keep the high level during 2012-2015.It is necessary to investigate the clinical distribution and resistance of PAE,so as to provide guidance for reasonable clinical use of antibiotics.

OBJECTIVETo determine the hepatitis B immunoprophylactic failure rate in infants born to hepatitis B virus (HBV) infected mothers and to characterize HBV genes.

METHODSHBV-serological testing was conducted for pregnant women and infants. The complete genomes of 30 HBV isolates were sequenced, and genetic characteristics were analyzed using MEGA 5 software.

RESULTSThe immunoprophylactic failure rate for infants who had completed the scheduled hepatitis B vaccination program was 5.76% (32/556). High sequence homology (99.8%-100%) was observed in 8 of the 10 mother-infant pairs. We identified 19 subgenotype C2 strains, 9 subgenotype B2 strains, and 2 subgenotype C1 strains. Three serotypes were detected: adr (19/30), adw (9/30), and ayw (2/30). The frequency of amino acid mutation of the 'a' determinant region was 16.67% (5/30), including that of Q129H, F134Y, S136Y, and G145E. We detected 67 amino acid mutations in the basal core promoter, precore, and core regions of the genome.

CONCLUSIONThe immunoprophylactic failure rate in infants born to HBV-infected mothers is low in the regions of China examined during this study. Moreover, HBV mutation in the 'a' determinant region could not account for immunoprophylactic failure for all infants.

Adult ; Animals ; CHO Cells ; China ; epidemiology ; Cricetinae ; Cricetulus ; Female ; Hepatitis B ; congenital ; epidemiology ; prevention & control ; transmission ; Hepatitis B Vaccines ; therapeutic use ; Hepatitis B virus ; genetics ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Mutation ; Phylogeny ; Pregnancy ; Treatment Failure ; Young Adult

Objective To explore the changes of expression level of four miRNAs ( miRNA -122, miRNA -192, miRNA -193, miRNA -125 b1 ) in isoniazid-induced liver injury rats.Methods The rats were randomly divided into six experimental groups and control group.The experimental groups were given isoniazid orally at 55 mg? kg-1? d-1 for 3 , 7 , 10 , 14 , 21 and 28 days and control group was given saline.The pathological changes of liver were observed by light microscope with HE staining.The activity of serum alanine aminotransferase ( ALT ) and aspartate aminotransferase ( AST ) were measured. The expression of miRNAs were determined by real -time fluorescent quantitative PCR. Results With medication time extension, the expression of miRNA-122, miRNA-192 and miRNA-125b1 declined (P<0.01) and significantly lower in 3 days ( P <0.01 ) .While miRNA -193 increased and had a sharp increase at 10 days ( P <0.01 ) . The pathology of liver tissues indicated that liver injury happened at 7 days. The serum activity of ALT, AST showed a trend of increase and had a sharp increase at 10 days ( P <0.01 ) . The abnormal expression of miRNA-122 , miRNA -192 and miRNA -125 b1 were earlier than ALT, AST and pathological changes and had linear correlation with ALT and AST ( P<0.05).In addition, there were linear correlation between four miRNAs ( P <0.05 ) . Conclusion The abnormal expression of miRNA -122 , miRNA-192 and miRNA-125b1 were earlier than ALT and AST, which might be severed as a novel candidate bio-markers for isoniazid-induced liver injury.

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.
China ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery

Objective To explore the clinical effect of application of empowerment theory on patients with irritable bowel syndrome with diarrhea (IBS-D).Methods Sixty-four patients with IBS-D were chosen and randomly divided into two groups,each with 32 cases.The control group received routine nursing care,and the experimental group received empowerment theory for nursing intervention on the basis of routine nursing care.The curative effect and treating compliance in the two groups were compared,and the quality of life before and after intervention was assessed by IBS-QOL.Results The curative effect was 84.3％ in the experimental group after intervention,and 59.5％ in the control group,and the difference was statistically significant (x2 =4.95,P ＜ 0.05).The score of treating compliance was (36.12 ± 5.84) in the experimental group after intervention,and (29.51 ± 5.36) in the control group,and the difference was statistically significant (t =4.717,P ＜ 0.01).The scores of IBS-QOL in all factors between two groups were no statistically significant before intervention (P ＞0.05).The scores of IBS-QOL in all factors excluding picky eaters dimension in the experimental group after intervention were higher than those of the control group,and the differences were statistically significant (P ＜0.05).Conclusions Empowerment theory helps to improve the patients' quality of life and treating compliance,and enhance the curative effects.

Objective To investigate the epidemiological characteristics of HW-1 subtype in Shenzhen from 1992 to 2008.Methods 489 HIV-1 positive plasma samples were collected from 1992 to 2008 in Shenzhen.HIV-1 env genes were amplified by nested-PCR from RNA.Phylogenetic analysis was performed on data regarding the nucleotide sequence.Results A total of 464 sequences were amplified and genotyped.Data from this study revealed that CRF01_AE was a predominant HIV-1 subtype in Shenzhen (64.4％,299/464),followed by subtypes CRF_BC( 17.5％,81/464),B'( 14.7％,68/464) and B (2.4％,11/464).Subtype C (0.4％,2/464),A1 (0.2％,1/464),CRF02_AG(0.2％,1/464) and CRF06_cpx (0.2％,1/464) were also prevalent in Shenzhen.CRF01_AE and CRF_BC were predominant among heterosexuals,homosexuals and injection drug users,while B'was predominant among blood donors.Results from phylogenetic tree analysis showed that some of the HIV-1 clusters had been defined in CRF01_AE strains at different time or groups with different transmission routes.Cross-infections were also seen.Conclusion CRF01_AE was the predominant HIV-1 subtype in Shenzhen while CRF_BC,B,B',C,A1,CRF02_AG and a small amount of CRF06_cpx or recombinant subtypes were prevalent in this city.Different subtypes showed great variation in the process of epidemics.