Objective To explore the factors related to the severity of disease symptoms in patients with acute leukemia (AL). Methods 198 AL patients with symptoms of disease (anemia, bleeding, infection, fever, etc.) from September 2013 to July 2016, were evaluated by the questionnaires of self-rating anxiety scale (SAS), self-rating depression scale (SDS), eysenck personality questionnaire (EPQA), Toronto alexithymia scale (TAS), family environment scale (FES), self-rating scale of illness conception and health seeking behavior (ICHSB). The results were compared with 198 healthy volunteers. Results The scores of SDS, SAS, factorⅠin FES, factor Ⅲ in FES, factor Ⅳ in FES, nervous and the total scores of EPQA, factor Ⅱ in TAS, factor Ⅱ in ICHSB were significantly higher in AL patients than those in healthy subjects [(41.09 ±6.85) scores vs. (36.74±6.99) scores, t=2.150, P=0.031; (38.64±7.51) scores vs. (31.79±7.57) scores, t= 3.327,P=0.001;(2.38±1.54) scores vs. (5.18±1.33) scores, t=3.319, P=0.001;(3.31±1.82) scores vs. (2.23±1.99) scores, t= 3.325, P= 0.001; (2.41±1.62) scores vs. (5.75±1.51) scores, t= 3.332, P= 0.001; (14.14±5.37) scores vs. (11.01±5.51) scores, t= 5.179, P= 0.000; (42.97±7.10) scores vs. (40.41±6.51) scores, t= 2.930, P=0.004;(22.97±4.57) scores vs. (21.54±4.13) scores, t=2.926, P=0.004; (16.37±3.89) scores vs. (15.92± 3.93) scores, t= 2.104, P= 0.034]. The difference was statistically significant (P< 0.05). The risk factors of AL were SAS (95 %CI= 1.064-1.210, P= 0.001), factor Ⅲ in FES (95 %CI= 1.104-1.694, P= 0.004), age (95 %CI= 1.027-1.094, P= 0.001), factor Ⅱ in TAS (95 %CI= 1.046-1.352, P= 0.005), besides, education level (95 %CI= 0.708-0.866, P= 0.001) acted as the protective role. Conclusions AL patients tend to the psychological problems such as depression, anxiety. Those will show much severer symptoms as a consequence of lacking of family warmth and concern, low expression of emotion, lacking of organization, low economic capacity, tension, and lacking of the ability to distinguish between emotion and physical feelings.

AIM: To investigate the genes differential expression in cortex during rat focal cerebral ischemia. METHODS: cDNA microarray chips containing numerous cDNAs were used to investigate the gene expression pattern between samples of focal cerebral ischemia and sham-control operation rats. RESULTS: Two hundred and eleven genes differentially expressed were screened out, among these genes, up-and down-regulated genes were 199 and 12, respectively. CONCLUSIONS: The analysis of gene expression pattern of focal cerebral ischemia based on cDNA microarray can realize high-throughput screening of the genes associated with the focal cerebral ischemia. The differential expression of genes may be related to the pathogenesis of focal cerebral ischemic diseases.

The Prescription for Pharmacoeconomic Analysis (PFPA) of New Zealand was firstly published in 1999. The original version was reviewed in 2004 and version 2, approved and published in 2007, is the living document. The main purpose for this guideline is to provide an overview of the methods PHARMAC (Pharmaceutical Management of Agency) uses when conducting cost-utility analysis. Compared with version 1, version 2 involved and discussed the most frequently mentioned issues in pharmacoeconomic guidelines around the world. This paper describes the distinguishes between version 1 and 2, the advantages of version 2 as well as the amendments that will be made in PHARMAC's future work, in order to provide meaningful advice for standardizing and documenting methods in China
Costs and Cost Analysis ; Economics, Pharmaceutical ; Humans ; New Zealand

Objective: To investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and myocardial injury induced by acute carbon monoxide poisoning. Methods: A retrospective analysis was performed on 214 patients with acute carbon monoxide poisoning who were admitted to Emergency Depart-ment of Harrison International Peace Hospital, Hebei Medical University, from 2015 to 2017. According to the diagnostic criteria for toxic heart disease and the level of cardiac troponin I (cTnI), a biomarker of cardiac injury, these patients were divided into myocardial injury group (n = 84) and non-myocardial injury group (n=130). The general information of age and sex, as well as routine blood test results and cardiac injury biomarkers on admission, were collected. NLR was calculated and compared between the two groups. The relationship between NLR and cTnI was analyzed. Logistic regression analysis was used to identify the influenc-ing factors for myocardial injury induced by acute carbon monoxide poisoning. The receiver operating charac-teristic curve was used to evaluate the predictive value of NLR on admission for myocardial injury induced by acute carbon monoxide poisoning. Results: There were significant differences between two groups in male patients, the history of smoking, white blood cell count (WBC), NLR, creatine kinase-MB, and lactate dehydro-genase(P<0.01). In the myocardial injury group, NLR was positively correlated with cTnI (r=0.295, P<0.01). The multivariate logistic regression analysis showed that NLR (odds ratio OR=1.079, 95% confidence inter-val CI: 1.017~1.144, P<0.01), WBC (OR=1.216, 95% CI: 1.098~1.346, P<0.01), and male sex (OR = 2.693, 95% CI: 1.045~6.939, P= 0.05) were independent risk factors for myocardial injury induced by acute carbon monoxide poisoning. In predicting myocardial injury induced by acute carbon monoxide poisoning, NLR on admission had a sensitivity of 85.7% and a specificity of 45.4% at the optimal cut-off value of 4.83. Conclusion Increased NLR on admission has a certain predictive value for myocardial injury induced by acute carbon monoxide poisoning.

Objective:To analyze the value of color Doppler flow imaging (CDFI) in evaluating effects of neoadjuvant chemotherapy (NAC) for breast cancer.Methods:100 patients with breast cancer who underwent surgery after NAC in Cancer Hospital of Inner Mongolia Autonomous Region from January 2018 to April 2019 were selected for retrospective analysis. According to effects of chemotherapy, they were divided into effective group and ineffective group. The changes in lesion size, ultrasound findings, grade of blood flow in lesions, resistance index (RI) and peak systolic velocity (PSV) before and after NAC were compared between the two groups.Results:The length, width, thickness and volume of masses in effective group after NAC [(2.03±0.24)cm, (1.69±0.24)cm, (1.06±0.14)cm, (3.64±0.39)cm 3] were smaller than those before NAC [(3.40±0.36)cm, (2.35± 0.26)cm, (1.78±0.19)cm, (14.24±1.53)cm 3] and those in ineffective group after NAC [(3.31±0.34)cm, (2.36±0.27)cm, (1.76±0.19)cm, (14.19±1.42)cm 3] ( P<0.05). After NAC, the the proportion of regular shape, clear boundary, more internal echo, and no abnormal posterior echo in effective group was statistically significant ( P<0.05), but there was no significant change in the ineffective group ( P>0.05). The proportion of clear boundary and excessive internal echo in the effective group was higher than that in the ineffective group ( P<0.05); the blood flow grade of the effective group after NAC was lower than that of the ineffective group ( P<0.05) After NAC, the RI (0.54±0.06) in effective group was lower than that in ineffective group (0.65±0.08) ( P<0.05), and there was no significant difference in PSV between the two groups ( P>0.05). Conclusions:The value of CDFI is high in evaluating NAC effect on patients with breast cancer. It can effectively measure and judge lesion size and blood flow changes, and provide basis for clinical curative effect evaluation.

Objective To summarize the clinical characteristics,diagnosis and treatments of 50 chil-dren with no history of anti-coagulation rodenticide poisoning.Methods Fifty children lacking of poisoning history were admitted to our hospital from Feb 2011 to Dec 2015,who were due to hemorrhage and finally di-agnosed as rodenticide poisoning.The clinical manifestation,characteristics of blood coagulation dysfunction, toxicology screening results and treatments of 50 cases were retrospectively analyzed.Results All 50 cases were from rural area,and denied the history of taking rodenticide by mistake.The time from the onset to ad-mission to the hospital was from 1 d to 120 d,with an average of 11.66 d.Major clinical manifestations in-cluded:34 cases(68%)of skin ecchymosis,26 cases(52%)of epistaxis,10 cases(20%)of bleeding gums and 4 cases(8%)of hematoma at the injection site,with PT 20 to over 200 s and APTT 31 to over 200 s (maximal detection value).The children were diagnosed as rodenticide poisoning when one of brodifacoum, bromadiolone,and diphacinone-sodium or combination of brodifacoum and bromadiolone were detected from their blood specimens,with an concentration of 5 to 3 270 μg/L.The diagnosed children were intravenous dripped with specific antagonist vitamin K1 and the critically ill children were added fresh frozen plasma.All children recovered from hemorrhage within 24 hours after treatment.The level of PT,APTT was close to nor-mal after 3 to 7 days of treatment,and the using of vitamin K1 was accumulated about 30 to 70 mg.The chil-dren were given maintenance treatment of vitamin K1 for three months after discharge until the condition was stable.Conclusion Commonly used rodenticide has the characteristics of fat soluble, easy to accumulate, long incubation period,and long treatment period and so on.Children with no bleeding performance have the clinical tendency of acute bleeding,prolonged PT and APTT should be considered the possibility of rodenti-cide poisoning.Blood or urine samples should be screened for toxicology as soon as possible,and meanwhile children should be given antagonist treatment with special antidote vitamin K1 until the coagulation function is stable in normal range to avoid recurrence of the illness.

Objective: To investigate the clinical significance of monitoring ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia (ALL) after allogeneic stem cell transplantation (allo-HSCT) . Methods: Clinical data of 13 children received allo-HSCT in Peking University Institute of Hematology from May 2009 to March 2016 were retrospectively collected. The ETV6-RUNX1 gene was examined by real-time quantitative polymerase chain reaction (RQ-PCR) . The correlation between its expression level and the disease status was analyzed. Results: Of 13 enrolled ALL cases, the ETV6-RUNX1 expression of 7 patients converted to positive after transplant at a median time of 137 days (range, 28-270 days) . The expression level of the first positive sample was 0.034% (range, 0.004%-0.061%) . The duration from ETV6-RUNX1 positive to hematological relapse was 196 days (range, 28-666 days) . Four patients experienced relapse at a median time of 294 days (range, 104-803 days) after allo-HSCT. The ETV6-RUNX1 expression converted to positive prior to MRD. Patients with positive ETV6-RUNX1 gene expression pre-transplantation would be more likely to relapse. Conclusion Monitoring ETV6-RUNX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive ETV6-RUNX1 after transplant had a poor prognosis.

Cerebral small vessel disease(CSVD)is a slowly progressive cerebrovascular disease caused by structural and functional disorders of small vessels and vascular neural units in the brain,and CSVD imaging markers may be evidence as manifestations of brain aging.Clinically,the onset of CSVD is not limited to individuals in middle-to-old age.Young patients without typical vascular risk factors may also have imaging markers,such as enlarged perivascular space and white matter hyperintensity.The diagnosis and treatment of these cases must be approached seriously.Compared with Western medicine,traditional Chinese medicine(TCM)has an advantage in treating disorders related to emotions,sleep,and cognition in patients with CSVD.Regarding CSVD,there are commonalities between anatomical structures,physiological functions,pathogenic mechanisms,and xuanfu and collateral theories in TCM.We combined the xuanfu and abnormal collateral theory and classified CSVD into three clinical stages:early-stage,dysfunction in xuanfu and stagnation in the qi collaterals;middle-stage,endogenous toxins and damage to the blood vessels;and late-stage,kidney and marrow deficiency and toxins damaging the brain collaterals.Different treatment strategies,such as promoting qi circulation,calming the mind,and dredging collaterals in the early stage;dispelling pathogenic factors and promoting blood circulation in the middle stage;tonifying the kidney and replenishing the marrow and removing toxins from collaterals in the late stage,are applied at different stages to offer novel perspectives on TCM treatment for CSVD.

With the rapid development of society and the improvement of Western medicine,the average life expectancy of the Chinese population has steadily increased. Since the beginning of the 21th century,China has officially entered an aging society and is currently in a phase of rapid growth in the elderly population. The effective management and improvement of the health levels of the elderly have become urgent issues that society needs to address. Traditional Chinese medicine (TCM),rooted in Chinese traditional culture,has developed a rich system of health preservation through thousands of years of historical practice,which has important guiding significance in actively coping with the aging of the population. This article discusses the historical evolution of the theory of health preservation in TCM,the interpretation of aging mechanisms by TCM,and the strategies for elderly health preservation from the perspective of TCM. By exploring TCM health preservation concepts,a theoretical framework for the health care of the elderly is constructed,so as to provide a scientific basis for their health management.

Objective To investigate the biological characteristics of monoclonal antibodies against human liver cancer stem cells and its therapeutic effect in combination with cisplatin in the treatment of hepatocellular carcinoma. Methods Cell culture in serum?free medium and PKH26 staining were used to determine the existence of cancer stem cells in human liver Bel7402?V3 cell line. The co?expression of antigen recognized by monoclonal antibody ( McAb ) 15D2 and epithelial specific antigen ( ESA ) and PKH26?positive cells in the Bel7402?V3 cells were detected by immunofluorescence assay. Serum?free suspension culture was used to detect the self?renewal ability of 15D2?positive Bel7402?V3 cells sorted by flow cytometry and the effect of 15D2 on the self?renewal ability of Bel7402?V3 cells. The effect of 15D2 on cisplatin resistance in the cells was examined by CCK8 method. The inhibitory effect of 15D2 combined with cisplatin on the transplanted tumor growth in mice was also observed. Results Single PKH26?positive cells were observed in the Bel7402?V3 cell spheroids cultured for 11 days. Immunofluorescence assay showed that the 15D2?recognized antigen could be conjugated with PKH26 and ESA and co?localized on Bel7402?V3 cells. The spheroid formation rate of 15D2?positive cells in serum?free medium was significantly higher than that of 15D2?negative cells [(30.4±3.4)% vs. (8.8±1.8)%,P<0.01]. The cisplatin resistance of 15D2?positive cells was obviously higher than that of 15D2?negative cells (IC50:1.014μmol/L vs. 0.365μmol/L). McAb 15D2 significantly suppressed the spheroid formation of Bel7402?V3 cells, with an inhibition rate of 37.5%. McAb 15D2 also notably inhibited the cisplatin resistance of Bel7302?V3 cells. The IC50 was 0.211μg/ml in the 15D2 group and 0. 325 μg/ml in the control group. The mouse experiment showed that the tumor growth rates of 50 mg/kg, 25 mg/kg and 12.5 mg/kg 15D2?treatment groups were 82.6%, 71.4% and 60.0%, respectively; that of the 50 mg/kg 15D2 + cisplatin group was 91. 0%, and that of the cisplatin monotherapy was 56. 7%. Conclusion McAb 15D2 is a functional monoclonal antibody targeting liver cancer stem cells, which could be a potential monoclonal antibody drug for the stem cell?targeted therapy of liver cancer.