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 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 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 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.

Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.

OBJECTIVETo study the effect and safety of Kudiezi injection on patients with acute ischemic stroke.

METHODSeven hundreds patients were divided into two groups by central randomization system. The study group, 346 cases, was treated with kudiezi injection plus traditional Chinese medicine (TCM) synthesis rehabilitation project, and the control group, 354 cases, was treated with synthetic rehabilitation project. The patients were treated for 10 to 21 days. Before treatment and at the 7th, 14th and 21th day of treatment, the indexes include NIHSS used for evaluating the neurological deficit degree and the motor function score (Fugl-Meyer) for evaluating motor function were observed. The safety index is defined by adverse observation event and laboratory test. The incidence of adverse events and laboratory tests results were observed before and after treatment at the same time.

RESULTApplication of generalized estimating equation model, we found that as the treatment time, NIHSS score and FMI score of the two groups showed a trend of improvement. And at the 14th days and 21th days of treatment, compared to the control group the treatment group showed significant statistical difference on the impact of NIHSS and FMI (P<0.05). No serious adverse events were observed.

CONCLUSIONKudiezi injection plus TCM rehabilitation project of ischemic stroke showed some superiority to western medicine rehabilitation program on improving the neurological deficit and motor function. Kudiezi injection is safe and effective in the treatment of acute ischemic stroke.

Aged ; Brain Ischemia ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Injections ; Male ; Medicine, Chinese Traditional ; adverse effects ; Middle Aged ; Product Surveillance, Postmarketing ; Stroke ; drug therapy

OBJECTIVETo verify the efficacy and safety of post-marketed fleabane injection combined with Dengzhan Shengmai capsules in the treatment of ischemic stroke (IS).

METHODA multicentre, prospective, practical, randomized controlled study was carried out to compare the efficacy and safety of Dengzhan group (n = 343) and western medicine group (n = 335), appling "clinical study central stochastic system". The treatment of Dengzhan group is using fleabane injection in acute stage and Dengzhan Shengmai capsules in convalescence. The primary indexes of effect evaluation are the important outcome events in 360 days' follow-up, including mortality, recurrence, disability and quality of life to reflect the effect of clinical study. The indexes of safety evaluation involve laboratory examination results and incidence of adverse events.

RESULTAfter 360 days' follow-up, 4 people died of IS in Dengzhan group, and the mortality rate of which is 1.17%, while 16 died in Western medicine group (WM group), and the mortality rate is 4.78%, suggesting that the mortality rate of Dengzhan group is significantly lower than WM group (P<0.05). Eleven cases recurred in Dengzhan group, and the recurrence rate of which is 3.21%, while 12 recurred in WM group, and the recurrence rate is 3.59%, indicating that the recurrence rate of Dengzhan group is slightly lower than WM group. The disability rate of Dengzhan group is 39.53%, among which the rate of severely disabled cases are 1.49%, while the disability rate of WM group is 40.13%, among which the rate of severely disabled cases are 3.13%, suggesting that the disability rate of Dengzhan group is lower and the severity of disability is also lighter than WM group. In the field of quality of life, the activity ability and the upper limb function store of stroke patients in Dengzhan group improved far much better than WM group (P<0.05). Analysis of safety suggested that, adverse events occurred in 11 cases in Dengzhan group, among which 4 cases is related with the drug treatment, the incidence of adverse events of which is 1.17%, and the main manifestations involve fever and chilling, rash, nausea, dizziness, palpitation, etc. which were all appeared after the treatment of fleabane injection, and disappeared 1 to 2 days after drug withdrawal. 13 cases occurred abnormal liver function and 2 cases abnormal kidney function in Dengzhan group. According to the judgment of clinical physicians, 3 case of ALT abnormality is possibly related to the treatment, the others are all unrelated with the treatment.

CONCLUSIONFleabane injection and Dengzhan Shengmai capsules are all safe and effective TCM in the treatment of ischemic stroke.

Adult ; Aged ; Brain Ischemia ; drug therapy ; Capsules ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Erigeron ; adverse effects ; Female ; Humans ; Injections ; Male ; Middle Aged ; Product Surveillance, Postmarketing ; Prospective Studies ; Stroke ; drug therapy