At the 58th American Society of Hematology Annual Meeting,there were many reports on clonal evolution related with blood disease.Gene mutation and clonal evolution after treatment of azacitidine (AZA) in myelodysplastic syndromes (MDS) were summarized to explore the relationship between clonal evolution and treatment response and clinical process in MDS,and to provide reference for clinical treatment decision.

In comparison with the American Society of Hematology (ASH) annual meeting last year,more studies of hematologic malignancies using next generation sequencing (NGS) are published in the 56th ASH meeting this year.NGS was mainly used in the diagnosis and classification,risk stratification,MRD detection,clonal evolution,prognosis and therapy guidance.This short report will address the application of NGS in the study of hematologic malignancies by summarizing several representative publications from the 56th ASH meeting.

[ ABSTRACT] AIM: To investigate the seroprevalence of neutralizing antibodies to human adenovirus type 5 (AdHu5) , human adenovirus type 26 (AdHu26) and chimpanzee adenovirus type 68 (AdC68) in the patients with chro-nic hepatitis B ( CHB) and the patients with primary liver cancer ( PLC) , and to provide guidance for developing safe and effective biotherapy vectors against CHB and PLC.METHODS:The blood samples from 196 patients with CHB and 193 patients with PLC were examined to assess the presence of neutralizing antibodies against AdHu5, AdHu26 and AdC68 by adenovirus neutralization assays.RESULTS:The seroprevalence rates of neutralizing antibodies to AdHu5, AdHu26 and AdC68 in the CHB patients were 84.7%, 58.2%and 39.8%, respectively.Among the patients with PLC, the prevalence rates of neutralizing antibodies were as follows:AdHu5, 75.1%;AdHu26, 66.8%;AdC68, 32.1%.CONCLUSION:The prevalence rates and titers of neutralizing antibodies against AdC68 were the lowest among the 3 adenoviruses.There-fore, AdC68 serves as more suitable biological therapy vectors for CHB and PLC than AdHu5 and AdHu26.

Objective:To explore the distribution characteristics of respiratory pathogens in patients with community-acquired pneumonia in Lianyungang.Methods:A total of 612 patients admitted to the second people′s Hospital of Lianyungang City because of community-acquired pneumonia (CAP) in 2019 were selected as subjects. Sputum or pharyngeal swabs were collected to extract nucleic acids, and 13-fold nucleic acids of respiratory pathogens were detected by PCR capillary electrophoresis fragment analysis. SPSS statistical software and GraphPad5.0 statistical mapping software were used for statistical analysis.Results:The physical examination rate of respiratory pathogens in the adult group was 82.0% in winter, 48.4% in spring, 28.0% in autumn, 20.0% in summer, χ 2=38.473, P=0.000. The positive rate of nucleic acid detection was significantly different in different seasons, among which the physical examination rate of respiratory pathogens in winter was the highest. The physical examination rate of respiratory pathogens in the juvenile group was 86.0% in spring, 76.2% in winter, 71.3% in summer and 66.7% in autumn, χ 2=7.946, P=0.047 . The positive rate of nucleic acid detection was calculated according to gender grouping. The comparison of nucleic acid positive rate between adult group and juvenile group in different seasons: 86.0% vs 48.4% in spring, χ 2=19.436, P=0.000; 71.3% vs 20.0% in summer, χ 2=22.180, P=0.000; 66.7% vs 28.0% in autumn, χ 2=13.485, P=0.000; 76.2% vs 82.0% in winter, χ 2=0.758, P=0.384. Except in winter, the detection rate of nucleic acid of pathogens in the juvenile group was significantly higher than that in the adult group. Conclusions:The nucleic acid detection rate and etiological distribution characteristics of respiratory pathogens are different in patients with community-acquired pneumonia in different seasons and different age groups. 13 kinds of multiple detection methods of respiratory pathogens can provide favorable laboratory data support for the diagnosis and treatment of clinical CAP patients.

Objective:To investigate the expression of fibroblast growth factor 7 (FGF7) and related inflammatory factors in the serum of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:A case control study was conducted. The patients with AECOPD admitted to the First Affiliated Hospital of Xinjiang Medical University from November 2016 to January 2020 were enrolled. The patients were divided into mild group [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio (FEV1/FVC) < 0.70, FEV1 percentage in predicted value (FEV1%) ≥ 80%], moderate group (FEV1/FVC < 0.70, 50% ≤ FEV1% < 80%), and severe group (FEV1/FVC < 0.70, 30% ≤ FEV1% < 50%) based on their lung function test results, with 20 patients in each group, and 20 patients with normal pulmonary function who underwent elective non-thoracic surgery such as gastrointestinal surgery and orthopedics surgery in the same period were selected as controls. The demographic data, FEV1/FVC, FEV1%, FVC, maximum mid-expiratory flow percentage in predicted value (MMEF%), 6-minute walking test (6MWT), and St George Respiratory Questionnaire (SGRQ) score were recorded respectively. Serum levels of FGF7, interleukins (IL-6, IL-1β) and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA). Pearson correlation was used to analyze the correlation between TNF-α and lung function.Results:Compared with the normal pulmonary function group, the levels of FEV1/FVC, FEV1%, MMEF% and 6MWT in the mild, moderate and severe groups were significantly decreased, and the SGRQ scores were increased, the indicators continued to deteriorate with the aggravation of the disease, the statistical differences were found between severe group and normal pulmonary function group [FEV1/FVC: 0.39±0.09 vs. 0.81±0.04, FEV1%: (38.80±6.28)% vs. (109.58±13.80)%, MMEF%: (0.34±0.14)% vs. (2.69±0.99)%, 6MWT (m): 279.00±41.61 vs. 402.85±53.97, SGRQ scores: 34.95±6.71 vs. 2.60±2.06, all P < 0.05]. Compared with the normal pulmonary function group, the levels of FGF7 in the mild, moderate and severe groups were significantly lowered (ng/L: 6.31±2.65, 6.10±1.39, 6.64±1.77 vs. 8.29±3.51, all P < 0.05), but no significant difference was found among the mild, moderate and severe groups (all P > 0.05). Compared with the normal pulmonary function group, IL-6 and TNF-α levels were significantly increased in the mild, moderate and severe groups, and TNF-α increased with the aggravation of the disease, the statistical difference was found between severe group and normal pulmonary function group (ng/L: 7.42±2.28 vs. 3.83±0.92, P < 0.05). There was no significant difference in IL-1β level between the normal pulmonary function group and the mild, moderate, severe groups. Correlation analysis showed that TNF-α was negatively correlated with FEV1/FVC and FEV1% ( r values were -0.350 and -0.527, respectively, both P < 0.01). Conclusion:In AECOPD patients, serum FGF7 was decreased, while IL-6 and TNF-α were increased; however, with the aggravation of the disease, there was no significant change in the level of FGF7 in the peripheral blood, but the TNF-α level might be increased, accompanied by severe damage of small airway function.

Objective To investigate the antibiotic resistance and pulsed field gel electrophoresis (PFGE) patterns of clinical isolates of Salmonella (S.) typhi and S.paratyphi in Henan province during 2009-2011.Methods According to molecular typing and Salmonella K-B drug susceptibility test method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI),the drug susceptibility and PFGE molecule characteristics of 78 S.typhi and S.paratyphi strains isolated from sentinel hospitals in Henan were analyzed.Results The 78 strains orS.typhi and S.paratyphi were resistant to 13 kinds of antibiotics,in which 62 were multidrug resistant (79.5％),4 were resistant to 2-3 kinds of antibiotics (5.1％),41 were resistant to 5-8 kinds of antibiotics (52.6％),14 were resistant to 9-10 kinds of antibiotics (17.9％),3 were resistant to 11-12 kinds of antibiotics (3.8％).The resistant rate to cephalosporins,quinolones and other 3 kinds of antibiotic showed an increase trends.Seventy two strains ofS.typhi and S.paratyphi could be divided 14 molecular patterns by digestion with Xba Ⅰ and PFGE,each pattem contains 1-47 strains which shared the similarity of 66.03％-100.00％.Conclusions The drug resistance of clinical isolates of S.typhi and S.paratyphi was serious in Henan.The PFGE patterns showed diversity,but the predominant patterns could be still found.The PFGE patterns of some strains were associated with their drug resistance.

Objective: To investigate the effect and mechanism of all-trans retinoic acid (ATRA) on leukemic cell line U937 cells with NPM1 mutation. Methods: Human acute myeloid leukemia cell line U937 was explored, NPM1 mutated (A type) plasmids were transfected into U937 to form stable clones A1 and A2, which were identified by Western blot and Co-immunoprecipitation. The cell proliferation was measured by methylthiazolyl tetrazolium bromide (MTT) ; cell cycle and cell apoptosis were explored by flow cytometric; cell colony formation was measured by microscope count, the molecular pathways related to cell proliferation were measured by Western blot. Results: ①The cell proliferations of mutant A1 and A2 were inhibited significantly by 52.6% and 35.8% (P<0.05) , respectively under ATRA exposure. ②The percentages of G₀/G₁ stage of mutant A1 and A2 increased by 20.1% and 35.8%, respectively under ATRA exposure. ③All the U937 leukemic cells were inhibited under ATRA exposure; the decreased percentages of vector, wild-type and mutant NPM1 cells were 32.7%, 57.9% and 90.9% respectively. ④p-ERK decreased obviously after ATRA exposure in NPM1 mutated leukemic cells. ⑤More mutant NPM1 cells inclined to apoptosis under the exposure of ATRA and cytotoxic drugs than cytotoxic drugs alone, meanwhile more cells apoptosis occurred when ATRA was administrated after cytotoxic drugs exposure. Conclusions ATRA could inhibit cell proliferation and colony formation, blocked the cell cycle in the G₀/G₁ stage accompanied by the significant reduction of p-ERK in U937 leukemic cells with NPM1 mutation. Besides, ATRA could synergize with drugs to suppress the leukemic cells survival more effectively when ATRA was administered after the cytotoxic drugs exposure in U937 leukemic cells with NPM1 mutation.

Objective: To investigate the antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of S.paratyphi A strains in Zhengzhou city isolated from sentinel hospitals in 2013-2015. Methods: According to Salmonella molecular typing and K-B drug susceptibility testing method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI2015), we analyzed drug sensitivity and PFGE molecular characteristics of 67 S.paratyphi A strains(11 strains in 2013, 7 strains in 2014, 49 strains in 2015) isolated from blood and stool samples in two sentinel hospitals of fever with rash syndrome surveillance system established in Zhengzhou city in 2013-2015. Results: The results showed 67 strains of S.paratyphi A had different levels of resistance to 13 kinds of antibiotics, 65 strains were multi-drug resistant strains (97.0%), 5 isolates were resistant to 2-3 kinds of antibiotics (7.5%), 41 isolates were resistant to 5-8 kinds of antibiotics (61.2%),11 isolates were resistant to 9-10 kinds of antibiotics(16.4%),8 isolates were resistant to 11-12 kinds of antibiotics(11.9%). 67 strains of S.paratyphi A were divided into 10 molecular patterns(PTYA1-PTYA10) by digestion with XbaⅠ restriction endonuclease and pulsed field gel electrophoresis, each pattern contains 1-48 strains with similarity ranged from 94.31%-100%. PTYA3 contained 48 strains, which was predominant band type; PTYA1, 9 contained 6 strains; PTYA 2, 4, 5, 6, 7, 8, 10 contained 1 strains among them. Conclusion The status of drug resistance of clinical isolates of S.paratyphi A in Zhengzhou city was rather serious, PFGE patterns showed diversity and dominant characteristics. The PFGE patterns of partial strains and its corresponding anti-drug spectrum have certain relevance and cluster relationship.

Objective To detect and analyze the distribution of virulence factors,antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of Shigella sonnei,isolated in Henan province from 2011 to 2014.Methods Samples of diarrhea patients were collected and isolated with SS selective culture medium in 37 ℃ for 18-24 hours.All strains were identified under the Kligler iron agar/motility-indol-urea biochemical action and API20E biochemical system.Serological typing and prepared DNA template were carried out with thermal cracking method and multiplex PCR,to detect the virulence genes of Shigella sonnei.According to the molecular typing method and K-B drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA clinical and Laboratory Standards Institute,antimicrobial susceptibility tests and PFGE molecular characteristics of these positive strains isolated from sentinel hospitals patients stool samples were analyzed.Results Among the 98 strains of Sonnei type Ⅰ and 118 strains of Sonnei type Ⅱ,all the strains carried carry different virulence genes including SHET-1B,SHET-2,ial,ipaH genes,with 4 kinds of virulence gene combination types.All the 216 strains of Shigella sonnei belonged to the multi-drug resistant strains,including 34 isolates resistant to 2-4 kinds of antibiotics (15.7％),147 isolates to 5-8 kinds of antibiotics (68.1％),24 to 9-10 kinds of antibiotics (11.1％),7 to 11 kinds of antibiotics (3.2％),and 4 to 13 kinds of antibiotics (1.9％).A total of 100 strains of Shigella sonnci were divided into 31 molecular patterns,digested by Xba Ⅰ and PFGE.Each pattern contained 1-13 strains with similarities ranged from 68.6％-100.0％.Conclusions All the Shigella sonnei strains carried virulence pathogenic factors,presenting serious status on drug resistance.PFGE fingerprinting patterns showed high polymorphism and dominant characteristics.PFGE patterns of partial strains and corresponding antidrug spectrum presented certain relevance and with same aggregation relationship.

Objective To analyze the distribution and pulsed field gel electrophoresis (PFGE) patterns of five kinds of diarrheagenic Escherichia coli (DEC) in infected diarrhea population of Henan province in 2013. Methods Gathering 1 037 strains of E. coli of 1 037 diarrhea patients from four sentinel hospitals of multi-pathogen monitoring system in Henan province in 2013. Stool samples were cultured with Mac agar plates and using KIA/MIU biochemical action as the preliminary method to identify E. coli strains;preparation of DNA template with thermal cracking method and using multiplex PCR to detect five kinds of DEC. According to molecular typing method published by the international PulseNet bacterial infectious disease monitoring network, the PFGE molecular characteristics of DEC strains were analyzed. Results 125 DEC positive strains were detected in 1 037 strains of E. coli, the total detection rate was 12.05%. 90 strains were enteroaggregative E.coli (EAEC), detection rate was 8.68% (n=90); 24 strains were enteropathogenic E.coli (EPEC), detection rate was 2.31%; 7 strains were enteroinvasive E.coli (EIEC), detection rate was 0.68%; 4 strains were enterotoxigenic E.coli (ETEC), detection rate was 0.39%;enterohemorrhagic E.coli (EHEC) was not detected. 639 cases of diarrhea samples were collected from male patients, 398 cases were from female patients, 94 positive cases were from male patients, the detection rate was 14.71%.The positive number of female cases were 31 cases, the detection rate was 7.79%. 97 positive cases were detected from 782 countryside cases and 28 positive cases were detected from 255 urban area cases, with detection rate 12. 40%and 10.98%respectively. In 125 cases of DEC positive samples, children below 5 years old were 83 cases, accounting for 66.4%;53 strains of EAEC were divided into 52 molecular patterns by digestion with XbaⅠ and pulsed field gel electrophoresis, each pattern contained 1-2 strains with similarity ranged from 66.3%-100%;18 strains of EPEC were divided into 18 molecular patterns, each pattern contains 1 strain with similarity ranged from 72.6%-94.8%;5 strains of EIEC were divided into 5 molecular patterns, each pattern contains 1 strain with similarity ranged from 71.9%-98.5%. 2 strains of ETEC were divided into 2 molecular patterns and similarity below 70%. Conclusion Through the research we could find that four kinds of DEC as a pathogenic bacteria took an important component in pathogenic spectrum of bacterial diarrhea of Henan province in 2013. Four kinds of DEC carrying different virulence genes and taking multiple PFGE patterns showed diversity and complexity characteristics.