1.Therapeutic effect of allogeneic hematopoietic stem cell transplantation on acute myeloid leukemia and influencing factors of survival prognosis
Ying DONG ; Xiong ZHANG ; Wei YANG ; Zan LI ; Ying LE ; Maoqun GU
Journal of Clinical Medicine in Practice 2024;28(22):41-45
Objective To observe the therapeutic effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on acute myeloid leukemia (AML) and analyze the influencing factors of survival prognosis. Methods The clinical data of 32 AML patients who underwent allo-HSCT treatment were retrospectively analyzed. The hematopoietic reconstitution, occurrence of graft-versus-host disease (GVHD), survival status, recurrence, and transplantation-related mortality (TRM) of patients were observed, and the influencing factors of survival prognosis were analyzed. Results All 32 AML patients who underwent allo-HSCT achieved granulocyte reconstitution, with a time range of 10 to 26 days and a median time of 11.0 days. Granulocyte-macrophage lineage reconstitution was achieved in 30 patients, with a time range of 10 to 54 days and a median time of 13.5 days. Among the 30 evaluable patients, 10 developed acute GVHD (with incidence rate of 33.33%) and 10 developed chronic GVHD (incidence rate of 33.33%). Up to May 31, 2023, the follow-up time ranged from 2 to 28 months, with a median follow-up time of 14.5 months. Of the 30 patients, 28 survived (25 patients were in disease-free survival status), and 2 died. Multivariate Cox regression analysis showed that age>35 years (
2.Correlation of serum antibody titers with clinical features and prognosis of anti leucine-rich glioma inactivated 1 antibody encephalitis
Zan DONG ; Fang ZHANG ; Jing WANG ; Jie WANG
Chinese Journal of Neurology 2023;56(7):738-746
Objective:To analyze the relationship between serum antibody titers, clinical characteristics, and prognosis in patients with encephalitis induced by anti leucine-rich glioma inactivated 1 (LGI1) antibody.Methods:Clinical data of 20 patients diagnosed with encephalitis in the Department of Neurology, First Hospital of Shanxi Medical University from February 2015 to February 2021 were collected and retrospectively analyzed. Patients were divided into 2 groups based on their serum anti LGI1 antibody titers, namely the high titer group (1∶100, 1∶320) and the low titer group (1∶10, 1∶32). The clinical characteristics, laboratory test results, and prognosis of the 2 groups of patients were compared. Relusts The age of the 20 patients with anti LGI1 antibody encephalitis ranged from 27 to 69 (53.5±11.2) years, with a male to female ratio of 1∶1. There were 9 patients in the low titer group and 11 patients in the high titer group. There was no statistically significant difference in the types and quantities of clinical symptoms between the 2 groups. Patients in the high titer group were more prone to abnormal lesions on cranial magnetic resonance imaging (10/11 vs 3/9, P=0.014). There was no statistically significant difference between the 2 groups in the presence or absence of cerebrospinal fluid anti LGI1 antibodies (9/11 vs 4/9, P=0.160). During the follow-up, it was found that 1/20 patient died of pulmonary embolism, 7/20 of patients were able to recover to their predisease state, and 9/20 of patients had residual memory impairment. In the high titer group, 3/11 of patients experienced recurrence, while there was no recurrence in the low titer group. There was no statistically significant difference in the neurological prognosis between the 2 groups at 3 months of discharge and follow-up (the number of patients whose modified Rankin Scale score≤2: 10/10 vs 8/9, P=0.474). Conclusions:Patients with high serum anti LGI1 antibody titers are more likely to develop intracerebral lesions. Higher antibody titers may be associated with a higher risk of disease recurrence. There was no significant correlation between serum antibody titers and neurological outcomes.
3.Establishment of Feedforward Control Model for Dry Granulation of Polysaccharide Components Based on Quality by Design
Zan-yang HUANG ; Ya-jing WANG ; Dong-li QI ; Di GAO ; Xiao-yu WANG ; Yu WANG ; Yan-wen WANG ; Xiang-yin YE
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(4):130-137
ObjectiveA feedforward control model for dry granulation of polysaccharide components was established to guide the adjustment and optimization of critical process parameters (CPPs) in the design space, so as to reduce the impact of fluctuations in raw materials properties on the quality of medicines. MethodTaking Astragali Radix extract powder as the model drug, the design space of dry granulation CPPs was determined by Box-Behnken design. Astragali Radix mixed powder with different powder properties were prepared by mixture design, the variance inflation factor (VIF) was used to diagnose the multicollinearity of the powder properties, and principal component analysis (PCA) was used to extract the characteristic data of the model. Radial basis function neural network (RBFNN) was used to establish a feedforward control model for reflecting the relationship between the powder properties of polysaccharide components, dry granulation CPPs and one-time molding rate. ResultThe design space for dry granulation CPPs of polysaccharide components was 16-35 Hz for feeding speed, 10-23 Hz for roller speed, and 10-46 kg·cm-2 for roller pressure. The established RBFNN feedforward control model had a good predictive effect on the one-time molding rate of dry granulation of polysaccharide components, which could be used to guide the adjustment and optimization of CPPs in the design space, the relative error was 0.38%-6.73%, and the average relative error was 3.42%. ConclusionThe established feedforward control model can well reflect the relationship between the powder properties of the polysaccharide components, the dry granulation CPPs and the one-time molding rate of the granules, which can be used to guide the adjustment and optimization of CPPs in the design space, reduce the impact of material property fluctuation on product quality, and provide ideas for promoting the quality of traditional Chinese medicine from passive control to active control.
4.Diagnostic value of 18F-fulorodeoxyglucose marked positron emission computed tomography in anti- N-methyl-daspartate receptor encephalitis and viral encephalitis
Zan DONG ; Keyu YANG ; Jing WANG ; Rui WANG ; Yuchen LI ; Jie WANG
Chinese Journal of Neuromedicine 2021;20(1):87-91
The clinical manifestations of anti- N-methyl-daspartate (NMDA) receptor encephalitis and viral encephalitis are similar but the treatments and prognoses are different, so the early differentiation of the two diseases is very important. Early diagnosis is affected by delayed antibody detection and false negative detection, while routine auxiliary tests lack specificity; therefore, they have limited value in identification. The 18F-fulorodeoxyglucose (FDG) marked positron emission computed tomography (PETCT) is highly sensitive to abnormal cerebral metabolism in the early stage of anti-NMDA receptor encephalitis, showing a characteristic metabolic pattern of frontal or temporal lobe increase metabolism and occipital decrease metabolism. The number of patients who underwent 18F FDG PETCT examination for viral encephalitis was small; different kinds of viral encephalitis show different brain metabolism, but there was no characteristic hypometabolism of the occipital lobe. This paper reviews the cerebral metabolic characteristics of 18F-FDG PETCT in anti-NMDA receptor encephalitis and viral encephalitis.
5.Recent advance in cerebrospinal fluid biomarkers in patients with anti- N-methyl- D-aspartic acid receptor encephalitis
Keyu YANG ; Zan DONG ; Yuchen LI ; Jing WANG ; Rui WANG ; Jie WANG
Chinese Journal of Neuromedicine 2021;20(6):640-643
Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis. Most patients have a good prognosis, but a small number of patients have memory impairment and other sequelaes. Early immunotherapy is a key factor for good prognosis of patients with this disease. However, a key problem in the treatment of this disease is the lack of biomarkers for disease monitoring and prognosis assessment. Therefore, it is positive for guiding the diagnosis and treatment and evaluating the prognosis to find biomarkers that can reflect the disease. Here, biological factors abnormally elevated in cerebrospinal fluid of patients with anti-NMDA receptor encephalitis are reviewed, and biological factors with potential as biomarkers are summarized.
6.Recent advance in imaging features of anti- N-methyl- D-aspartic acid receptor encephalitis
Qian PANG ; Zan DONG ; Xiaoyang CHAI ; Fei HU ; Keyu YANG ; Yuli HOU ; Jing WANG ; Jie WANG
Chinese Journal of Neuromedicine 2020;19(6):645-648
Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis mediated by anti-NMDA receptor antibody. At present, the diagnosis of the disease depends mainly on typical clinical symptoms and detection of specific antibodies in cerebrospinal fluid. Early and timely treatment can curb the disease progression and improve the prognosis of the disease. However, because of the atypical clinical manifestations of patients and long waiting time for antibody detection, early identification is difficult. Imaging equipment is more popular in primary hospitals in China, and it is easier to perform imaging examination for suspected patients in the early stage; therefore, this article aims to review the imaging characteristics and current imaging research progress of anti-NMDA receptor encephalitis in recent years, so as to improve clinicians' understanding and early recognition of this disease.
7.Influencing factors and clinical significance of liver function damage in patients diagnosed with COVID-19
Dawei SUN ; Dong ZHANG ; Runhui TIAN ; Yang LI ; Yushi WANG ; Jie CAO ; Ying TANG ; Nan ZHANG ; Tao ZAN ; Lan GAO ; Yanzhu HUANG ; Yang ZHENG ; Guoyue LYU
Chinese Journal of Digestive Surgery 2020;19(4):360-365
Objective:To invetigate the influencing factors and clinical significance of liver function damage (LFD) in patients diagnosed with Corona Virus Disease 2019 (COVID-19).Methods:The retrospective case-control study was conducted. The clinicopathological data of 51 patients with COVID-19 who were admitted to the Sino-French New City Branch of Tongji Hospital Affiliated to Huazhong University of Science and Technology by the 5th group assisting team from the First Hospital of Jilin University from February 9th to 27th in 2020 were collected. There were 27 males and 24 females, aged from 36 to 86 years, with an average age of 68 years. The treatment modality was according to the diagnostic and therapeutic guideline for COVID-19 (Trial 6th edition) issued by National Health Commission. Observation indicators: (1) clinical data of patients; (2) analysis of liver function index and treatment of LFD; (3) analysis of influencing factors for LFD. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. The Logistic regression method was used for univariate analysis. Results:(1) Clinical data of patients: of the 51 patients, 21 were classified as ordinary type of COVID-19, 19 as severe type and 11 as critical type. In terms of medical history, 31 patients suffered from more than or equal to one kind of chronic disease, 20 had no history of chronic disease. Thirteen patients had the drinking history and 38 had no drinking history. Seven patients were hepatitis positive and 44 were hepatitis negative. Five patients had septic shock at admission, 5 had systemic inflammatory response syndrome (SIRS), and 41 had neither shock nor SIRS. The body mass index (BMI), time from onset to admission, temperature, heart rate, respiratory rate of the 51 patients were (24±3)kg/m 2, (13±5)days, 36.5 ℃ (range, 36.0-38.1 ℃), 82 times/minutes (range, 50-133 times/minutes), 20 times/minutes (range, 12-40 times/minutes). The white blood cell count, level of creatinine, and level of b-type natriuretic peptide within 24 hours after admission were 6.3×10 9/L [range, (2.2-21.7)×10 9/L], 75 μmol/L (range, 44-342 μmol/L), 214 ng/L (range, 5-32 407 ng/L). (2) Analysis of liver function index and treatment of LFD: the level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), direct bilirubin (DBil), indirect bilirubin (IBil), activated partial thromboplastin time (APTT) and prothrombin time (PT) were 31 U/L (range, 7-421 U/L), 29 U/L (range, 15-783 U/L), 36 U/L (range, 13-936 U/L), 76 U/L (range, 41-321 U/L), 4.9 μmol/L (range, 2.6-14.3 μmol/L), 5.8 μmol/L (range, 2.6-23.9 μmol/L), 37.2 s (range, 30.9-77.1 s), 13.9 s (range, 12.5-26.7 s), respectively. The percentages of cases with abnormal ALT, AST, GGT, ALP, DBil, IBil, APTT and PT were 47.1%(24/51), 47.1%(24/51), 35.3%(18/51), 13.7%(7/51), 7.8%(4/51), 2.0%(1/51), 21.6%(11/51), and 19.6%(10/51), respectively. Of the 51 patients, LFD was detected in 10 patients classified as ordinary type, in 9 patients as severe type, and in 10 as critical type, respectively. In the 51 patients, 1 of 22 patients with normal liver function developed respiratory failure and received mechanical ventilation within 24 hours after admission, while 9 of 29 patients with abnormal liver function developed respiratory failure and received mechanical ventilation, showing a significant difference between the two groups ( χ2=5.57, P<0.05). (3) Analysis of influencing factors for LFD. Results of univariate analysis showed that clinical classification of COVID-19 as critical type was a related factor for LFD of patients ( odds ratio=10.000, 95% confidence interval: 1.050-95.231, P<0.05). Conclusions:COVID-19 patients with LFD are more susceptible to develop respiratory failure. The clinical classification of COVID-19 as critical type is a related factor for LFD of patients.
8.Recent advance in epilepsy associated with autoimmune encephalitis
Xiaoyang CHAI ; Jie WANG ; Qian PANG ; Fei HU ; Keyu YANG ; Zan DONG
Chinese Journal of Neuromedicine 2019;18(2):207-210
Autoimmune encephalitis (AE) is a novel form of encephalitis associated with antibodies to cell-surface or synaptic proteins. Epileptic seizures act as the predominant manifestation of AE which are triggered by interaction between kinds of antibodies and antigens on cell-surface or intracellular. Patients with AE-related epilepsy are insensitive to antiepileptic drugs but sensitive to immunotherapy. Early initiation of immunotherapy can significantly improve the prognosis. To date, there are few reports on the treatment plan of antiepileptic drug to the patients with AE-related epilepsy. In this review we report the most relevant data about the morbidity, pathogenesis and treatment of AE-related epilepsy with aim of providing better treatment options.
9.Treatment of aseptic ulnar diaphyseal nonunion with locking compression plate and autogenous iliac bone graft.
Dong-Xu FENG ; Liang SUN ; Wei-Lou FENG ; Kun ZHANG ; Shu-Hao LI ; Wei HUANG ; Yang-Jun ZHU ; Zan-Dong ZHAO
China Journal of Orthopaedics and Traumatology 2019;32(12):1160-1164
OBJECTIVE:
To investigate the clinical results of locking compression plate combined with autologous iliac bone graft in the treatment of aseptic ulnar nonunion.
METHODS:
From March 2009 to July 2017, 22 patients with aseptic ulnar diaphyseal nonunion with complete follow-up data were treated with surgery, including 12 males and 10 females, aged from 16 to 58 (39.7±9.9) years old and ranging in course of disease from 10 to 192 (39.4±55.7) months. There were 15 atrophic nonunions, 5 hypertrophic nonunions and 2 synovial pseudo-articular nonunions. After debridement of the nonunion, locking compression plate was used to fix the nonunion and autogenous iliac bone graft was given. Bone healing rate, surgical complications and clinical results were evaluated.
RESULTS:
All the patients were followed up, and the duration ranged from 13 to 42 months, with a mean of (22.5±8.2) months, and 1 patient did not heal. Visual analogue pain scores ranged from 0 to 3 (0.9±0.9). Pronation of forearm was 47 to 86 (69.0±14.7) degrees, supination was 35 to 85 (63.0±9.4) degrees, wrist flexion was 20 to 80 (51.0±10.2) degrees, wrist flexion was 32 to 88 (71.0±11.7) degrees, elbow flexion contracture was 0 to 25 (9.0±5.6) degrees, further flexion was 105 to 150 (134.0±13.9) degrees, and grip strength was 87% on the opposite side. According to the Anderson scoring system, 8 cases were excellent, 11 were satisfied, 2 were not satisfied, and 1 was failed.
CONCLUSIONS
LCP combined with autologous iliac bone graft can effectively treat aseptic ulna diaphyseal nonunion.
Adolescent
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Adult
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Bone Plates
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Bone Transplantation
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Diaphyses
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Female
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Fracture Fixation, Internal
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Fractures, Ununited
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surgery
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Humans
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Ilium
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Male
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Middle Aged
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Retrospective Studies
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Treatment Outcome
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Ulna
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Young Adult
10.Laparoscopic ureteroureterostomy for the treatment of complete duplicated systems with hydronephrosis and ureteral dilation in children
Liqu HUANG ; Jun DONG ; Haobo ZHU ; Jun WANG ; Chenjun CHEN ; Xiaojiang ZHU ; Zan WAN ; Lixia WANG ; Rugang LU
Chinese Journal of Applied Clinical Pediatrics 2018;33(23):1777-1780
Objective To discuss the efficacy of laparoscopic ureteroureterostomy for upper pole hydronephro-sis and ureteral dilatation in children with complete duplex kidney.Methods The clinical data of 14 patients (15 units in total)who underwent laparoscopic ureteroureterostomy from April 2016 to October 2017 were retrospectively analyzed. Nine out of 14 cases had repeated urinary tract infections(UTI)and other symptoms[6 cases in group A:patients without vesicoureteral reflux(VUR)but presenting urinary tract infection (UTI)symptoms,3 cases in group C:patients diagnosed with VUR];5 cases of asymptomatic patients were selected as group B.All the 14 cases had upper pole hydronephrosis and ureteral dilatation.Preoperative examinations included ultrosonograpy,urinary magnetic resonance urography(MRU), intravenous pyelography (IVP),voiding cystourethrogram(VCUG),and nuclear renal scanning.It was found that 4 cases had ureterocele;3 cases had recurrent cystoureteral reflux (group C)before operation,and 1 case had cystoureteral re-fluxed after replantation.Results Laparoscopic surgery was successful in all of 14 children.None of them were shifted to open surgery because of abdominal viscera injury bleeding.The operation duration was 85-140 min.The average posto-perative hospital stay was 5.58 days.There was neither urinary anastomotic leakage nor UTI.Fourteen cases were followed up and the postoperative follow-up period was 7-23 months.No cases developed urinary tract infection except 2 cases with vescioureteral reflux.Ultrasound examination showed that the upper renal parenchyma of 5 children was thicker,ul-trasonography showed that upper pole hydronephrosis was better and ureteroceles were smaller.There was no complication such as lower pole hydronephrosis.The symptoms of urinary tract infection disappeared after operation.Conclusions Laparoscopic ureteroureterostomy can treat renal duplication with less trauma,and it is safe and effective.It can be one of therapeutic regimen to treat low-functional upper pole hydronephrosis and ureteral dilatation in renal duplication.Howe-ver,this procedure cannot be used for vescoureteral reflux cases because of high rate of stump infection.


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