Objective:To evaluate the long-term efficacy and safety of recombinant coagulation factor Ⅷ (Octocog alfa) in Chinese patients with hemophilia A (HA) enrolled in the International Antihemophilic Factor Hemophilia A Outcome Database (AHEAD) study (NCT02078427) .Methods:Enrollment of Chinese patients in the AHEAD study was completed by January 2021, and data were collected up to July 15, 2022. This study primarily assessed patients in terms of the Gilbert score, global gait score within the Hemophilia Joint Health Score (HJHS), annualized bleeding rate (ABR), annualized joint bleeding rate, and adverse events.Results:A total of 168 male patients were included in this study, of which 113 received prophylactic treatment and 53 received on-demand treatment. The average age of the patients was 21.4±13.37 years. Compared with baseline, the global gait score within HJHS significantly decreased during the 1-year follow-up in patients with moderately severe HA in the prophylactic treatment group ( P=0.01) and on-demand treatment group ( P=0.008). The mean reduction in Gilbert score was greater in the prophylactic treatment group than in the on-demand treatment group (28.6% vs 8.2%). The average ABR decreased significantly during the 1-year follow-up (3.70 vs 7.78, P=0.01) in the prophylactic treatment group, particularly in patients with severe HA (2.14 vs 8.98, P=0.006) and pediatric patients (2.1 vs 4.73, P=0.03). The ABR score also decreased significantly in the moderate-dose prophylactic treatment group ( P=0.015). During the 1-year follow-up, 25 patients (14.9%) reported 39 adverse events, with only one patient developing treatment-related F Ⅷ inhibitor. Conclusion:Joint mobility improved in patients receiving either prophylactic or on-demand Octocog alfa. Bleeding episodes significantly reduced in patients receiving prophylactic treatment, particularly in pediatric patients and those with severe HA.

Objective:To evaluate the long-term efficacy and safety of recombinant coagulation factor Ⅷ (Octocog alfa) in Chinese patients with hemophilia A (HA) enrolled in the International Antihemophilic Factor Hemophilia A Outcome Database (AHEAD) study (NCT02078427) .Methods:Enrollment of Chinese patients in the AHEAD study was completed by January 2021, and data were collected up to July 15, 2022. This study primarily assessed patients in terms of the Gilbert score, global gait score within the Hemophilia Joint Health Score (HJHS), annualized bleeding rate (ABR), annualized joint bleeding rate, and adverse events.Results:A total of 168 male patients were included in this study, of which 113 received prophylactic treatment and 53 received on-demand treatment. The average age of the patients was 21.4±13.37 years. Compared with baseline, the global gait score within HJHS significantly decreased during the 1-year follow-up in patients with moderately severe HA in the prophylactic treatment group ( P=0.01) and on-demand treatment group ( P=0.008). The mean reduction in Gilbert score was greater in the prophylactic treatment group than in the on-demand treatment group (28.6% vs 8.2%). The average ABR decreased significantly during the 1-year follow-up (3.70 vs 7.78, P=0.01) in the prophylactic treatment group, particularly in patients with severe HA (2.14 vs 8.98, P=0.006) and pediatric patients (2.1 vs 4.73, P=0.03). The ABR score also decreased significantly in the moderate-dose prophylactic treatment group ( P=0.015). During the 1-year follow-up, 25 patients (14.9%) reported 39 adverse events, with only one patient developing treatment-related F Ⅷ inhibitor. Conclusion:Joint mobility improved in patients receiving either prophylactic or on-demand Octocog alfa. Bleeding episodes significantly reduced in patients receiving prophylactic treatment, particularly in pediatric patients and those with severe HA.

In this paper， the latest research progress on the mechanism of comorbid alcohol use disorder and depressive disorder at home and abroad is elucidated from genetic， neurochemical， neuroendocrine and neuroimmunologic perspectives. It aims to identify the gaps in current research and predict future research directions， providing a further basis for the clinical management of comorbid alcohol use disorder and depressive disorder.

Purpose To evaluated the effect of ureteral stent placement before flexible ureteroscopic lithotripsy(FURL).Methods A systematic search of PubMed,Cochrane Library,Embase,Scopus,VIP,CNKI,Wanfang database from databases establishment to February 2017 was performed to identify all clinical trials on the effect of ureteral stenting before flexible ureteroscopic lithotripsy.The outcomes included stone-free rate,mean operative time,success rate of ureteral access sheath placement and postoperative complications.RevMan 5.3 software was used to complete the Meta statistical analysis.Results Three randomized and four non-randomized studies were analyzed,which consisted of 1 176 patients including 788 cases in experimental group,388 cases in control group.Meta-analysis showed significant differences between experimental group and control group in stone-free rate (OR =1.88,95％ CI 1.30-2.71,P ＜ 0.001).There was no statistically significant difference in mean operative time between experimental group and control group (WMD =-0.99,95 ％ CI-10.63-8.65,P =0.84).The success rate of ureteral access sheath placement was significantly higher in experimental group than that in the control group (OR =8.24,95％ CI 3.17-21.45,P ＜ 0.001).In term of postoperative complications,two groups had significant differences (OR =0.57,95 ％ CI 0.33-0.99,P =0.04).Conclusions Preoperative ureteral stenting can increase the stone-free rate and the success rate of ureteral access sheath placement,and reduce complications of FURL.There is no statistically significant difference in mean operative time.

Objective The aim of this study was to evaluate the value of serum exosomal miRNAs,originating from tumor tissue cells,could be used as noninvasive biomarker for distinguishing clear cell renal cell carcinoma (ccRCC).Methods 30 pairs of tissue samples and the corresponding serum samples were collected from 20 ccRCC male patients and 10 female ccRCC patients,operated in our department from June 2015 to June 2016.Their age ranged from 45 to 70 years old,mean 57 years old.Based on the miRNA microarray analysis of ccRCCs miRNA expression profiles,we picked up four miRNAs,including miR-210,miR-224,miR-452,and miR-34a,to confirm our hypothesis.Then the expression quantity of these four miRNAs in tissues,serums and serum exosomes were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR).Sensitivity,specificity and area under curve (AUC) for serum miRNA levels were determined using receiver operator characteristic (ROC) analysis.Results Expression of miR-210,miR-224,and miR-452 were higher in tumor tissues compared to those in adjacent noncancerous tissues (P＜0.05),increasing by 20.51-fold,54.08-fold and 2.48-fold respectively.But only miR-210 was significantly higher in ccRCC patients compared to healthy controls (HCs) in serum and serum exosome (P ＜0.05),increasing by 2.45-fold and 2.32-fold respectively.ROC curve analysis indicated that the serum exosomal miR-210 level might serve as a useful biomarker for differentiating patients with ccRCC from those with HCs;the AUC was 0.8789 (95％ CI 0.7803-0.9775) and the sensitivity and specificity was 92.1％ and 80.0％,respectively.Conclusion The detection of miR-210 in the serum exosome is useful for early diagnosis of clear cell renal cell carcinoma.

Objective:To establish an UHPLC-MS/MS method to determine the contents of baicalin,scutellarin,wogonin,caffeic acid,ephedrine,belamcandin,irisflorentin and baicalein in Shegan mixtures. Methods:The chromatographic separation was performed on a ZORBAX SB-C18 column(2. 1 mm × 50 mm,1. 8 μm)with the mobile phase consisting of acetonitrile and water(0. 1% formic acid),the flow rate was 0.3 ml·min-1,and the column temperature was 35℃. Electrospray ionization source(ESI)was used with multiple reaction monitoring( MRM)combined with positive and negative scanning switch. üegative ion mode detection was used for caf-feic acid,belamcandin and scutellarin ,while positive ion mode detection was used for baicalin,wogonin,irisflorentin,baicalein and e-phedrine. Results:The quantification limit of baicalin,scutellarin,wogonin,caffeic acid,ephedrine,belamcandin,irisflorentin and ba-icalein was 1. 44 × 10-4 ,4. 20 × 10-3 ,2. 95 × 10-4 ,7. 80,4. 90 × 10-3 ,4. 6 × 10-2 ,3. 18 × 10-4 ng·ml-1 and 4. 85 ng·ml-1 . The detection limit was 4.32 ×10-5,1.3 ×10-3,8.84 ×10-5,0.77,2.90 ×10-4,3.33 ×10-4,9.5 ×10-5 ng·ml-1 and 1.46 ng· ml-1 ,respectively. The correlation coefficients( R2 )were all higher than 0. 992 3 within the linear ranges. Both intra- and inter-day RSD were less than 5%. The average recoveries of the eight components were within the range of 80%-120%. Conclusion:The method is simple,rapid,sensitive and accurate. It can be used to determine the contents of baicalin,scutellarin,wogonin,caffeic acid,ephed-rine,belamcandin,irisflorentin and baicalein in Shegan mixtures for the quality control.

OBJECTIVETo evaluate the value and clinical effect of peripheral aneurysms with polytetrafluoroethene (PTFE) stent graft after peripheral endovascular procedures.

METHODSFrom May 2012 to November 2013, 13 patients of peripheral aneurysms were treated with PTFE stent graft. There were 9 male and 4 female patients, aged from 24 to 74 years with a mean of 52 years. There were 7 aneurysms and 6 pseudoaneurysms. This stent graft was a self-expanding nitinol stent, internally covered by an ultra-thin polytetrafluoroethene (PTFE) graft. All peripheral aneurysms were repaired with the PTFE stent graft, using an entirely percutaneous approach. All patients were given clopidogrel and (or) aspirin postoperatively. Complications and reintervention rates were also examined.

RESULTSPTFE stent graft placement was successfully performed in all the 13 cases, and the instant isolation effect was quite satisfactory. During the follow-up period of 3 to 18 months, no stent graft related complications occurred in all patients except one patient with iliac arterial pseudoaneurysm, who developed pseudoaneurysms presented as a complication at puncture site. There were no other symptomatic complications with graft patience.

CONCLUSIONEndovascular repair can be considered as an effective treatment strategy for peripheral aneurysms by PTFE stent graft.

Adult ; Aged ; Aneurysm ; surgery ; Drug-Eluting Stents ; Endovascular Procedures ; Female ; Fluorocarbons ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Polymers ; Treatment Outcome

Objective To detect whether adipose-derived mesenchymal stem cells (ADMCSs)can differentiate into renal tubular epithelial cells and be used for treatment of acute kidney injury (AKI).Methods ADMSCs were separated and cultured in vitro,and were transfected with lentivirus carrying reporter genes of firefly luciferase and monomeric red fluorescent protein (fluc-mrfp).Transfected ADMCSs (2 × l06) were directly injected into renal parenchyma after establishment of AKI models induced by ischemic reperfusion injury.Distribution and differentiation of ADMSCs in rats were detected by bioluminescence imaging (BLI) and immunofluorescent staining,respectively.Results ADMSCs had positive expressions of CD29 and CD90,rather than expressions of CD34,CD45 and CD31.Lentivirus-transduced ADMSCs had stable expressions of mrfp and fluc reporter genes.BLI showed persistent fluorescence signal in vivo even at day 14 after ADMSCs transplantation.Immunofluorescence staining further indicated that the transplanted ADMSCs could differentiate into tubular epithelial cells.Conclusion ADMSCs in vivo can differentiate into renal tubular epithelial cells,which provides an experimental basis for more researches on ADMSCs transplantation for treatment of AKI.

Objective To explore the expression and significance of CD34, CD117 on bone marrow mononuclear cells of myelodysplastic syndromes (MDS). Methods Direct immunofluorescence staining was used by means of flow cytometry. 37 patients with MDS were divided into RA/RARS/RCMD subgroup, RAEB Ⅰ/RAEB Ⅱ subgroup; favorable chromosomal subgroup, poor chromosomal subgroup; intermediate-risk Ⅰ subgroup, intermediate-risk Ⅱ subgroup, high-risk subgroup respectively according to WHO classification,cytogenetic abnormalities and international prognostic scoring system (IPSS). Results CD34 and CD117 were positive respectively in 11 of 19 patients with RMRARS/RCMD, all cases in RAEB Ⅰ/RAEB Ⅱ expressed CD34 and CD117; increased expression of CD34 and CD117 was MDS grade-related. Favorable chromosomal subgroup, 14 of 22 patients were positive for CD34, CD117, all cases in poor chromosomes expressed CD34 and CD117; there was a direct relationship between phenotytic density and poor cytogenetic risk factor. CD34 and CD117 expression was present respectively in intermediate-risk Ⅰ (9/17), intermediate-risk Ⅱ (11/11) and highrisk subgroup (9/9); the phenotypic intensity also was correlated with IPSS scores. Conclusion Detection of CD34, CD117 may be a useful tool for subtyping and predicting the prognosis of MDS.

Objective To examine the frequency and the course of cytomegalovims infection after allogeneic hematopoietic stem cell transplantation, and correlation of transplant factors with Cytomegalovirus (CMV) infection and viral load. Methods Using real-time polymerase chain reaction, we detected the copies of CMV-DNA in blood samples of the 62 patients after allo-HSCT. Furthermore, we studied the relationship between transplant factors and CMV infection. Results Among the total, 23 cases were contracted with CMV infection, 4 cases developed to CMV disease. 22 cases were cured and 1 case died. Course of CMV infection influenced the viral load significantly. Donor type, stem cell source, use of ATG, Ⅱ-Ⅳ grade aGVHD, use of glucocorticoid, complicating with other infection and use of cellular filter significantly influenced CMV infection. However, in multivariate analysis, none of them was the independent risk factors. Conclusion Real-time polymerase chain reaction may be used to early diagnose of the CMV infection and to guide treatment. Many factors influenced CMV infection. Early diagnosis and treatment could decrease the morbidity and mortality of CMV infection.