Objective:To analyze the clinical efficacy of electrolysis of depigmented hair using a trichiasis electrolyzer combined with hair follicle transplantation in the treatment of vitiligo-associated leukotrichia.Methods:Clinical data were retrospectively collected from 25 patients with stable vitiligo-associated leukotrichia in the Department of Dermatologic Surgery, Hangzhou Third People′s Hospital from January 2019 to January 2021. All the patients received electrolysis of depigmented hair using a trichiasis electrolyzer combined with hair follicle transplantation. Outpatient follow-up visits were conducted in the first week, as well as the first, third and sixth months after surgery. The texture and growth status of transplanted hair were observed, and the survival rate of transplanted hair follicles and the proportion of newborn white hair in white hair in the original lesions were recorded.Results:Among the 25 patients with stable vitiligo, there were 14 males and 11 females, and their disease duration ranged from 2 to 15 years, with the average duration being 5.8 years. A total of 30 white patches accompanied by leukotrichia were included, including 9 on the scalp, 7 on the eyebrows and 14 on the eyelashes. One week after surgery, the transplanted hair survived well in all patients, without obvious shedding or local infection. Six months after surgery, repigmentation was observed in most hair in the original lesion area, and only a small amount of white hair grew out, without obvious scarring; the survival rate of transplanted hair follicles was 76.5% ± 10.0%, and the proportion of newborn white hair in white hair in the original lesions was 16.7% ± 7.8%.Conclusion:Electrolysis of depigmented hair using a trichiasis electrolyzer combined with hair follicle transplantation was effective in the treatment of vitiligo-associated leukotrichia, with a simple treatment process and few postoperative complications, which provided a reliable choice for the clinical treatment of vitiligo-associated leukotrichia.

Objective:To investigate the clinical effects of modified automatic hemorrhoidal ligation using elastic string (RPH-4) combined with Xiaozhilling injection for grade Ⅲ hemorrhoids.Methods:The prospective randomized controlled study was conducted. The clinical data of patients with grade Ⅲ hemorrhoids who underwent modified RPH-4 combined with Xiaozhiling injection in Traditional Chinese Medicine Hospital of Chongqing Shapingba District from July 2021 to December 2022 were selected. Patients with grade Ⅲ hemorrhoids who meeting the inclusion criteria were randomly divided into the experimental group and the control group using a random number table method. Patients in the experiment group underwent submucosal injection of the Xiaozhilling injec-tion followed by modified RPH-4, and patients in the control group underwent submucosal injection of the 0.9% sodium chloride solution followed by modified RPH-4. Observation indicators: (1) grouping of enrolled patients; (2) postoperative situations; (3) short-term efficacy; (4) long-term efficacy. Com-parison of measurement data with normal distribution between groups was conducted using the inde-pendent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the nonparameter test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping of enrolled patients. A total of 120 patients were selected. There were 72 males and 48 females, aged 48(range, 18-69)years, including 60 cases in the experiment group and 60 cases in the control group, respectively. There was no significant difference in gender, age, type of hemorrhoids, time to hemorrhoid prolapsis, stool blood, symptom score and Wexner score between the two groups ( P>0.05), confounding bias ensured comparability. At the end of the study, there were 59 cases in the experimental group and 58 cases in the control group. (2) Postoperative situations. There were 5 cases of secondary bleeding after modified RPH-4 in the experiment group and 15 cases of secondary bleeding after modified RPH-4 in the control group, showing a significant difference between the two groups ( χ2=6.239, P<0.05). The post-operative hemorrhoidal shedding time was (6.9±1.4)days in the experiment group, versus (8.1±2.2)days in the control group, showing a significant difference between the two groups ( t=-3.566, P<0.05). (3) Short-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing short-term follow-up. The cure rate was 88.14%(52/59) in the experiment group, versus 84.48%(49/58) in the control group, showing no significant difference in short-term efficacy between the two groups ( χ2=0.331, P>0.05). The wound healing time was (24±5)days in the experi-ment group, versus (25±5)days in the control group, showing no significant difference between the two groups ( t=-1.082, P>0.05). (4) Long-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing long-term follow-up. None of patient in the two groups had anal incontinence. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of rectal hard segment in the experiment group were 2 and 1, respectively, and there was no anorectal stenosis. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of anorectal stenosis were 8 and 1, respectively, and there was no rectal hard segment. There was no significant difference of above situations between the two groups ( P>0.05). Conclusion:The modified RPH-4 combined with Xiaozhiling injection for grade Ⅲ hemorrhoids can achieve double solid and hemorrhoidal removal efficacy, which can further reduce the risk of complications after severe hemorrhoids modified RPH-4 alone treatment.

Objective:To investigate the clinical effects of modified automatic hemorrhoidal ligation using elastic string (RPH-4) combined with Xiaozhilling injection for grade Ⅲ hemorrhoids.Methods:The prospective randomized controlled study was conducted. The clinical data of patients with grade Ⅲ hemorrhoids who underwent modified RPH-4 combined with Xiaozhiling injection in Traditional Chinese Medicine Hospital of Chongqing Shapingba District from July 2021 to December 2022 were selected. Patients with grade Ⅲ hemorrhoids who meeting the inclusion criteria were randomly divided into the experimental group and the control group using a random number table method. Patients in the experiment group underwent submucosal injection of the Xiaozhilling injec-tion followed by modified RPH-4, and patients in the control group underwent submucosal injection of the 0.9% sodium chloride solution followed by modified RPH-4. Observation indicators: (1) grouping of enrolled patients; (2) postoperative situations; (3) short-term efficacy; (4) long-term efficacy. Com-parison of measurement data with normal distribution between groups was conducted using the inde-pendent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the nonparameter test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping of enrolled patients. A total of 120 patients were selected. There were 72 males and 48 females, aged 48(range, 18-69)years, including 60 cases in the experiment group and 60 cases in the control group, respectively. There was no significant difference in gender, age, type of hemorrhoids, time to hemorrhoid prolapsis, stool blood, symptom score and Wexner score between the two groups ( P>0.05), confounding bias ensured comparability. At the end of the study, there were 59 cases in the experimental group and 58 cases in the control group. (2) Postoperative situations. There were 5 cases of secondary bleeding after modified RPH-4 in the experiment group and 15 cases of secondary bleeding after modified RPH-4 in the control group, showing a significant difference between the two groups ( χ2=6.239, P<0.05). The post-operative hemorrhoidal shedding time was (6.9±1.4)days in the experiment group, versus (8.1±2.2)days in the control group, showing a significant difference between the two groups ( t=-3.566, P<0.05). (3) Short-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing short-term follow-up. The cure rate was 88.14%(52/59) in the experiment group, versus 84.48%(49/58) in the control group, showing no significant difference in short-term efficacy between the two groups ( χ2=0.331, P>0.05). The wound healing time was (24±5)days in the experi-ment group, versus (25±5)days in the control group, showing no significant difference between the two groups ( t=-1.082, P>0.05). (4) Long-term efficacy. There were 59 cases in the experiment group and 58 cases in the control group completing long-term follow-up. None of patient in the two groups had anal incontinence. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of rectal hard segment in the experiment group were 2 and 1, respectively, and there was no anorectal stenosis. Cases of hemorrhoid recurrence (blood stool or prolapse) and cases of anorectal stenosis were 8 and 1, respectively, and there was no rectal hard segment. There was no significant difference of above situations between the two groups ( P>0.05). Conclusion:The modified RPH-4 combined with Xiaozhiling injection for grade Ⅲ hemorrhoids can achieve double solid and hemorrhoidal removal efficacy, which can further reduce the risk of complications after severe hemorrhoids modified RPH-4 alone treatment.

OBJECTIVE: To explore the expression level of exosome derived miR-181b-5p in different disease stages of children with acute lymphoblastic leukemia and its relationship with clinical characteristics. METHODS: Bone marrow plasma samples of 86 children with ALL were collected. Exosomes were extracted by exosome extraction kit, and RNA in exosomes was extracted by TRIzol method. The levels of miR-181b-5p in the blood plasma exosomes of the patients in the newly diagnosed group, relapse group, remission group and control group were detected by qRT- PCR. The difference of miR-181b-5p expression level in each group was compared and analyzed, and the relationship between miR-181b-5p expression level and clinical characteristics was analyzed. RESULTS: The expression level of exosomal miR-181b-5p in the newly diagnosed group and the relapsed group was significantly lower than that in the remission group and the control group (P< 0.05). The expression level of exosomal miR-181b-5p in T-ALL children was higher than that in B-ALL children (P<0.05). The expression level of plasma exosomal miR-181b-5p in male children was higher than that in female children (P<0.01). CONCLUSION Exosome derived miR-181b-5p changes dynamically in the course of ALL children, and can be used as a marker miRNA to monitor disease status. Exosomes can transmit information in the tumor microenvironment and serve as a potential carrier for biomolecular targeted therapy.
Humans ; Male ; Female ; Child ; Exosomes/metabolism* ; Clinical Relevance ; MicroRNAs/genetics* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism* ; Tumor Microenvironment

OBJECTIVE: To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control. METHODS: From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests. RESULTS: A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05). CONCLUSION Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).
Humans ; Vancomycin/therapeutic use* ; Cefuroxime ; Levofloxacin ; Oral Ulcer/drug therapy* ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/adverse effects* ; Ampicillin ; Penicillins ; Cefotaxime ; Gram-Positive Bacteria ; Gram-Negative Bacteria ; Gentamicins ; Stomatitis/drug therapy*

Objective: To investigate the clinical characteristics and maternal and fetal prognosis of pregnant women with acute fatty liver of pregnancy (AFLP). Methods: The clinical data of 86 AFLP pregnant women admitted to the Third Affiliated Hospital of Guangzhou Medical University from September 2017 to August 2022 were collected, and their general data, clinical characteristics, laboratory tests and maternal and fetal outcomes were retrospectively analyzed. Results: (1) General information: the age of the 86 pregnant women with AFLP was (30.8±5.4) years, and the body mass index was (21.0±2.5) kg/m². There were 50 primiparas (58.1%, 50/86) and 36 multiparas (41.9%, 36/86). There were 64 singleton pregnancies (74.4%, 64/86) and 22 twin pregnancies (25.6%, 22/86). (2) Clinical characteristics: the main complaints of AFLP pregnant women were gastrointestinal symptoms, including epigastric pain (68.6%, 59/86), nausea (47.7%, 41/86), anorexia (46.5%, 40/86), vomiting (39.5%, 34/86). The main non-gastrointestinal symptoms were jaundice of skin and/or scleral (54.7%, 47/86), edema (38.4%, 33/86), fatigue (19.8%, 17/86), bleeding tendency (16.3%, 14/86), polydipsia or polyuria (14.0%, 12/86), skin itching (8.1%, 7/86), and 17.4% (15/86) AFLP pregnant women had no obvious symptoms. (3) Laboratory tests: the incidence of liver and kidney dysfunction and abnormal coagulation function in AFLP pregnant women was high, and the levels of blood ammonia, lactate dehydrogenase and lactic acid were increased, and the levels of hemoglobin, platelet and albumin decreased. However, only 24 cases (27.9%, 24/86) of AFLP pregnant women showed fatty liver by imageology examination. (4) Pregnancy outcomes: ① AFLP pregnant women had a high incidence of pregnancy complications, mainly including renal insufficiency (95.3%, 82/86), preterm birth (46.5%, 40/86), hypertensive disorders in pregnancy (30.2%, 26/86), gestational diabetes mellitus (36.0%, 31/86), fetal distress (24.4%, 21/86), pulmonary infection (23.3%, 20/86), disseminated intravascular coagulation (16.3%, 14/86), multiple organ dysfunction syndrome (16.3%, 14/86), hepatic encephalopathy (9.3%, 8/86), and intrauterine fetal death (2.3%, 2/86). ② Treatment and outcome of AFLP pregnant women: the intensive care unit transfer rate of AFLP pregnant women was 66.3% (57/86). 82 cases were improved and discharged after treatment, 2 cases were transferred to other hospitals for follow-up treatment, and 2 cases (2.3%, 2/86) died. ③ Neonatal outcomes: except for 2 cases of intrauterine death, a total of 106 neonates were delivered, including 39 cases (36.8%, 39/106) of neonatal asphyxia, 63 cases (59.4%, 63/106) of neonatal intensive care unit admission, and 3 cases (2.8%, 3/106) of neonatal death. Conclusions: AFLP is a severe obstetric complication, which is harmful to mother and fetus. In the process of clinical diagnosis and treatment, attention should be paid to the clinical manifestations and laboratory tests of pregnant women, early diagnosis and active treatment, so as to improve maternal and fetal outcomes.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Adult ; Retrospective Studies ; Premature Birth/epidemiology* ; Pregnancy Complications/diagnosis* ; Fatty Liver/diagnosis* ; Fetal Death ; Stillbirth

OBJECTIVE: To explore the expression characteristics of antigens and functional markers of natural killer (NK) cells in patients with acute myeloid leukemia (AML). METHODS: Multi-parameter flow cytometry was used to detect NK cell surface markers and their functional indicators in 56 newly diagnosed AML patients and 24 healthy controls, including activating receptors NKG2D, NKP46, DNAM-1, and killing indicators granzyme B, perforin. RESULTS: Referring to the WHO hematopoiesis and lymph tissue tumor classification criteria, 56 cases were roughly divided into three types: AML M₁, M₂, and M₄/M₅. However, there was no differences about NK cells among the three types, so it was no longer subdivided. NK cells were divided into two groups: CD3^-CD56^hiCD16^- (CD56^hiNK) and CD3^-CD56^dimCD16⁺ (CD56^dimNK). Compared with CD56^dimNK cell population, except for NKP46, the positive expression levels of NKG2D and other receptors of CD56^hiNK cells in AML patients decreased (P<0.001). Compared with healthy controls, the proportion of CD56^hiNK cells in AML patients increased, while the number and proportion of NK cells and proportion of CD56^dimNK cells significantly decreased (P<0.05). The proportion of perforin in CD56^hiNK cells significantly increased (P<0.05). The expression of DNAM-1 in CD56^hiNK cells, NKG2D, DNAM-1, and perforin in CD56^dimNK cells decreased significantly (P<0.05). There was no statistically significant difference in expression of other functional indexes in AML patients compared with corresponding indexes of healthy controls. In addition, the proportion of CD56^hiNK cells was positively correlated with the expression of CD34⁺ in AML (r=0.303). CONCLUSION Compared with CD56^dimNK, the ratio of CD56^hiNK and the expression of functional markers in AML patients are lower. Compared with healthy controls, the number and expression ratio of NK cells in AML patients decrease and the expression of functional markers is abnormal, indicating that its function is impaired.
CD56 Antigen ; Flow Cytometry ; Humans ; Killer Cells, Natural ; Leukemia, Myeloid, Acute

OBJECTIVE: To establish an animal model of acute B lymphoblastic leukemia (B-ALL) with minimal residual disease. METHODS: The transplanted tumor was formed by subcutaneous injection of 2×10⁷ Nalm-6 cells, and the body weight, activity status and tumor formation status of nude mice were observed. Peripheral blood, bone marrow, liver and spleen and other tissues of nude mice were taken for pathological examination to understand whether the success of subcutaneous modeling was accompanied by systemic metastasis. RESULTS: There were 2×10⁷ Nalm-6 cells injected subcutaneously in nude mice, (11.0±2.5) days later, the tumors of (3-4) × (3-4) mm were observed, the body weight of the nude mice was reduced and activity showed no limited. Infiltration of tumor cells in liver, spleen and bone marrow were observed in pathological sections. CONCLUSION The animal model of subcutaneous tumor of B-ALL was successfully established in nude mice.
Animals ; Body Weight ; Disease Models, Animal ; Humans ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Neoplasm, Residual ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Calreticulin/genetics* ; DNA Methylation ; Female ; Humans ; Janus Kinase 2/genetics* ; Mutation ; Myeloproliferative Disorders/genetics* ; Polycythemia Vera/genetics*

OBJECTIVE: To analyze the clinical efficacy of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) by using parental donors on thalassemia patients. METHODS: The 13 thalassemia patients treated by haplo-HSCT using parental donors in our hospital from July 1, 2016, to July 1, 2020 were retrospectively reviewed. Hematopoiesis reconstitution, the incidence of GVHD, infections and the long-term survival of the patients were analyzed. RESULTS: Twelve of the 13 patients were successfully implanted, the success rate of implantation was 92.3%. The median time of neutrophil and platelet engraftment was 12.5 days (range, 9-22 days) and 21 days (range,12-34 days), respectively. One patient achieved primary graft failure. Three (25%) patients developed to acute GVHD (aGVHD) and achieved complete remission after treatment. Chronic GVHD developed in three (25%) patients, one of them was extensive and under treatment, while one patient developed to severe bacterial infection (7.7%). CMV viremia was diagnosed in two patients (15.4%). There were no patients developed to CMV disease. Three (23.1%) patients achieved EB viremia after transplantation, one of them developed to EBV-related lymphocytic proliferative disease, while there were no patients showed invasive fungal infection. At the last follow-up, all patients survived, twelve of them were free from transfusion dependency. There were no transplant-related deaths. Projected overall and thalassemia-free survival at three years was 100% and 92.3%, respectively. CONCLUSION The transplant protocol of haplo-HSCT by using parental donors in patients with thalassemia has reliable source of donors, high incidence of successful implantation and low incidence of GVHD, which can be used as an effective way to increase the source of donors in children with thalassemia.
Child ; Cytomegalovirus Infections ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Parents ; Retrospective Studies ; Thalassemia/therapy* ; Transplantation Conditioning/methods* ; Treatment Outcome ; Viremia