BACKGROUND: Treatment with chimeric antigen receptor-T (CAR-T) cells has shown promising effectiveness in patients with relapsed/refractory B-cell acute lymphoblastic leukemia (R/R B-ALL), although the process of preparing for this therapy usually takes a long time. We have recently created CD19 Fast-CAR-T (F-CAR-T) cells, which can be produced within a single day. The objective of this study was to evaluate and contrast the effectiveness and safety of CD19 F-CAR-T cells with those of CD19 conventional CAR-T cells in the management of R/R B-ALL. METHODS: A multicenter, retrospective analysis of the clinical data of 44 patients with R/R B-ALL was conducted. Overall, 23 patients were administered with innovative CD19 F-CAR-T cells (F-CAR-T group), whereas 21 patients were given CD19 conventional CAR-T cells (C-CAR-T group). We compared the rates of complete remission (CR), minimal residual disease (MRD)-negative CR, leukemia-free survival (LFS), overall survival (OS), and the incidence of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) between the two groups. RESULTS: Compared with the C-CAR-T group, the F-CAR-T group had significantly higher CR and MRD-negative rates (95.7% and 91.3%, respectively; 71.4% and 66.7%, respectively; P = 0.036 and P = 0.044). No significant differences were observed in the 1-year or 2-year LFS or OS rates between the two groups: the 1-year and 2-year LFS for the F-CAR-T group vs.C-CAR-T group were 47.8% and 43.5% vs. 38.1% and 23.8% (P = 0.384 and P = 0.216), while the 1-year and 2-year OS rates were 65.2% and 56.5% vs. 52.4% and 47.6% (P = 0.395 and P = 0.540). Additionally, among CR patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) following CAR-T-cell therapy, there were no significant differences in the 1-year or 2-year LFS or OS rates: 57.1% and 50.0% vs. 47.8% and 34.8% (P = 0.506 and P = 0.356), 64.3% and 57.1% vs. 65.2% and 56.5% (P = 0.985 and P = 0.883), respectively. The incidence of CRS was greater in the F-CAR-T group (91.3%) than in the C-CAR-T group (66.7%) (P = 0.044). The incidence of ICANS was also greater in the F-CAR-T group (30.4%) than in the C-CAR-T group (9.5%) (P = 0.085), but no treatment-related deaths occurred in the two groups. CONCLUSION Compared with C-CAR-T-cell therapy, F-CAR-T-cell therapy has a superior remission rate but also leads to a tolerably increased incidence of CRS/ICANS. Further research is needed to explore the function of allo-HSCT as an intermediary therapy after CAR-T-cell therapy.

The placement of the flexible ureteroscopic sheath during lithotripsy may injure the ureter. We have developed a double-tube flexible ureteral access sheath. Thirteen patients with renal calculi were treated with double-tube and flexible sheath in one stage. CT examination of 13 cases showed that the ureter was normal. The double-tube flexible ureteral access sheath makes the operation of sheathing easy, safe and effective.

Through providing rhythmic stimulation to movement center, rhythmic auditory stimulation (RAS) may encourage hemiplegic patients to adjust movement pattern and external rhythm in time to improve the walking function after stroke. As an emerging intervention to treat the hemiplegic patients after stroke, RAS could effectively improve temporospatial gait parameters (gait velocity, stride length, cadence, and symmetry, etc.), joint movement pattern (angle of pelvis anterior tilt, and peak angle of knee flexion in mid-swing, etc.) and balance, which may be related to rhythmic entrainment movement system and the theory of auditory-movement synchronization. Simultaneously, frequency and dosage of RAS and the patient's lesions all have effect on the outcome of intervention.

Objective To establish a simultaneous method for determination of 5 constituents from Panax quinquefolium stem leaf 20(S)-protopanaxdiol saponins,Ginsenoside-Rb1,Rc,Rb2,Rb3 and Rd by RP-HPLC.MethodsPanax quinquefolium stem leaf 20(S)-protopanaxdiol saponins was provided by the Ji'an Yisheng Pharmaceutical Stock Co.Ltd..The Agilent ODS column(5 ?m,4.6 mm?250 mm)was used,and eluted with acetonitrile-0.2% phosphoric acid water in gradient mode.The UV detection wavelength was 203 nm,and the flow rate was 1.0 ml/min,with the temperature of column at 40 ℃.The accuracy,stability and repeability of this method was evaluated.The yield rate was measured.ResultsFive compounds were baseline separated,with good linearity.A standard curve was plotted.Our method was proved to have sound accuracy,stability and repeability.The yield rate was 98.39%,97.36%,98.02%,97.70% and 97.01% respectively for Ginsenoside-Rb1,Rc,Rb2,Rb3 and Rd.ConclusionOur method of determination is rapid and accurate,and can be used for controlling the quality of Panax quinquefolium 20(S)-protopanaxdiol saponins.

OBJECTIVETo study lumbar vertebral degenerations of coal miners with low back pain.

METHODS40 underground miners with low back pain, aged from 30 to 50 years and employed for a length from 10 to 30 years, were taken as observation group. 30 ground workers without low back pain but with almost the same age, employment length and height etc. were selected as control group. Intervertebral discs at L3/L4, L4/L5, L5/S1 were scanned with computerized tomography, comparing herniated discs, sagittal diameter of vertebral canal, height of lateral recess, vertebral hypertostosis, ligament hypertrophy and calcification between two groups.

RESULTSL3/L4, L4/L5, L5/S1 herniated discs and narrow lateral recess in observation group(0.33 +/- 0.15, 0.53 +/- 0.25, 0.45 +/- 0.18 and 0.40 +/- 0.08, 0.31 +/- 0.05, 0.37 +/- 0.07) were more serious than that in control group(0.28 +/- 0.11, 0.32 +/- 0.21, 0.37 +/- 0.19 and 0.42 +/- 0.10, 0.43 +/- 0.07, 0.40 +/- 0.06), but only with significant difference at L4/L5 (P < 0.01). Sagittal diameter of vertebral canal in observation group is narrower than that in control group but of little significance(P > 0.05). Cases of vertebral hyperostosis, ligament hypertrophy and calcification were found more frequent in observation group(45.00%, 42.50%, 22.50%) than in control group(23.33%, 16.67%, 16.67%), but only ligament hypertrophy was remarkable(P < 0.05).

CONCLUSIONSAs compared with control group lumbar vertebral degenerations are more serious in underground miners with manifestations like herniated disc and narrow lateral recess mainly at L4/L5.

Adult ; Coal Mining ; Humans ; Low Back Pain ; diagnostic imaging ; Middle Aged ; Spinal Diseases ; diagnostic imaging ; Spine ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

With the development of HIS/RIS(Hospital/Radiolog y Information System), it is very important to study the HL7(Health Level Seven) Sta ndard for electronic data exchange in healthcare environments. Firstly, in this paper, the history, development goal and conceptions of HL7 are introduced. Secondly, its applications and auto-realization technologies are presented. Then, the problems which exist in the standard and the difficulties of HL7 in China are ana lyzed. Finally, some helpful suggestions about the development of HL7 in China are proposed.