Objective:To explore the coexisting gene mutations of FLT3-ITD mutation and its association with partial clinical parameters in acute myeloid leukemia (AML).Methods:The clinical data of 236 newly diagnosed AML outpatients and hospitalized patients of Changzhou No.2 People's Hospital and the Second People's Hospital of Wuxi between December 2012 and August 2019 were retrospectively analyzed. Genome DNA-polymerase chain reaction (PCR) combined with Sanger sequencing was used to detect FLT3-ITD mutations, and 51 tumor target gene mutations in patients with FLT3-ITD mutations were detected by using high-throughput DNA sequencing combined with Sanger sequencing.Results:Among 236 AML patients, FLT3-ITD mutations were found in 71 cases (30.1%). About 97.2% (69/71) patients with FLT3-ITD mutations were accompanied by additional mutations, of which 19 patients harbored double coexisting genes mutations, 24 patients harbored 3 coexisting genes mutations and 26 patients harbored ≥ 4 coexisting genes mutations. The most common coexisting genes mutations were NPM1 (55 cases, 77.5%), followed by DNMT3A (36 cases, 50.7%), TET2 (9 cases, 12.7%), CEBPA (5 cases, 7.0%), IDH1 (4 cases, 5.6%) and NRAS (4 cases, 5.6%). In FLT3-ITD mutation group, the hemoglobin level of patients with DNMT3A mutation type was lower than that of those with DNMT3A wild type ( t = -2.37, P = 0.020); the hemoglobin level of patients with NPM1 mutation type was higher than that of those with NPM1 wild type ( t = 2.04, P = 0.045). The platelet in patients with 3 mutations and ≥ 4 mutations was higher than that in those with double mutations ( χ2 = 7.72, P = 0.021). After chemotherapy in 71 patients, the curative effect of 66 cases was evaluable, and the white blood count of 18 patients who did not reach complete remission was higher than that of 48 patients who reached complete remission ( Z = -2.74, P = 0.006). Conclusions:Most FLT3-ITD mutated patients with AML commonly show coexisting gene mutations, and the mutation types of coexisting genes are correlated with the clinical features of patients.

【Objective】 To analyze and evaluate the occurrence of adverse reactions to incompatible blood component transfusion in patients undergoing ABO-incompatible allogeneic hematopoietic stem cell transplantation (ABO-incompatible allo-HSCT) in our hospital, and provide a basis for clinical safety management of incompatible blood component transfusion. 【Methods】 The case data of 467 ABO-incompatible allo-HSCT patients with incompatible blood components transfused in our hospital from June 2021 to December 2021 were retrospectively analyzed, and the adverse reactions to blood transfusion that occurred were diagnosed according to the clinical manifestations and changes before and after blood transfusion as well as the results of related laboratory tests. The evaluation was based on three aspects as the degree of certainty of the type of reaction, the severity of it, and its probablity associated with blood transfusion. 【Results】 The overall incidence of adverse reactions to transfusion of incompatible blood components was 30.19% (141/467). The incidence occurred in suspended red blood cells were 42.86%(15/35), apheresis platelets 39.25%(73/186), frozen plasma 28.26%(26/92), cryoprecipitated coagulation factors 19.05%(8/42) and washed red blood cells 16.96%(19/112). The incidence of adverse reactions of washed red blood cells and suspended red blood cells was statistically different(P<0.05). The types of adverse reactions were mainly allergic reactions (67.37%, 95/141), followed by non-hemolytic febrile reactions (22.69%, 32/141), transfusion-related graft-versus-host disease(2.84%, 4/141), acute hemolytic transfusion reactions(2.84%, 4/141), transfusion-related hypotension(2.84%, 4/141) and 2 cases (1.42%, 2/141) of other adverse reactions. A total of 141 adverse reactions were graded: 113 cases (80.14%, 113/141) were " sure" , 20 cases (14.19%, 20/141) were " basically sure" , 8 cases were " suspected" (5.67%, 8/141); 130 cases (92.20%, 130/141) were " mild" , and 10 cases (7.09%, 10/141) were" moderate" , 1 case was " severe" (0.71%, 1/141). As to the occurrence associated with blood transfusion: 117 cases (82.98%, 117/141) were " highly correlated" , 17 cases (12.06%, 17/141) were " likely correlated" , and 7 cases (4.96%, 7/141) were " less correlated" . 【Conclusion】 Evaluating and grading the adverse reactions to transfusion of incompatible blood components can deepen the cognition of clinical medical staff, increase the accuracy and rigor of their judgment of adverse reactions, and avoid the missed and false reports of adverse reactions to a certain extent, which laid the foundation for the establishment of a unified standard for adverse reactions to incompatible blood transfusion.

Objective　To observe the influences of circular RNA HECT domain E3 ubiquitin ligase 1 (Circ_HECTD1) on the proliferation and apoptosis of HT22 cells and its regulatory mechanism on the microRNA-135a-5p (miR-135a-5p)/tumor protein 53-induced nuclear protein 1 (TP53INP1) axis by in vitro oxygen-glucose deprivation/reoxygenation (OGD/R)-induced hippocampal neuron damage.Methods　HT22 cells were routinely cultured,and the cells were separated into Con group,OGD/R group,si-NC group,and si-Circ_HECTD1 group,miR-NC group,miR-135a-5p group,si-Circ_HECTD1+anti-miR-NC group,and si-Circ_HECTD1+anti-miR-135a-5p group.qRT-PCR method was used to detect the expression of Circ_HECTD1,miR-135a-5p and TP53INP1 mRNA;MTT was used to detect cell viability;flow cytometry was used to detect apoptosis;dual-luciferase reporter gene experiment was applied to verify the targeting relationship between Circ_HECTD1 and miR-135a-5p,miR-135a-5p and TP53INP1;Western blot was applied to measure the protein expressions of Bax,Bcl-2 and TP53INP1.Results　After OGD/R induction,the expressions of Circ_HECTD1 and TP53INP1 in HT22 cells were up-regulated,the expression of miR-135a-5p was down-regulated,the cell survival rate and the expression of Bcl-2 protein were remarkably decreased,the apoptosis rate and the expression of Bax protein were remarkably increased (all P<0.05).Silencing the expression of Circ_HECTD1 could remarkably up-regulate the expression of miR-135a-5p in OGD/R-induced HT22 cells,down-regulate the expression of TP53INP1,increase cell survival rate and Bax protein expression,decrease cell apoptosis rate and Bcl-2 protein expression (all P<0.05).There was a targeting relationship between Circ_HECTD1 and miR-135a-5p,between miR-135a-5p and TP53INP1.Overexpression of miR-135a-5p could remarkably down-regulate the expression of TP53INP1,increase cell survival rate and Bcl-2 protein expression,decrease cell apoptosis rate and Bax protein expression (all P<0.05).Inhibition of miR-135a-5p expression could partially reverse the protective effect of silencing Circ_HECTD1 on HT22 cell damage.Conclusion　Silencing Circ_HECTD1 can regulate the miR-135a-5p/TP53INP1 axis and promote cell survival,inhibit cell apoptosis,and protect against OGD/R-induced hippocampal neuron damage.

Aiming at the medical practice problems of the surgical steel medical instruments, such as the crevice corrosion, the poor mechanical compatibility and the Ni, Cr plasma exudation, the laser deposition of Ti-6Al-4V alloy cladding layer at the local functional area as alternative coating was proposed and realized as a new process method. The accurate element content and good formability Ti-6Al-4V cladding powder was chosen, the low power and high duty cycle optimized laser process was adopt, the alternative coating of good fusion and low dilution was prepared. Through the elemental line scanning, the interface microstructure analysis and the experiments of basic mechanical properties, the basic properties of the cladding were characterized and verified. The experiments results showed that, the Ti, Al and V contents of the top coating were respectively about 88%, 4.9% and 3.9%, no sensitizing ions such as Cr and Ni were detected. Initial equiaxed α phase, flake β phase dist were distributed in the coating and interface, the α' martensite was precipitated at the boundary of the flake β phase, some refined granular β phase dispersion pinned to the grain boundary of basket structure. The microhardness of cladding layer was 352.08~312.76 HV_0.1. The friction coefficient of the cladding layer was about 0.22~0.65. A new technology and method reference for improving and upgrading the performance of surgical medical devices is provided by this research.
Alloys ; Corrosion ; Materials Testing ; Steel ; Titanium

Objective:To explore influence on physical development of children aged 18 months from HIV-positive mothers for prevention mother to child transmission of HIV (PMTCT) in Guangxi Zhuang autonomous region, and provide evidence for the improvement PMTCT program.Methods:This retrospective case control study was conducted in 554 HIV negative infants aged 18 months whose HIV positive mothers had received PMTCT services reported through PMTCT system database from January 1, 2010 to December 31, 2017 and 1 109 healthy infants born in 2017, whose mothers were healthy, in Lingshan, Luzhai, and Hengxian counties, ranking top three counties with high HIV infection prevalence, in Guangxi. PMTCT data and physical development data such as height, weight and head circumference of children aged 18 months were collected. The physical dysplasia in the infants was defined as at least one of the three main indicators of height, weight and head circumference below the normal range.Results:The number of HIV-positive mother and their infants in the case group were 667 and 554 respectively, and the PMTCT rates were 91.15 % (608/667) and 96.57 % (535/554) respectively. HIV positive rate, mortality rate and mother to child transmission rate of the infants aged 18 months were 1.44 % (8/554), 3.07 % (17/554) and 1.91 % (8/418) respectively, and the physical examination results of the infants aged 18 months showed that the physical dysplasia rate was 30.51 % (169/554). Among the 1 109 infants in the control group, the physical dysplasia rate was 9.83 % (109/1 109). The difference between the case group and the control group was significant ( P<0.01). Conclusion:The PMTCT rates of HIV positive mother and their children were more than 90.00 %, respectively. However, poor physical development rate of infants aged 18 months were more than 30.00 %. The possible influence of PMTCT on physical development of the infants aged 18 months of HIV positive mother’s needs to be further studied.

Objective To investigate the impact of sample typeon the detection of c-KIT exon 17 mutation in acute myeloid leukemia (AML) patients. Methods A retrospective study was conducted on 51 bone marrow samples collected from 37 AML patients [17 maleand 20 female, with a median age of 33 (range from 1 to 82)] at diagnosis or after treatment from June 2016 to August 2018. Of the 37 cases of AML, 24 were t(8; 21) AML, 11 were inv(16)/t(16;16) AML and 2 were non-CBF-AML. RNA and DNA were simultaneously extracted from every sample. PCR followed by Sanger sequencing were used to screen c-KIT exon 17 mutation, and the comparisons were made between paired cDNA and DNAsamples. Results (1) Of the 51 paired samples, 14 pairs were simultaneously detected positive for c-KITmutation in both of cDNA and DNA samples, but 17 pairs were detected negative in both, and the remaining 20 pairswere only detected positive for the mutation in cDNA but not in DNA, with an inconsistency rate of 39.2％. The positive rate of detecting c-KITmutation was significantly higher in cDNA than in DNA samples (66.7％vs 27.5％,P=0.000073). (2)Inconsistent mutation results between paired cDNA and DNA samples occurred in t(8;21)AML, inv(16)AML and non-CBF-AML patients with the inconsistency rate of 36.4％(12/33), 27.2％(3/11) and 71.4％ (5/7), respectively. (3)The inconsistency rate was significantly higher in samples collected after treatment compared with those collected at diagnosis (72.7％vs 13.8％, P=0.00003). (4) All 5 serially monitored patients with c-KITmutation had inconsistency in mutation detection between cDNA and DNA samples during follow up. Conclusion cDNA improves the detection of c-KIT exon 17 mutation in AML patients compared with DNA, which is especially common after treatment.

The epidemiology, clinical manifestations and appropriate diagnostic methods of drug eruption in children are still poorly understood.On the one hand, children′s adverse reactions to drugs are different from adults because of their weight and age characteristics.On the other hand, they can mimic many other skin diseases, especially viral exanthems, frequently appearing as a maculopapular or morbilliform rash sometimes indistinguishable from a cutaneous adverse drug reaction.Meanwhile, the tools used for drug eruption management in adults are applied also for children.Whereas this appears generally acceptable, some aspects of drug eruption and management differ with age.The pathogenesis of drug eruption in children is related to virus infection, immune state, drug and metabolic enzyme effect.Most reactions in children are still attributed to betalactams.The practicability and validity of skin test and other diagnostic procedures need further assessment in children.The key to treatment is early diagnosis, discontinuation of suspect drugs, assessment of prognosis, and specialist support.

Objective: To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison. Methods: Peking University People’s Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated. Results: ①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories’ results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH. Conclusion The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

Objective To analyze the effect of endoscopic middle turbinate angioplasty on postoperative nasal function and olfaction in patients with chronic sinusitis and nasal polyp.Methods Clinical materials of 80 patients with chronic sinusitis and nasal polyps were analyzed retrospectively,and they were divided into control group and research group,40 cases in each group.Control group was treated with endoscopic partial middle turbinate resection,while research group was treated with endoscopic middle turbinate angioplasty.Clinical efficacy,nasal function,olfactory function,SNOT-20CV score,and Lund-Kennedy scoring and complications were compared between two groups.Results Total effective rate of the research group was significantly higher than the control group (P ＜0.05).Before operation,nasal airway resistance and minimal nasal cross-section to anterior nostril distance (DCAN),nasal minimum cross-sectional area (NMCA),nasal volume (NCV),SNOT-20 CV,nasal endoscopic Lund-Kennedy scores showed no significant differences between two groups (P ＞ 0.05).After operation,nasal airway resistance and DCAN and SNOT-20 CV,nasal endoscopic Lund-Kennedy scores decreased significantly in both groups,and these indexes in research group were significantly lower than the control group (P ＜ O.05).The NMCA and NCV increased significantly in both groups,and these indexes in research group were significantly higher than control group (P ＜ 0.05).There was no significant difference in incidence rate of postoperative complications between the two groups (P ＞ 0.05).Conclusion Endoscopic middle turbinate angioplasty is effective in treating chronic sinusitis patients with nasal polyp,which can effectively relieve nasal obstruction and promote nasal function and the sense of smell.

Objective To analyze the effect of endoscopic middle turbinate angioplasty on postoperative nasal function and olfaction in patients with chronic sinusitis and nasal polyp.Methods Clinical materials of 80 patients with chronic sinusitis and nasal polyps were analyzed retrospectively,and they were divided into control group and research group,40 cases in each group.Control group was treated with endoscopic partial middle turbinate resection,while research group was treated with endoscopic middle turbinate angioplasty.Clinical efficacy,nasal function,olfactory function,SNOT-20CV score,and Lund-Kennedy scoring and complications were compared between two groups.Results Total effective rate of the research group was significantly higher than the control group (P ＜0.05).Before operation,nasal airway resistance and minimal nasal cross-section to anterior nostril distance (DCAN),nasal minimum cross-sectional area (NMCA),nasal volume (NCV),SNOT-20 CV,nasal endoscopic Lund-Kennedy scores showed no significant differences between two groups (P ＞ 0.05).After operation,nasal airway resistance and DCAN and SNOT-20 CV,nasal endoscopic Lund-Kennedy scores decreased significantly in both groups,and these indexes in research group were significantly lower than the control group (P ＜ O.05).The NMCA and NCV increased significantly in both groups,and these indexes in research group were significantly higher than control group (P ＜ 0.05).There was no significant difference in incidence rate of postoperative complications between the two groups (P ＞ 0.05).Conclusion Endoscopic middle turbinate angioplasty is effective in treating chronic sinusitis patients with nasal polyp,which can effectively relieve nasal obstruction and promote nasal function and the sense of smell.