Objective:To evaluate the clinical efficacy and safety of Blinatumomab on the treatment of refractory or relapsed precursor B-cell acute lymphoblastic leukemia (R/R BCP-ALL) in children.Methods:Clinical data of children with R/R BCP-ALL treated with Blinatumomab in the Department of Hematology, Children′s Hospital of Soochow University, from August 2021 to June 2022 were retrospectively analyzed.Children were divided into<45 kg group and ≥45 kg group according to their weight at admission.They were treated with different dosages of Blinatumomab, and bone marrow remission was assessed at about 15 days.Clinical indicators and adverse events during the treatment period were recorded.The rank sum test of two independent samples were used to compare the differences between groups.The Fisher′ s test was used for comparing categorical variables. Results:Among the 16 children with R/R BCP-ALL, 12 cases (75%) achieved complete response (CR) and minimal residual lesion (MRD) turned negative at about 14 days.Among them, 5 out of 9 children with bone marrow primitive naive cell ratio≥0.5 achieved CR, and 7/7 children with bone marrow primitive naive cell ratio<0.5 achieved CR.The peak value of interleukin-6 (IL-6) in children with CR was significantly higher than those without CR ( Z=2.50, P=0.012). Twelve cases achieved CR on bone marrow assessment around day 15, and 3 cases who did not achieve CR remained in remission on day 28, with an efficacy prediction accuracy of 93.8%(15/16). Adverse events included fever, neutropenia, hypokalemia, abnormal liver function, hypocalcemia, edema, rash, hypertension, myocardial damage, abdominal pain, hypotension, and cytokine release syndrome, which were all grade 1.Neurotoxicity and death were not reported. Conclusions:The remission rate of R/R BCP-ALL in children treated with Blinatumomab was high, especially in patients with a low tumor load.The toxicity and adverse events of Blinatumomab treatment are minor and controllable.Day 15 is the optimal time point to evaluate the efficacy of Blinatumomab on children with R/R BCP-ALL, and a higher IL-6 peak can be served as a predictor of its efficacy.

Objective: To explore the potential therapeutic role of miR-489 in silica-induced pulmonary fibrosis mouse models. Methods: A total of 32 C57BL/6 male mice were randomly divided into four groups: saline, silica, silica plus miRNA control and silica plus miR-489 agomir (n=8 in each group) . The mice were instilled with silica particles suspended in saline or sterile saline intratracheally. Subsequently, miR-489 agomir or miRNA control was injected via the tail vein into each mouse at days 28, 35, 42 and 49, the miR-489 levels, histological examination, collagen deposition, fibrotic biomarkers (E-cadherin, α-SMA, Vimentin, Fibronectin) and transforming growth factor-β₁ (TGF-β₁) protein levels in mouse lung tissues were measured. Results: miR-489 levels in silica plus miR-489 group were significantly increased in lung tissues compared with silica plus miRNA control group (P<0.05) . Histological examination showed attenuated inflammation, less severe fibrotic foci and less destruction of alveolar architecture in the silica plus miR-489 group. Additionally, both the severity and distribution of lung lesions were ameliorated in silica plus miR-489 group compared with the silica plus miRNA control group (P<0.05) . The collagen deposition and hydroxyproline levels in silica plus miR-489 group were significantly decreased compared with the silica plus miRNA control group (P<0.05) . These changes were supported by decreased protein levels of α-SMA, Vimentin, Fibronectin, TGF-β1 along with increased protein levels of E-cadherin in silica plus miR-489 group (P<0.05) . Conclusion Our data indicate that the upregulation of miR-489 has potential therapeutic role in silica-induced pulmonary fibrosis in vivo, which may be associated with the depression of TGF-β1 release.

Objective Our purpose was to evaluate the teaching satisfaction of clinical epi-demiology among medical postgraduate and to come up with measures for further improvement of teaching quality. Methods A self-administered questionnalre was given to all the medical postgradu-ates and doctoral students of Grade 2013 by cluster sampling when they finished the course of clinical epidemiology. A total of 559 graduate students, including 324 graduate students (58%), 235 doctoral students (42%), recruitment graduate students 350 (62.6%), on-the-job graduate student 209 (37.4%).The contents of the questionnalre included many aspects such as the investigation object in general, teaching materials evaluation satisfaction, curriculum and teacher satisfaction evaluation. Respondents ' self-administered manner was adopted. Parallel input was done by using Epidata software; data were analyzed with SPSS 19.0 software, continuous variable was made by x±s, categorical variables was expressed by n(%). Continuous variables were compared among groups by t test and analysis of vari-ance. Classification grouping variable was compared by chi-square test, and P<0.05 for the difference was statistically significant . Results Overall evaluation of theory was below that of the internship teaching materials. The satisfaction rate of practicability, meeting the learning needs and difficulty degree for theory and practice teaching material were 83.7% (468/559), 87.5% (489/559), 67.1% (375/559) and 92.7%(518/559), 89.6%(501/559), 83.0%(464/559) respectively. 41.6%(87/209) of on-the-job students and 36.7% (119/324) of postgraduates considered theory teaching material was difficult for them. The satisfaction rate for faculty teaching attitude (99.5%, 556/559), faculty teaching method (98.6%,551/559), the theories combining with practice teaching method (97.5%, 545/559) were high, but the satisfaction rate for teaching hours was low (67.4%, 377/559), with one third students consider more hours for the course. Conclusion The Teaching effect of clinical epidemiology is falrly good in our school. The postgraduates are satisfied with the teaching materials, curriculum setting, and teach-ing faculty. But there are also some shortcomings. In the future teaching work, we should appropriately increase the hours, and set corresponding teaching contents and methods according to the different learning characteristics of the on-the-job graduate students and recruitment graduate students, to improve the teaching effect and teaching quality.

Objective:To establish a method for the determination of puerarin and balcalin in Xiao’ er Shuangjie Zhixie granules by HPLC. Methods:An Agilent Zorbax SB-C18 column (250 mm × 4. 6 mm,5 μm) was used. The mobile phase A was 0. 1% phos-phoric acid solution and the mobile phase B was methanol with gradient elution. The detection wavelength was 265 nm,the flow rate was 1. 0 ml·min-1 ,the column temperature was 30℃ and the sample size was 20 μl. Results: The linear range of pueratin was 0. 121-1. 942 μg (r=0. 999 5)and that of balcalin was 0. 230-3. 686 μg(r=0. 999 5). The average recovery was 98. 10% and 98. 20%with RSD of 1. 34% and 1. 11%(n=6), respectively. Conclusion:The method is convenient and accurate, which can be used in the de-termination of pueraln and balcalin in Xiao’ er Shuangjie Zhixie granules.

Objective To discuss the cleaning effect of biofilm cleaners for the endoscopic equipment,in order to clean the endoscopic equipment in the operation room thoroughly,improve the cleaning quality of surgical instruments in hospital and prevent nosocomial infection.Methods 300 polluted endoscopic equipments were selected in the operation room and were divided into the experimental group and the control group randomly.Then the two groups were dealt with biofilm cleaners and multi-enzyme detergent respectively.At the end of the cleaning step,the cleaning effect were compared between the two groups.Results The passing rate of cleaning in the experimental group was 96.8％,significantly better than that of the control group,which was 78.0％.The difference between two groups had statistical significance.Conclusions Cleaning endoscopic equipment with biofilm cleaners can improve the cleaning effect of the surgical instruments,ensure the cleaning quality of the surgical instruments.

OBJECTIVETo reveal the factors that affect the contents of volatile oil and beta-elemene in oil in Sarcandrae and to provide scientific basis for Sarcandrae's reasonable exploitation and quality assessment.

METHODA GC method was established and the contents of volatile oil and beta-elemene were determined in Sarcandrae from different length of time to grow, different medicament portions, different collection periods and different length of time to dry.

RESULTThe length of time to grow had no significant effect and the collection periods had effect on the volatile oil yield and content of beta-elemene. The volatile oil yield and content of beta-elemene were the highest in Sarcandrae harvested in December. The yield of volatile oil in different medicament portions descended in an order of roots, leaves and stems. The content of beta-elemene was the highest in leaves and the lowest in stems. With the increasing of the length of time to dry, the volatile oil yield and content of beta-elemene decreased calculated on an anhydrous basis.

CONCLUSIONThe established method is simple, accurate and repeatable. It can be used for the quality control of beta-elemene in Sarcandrae. The study provides a valuable basis for the quality assessment, the development and utilization of Sarcandrae.

OBJECTIVETo prepare the submicron emulsion of fresh Zhongjiefeng volatile oil.

METHODThe Zhongjiefeng volatile oil submicron emulsion was obtained after passing the elementary emulsion through a high pressure homogenizer. The physical and chemical stability of the emulsion was evaluated with the stability parameter of centrifugation, appearance of emulsion and the pH. The formulation and processing factors were optimized by single factor reviewing and orthogonal experimental design.

RESULTBy controlling various processing factors and optimizing formulation, the stable submicron emulsion of Zhongjiefeng volatile oil was prepared. Its mean particle diameter was 164-169 nm with PDI 0.084-0.107 and Zeta electric potential was -40 mV.

CONCLUSIONThe formulation and preparation technique of the emulsion is reasonable.

Objective To establish a soluble expression of recombinant survivin in E. coli, and evaluate the role of anti-survivin in tumor diagnosis. Methods The recombinant survivin was screened by ampicillin resistance, identified by PCR and double digestion of endonucleases. The sequenced DNA of survivin was analyzed by BLAST. The survivin/Trx fusion protein expressed in E.coli BL21 (DE3) was induced with IPTG, identified by Western blot and purified with Ni-NTA agarose respectively. The anti-survivin antibodies in serum were detected with an indirect ELISA. By the methods above, 144 serum samples from cancer patients and 300 serum samples from normal subjects were analyzed. Meanwhile, the joint detection of anti-survivin, AFP, CEA, CA199, CA125 in blood sera from cancer patients was detected. Results After PCR and double digestion with endonucleases, the survivin gene was inserted into the prokaryotic expression vector PET 32a(+). After DNA sequencing, the constructed expression plasmid was transformed into competent cells E.coli BL21(DE3). Western blot identified that the recombinant survivin/Trx fusion protein was specific against survivin antibody. The purity of the protein was over 96% after purified by Ni-NTA agarose. Anti-survivin was expressed in the sera of different cancer patients, but the positive rate varied. Conclusion Prokaryotic expression plasmid PET 32a(+)/survivin was successfully constructed and highly purified survivin/Trx fusion protein was obtained. The detection results of anti-survivin, AFP, CEA, CA199, CA125 in blood serum show in the diagnosis of tumors, the joint detection can overcome the shortfall of each gene and enhance the diagnostic rate.

This article introduces the development and experience of the educational reforms in the teaching of medical ethics at Sun Yat-Sen University,concerning the "three-in-one" model,constituting "classroom instruction,practical experience,and independent research".Practical experience is considered an effective way of implementing and consolidating theories and practices,just as knowledge in professional ethics are exercised in coherence.It is an important step for medical students to have early contacts with society,enhance social responsibility,increase understanding and practices of medical ethics and developing practical and creative abilities.

Object To study specific TLC identification of the root bark of Morus alba L. (RBMA)Methods The ethanol extracts of RBMA and other confusable species were subjected to TLC in different development system. The TLC plats were examined under shortwavelength UV light or colored by FeCl 3 solution.Results A mixture of chloroform and methanol (5∶1) is used for development and ferric chloride solution is used to color, a specific purple spot of the certified RBMA can be found.Conclusion The specific spot showed with TLC can be regarded as the basis of identification of RMBA and it was separated and identified as sanggenon C.