1.Treatment status of tyrosine kinase inhibitor for newly-diagnosed chronic myeloid leukemia: a domestic multi-centre retrospective real-world study
Xiaoshuai ZHANG ; Bingcheng LIU ; Xin DU ; Yanli ZHANG ; Na XU ; Xiaoli LIU ; Weiming LI ; Hai LIN ; Rong LIANG ; Chunyan CHEN ; Jian HUANG ; Yunfan YANG ; Huanling ZHU ; Ling PAN ; Xiaodong WANG ; Guohui LI ; Zhuogang LIU ; Yanqing ZHANG ; Zhenfang LIU ; Jianda HU ; Chunshui LIU ; Fei LI ; Wei YANG ; Li MENG ; Yanqiu HAN ; Li'e LIN ; Zhenyu ZHAO ; Chuanqing TU ; Caifeng ZHENG ; Yanliang BAI ; Zeping ZHOU ; Suning CHEN ; Huiying QIU ; Lijie YANG ; Xiuli SUN ; Hui SUN ; Li ZHOU ; Zelin LIU ; Danyu WANG ; Jianxin GUO ; Liping PANG ; Qingshu ZENG ; Xiaohui SUO ; Weihua ZHANG ; Yuanjun ZHENG ; Qian JIANG
Chinese Journal of Hematology 2024;45(3):215-224
Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.
2.Gesture action intent recognition based on surface electromyography: a systematic review
Xu ZHU ; Jing LIU ; Zeping DONG ; Dawei QIU
Chinese Journal of Rehabilitation Theory and Practice 2022;28(9):1032-1038
ObjectiveTo systematicly review the researches of gesture action intent recognition based on surface electromyography (sEMG). MethodsExperimental researches on gesture action intention recognition based on sEMG were retrieved from CNKI, Wanfang Data, PubMed and Web of Science. The literatures were screened, and the classification methods and other related factors were summarized. ResultsA total of 735 researches were returned, and 25 researches were finally included. The publication time was mainly from 2012 to 2021. The subjects were healthy people or amputees. The classification model included traditional machine learning models and deep learning models. Other related factors included acquisition, noise interference and sliding window size. ConclusionTraditional machine learning models based on sEMG signals have been maturely applied, and gesture recognition with deep learning models are of great potential. The individual differences of subjects, the real-time requirements of gesture classification and the stability requirements of sEMG devices still need to be addressed.
3.Reform and thinking of undergraduate teaching of Pharmaceutical Analysis
Meng NIE ; Hao XU ; Qingfei LIU ; Zeping HU
Chinese Journal of Medical Education Research 2022;21(9):1149-1153
Objective:To analyze the current situation of the course of Pharmaceutical Analysis in the education and training of undergraduate students, explore the teaching reform and innovation to better accommodate the pharmacy education in the new era and build an advanced mode for training pharmaceutical talents with interdisciplinary expertise that meet the requirements and needs of job market. Methods:The first stage was to investigate the suggestions and needs of teaching reform; the second stage was to carry out the exploration and practice of the course reform; the third stage was to evaluate the teaching effect.Results:The demand survey showed that the teaching content, course design, and teaching methods of the Pharmaceutical Analysis need to be further optimized and expanded. Conclusion:By adjusting the teaching content, expanding teaching methods, innovating diversified teaching practices, and integrating the "curriculum ideology and politics" into the construction, the course reform has stimulated students' interest in learning and innovative spirit, strengthened their theoretical literacy and practical ability, and cultivated their international vision and lofty professional ethics.
4.Preliminary study of prenatal ultrasound in predicting delivery mode of full-term primipara
Jing XU ; Zhijuan ZHENG ; Aohua ZHANG ; Zeping HUANG ; Dongmei HUANG ; Xinling ZHANG
Chinese Journal of Ultrasonography 2021;30(10):880-884
Objective:To explore the feasibility of prenatal ultrasound in predicting delivery mode of full-term primipara.Methods:The study prospectively enrolled primiparas with gestational age ≥37 weeks, singleton, cephalic and no contraindications to vaginal delivery who underwent routine prenatal examination in the Third Affiliated Hospital of Sun Yat-sen University from September 2020 to February 2021.In addition to routine fetal ultrasound examination, the transperineal ultrasound examination was performed to assess the angle of progression (AOP), head perineum distance (HPD), the angle of pubic arch and the anteroposterior diameter, left and right diameter, area and perimeter of levator ani hiatus of pregnant women in different states were measured; Cervical length (CL) was examined by transvaginal ultrasound. The delivery mode was tracked, and the indicators related to natural delivery were screened out. Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of relevant indicators in predicting natural delivery.Results:A total of 142 cases were included in this study, including 112 cases of natural delivery and 30 cases of manual intervention delivery. There were no significant differences in age, gestational weeks, biparietal diameter, head circumference, body mass index (BMI) and neonatal weight between the natural delivery group and the manual intervention delivery group (all P>0.05). Multivariate regression analysis showed that AOP was associated with natural delivery( OR=1.048, P=0.008). ROC curve analysis showed that the area under the curve was 0.648 with AOP 96.92° as the node, and the specificity and positive predictive values were 83.33% and 0.909 1 respectively. Conclusions:It is feasible to predict the mode of delivery by prenatal ultrasound in full-term primiparas. AOP is related to the mode of delivery, which can provide more reference information for clinical practice.
5.Feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse
Xin LIN ; Manli WU ; Zeping HUANG ; Jing XU ; Xudong WANG ; Ying CHEN ; Shuangyu WU ; Yuanchun FU ; Haiyan CHEN ; Shuliang NAN ; Weijun HUANG ; Yu CHEN ; Li WANG ; Chunli JING ; Wenjuan CHEN ; Jiawei TIAN ; Xinling ZHANG
Chinese Journal of Ultrasonography 2020;29(9):771-776
Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.
6.Development and characteristic evaluation of wireless sensor module for wound temperature and pressure
Yuheng ZHANG ; Bo HAN ; Zeping PAN ; Cheng ZHANG ; Xiaoli XU ; Xueyong LI
Chinese Journal of Burns 2020;36(8):671-678
Objective:To develop a wireless sensor module for wound temperature and pressure (hereinafter referred to as wireless sensor module), and to carry out related characteristic test and biosafety evaluation.Methods:(1) The structure and working mode of the wireless sensor module were designed. The temperature and humidity sensor welded at one end of the flexible cable and the pressure sensor were simultaneously connected with the printed circuit board, which was welded with the Bluetooth transmitter, microprocessor, and power interface to establish a wireless sensor module. A mobile data receiving application was developed and the monitoring values of the wireless sensor module exposed to the air were read through the Bluetooth function on the smart phone. (2) The temperature of a 35-42 ℃ hot water bag was measured by the wireless sensor module and an infrared thermometer at the same time, and 30 pairs of data were compared with correlation analysis performed. (3) The vacuum sealing drainage material was pasted on the arm of the second author, and the wireless sensor module was placed in the condition of negative pressure. The negative pressure values measured by the wireless sensor module and the negative pressure meter values were recorded at the same time, and 14 pairs of data were compared with correlation analysis performed. (4) The corresponding material extract was prepared by adding 1 mL normal saline per 3 square centimeters surface area of the pressure sensor or flexible cable with temperature and humidity sensor welded respectively. Twenty 6-8 week-old female C57BL/6 mice were weighed before experiment and divided into pressure sensor extract group, flexible cable extract group, mixed extract group, and normal saline group according to the random number table ( n=5). The abnormal toxic reactions of mice were observed after intraperitoneal injection of pressure sensor extract, flexible cable with temperature and humidity sensor welded extract, 1∶1 mixed extract of pressure sensor extract and flexible cable with temperature and humidity sensor welded extract, and normal saline for 50 mL/kg in corresponding groups. The body mass of mice was weighed at 24, 48, and 72 hours after injection, and the toxicity of the materials was evaluated comprehensively. (5) Four Japanese big ear white rabbits aged 3-6 months were selected, and there was no limit between male and female. Two regions on the left side of the spine were applied with aseptic gauze as aseptic gauze group, and two areas on the right side of the spine were applied with wireless sensor module as wireless sensor module group. The skin status of each region was evaluated at 1, 12, 24, 48 hours after application, and the score according to the skin irritation score standard was recorded. (6) The corresponding material extract was prepared by adding 1 mL serum-free Dulbecco′s modification of Eagle′s medium (DMEM) per 1 square centimeter surface area of the pressure sensor or flexible cable with temperature and humidity sensor welded respectively. L-929 fibroblasts were divided into pressure sensor extract group, flexible cable extract group, phenol control group, and medium control group. The corresponding extract was added in the first two groups, the phenol control group was added with 64 g/L phenol, and the medium control group was cultured with serum-free DMEM. The total volumes of the above four groups were all 100 μL. The absorbance values on the 2nd, 4th, 7th day of culture were detected by methyl thiazolyl tetrazolium method to calculate the cell proliferation rate ( n=6 at each time point) and to grade the cytotoxicity. Data were statistically analyzed with paired samples t test, Wilcoxon signed rank test, Pearson correlation analysis, Spearman correlation analysis, Mann-Whitney U test, analysis of variance for repeated measurement, analysis of variance for factorial design, one-way analysis of variance, and Bonferroni correction. Results:(1) The smart phone successfully received the air temperature, humidity, and pressure information detected by the wireless sensor module through the Bluetooth function. (2) The temperature of the hot water bag measured by the wireless sensor module was (37.7±1.7) ℃, which was close to (37.7±1.7) ℃ of the infrared thermometer ( t=-0.112, P>0.05), and there was a significant positive correlation between them ( r=0.996, P<0.01). (3) The negative pressure of arm under negative pressure material measured by the wireless sensor module was -36.7 (-38.8, -27.4) kPa, which was significantly lower than -22.7 (-32.7, -12.5) kPa of negative pressure meter ( Z=-3.235, P<0.01), but there was a significant positive correlation between their absolute values ( ρ=1.000, P<0.01). (4) There was no abnormal toxic reaction in all groups of rats, and there was no statistically significant difference in body mass among the four groups of mice ( F=3.132, P>0.05). (5) The scores of skin irritation in application region of rats in the two groups were similar at 1, 12, 24, 48 hours after application ( Z=-1.000, <0.001, -0.620, <0.001, P>0.05). (6) At each time point of culture, compared with that of medium control group, the cell proliferation rate increased significantly in pressure sensor extract group and flexible cable extract group ( P<0.01) but decreased significantly in phenol control group ( P<0.01). On the 2nd, 4th, 7th day of culture, the cytotoxicity grade of phenol control group was 1, 1, and 2 respectively, and the cytotoxicity grade of each extract group was 0. Conclusions:The wireless sensor module integrates temperature, humidity, and pressure sensors, which can monitor local temperature and pressure and realize the visualization of parameters on the mobile application program. The measurement of temperature is accurate and the pressure measurement results are consistent with the values of the negative pressure meter with good biosafety. It possesses a big value in clinical application and prospects for development.
7.Efficacy of different doses of oxycodone for prevention of fentanyl-induced cough during induction of general anesthesia
Qingming BIAN ; Qiaofang XU ; Zeping XU ; Minhao ZHANG ; Lianbing GU
Chinese Journal of Anesthesiology 2018;38(7):800-802
Objective To evaluate the efficacy of different doses of oxycodone for prevention of fen-tanyl-induced cough during induction of general anesthesia. Methods A total of 250 American Society of Anesthesiologists physical statusⅠor Ⅱ patients of both sexes, aged 22-62 yr, weighing 47-81 kg, un-dergoing elective surgery, were divided into 5 groups (n=50 each) using a random number table method:different doses of oxycodone groups (O1-4groups) and control group (group C). Oxycodone 0. 025, 0. 050, 0. 075 and 0. 100 mg∕kg were intravenously injected in O1-4groups, respectively, while the equal volume of normal saline was given instead of oxycodone in group C. Five minutes later fentanyl 3 μg∕kg was intrave-nously injected within 5 s, and then 2 min later the other drugs were administered for induction. The occur-rence and severity of cough were observed within 2 min after fentanyl injection. The development of respira-tory depression and hypotension and severe bradycardia during induction of anesthesia were recorded within 5 min after oxycodone injection. Results The incidence of cough was significantly lower in O1-4groups than in group C (P<0. 05). There was no significant difference in the incidence of cough among O1-4groups (P>0. 05). No respiratory depression was found in C and O1-3groups. The incidence of respiratory depression was significantly higher in group O4than in C and O1-3groups (P<0. 05). There were no significant differ-ences in the incidence of hypotension or severe bradycardia during induction of anesthesia among the five groups (P>0. 05). Conclusion Oxycodone 0. 025 mg∕kg provides better efficacy in preventing fentanyl-induced cough during induction of general anesthesia.
8.Protective effects of dexmedetomidine combined with lung-protective ventilation on lungs in patients undergoing thoracic surgery
Qingming BIAN ; Zeping XU ; Lijun WANG ; Rong GAO ; Xiaolan GU ; Lianbing GU
Chinese Journal of Anesthesiology 2017;37(9):1061-1065
Objective To evaluate protective effects of dexmedetomidine combined with lung-protective ventilation on lungs in patients undergoing thoracic surgery.Methods Eighty patients with normal pulmonary function,aged 40-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 20-25 kg/m2,scheduled for elective right lobectomy for lung cancer performed via a thoracoscope,were divided into 4 groups (n =20 each) using a random number table:conventional ventilation group (group C),dexmedetomidine combined with conventional ventilation group (group DC),lung-protective ventilation group (group P) and dexmedetomidine combined with lung-protective ventilation group (group DP).In DC and DP groups,dexmedetomidine was intravenously infused as a loading dose of 0.5 μg/kg (over 10 min) starting from 10 min before anesthesia induction,followed by an infusion of 0.6 μg · kg 1 · h-1 until the end of surgery.In C and DC groups,the tidal volume was set at 9 ml/kg,positive end-expiratory pressure 0 cmH2O,fraction of inspired oxygen 100%,respiratory rate 10-12 breaths/min,inspiratory/expiratory ratio 1 ∶ 2,and end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg during both two-lung ventilation (TLV) and one-lung ventilation (OLV).In P and DP groups,the tidal volume was set at 6 ml/kg,positive end-expiratory pressure 5 cmH2O,fraction of inspired oxygen 70%,respiratory rate 14-16 breaths/min,i nspiratory/expiratory ratio 1 ∶ 2,and end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg during TLV and OLV.Airway peak pressure (Ppe~),airway plateau pressure (Pp~t),dynamic lung compliance and airway resistance (Raw) were monitored and recorded immediately before OLV (T1),at 30 min,1 h and 2 h of OLV (T2-4) and at 15 min after restoration of TLV (T5).Arterial blood samples were collected at 10 min before induction of anesthesia (T0) and T1-5 for blood gas analysis,and oxygenation index was calculated.At T0,T1,T3,T4 and 2 and 24 h after surgery (T6,7),blood samples were taken from the right internal jugular vein for determination of the concentrations of serum tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6) and high-mobility group box 1 protein (HMGB1) by enzyme-linked immunosorbent assay.Results Compared with group C,Raw was significantly decreased at T2-4 in group DC,Ppeak,Pplat and Raw were significantly decreased at T2-4 in P and DP groups,oxygenation index was significantly increased at T5 in DC and P groups,oxygenation index was significantly inereased at T2-5 in group DP,the concentrations of serum TNF-α and IL-6 were significantly decreased at T3,4 and T6,7 in P,DC and DP groups,and the concentrations of serum HMGB1 were significantly decreased at T6,7 in DC and DP groups (P<0.05).Compared with group DC,Ppeak,Pplat and Raw were significantly decreased at T2-4,oxygenation index was increased at T3-5,and the concentrations of serum TNF-α and IL-6 were decreased at T3,4 and T6,7 in group DP (P<0.05).Compared with group P,Raw was signifieantly decreased at T2-4,oxygenation index was increased at T2-5,and the concentrations of serum TNF-α and IL-6 were decreased at T3,4 and T6,7,and the concentrations of serum HMGB1 were decreased at T6,7 in group DP (P<0.05).There was no significant difference in dynamic lung compliance at each time point among the four groups (P>0.05).Conclusion The combination of dexmedetomidine and lung-proteetive ventilation provides protective effects on lungs and exterts better efficacy than either alone,and the mechanism may be related to inhibiting systemic inflammatory responses of patients undergoing thoracic surgery.
9.Characteristics of smooth pursuit eye-movement in subjects at clinical high risk for psychosis
Yangyang XU ; Tianhong ZHANG ; Yu LI ; Lihua XU ; Huiru CUI ; Jijun WANG ; Zeping XIAO
Chinese Journal of Nervous and Mental Diseases 2017;43(3):157-162
Objective To investigate the eye-movement features of smooth pursuit in subjects at clinical high risk for psychosis.Methods sixty subjects at clinical high risk for psychosis and sixty healthy controls were recruited.The smooth pursuit tasks were assessed in both horizontal (0.4 Hz) and Lissajous (0.2 or 0.4 Hz) condition.The Wechsler Memory Scale-third edition and spatial span subtest were used to assess working memory.The difference of the smooth pursuit performance between the two groups and the relationship between smooth pursuit and working memory were analyzed.Results Subjects at clinical high risk for psychosis showed significantly lower Horizontal components for pursuit gain [Lissajous 0.2 Hz task (0.82±0.12) vs.(0.89±0.09),Lissajous 0.4 Hz task (0.78±0.13) vs.(0.84±0.14)],lower vertical components for pursuit gain [Lissajous 0.2 Hz task (0.80±0.14) vs.(0.86±0.12),Lissajous 0.4 Hz task (0.71±0.15)vs.(0.77±0.16)] and higher mean positional error [Lissajous 0.2 Hz task (37.00±19.10) vs.(30.45± 16.18),Lissajous 0.4 Hz task (44.18±19.70) vs.(37.61±16.26)] compared to healthy controls (P<0.05).There was a significant correlation between pursuit gain and performance on Spatial Span (Horizontal components:r=0.361,P=0.005;vertical components:r=0.327,P=0.01 1) in the Subjects at clinical high risk for psychosis.Conclusions Subjects at clinical high risk for psychosis showed deficits in smooth pursuit,and the deficits were related to the working memory.
10. Efficacy and safety of IA regimen containing different doses of idarubicin in de-novo acute myeloid leukemia for adult patients
Aining SUN ; Xiaopeng TIAN ; Xiangshan CAO ; Jian OUYANG ; Jian GU ; Kailin XU ; Kang YU ; Qingshu ZENG ; Zimin SUN ; Guoan CHEN ; Sujun GAO ; Jin ZHOU ; Jinghua WANG ; Linhua YANG ; Jianmin LUO ; Mei ZHANG ; Xinhong GUO ; Xiaomin WANG ; Xi ZHANG ; Keqian SHI ; Hui SUN ; Xinmin DING ; Jianda HU ; Ruiji ZHENG ; Hongguo ZHAO ; Ming HOU ; Xin WANG ; Fangping CHEN ; Yan ZHU ; Hong LIU ; Dongping HUANG ; Aijun LIAO ; Liangming MA ; Liping SU ; Lin LIU ; Zeping ZHOU ; Xiaobing HUANG ; Xuemei SUN ; Depei WU
Chinese Journal of Hematology 2017;38(12):1017-1023
Objective:
To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m2, 10 mg/m2 or 12 mg/m2 as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) .
Methods:
A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m2) as induction chemotherapy in newly diagnosed patients of adult AML.
Results:
Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m2 group, IDA 10 mg/m2 group and IDA 12 mg/m2 group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (

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