Allogeneic stem cell transplantation in AML with t(6;9)(p23;q34);DEK-NUP214 shows a favourable outcome when performed in first complete remission

Acute myeloid leukaemia (AML) with t(6;9)(p23;q34) is a poor-risk entity, commonly associated with FLT3-ITD (internal tandem duplication). Allogeneic stem-cell tranplantation (allo-SCT) is recommended, although studies analysing the outcome of allo-SCT in this setting are lacking. We selected 195 patients with t(6;9) AML, who received a first allo-SCT between 2000 and 2016 from the EBMT (European Society for Blood and Marrow Transplantation) registry. Disease status at time of allo-SCT was the strongest independent prognostic factor, with a two-year leukaemia-free survival and relapse incidence of 57% and 19% in patients in CR1 (first complete remission), 34% and 33% in CR2 (second complete remission), and 24% and 49% in patients not in remission, respectively (P < 0·001). This study, which represents the largest one available in t(6;9) AML, supports the recommendation to submit these patients to allo-SCT in CR1.     

Influence of contact time and concentration of chlorhexidine varnish on mutans streptococci in interproximal dental plaque

This study describes the effects of varnishes containing 0, 25, 33 and 40% chlorhexidine diacetate on mutans streptococci in human approximal dental plaque. The chlorhexidine release from the varnishes was determined in vitro. Eleven subjects participated in the clinical experiment, each with at least five approximal areas harboring high levels of mutans streptococci. The approximal areas in each of the individuals were randomly assigned to five experimental groups, in each of which one of the varnishes was tested; 40% chlorhexidine varnish was tested in two experimental groups. The varnish treatment consisted of a single application of a small amount of varnish onto the selected approximal areas. From one of the sites receiving the 40% chlorhexidine varnish, all visible varnish was removed 15 min after application. The volunteers were asked to leave the varnish on the remaining treated sites and not to brush their teeth for 8 h. All chlorhexidine varnishes strongly suppressed mutans streptococci until 4 months after the varnish application. The extent of the suppression depended upon the concentration of chlorhexidine in the varnish, 40% chlorhexidine varnish giving the greatest suppression of mutans streptococci. No significant difference was found between the numbers of mutans streptococci from sites where the 40% varnish was removed after 15 min and sites where the 40% chlorhexidine varnish was left. The results suggested that 40% chlorhexidine varnish can be used successfully for the long-term suppression of mutans streptococci. A contact time of the varnish with the tooth surface of only 15 min is sufficient to achieve this long-term suppression.     

Disentangling Somatosensory Evoked Potentials of the Fingers: Limitations and Clinical Potential

In searching for clinical biomarkers of the somatosensory function, we studied reproducibility of somatosensory potentials (SEP) evoked by finger stimulation in healthy subjects. SEPs induced by electrical stimulation and especially after median nerve stimulation is a method widely used in the literature. It is unclear, however, if the EEG recordings after finger stimulation are reproducible within the same subject. We tested in five healthy subjects the consistency and reproducibility of responses through bootstrapping as well as test–retest recordings. We further evaluated the possibility to discriminate activity of different fingers both at electrode and at source level. The lack of consistency and reproducibility suggest responses to finger stimulation to be unreliable, even with reasonably high signal-to-noise ratio and adequate number of trials. At sources level, somatotopic arrangement of the fingers representation was only found in one of the subjects. Although finding distinct locations of the different fingers activation was possible, our protocol did not allow for non-overlapping dipole representations of the fingers. We conclude that despite its theoretical advantages, we cannot recommend the use of somatosensory potentials evoked by finger stimulation to extract clinical biomarkers.     

血管内皮生长因子与白细胞介素12在急性白血病不同时期血清中的变化

目的:由于造血干/祖细胞发生基因突变,子代细胞增殖失控等导致的恶性血液病。血管内皮生长因子和白细胞介素12参与这一发生发展过程,检测不同时期其在急性白血病患者静脉血中的水平,有利于认知与血管新生及体液免疫的相关性。方法:随机选择2005-06/2006-04在吉林市中心医院住院的急性白血病患者25例,均经FAB分型或免疫学分型确诊,患者知情同意,并经医院伦理委员会批准。将患者分为:①初诊未治组10例。②复发组5例。③完全缓解组10例。并设9名健康查体者为正常对照。应用定量酶联免疫吸附实验测定受试者血清中血管内皮生长因子和白细胞介素12的水平,在评定白细胞介素12水平时,将初诊未治组与复发组合并为初诊复发组:①两组的发病机制相似。②两组病例数较少,单独观察没有统计学意义。结果:25例患者和9名健康对照者均进入结果分析。①初诊未治组血管内皮生长因子含量高于完全缓解组及正常对照组(P均<0.05)。②正常对照组白细胞介素12水平与初诊复发组、完全缓解组之间差异均具有显著性意义(P均<0.05)。③正常对照组血管内皮生长因子含量与白细胞介素12之间存在负相关(r=-0.9644P<0.05)。④初诊复发组、完全缓解组血管内皮生长因子和白细胞介素12含量之间均无相关性(r=-0.0883,-0.3593,P均>0.05)。结论:急性白血病患者血清中血管内皮生长因子和白细胞介素12含量与临床病情变化有关,可以作为诊断和预测急性白血病发生和复发的指标。     

Demographic characteristics and prevalence of serologic markers among donors who use the confidential unit exclusion process: the Retrovirus Epidemiology Donor Study

BACKGROUND: Most blood centers utilize a confidential unit exclusion (CUE) process, intended to reduce the risk of transfusion-associated infectious diseases by allowing high-risk donors confidentially to exclude their blood from use for transfusion. The effectiveness of this method remains controversial. STUDY DESIGN AND METHODS: Confirmatory or supplemental test results for antibodies to human immunodeficiency virus, human T-lymphotropic virus type I, and hepatitis C virus, as well as hepatitis B surface antigen and syphilis and screening test results for antibodies to hepatitis B core (antigen) and alanine aminotransferase levels were obtained for approximately 1.8 million units donated during 1991 and 1992 at five blood centers within the United States. The prevalences of these infectious disease markers in units that the donors confidentially excluded (CUE+) and units that the donors did not exclude (CUE-) were calculated and examined within demographic subgroups. RESULTS: Units that were CUE+ were 8 to 41 times more likely to be seropositive for antibodies to human immunodeficiency virus and hepatitis C virus, hepatitis B surface antigen, and syphilis and three to four times more likely to react for antibody to hepatitis B core (antigen) or to have elevated alanine aminotransferase levels than units that were CUE- (p < 0.001). The positive predictive value of CUE (the percentage of CUE+ units that were confirmed seropositive for any marker) was 3.5 percent, and the sensitivity of CUE (the percentage of confirmed-seropositive units that were CUE+) was 2.3 percent. CONCLUSION: The current CUE process has low sensitivity and apparently low positive predictive value, and in many cases, it appeared that donors misunderstood it. Yet, CUE was not a “random process,” as CUE+ units were more likely to be seropositive for any infectious disease marker than CUE- units. This suggests that efforts to improve the CUE system may be warranted. As risk factors for transfusion-transmitted infection become more difficult to identify by history-based screening, however, such efforts may have limited effect.     

Nociceptive Intra-epidermal Electric Stimulation Evokes Steady-State Responses in the Secondary Somatosensory Cortex

Brain Topography - Recent studies have established the presence of nociceptive steady-state evoked potentials (SSEPs), generated in response to thermal or intra-epidermal electric stimuli. This...     

人类白细胞抗原分型技术的进展

学术背景：以往人类白细胞抗原分型主要采用血清学和细胞学方法，随着PCR技术、基因芯片技术及分子生物学技术的发展，已建立从基因水平上进行的人类白细胞抗原分型技术。目的：介绍人类白细胞抗原分型方法，为实际应用提供依据。检索策略：应用计算机检索PubMed1997—07／2007—07期间的相关文章，检索词“HLA technology”，并限定文章语言种类为English。同时检索万方数据库1997—07／2007—07相关文章，检索词为“人类白细胞抗原”，并限定文献语种为中文。共检索到相关文献142篇，选择与人类白细胞抗原分型技术有关的文献55篇。将初步筛选的文章进一步查找全文，排除综述和重复文献，内容相似的选择发表在权威杂志或近3年发表的文献，最后共纳入30篇进行综述。文献评价：文献对不同的人类白细胞抗原分型方法进行汇总分析，符合纳入标准的30篇文献中，6篇为中文文献，24篇为英文文献。资料综合：传统的人类白细胞抗原分型方法主要是血清学和细胞学方法，分型准确性较差。随着PCR技术的广泛应用，人类白细胞抗原基因分型方法得到了迅速的发展。序列特异性引物、序列特异性寡核苷酸探针、直接测序、基因芯片等各具特点的人类白细胞抗原分型技术不断出现，使人类白细胞抗原的分型更加准确、精细、简便、实用，为临床推广应用打下了基础。结论：各种人类白细胞抗原基因分型方法各有优势，不能相互替代，这也是由人类自细胞抗原系统的高度多态性和复杂性所决定的，根据不同的用途可选择相应的方法。     

健胃愈疡颗粒干预下大鼠胃溃疡黏膜乳癌相关肽和血小板活化因子的表达及与胃黏膜疏水性的相关性研究

目的:观察对胃溃疡复发有较好疗效的健胃愈疡颗粒对溃疡黏膜乳腺癌相关肽和血小板活化因子表达的影响,分析其可能的作用机制。方法:实验于2005-07/2006-07在湘雅医院中心实验室完成。SD大鼠110只,雌雄各半,随机抽签法分为5组,即正常对照组、假手术组、雷尼替丁组、健胃愈疡组,各20只;模型组30只。以Okabe改良法复制大鼠实验性胃溃疡,假手术组仅以生理盐水代替乙酸注入玻管内。造模后24h,雷尼替丁组、健胃愈疡组大鼠分别灌服盐酸雷尼替丁和健胃愈疡颗粒(药物组成为:柴胡、党参、白芍、延胡索、白芨、珍珠层粉、青黛、甘草,湖南湘雅制药有限公司生产)药液10mL/kg,分别相当于2.70,1.62g/kg,1次/d。假手术组、模型组灌服蒸馏水10mL/kg。10d后各组中随机取出10只大鼠剖腹取胃(处死前大鼠禁食24h),90d时将模型组20只大鼠再分为模型复发组和模型非复发组,各10只;除正常对照组、假手术组、模型非复发组大鼠腹腔内注射生理盐水外,其余各组大鼠腹腔内注射白细胞介素1,1μg/kg;在注射48h,大鼠禁食24h后,剖腹取胃。观察其对胃溃疡大鼠胃黏膜氨基己糖及磷脂含量、溃疡指数和胃黏膜血流的影响,并用RT-PCR观察乳癌相关肽乳癌相关肽和血小板活化因子表达的变化。结果:实验动物110只,全部进入结果分析。①模型组10,92d胃黏膜血流均低于正常对照组(P<0.01);健胃愈疡组同期胃黏膜血流均高于模型组(P<0.01)。②健胃愈疡组和雷尼替丁组10d溃疡指数均低于模型组(P<0.01,P<0.05);模型复发组、健胃愈疡组和雷尼替丁组92d溃疡指数均高于模型组(P<0.01);健胃愈疡组10,92d溃疡指数及复发率均低于雷尼替丁组(P<0.05,P<0.01)。③模型组10,92d氨基己糖和磷脂含量均低于正常对照组(P<0.01)。健胃愈疡组10,92d氨基己糖和磷脂含量均高于模型组和雷尼替丁组(P<0.01)。溃疡指数与氨基已糖、磷脂含量呈负相关(r=-0.957,-0.960,P<0.01)。④健胃愈疡组和雷尼替丁组10d乳癌相关肽mRNA表达较正常组和假手术组提高,血小板活化因子mRNA的表达下调(P<0.01),健胃愈疡组两指标表达变化较雷尼替丁组显著(P<0.01);模型复发组、健胃愈疡组和雷尼替丁组92d乳癌相关肽mRNA、血小板活化因子mRNA的表达同组10d比较差异无显著性意义(P>0.05);模型组乳癌相关肽mRNA、血小板活化因子mRNA的表达同组10d比较差异有显著性意义(P<0.01)。结论:健胃愈疡颗粒可提高乳癌相关肽mRNA及下调血小板活化因子mRNA的表达,影响胃黏膜氨基己糖及磷脂含量,可能是其促进溃疡愈合的机制之一。     

A study of confidential unit exclusion

The effectiveness of the confidential unit exclusion (CUE) procedure recommended by the Food and Drug Administration has been questioned by the blood banking community. The purpose of this study was to determine whether donors were informing the blood center correctly regarding the disposition (transfuse or do not transfuse) of their donated blood. A letter explaining the confidential study and requesting permission to send the participant a questionnaire noting his or her self-exclusion choice was mailed to 230 donors who had chosen transfuse and 276 donors who had chosen do not transfuse. After consent was obtained, participants were sent a second packet and asked to indicate whether they had chosen correctly and, if not, to identify reasons for that incorrect choice. A seven-word terminology quiz made up of words from the CUE form was also enclosed. All participants who had chosen transfuse indicated that this was the correct choice. Approximately 50 percent of those who had chosen do not transfuse indicated that this was an incorrect choice; the most common reason was that "I was not paying attention." The most frequently misunderstood term was "confidential." Donors who chose do not transfuse had a significantly higher rate of error on the terminology quiz (p less than 0.01) than did those who chose transfuse.