Significance of cytogenetic and fluorescence in situ hybridization analysis in evaluating antichronic myeloid leukemia efficacy of different immune effector cells

We report on the antileukemia effect of interleukin 2 (IL2) on different immune cells from 22 patients with chronic myeloid leukemia (CML). Bone marrow cells from these patients were first cultured in modified long-term bone marrow culture medium for several days, then separately cultured with lymphokine activated killer cells (LAK), cytokine-induced killer cells (CIK), and dendritic cell cocultured CIK (DC-CIK) for another 1-2 days. They were then detected for presence of the Philadelphia chromosome (Ph) by cytogenetic analysis and fluorescence in situ hybridization (FISH). The percentage of Ph-chromosome-positive cells in the bone marrow mononuclear cells after culturing with CIK and DC-CIK was significantly lower than that after culturing with IL2 or LAK. Our results demonstrate that cytogenetics and FISH are useful techniques for the evaluation of the anti-CML effect of immune cells and that CIK or DC-CIK can be appropriate candidates for adoptive immune cell therapy in vivo or for leukemia cell purging ex vivo.     

Immunobiology of tumor necrosis factor receptor superfamily

The proteins of the tumor necrosis factor (TNF) receptor superfamily are a group of cell-surface receptors critically involved in the maintenance of homeostasis of the immune system. By interacting with their corresponding ligands, these receptors either induce cell death or promote cell survival of immune cells. The number of recognized members of the TNF receptor and ligand superfamily has expanded substantially in the last several years. More important, the biologic function of this group of proteins has been closely associated with the regulation of the immune response and the pathogenesis of autoimmune disease. Thus, the direct targeting of these receptors by either inducing apoptosis or blocking survival of autoimmune T and B cells may be an important therapeutic strategy in the treatment of autoimmune disease. This review summarizes the recent progress in immunobiology of the TNF receptor superfamily and focuses on our studies of three critical family members-FasL/Fas, TNF-related apoptosis-inducing ligand (TRAIL)/TRAIL-Rs, and B lymphocyte stimulator(BLyS)/BLyS-Rs--to demonstrate the therapeutic potential of targeting these receptors for the treatment of autoimmune disease.     

慢性癫痫大鼠海马内GABA_A受体γ_2亚单位的改变──原位杂交组织化学研究

将马桑内酯作腹腔注射诱发大鼠慢性癫痫动物模型。然后，对模型动物和对照动物海马组织进行ＧＡＢＡ_Ａ受体γ_２亚单位的原位杂交组织化学研究。结果表明，慢性癫痫动物海马回和齿状回内的ＧＡＢＡＡ受体γ_２亚单位ｍＲＮＡ较对照组明显减少。提示ＧＡＢＡＡ受体γ_２亚单位可能在癫痫发病机理中起一定作用。     

急性ST段抬高型心肌梗死患者提前肝素化的疗效评价及风险观察

目的探讨急性ST段抬高型心肌梗死(STEMI)患者提前肝素化的疗效及风险。方法选取2019年5月至2020年5月我院收治的160例STEMI患者作为研究对象,随机分为两组各80例。治疗组给予提前肝素化PCI术治疗,对照组给予常规肝素化PCI术治疗。比较两组的TIMI血流分级、不良事件发生率以及治疗前后的症状评分、 LVEF。结果术后,治疗组的TIMI血流0~1级率低于对照组,3级率高于对照组(P <0.05)。治疗后,两组的症状评分均低于治疗前,LVEF水平均高于治疗前(P<0.05);治疗组的症状评分低于对照组,LVEF水平高于对照组(P <0.05)。治疗组的不良事件发生率低于对照组(P <0.05)。结论 PCI术提前肝素化可以提高灌注效果,有效缓解STEMI患者的病情,改善患者心功能,改善预后,且具有较高的安全性。     

Use of a Telemedicine Risk Assessment Tool to Predict the Risk of Hospitalization of 496 Outpatients With COVID-19: Retrospective Analysis

BackgroundRisk assessment of patients with acute COVID-19 in a telemedicine context is not well described. In settings of large numbers of patients, a risk assessment tool may guide resource allocation not only for patient care but also for maximum health care and public health benefit.ObjectiveThe goal of this study was to determine whether a COVID-19 telemedicine risk assessment tool accurately predicts hospitalizations.MethodsWe conducted a retrospective study of a COVID-19 telemedicine home monitoring program serving health care workers and the community in Atlanta, Georgia, with enrollment from March 24 to May 26, 2020; the final call range was from March 27 to June 19, 2020. All patients were assessed by medical providers using an institutional COVID-19 risk assessment tool designating patients as Tier 1 (low risk for hospitalization), Tier 2 (intermediate risk for hospitalization), or Tier 3 (high risk for hospitalization). Patients were followed with regular telephone calls to an endpoint of improvement or hospitalization. Using survival analysis by Cox regression with days to hospitalization as the metric, we analyzed the performance of the risk tiers and explored individual patient factors associated with risk of hospitalization.ResultsProviders using the risk assessment rubric assigned 496 outpatients to tiers: Tier 1, 237 out of 496 (47.8%); Tier 2, 185 out of 496 (37.3%); and Tier 3, 74 out of 496 (14.9%). Subsequent hospitalizations numbered 3 out of 237 (1.3%) for Tier 1, 15 out of 185 (8.1%) for Tier 2, and 17 out of 74 (23%) for Tier 3. From a Cox regression model with age of 60 years or older, gender, and reported obesity as covariates, the adjusted hazard ratios for hospitalization using Tier 1 as reference were 3.74 (95% CI 1.06-13.27; P=.04) for Tier 2 and 10.87 (95% CI 3.09-38.27; P<.001) for Tier 3.ConclusionsA telemedicine risk assessment tool prospectively applied to an outpatient population with COVID-19 identified populations with low, intermediate, and high risk of hospitalization.     

基于住院病案首页数据的全国部分医院心血管临床专科评估探索

目的运用“基于住院病案首页数据的心血管临床专科评估框架”,对全国部分医院的心血管临床专科进行评估。方法梳理112所医院心血管专科重点疾病和重点手术操作的编码情况,计算评估框架中的各个指标,根据医院纳入标准,运用基于数据的多指标综合评价方法,对医院进行打分排序。结果112所医院2010—2012年心血管疾病患者出院人次、重点疾病和重点手术/操作缺失数量均呈偏态分布。按照综合评价医院的纳入标准共56所医院纳入排序,前十位是YN05、SD04、BJ14、SH02、ZJ01、HN01、SX09、YN08、SD01、SX08。重点疾病和重点手术操作均完整的医院共12所,其排序是:BJ14、SH02、HN02、BJ01、TJ01、SH05、SC01、NA03、GD02、SH08、YN03、HL01。本研究综合评价的56所医院中,有30所在国家公布的名单之内,26所不在国家公布的名单之内。结论运用“基于住院病案首页数据的心血管临床专科评估框架”进行心血管临床专科评估是科学、可行的,为专科评估方法提供了新的思路,为专科对口支援建设提供了数据支持。     

尿胰蛋白酶原—2测定对急性胰腺炎的早期诊断价值

目的 探讨尿胰蛋白酶原－2测定在急腹症中筛选急性胰腺炎的价值。方法 对346例连续就诊的急腹症病人同时测定尿胰蛋白酶原－2及血、尿淀粉酶。结果 41例急性胰腺炎中有38例尿胰蛋白酶原－2阳性,敏感性为92．7％,305例非胰腺炎的急腹症病人有15例假阳性,特异性为95．1％。5例重症急性胰腺炎中尿胰蛋白酶原－2全部阳性。结论 尿胰蛋白酶原－2是急腹症病人筛选急性胰腺炎快而简便的方法,具有较高的特异性和敏感性。     

外伤性脾破裂24例非手术治疗体会

目的总结外伤性脾破裂非手术治疗经验.方法回顾性分析自1995年1月～1999年12月收治的非手术治疗的24例外伤性脾破裂的致伤原因、伤情等级、诊断方法、治疗措施以及非手术治疗失败的原因.结果本组22例非手术治疗成功,并得到6个月以上的随访或B超复查证实无并发症.2例治疗失败中转手术治疗.本组无死亡.结论脾脏具有重要的生理功能,严格掌握适应证,密切监测病情变化,合理正确运用治疗措施,外伤性脾破裂的非手术治疗是安全有效的.     

幽门螺杆菌分离培养技术的改进

探讨自制的改良布氏活性炭巧克力培养基,置厌氧罐蜡烛培养环境分离临床粘膜标本幽门螺杆菌(Hp)的检出率.结果表明66例粘膜标本中分离出Hp54株(81.8%),44株Hp滤液有24株(54.5%)具有细胞毒活性,其中26例消化性溃疡患者有18例(69.2%),18例慢性胃炎患者有6例(33.3%)为Hp(Toxin+)感染.结果提示通过对Hp生物学性状和毒素的检测结果证实,该法可用于临床粘膜标本Hp的常规分离培养.