Engraftment after autologous hematopoietic stem cell transplantation in patients mobilized with Plerixafor: A retrospective,multicenter study of a large series of patients

Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (≥2 × 10⁶ CD34⁺ cells/kg) was 1 (range 1–4) and the median PLX administration time before apheresis was 11 h (range 1–18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1–5) and the mean number of CD34⁺ cells collected was 2.95 × 10⁶/kg (range 0–30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/μL was 11 days (range 3–31) and the median time to platelet recovery >20 × 10³/μL was 13 days (range 5–69). At 100 days after auto-HCT, the platelet count was 137 × 10⁹/L (range 7–340), the ANC was 2.3 × 10⁹/L (range 0.1–13.0), and the hemoglobin concentration was 123 g/L (range 79–165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34⁺ cell concentration on day +4 or low CD34⁺ cell yield on apheresis.     

不同清洗口腔器械方法的效率与质量比较

目的 比较手工、手工联合超声清洗口腔器械的效率与质量。方法 将安徽医科大学附属口腔医院2019年1~6月口腔器械按随机数字表法分为A组（手工清洗）与B组（手工联合超声清洗）,每组200件。比较两组器械清洗耗时及合格率。结果 A组器械一次清洗耗时（1.02±0.29）h,B组（1.33±0.19）h,两组差异有统计学意义（t=-12.500,P<0.001）;A组器械二次清洗耗时（0.68±0.32）h,B组（0.32±0.20）h,两组差异有统计学意义（t=4.318,P<0.001）;A组器械完全合格清洗耗时（1.12±0.44）h,B组（1.34±0.21）h,两组差异有统计学意义（t=-6.367,P<0.001）。A组器械一次清洗合格率为85.50%,B组为94.50%,两组差异有统计学意义（χ²=9.000,P=0.003）。A组器械二次清洗合格率为89.66%,B组为100.00%,两组差异无统计学意义（P>0.05）。结论 手工联合超声清洗口腔器械,效率、清洗质量更高。     

Validity of Chinese Version of the Composite International Diagnostic Interview-3.0 in Psychiatric Settings

Background:

The Composite International Diagnostic Interview-3.0 (CIDI-3.0) is a fully structured lay-administered diagnostic interview for the assessment of mental disorders according to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The aim of the study was to investigate the concurrent validity of the Chinese CIDI in diagnosing mental disorders in psychiatric settings.

Methods:

We recruited 208 participants, of whom 148 were patients from two psychiatric hospitals and 60 healthy people from communities. These participants were administered with CIDI by six trained lay interviewers and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, gold standard) by two psychiatrists. Agreement between CIDI and SCID-I was assessed with sensitivity, specificity, positive predictive value and negative predictive value. Individual-level CIDI-SCID diagnostic concordance was evaluated using the area under the receiver operator characteristic curve and Cohen''s K.

Results:

Substantial to excellent CIDI to SCID concordance was found for any substance use disorder (area under the receiver operator characteristic curve [AUC] = 0.926), any anxiety disorder (AUC = 0.807) and any mood disorder (AUC = 0.806). The concordance between the CIDI and the SCID for psychotic and eating disorders is moderate. However, for individual mental disorders, the CIDI-SCID concordance for bipolar disorders (AUC = 0.55) and anorexia nervosa (AUC = 0.50) was insufficient.

Conclusions:

Overall, the Chinese version of CIDI-3.0 has acceptable validity in diagnosing the substance use disorder, anxiety disorder and mood disorder among Chinese adult population. However, we should be cautious when using it for bipolar disorders and anorexia nervosa.     

Changes of mesenchymal stromal cells mobilization and bone turnover in an experimental bone fracture model in ovariectomized mice

Objective: The aim of this study was to characterize the mesenchymal stromal cells (MSCs) and endothelial progenitor cells (EPCs) mobilization, and bone turnover in osteoporotic fracture healing in ovariectomized mice. Methods: In total, 112 female C57/BL mice were divided into two groups. The first group was sham-operated (SO), and the other group was ovariectomized (OVX). After three weeks, the right femora of the mice were fractured under anesthesia and internally fixed with steel pin. Peripheral blood and bone marrow were was collected for flow cytometry analysis, at 0 hours (h), 12 h, 24 h, 72 h and 168 h after fracture. MSCs and EPCs levels were assessed using cell surface antigens in different combinations (CD44+ CD34-CD45-, and CD34+ KDR+CD45-) by flow cytometry. At 0, 14, 28 and 42 days after fracture, sera were assayed for circulating levels of procollagen type I-N-terminal propeptide (P1NP) and C-terminal telopeptide of type I-collagen (CTX) by ELISA. Femurs were harvested at 2 weeks and 6 weeks after fracture for X-ray radiography, micro-computed tomography (micro-CT) and histology. Results: Our results showed that bone marrow and peripheral blood MSCs numbers of the OVX mice were significantly lower than the SO mice, at 12 h, 24 h and 72 h after fracture. In addition, circulating P1NP and CTX levels of the OVX mice were significantly higher than the SO mice, at 2 and 4 weeks. Conclusion: Results of the present study revealed disorders of bone marrow MSCs mobilization and bone turnover may partially account for the delay of osteoporotic fracture healing.     

等速运动训练结合Maitland手法对创伤性膝关节僵直的疗效观察

目的:探讨分析等速运动训练结合Maitland手法对创伤性膝关节僵直患者关节功能及关节周围肌肉力量恢复的影响。方法:将40例创伤性膝关节僵直患者随机分为研究组和对照组各20例。研究组行等速运动训练及Maitland手法治疗,对照组行Maitland手法治疗,2组患者同时配合常规运动疗法及消肿止痛等对症支持治疗。治疗前后分别对2组患者行视觉模拟评分(VAS)评定、膝关节活动度(ROM)评定,采用HSS指数评定及等速肌力测试系统评定膝关节伸屈肌的峰力矩值(PT)、峰力矩与体重比值(PT/BW)。结果:治疗后研究组VAS较治疗前及对照组治疗后明显下降(P<0.05),而对照组无明显下降;治疗后2组屈曲度、伸直度、屈伸弧度均较治疗前有明显提高(P<0.05),且研究组更高于对照组(P<0.05);治疗后2组伸屈肌群PT、PT/BW均较治疗前有明显提高(P<0.05),且研究组更高于对照组(P<0.05);治疗后2组HSS指数均明显升高(P<0.05),且研究组更高于对照组(P<0.05)。结论:等速运动训练结合Maitland手法对创伤性膝关节僵直的疗效明显,可以很好地减轻疼痛,提高关节活动度,增强膝关节周围肌群力量,从而改善膝关节功能。     

FemoSeal Evaluation Registry (FER). Prospective study of femoral arterial closure with a mechanical system on 100 patients who underwent angioplasty procedures

Background

The objective of this study is to evaluate the effectiveness and the safety of the FemoSeal mechanical closure system in order to obtain hemostasis of the puncture site following angioplasty procedures performed through femoral arterial approach.

Method

A single-centre prospective registry was conducted from November 2010 to April 2011, comparing the results of manual compression (n = 111 patients), hemostatic bandages compression (n = 43 patients) and FemoSeal mechanical closure (n = 100 patients). The end points evaluated were the following: successful hemostasis, major and minor complications right after the procedures and major and minor complications at 1 month follow-up. The patients’ feedback about their comfort was also collected right after the procedure and after one month.

Results

Successful hemostasis with FemoSeal was obtained in 93% of the patients (n = 93). Seven patients required additional slight manual compressions or compression bandages. The use of FemoSeal was not associated with any major complications, significantly reducing (P < 0.05) the number of complications compared to other compression techniques over the studied period. Only one minor complication was observed with FemoSeal (a 1.5-cm-hematoma, which reabsorbed spontaneously without any issue).

Conclusion

In our experience, the use of FemoSeal is effective in achieving hemostasis performed through femoral arterial approach up to 7F and is associated with a very low rate of complications.     

机械和人工土埋灭螺的效果-成本分析

目的 目的 探索特殊有螺环境 （特殊环境） 的高效灭螺方法。方法 方法 2006年对乱石溪滩、 渗水荒山等大面积特殊环 境, 采用挖掘机进行一次性深挖深埋灭螺 （机埋灭螺）, 灭螺后, 连续7年观察灭螺效果, 并与2005年采用春、 秋两季人工铲 草土埋2次、 药杀8次的灭螺方法 （人工灭螺） 的效果和成本进行比较。结果 结果 2006年采用机埋灭螺法, 投入为0.78元/ m2 , 有螺面积压缩率达100%; 2005年采用人工灭螺法, 投入为1.34元/m2 , 有螺面积压缩率为20.26%。机埋灭螺比人工灭螺投 入降低41.79%, 灭螺效果提高79.74%。结论 结论 大面积特殊环境采用机埋灭螺优于人工灭螺。     

针刺联合关节松动术治疗粘连期肩周炎的临床观察

目的 探讨运用针刺联合关节松动术治疗粘连期肩周炎的临床疗效及对超声观察指标粘连厚度的影响。方法 将符合相应标准的90例粘连期肩周炎患者随机分为针刺组、关节松动术组、联合疗法组,每组30例,其中针刺组接受针刺治疗,关节松动组接受关节松动术治疗,联合疗法组接受针刺及关节松动术治疗。每组患者每天进行治疗1次,每周5次,持续4周。各组患者在性别、年龄、病程方面无统计学差异（P＞0.05）。在治疗前及治疗4周后对3组患者肩关节功能评分（CMS）及肩关节粘连程度(肌骨超声观察粘连厚度)进行评定,并将关节活动度评分与粘连厚度作直线相关分析。结果 经治疗后,3组患者的肩关节功能评分（CMS）、粘连厚度治疗前后比较有统计学意义（P＜0.05）,且联合疗法组的肩关节功能评分（CMS）明显优于针刺组和关节松动术组（P＜0.01）,联合疗法组的粘连厚度明显小于针刺组和关节松动术组（P＜0.01）。Pearson相关分析显示3组患者的粘连厚度与关节活动度呈中度负相关,r=-0.51- -0.43,（P＜0.01）。结论 针刺联合关节松动术治疗粘连期肩周炎能更好的改善患者的疼痛症状,减轻肩关节粘连,改善关节活动度。肌骨超声是一种精准、无创、快速诊疗肩周炎的工具。     

Heparan sulfate mimetics can efficiently mobilize long-term hematopoietic stem cells

Background

Although mobilization of hematopoietic stem cells and hematopoietic progenitor cells can be achieved with a combination of granulocyte colony-stimulating factor and plerixafor (AMD3100), improving approaches for hematopoietic progenitor cell mobilization is clinically important.

Design and Methods

Heparan sulfate proteoglycans are ubiquitous macromolecules associated with the extracellular matrix that regulates biology of hematopoietic stem cells. We studied the effects of a new family of synthetic oligosaccharides mimicking heparan sulfate on hematopoietic stem cell mobilization. These oligosaccharides were administered intravenously alone or in combination with granulocyte colony-stimulating factor and/or AMD3100 in mice. Mobilized hematopoietic cells were counted and phenotyped at different times and the ability of mobilized hematopoietic stem cells to reconstitute long-term hematopoiesis was determined by competitive transplantation into syngenic lethally irradiated mice followed by secondary transplantation.

Results

Mimetics of heparan sulfate induced rapid mobilization of B-lymphocytes, T-lymphocytes, hematopoietic stem cells and hematopoietic progenitor cells. They increased the mobilization of hematopoietic stem cells and hematopoietic progenitor cells more than 3-fold when added to the granulocyte colony-stimulating factor/AMD3100 association. Hematopoietic stem cells mobilized by mimetics of heparan sulfate or by the granulocyte colony-stimulating factor/AMD3100/mimetics association were as effective as hematopoietic stem cells mobilized by the granulocyte colony-stimulating factor/AMD3100 association for primary and secondary hematopoietic reconstitution of lethally irradiated mice.

Conclusions

This new family of mobilizing agents could alone or in combination with granulocyte colony-stimulating factor and/or AMD3100 mobilize a high number of hematopoietic stem cells that were able to maintain long-term hematopoiesis. These results strengthen the role of heparan sulfates in the retention of hematopoietic stem cells in bone marrow and support the use of small glyco-drugs based on heparan sulfate in combination with granulocyte colony-stimulating factor and AMD3100 to improve high stem cell mobilization, particularly in a prospect of use in human therapeutics.