Molecular monitoring of tumour load kinetics predicts disease progression after non-myeloablative allogeneic stem cell transplantation in multiple myeloma.

BACKGROUND: Non-myeloablative allogeneic stem cell transplantation followed by immunomodulatory therapies is considered a potentially curative approach in the treatment of multiple myeloma and most effective in a minimal residual disease setting. PATIENTS AND METHODS: The aim of this study was to find the most sensitive real-time PCR assay (TaqMan), based on the IGH rearrangement, to quantify the tumour load of 11 patients with multiple myeloma after non-myeloablative allogeneic transplantation. Patient-allele specific primers (ASO) and the TaqMan probe were derived from CDR2 and CDR3 hypervariable regions of IGH, while consensus primers were located within the FR3 and FR4/JH regions. Four different approaches of primer combinations were tested. RESULTS: ASO-forward and -reverse primers together with the clone-specific TaqMan probe were the most sensitive approach compared with the JH (P=0.071) or the FR3 consensus primer (P <0.001). The detection limit amounted to 1/10(4)-1/10(5) cells. Consecutively, 120 samples from 11 patients prior and post allogeneic transplantation were analysed. Three patients reached complete clinical remission accompanied by molecular remission. Disease progression or relapse was seen in six patients. In five, molecular progressive disease was detected prior to the clinical diagnosis of progression or relapse. CONCLUSION: Patient-specific real-time IGH-PCR provides the opportunity for earlier treatment intervention.     

乙酸奥曲肽中有机溶剂残留量的毛细管GC测定

建立了毛细管气相色谱法测定乙酸奥曲肽中有机溶剂乙醚、甲醇、二氯甲烷、N,N-二甲基甲酰胺的含量.用HP-Innowax毛细管柱,程序升温的方法.各组分的线性范围分别为25～300、25～300、15～180和25～300μg/ml(r均大于0.999).平均回收率分别为99.7%、99.5%、99.3%和99.2%.检测限分别为1、1、0.6和1ng.     

试论扶正法在微小残留白血病治疗中的作用

通过探讨"扶正法"在微小残留白血病治疗中的运用,认为正气虚弱,余毒留伏阴分是微小残留白血病基本病机.运用扶持正气,培植元气来调节阴阳气血、脏腑经络生理功能,提高患者的抗病能力,增强免疫达到防治微小残留白血病,间接抗肿瘤的目的.     

中医药在血液透析治疗中应用研究概况

从保护残余肾功能、改善营养不良、改善免疫功能、治疗血透并发症、中药血液透析液应用等方面介绍中医药在血液透析治疗中应用研究概况。血液透析是一个非生理过程,随着血液透析时间的延长,在血透中或血透后常常引起多种并发症,严重影响患者的生活质量和生存时间。中医药在血液透析中能减少血压透析的不良反应及并发症,提高生存质量。     

Impact of Ocular Residual Astigmatism on Visual Outcomes of Myopic Astigmatism Correction after Small Incision Lenticule Extraction

Objective: To calculate ocular residual astigmatism (ORA) by vector analysis and to evaluate the impact of ocular residual astigmatism on refractive and visual outcomes after correction of myopic astigmatism by small incision lenticule extraction (SMILE). Methods: In this prospective case-series study, 115 eyes with myopic astigmatism were treated with SMILE from Jauary 2019 to August 2019 atRefractive Center of Ophthalmology Department, Shengjing Hospital, China Medical University. ORA was calculated by vector analysis and patients were divided into two groups according to the magnitude of ORA: high ORA group (ORA≥1.00 D) with 42 eyes and low ORA group (ORA<1.00 D) with 73 eyes. The follow-up period was 3 months after the operation. Uncorrected visual acuity (UCVA) and pythagorean length were measured and compared after the operation. The following measurements were compared: refractive outcomes, total higher order aberrations (tHOAs), vertical trefoil, vertical coma, horizontal coma, oblique trefoil, oblique quadrafoil, oblique secondary astigmatism, spherical aberration, vertical secondary astigmatism, and vertical quadrafoil. Contrast sensitivity was compared between the high and low ORA groups under either 85 cd/m2 or 3 cd/m2 illumination from 1.5 c/d to 18 c/d. The data were analyzed by an independent-samples t test and Mann-Whitney U test to compare the differences between the two groups. Results: Three months postoperatively, refractive outcomes showed that postoperative residual astigmatism in the high ORA group was significantly higher than in the low ORA group (t=3.293, P=0.001). Vector analysis showed that the error vector (EV), absolute error of angle (absolute EA) and index of success (SI) were higher in the high ORA group (t=-3.235, P=0.001; t=-2.326, P=0.020; t=-2.587, P=0.010). After SMILE，all cases had achieved a desirable visual acuity: high ORA group: -0.15±0.05, low ORA group: -0.15±0.05. There were no statistically significant differences in visual acuity, pythagorean length, tHOAs, vertical trefoil, vertical coma, horizontal coma, oblique trefoil, oblique quadrafoil, oblique secondary astigmatism, spherical aberration, vertical secondary astigmatism, or vertical quadrafoil between the two groups. An obvious difference was found in contrast sensitivity, which showed a higher contrast sensitivity at a spatial frequency of 18 c/d with 85 cd/m2 in the low ORA group than in the high ORA group (t=-2.877, P=0.005), but this tendency was not present at 3 cd/m2 . Conclusions: Ocular residual astigmatism impacts the precision of SMILE in correcting myopic astigmatism. This leads to a tendency of more residual astigmatism in refractive outcomes, and reduces contrast sensitivity at high spatial frequencies. However, it does not affect the outcome of obtaining good visual quality in both visual acuity and higher order aberrations.     

Haploidentical hematopoietic stem cell transplantation may improve long-term survival for children with high-risk T-cell acute lymphoblastic leukemia in first complete remission

Background: The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with high-risk (HR) T-cell acute lymphoblastic leukemia (T-ALL) in first complete remission (CR1) is still under evaluation. Moreover, relapse is the main factor affecting survival. This study aimed to explore the effect of allo-HSCT (especially haploidentical HSCT [haplo-HSCT]) on improving survival and reducing relapse for HR childhood T-ALL in CR1 and the prognostic factors of childhood T-ALL in...     

A New Stored Energy Model Based on Plastic Work of Back Stress during Cyclic Loading in Polycrystalline Metal

Two mesomechanics models were analyzed in an attempt to reveal the relationship between stored energy and back stress. It has been indicated that the portion of elastic stored energy due to residual microstresses (E_SR) is closely related to intergranular back stress (X_inter), and the stored energy of dislocations inside grains (E_SD) can be estimated with the plastic work of intragranular back stress (X_intra). Then, the evolution of back stress during cyclic loading was studied, and the plastic work of back stress (W_pB) was calculated with the low cycle fatigue experimental data of Ti-6Al-4V. The result shows that W_pB is partially released at every reverse loading, sufficient to reproduce the evolution of stored energy correctly under cyclic loading. The study also reveals that partially released energy is related to the decrease of X_inter at the initial state of reversal loading resulting from the reduction of the plastic strain incompatibility between grains.     

急性髓系白血病诊断与治疗最新进展:第54届美国血液学会年会深入报道

 急性髓系白血病（AML）是成年人最常见的血液系统恶性疾病。第54届美国血液学会（ASH）年会有关AML的发病机制、诊断及治疗方面的报道亮点不断。特别是应用下一代基因组测序（NGS）技术,发现了很多与AML发病密切相关的基因、与复发有关的克隆及与预后有关的分子标志物。微小残留病（MRD）的检测在AML的疗效和预后评价中成为可能。靶向FLT3-ITD的激酶抑制剂是本届年会报道的治疗难治复发AML的最大亮点。     

Picosecond Laser Shock Micro-Forming of Stainless Steel: Influence of High-Repetition Pulses on Thermal Effects

A study of the peen forming of thin stainless steel metal foils (50 μm thick) using a solid-state ps-pulsed laser, emitting at a wavelength of 1064 nm was conducted. The pitch distance between consecutive laser pulses was kept constant by tuning the laser repetition rate from 0.4 to 10 kHz, and subsequently the scanning speed. The induced bending angle and the radius of curvature were used to measure the effect of the treatment. Their dependence on the pulse energy, the treated area, the distance between lines, and the laser repetition rate was studied. High repetition rates do not allow the sample to cool down, affecting the bending to the point of being negligible. An FEM simulation and experiments were carried out to prove that the increase in temperature due to high repetition rate can relax the stresses induced by laser peen treatment, thus preventing bending in the sample.