[Rituximab combined with short-course and intensive regimen for Burkitt leukemia: efficacy and safety analysis]

目的

探讨利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病患者的疗效和安全性。

方法

收集2006年1月30日至2018年9月12日中国医学科学院血液病医院收治的11例Burkitt白血病患者病例资料，分析统计患者的临床特征、完全缓解（CR）率、总生存率、无复发生存率及不良事件。

结果

11例患者中位年龄34（15~54）岁，其中男6例，女5例。发病时中位WBC 12.28（2.21~48.46）×10⁹/L，HGB 113（74~147）g/L，PLT 35（13~172）×10⁹/L，乳酸脱氢酶2 721（803~17 370）U/L，外周血中位原始细胞比例0.40（0.03~0.76），骨髓中位原始细胞比例0.840（0.295~0.945）。10例患者接受利妥昔单抗联合短疗程、高强度化疗，其中2例患者巩固化疗后行自体造血干细胞移植。所有治疗患者1个疗程CR率为100%，4年总生存率为90%，4年无复发生存率为90%。所有治疗患者中，只有1例患者在诱导化疗中出现肿瘤溶解综合征，经血液透析等治疗后肾功能恢复。无治疗相关性死亡病例。

结论

利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病疗效及安全性均较为理想。

Shift from slow- to fast-twitch muscle fibres in skeletal muscle of newborn heterozygous and homozygous myostatin-knockout piglets

Myostatin (MSTN) is a member of the transforming growth factor-β superfamily that negatively regulates skeletal muscle development. A lack of MSTN induces muscle hypertrophy and increases formation of fast-twitch (Type II) muscle fibres. This study investigated muscle development in newborn heterozygous (MSTN+/-) and homozygous (MSTN-/-) MSTN-knockout piglets. Detailed morphological and gene and protein expression analyses were performed of the biceps femoris, semitendinosus and diaphragm of MSTN+/-, MSTN-/- and wild-type (WT) piglets. Haematoxylin-eosin staining revealed that the cross-sectional area of muscle fibres was significantly larger in MSTN-knockout than WT piglets. ATPase staining demonstrated that the percentage of Type IIb and IIa muscle fibres was significantly higher in MSTN-/- and MSTN+/- piglets respectively than in WT piglets. Western blotting showed that protein expression of myosin heavy chain-I was reduced in muscles of MSTN-knockout piglets. Quantitative reverse transcription-polymerase chain reaction revealed that, compared with WT piglets, myogenic differentiation factor (MyoD) mRNA expression in muscles was 1.3- to 2-fold higher in MSTN+/- piglets and 1.8- to 3.5-fold higher MSTN-/- piglets (P<0.05 and P<0.01 respectively). However, expression of myocyte enhancer factor 2C (MEF2C) mRNA in muscles was significantly lower in MSTN+/- than WT piglets (P<0.05). MSTN plays an important role in skeletal muscle development and regulates muscle fibre type by modulating the gene expression of MyoD and MEF2C in newborn piglets.

[CD19 antigen loss after treatment of Bispecific T-cell Engager and effective response to salvage bispecific CAR-T therapy in B cell acute lymphoblastic leukemia: a case report and literature review]

Objective: To analyze the influence of CD19 isoforms to the efficacy of CD19/CD3 Bispecific T-cell Engager (BiTE) antibody, and explore the resistance mechanism of BiTE immunotherapy. Methods: Semi-quantitative RT-PCR (qRT-PCR) was used to detect the expression of CD19 mRNA isoforms before and after BiTE treatment in a patient with CD19(+) B cell acute lymphoblastic leukemia (ALL) . CD19 isoforms were analyzed by Sanger sequencing. Flow cytometry and transcriptome sequencing were performed to analyze the expression of cell lineage specific molecules before and after BiTE treatment. Results: The expression of CD19 isoform with exon 2 deletion was identified at diagnosis. After relapsed and treatment of BiTE antibody, the patient did not achieve remission and CD19 antigen on leukemic cells turned negative detected by flow cytometry after BiTE treatment. However the expression ratio of CD19 isoform with exon 2 deletion was not increased. Flow cytometry phenotype and transcriptome sequencing confirmed that no linage switching developed, which suggested the expression of CD19 isoform caused by exon alternative splicing and lineage switching was not related to CD19 epitope loss in this patient. This patient achieved complete remission by sequential administration of self-developed CD22 CAR-T and CD19 CAR-T after disease progression. Conclusion: Targeting or combining an alternative antigen specific CAR-T may be a promising treatment option after losing CD19 expression in relapsed ALL.

[Clinical and laboratory characteristics in patients with myeloid neoplasms complicated with clonal T large granular lymphocyte proliferation]

Objective: To analyze the clinical manifestations and laboratory features in patients with myeloid neoplasms complicated with clonal T large granular lymphocyte (T-LGL) proliferation. Methods: The clinical data of 5 patients with myeloid neoplasms complicated with clonal T-LGL proliferation from November 2017 to November 2018 in Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College were analyzed retrospectively. Results: The median age was 60 years old. All patients had a history of abnormal peripheral blood cell counts for over 6 months. The absolute lymphocyte count in peripheral blood was less than 1.0×10(9)/L. In addition to the typical T-LGL phenotype, the immunophenotype was heterogenous including CD4(+)CD8(-) in 2 patients, the other 3 CD4(-)CD8(+). Four patients were αβ type T cells, the other one was γδ type. STAT3 mutation was detected in 1 patient by next-generation sequencing, the other 4 cases were negative. Conclusions: Clonal T-LGL proliferation with myeloid neoplasm develops in an indolent manner, mainly in elderly patients. Hemocytopenia is the most common manifestation. The diagnosis of T-LGL proliferation does not have specific criteria, that it should be differentiated from other T cell proliferative disorders, such as T-cell clones of undetermined significance. STAT3 or STAT5b mutation may help distinguish.

Baicalin improves the in vitro developmental capacity of pig embryos by inhibiting apoptosis, regulating mitochondrial activity and activating sonic hedgehog signaling

Baicalin, a traditional Chinese medicinal monomer whose chemical structure is known, can be used to treat female infertility. However, the effect of baicalin on embryonic development is unknown. This study investigated the effects of baicalin on in vitro development of parthenogenetically activated (PA) and in vitro fertilized (IVF) pig embryos and the underlying mechanisms involved. Treatment with 0.1 μg/ml baicalin significantly improved (P < 0.05) the in vitro developmental capacity of PA pig embryos by reducing the reactive oxygen species (ROS) levels and apoptosis and increasing the mitochondrial membrane potential (ΔΨm) and ATP level. mRNA and protein expression of sonic hedgehog (SHH) and GLI1, which are related to the SHH signaling pathway, in PA pig embryos at the 2-cell stage, were significantly higher in the baicalin-treated group than in the control group. To confirm that the SHH signaling pathway is involved in the mechanism by which baicalin improves embryonic development, we treated embryos with baicalin in the absence or presence of cyclopamine (Cy), an inhibitor of this pathway. Cy abolished the effects of baicalin on in vitro embryonic development. In conclusion, baicalin improves the in vitro developmental capacity of PA and IVF pig embryos by inhibiting ROS production and apoptosis, regulating mitochondrial activity and activating SHH signaling.

[Construction of a new anti-CD123 chimeric antigen receptor T cells and effect of anti-acute myeloid leukemia]

目的

构建一种新的靶向CD123的嵌合抗原受体T细胞(CAR-T细胞)，为CD123阳性白血病的免疫治疗提供实验参考。

方法

通过单克隆筛选技术获得能稳定分泌CD123抗体的杂交瘤细胞株6E11，将杂交瘤细胞扩增后腹腔注射至Balb/c小鼠腹腔内，收集腹水并处理、纯化得到单克隆抗体，测定抗体效价并对其特异性进行验证；RT-PCR法获得轻链和重链可变区序列，并以此为基础利用分子克隆技术构建一种新的靶向CD123嵌合抗原受体，包装病毒后感染T细胞制备CD123CAR-T细胞，通过功能实验初步探讨6E11CAR-T细胞体外抗白血病的能力。

结果

①获得1株稳定分泌抗人CD123抗体的杂交瘤细胞株6E11并获得其可变区序列。②6E11单克隆抗体对CD123蛋白亲和性高，解离常数(K_d值)为2.10nmol/L，特异性识别CD123阳性细胞且与CD123阴性细胞无交叉反应。 ③成功构建了CD123CAR慢病毒载体，感染T细胞后获得了靶向CD123的CAR-T细胞(6E11CAR-T)，感染效率大于60％。 ④6E11CAR-T能明显杀伤CD123阳性靶细胞MV4-11，效靶比1∶1时6E11CAR-T细胞对MV4-11细胞的杀伤比例明显高于 Vecor-T细胞[(98.60±1.20)％对(20.28±6.74)％，P<0.001]，但对CD123阴性靶细胞K562没有明显杀伤作用。 ⑤MV4-11细胞可以显著激活6E11CAR-T，但对Vecor-T细胞无明显激活作用[(26.33±3.30)％对(1.17±0.06)％，P<0.001]。⑥6E11CAR-T与MV4-11细胞共培养上清中细胞因子水平均显著高于Vecor-T组[IL-2：(92.90±1.51)pg/ml对(6.05±3.41)pg/ml，P<0.001；TNF-α：(1 407.20±91.95)pg/ml对(7.86±0.85)pg/ml，P<0.001；IFN-γ：(5 614.60±170.17)pg/ml对(8.42±2.70)pg/ml，P<0.001]但与 K562细胞共培养后，两组各细胞因子水平差异无统计学意义。 ⑦6E11CAR-T在与CD123阳性髓系白血病(AML)原代细胞共培养过程中被显著激活，且能有效杀伤原代 AML细胞。

结论

杂交瘤细胞株6E11能稳定分泌高效特异的抗人CD123单克隆抗体，可用于检测表达人CD123的细胞，也能应用在靶向人CD123蛋白的肿瘤免疫治疗中，以 6E11Ig可变区序列为抗原识别区的CD123CAR-T细胞，具有明确的体外抗白血病活性，为进一步的临床研究奠定了基础。

Heparin-binding protein measurement improves the prediction of myocardial injury-related cardiogenic shock

Background

Heparin-binding protein (HBP), a potent inducer of increased vascular permeability, is a potentially useful biomarker for predicting outcomes in patients with postoperative myocardial injury-related cardiogenic shock (MIRCS). We aimed to evaluate and validate HBP as a prognostic biomarker for postoperative MIRCS.

Methods

We performed a case-control study in 792 patients undergoing cardiac surgery from January 1, 2016, to August 1, 2019, including 172 patients with postoperative MIRCS and 620 age- and sex-matched controls. The association between HBP and MIRCS was determined by multivariate logistic regression analysis. Receiver operating characteristic curves (ROCs) with area under the curve (AUC) were performed to calculate the cut-off value, sensitivity and specificity. The association between HBP and cardiac troponin T (cTnT) was determined by multivariable linear regression analysis. Blood samples were drawn from the coronary sinus and arterial line of the cardiopulmonary bypass (CPB) before aortic cross-clamping (time point 1) and 5 min after aortic declamping (time point 2).

Results

Before aortic cross-clamping, coronary sinus HBP (HBP_CS1) showed no differences between the two groups. However, after declamping, the MIRCS group had a significantly higher sinus HBP level (HBP_CS2) than did the control group. HBP_CS2 predicted MIRCS with an AUC of 0.85 (95% CI: 0.81–0.89, cut-off: 220 ng/ml, sensitivity: 92% and specificity: 70%). After adjusting for confounding factors, we found that HBP was an independent risk factor for MIRCS (OR: 7.65, 95% CI: 4.86–12.06, P < 0.01) and was positively associated with cTnT (β > 0, P < 0.01).

Conclusions

Elevated levels of coronary sinus HBP were useful biomarkers for predicting MIRCS after cardiac surgery.

[Therapy-related myeloid neoplasms after successful treatment for acute promyelocytic leukemia: a report of four cases and literature review]

目的

探讨急性早幼粒细胞白血病（APL）患者继发治疗相关性髓系肿瘤（t-MN）的临床特点、诊断、治疗及预后。

方法

回顾性分析中国医学科学院血液病医院2012年10月至2019年1月收治的4例APL继发t-MN患者的临床资料，并进行相关文献复习。

结果

4例APL继发t-MN患者均为女性，中位年龄42（40~53）岁，3例接受了以维甲酸（ATRA）+亚砷酸（ATO）为基础联合蒽环/蒽醌类药物±阿糖胞苷的前期诱导缓解及巩固治疗方案，1例采用了ATRA联合蒽环/蒽醌类药物±阿糖胞苷的治疗方案，均没有使用烷化剂。在APL获得完全缓解（CR）后40~43个月出现t-MN，其中治疗相关性骨髓增生异常综合征（t-MDS）1例，治疗相关性急性髓系白血病（t-AML）3例，出现t-MN时PML-RARα融合基因均为阴性。3例t-AML患者接受了2~4个疗程再诱导治疗，其中有1例t-AML患者在获得CR后行异基因造血干细胞移植（allo-HSCT），1例t-MDS患者接受了去甲基化治疗。中位随访54.5（48~62）个月，2例t-AML患者死亡，出现t-MN后中位生存期为12（5~18）个月。1989至2018年文献共报道63例APL继发t-MN病例，与本次报道的4例汇总分析，67例患者中男27例，女40例；中位年龄为52.5（15~76）岁；中位潜伏期39（12~168）个月，确诊t-MN后中位生存时间为10（1~39）个月。

结论

APL继发t-MN较为少见，目前缺乏有效的防治措施，预后不佳，在随访过程中（尤其是获得CR后39个月左右）若出现病情变化，应警惕t-MN的发生，对此类患者应尽快明确疾病的变化，给予合理的治疗。

Baicalin improves IVM of pig oocytes and subsequent preimplantation embryo development by inhibiting apoptosis

Baicalin, a monomer of flavonoids extracted from dried roots of Scutellaria baicalensis, is used to treat female infertility. However, the effect of baicalin on oocyte maturation is unknown. In this study we investigated the effects of baicalin on the IVM of pig oocytes and subsequent embryo development following parthenogenetic activation (PA). We found that 0.1µgmL-1 baicalin significantly (P<0.05) increased the IVM rate of oocytes compared with the non-treatment (control) group by reducing levels of reactive oxygen species (ROS). In addition, the mRNA expression of genes related to nuclear maturation and cumulus cell expansion, mitochondrial membrane potential and ATP content was significantly (P<0.05) higher in baicalin-treated than control oocytes. To determine whether baicalin treatment during IVM of pig oocytes improves subsequent development of PA embryos, we measured the cleavage and blastocyst formation rates, as well as the number of cells per blastocyst. All these parameters were significantly (P<0.05) higher in the baicalin-treated than control group. In conclusion, this study demonstrates that baicalin improves pig oocyte maturation and subsequent embryo development invitro by inhibiting production of ROS and reducing apoptosis in oocytes.

[Long-term efficacy analysis of laparoscopic-assisted anorectoplasty for high and middle imperforate anus]

Objective: To explore the long-term efficacy of laparoscopic-assisted anorectoplasty and conventional anorectoplasty in the treatment of children with high and middle anal atresia. Methods: A retrospective cohort study was used. Inclusion criteria: (1) children with high and middle anal atresia; (2) complicated with rectourethral or rectovesical fistula; (3) complete follow-up data. Exclusion criteria: (1) complicated with 21-trisomy; (2) cerebral palsy and other mentaldisabilities; (3) Currarino syndrome; (4) FG syndrome. Clinical data of 88 patients with middle and high anal atresia, who complicated with rectourethral fistula or rectovesical fistula, and underwent anoplasty at Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from January 2009 to June 2014 were enrolled in the study and analyzed. There were 24 cases with middle atresia and 64 cases with high atresia. All the cases were divided into 2 groups based on the operative method: laparoscopic group (laparoscopic-assisted anorectoplasty, 49 cases), pena group (posterior sagittal anorectoplasty, 39 cases). The demographic features of two groups were comparable. There were no statistically significant differences in gender, age, body mass, classification of anomaly types and sacral ratio (all P>0.05). Student t test and Chi square tests were used to compare the surgical conditions (operative time, postoperative hospital stay and complications), anal function (Kelly score), constipation (Krickenbeck constipation score) and anorectal pressure. Results: Children of both groups all completed operation ssuccessfully. There were no statistically significant differences between laparoscopic group and pena group in the operative time [(120±31) minutes vs. (112±23) minutes, t=1.343, P=0.091] and postoperative hospital stay [(7.1±2.3) days vs. (10.7±3.3) days, t=6.021, P=1.000]. Complications were more common in the pena group [16.3% (8/49) vs. 35.9% (14/39), χ(2)=4.436, P=0.035]. The main complications in laparoscopic group were anal prolapse (8.2%, 4/49) and anal stenosis (6.2%, 3/49), while in pena group were anal stenosis (12.8%, 5/39) and perioperative perianal skin erosion (10.3%, 4/39). As for the anal function, the degree of feces, defecation control and sphincter contractility, the single scoring differences of Kelly scoring system were not statistically significant between the two groups, but the proportion of good function in the laparoscopic group was higher than that in the pena group [67.3% (8/49) vs. 38.5% (15/39), χ(2)=7.308, P=0.007]. Constipation occurred in 6 (12.2%) patients in the laparoscopic group, of whom 5 were improved by diet regulation and 1 required laxatives, while 9 (23.1%) patients developed constipation in the pena group, of whom 4 were improved by diet regulation and 5 required long-term laxatives. The difference of constipation ratio was not statistically significant (χ(2)=1.802, P=0.180). There were no cases of Krickenbeck constipation grade 3. Compared to the pena group, the laparoscopic group had higher anal resting pressure [(33.35±9.69) mmHg vs. (27.68±10.74) mmHg, t=2.599, P=0.011], higher dilating pressure [(9.00±5.61) mmHg vs.(6.51±3.24) mmHg, t=2.462, P=0.016], higher maximal squeeze pressure [(65.80±17.23) mmHg vs. (56.74±18.93) mmHg, t=2.389, P=0.019] and longer maximal contraction time [(21.16±5.02) seconds vs. (18.44±7.24) seconds, t=2.079, P=0.041]. The rectal resting pressure [(5.36±3.00) mmHg vs. (4.61±3.93) mmHg, t=1.015, P=0.312] was not statistically significantly different. Conclusions: Compared with posterior sagittal anorectoplasty, laparoscopic-assisted anorectoplasty in the treatment of high and middle anal atresia has better long-term efficacy with less perioperative complications.

[Myeloid/lymphoid neoplasms with eosinophilia and FGFR1 rearrangement: 5 cases report and literatures review]

目的

分析罕见疾病伴嗜酸性粒细胞增多和FGFR1重排的髓系/淋系肿瘤（即8p11骨髓增殖综合征，EMS）的临床特征、诊断及治疗。

方法

总结中国医学科学院血液病医院2014年1月至2018年5月收治的5例确诊EMS患者的临床表现、实验室特征、诊治经过及转归。

结果

5例EMS患者外周血白细胞计数均明显升高，伴有嗜酸性粒细胞绝对值增高（均值18.89×10⁹/L）；骨髓髓系极度增生，原始细胞均<5%，嗜酸性粒细胞比例增高（均值17.24%）。5例患者染色体核型各不相同，但FISH检查均存在FGFR1基因重排。发病至确诊平均时间为4.8个月，中位生存期仅14个月。

结论

EMS是一种罕见病，恶性程度高，对常规化疗反应差，生存期短，且易发生误诊漏诊，细胞遗传学及分子生物学检查有助于早期诊断。

Comparison of internal organs between myostatin mutant and wild-type piglets

BACKGROUND

Myostatin (MSTN) negatively regulates skeletal muscle development; however, its functions in internal organs have not been thoroughly investigated. Here, we compared the morphological, molecular, and biological characteristics of the heart, liver, spleen, lungs, kidneys, and tongue of homozygous MSTN mutant (MSTN^-/- ), heterozygous MSTN mutant (MSTN^+/- ), and wild-type (WT) piglets.

RESULTS

The heart and liver were lighter in MSTN^-/- piglets than in MSTN^+/- piglets, while the tongue was heavier in MSTN^-/- piglets than in WT piglets (P < 0.05). Furthermore, the tongue was longer in MSTN^-/- piglets than in WT piglets, and myofibers of the tongue were significantly larger in the former piglets than in the latter ones (P < 0.01). mRNA expression of MSTN in all organs was significantly lower in MSTN^-/- and MSTN^+/- piglets than in WT piglets (P < 0.05). Meanwhile, mRNA expression of follistatin, which is closely related to MSTN, in the heart and liver was significantly higher in MSTN^-/- piglets than in MSTN^+/- and WT piglets (P < 0.05). In addition, protein expression of MSTN in the heart, kidneys, and tongue was significantly lower in MSTN^-/- piglets than in WT piglets (P < 0.01).

CONCLUSION

These results suggest that MSTN is widely expressed and has marked effects in multiple internal organs. Myostatin has crucial functions in regulating internal organ size, especially the tongue. © 2019 Society of Chemical Industry.

[A single-center, randomized controlled trial of PEG-rhG-CSF and common rhG-CSF to promote neutrophil recovery after induction chemotherapy in newly diagnosed acute myeloid leukemia]

目的

比较初诊急性髓系白血病（AML）患者诱导化疗后骨髓抑制期应用聚乙二醇化重组人G-CSF（PEG-rhG-CSF）与普通重组人G-CSF（rhG-CSF）促进中性粒细胞或白细胞恢复的时间。同时比较两种药物对患者感染发生率、住院时间的影响。

方法

采用前瞻性随机对照研究方法，将2014年8月至2017年12月间符合入组条件的初诊AML患者诱导治疗后按1∶1比例随机分成两组：PEG-rhG-CSF组和rhG-CSF组。对比分析两组患者中性粒细胞计数（ANC）或WBC恢复时间、感染发生率和住院时间。

结果

共入组初诊AML患者60例，PEG-rhG-CSF组30例，rhG-CSF组30例。两组患者除性别构成外，在年龄、化疗方案、化疗前ANC、WBC、诱导化疗疗效方面差异均无统计学意义（P值均>0.05）。PEG-rhG-CSF组患者与rhG-CSF组患者的ANC、WBC恢复中位时间分别为19（14~35）d、19（15~26）d，差异无统计学意义（t=0.580，P=0.566）。PEG-rhG-CSF组、rhG-CSF组患者骨髓抑制期感染的发生率分别为90.0%、93.3%，差异无统计学意义（P=1.000）。两组患者的中位住院时间分别为20.5（17~49）d、21（19~43）d，差异无统计学意义（P=0.530）。

结论

AML患者诱导治疗后应用PEG-rhG-CSF与rhG-CSF无论在ANC或WBC恢复时间，还是在感染的发生率及住院时间均相当。

Outcomes of early versus delayed initiation of extracorporeal life support in cardiac surgery

Background

Extracorporeal membrane oxygenation offers temporary hemodynamic support for patients with refractory cardiogenic shock after cardiovascular surgery. However, the initiation time for such patients is controversial. Changing the initiation time might improve the outcomes. This study aimed to investigate whether early extracorporeal membrane oxygenation could improve postoperative outcomes in patients at a high risk of cardiogenic shock.

Methods

In this retrospective study, 173 patients with cardiovascular diseases at a high risk of refractory cardiogenic shock which assessed via empirical risk evaluation from 2010 to 2017 were included. After propensity matching, 36 patients, who were matched to patients initiated with extracorporeal membrane oxygenation after cardiovascular operation (delayed extracorporeal membrane oxygenation group, n = 36), were also initiated with such early in the operating room (early extracorporeal membrane oxygenation group, n = 36). The primary outcome was death. The secondary outcomes included receiving continuous renal replacement therapy, ventricular arrhythmia, and pulmonary infection.

Results

The demographic and baseline variables were similar between the matched groups. The early extracorporeal membrane oxygenation group showed lower mortality (69.44% vs 41.67%, P = 0.03), pulmonary infection morbidity (86.11% vs 55.56%, P < 0.01), and continuous renal replacement therapy rate(88.89% vs 66.67%, P = 0.04). Moreover, they showed improved cardiac index (P = 0.01) and lactate clearance (P < 0.01).

Conclusions

Extracorporeal membrane oxygenation provides effective support for cardiogenic failure refractory to medical management; early initiation improves cardiac output and promotes lactate clearance, thus increasing survival in patients with cardiogenic shock after cardiovascular surgery.

Trial registration

This is a retrospective study. It was not registered.

Role of co- and post-translational modifications of SFKs in their kinase activation

Src family kinases (SFKs) are non-receptor tyrosine kinases and are involved in various cellular functions (proliferation, differentiation, migration, survival and invasion) by regulating downstream pathways. Considerable evidence suggests that co- and post-translational modifications are highly related to the activation of SFKs and their downstream signals. How SFKs are activated and how their subsequent cascades were regulated has been reviewed in previous reports. However, the contribution of co- and post-translational modification to SFKs activation has not been fully elucidated. This review focuses on the effect of these modifications on SFKs activity according to structural and biochemical studies and uncovers the significance of co-and post-translational modifications in the regulation of SFKs activity.

[Application of immunophenotypic analysis and molecular genetics in the diagnosis of acute promyelocytic leukemia]

目的

研究免疫表型分析及分子遗传学在急性早幼粒细胞白血病（APL）诊断中的应用价值。

方法

对2012年5月–2017年12月门诊或住院的798例APL患者的流式细胞术（FCM）免疫分型、染色体核型及染色体荧光原位杂交（FISH）进行回顾性分析，并深入研究FCM免疫表型及分子遗传学在APL诊断中的应用价值。

结果

FCM诊断APL敏感性为91.9%，特异性为98.7%。APL具有独特免疫表型特点：典型APL的表型为侧向（SSC）偏大，CD34和HLA-DR表达缺失，表达或强表达CD33，均一表达CD13、CD9、CD123，可伴有CD56、CD7、CD2的表达。约10%的患者为非典型APL表型，一般伴有CD34和（或）HLA-DR表达，SSC减小，经常伴有CD2表达，而FCM免疫分型很难明确诊断为APL，需要依赖遗传学或者分子生物学检查结果。约1/3的患者除存在t（15;17）（q22;q21）外，还存在额外染色体异常；伴有t（15；17）的复杂核型、变异易位或者t（11;17）、t（5;17）等变异型的APL，FCM表型与单纯t（15；17）APL差异无统计学意义（P>0.05）。

结论

FCM能够快速诊断APL，伴有额外染色体异常患者和单纯t（15；17）患者FCM免疫表型没有明显差异。遗传学是诊断APL的金标准，免疫分型中约10%的患者依赖于分子遗传学来确诊。

[Using Multiple Linear Regression Method to Evaluate the Impact of Meteorological Conditions and Control Measures on Air Quality in Beijing During APEC 2014]

Meteorological conditions have important impact on the diffusion and transport of air pollutants, thus separating and quantifying the impact of meteorological factors is a prerequisite for evaluation of air pollution control measures. Using observation data on SO₂, NO, NO₂, NO_x, CO, PM_2.5, PM₁, and PM₁₀ as well as meteorological factors at the Chaoyang site, an urban site in Beijing, we evaluated the impact of meteorological conditions and control measures on air quality in Beijing during APEC 2014 (from 15 October to 30 November, 2014) by the multiple linear regression method. The simulation performance of a multivariate linear regression model based on the parameters of meteorological factors for predicting pollutant concentration assuming constant emission conditions were ideal, produced a range of determination coefficient (R²) of 0.494-0.783. Our results suggested that air pollution control measures reduced the concentration of SO₂, NO, NO₂, NO_x, CO, PM_2.5, PM₁, and PM₁₀ by 48.3%, 53.5%, 18.7%, 40.6%, 3.6%, 34.8%, 28.8%, and 40.6%, while meteorological conditions reduced the concentration of SO₂, NO, NO₂, NO_x, CO, PM_2.5, PM₁, and PM₁₀ by 1.7%, -2.8%, 18.7%, 4.5%, 18.6%, 27.5%, 30.6%, and 35.6%. The combination of meteorological factors and control measures has significantly improved the air quality in Beijing during the APEC period. Control measures played a leading role in the reduction of SO₂ and nitrogen oxides, and meteorological factors played a leading role in the reduction of CO. Meteorological factors and control measures made roughly equal contributions to the reduction of particulate matter. We also used the relative weight method to study the contribution of meteorological factors to the pollutant concentration. The results showed that the decisive meteorological factors on the concentrations of different pollutants were different.

[Impact of duration of antibiotic therapy on the prognosis of patients with acute myeloid leukemia who had Gram-negative bloodstream infection in consolidation chemotherapy]

目的

分析巩固化疗期间伴发革兰阴性菌（G⁻菌）血流感染的急性髓系白血病（AML）患者抗感染疗程对感染转归的影响。

方法

回顾性分析2010年9月至2016年1月入组“依据危险度分层对急性髓系白血病优化治疗的研究”临床试验的591例AML（非急性早幼粒细胞白血病）患者的血流感染资料，将其中巩固化疗期间发生G⁻菌血流感染且持续发热时间<7 d的114例次血流感染（89例患者）纳入研究，分析抗感染疗程对感染转归的影响。

结果

114例次血流感染发生时，患者中位ANC为0（0~5.62）×10⁹/L，中性粒细胞缺乏（粒缺）持续的中位时间为9（3~26）d，抗感染治疗的中位时间为7（4~14）d。抗感染疗程≤7 d与>7 d组比较，停药后3 d内再发热比例、再次发生相同菌株血流感染比例分别为1.2%对3.0%、18.5%对21.2%，差异均无统计学意义（P=0.522，OR=0.400，95%CI 0.024~6.591；P=0.741，OR=0.844，95%CI 0.309~2.307）。同时，两组患者均未发生7 d及30 d内感染相关死亡。且倾向性评分平衡患者特征及用药差异因素后，抗感染疗程≤7 d较>7 d组再次发生相同菌株血流感染比例仍无明显增高（P=0.525，OR=0.663，95%CI 0.187~2.352）。

结论

对于巩固化疗期间伴发G⁻菌血流感染的AML患者，若发热时间<7 d，敏感抗菌药物治疗7 d后停药并不增加停药后3 d内再发热，粒缺期再次出现相同菌株血流感染及感染相关7 d、30 d内死亡风险。提示短疗程抗感染方案可以成为巩固化疗伴发G⁻菌血流感染AML患者感染控制情况下合理的治疗选择。

Deep ultraviolet light-emitting diodes with improved performance via nanoporous AlGaN template

We report the performance enhancement of AlGaN-based deep ultraviolet light-emitting diodes (DUV LEDs) using AlGaN nanoporous template (NPT). The NPT was fabricated by the electrochemical etching method and served as the dislocation filtering layer and strain relieving layer. The n-AlGaN laterally regrown on NPT showed reduced dislocation density and mitigated compressive strain comparing with that on the as-grown template (AGT). A 23% improvement of internal quantum efficiency was achieved for the multiple quantum wells thereon. Moreover, the nanopores in the NPT transformed into elongated air voids during high temperature growth process, which could facilitate the escaping of photons by scattering and thus improve the light extraction efficiency. As a consequence, the DUV LED based on NPT demonstrated an increase of the light outpower by 50% at 20 mA than that on AGT.

[Screening of adult Ph-like acute lymphoblastic leukemia by multiplex real-time quantitative PCR]

目的

探讨多重实时荧光定量PCR法早期、快速筛查Ph样急性淋巴细胞白血病（ALL）的可行性，了解Ph样ALL的临床特征及预后。

方法

2010年10月至2016年3月收治的118例初诊成人B-ALL患者纳入研究，利用多重实时荧光定量PCR法检测其中58例BCR-ABL融合基因和MLL重排均阴性患者Ph样相关融合基因及细胞因子受体样因子2（CRLF2）表达情况。比较分析Ph样融合基因阳性和（或）CRLF2高表达患者的临床特征、疗效和预后。

结果

检出Ph样融合基因阳性患者9例（9/58，15.5%），CRLF2高表达患者10例（10/58，17.2%）。Ph样融合基因阳性和（或）CRLF2高表达组、Ph阳性组、MLL重排阳性组以及其他患者组在年龄、WBC、免疫分型、细胞遗传学、危险度分组方面差异有统计学意义（P值均<0.01）。四组患者的2年总生存率分别为65%、47%、64%、74%（P=0.043），2年无复发生存率分别为51%、39%、62%、70%（P=0.010）。

结论

采用多重实时荧光定量PCR法筛查Ph样ALL患者可行，Ph样ALL患者预后较差。

[Effects of NPM1 gene expression on acute myeloid leukemia cell lines and its mechanism]

目的

探讨NPM1基因表达对急性髓系白血病（AML）细胞系的影响及其机制。

方法

选取AML细胞系U937和HL-60细胞，转染NPM1质粒至细胞系构建稳定克隆，采用Western blot法鉴定高表达NPM1蛋白的单克隆细胞。MTT法检测细胞增殖活性，流式细胞术检测细胞周期分布和细胞凋亡率，显微镜下计数检测集落形成能力，Western blot法检测细胞周期相关信号通路蛋白表达，实时荧光定量PCR（RQ-PCR）法检测初诊AML患者骨髓单个核细胞NPM1基因表达水平。

结果

①U937和HL-60细胞中NPM1高表达组相对细胞增殖率与对照组相比，差异无统计学意义（4.68±1.28对3.89±0.81，3.34±0.37对2.68±0.29，P值均>0.05）。②U937和HL-60细胞中NPM1高表达组S期细胞比例均明显高于对照组[（50.22±3.42）%对（39.78±3.80）%，（59.01±3.27）%对（43.94±2.08）%，P值均<0.05]。③U937细胞NPM1高表达组和对照组相比具有更强的抗凋亡能力[（48.67±3.22）%和（68.77±10.21）%，P<0.05]和集落形成能力（772.7±24.0和652.3±16.5，P<0.05），而HL-60细胞相应的两组细胞上述能力均相似。④NPM1高表达组细胞中CDK4、Cyclin D1、Cyclin D2及Cyclin E表达明显高于对照组，而Cyclin D3表达明显低于对照组。⑤细胞遗传学预后良好组AML患者NPM1定量水平低于预后中等组。

结论

NPM1蛋白能够促进更多的细胞进入S期，增强抗凋亡和细胞集落形成能力。NPM1定量水平可能预示细胞遗传学的危险度。

[Plaque features in saphenous vein graft evaluated by virtual histology intravascular ultrasound]

Objective: To investigate the features of plaques of saphenous venous graft (SVG) with virtual histology intravascular ultrasound (VH-IVUS) in patients underwent coronary artery bypass graft surgery. Methods: From March 2016 to March 2018, a total of 45 patients ((64.4±7.9) years old, 88.9% male (40 cases)) with ischemic symptoms after coronary artery bypass graft surgery and with coronary artery angiography evidenced SVG stenosis greater than or equal to 50%, who received percutaneous coronary intervention in Tianjin chest hospital were continuously included in this study, and the clinical data were retrospectively analyzed. VH-IVUS was performed before PCI to analyze plaque composition. The patients were divided into no smoking group (21 cases) and smoking group (24 cases), no diabetes group (30 cases) and diabetes group (15 cases), normal very low density lipoprotein cholesterin (VLDL-C) group (24 cases) and elevated VLDL-C group (21 cases), stable angina pectoris group (5 cases) and acute coronary syndrome group (40 cases), plaque burden (PB) < 70% group (11 cases) and PB ≥ 70% group (34 cases), without thin-cap fibroatheroma group (35 cases) and thin-cap fibroatheroma group (10 cases), and plaque features were compared between different groups. Results: The graft age was (8.9±3.7) years.The stenosis degree of SVG lesions was 90 (90, 98) %. The minimum lumen diameter was 1.6 (1.5, 1.8) mm. The vessel cross-sectional area was (12.1±4.0) mm(2). The plaque area was 8.6 (5.7,12.0) mm(2). The minimum lumen area was 2.5 (2.1,3.3) mm(2). The plaque burden was (75.3±8.3)%. The fibrotic tissue (FI) ratio was (65.1±10.1)%, fibrofatty plaque (FF) ratio was 13.8 (5.4,25.3) %, necrotic core tissue (NC) ratio was 12.0 (5.4,24.0)%, and dense calcium tissue (DC) ratio was1.0 (0.2,3.8)% in SVG lesions. There were no significant differences in SVG plaque area, FI area,FF area,NC area,and DC area between no smoking group and smoking group, no diabetes group and diabetes group, and normal VLDL-C group and elevated VLDL-C group. SVG plaque volume was significantly higher in acute coronary syndrome group than in stable angina pectoris group (262.2 (148.5,401.2) mm(3) vs. 93.1 (50.6,155.9) mm(3),P=0.006), and plaque area (10.1 (6.6,13.3) mm(2) vs. 5.0 (3.6,6.9) mm(2), P<0.001), FI area(4.8 (3.2,6.8) mm(2) vs. 2.8 (1.9,3.0) mm(2), P<0.001),and FF area (1.15 (0.60, 2.07) mm(2) vs. 0.30 (0.10,0.90) mm(2), P=0.009) were significantly larger in PB ≥ 70% group than in PB < 70% group.The NC area (1.75(0.40,2.78) mm(2) vs. 0.60 (0.20,1.30) mm(2), P=0.030) and DC area (0.35 (0.10,0.50) mm(2) vs. 0.00 (0.00,0.10) mm(2), P=0.006) were significantly larger in thin-cap fibroatheroma group than that in without thin-cap fibroatheroma group. Spearman correlation analysis showed that the plaque area of SVG lesion was positively correlated with FF area (r=0.64, P<0.001) and NC area (r=0.43, P=0.003). PB was positively correlated with FF area (r=0.50, P<0.001) and NC area (r=0.33, P=0.028). Graft age was positively correlated with FF area (r=0.30, P=0.047). Conclusions: The main components of SVG plaque are fibrotic tissue, conversely, calcified tissue is rare in patients with SVG stenosis after coronary artery bypass graft surgery. Fibrofatty tissue is increased in the plaque in patients with PB ≥ 70%. The necrotic component is also increased in patients with thin-cap fibroatheroma. The fibrofatty component increases and the plaque tends to be unstable in proportion with increaing age of the graft in this patient cohort.

The construction of accelerated catalytic Fenton reaction based on Pd/MIL-101(Cr) and H2

A novel catalytic Fenton system based on H₂ and the solid catalyst Pd/MIL-101(Cr) (MHACF-MIL-101(Cr)) was developed at normal temperature and pressure. In this system, the reduction process of Fe^III back to Fe^II was accelerated significantly.