[A clinical study of haploidentical hematopoietic stem cell transplantation in the treatment of pediatric patients with acquired severe aplastic anemia: single center experience]

目的

探讨单倍型造血干细胞移植（haplo-HSCT）治疗儿童获得性重型再生障碍性贫血（SAA）的疗效。

方法

回顾性分析2011年12月1日至2017年12月1日接受haplo-HSCT的59例SAA患者。

结果

①全部59例SAA患儿中男37例、女22例，中位年龄4.5（1.2~14.8）岁，中位体重43（12~80）kg；SAA-Ⅰ型47例，SAA-Ⅱ型12例，26例为极重型再生障碍性贫血（VSAA）；首次移植56例，二次移植3例。②预处理选用白消安+环磷酰胺+抗胸腺细胞球蛋白（ATG）方案或白消安+氟达拉滨+环磷酰胺+ATG方案；采用环孢素A（CsA）+霉酚酸酯+甲氨蝶呤方案预防急性GVHD；回输单个核细胞中位数为15.60（7.74~21.04）×10⁸/kg，CD34⁺细胞中位数为4.86（3.74~7.14）×10⁶/kg。③全部59例患儿均获得中性粒细胞和血小板植入。中性粒细胞植入中位时间为13（10~19）d，血小板植入中位时间为19（9~62）d。④Ⅰ~Ⅱ、Ⅲ/Ⅳ度急性GVHD发生率分别为45.76%（27/59）、13.56%（8/59），慢性GVHD发生率为8.47%（5/59）。巨细胞病毒血症发生率为59.32%（35/59）、EB病毒血症发生率为28.81%（17/59）。⑤中位随访时间30（8~80）个月，57例无病存活，2例死亡（均死于GVHD），5年总生存率、无失败生存率均为（96.4±2.5）%。

结论

haplo-HSCT是儿童SAA疗效较好的治疗方法。

Nomogram for Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Patients With Devastating Neurological Injury

Reliable prediction of time of death after withdrawal of life-sustaining treatment in patients with devastating neurological injury is crucial to successful donation after cardiac death. Herein, we conducted a study of 419 neurocritical patients who underwent life support withdrawal at four neurosurgical centers in China. Based on a retrospective cohort, we used multivariate Cox regression analysis to identify prognostic factors for patient death, which were then integrated into a nomogram. The model was calibrated and validated using data from an external retrospective cohort and a prospective cohort. We identified 10 variables that were incorporated into a nomogram. The C-indexes for predicting the 60-min death probability in the training, external validation and prospective validation cohorts were 0.96 (0.93-0.98), 0.94 (0.91-0.97), and 0.99 (0.97-1.00), respectively. The calibration plots after WLST showed an optimal agreement between the prediction of time to death by the nomogram and the actual observation for all cohorts. Then we identified 22, 26 and 37 as cut-points for risk stratification into four groups. Kaplan-Meier curves indicated distinct prognoses between patients in the different risk groups (p < 0.001). In conclusion, we have developed and validated a nomogram to accurately identify potential cardiac death donors in neurocritical patients in a Chinese population.

Removal of fluoride from water by carbon nanotube supported alumina

This paper describes a new adsorption material carbon nanotube supported alumina, used for fluoride removal from water. The effects of calcination temperature, alumina loading and pH on fluoride removal capacity were investigated. The optimum calcination temperature for preparing the adsorbents is 450 degrees C and the largest adsorption capacity takes place at alumina loading of 30 wt%. The broad pH range of 6.0-9.0 with high adsorption capability suggests that carbon nanotube supported alumina have great potential applications in practice. The adsorption data at different pH were well fitted to the Freundlich isotherm. The kinetic studies show that the adsorption reaction of fluoride removal by carbon nanotube supported alumina can be described by a second orderrate equation.

[Treatment of 2-naphtholwastewater using air oxidation and ion exchange]

The properties of 2-naphtholwastewater were studied in details in this paper, the wastewater was characterized by the strong acidity, high buffer capability and concentrated salt. Air oxidation and anion exchange were employed for the treatment of the wastewater. Under formal pH, room temperature and 1 BV/h rate, the result showed that the removal of COD reached to 97% and the recovery of sodium naphthalensulfonate to 98%. Besides, wastewater treated can be reused for washing the sodium naphthalensulfonate.

The scaffolding protein CASK mediates the interaction between rabphilin3a and beta-neurexins

CASK, a member of the membrane-associated guanylate kinase (MAGUK) superfamily, binds to the carboxyl-terminus of beta-neurexins on the intracellular side of the presynaptic membrane. The guanylate kinase-like (GUK) domains of MAGUKs lack kinase activities, but might be important for mediating specific protein-protein interaction. By a yeast two-hybrid approach, we identified an interaction between the GUK domain of CASK and the C2B domain of rabphilin3a, a presynaptic protein involved in synaptic vesicle exocytosis. The interaction was confirmed by in vitro GST pull-down and co-immunoprecipitation assays. It was proposed that presynaptic vesicles might be guided to the vicinity of points of exocytosis defined by beta-neurexins via the interaction between rabphilin3a-CASK-beta-neurexins.

[Relationship between obese gene expressive product and simple obesity in children]

OBJECTIVE

To investigate the relationship between obese gene expressive product-obese protein (OP) and the pathogenesis and prognosis of simple obesity in 30 children with normal body weight (control group).

METHODS

Before immunoassay, OP was extracted from the whole blood samples with Sep-pak C(18) Cartridge.

RESULTS

The plasma contents of OP in the obese group were (118.53 +/- 25.02) ng/L and (197.14 +/- 26.83) ng/L (P < 0.001), respectively. In the obese group, plasma OP was not detected in three cases and was (19.90 +/- 3.94) ng/L in other three cases. These obese children with severe OP deficit not only had more increased body mass index, and levels of total cholesterol, triglyceride and low-density lipoprotein-cholesterol, but also had lower therapeutic effect (16.67%) than those with mild OP depletion (79.16%).

CONCLUSION

The children with simple obesity have OP deficit. Simple obesity may be related with the reduced plasma content of OP. The obese children with severe OP deficit have poorer curative effect and unfavorable prognosis.