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    30 December 2022, Volume 17 Issue 06 Previous Issue    Next Issue
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    Expert forum
    The prospect of cure on multiple myeloma
    HOU Jian
    2022, 17 (06):  425-427.  DOI: 10.16138/j.1673-6087.2022.06.001
    Abstract ( 121 )   HTML ( 4 )   PDF (324KB) ( 83 )  
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    Original article
    Low-dose sorafenib combined with all-trans retinoic acid induces differentiation of acute myeloid leukemia cells with wild type Fms like tyrosine kinase 3
    LU Hao, XI Huimin, LI Lu, CAI Xun
    2022, 17 (06):  428-434.  DOI: 10.16138/j.1673-6087.2022.06.002
    Abstract ( 160 )   HTML ( 2 )   PDF (1090KB) ( 67 )  

    Objective To explore the effect and the mechanisms of the combination of low-dose sorafenib and all-tran retinoic acid (ATRA) in acute myeloid leukemia (AML) cells with wild type Fms like tyrosine kinase 3 (FLT3). Methods The wild type FLT3 AML cell lines HL-60, U937 and the ATRA-resistant HL-60 cell line, HL-60Res were used as in vitro models. The cell differentiation was evaluated with cell surface differentiation antigen CD11b and cellular morphology. The activation of Raf, mitogenactivated protein kinase (MEK) and extracellular signal-regulated kinase (ERK), the protein expression levels of PU.1, C/EBPβ and C/EBPε were measured by Western blotting assay. Results Low dose (0.1~0.5 μmol/L) sorafenib enhanced ATRA-induced differentiation in all three cell lines studied. The combination activated Raf, MEK and ERK, and up-regulated the levels of C/EBPβ, C/EBPε and PU.1. Addition of trametinib, a MEK specific inhibitor, suppressed the differentiation induced by sorafenib and ATRA, preventing the activation of MEK/ERK and up-regulation of the levels of C/EBPβ, C/EBPε and PU.1. Conclusions The combination of low-dose sorafenib and ATRA induced differentiation of AML cells with wild type FLT3 via RAF/MEK/ERK-mediated up-regulation of the protein levels of C/EBPβ, C/EBPε and PU.1.

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    Risk analysis of malignant tumor incidence in pre-diabetes patients in Shanghai
    MIAO Ya, LIU Lili, HOU Tianzhichao, YAN Qinghua, PANG Yi, WU Chunxiao, CHENG Minna, SHI Yan, LI Yanyun, TIAN Jingyan
    2022, 17 (06):  435-440.  DOI: 10.16138/j.1673-6087.2022.06.003
    Abstract ( 211 )   HTML ( 1 )   PDF (469KB) ( 75 )  

    Objective To explore the risk of incidence of over all cancer and site-specific cancers in patients with pre-diabetes. Methods From 2011 to 2018, 31 568 pre-diabetes patients aged 20 years and above who were newly diagnosed and registered in the community diabetes management information system of Shanghai were used as the unique identifier to link data with the Shanghai Malignant Tumor Registration System to obtain their malignant tumor incidence, to calculate the incidence of all causes and the top ten malignant tumors of pre-diabetes patients of different sexes and ages standardized incidence rate and standardized incidence ratio (SIR). Results The crude incidence rate of all cause tumors in pre-diabetes patients was 868.1/100 000 person years, 1 099.48/100 000 person years for male and 729.19/100 000 person years for female. The standardized incidence rate was 567.49/100 000 person years, 512.15/100 000 person years for male and 597.91/100 000 person years for female. The SIR of all cause tumors was 0.97, 0.99 for male and 0.99 for female, respectively. The relative incidence risk of all cause tumors in pre-diabetes patients gradually decreased with age, and the SIR of pre-diabetes patients in the 20-49, 50-59, 60-69, 70-79 and ≥80 age groups was 3.04, 1.21, 1.00, 0.92 and 0.66, respectively. The incidence risk of thyroid cancer in the 20-49 and 50-59 year old pre-diabetes patients were 4.85 and 1.86 times higher than that of the total population of the same age, respectively, and the incidence risk of thyroid cancer in the 20-49 and 50-59 year old female pre-diabetes patients were 4.46 and 1.53 times higher than that of the total population of the same sex and age, respectively. The risk of bladder cancer and kidney cancer in male under 50 years of age with pre-diabetes were 36.34 and 13.49 times higher than that in the total population of the same sex and age, respectively. The risk of prostate cancer in male aged 60 to 69 years in pre-diabetes was 2.66 times higher than that in total population of the same sex and age. Conclusions The risk of all-cause cancer in pre-diabetes patients was not significantly higher than that in the total population. The relative risk of all-cause cancer and site-specific cancers of the population decreased with age. It is necessary to increase the screening of specific cancer species in specific gender and age groups. For newly diagnosed pre-diabetes patients over 80 years old, it is recommended to reevaluate the risk of disease diagnosis and prognosis.

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    Efficacy and safety of selective granulocyte and monocyte adsorptive apheresis in treatment of moderate to severe inflammatory bowel disease
    CHEN Ying, ZHANG Chenli, YAO Weiyan
    2022, 17 (06):  441-446.  DOI: 10.16138/j.1673-6087.2022.06.004
    Abstract ( 282 )   HTML ( 11 )   PDF (604KB) ( 99 )  

    Objective To explore the efficacy and safety of granulocyte and monocyte apheresis(GMA) in the patients of moderate to severe inflammatory bowel disease(IBD). Methods Thirty-eight patients of moderate to severe IBD received GMA treatment at our hospital from May 2013 to September 2021 were enrolled, which included 28 cases of ulcerative colitis(UC) and 10 cases of Crohn disease(CD); and the data were analyzed retrospectively. The indexes including patients’ disease clinical activity scores [Mayo score, CD activity index(CDAI) score], endoscopic activity scores [UC endoscopic index of severity (UCEIS) score, Mayo endoscopic (MES) score, Baron score, CD endoscopic index of severity(CDEIS) score], changes in laboratory tests, and adverse events were compared before and 2 weeks after GMA treatment. Results After GMA treatment, the overall clinical response rate in 38 patients was 79% and remission rate was 42%; in which, the efficacy rate in 28 UC patients was 82%(n=23), and 10(36%) patients were in remission; the efficacy rate in 10 CD patients was 70% (n=7), and 6 (60%) cases were in remission. In UC patients, GMA significantly decreased Mayo score, UCEIS score, MES and Baron score. In CD patients, GMA significantly decreased CDAI score and CDEIS score(P<0.05). In all patients with IBD, GMA significantly increased the level of hemoglobin (Hb) and albumin (Alb), and reduced C-reactive protein (CRP) levels and defecate frequency (P<0.05). There was no significant difference in white blood cell (WBC), neutrophil (N)%, lymphocyte(L)%, monocyte (M)%, platelet (PLT) and erythrocyte sedimentation rate(ESR) level before and after treatment. The GMA-related severe adverse events were not observed. Conclusions GMA was effective and highly safe for the patients of moderate to severe IBD, while further randomized controlled trials in larger samples still need to be done as considering small case number in our research.

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    A retrospective study on prediction of neurological outcome in cardiac arrest patients of out-hospital
    LI Yongde, WANG Yang, LI Xiang, LI Wenjie, XIE Di, JIANG Shaowei, GE Xiaoli, WANG Hairong, GAO Chengjin, PAN Shuming
    2022, 17 (06):  447-452.  DOI: 10.16138/j.1673-6087.2022.06.005
    Abstract ( 207 )   HTML ( 1 )   PDF (586KB) ( 77 )  

    Objective To investigate the predictive power of neurological examination results and serum neuron specific enolase(NSE) concentration for the neurological outcome of cardiac arrest patients. Methods All cardiac arrest patients were retrospectively analyzed. They were divided into good outcome group [cerebral performance category (CPC)≤2] and poor outcome group (CPC≥3) according to CPC scores on day 30. According to Glasgow coma scale (GCS), serum NSE concentration, pupil light reflex, eye opening score (eGCS), limb movement score (mGCS) and the sum of two (emGCS) were compared between two groups. Repeated measures were used to evaluate the correlation, and Logistic regression analysis was used to explore the univariate and multivariate predictors. Results The serum NSE concentration in poor outcome group was significantly higher than that in good outcome group (P<0.01). The change of mGCS (Δ mGCS) and emGCS (Δ emGCS) within first 3 days in good outcome group was significantly higher than that in poor outcome group (P<0.05). Repeated measures ANOVA showed eGCS, mGCS and emGCS were significantly correlated with CPC grades(P<0.001). The analysis of generalized linear mixed model showed there was a significant correlation between absent of pupillary light reflex and poor neurological outcome (P=0.002). The eGCS, mGCS and emGCS in first 3 days, and presence of pupil light reflex on the second and third day, Δ mGCS, Δ emGCS and serum NSE levels were univariate predictors (P<0.05). Male and mGCS on day 3 were multivariate predictors (P<0.05). Conclusions The combination of male and mGCS on the 3rd day could be used to predict the poor neurological outcome in cardiac arrest patients.

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    Inverse correlation between asymptomatic erosive esophagitis and chronic active gastritis
    SUN Chao, YAO Weiyan, TANG Yuming, HUANG Jia, ZHU Ying
    2022, 17 (06):  453-456.  DOI: 10.16138/j.1673-6087.2022.06.006
    Abstract ( 162 )   HTML ( 1 )   PDF (501KB) ( 90 )  

    Objective To explore the correlation between asymptomatic erosive esophagitis (AEE) and chronic active gastritis. Methods In this case-control study, the individuals without gastroesophageal reflux symptoms underwent esophagogastroduodenoscopy for routine health checkup were included and divided into two groups. AEE group was consisted of subjects with erosive esophagitis but without gastroesophageal reflux symptoms. The control group was consisted of individuals with neither gastroesophageal reflux symptoms nor endoscopic erosive esophagitis. The demographics, gastroscopy and histopathologic results were collected. Results A total of 1 818 individuals were included in the study, including 209 subjects in AEE group and 1 609 subjects in the control group. In multivariate Logistic regression analysis, advanced age (P=0.008), higher body mass index (P<0.001) and hiatus hernia (P<0.001) were associated with an increased risk of AEE. Female(P<0.001), bile reflux (P=0.007) and chronic active gastritis (P=0.041) were associated with a decreased risk of AEE. Conclusions Chronic active gastritis exhibited inverse relationship with AEE.

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    Analysis of knowledge depth and breadth of understanding chronic heart failure in general practitioners in Shanghai and influencing factors
    ZHANG Ruixin, QU Chunyan, JIANG Jie, TONG Jianjing
    2022, 17 (06):  457-462.  DOI: 10.16138/j.1673-6087.2022.06.007
    Abstract ( 143 )   HTML ( 4 )   PDF (889KB) ( 124 )  

    Objective To investigate the knowledge depth and breadth of understanding the chronic heart failure in general practitioners in Shanghai community healthcare center, analyze the influencing factors, and to provide a scientific basis for the prevention and treatment of heart failure in the future. Methods Based on the“Guidelines for Primary Diagnosis and Treatment of Chronic Heart Failure (2019)”, a questionnaire was designed, and it covered the definition and epidemiology of heart failure, etiology and pathogenesis, diagnostic evaluation, drug therapy, and non-drug management. The questionnaire was conducted on general practitioners working in 10 community health service centers in Shanghai from May to June 2021, the demographic characteristics of the study subjects was collected, the knowledge depth and breadth of understanding chronic heart failure was investigated, and the influencing factors were analyzed. Results The average score of 136 primary doctors on the knowledge test of heart failure was (63.5±11.2) points, and the pass rate was 52.2%(71/136); in which, the correct rate of understanding the heart failure of preserved ejection fraction, the use of three new anti-heart failure drugs, the vulnerable period of heart failure and the management of water and sodium were less than 50 percent, while the remaining parts was greater than 50.0%. Consulting with a cardiologist, participating the heart failure-related training in past 2 years, and studying the“Guidelines” were independent influencing factors(P<0.05). Conclusions This study showed that the general practitioners in Shanghai overall have a good understanding of chronic heart failure knowledge, but they still need to improve understanding of heart failure of preserved ejection fraction, the use of new anti-heart failure drugs, and the comprehensive management of heart failure patients.

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    Review article
    Progress of novel antibody-like drugs in treatment of acute B lymphoblastic leukemia
    REN Jiayi, MI Jianqing
    2022, 17 (06):  463-467.  DOI: 10.16138/j.1673-6087.2022.06.008
    Abstract ( 173 )   HTML ( 1 )   PDF (583KB) ( 237 )  
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    Recent advances using orelabrutinib in the treatment of mantle cell lymphoma
    YU Lingling, WU Tao, BAI Hai
    2022, 17 (06):  468-470.  DOI: 10.16138/j.1673-6087.2022.06.009
    Abstract ( 132 )   HTML ( 3 )   PDF (333KB) ( 161 )  
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    Progress of research on Niemann-Pick disease type A and type B
    QIAN Lan, WU Tao
    2022, 17 (06):  471-474.  DOI: 10.16138/j.1673-6087.2022.06.010
    Abstract ( 150 )   HTML ( 0 )   PDF (467KB) ( 119 )  
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    Geometric deep learning and computational medicine research prospects of “preventing disease” in pre diabete
    RUAN Ming, HOU Tianzhichao, WANG Haiyan, et al
    2022, 17 (06):  475-481.  DOI: 10.16138/j.1673-6087.2022.06.011
    Abstract ( 355 )   HTML ( 6 )   PDF (830KB) ( 467 )  
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    Progress of research on complement-C1q/tumor necrosis factor-related protein and metabolism-related disease
    QIN Xue, GUO Hua, ZHANG Yunyun, et al
    2022, 17 (06):  482-485.  DOI: 10.16138/j.1673-6087.2022.06.012
    Abstract ( 143 )   HTML ( 1 )   PDF (445KB) ( 171 )  
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    Novel coronavirus infection: a new challenge for the management of thyroid disease
    XIANG Pingping, LIU Chao
    2022, 17 (06):  486-490.  DOI: 10.16138/j.1673-6087.2022.06.013
    Abstract ( 154 )   HTML ( 2 )   PDF (531KB) ( 699 )  
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    Medical education