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Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical

Meng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo

《医学前沿（英文）》 2019年 第13卷 第6期   页码 667-679 doi: 10.1007/s11684-019-0702-z

摘要： Chronic graft-versus-host disease (cGVHD) is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia ( =280). The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria. A total of 169 patients suffered from cGVHD. The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD (total, 66.0% vs. 53.7%, =0.031; moderate to severe, 42.4% vs. 30.1%, =0.036) than the patients who had 1 to 2 loci mismatched. The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD (49.2% vs. 32.9%, =0.024) compared with the patients who had other donors. The patients who had grades III to IV acute GVHD (aGVHD) had higher 8-year incidence of cGVHD (total, 88.0% vs. 50.4%, <0.001; moderate to severe, 68.0% vs. 27.0%, <0.001) compared with the patients without aGVHD. In multivariate analysis, grades III to IV aGVHD was the only independent risk factor for cGVHD. Thus, further interventions should be considered in patients with severe aGVHD to prevent cGVHD.

关键词： acute graft-versus-host disease     chronic graft-versus-host disease     National Institutes of Health consensus criteria     acute myeloid leukemia     anti-thymocyte globulin    

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免疫调节细胞生物学及其在急性移植物抗宿主病预防或治疗中的临床应用 Review

Bruce R. Blazar

《工程（英文）》 2019年 第5卷 第1期   页码 98-105 doi: 10.1016/j.eng.2018.11.016

摘要：

预防和治疗移植物抗宿主病（GVHD）最常见的方法是尝试耗竭或抑制能介导或支持同种异体反应的T细胞；但这会导致T细胞受体功能缺陷，并因此对感染和肿瘤复发高度敏感。通常通过广泛使用反应性抗体来实现耗竭，而功能损坏通常在使用需长期给药（一般为6个月或更长时间）且具有明显副作用的药物后发生，这种药物可能不会导致供体T细胞对耐调节方案且携带宿主同种抗原的细胞产生耐受性（即无反应性）。随着对免疫系统稳态认识的深化，我们已能鉴定和表征具有免疫调节功能的细胞群。虽然这种细胞群通常比较少见，但可通过分离和扩增此类细胞的方法在移植后晚期增补供体移植物或进行输注，来抑制GVHD。本文将探讨GVHD模型中的生物学和临床前概念验证，以及现已发展至临床测试阶段的免疫调节细胞疗法对GVHD的疗效。

关键词： 移植物抗宿主病（GVHD）     免疫调节细胞     细胞疗法    

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Graft versus host disease after liver transplantation: A case report

Peng-Ji GAO, Xi-Sheng LENG, Dong WANG, Guang-Ming LI, Lei HUANG, Jie GAO, JI-Ye ZHU,

《医学前沿（英文）》 2010年 第4卷 第4期   页码 469-472 doi: 10.1007/s11684-010-0120-8

摘要： In documenting clinical experience in the diagnosis and treatment of graft host disease (GVHD), we retrospectively analyzed data of one case that has developed GVHD after liver transplantation. This patient exhibited fever, skin rash, and diarrhea on day 9 after liver transplantation. His liver function was normal. Skin biopsy showed scattered keratinocytes accompanied by satellite-like lymphocyte infiltration and basal cell liquefaction degeneration. After carefully analyzing the complications, we took the strategy of decreasing the dose of tacrolimus. Thereafter, the patient’s temperature decreased to normal, his skin rashes subsided, and his diarrhea was relieved. This case suggests that reducing the dosage of immunosuppressive agents can be an effective strategy for GVHD after liver transplantation.

关键词： liver transplantation     graft versus host disease    

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Everyone has a donor: contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation

Meng Lv, Yingjun Chang, Xiaojun Huang

《医学前沿（英文）》 2019年 第13卷 第1期   页码 45-56 doi: 10.1007/s11684-017-0595-7

摘要： Human leukocyte antigen (HLA)-matched donors for hematopoietic stem cell transplantation (HSCT) have long been scarce in China. Haploidentical (haplo) donors are available for the vast majority of patients, but toxicity has limited this approach. Three new approaches for haplo-HSCT originated from Italy, China, and USA in 1990 and have been developed to world-renowned system up to now. The Chinese approach have been greatly improved by implementing new individualized conditioning regimens, donor selection based on non-HLA systems, risk-directed strategies for graft-versus-host disease and relapse, and infection management. Haplo-HSCT has exhibited similar efficacy to HLA-matched HSCT and has gradually become the predominant donor source and the first alternative donor choice for allo-HSCT in China. Registry-based analyses and multicenter studies adhering to international standards facilitated the transformation of the unique Chinese experience into an inspiration for the refinement of global practice. This review will focus on how the new era in which “everyone has a donor” will become a reality in China.

关键词： haploidentical hematopoietic stem cell transplantation     conditioning     graft-versus-host disease     relapse     infection     donor selection    

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Gene and protein expression of proteinase-activated receptor-1, 2 in a murine model of acute graft hostdisease

Quan LI MD , Weiming LI MD , Ping ZOU MD , Jian ZHANG BM ,

《医学前沿（英文）》 2009年 第3卷 第3期   页码 309-315 doi: 10.1007/s11684-009-0043-4

摘要： Proteinase-activated receptors (PARs) are a novel subclass of seven transmembrane-spanning, G protein-coupled receptors. PAR-1 and PAR-2 are widely expressed in a variety of cells and are found to be involved in many physiological and pathological processes including inflammation and immune response. However, little is known about the function of PAR-1, 2 in acute graft host disease (GVHD). In the present study, we first detected the expression of PAR-1, 2 protein and mRNA in a murine model of acute GVHD using the methods of immunohistochemistry, Western blot and quantitative real-time polymerase chain reaction (PCR). Syngeneic hematopoietic stem cell transplantation (HSCT) mice served as controls. The relative gene expression level of PAR-1 was significantly increased in the skin, liver, small intestine of allogeneic HSCT mice (in skin: 0.039±0.013 0.008±0.002 of controls, =0.009; in liver: 0.165±0.006 0.017±0.006 of controls, =0.004; in small intestine: 0.215±0.009 0.016±0.002 of controls, =0.003), but not in the stomach, lung and kidney of allogeneic HSCT mice (>0.05). PAR-2 mRNA expression in the liver and small intestine of allogeneic HSCT mice (in liver: 0.010±0.002 0.003±0.001 of controls, =0.008; in small intestine: 0.006±0.001 0.003±0.001 of controls, =0.024) was increased significantly, but PAR-2 mRNA expression in the other organs (>0.05) was not found to be significantly elevated. PAR-1, 2 protein expression was in accordance with the mRNA expression, as shown by Western blot. Using immunohistochemistry the present study demonstrated that there was strong PAR-1, 2 immunoreactivity in the epithelial cell and vascular endothelial cell of target organs of acute GVHD. Our findings of markedly increased expression of PAR-1, 2 in target organs of acute GVHD suggest that PAR-1 and PAR-2 may play an important role in the pathogenesis of acute GVHD.

关键词： graft vs host disease     proteinase-activated receptor     murine model     hematopoietic stem cell transplantation    

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Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype

null

《医学前沿（英文）》 2013年 第7卷 第4期   页码 425-432 doi: 10.1007/s11684-013-0295-x

摘要：

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality throughout the world and is mainly characterized by persistent airflow limitation. Given that multiple systems other than the lung can be impaired in COPD patients, the traditional FEV1/FVC ratio shows many limitations in COPD diagnosis and assessment. Certain heterogeneities are found in terms of clinical manifestations, physiology, imaging findings, and inflammatory reactions in COPD patients; thus, phenotyping can provide effective information for the prognosis and treatment. However, phenotypes are often based on symptoms or pathophysiological impairments in late-stage COPD, and the role of phenotypes in COPD prevention and early diagnosis remains unclear. This shortcoming may be overcome by the potential genotypes defined by the heterogeneities in certain genes. This review briefly describes the heterogeneity of COPD, with focus on recent advances in the correlations between genotypes and phenotypes. The potential roles of these genotypes and phenotypes in the molecular mechanisms and management of COPD are also elucidated.

关键词： chronic obstructive pulmonary disease     heterogeneity     phenotype     genotype     prediction    

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Exploration of Strategies for Chronic Disease Prevention and Control and Relevant System Development

Long-de Wang

《工程管理前沿（英文）》 2015年 第2卷 第1期   页码 2-12 doi: 10.15302/J-FEM-2015002

摘要： Chronic non-communicable diseases have become a major threat to humanity. International studies have shown that of 57 million deaths worldwide in 2008, 36 million (63%) were caused by chronic non-communicable diseases; of these, 29 million (80%) occurred in low and middle income countries. The WHO predicts that if the current trend continues, the annual number of deaths due to chronic non-communicable diseases will increase to 55 million by 2030. Due to acceleration of industrialization and urbanization, along with population aging and rapid changes of people’s lifestyle, the morbidity and mortality from chronic diseases are rapidly increasing in China. Therefore, dealing with the prevalence of chronic non-communicable diseases has become one of the current major health issues for China to address. On the basis of summarizing the status of major chronic diseases in China, analyzing the key issues and key factors in chronic disease prevention and control, and reviewing and summarizing the experience from the previous projects, this paper proposes the following recommendations as strategies for chronic disease prevention and control and development of relevant system, which China should adopt. All relevant government departments should formulate corresponding policies; establish a coordinated and efficient work system with rational structure and clear division of tasks and responsibilities within the system. Implementation and development of “integrated medicine” in system is necessary. Work norms and requirements will then improve the performance and efficiency in chronic disease prevention and control in China.

关键词： chronic disease prevention and control     strategy and system construction    

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Identification of differentially expressed miRNAs associated with chronic kidney disease–mineral bone

null

《医学前沿（英文）》 2017年 第11卷 第3期   页码 378-385 doi: 10.1007/s11684-017-0541-8

摘要：

The purpose of this study is to characterize a meta-signature of differentially expressed mRNA in chronic kidney disease (CKD) to predict putative microRNA (miRNA) in CKD–mineral bone disorder (CKD–MBD) and confirm the changes in these genes and miRNA expression under uremic conditions by using a cell culture system. PubMed searches using MeSH terms and keywords related to CKD, uremia, and mRNA arrays were conducted. Through a computational analysis, a meta-signature that characterizes the significant intersection of differentially expressed mRNA and expected miRNAs associated with CKD–MBD was determined. Additionally, changes in gene and miRNA expressions under uremic conditions were confirmed with human Saos-2 osteoblast-like cells. A statistically significant mRNA meta-signature of upregulated and downregulated mRNA levels was identified. Furthermore, miRNA expression profiles were inferred, and computational analyses were performed with the imputed microRNA regulation based on weighted ranked expression and putative microRNA targets (IMRE) method to identify miRNAs associated with CKD occurrence. TLR4 and miR-146b levels were significantly associated with CKD–MBD. TLR4 levels were significantly downregulated, whereas pri-miR-146b and miR-146b were upregulated in the presence of uremic toxins in human Saos-2 osteoblast-like cells. Differentially expressed miRNAs associated with CKD-MBD were identified through a computational analysis, and changes in gene and miRNA expressions were confirmed with an in vitro cell culture system.

关键词： chronic kidney disease     microRNA     mineral bone disorder     uremia    

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中国慢性病防控策略和体系建设探索

王陇德

《中国工程科学》 2014年 第16卷 第10期   页码 22-30

摘要：

慢性非传染性疾病已成为当前人类的重大威胁。国际研究表明，2008 年全球5 700 万人死亡，其中的63 %（3 600 万人）死于慢性非传染性疾病；80 %的非传染性疾病所致死亡（2 900 万人）发生在低收入和中等收入国家。WHO预测，如果按目前的情况继续发展，到2030 年每年死于慢性非传染性疾病的人数将增加至5 500 万人。在中国，伴随着工业化、城镇化、老龄化进程的加快和国民生活方式的快速变迁，居民慢性病患病率、死亡率呈持续快速增长趋势。因此，慢性非传染性疾病流行的应对，是中国当前必须尽快考虑的重大问题。本文在总结中国重大慢性病流行状况、分析中国慢性病防控中存在的主要问题和关键影响因素以及总结前期项目探索经验的基础上，对中国慢性病防控应制定和采取的策略及防控体系建设工作要点提出了建议：如相关政府部门都应制定相应政策；建立结构合理、系统内任务分工明确，协调、高效的工作体系；从制度、工作规范与要求上推行“整合医学”的发展，从而提高中国慢性病防控工作效能与效益等。

关键词： 慢性病防控     策略与体系建设    

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Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronicobstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study

null

《医学前沿（英文）》 2014年 第8卷 第3期   页码 368-375 doi: 10.1007/s11684-014-0360-0

摘要：

This study aimed to evaluate the efficacy of comprehensive therapy based on traditional Chinese medicine (TCM) patterns on older patients with chronic obstructive pulmonary disease (COPD) through a four-center, open-label, randomized controlled trial. Patients were divided into the trial group treated using conventional western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on TCM patterns respectively; and the control group treated using conventional western medicine. A total of 136 patients≥65 years completed the study, with 63 patients comprising the trial group and 73 comprising the control group. After the six-month treatment and the 12-month follow-up period, significant differences were observed between the trial and control groups in the following aspects: frequency of acute exacerbation (P≤0.040), duration of acute exacerbation (P = 0.034), symptoms (P≤0.034), 6-min walking distance (6MWD) (P≤0.039), dyspnea scale (P≤0.036); physical domain (P≤0.019), psychological domain (P≤0.033), social domain (P≤0.020), and environmental domain (P≤0.044) of the WHOQOL-BREF questionnaire; and daily living ability domain (P≤0.007), social activity domain (P≤0.018), depression symptoms domain (P≤0.025), and anxiety symptoms domain (P≤0.037) of the COPD-QOL. No differences were observed between the trial and control groups with regard to FVC, FEV1, and FEV1%.

关键词： chronic obstructive pulmonary disease     older adult     clinical trial     Bu-Fei Jian-Pi granules     Bu-Fei Yi-Shen granules     Yi-Qi Zi-Shen granules    

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Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

null

《医学前沿（英文）》 2017年 第11卷 第1期   页码 110-119 doi: 10.1007/s11684-016-0484-5

摘要：

This study aims to investigate the link between glycated hemoglobin and diabetic complications with chronic periodontitis. A total of 207 patients with type 2 diabetes and chronic periodontitis (CP) were divided according to tertiles of mean PISA (periodontal inflamed surface area) scores as low, middle and high PISA groups. Simultaneously a group of 67 periodontally healthy individuals (PH) was recruited. Periodontal examinations, including full-mouth assessment of probing depths (PPD), bleeding on probing, clinical attachment level and plaque scores were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2 h post parandial glucose (PPG). Individuals in PH group had significantly better glycemic control than CP group. Upon one-way analysis of variance, subjects with increased PISA had significantly higher HbA1c levels, retinopathy and nephropathy (P<0.05). After controlling for age, gender, body mass index (BMI), socioeconomic status (SES), family history of diabetes and periodontitis, duration of diabetes, the mean PISA in mm2, PPD 4--6 mm (%) and PPD≥7 mm (%) emerged as significant predictors for elevated HbA1c in regression model (P<0.05). Logistic regression analysis revealed that PISA was associated with higher risk of having retinopathy and neuropathy (odds ratio). In our study, the association between glycemic control and diabetic complications with periodontitis was observed.

关键词： type 2 diabetes mellitus     hemoglobin A     glycated     chronic periodontitis    

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Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults

《医学前沿（英文）》 doi: 10.1007/s11684-023-1019-5

摘要： Studies have found a U-shaped relationship between sleep duration and chronic kidney disease (CKD) risk, but limited research evaluated the association of reallocating excessive sleep to other behavior with CKD. We included 104 538 participants from the nationwide cohort of the Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study, with self-reported time of daily-life behavior. Using isotemporal substitution models, we found that substituting 1 h of sleeping with sitting, walking, or moderate-to-vigorous physical activity was associated with a lower CKD prevalence. Leisure-time physical activity displacement was associated with a greater prevalence reduction than occupational physical activity in working population. In stratified analysis, a lower CKD prevalence related to substitution toward physical activity was found in long sleepers. More pronounced correlations were observed in long sleepers with diabetes than in those with prediabetes, and they benefited from other behavior substitutions toward a more active way. The U-shaped association between sleep duration and CKD prevalence implied the potential effects of insufficient and excessive sleep on the kidneys, in which the pernicious link with oversleep could be reversed by time reallocation to physical activity. The divergence in the predicted effect on CKD following time reallocation to behavior of different domains and intensities and in subpopulations with diverse metabolic statuses underlined the importance of optimizing sleeping patterns and adjusting integral behavioral composition.

关键词： sleep     physical activity     chronic kidney disease     isotemporal substitution     behavioral pattern    

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Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study

null

《医学前沿（英文）》 2015年 第9卷 第3期   页码 356-360 doi: 10.1007/s11684-015-0404-0

摘要：

Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.

关键词： distal pancreatectomy     pancreatic neoplasm     robotic surgery    

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Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran

null

《医学前沿（英文）》 2016年 第10卷 第3期   页码 345-350 doi: 10.1007/s11684-016-0462-y

摘要：

Asthma is the most common chronic disease among children, and its incidences are often imminent among elementary schoolchildren. This study aimed to examine the prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran. The prevalence rate was compared according to age group (aged 6–7 years vs. aged 13–14 years) and gender (male vs. female). In this cross-sectional study, 1706 Iranian schoolchildren aged 6–7 and 13–14 years in Golestan Province were enrolled. Participants completed questionnaires between February and July 2014. Asthma symptoms were assessed using the questionnaire of the International Study of Asthma and Allergies in Childhood protocol in Persian. The logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the asthma symptoms for each of the gender and age groups. The prevalence rates of “current asthma” symptoms and “asthma ever” in all the children were estimated as 9.5% and 7.5%, respectively. The prevalence of asthma (“asthma ever” and “wheezing in the past 12 months”) in junior high schoolchildren (aged 13–14 years) is higher than that in elementary schoolchildren (aged 6–7 years) (P <0.05). The prevalence of the severity of wheezing in girls is lower than that in boys (OR= 1.7, 95%CI= 1.06–2.96, P = 0.02). Asthma is still a major public health problem. This study shows that the prevalence of the asthma symptoms in boys is lower than that in girls in both age groups, and the severity of asthma in girls is higher than that in boys aged 13–14 years.

关键词： asthma     asthma symptoms     epidemiology     childhood     chronic disease    

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国外重大慢性非传染性疾病防治对策研究

张祝琴,刘德培

《中国工程科学》 2017年 第19卷 第2期   页码 112-116 doi: 10.15302/J-SSCAE-2017.02.019

摘要：

重大慢性非传染性疾病包括心脑血管疾病、癌症、呼吸系统疾病、糖尿病等，其流行给全球居民健康造成了重大威胁。为进一步对慢性病进行有效预防控制，促进健康、推动经济和社会发展，2014年中国工程院立项并开展了“重大慢性非传染性疾病防治的国际对比研究”项目，对国内外慢性病预防控制情况以及可供我们借鉴的经验进行了详细分析。本文从慢性病发病概况入手，分析了各种疾病的预防控制措施，并对不同国家的慢性病预防控制体系进行比较，凝练有益经验和方法，提出了增强我国慢性病预防控制的措施和建议。

关键词： 慢性病     心脑血管疾病     癌症     呼吸系统疾病     糖尿病     疾病预防控制体系    

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标题 作者 时间 类型 操作

Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical

Meng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo

期刊论文

免疫调节细胞生物学及其在急性移植物抗宿主病预防或治疗中的临床应用

Bruce R. Blazar

期刊论文

Graft versus host disease after liver transplantation: A case report

Peng-Ji GAO, Xi-Sheng LENG, Dong WANG, Guang-Ming LI, Lei HUANG, Jie GAO, JI-Ye ZHU,

期刊论文

Everyone has a donor: contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation

Meng Lv, Yingjun Chang, Xiaojun Huang

期刊论文

Gene and protein expression of proteinase-activated receptor-1, 2 in a murine model of acute graft hostdisease

Quan LI MD , Weiming LI MD , Ping ZOU MD , Jian ZHANG BM ,

期刊论文

Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype

null

期刊论文

Exploration of Strategies for Chronic Disease Prevention and Control and Relevant System Development

Long-de Wang

期刊论文

Identification of differentially expressed miRNAs associated with chronic kidney disease–mineral bone

null

期刊论文

中国慢性病防控策略和体系建设探索

王陇德

期刊论文

Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronicobstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study

null

期刊论文

Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

null

期刊论文

Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults

期刊论文

Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study

null

期刊论文

Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran

null

期刊论文

国外重大慢性非传染性疾病防治对策研究

张祝琴,刘德培

期刊论文