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Impact of conditioning regimen on peripheral blood hematopoietic cell transplant

World Journal of Clinical Oncology 2019年第2期10卷 86-97页

作者： Michael burns Anurag K singh Carrie C Hoefer yali Zhang Paul K Wallace George L Chen alexis Platek Timothy b Winslow Austin J Iovoli Christopher Choi Maureen Ross Philip L McCarthy Theresa Hahn Department of Medicine Roswell Park Comprehensive Cancer Center Department of Radiation Medicine Roswell Park Comprehensive Cancer Center Department of Flow Cytometry Roswell Park Comprehensive Cancer Center Center for Immunotherapy Roswell Park Comprehensive Cancer Center

AIM To investigate infused hematopoietic cell doses and their interaction with conditioning regimen intensity +/-total body irradiation(TbI) on outcomes after peripheral blood hematopoietic cell transplant(PbHCT).METHODs Our retrospective cohort included 247 patients receiving a first, T-replete, human leukocyte antigen-matched allogeneic PbHCT and treated between 2001 and2012. Correlations were calculated using the Pearson product-moment correlation coefficient. Overall survival and progression free survival curves were generated using the Kaplan-Meier method and compared using the log-rank *** Neutrophil engraftment was significantly faster after reduced intensity TbI based conditioning [reduced intensity conditioning(RIC) + TbI] and > 4 × 10~6 CD34+cells/kg infused. A higher total nucleated cell dose led to a higher incidence of grade II-IV acute graft-versus-host disease in the myeloablative + TbI regimen group(P = 0.03), but no significant difference in grade III-IV graft-versus-host disease. A higher total nucleated cell dose was also associated with increased incidence of moderate/severe chronic graft-versus-host disease, regardless ofconditioning regimen. Overall and progression-free survival were significantly better in patients with a RIC + TbI regimen and total nucleated cell dose > 8 ×10~8/kg(3 years, overall survival: 70% vs 38%, P = 0.02, 3 years, progression free survival: 64% vs 38%, P = 0.02).CONCLUsION TbI and conditioning intensity may alter the relationship between infused cell doses and outcomes after PbHCT. Immune cell subsets may predict improved survival after unmanipulated PbHCT.

关键词： Total body radiation Peripheral blood hematopoietic cell transplant Total nucleated dose Neutrophil engraftment Graft-versus-host-disease

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Immunoglobulin G specific Antibody Level against Ebola Viral Glycoprotein and Nucleoprotein in Ebola Virus Disease survivors and Their Relatives

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Journal of biosciences and Medicines 2021年第4期9卷 179-196页

作者： Nadège Goumkwa Mafopa Raoul Emeric Guetiya Wadoum Marta Giovanetti Antonella Minutolo béatrice Dambaya Claude Kwe yinda Gianluca Russo Georges Teto Georgia Ambada Patrick Turay Judith Torimiro alexis Ndjolo Jules Roger Kuate Vittorio Colizzi Carla Montesano Chantal bIyA International Reference Centre for Research on HIV/AIDs Prevention and Management Yaoundé Cameroon University of Roma “Tor Vergata” Rome Italy Department of biochemistry University of Dschang Dschang Cameroon Departement of Public Health University of Makeni Makeni Sierra Leone National Institute of Health—Iss Rome Italy Faculty of science University of Yaoundé I Yaoundé Cameroon Intramural Research Program National Institute of Health Bethesda Maryland USA University di Roma “sapienza” Rome Italy Holy spirit Hospital Makeni Makeni Sierra Leone Faculty of Medicine and biomedical sciences University of Yaoundé I Yaoundé Cameroon

Ebola virus disease is a complex zoonosis that is highly virulent in humans. Despite its sorely pathogenic and lethal nature, survivors of this infection and even asymptomatic cases are able to develop both humoral and cellular immunity against several Ebola virus (EbOV) proteins. We aimed at determining immunoglobulin G (IgG) antibodies level against two Ebola viral antigens, the glycoprotein and the nucleoprotein in Ebola survivors and their relatives. Anti-EbOV glycoprotein (GP) and nucleoprotein (NP) IgG antibodies were quantified using ELIsA. We enrolled 199 participants in two different sites as follow: 91 survivors at the Loreto clinic and 70 survivors with 38 relatives of sierra Leone Association of Ebola survivors bombali branch (sLAEsb) tested for anti-EbOV NP and anti-EbOV GP IgG antibodies. Our findings revealed that the median anti-EbOV IgG level among survivors was 5.7128 U/ml [IQR: 2.793 - 7.783] for anti-EbOV GP IgG and 4.431 U/ml [IQR: 2.083 - 7.696] for anti-EbOV NP IgG. survivors relatives had a median anti-EbOV GP IgG level of ?0.7128 U/ml [IQR: -0.903 to -0.04327] and -2.711 U/ml [IQR: -4.01 to -1.918] for anti-EbOV NP IgG. We observed that IgG levels in survivors were higher than in relatives with a significant difference of about 0.0001. The median value of anti-EbOV IgG level among seropositive relatives was 0.7043 U/ml [IQR: 0.5686 to 3.716] for anti-EbOV GP IgG and 4.05 U/ml [IQR: 0.2765 to 7.759] for anti-EbOV NP IgG respectively. Interestingly, we observed that 3.30% of Loreto clinic survivors did not developed anti-EbOV NP IgG antibodies;also about 10% survivors of the sLAEsb were not reactive to anti-EbOV NP IgG and 1.43% of these survivors did not express antibodies against the Ebola viral glycoprotein. Our work is consistent with previous published studies showing heterogeneity in both survivors and asymptomatic cases of Ebola infection developing adaptive immunity against EbOV proteins.

关键词： Immunoglobulin IgG Level Ebola survivors and Relatives Glycoprotein and Nucleoprotein

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Hepatitis b virus infection in Latin America:A genomic medicine approach

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World Journal of Gastroenterology 2014年第23期20卷 7181-7196页

作者： sonia Roman alexis Jose-Abrego Nora Alma Fierro Griselda Escobedo-Melendez Claudia Ojeda-Granados Erika Martinez-Lopez Arturo Puro Department of Molecular biology in Medicine Civil Hospital of Guadalajara "Fray Antonio Alcalde" and University of GuadalajaraGuadalajaraJalisco 44280Mexico Immunovirology Unit Department of Molecular Biology in MedicineCivil Hospital of Guadalajara "Fray Antonio Alcalde" and University of GuadalajaraGuadalajaraJalisco 44280Mexico Viral Hepatitis Clinic Pediatric Infectious Disease UnitDepartment of Pediatric Hematology and OncologyCivil Hospital of Guadalajara "Juan I.Menchaca" and University of GuadalajaraGuadalajaraJalisco 44280Mexico

Hepatitis b virus(HbV)infection is the leading cause of severe chronic liver *** article provides a critical view of the importance of genomic medicine for the study of HbV infection and its clinical outcomes in Latin *** levels of evolutionary adaptation may correlate with the clinical outcomes of HbV *** in Latin America are predominantly of genotype H in Mexico and genotype F in Central and south America;these strains have historically circulated among the indigenous *** genotypes appear to be linked to a benign course of disease among the native and mestizo Mexicans and native south *** contrast,genotypes F,A and D are common in acute and chronic infections among mestizos with Caucasian *** carcinoma is rare in Mexicans,but it has been associated with genotype F1b among *** observation illustrates the significance of ascertaining the genetic and environmental factors involved in the development of HbV-related liver disease in Latin America,which contrast with those reported in other regions of the world.

关键词： Genomic medicine Hepatitis b virus Hepatitis b vir

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中国农村医生医疗服务质量的测量——基于标准化病人法的实验研究

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劳动经济研究 2016年第2期4卷 48-71页

作者：史耀疆薛浩王欢 sean sylvia alexis Medina scott Rozelle 陕西师范大学教育实验经济研究所中国人民大学经济学院斯坦福大学弗里曼-斯波格利国际问题研究所

过去十年中,中国政府在农村地区进行了一系列的医疗改革,这些改革极大地提高了医疗服务的可及性,但却很少关注医疗服务的质量。本文采用标准化病人法,测量和评估中国农村基层医疗服务的质量。我们招募样本地区的农民作为"标准化病人",... 详细信息

过去十年中,中国政府在农村地区进行了一系列的医疗改革,这些改革极大地提高了医疗服务的可及性,但却很少关注医疗服务的质量。本文采用标准化病人法,测量和评估中国农村基层医疗服务的质量。我们招募样本地区的农民作为"标准化病人",培训他们稳定地展示小儿痢疾和心绞痛这两种常见疾病的症状。基于标准化病人在村卫生室的就诊案例,我们发现作为基层医疗服务第一线的村医可能无法给患者提供高质量的医疗服务。村医在诊断过程中仅完成了18%的建议问诊条目,诊断正确率仅为26%;在所有开具处方的病例中,有64%的药物是不必要的,甚至是有害的。进一步分析表明,医疗服务质量与医生的受教育水平和是否获得医疗资格证书密切相关。此外,我们发现农民患者并不能很好地识别出哪些医生是相对好的医生,这样的医患信息不对称的情况可能使村医更加缺乏提高医疗服务质量的激励。研究结果建议政府在投资硬件改善基层医疗服务设施的同时,应更加注重提高农村医生的诊断和治疗水平。

关键词：农村医疗医疗服务质量标准化病人法

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南海台风“悟空2000”生成及发展的数值模拟

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北京大学学报（自然科学版） 2008年第5期44卷 773-780页

作者：伊炳祺刘启汉梁爱民张庆红北京大学物理学院大气科学系北京100871 香港科技大学环境实验所/环境研究所民航北京气象中心北京100621

应用NCAR/PsU中尺度非静力模式MM5模拟了南海台风"悟空2000"从一个热带扰动发展为强台风的过程。模拟结果表明,MM5模式能够很好地模拟出"悟空2000"台风的强度和最大风速,清晰显示出南海台风发展中具有的阶段性和爆发性。从水汽和位涡等... 详细信息

应用NCAR/PsU中尺度非静力模式MM5模拟了南海台风"悟空2000"从一个热带扰动发展为强台风的过程。模拟结果表明,MM5模式能够很好地模拟出"悟空2000"台风的强度和最大风速,清晰显示出南海台风发展中具有的阶段性和爆发性。从水汽和位涡等诊断量的分析出发,分析了模拟的台风结构和台风眼生成的可能影响因素。敏感性试验结果显示,南海海面温度对台风发生发展有至关重要的作用:如果海表温度降低1℃,模拟的台风最大风速将降低近10m/s,风速达到台风级别(32.8m/s)的时间推迟约7个小时;如果海表温度降低2℃(ssT仍高于26.5℃),该热带扰动将不能发展到台风的强度。

关键词： “悟空2000” 台风眼海温

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Assessment of surface Water Quality of bétaré-Oya Gold Mining Area (East-Cameroon)

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Journal of Water Resource and Protection 2017年第8期9卷 960-984页

作者： Felaniaina Rakotondrabe Jules Remy Ndam Ngoupayou Zakari Mfonka Eddy Harilala Rasolomanana alexis Jacob Nyangono Abolo banakeng Lucian Asone Andrew Ako Ako Miora Harivony Rakotondrabe Department of Earth sciences Faculty of Science University of Yaoundé 1 Yaoundé Cameroon Department of Mines Advanced School of Engineering of Antananarivo University of Antananarivo Antananarivo Madagascar Institute of Geological and Mining Research (IRGM) Hydrological Research Centre Yaoundé Cameroon

To assess the water quality in the locality of bétaré-Oya affected by an intensive artisanal and semi mechanized mining activities, 71 samples were collected from sixteen points during the 2015-2016 hydrological year. These points include: three in Lom river which is the main stream of the study area, five in Mari river which is one of the left bank tributaries of the Lom, in bétaré-Oya and eight in the left and the right bank of Mari. Different physicochemical parameters such as pH, electrical conductivity (EC), alkalinity, turbidity, total suspended solids (Tss), cyanide (CN-), major elements and heavy metals (Pb, Zn, Cd, Fe, Cu, As, Mn and Cr) were analyzed. Water Quality Indices (WQI), Heavy metal Pollution Index (HPI), sodium adsorption ratio (sAR) and percent sodium (Na%) were also computed to evaluate the suitability of water for drinking and irrigation. The results showed that the surface water from bétaré-Oya was acidic to basic (5.40 y mineralized (11.60 s/cm) with a high concentration of Tss (2 ss bidity (1.22 to 4758.00 NTU). The WQI scores show excellently to unsuitable quality in almost all the sampling sites. The water quality is found to be most deteriorated in Lom river and in the downstream of Mari river where an extensive mining activity is carried out, with the high WQI value of 5137.40. based on heavy metal pollution index, the mean value was 1195.36 and thus under the critical pollution index. We thus notice a serious physical degradation by organic and mineral suspended particles as well as chemical degradation by heavy metals. This results from mining activities in the Lom river and its main tributaries such as the Mari river in the upstream part of the sanaga basin. According to the percentage of sodium and sAR, these waters can be used for irrigation purposes in almost all types of soils.

关键词： bétare-Oya in East Cameroon Hydrochemistry Gold Mining Water Quality Index Heavy Metal Pollution Index

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Episiotomy: Epidemiological Aspects, Indications and Prognosis in the bogodogo Health District

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1354-1363页

作者： Ouattara Adama Lankoandé bako Natacha Ouédraogo smaila sawadogo yobi alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba bonané blandine Training and Research Unit in Health sciences (TRU/Hs) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objectives: To study the epidemiological aspects, indications and short and medium term prognosis of episiotomy in the health district of bogodogo in Ouagadougou, burkina Faso. Materials and Method: It was a descriptive prospective study over 4 months from 1 July 2016 to 30 October 2016. It was conducted in 4 health facilities in the health district of bogodogo in the city of Ouagadougou. The study concerned the patients who gave birth after 28 gestational age (GA) and more, vaginally with episiotomy, in the 4 health facilities and who were reviewed at the appointment of the 9th day and the 3rd month. The data were collected using a questionnaire developed for the purposes of the study, seized with a laptop, then analyzed using the Epi-info software in its 3.5.1 version of the Atlanta C.D.C. statistical comparisons were made using the Pearson chi-square test, with a significance level of p 0.05. Results: The overall episiotomy rate was 22%. For follow-up, 248 patients were reviewed on the 9th day and 109 patients on the 3rd month. The average age of our patients was 23.1 years. The average number of pregnancies was 1.7 with nulliparous women predominating (60.5% of cases). Excision was associated with episiotomy in 92.3% of cases, with perineal narrowing in 82.5% of patients. The mediolateral episiotomy was the most performed, in 76.6% of patients. Vulvo-perineal stricture was the main indication (75% of cases). The experience during the episiotomy and the evolution following the immediate layer was marked by pain. Dyspareunia was the main difficulty in resuming sexual intercourse. Conclusion: The episiotomy rate in our study was 22%. A program of continuous improvement of the quality of care concerning episiotomy encompassing various actions (audits, training) could reduce the use of episiotomies.

关键词： Episiotomy Epidemiology bogodogo

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圭亚那乔治敦公立医院院内感染与抗生素的耐药分析——附1351份各类标本细菌培养检出分析

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抗感染药学 2006年第2期3卷 71-73页

作者：吴玉强 alexis Wilson Renuka Lall Angela Hopkinson 东南大学附属南京第二医院江苏南京210003 Gentral Medical Laboratory Georgetown Public Hospital

目的:了解圭亚那乔治敦公立医院院内细菌感染、分布及耐药情况。方法:细菌分离、鉴定按常规进行,药敏试验采用K-b纸片法。结果:1351份标本细菌培养共检出细菌697株,阳性检出率51.6%。G+菌207株占29.7%、G-菌490株占70.3%,血液细菌检出率... 详细信息

目的:了解圭亚那乔治敦公立医院院内细菌感染、分布及耐药情况。方法:细菌分离、鉴定按常规进行,药敏试验采用K-b纸片法。结果:1351份标本细菌培养共检出细菌697株,阳性检出率51.6%。G+菌207株占29.7%、G-菌490株占70.3%,血液细菌检出率16.4%,尿液细菌检出率37.9%,伤口分泌物细菌检出率74.6%。院内感染致病菌位居前5位的依次是:金葡菌17.7%、肺炎克雷伯菌12.7%、肠杆菌属11.6%、大肠埃希菌11.5%、变形杆菌10%。除肺炎克雷伯菌对氨苄西林100%耐药及其它G-菌对氨苄西林79.6%耐药外,其余各细菌对常用抗生素耐药率较低。结论:圭亚那乔治敦公立医院院内感染中,主要感染的细菌与国内相近,大部分细菌对常用的抗生素耐药性较低。

关键词：院内感染细菌耐药

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Factors associated with success of telaprevir-and boceprevir-based triple therapy for hepatitis C virus infection

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World Journal of Hepatology 2017年第11期9卷 551-561页

作者： Kian bichoupan Neeta Tandon Valerie Martel-Laferriere Neal M Patel David sachs Michel Ng Emily A schonfeld alexis Pappas James Crismale Alicia stivala Viktoriya Khaitova Donald Gardenier Michael Linderman William Olson Ponni V Perumalswami Thomas D schiano Joseph A Odin Lawrence U Liu Douglas T Dieterich Andrea D branch Division of Liver Diseases Icahn School of Medicine at Mount Sinai Icahn Medical Instititute Janssen Pharmaceuticals Com-panies Division of Janssen Scientific Affairs Inc. Genetics and Genomics Icahn School of Medicine at Mount Sinai

AIM To evaluate new therapies for hepatitis C virus(HCV), data about real-world outcomes are *** Outcomes of 223 patients with genotype 1 HCV who started telaprevir-or boceprevir-based triple therapy(May 2011-March 2012) at the Mount sinai Medical Center were analyzed. Human immunodeficiency viruspositive patients and patients who received a liver transplant were excluded. Factors associated with sustained virological response(sVR24) and relapse were analyzed by univariable and multivariable logistic regression as well as classification and regression trees. Fast virological response(FVR) was defined as undetectable HCV RNA at week-4(telaprevir) or week-8(boceprevir). REsULTs The median age was 57 years, 18% were black, 44% had advanced fibrosis/cirrhosis(FIb-4 ≥ 3.25). Only 42%(94/223) of patients achieved sVR24 on an intention-totreat basis. In a model that included platelets, sVR24 was associated with white race [odds ratio(OR) = 5.92, 95% confidence interval(CI): 2.34-14.96], HCV sub-genotype 1b(OR = 2.81, 95%CI: 1.45-5.44), platelet count(OR = 1.10, per x 104 cells/μL, 95%CI: 1.05-1.16), and IL28 b CC genotype(OR = 3.54, 95%CI: 1.19-10.53). Platelet counts > 135 x 103/μL were the strongest predictor of sVR by classification and regression tree. Relapse occurred in 25%(27/104) of patients with an end-oftreatment response and was associated with non-FVR(OR = 4.77, 95%CI: 1.68-13.56), HCV sub-genotype 1a(OR = 5.20; 95%CI: 1.40-18.97), and FIb-4 ≥ 3.25(OR = 2.77; 95%CI: 1.07-7.22). CONCLUsION The sVR rate was 42% with telaprevir-or boceprevirbased triple therapy in real-world practice. Low platelets and advanced fibrosis were associated with treatment failure and relapse.

关键词：持续 virologic 反应丙肝病毒恶化 Telaprevir boceprevir 三倍治疗分类和回归不利事件真实世界

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The Role of Ultrasound in the Diagnosis and Management of Trophoblastic Diseases (TMD) at the University Teaching Hospital yalgado Ouedraogo (UTH-yO) of Ouagadougou

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1376-1388页

作者： Ouattara Adama Ouedraogo Nde Nina Astrid Lankoandé bako Natacha Tougma sanou Aline sawadogo yobi alexis Millogo Traoré Francoise Ouédraogo Marie Charlemagne Ouédraogo Ali Thieba bonané blandine Training and Research Unit in Health sciences (TRU/Hs) University Ouaga 1 Pr Joseph KI ZERBO Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The University Teaching Hospital Yalgado Ouedraogo of Ouagadougou (UTH-YO) Ouagadougou Burkina Faso Department of Gynecology and Obstetrics The Bogodogo University Teaching Hospital of Ouagadougou (UTH-B) Ouagadougou Burkina Faso

Objective: To describe the place of ultrasound in the diagnosis and management of Gestational Trophoblastic Diseases (GTD) at the Ouagadougou UTH-yO, Ouagadougou, burkina Faso. Materials and Patients: It was a prospective and descriptive study over a 3-year period from 1 January 2015 to 31 December 2017. It took place in the gynecology and obstetrics department of at the University Teaching Hospital yalgado Ouedraogo (UTH-yO) of Ouagadougou. Monitoring was based on clinical examination data, ultrasound and kinetics of β-gestational chorionic hormone (GCH) levels. Results: During the study period, we recorded 34 cases of trophoblastic diseases. The average age of the patients was 35 years with extremes of 22 and 52 years. Physical examination revealed a uterus larger than gestational age in 17 patients (56.67%) of cases. Eight (26.67%) patients were asymptomatic. The initial mean β-GCH was 453,747.8 IU/l with extremes of 5903 IU/l and 1,890,000 IU/l. Ultrasound was used to evoke the diagnosis in 23 patients, that to say 76.67% of the cases. Ultrasound identified 10 complete mole cases, 20 partial mole cases. For the 3 cases of invasive mole, pelvic ultrasound revealed heterogeneous intrauterine multi-vesicular images. In a case of choriocarcinoma, ultrasound found an enlarged uterus with a poorly limited intracavitary heterogeneous fundic image. Conclusion: This short series shows the central role of ultrasound in the diagnosis and follow-up of gestational trophoblastic diseases. Indeed, the sensitivity of ultrasound is excellent in the early diagnosis of complete moles. Ultrasonography remains a good examination choice for the diagnosis of gestational trophoblastic tumors despite their great polymorphism. The place of ultrasound in prognostic evaluation and treatment monitoring deserves to be studied by more important series.

关键词： Gestational Trophoblastic Diseases (GTD) UTH-yO Ultrasound

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