Analysis of the Exploration of Hematology Integration Education Model Guided by“Social Learning Theory”

Diseases of the blood system are highly complicated and involve many aspects.This article aimed to put forward the necessity of integrating quality and professional education,the necessity of learning logic,and the importance of establishing an integrated medical education model when teaching about blood system diseases.According to the requirements of the new medical science,this article puts forward the integration of an“online+offline+clinical”medical education mode based on the social learning theory and a learning evaluation mode based on medical literacy.The fundamental task of cultivating human beings into clinical medical talents with professional ethics,independent learning abilities,interpersonal communication abilities,complex problem-solving abilities,innovative consciousness,and critical thinking was implemented.This article aims to propose an improved construction plan to create a new and improved teaching system in medicine.

Smart palm-size optofluidic hematology analyzer for automated imaging-based leukocyte concentration detection

A critical function of flow cytometry is to count the concentration of blood cells,which helps in the diagnosis of certain diseases.However,the bulky nature of commercial flow cytometers makes such tests only available in hospitals or laboratories,hindering the spread of point-of-care testing(POCT),especially in underdeveloped areas.Here,we propose a smart Palm-size Optofluidic Hematology Analyzer based on a miniature fluorescence microscope and a microfluidic platform to lighten the device to improve its portability.This gadget has a dimension of 35×30×80 mm and a mass of 39 g,less than 5%of the weight of commercially available flow cytometers.Additionally,automatic leukocyte concentration detection has been realized through the integration of image processing and leukocyte counting algorithms.We compared the leukocyte concentration measurement between our approach and a hemocytometer using the Passing-Bablok analysis and achieved a correlation coefficient of 0.979.Through Bland-Altman analysis,we obtained the relationship between their differences and mean measurement values and established 95%limits of agreement,ranging from−0.93×10^(3)to 0.94×10^(3)cells/μL.We anticipate that this device can be used widely for monitoring and treating diseases such as HIV and tumors beyond hospitals.

Positive moderation of the hematology,plasma biochemistry and ocular indices of oxidative stress in alloxan-induced diabetic rats,by an aqueous extract of the leaves of Sansevieria liberica Gerome and Labroy

Objective:To investigate the ability of an aqueous extract of the leaves of Sansevieria liberica (S.liberica) to alter the hematology,plasma biochemistry and ocular indices of oxidative stress in alloxan-induced diabetic rats.Method:Diabetes meUitus was induced by injection of alloxan (80 mg/kg body weight),via the tail vein.The extract was administered orally at 100,200 and 300 mg/kg body weight(both to normal and diabetic rats),and metformin at SO mg/kg body weight. Results:Compared to test control,the treatment dose dependently,significantly lowered(P【0.05) ocular malondialdehyde content,atherogenic indices,red cell,total white cell and lymphocyte counts,mean cell hemoglobin concentration;and plasma levels of glucose,triglyceride,total-, very low density lipoprotein-,low density lipoprotein- and non-high density lipoprotein cholesterols,total,conjugated and unconjugated bilirubin,sodium,urea,blood urea nitrogen,as well as plasma activities of alkaline phosphatase,alanine and aspartate transaminases.However, the treatment significantly increased(P【0.05) hematocrit,hemoglobin concentration,mean cell hemoglobin,and mean cell volume,neutrophil and monocyte counts,and plasma levels of high density lipoprotein cholesterol,potassium,chloride,calcium,bicarbonate and total protein, ocular ascorbic acid content and ocular activities of catalase and superoxide dismutase.This study showed the hypoglycemic,hypolipidemic,immune-modulating,ocular-,hepato-renal and cardio-protective potentials of the extract.Conclusions:All these,support the use of the leaves of S.liberica in African traditional health care practices for the management of diabetes mellitus.

A Review of Chelonian Hematology

Hematologic investigations have been used successfully to diagnose disease and assess the physiological status of chelonians. Here, the microstructure, ultrastructure, development, and function of chelonian blood cells are summarized, and factors that affect hematologic results are reviewed. The limited body of chelonian hematology research is discussed, and recommendations for future work are provided.

Hematology and blood serum chemistry reference intervals for children in Iganga district of Uganda

In this study, normal ranges for hematology and serum biochemistry in children aged 1 to 5 years inUgandawere determined. By a cross-sectional study, 1168 children from Iganga, a prospective site for clinical trials in Uganda, were screened. From 1168 households, 460 children were selected for enrollment, while 600 (58%) were excluded because of either a history of fever in the previous 24 hours, presence of asexual malaria parasites in the peripheral blood or presence of fever. Accordingly, 460 children (39.4%) of median age = 3 years were enrolled in the baseline study. While the lower limits of hemoglobin, hematocrit levels, mean corpuscular volume and platelet counts for the Ugandan children were found to be less than conventional reference values of Caucasisan children, the white blood cell count reference values were higher than the international intervals. On the other hand, the upper limits of the reference intervals for serum transaminases, bilirubin, creatinine, urea, total protein and albumin in sera of the Ugandan children were higher than the corresponding values for a Caucasian pediatric population. This study showed that, if hematology test results of the Ugandan children were assessed against “imported” international reference values, up to 44.6% of the study participants would have been excluded from clinical trials or would have been reported as adverse events in such trials. The present study was not only the first report of serum biochemistry reference ranges for children aged one to five years in Uganda but also one of very few such studies in Africa.

Comparative Evaluation of the Effects of Velogenic Newcastle Disease Virus Infection on the Hematology of Ducks and Chickens

The hematological lesions consequent upon velogenic Newcastle disease virus (NDV) infection were investigated in 6-week-old ducks and chickens. Following intramuscular inoculation, the results indicated significantly lower (p < 0.05) packed cell volume (PCV) in infected chickens (IC) on days 3 - 9 post inoculation (PI) and in infected ducks (ID) on days 3 - 15 PI. The hemoglobin concentrations were significantly lower (p < 0.05) in IC on days 3, 6 and 15 PI while in the ID, they were significantly lower (p < 0.05) on days 3, 9 and 15 PI. The total erythrocyte counts were significantly lower (p < 0.05) in IC on days 3, 9 and 15 PI and in ID, they were significantly lower (p < 0.05) on days 3 and 9 PI. The mean corpuscular values indicated macrocytic hypochromic anemia in IC and macrocytic normochromic anemia in ID. The leucogram showed leucopenia in IC and initial leucopenia followed by leucocytosis in ID. The hematological pictures of the velogenic NDV in this experiment indicate less susceptibility of ducks when compared with the chickens. The severity of this virus infection in chickens and the mild clinical signs and lesions presented by ducks showed that ducks are far less susceptible than chickens.

An exciting time to launch the World Journal of Hematology

This first issue of the World Journal of Hematology(WJH) marks the birth of a new member of the World Series Journal family and comes at one of the most exciting times in stem cell biology and translational medicine. The pace of discovery in the field of hematology has accelerated signeificantly in recent years, due to important scientific discoveries and new technologies for purification of hematopoietic stem cells and identification of specific stem cell biomarkers; whole genome sequencing using next-generation sequencing technology; and development of molecularly-targeted therapies, leading to the translation of highly promising science into advanced diagnosis and proven targeted therapies for hematopoietic disorders. The WJH is an open-access, peer-reviewed journal, which is officially published on June 6, 2012. The WJH Editorial Board consists of 102 experts in hematology from 26 countries. There is clearly a niche for this new journal, which provides access to all articles without boundaries to all internet users throughout the world. The WJH aims to provide rapid access to high impact publications in fundamental and clinical hematology, with multidisciplinary coverage, through an established system that is targeted at dissemination to the scientific community via online openaccess.

Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

Objective:To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards.Methods:A total of 124 patients with hematological malignancies(69 male,55 female)hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions,between January 2007 and December 2010,were evaluated,retrospectively.Results:In this study,250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated.Of the patients,69 were men(56%)and 55 women(44%).A total of 40 patients(32%)had acute myeloid leukemia,25(20%)acute lymphoblastic leukemia,19(15%)non-Hodgkin's lymphoma,10(8%)multiple myeloma,and 8(8%)chronic myeloid leukemia.In our study,56 patients(22%)were diagnosed as pneumonia,38(15%)invasive aspergillosis,38(15%)sepsis,16(6%)typhlitis,9(4%)mucormycosis,and 4(2%)urinary tract infection.Gram-positive cocci were isolated from 52%(n=20),while Gram-negative bacilli 42%(n=16)and yeasts from 6%(n=2)of the sepsis patients,respectively.The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci(n=18),while the most frequently isolated Gram-negative bacteria was Escherichia coli(n=10).Conclusions:Febrile neutropenia is still a problem in patients with hematological malignancies.The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy.Infection control procedures should be applied for preventing infections and transmissions.

Development of the personalized criteria for microscopic review following four different series of hematology analyzer in a Chinese large scale hospital

Background A generally accepted guideline （＂41 rules＂） published by the International Consensus Group for Hematology Review （ICGHR） can not be suitable for all the laboratories because the facility type, laboratory requirements, sample volume, review rate, turn around time, instrument model and characters etc. are quite different from each other, which may cause a higher workload for microscopy review or lead to false or misleading results. Therefore, we decided to develop the personalized review criteria for 4 series of hematology analyzers in the same hospital, and describe all the implement procedures in detail. Methods The total 1770 blood samples were collected from Peking Union Medical College Hospital. Referring to the suggested criteria by international consensus group for hematology review （＂41 rules＂）, the personalized review criteria for 4 series of hematology analyzers including Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i were established and validated by adjusting the rules in order to reduce the false positive rate and keep the false negative acceptable by clinical. Results Using the ＂41 rules＂, high review rates of 37.94%, 35.56%, 33.44% and 37.94% were got respectively in Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i. Three false positive rules mainly were observed in all of 4 analyzers： white blood cell 〈3×10^9/L or 〉30×10^9/L, platelet 〈100×10^9/L or 〉1000×10^9/L and immature granulocyte. Specialized rules were observed in different series of analyzers, atypicaVvariant lymphs flag were found mainly in Sysmex XE-2100, Aniso-RBC were found mainly in Sysmex XT-1800i, flag of ＂immature granulocyte＂ mainly in Sysmex XS-800i, Micro-RBC, Macro-RBC and Aniso-RBC mainly in Siemens Advia 2120. Rules of immature granulocyte blast, and NRBC flag would be mainly triggered by hematology malignant tumor. We could not delete these rules due to the risk of false negative of serious disease, other rules were deleted or revised. After continually optimizing to the rules, we finalized the criteria suitable for Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i in our laboratory. The false negative rates were 2.94%, 2.86%, 3.10% and 2.78%, the review rates were 31.07%, 30.00%, 30.01% and 30.09%, and there was no hematology malignant tumor missed. Validated by 547 samples, the false negative rates of our optimized rules were 0.37%, 0.55%, 0.55%, and 0.91% respectively. Conclusion The criteria can be based on the criteria established by International Consensus Group for Hematology Review but must be optimized according to the different requirements.

Characteristics of blood chemistry, hematology, and lymphocyte subsets in pregnant rhesus monkeys

The present study was designed to characterize the blood chemistry, hematology, and lymphocyte subsets in pregnant rhesus monkeys and provide baseline parameters for future studies of reproductive and developmental toxicity and developmental immunotoxicity. Harem-mating was used in 96 female and 16 male rhesus monkeys. Pregnancy was confirmed on gestation day(GD)18 by ultrasound. The blood samples of rhesus monkeys were collected at various times(20 days before pregnancy and GD20, 100 and 150). The analyses of blood chemistry, hematology, and lymphocyte subsets were performed. Copmpared with 20 days before pregnancy, Significant decreases(P < 0.05) were observed in HCT and RBC on GD20, GD150 and in HGB on GD150, Significant increases in NEUT and decreases in LYMPH on GD20 were observed. Significant decreases in ALB from GD20 to GD150 were observed, significant decreases in TP was observed on GD100. Significant increases in mean GLU were observed on GD20 and GD150 during pregnancy. Significant decreases(P < 0.05) in CD20+ subsets on GD100, GD150 and CD4+/CD8+ ratio on GD150 were observed, The significant changes of MCV, MCHC, RDW-SD, MCV, MONO, ALT, AST, GLB, ALP, TBIL, DBIL, IBIL, GGT, CR-S, URIC, TC, TG and CK were observed during the pregnant period, but no biologic change were observed, There were no significant changes in MCH, RDW-CV, MPV, BUN, CD3+, CD4+ and CD8+ during pregnancy. These data provide a database for preclinical study in rhesus monkeys. Physiological anemia, hyperglycemia, and immune suppression may occur in pregnant rhesus monkey which is similar to that found in human, and it is essential to distinguish the physiological changes from the pharmacological effects in reproductive and developmental toxicity and developmental immunotoxicity studies of pharmaceuticals.

Blockade of CD300A enhances the ability of human NK cells to lyse hematologic malignancies

Objective: The human cluster of differentiation(CD)300A, a type-I transmembrane protein with immunoreceptor tyrosine-based inhibitory motifs, was investigated as a potential immune checkpoint for human natural killer(NK) cells targeting hematologic malignancies(HMs).Methods: We implemented a stimulation system involving the CD300A ligand, phosphatidylserine(PS), exposed to the outer surface of malignant cells. Additionally, we utilized CD300A overexpression, a CD300A blocking system, and a xenotransplantation model to evaluate the impact of CD300A on NK cell efficacy against HMs in in vitro and in vivo settings. Furthermore, we explored the association between CD300A and HM progression in patients.Results: Our findings indicated that PS hampers the function of NK cells. Increased CD300A expression inhibited HM lysis by NK cells. CD300A overexpression shortened the survival of HM-xenografted mice by impairing transplanted NK cells. Blocking PS–CD300A signals with antibodies significantly amplified the expression of lysis function-related proteins and effector cytokines in NK cells, thereby augmenting the ability to lyse HMs. Clinically, heightened CD300A expression correlated with shorter survival and an “exhausted” phenotype of intratumoral NK cells in patients with HMs or solid tumors.Conclusions: These results propose CD300A as a potential target for invigorating NK cell-based treatments against HMs.

Preclinical evaluation of cyclophosphamide and fludarabine combined with CD19 CAR-T in the treatment of B-cell hematologic malignancies in vivo

Background:Chimeric antigen receptor T(CAR-T)cell therapy has achieved marked therapeutic success in ameliorating hematological malignancies.However,there is an extant void in the clinical guidelines concerning the most effective chemotherapy regimen prior to chimeric antigen receptor T(CAR-T)cell therapy,as well as the optimal timing for CAR-T cell infusion post-chemotherapy.Materials and Methods:We employed cell-derived tumor xenograft(CDX)murine models to delineate the optimal pre-conditioning chemotherapy regimen and timing for CAR-T cell treatment.Furthermore,transcriptome sequencing was implemented to identify the therapeutic targets and elucidate the underlying mechanisms governing the treatment regimen.Results:Our preclinical in vivo evaluation determined that a combination of cyclophosphamide and fludarabine,followed by the infusion of CD19 CAR-T cells five days subsequent to the chemotherapy,exerts the most efficacious therapeutic effect in B-cell hematological malignancies.Concurrently,RNA-seq data indicated that the therapeutic efficacy predominantly perturbs tumor cell metabolism,primarily through the inhibition of key mitochondrial targets,such as C-Jun Kinase enzyme(C-JUN).Conclusion:In summary,the present study offers critical clinical guidance and serves as an authoritative reference for the deployment of CD19 CAR-T cell therapy in the treatment of B-cell hematological malignancies.

Prevention of hepatitis B reactivation in patients with hematologic malignancies treated with novel systemic therapies:Who and Why?

The risk of reactivation in patients with chronic or past/resolved hepatitis B virus(HBV)infection receiving chemotherapy or immunosuppressive drugs is a wellknown possibility.The indication of antiviral prophylaxis with nucleo(t)side analogue is given according to the risk of HBV reactivation of the prescribed therapy.Though the advent of new drugs is occurring in all the field of medicine,in the setting of hematologic malignancies the last few years have been characterized by several drug classes and innovative cellular treatment.As novel therapies,there are few data about the rate of HBV reactivation and the decision of starting or not an antiviral prophylaxis could be challenging.Moreover,patients are often treated with a combination of different drugs,so evaluating the actual role of these new therapies in increasing the risk of HBV reactivation is difficult.First results are now available,but further studies are still needed.Patients with chronic HBV infection[hepatitis B surface antigen(HBsAg)positive]are reasonably all treated.Past/resolved HBV patients(HBsAg negative)are the actual area of uncertainty where it could be difficult choosing between prophylaxis and pre-emptive strategy.

Navigating the complex terrain of hepatitis B virus reactivation in the era of Bruton tyrosine kinase inhibitors

In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights derived from current studies.Furthermore,we emphasize the critical need for a framework regarding robust risk evaluation in patients undergoing such treatments.This framework is essential for identifying those at increased risk of HBVr,enabling healthcare providers to implement proactive measures to prevent reactivation and ensure the safe administration of BTK inhibitor therapy.

Carrimycin in the treatment of acute promyelocytic leukemia combined with pulmonary tuberculosis: A case report

BACKGROUND Pulmonary tuberculosis(PTB)is prevalent in immunocompromised populations,including patients with hematologic malignancies,human immunodeficiency virus infections,and chronic diseases.Effective treatment for acute promyelocytic leukemia(APL)combined with PTB is lacking.These patients show an extremely poor prognosis.Therefore,studies should establish efficient treatment options to improve patient survival and prognosis.CASE SUMMARY A 60-year-old male with pain in the right side of his chest and a fever for 4 d visited the outpatient department of our hospital.Peripheral blood smear revealed 54%blasts.Following bone marrow examinations,variant APL with TNRC18-RARA fusion gene was diagnosed.Chest computed tomography scan showed bilateral pneumonitis with bilateral pleural effusions,partial atelectasis in the lower lobes of both lungs,and the bronchoalveolar lavage fluid gene X-Pert test was positive,indicative of PTB.Carrimycin,ethambutol(EMB),and isoniazid(INH)were administered since he could not receive chemotherapy as the WBC count decreased continuously.After one week of treatment with carrimycin,the patient recovered from fever and received chemotherapy.Chemotherapy was very effective and his white blood cells counts got back to normal.After being given five months with rifampin,EMB and INH and chemotherapy,the patient showed complete remission from pneumonia and APL.CONCLUSION We report a case of PTB treated successfully with carrimycin with APL that requires chemotherapy.

Hematological Malignancies in Sickle Cell Disease Patients: Report of Four Cases in Togo and Literature Review

Background: Hemopathies were rarely observed in major sickle cell disease patients some thirty years ago, probably due to the high mortality rate among the latter as a result of progressive complications. Thanks to advances in the management of sickle cell disease, patients' life expectancy has increased considerably, exposing them more frequently to neoplasia, including hematological malignancies. The increased risk of leukemogenesis is multifactorial and linked to the pathophysiological mechanisms of the clinical manifestations of sickle cell disease. Study Setting: The clinical haematology department of campus teaching hospital and the paediatric onco-haematology unit of Sylvanus Olympio teaching hospital in Lomé were used as study settings. Observations: Four hematologic malignancies were collected in a cohort of 5847 major sickle cell syndromes. The median age of the patients was 31.25 years (extremes: 14 and 58 years) and they were predominantly female (sex ratio M/F = 0.25). Two were on background therapy with hydroxyurea. Among the four patients, there were two cases of acute lymphocytic leukemia, including ALL3 in a 58-year-old SS woman and T-ALL2 in a 12-year-old SC. Then, a case of lymphocytic lymphoma in a 20-year-old SS man was reported and finally a case of chronic myelocytic leukemia in a 33-year-old woman of Sβ+ thalassaemia phenotype. Conclusion: To further report this coexistence, it is therefore essential to systematically consider hematological malignancies during major sickle cell syndromes even if there are similarities in the symptomatology of these two serious pathological situations.

Growth performance and hematology of Djallonké rams fed haulms of four varieties of groundnut (Arachis hypogaea L.)

The study was conducted to assess the chemical composition of the haulms of 4 dual-purpose groundnut(Arachis hypogaea L.) varieties and their effects on the growth and hematology of Djallonke rams. The groundnut varieties were ICGV 97049(Obolo), ICGX SM 87057(Yenyawoso), RMP 12(Azivivi) and Manipinta. Rams(live weight 15.0 ± 3.0 kg) were randomly assigned to 4 sole groundnut haulm meal(GHM) treatments, with 4 rams each in an individual pen per treatment(total n = 16 rams). Samples of the groundnut haulms were milled and analyzed for crude protein(CP), neutral detergent fiber(NDF)and acid detergent fiber(ADF). The CP concentration was higher(P < 0.05) in Azivivi, Manipinta and Yenyawoso than in Obolo. The highest(P < 0.05) NDF and ADF fractions were obtained in Obolo. Whilst no significant difference was reported in total and daily dry matter(DM) intake among the varieties,CP,NDF and ADF intake all differed between Obolo and other varieties. The apparent nutrient digestibility did not differ(P> 0.05) when the Djallonke rams were fed the haulms. However, significant differences were observed in final live weight and average daily live weight gain. Rams fed the Yenyawoso variety had higher(P < 0.05) final live weight and average daily live weight gain compared with those fed Obolo and Azivivi varieties. Consumption of any of the 4 varieties of groundnut haulms by Djallonke rams did not have any harmful effect on their red and white blood cell numbers and hemoglobin concentration.The study revealed that the different varieties of groundnut haulms differ in nutrient composition and also affect the growth performance of the rams. The Yenyawoso variety may be used as a sole diet for fattening Djallonke rams.

Primary exploration of the application of case based learning method in clinical probation teaching of the integrated curriculum of hematology

Objective To explore the application and the effect of the case based learning(CBL)method in clinical probation teaching of the integrated curriculum of hematology among eight-year-program medical students.Methods The CBL method was applied to the experimental group,and the traditional approach for the control group.After the lecture,a questionnaire survey was conducted to evaluate the teaching effect in the two groups.Results The CBL method efficiently increased the students’interest in learning and autonomous learning ability,enhanced their ability to solve clinical problems with basic theoretic knowledge and cultivated their clinical thinking ability.Conclusion The CBL method can improve the quality of clinical probation teaching of the integrated curriculum of hematology among eight-year-program medical students.

Practical notes on an integrated curriculum of hematology

Objective To review the experiences on an integrated curriculum of hematology for eight-year students in the first half of 2015 and to lay the foundation for improvement and application to students in the five-year program of clinical medicine.Methods The reform processes were described and the advantages and disadvantages of the integrated curriculum were analyzed by using descriptive and comparative methodologies.Results The original teaching contents were simplified.A teaching group composed of basic science researchers and clinicians was established.New small-group learning mode was conducted.Conclusion The integrated hematology course was established and after improvement this course can be implemented into the five-year program of clinical medicine in the future.