Ifosfamide, Cisplatin or Carboplatin, and Etoposide (ICE)-based Chemotherapy for Mobilization of Autologous Peripheral Blood Stem Cells in Patients with Lymphomas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a promising approach for lymphomas. This study aimed to evaluate the effect of ifosfamide, cisplatin or carboplatin, and etoposide (ICE)-based regimen as a mobilization regimen on relapsed, refractory, or high-risk aggressive lymphoma.</p><p><b>METHODS</b>From June 2001 to May 2013, patients with lymphomas who mobilized by ICE-based regimen for ASCT were analyzed in this retrospective study. The results of the autologous peripheral blood stem cells collection, toxicity, engraftment after ICE-based mobilization regimen were analyzed in this study. Furthermore, risk factors for overall survival (OS) and progression free survival (PFS) were evaluated by univariate analysis.</p><p><b>RESULTS</b>The stem cells were mobilized using ICE-based regimen plus rituximab or ICE-based regimen alone in 12 patients and 54 patients, respectively. The results of stem cell mobilization were excellent. Ninety-seven percentages of the patients had the stem cell collection of at least 2.0 × 10 6 CD34 + cells/kg and 68% had at least 5 × 10 6 CD34 + cells/kg. Fifty-eight percentage of the patients experienced Grade 4 neutropenia, 20% developed febrile neutropenia, and only 12% had Grade 4 thrombocytopenia. At a median follow-up of 63.8 months, the 5-year PFS and OS were 64.4% and 75.3%, respectively.</p><p><b>CONCLUSION</b>ICE is a powerful regimen for stem cell mobilization in patients with lymphomas.</p>

Relationship between serum HER2 extracellular domain levels, tissue HER2 expression, and clinico-pathological parameters in early stage breast cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Measurement of human epidermal growth factor receptor 2 (HER2) protein in the serum of metastatic breast cancer patients has previously been reported, but there are no consistent data to support the clinical utility of serum HER2 extracellular domain for patients with early stage breast cancer. We aimed to evaluate the correlation between serum extracellular domain levels and tissue HER2 expression, and analyzed their relationship with clinico-pathological parameters in patients with early stage disease.</p><p><b>METHODS</b>A prospective study was conducted on 232 breast cancer patients with stage I-III prior to treatment. Preoperative serum samples were measured by enzyme-linked immunosorbent assay. Tissue HER2 status was analyzed by immunohistochemistry and fluorescence in situ hybridization assays.</p><p><b>RESULTS</b>The median serum extracellular domain concentration was 6.8 ng/ml. The best diagnostic cut-off value was 7.4 ng/ml, with 62.9% sensitivity and 85.3% specificity. High serum extracellular domain levels were reported in 89 patients (38.3%), and HER2-positive expression was observed in 77 patients (33.2%). Multivariate analysis showed that elevated serum extracellular domain correlated with postmenopausal status (P < 0.001), high histological grade (P < 0.001), negativity of both estrogen (P = 0.012) and progesterone receptors (P < 0.001), and high levels of carcinoembryonic antigen 153 (P = 0.048).</p><p><b>CONCLUSIONS</b>We recommend that 7.4 ng/ml should be used as the cut-off value when evaluating serum extracellular domain levels in early stage of breast cancer. Patients with high serum extracellular domain levels have a certain clinico-pathological characteristics, may provide a basis for clinical practice.</p>

Effect of electroacupuncture on inflammatory injury induced by intestinal ischemia/reperfusion in rats / 中国针灸

<p><b>OBJECTIVE</b>To observe the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) on inflammatory injury induced by intestinal ischemia/reperfusion (I/R) in rats.</p><p><b>METHODS</b>Forty-eight Wistar rats were randomly divided into a sham injury group, a model group, an EA group and a sham EA group, 12 rats in each group. Intestinal I/R rat models were established by method of clamping with occlusion of superior mesenteric artery (SMA) for 45 min followed by reperfusion. The EA group was treated with EA (2.5 mA, 2 Hz/100 Hz, 0.5 h) at "Zusanli" (ST 36) 30 min before reperfusion, and at the same time, the sham EA group was treated with fast insertion at two non-meridian acupoints on skin surface (2 cm horizontally away from linea alba abdominis and about 5 cm paralleled to cartilago ensiformis downward). No interventions were added on the sham injury group and the model group. The degree of pathological injury in intestines, water rate of intestines, diamine oxidase (DAO) activity and intestinal mucosal blood flow (IMBF) were examined at 1 h and 3 h after reperfusion.</p><p><b>RESULTS</b>At 1 h and 3 h after reperfusion, the intestinal pathological injury in EA group was significantly attenuated compared with that in model group, and the intestinal water rate of (74.00 +/- 2.11)% and (78.78 +/- 0.80)% in EA group were significantly lower than (80.69 +/- 1.66)% and (83.17 +/- 2.08)% in model group (both P < 0.01), but DAO of (68.83 +/- 4.31) U/L and (47.84 +/- 5.57) U/L as well as IMBF of (152 +/- 5.8) PU and (139.8 +/- 6.1) PU in EA group were significantly higher than DAO of (32.86 +/- 4.72) U/L, (17.01 +/- 2.96) U/L as well as IMBF of (124.7 +/- 8.3) PU and (89.4 +/- 13.2) PU in model group (all P < 0.01). Meanwhile, the above mentioned changes in sham EA group showed no significant differences compared with those in model group (all P > 0.05).</p><p><b>CONCLUSION</b>Electroacupuncture can not only reduce the inflammatory injury induced by intestinal IR but also increase intestinal blood supply so as to protect the intestine function.</p>

Effects of electroacupuncture at "Zusanli" (ST 36) on hepatic ischemic injury in rats with delayed fluid replacement after hemorrhagic shock / 中国针灸

<p><b>OBJECTIVE</b>To investigate the effects of electroacupuncture at "Zusanli" (ST 36) on the volume of hepatic blood flow, water ratio and plasma alanine aminotransferase (ALT) in rats with delayed fluid replacement after hemorrhagic shock and to provide the references for electroacupuncture at Zusanli (ST 36) in treating hemorrhagic shock.</p><p><b>METHODS</b>Forty SD rats with hemorrhagic shock induced by bloodletting 40% of whole blood volume were randomly divided into a hemorrhage with no treatment (NT) group, an immediate fluid replacement (IFR) group, an electroacupuncture at Zusanli (ST 36) and delayed fluid resuscitation (EA/DFR) group and a sham electroacupuncture and delayed fluid replacement (SEA/DFR) group, 10 rats in each group. No treatment was performed in NT group. IFR group was treated with fluid replacement at 10 minutes after blood loss, and EA/DFR group was treated with electroacupuncture at "Zusanli" (ST 36) at 10 minutes after blood loss, while non-acupoint was punctured in SEA/DFR group. Two EA groups were received delayed fluid replacement at 3 hours after blood loss. The volume of hepatic blood flow and ALT before blood loss and 3 h and 12 h after blood loss, and water ratio 12 h after blood loss were measured.</p><p><b>RESULTS</b>After blood loss, all parameters in IFR group and EA/DFR group were improved significantly in contrast with those in NT group (all P < 0.05). There was no significant difference between SEA/DFR group and NT group. Three hours after blood loss, the hepatic blood flow of IFR group was significant higher than those of NT group, EA/DFR group and SEA/DFR group (all P < 0.05), while the plasma ALT of IFR group was significant lower than those of NT group, EA/DFR group and SEA/DFR group (all P < 0.05), and the plasma ALT of EA/DFR group was lower than those of NT group and SEA/DFR group (both P < 0.05), the hepatic blood flow of EA/DFR group showed no significant difference compared with that of SEA/DFR group (P > 0.05). Twelve hours after blood loss, the plasma ALT and the water ratio of EA/DFR group and IFR group were significant lower than those of NT group and SEA/DFR group (all P < 0.05), and the hepatic blood flow of EA/DFR group and IFR group was significant higher than those of NT group and SEA/DFR group (all P < 0.05), while the plasma ALT of IFR group was significant lower than that of EA/DFR group (P < 0.05), and the hepatic blood flow of IFR group was significant higher than that of EA/DFR group (P < 0.05).</p><p><b>CONCLUSION</b>Electroacupuncture at "Zusanli" (ST 36) has a protective effects for hepatic ischemic injury in rats with delayed fluid replacement after hemorrhagic shock.</p>

Clinical features and prognostic factors of angioimmunoblastic T cell lymphoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the clinical features and prognostic factors of patients with angioimmunoblastic T-cell lymphoma (AITL).</p><p><b>METHODS</b>The clinicopathological and follow-up data of 18 AITL patients undergoing integrated treatment from Feb. 1998 to April 2009 in our department were retrospectively analyzed. All of the patients received CHOP-like regimens as initial chemotherapy, including 4 once treated with radiotherapy and 1 with high dose therapy followed by autologous stem cell transplantation (HDT-ASCT) as upfront consolidation therapy. B-cell, T-cell and NK-cell subgroup proportions in the peripheral blood were tested by flow cytometry in 6 patients.</p><p><b>RESULTS</b>The median age of the 18 patients was 55 years, male and female ratio was 2.6:1. Seventy-two percent of the patients were in an advanced stage. 72% of them had B symptoms, 69% hypergammaglobulinemia, 60% elevated LDH and 47% anemia. Forty-four percent achieved CR after initial treatment with CHOP-like regimens. With the median follow-up of 26 months, the overall 2-year survival and disease free survival (DFS) rates were 62.2% and 44.4%, respectively. In the univariate analysis, only age > 30 years and primary refractory disease adversely affected overall survival (OS); age > 30 years, advanced stage, B symptoms and splenomegaly adversely affected DFS. Four patients suffered from severe pneumonia during treatment, 2 of them died of respiratory failure. Flow cytometry of peripheral blood lymphocytes showed that 5 of the 6 tested cases had decreasing proportion of CD3(+)CD4(+) T cells, B cells and NK cells but elevated CD3(+)CD8(+) T cells. Two heavily treated patients achieved partial and complete response by thalidomide therapy, with a progression free survival (PFS) of 2 and 6+ months, respectively.</p><p><b>CONCLUSION</b>AITL patients do not response well to CHOP-like regimens chemotherapy. Age < 30 years and sensitive to initial chemotherapy are associated with prolonged OS. Effectiveness of thalidomide in the treatment of AITL deserves further investigation. Peripheral blood lymphocytes test indicates that AITL patients suffered from both natural and acquired immune defects.</p>