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Objective To explore the correlation of metabolic syndrome (MS ) with low triiodothyronine(T3)syndrome(LT3S ,or It is known as ESS :euthyroid sick syndrome) ,subclinical hypothyroidism (SCH )and a high serum total homocysteine (tHcy )level (hyperhomocysteinemia )in elderly patients. Methods We retrospectively analyzed thyroid function ,serum glucose ,lipids and homocysteine(Hcy)level in 83 MS patients(MS group) ,30 patients with low T3 syndrome(low T3 group) ,41 patients with SCH (SCH group)and 80 healthy individuals (control group)aged over 60 years from January 2015 to March 2017 in outpatient and inpatient departments of our hospital. The correlations of thyroid function and serum Hcy level with MS components were analyzed by multiple Logistic regression model. Results The incidence of low T3 syndrome and SCH in MS patients was 37.3％ (31/83)and 49.4％ (41/83) ,respectively.Low T3 group versus control group showed the lower levels in free triiodothyronine ,FT4 ,folic acid ,and Hcy ,with statistically significant differences (all P<0.05).SCH group versus control group showed a lower levels of FT 4 ,of Hcy and of folic acid ,but an increased TSH level ,with statistically significant differences (all P<0.05).Patients with TSH >5.5 mU/L had decreased FT3 which occurred later than the rise of TSH (P<0.05) .Univariate correlation analysis showed that FT3 was negatively correlated with Hcy (P< 0.01) ,and TSH was negatively correlated with high-density lipoprotein cholesterol(P<0.01).Multivariate linear regression analysis found linear correlations of TSH with triglyceride ,high-density lipoprotein cholesterol ,and Hcy(all P < 0.05).Logistic regression analysis showed that FT3 ,Hcy and TSH are highly associated with hypertension after adjustment for gender and body mass index (all P< 0.05).Decreased FT3(P<0.01) ,elevated Hcy(P<0.05) ,and increased TSH(P<0.05)were independent risk factors for MS in elderly patients. Conclusions The incidences of low T3 syndrome and SCH are increased with aging. FT3 ,TSH ,and Hcy are independent risk factors for MS in the elderly.
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Objective To investigate the clinical data and laboratory features of acute megakaryocytic leukemia transformed from idiopathic myelofibrosis after 26 years in one case and the prognostic factors of myelofibrosis.Methods A case of acute megakaryocytic leukemia (M7) transformed from idiopathic myelofibrosis after 26 years was reported,and the clinical data was analyzed.Bone marrow cytology,cytogenetic and mutation detection in JAK2V617F were detected before and after transformation.Standard chemotherapeutic protocols including idarubicin plus cytarabine (IDA),homoharringtonine and cytarabine (HA),mitoxantrone and cytarabine (MA),pirarubicin plus cytarabine (TA) sequential therapies were performed.Results JAK2V617F mutation and normal karyotype were found before and after the transformation.This patient was treated with standard chemotherapeutic protocols of IDA,HA,MA and TA sequential therapies until getting complete remission,and he lived well till now.Conclusions Chromosome karyotype is related to the prognosis of IMF.Acute megakaryocytic leukemia (M7) with the normal karyotype transformed from the IMF can achieve complete remission by rational consecutive chemotherapy.
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Objective To summarize the clinical data and laboratory features of vera polycythemia incorporated with hemolysis in one case. Methods The treatment and diagnosis of series of laboratory detection with conventional cytogenetics,mutation detection in JAK2V617F,BCR/ABL fusion gene were investigated with literature. Results JAK2V617F point mutation was detected positively,BCR/ABL fusion gene was negative and trisomic chromosome 8. The case was mend and discharged after successively treated with conventional treatment of dexamethasone,antiinfective,hepatoprotective and follow-up treatment of bloodletting,hydroxyurea and interferon.Conclusions The onset of vera polycythemia is latent which is difficult to find in the early phase.Allele-specific PCR (AS-PCR) of JAK2V617F mutation will be helpful to the diagnosis.
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Objective To explore the effects of celecoxib, a cyclooxygenase-2 (COX-2) specific inhibitor, on the mRNA expression protein expression and protein tyrosine kinase (PTK) activity of bcr-abl fusion gene in chronic myeloid leukemia (CML) primary cells. Methods The primary cells were incubated with various concentration of celecoxib (0, 10, 20, 40, 80, 160 μmol/L) for 36 hours, then the changes of mRNA expression, p210 expression and PTK activity of bcr-abl fusion gene in each group were examined respectively by real time quantitative reverse transcriptase polymerase chain reaction (RQ-RT-PCR), Western blotting and PTK activity analysis. Results The mRNA expression was downregulated with high concentration of celecoxib (80-160 μmol/L), and p210 expression was decreased gradually after increasing celecoxib. The PTK activity was inhibited in a concentration-independent way, and the statistic difference was observed only above 40μmol/L concentration of celecoxib. Conclusion Celecoxib can downregulate mRNA,and the protein expression of bcr-abl fusion gene; and inhibit the PTK activity by defferent extent.
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Objective To explore the effects of celecoxib combined with arsenic trioxide (As2O3) on the mRNA expression,protein expression and protein tyrosine kinase (PTK) activity of bcr-abl fusion gene and its downstream signal transduction in chronic myeloid leukemia (CML) primary cells.Methods The cells were incubated with celecoxib (40 μmol/L) or As2O3 (2 μmol/L) alone and celecoxib (40 μmol/L) combined with As2O3 (2 μmol/L) for 36 hours.The changes of mRNA expression,p210 expression and PTK activity of bcr-abl fusion gene in each group were examined respectively by real time quantitative reverse transcriptase polymerase chain reaction (RQ-RT-PCR),Western blot and PTK activity analysis.The important proteins STAT1,STAT5 and their phosphorylatic proteins p-STAT1 and p-STAT5 and inhibitor of DNA binding 1 (ID1)a common downstream target of oncogenic tyrosine kinase were also analyzed by Western blot.Results The mRNA expressions in control group,celecoxib group,As203 group and celecoxib combined with As2O3 group were (5.97±0.53) ％,(5.74±0.46) ％,(5.94±0.57) ％ and (3.06±0.41) ％ respectively,and the statistical difference was found only between celecoxib combined with As2O3 group and control group (t =28.35,P =0.00).The similar statistic difference was only observed between the two groups from PTK activity tests (t =4.38,P =0.04).Western blot also showed that p210,STAT1,STAT5,p-STAT1,p-STAT5 and ID1 were more extraordinaryly downregulated by celecoxib combined with As2O3 than others treatments.Conclusion Celecoxib combined with As2O3 can downregulate mRNA,p210 expression,PTK activity of bcr-abl fusion gene and inhibit STAT and ID1 signal transduction pathways in a synergistic way.
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ctive method for previously untreated ITP patients and maintenece treatment with small-dose dexamethasone between high-dose dexamethasone contributes to improve the long-term curative effect.