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Objective:To explore the prognostic value of 18F-FDG PET-based radiomics features by machine learning in older patients(≥60 years) with diffuse large B-cell lymphoma (DLBCL). Methods:A total of 166 older patients (88 males, 78 females, age: 60-93 years) with DLBCL who underwent pre-therapy 18F-FDG PET/CT from March 2011 to November 2019 were enrolled in the retrospective study. There were 115 patients in training cohort and 51 patients in validation cohort. The lesions in PET images were manually drawn and the obtained radiomics features from patients in training cohort were selected by the least absolute shrinkage and selection operator (LASSO), random forest (RF), and extreme gradient boosting (Xgboost), and then classified by support vector machine (SVM) to build radiomics signatures (RS) for predicting overall survival (OS). A multi-parameter model was constructed by using Cox proportional hazard model and assessed by concordance index (C-index). Results:A total of 1 421 PET radiomics features were extracted and 10 features were selected to build RS. The univariate Cox regression analysis showed that RS was a predictor of OS (hazard ratio ( HR)=5.685, 95% CI: 2.955-10.939; P<0.001). The multi-parameter model that incorporated RS, metabolic metrics, and clinical risk factors, exhibited significant prognostic superiority over the clinical model, PET-based model, and the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in terms of OS (training cohort: C-index: 0.752 vs 0.737 vs 0.739 vs 0.688; validation cohort: C-index: 0.845 vs 0.798 vs 0.844 vs 0.775). Conclusions:RS can be used as a survival predictor for older patients(≥60 years) with DLBCL. Furthermore, the multi-parameter model incorporating RS is able to successfully predict prognosis.
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Great progress has been made in the treatment of lymphoma in recent decades, but the prognosis for patients with relapsed or refractory lymphoma is often disappointing. Studies have found that the pathogenesis of non-Hodgkin lymphoma is associated with changes in histone acetylation. Histone deacetylase inhibitors can increase the level of histone acetylation in lymphoma cells, and exert anti-lymphoma effects through mechanisms such as cell cycle inhibition, induction of apoptosis, and immunomodulation. However, histone deacetylase inhibitors alone have limited therapeutic effects, and the combination with other antineoplastic drugs for the treatment of relapsing and refractory non-Hodgkin lymphoma has shown good efficacy. Summarizing basic research and clinical trials of histone deacetylase inhibitor containing regimens provides ideas for the treatment of lymphoma.
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Objective:To investigate the symptom clusters and influencing factors among breast cancer patients receiving aromatase inhibitor treatment and to provide a theoretical basis for the symptom clusters management.Methods:From April 2020 to January 2021, 253 breast cancer patients were recruited in Peking University Cancer Hospital by convenient sampling method. All the patients were cross-sectional investigated by the demographic and clinical characteristics questionnaire, the M.D. Anderson Symptom Inventory, the Hospital Anxiety and Depression Scale. The principal component analysis was used to extract the symptom clusters and the multiple linear regression was used to analyze the risk factors.Results:During the period of breast cancer patients receiving aromatase inhibitor treatment, three symptom clusters were identified: sick symptom cluster, treatment related-psychological symptom cluster, digestive symptoms cluster. The prevalence of the three symptom clusters was 49.4%(125/253), 45.1%(114/253), 22.5%(57/253), respectively. The median severity of the three symptom clusters was 2.80, 2.00, 0.67, respectively. Multiple linear regression analysis showed that anxiety and education level were the influencing factors of sick symptom cluster ( β=0.25, -0.25, all P<0.05), anxiety, depression and educational level were the influencing factors of treatment related-psychological symptom cluster ( β = 0.34, 0.20, -0.16, all P<0.05), anxiety, depression and chemotherapy history were the influencing factors of digestive symptom cluster ( β= 0.17, 0.18, -0.13, all P<0.05). Conclusions:Breast cancer patients with aromatase inhibitor treatment are affected by symptom clusters. In order to relieve the symptom clusters, we need pay attention to the mentation, the education level and prerious treatment of the patients.
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The integrity of lysosomes is of vital importance to survival of tumor cells. We demonstrated that LW-218, a synthetic flavonoid, induced rapid lysosomal enlargement accompanied with lysosomal membrane permeabilization in hematological malignancy. LW-218-induced lysosomal damage and lysosome-dependent cell death were mediated by cathepsin D, as the lysosomal damage and cell apoptosis could be suppressed by depletion of cathepsin D or lysosome alkalization agents, which can alter the activity of cathepsins. Lysophagy, was initiated for cell self-rescue after LW-218 treatment and correlated with calcium release and nuclei translocation of transcription factor EB. LW-218 treatment enhanced the expression of autophagy-related genes which could be inhibited by intracellular calcium chelator. Sustained exposure to LW-218 exhausted the lysosomal capacity so as to repress the normal autophagy. LW-218-induced enlargement and damage of lysosomes were triggered by abnormal cholesterol deposition on lysosome membrane which caused by interaction between LW-218 and NPC intracellular cholesterol transporter 1. Moreover, LW-218 inhibited the leukemia cell growth
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Objective: To study the clinical efficacy of Sini-Moxibustion in the treatment of cancer-induced fatigue in patients with yang- deficiency gastrointestinal cancer. Methods: A total of 120 patients with gastrointestinal cancer treated in our department from January 2017 to January 2018 were randomly divided into 2 groups: the fire moxibustion group and the conventional group. The conventional group and the fire therapy group were treated with basic treatments such as anti-cancer and nutritional support. The conventional group added Sini-Moxibustion to the basic treatment, and the fire therapy group added"Sini-Moxibustion"therapy for a period of 1 month. Tthe indicators of the 2 groups of patients with Piper fatigue scale and grade, quality of life, symptoms of yang deficiency symptoms, clinical efficacy and blood tests of patients with chemotherapy were evaluated. Results: After the treatment, the degrees of fatigue in the fire moxibustion group was lower than that in the conventional group with statistically significant difference ( χ2 =4.24, P =0.037 ＜ 0.05). The scores of improvement in the quality of life scale and five subscales in the fire moxibustion were higher than those in the conventional group with statistically significant difference (P ＜ 0.01), and the improvement score of the body yang deficiency in the fire moxibustion group was greater than that of the conventional group (P ＜ 0.01). The scores of fatigue, nausea and vomiting, insomnia, anorexia, and diarrhea in the fire moxibustion group were higher than those in the conventional group with statistically significant difference (P ＜ 0.05 or P ＜ 0.01). After treatment, the total effective rate was 76.67％ in the fire moxibustion treatment group, which was higher than the conventional group 91.53％ with statistically significant difference ( χ2 =5.64, P =0.012 ＜ 0.01). Hemoglobin improvement value of 3.92 ± 1.18 in the fire moxibustion group was higher than that of the conventional group 1.02 ± 0.52 with statistically significant difference (t =7.212, P =0.003 ＜ 0.01). Conclusion: Sini-moxibustion can improve the CRF of patients with yangdeficiency gastrointestinal cancer, reduce the symptoms of yang deficiency, improve the quality of life, and increase the hemoglobin content in patients with chemotherapy.
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Objective To evaluate the effects of Xuebijing on apoptosis induced by traumatic brain injury in rabbits.Methods A total of 36 healthy adult male rabbits were randomly devided into 3 groups (n =12):sham group (group S),traumatic brain injury group (group T),and Xuebijing therapy group (group X).The model of traumatic brain injury was produced by improved Feeney' s traumatic brain injury model.Group S drill bone window and not crack down on brain tissue.The rabbits were sacrificed for injury brain tissue samples at 24 h after molding success in every groups.Brain cell apoptosis was evaluated by TUNEL staining.The cerebral expression of Bcl-2 and Bax was analyzed by Western blot.Results Compared with group S,the rates of apoptosis were increased and the protein expression ratios of Bcl-2/Bax were decreased in group T,and group X (P ＜0.01).Compared with group T,the rates of apoptosis were decreased and the protein expression ratios of Bcl-2/Bax were increased in group X (P ＜ 0.01).Conclusions Xuebijing can reduce the apoptosis of cerebral cells induced by traumatic brain injury to a certain extent,and protect the cerebrum,the signal of Bcl-2/Bax change to the way of anti-apoptosis is involved in the mechanism.
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Objective To explore the expression and significance of CD34, CD117 on bone marrow mononuclear cells of myelodysplastic syndromes (MDS). Methods Direct immunofluorescence staining was used by means of flow cytometry. 37 patients with MDS were divided into RA/RARS/RCMD subgroup, RAEB Ⅰ/RAEB Ⅱ subgroup; favorable chromosomal subgroup, poor chromosomal subgroup; intermediate-risk Ⅰ subgroup, intermediate-risk Ⅱ subgroup, high-risk subgroup respectively according to WHO classification,cytogenetic abnormalities and international prognostic scoring system (IPSS). Results CD34 and CD117 were positive respectively in 11 of 19 patients with RMRARS/RCMD, all cases in RAEB Ⅰ/RAEB Ⅱ expressed CD34 and CD117; increased expression of CD34 and CD117 was MDS grade-related. Favorable chromosomal subgroup, 14 of 22 patients were positive for CD34, CD117, all cases in poor chromosomes expressed CD34 and CD117; there was a direct relationship between phenotytic density and poor cytogenetic risk factor. CD34 and CD117 expression was present respectively in intermediate-risk Ⅰ (9/17), intermediate-risk Ⅱ (11/11) and highrisk subgroup (9/9); the phenotypic intensity also was correlated with IPSS scores. Conclusion Detection of CD34, CD117 may be a useful tool for subtyping and predicting the prognosis of MDS.
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OBJECTIVE To investigate the clinical characteristics of imipenem-resistant Pseudomonas aeruginosa sepsis in neutropenic hematological malignancy patients. METHODS A retrospective review of the medical records of 3 cases in neutropenic hematological malignancy patients with P.aeruginosa sepsis in June 2008 were taken. RESULTS All they died within 3 days,2 times blood culture results indicated.With imipenem-resistant P.aeruginosa growth. CONCLUSIONS Neutropenic hematological malignancy patients with imipenem-resistant P.aeruginosa sepsis have rapid progress of the disease and high mortality rates,we should step up surveillance.
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Objective To examine the frequency and the course of cytomegalovims infection after allogeneic hematopoietic stem cell transplantation, and correlation of transplant factors with Cytomegalovirus (CMV) infection and viral load. Methods Using real-time polymerase chain reaction, we detected the copies of CMV-DNA in blood samples of the 62 patients after allo-HSCT. Furthermore, we studied the relationship between transplant factors and CMV infection. Results Among the total, 23 cases were contracted with CMV infection, 4 cases developed to CMV disease. 22 cases were cured and 1 case died. Course of CMV infection influenced the viral load significantly. Donor type, stem cell source, use of ATG, Ⅱ-Ⅳ grade aGVHD, use of glucocorticoid, complicating with other infection and use of cellular filter significantly influenced CMV infection. However, in multivariate analysis, none of them was the independent risk factors. Conclusion Real-time polymerase chain reaction may be used to early diagnose of the CMV infection and to guide treatment. Many factors influenced CMV infection. Early diagnosis and treatment could decrease the morbidity and mortality of CMV infection.
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Objective To investigate the safety and efficacy of autologous haematopoietic stem cell transplantation (HSCT) in treatment of patients with refractory inflammatory bowel disease (IBD). Methods Ten patients with active moderate-severe IBD [nine with Crohn's disease (CD) and one with ulcerative disease (UC)] were treated with HSCT from January 2004 to August 2006.Among 9 CD patients,the CD active inedx(CDAl) of 2 patients were above 450 (severe),6 patients were 150-450 (active).One patient was suffered from severe UC(whole colon).The stem cells were collected from the patients who intravenously received cycloptlosphamide (2.0 g/m2 ) and granulocyte colony-stimulating factor (5 μg · kg-1 · d-1 ).The CD34+ cells were isolated and cryo-preserved.After 2 weeks,the HSCT was carried out.Results In 9 patients with CD,clinical complete remission (CDAI<150) was achieved in 5 and 1 patients at 3 and 12 months after HSCT.The CDAI of other 2 patients decreased but not reached clinical complete remission.The patients were followed up of 16.1 months (ranged 10-33 months).The disease relapsed in 4 patients and complete remission in 5 patients.However,no improvement was observed under repeated eolonoscopy in 1 patient with UC who had not relapsed in 10 months.HSCT-related side effects included neutropenia caused fever,infection,etc.One HBV-carrier developed asymptomatie increase of liver enzymes and HBV-DNA copies after HSCT.Conclusions Autologous HSCT can be conducted safely and is well tolerated in patients with refractory IBD.It can induce clinical remission in most of the patients,although endoscopic remission may not be achieved,and relapses can not be avoided in some patients.