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Objective To investigate the clinical effect of lenalidomide combined with modified MP regimen in the treatment of multiple myeloma( MM) . Methods Eighty=four elderly multiple myeloma patients treated in Tangshan City Workers'Hospital from January 2013 December 2016 were enrolled in this study. The patients were randomly divided into treatment group ( 42 cases) and control group ( 42 cases) . The patients in the treatment group were given LMP regimen +α2b? interferon. The patients in the control group received the standard MPT regimen. The changes of the level of β2 microglobulin in the two groups before and after treatment were compared,and the total effective rate in the two groups was compared. Results No statistically significant difference was showed between the two groups in β2 microglobulin before treatment ( P>0. 05) . After treatment,β2 microglobulin concentration in the treatment group was (3. 11±0. 28) and was (4. 75±0. 36) in the control group,there was significant difference between two groups ( t=9. 094,P<0. 05); the total effective rate of the treatment group was 83. 33％,59. 52％ in the control group,there was significant difference between two groups ( t=5. 833,P=0. 016) . The incidence of adverse reactions in the treatment group was 9. 52％,the control group was 26. 19％,and the two groups were statistically significant ( t=3. 977,P=0. 046) . Conclusion The clinical effect of Lenalidomide combined with modified MP regimen in the treatment of MM is better than that of conventional treatment,the total effective rate is highwe,with less adverse reactions.
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Objective@#To compare the outcome of surgical high-risk elderly patients with severe aortic stenosis(SAS) treated by different therapy procedures, including transcatheter aortic valve implantation(TAVI), surgical aortic valve replacement(SAVR), and drug therapy.@*Methods@#We retrospectively analyzed the clinical data of 242 surgical high-risk elderly (age ≥65 years old) SAS patients hospitalized in Fuwai Hospital between September 2012 and June 2015. According to the treatment method, patients were divided into TAVI group (81 cases), SAVR group (59 cases) and drug therapy group (102 cases). The primary end point was all-cause mortality at 1 year post procedure, and secondary end point included cardiac function class(NYHA), vascular complication, valvular function, non-fatal myocardial infarction, new atrial fibrillation, stroke, bleeding, pacemaker implantation, acute renal failure, and readmission. We used the Kaplan-Meier method to estimate survival function based on follow up data and survival was compared between groups with the use of the log-rank test.@*Results@#(1) In the baseline data, there were statistically significant difference among 3 groups for the age, left ventricular ejection fraction, cardiac function class Ⅲ and Ⅳ, rates of combined diabetes, chronic renal failure, mild and moderate mitral regurgitation (P<0.01 or 0.05). The risk score of the Society of Thoracic Surgeons(STS) was 7.28±4.98 in the TAVI group, and 5.67±3.49 in the SAVR group(P=0.036). (2) The perioperative rates of pacemaker implantation(11.3%(9/81) vs. 0, P=0.025) and mild paravalvular regurgitation(29.6%(24/81) vs.1.7%(1/59), P<0.001) were significantly higher in TAVI group than in SAVR group.(3)The rate of rehospitalization was significantly lower in TAVI group than in SAVR group(3.0%(2/67) vs. 22.7%(10/44) P=0.005) and the rate of pacemaker implantation was significantly higher in TAVI group than in SAVR group(17.5 (12/67) vs. 0, P=0.008) after 1 year. The rates of death from any cause in the TAVI (5.8%(4/67)) and SAVR group (11.4%(5/44)) were significantly lower than that in the drug therapy group (54.9%(50/91), both P<0.05) after 1 year and was similar between TAVI group and SAVR group(P=0.622). (4) The rates of cardiac function classⅠandⅡ increased and Ⅲ and Ⅳ decreased in TAVI and SAVR group after 1 year when compared with base line(P<0.001). The rates of cardiac function class Ⅱ, and Ⅲ increased , class Ⅰ and Ⅳ decreased in drug therapy group after 1 year compared with base line (P=0.020). (5)The survival rates after 1 year were significantly higher in the TAVI group and SAVR group than in the drug therapy group(log-rank test, P<0.001), and the difference was similar between TAVI group and SAVR group (log-rank test, P=0.062).@*Conclusion@#In surgical high-risk elderly patients with SAS, the prognosis of drug therapy was poor, and TAVI and SAVR were associated with similarly improved rates of survival after 1 year, although there were significant differences in periprocedural complications between TAVI and SAVR groups.
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Objective: Due to the high cost and complicated imaging interpretation of intravascular ultrasound (IVUS), we conducted a comparative study between AngioLight system and IVUS measurement of coronary diameter to explore the safety and efifcacy of AngioLight performance in experiment pigs. Methods: There were 3 reference target points established in left anterior descending (LAD), left circumlfex (LCX) and right coronary arteries (RCA) in 3 Chinese mini-pigs. Each coronary branch had①target point, ②proximal target point, which was (10-15) mm up to target point,③distaltarget point, which was (10-15) mm down to target point. The coronary diameters were measured and compared by both IVUS and AngioLight system. Upon stent implantation, the diameters were measured again by both IVUS and AngioLight system at distaltarget point, stent edge of distal target point and proximal target point, stent edge of proximal target point respectively. And results comparison between AngioLight and IVUS were also compared. Results: In 25 measurements, neither adverse complication nor death were occurred during the study. There were no significant statistical differences between IVUS real-time max diameter and AngioLight catheter max diameter measurements (2.57 ± 0.54) mm vs (2.70 ± 0.49) mm,P=0.09, as well as between IVUS analyzed max diameter and AngioLight catheter max diameter (2.68 ± 0.6) mm vs (2.59 ± 0.42) mm,P=0.37. In addition, good correlations were observed (r= 0.73,P Conclusion: Angio Light system has good safety and correlation with IVUS for quantitative measurement of coronary diameter in experimental pigs.
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Objective To study the efficacy and safety of recombinant human thrombopoietin (rhTPO)in the treatment of thrombocytopenia induced by chemotherapy in elder patients with acute myeloid leukemia. Methods 20 elder patients with acute myeloid leukemia who got CR received two cycles of consolidation chemotherapy. In the first cycle of chemotherapy(control cycle), they were transfused with platelet suspensions when they developed severe thrombocytopenia; In the second cycle of chemotherapy (treatment cycle), they were given subcutaneous injection of rhTPO 1.0μg·kg-2·d-1 for 14 days or until platelet count≥ 80×109/L with the treatment above all when platelet count ≤50×109/L. The efficacy and safety were evaluated. Results The duration of Plt count<100×109/L in the treatment cycle and the control cycle was (23.1±4.5)d and (25.8±5.7) d (P<0.005); the duration of Plt count≤20×109/L in the treatment cycle and in the control cycle was (6.8±2.6) d and (11.7±3.2) d (P<0.005). The minimal Plt count of the treatment cycle and the control cycle were (13.2±4.4)×109/L and (12.2±3.1)×109/L (P＝0.0967) respectively, and the maximal Plt count after its recovery were (239.3±48.7)×109/L and (163.5±32.4)×109/L (P<0.005) respectively. Platelet transfusion was (22.8±6.8) U in the treatment group, it was significantly lower than that in the control group (30.0±6.3) U (P<0.05).The changes of hemoglobin content, white blood cell count, Urine routine, the function of liver and kidney, the function of blood coagulation after chemotherapy in both groups were no obvious(P ＝0.0872). Transient adverse reaction was observed in 5 patients (25 %). No thrombotic incident had occurred. Conclusion rhTPO can significantly accelerate PLT recovery, reduce the degree and duration of thrombocytopenia induced by chemotherapy, and reduce platelet transfusion in the treatment of consolidation chemotherapy for the elder patients with acute myeloid leukemia. It is safe and can be recommended to use widely.
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OBJECTIVE To study the risk factors and clinical characteristics of nosocomial infection in senile patients with acute myelogenous leukemia who received chemotherapy.METHODS Ninety-one cases of senile patients with acute myelogenous leukemia received 304 times of chemotherapy with etiological examination,to analyze the relationship between nosocomial infection and absolute neutrophil count in peripheral blood,the cellularity of the marrow and chronic systemic disorder.RESULTS All indicators of senile patients with acute myelogenous leukemia were higher than those of younger patients(P0.05).CONCLUSIONS Age,different stage of chemotherapy,the neutrocytopenia level and prolongation,and hypocellularity of bone marrow are related to the nosocomial infection in senile patients with acute myelogenous leukemia,and the chronic systemic disorder is not a risk factor.
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Objective:? N oxalo L ?,? diaminopropionic acid were isolated from the powder of red ginseng. its physiological characteristics were studied. Method:This material is obtained by CM Sephadex C 25 and FPLC MonoQ. We have examined the effect of ? N oxalo L ?,? diaminopropionic acid on contraction of artery of guinea pig. Result:When histamin and adrenalin do not exist, there is neither contraction nor relaxation. It can strengthen induction of contraction of artery of guinea pig, but it has no such effect on adrenalin. Besides, it doesn't induce plaque coagulation through adrenalin, ADP blood coagulation enzyme and collagen. It doesn't suppress the transformation from tension peptide of blood vessel to enzyme.Conclusion:Hemostatic effect of ? N oxalo L ?,? dlaminopropinomie acid may caused by vesseles contraction through promoting Histamine.