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Objective:To discuss the clinical characteristics of the Pneumocystis jirovecii pneumonia (PCP) in the non-HIV-infected blood disease patients, and to analyze its risk factors, treatment methods, prognosis and prevention measures.Methods:A female patient aged 18years old was confirmed as acute myeloid leukemia (AML) , and experienced dyspnea, chest congestion and hypoxaemia during the recovery period of hemogram after chemotherapy.The chest CT showed the bilateral lung diffuse ground glass density images.The patient had a dry cough and the oxygen saturation was gradually decreased to 75％5dafter antibacteriological treatment.A repeat chest CT showed enlarged diffuse ground glass density images on both lungs.Considering about the possibility of PCP, the patient received oral trimethoprim/sulfamethoxazole (TMP/SMX) 1g, once every 6h, in combination with caspofungin.Results:Two days later, the symptoms of the patients were not improved.The patient was transferred to ICU and was diagnosed PCP by bronchoalveolar lavage.The patient was switched to oral TMP/SMX2g, once every 8h, in combination with caspofungin.Meanwhile, the patient received bi-level positive airway pressure ventilation (Bipap) for the increased work of breathing.Five days later, the symptoms of the patients were improved and the Bipap was stopped.The patient got better and discharged 5dlater.The patient continuely received oral TMP/SMX 2g, once every 8hfor 36d.Conclusion:Prevention of PCP should be focused, in the non-HIV-infected blood disease patients receiving chemotherapy.Diagnosis of PCP should be considered in these patients without prevention who once have suspected clinical manifestation of PCP in non-granulocytic phase.Early empirical treatment of PCP and ICU management in the non-HIV-infected blood disease patients with acute respiratory failure are the keys to reduce death and improve the prognosis of PCP.
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Objective ThispaperpresentedaninvestigationonthesimilaritiesanddifferencesintheclinicalfeaturesandCTfindings betweenallogeneichematopoieticstem celltransplantation (allo-HSCT)inducedandnon-transplantinducedair-leaksyndromes (ALS)inpatientssufferingfromhematopathy,toimprovetheunderstandingofALSinpatientswithhematopathy.Methods Retrospective analysesandcomparisonsofclinicaldataandCTimageswereconductedbetweenGroupA (12patientswithALSafterallo-HSCT) andGroupB (26patientswithnon-transplant-relatedALS).A M annG W hitney U testwasperformedtoevaluatethemeasurementdata, andthe χ 2testor Fisher exacttestwasconductedtoexaminetheenumerationdata.Differencethresholdsof P＜0.05from bothsides weretakentobethedeterminantforstatisticalsignificance.Results TheincidenceratesofALSinpatientswithhematopathyafter anallo-HSCTwerefoundtobesignificantlyhigherthanthoseinpatientsonwhomsuchtransplantshadnotbeenperformed(1.84%. vs.0.06%),P＜0.001.SymptomsofdyspneaweremuchmorefrequentlyobservedingroupAcomparedtogroupB (7/12vs1/26), P＜0.01;whereasthedifferencesforthesymptomsofchesttightness,chestpain,andpharyngalgia werenotadequateintermsofstatistical significance,P＞0.05.IngroupA,theoccurrencesofALSsecondarytolongonsetnon-infectionpulmonarycomplications(LONIPC) associatedwithchronicgraft-versus-hostdisease(cGVHD)werefoundin8/12patients,whereastheoccurrencesin15/26patients weresecondarytopulmonaryinfectioningroupB,P＜0.01.Therewerenostatisticallysignificantdifferencesinage,gender,BMI, backgroundblooddisease,basictreatmentcounts,CTtype,treatmentmethodsandCTdisappearancetimelengthbetweenthetwo groups,P＞0.05.Conclusion Thereweredifferencesintheincidencerates,basiclungdiseasesandclinicalsymptomsbetweenallo-HSCT inducedandnon-transplantinducedALSinpatientssufferingfromhematopathy.Hematopathy-associatedALSwascommoninyoung adultswithlankypostures,patientswithleukemiaasback-grounddisease,patientswithahistoryofchemotherapyandpatientswith pulmonarydiseases.Thecommonsymptomsofpatients with hematopathy-associated ALS were chesttightness and chest pain,andpatients’overallprognosisweregood,meanwhileCT manifestationsweremainlycharacterizedbymixedpulmonary interstitialemphysema(PIE)+pneumomediastinum (PM)andsimplepneumothorax (PT).
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Objective: To discuss the clinical characteristics of the Pneumocystis jirovecii pneumonia (PCP) in the non-HIV-infected blood disease patients, and to analyze its risk factors,treatment methods, prognosis and prevention measures. Methods: A female patient aged 18 years old was confirmed as acute myeloid leukemia (AMD, and experienced dyspnea,chest congestion and hypoxaemia during the recovery period of hemogram after chemotherapy. The chest CT showed the bilateral lung diffuse ground glass density images. The patient had a dry cough and the oxygen saturation was gradually decreased to 75% 5 d after antibacteriological treatment. A repeat chest CT showed enlarged diffuse ground glass density images on both lungs. Considering about the possibility of PCP,the patient received oral trimethoprim/sulfamethoxazole (TMP/SMX) 1 g< once every 6 h, in combination with caspofungin. Results: Two days later, the symptoms of the patients were not improved. The patient was transferred to ICU and was diagnosed PCP by bronchoalveolar lavage. The patient was switched to oral TMP/SMX 2 g once every 8 h∗ in combination with caspofungin. Meanwhile, the patient received bi-level positive airway pressure ventilation (Bipap) for the increased work of breathing. Five days later, the symptoms of the patients were improved and the Bipap was stopped. The patient got better and discharged 5 d later. The patient continuely received oral TMP/SMX 2 g, once every 8 h for 36 d. Conclusion: Prevention of PCP should be focused, in the non- HIV-infected blood disease patients receiving chemotherapy. Diagnosis of PCP should be considered in these patients without prevention who once have suspected clinical manifestation of PCP in non-granulocytic phase. Early empirical treatment of PCP and ICU management in the non-HIV-infected blood disease patients with acute respiratory failure are the keys to reduce death and improve the prognosis of PCP.
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Objective To improve the recognition of therapy-related acute myeloid leukemia (t-AML). Methods One patient who was diagnosed as AML with inv (16) following treatment of Hodgkin lymphoma (HL) was reported. The pathomechanism, diagnosis, treatments and prognosis of t-AML were systematically studied by reviewing a series of literature. Results A 36-year-old female with a history of HL 2 years ago was diagnosed t-AML. Karyotype analysis demonstrated inv (16) and the fusion gene of CBFβ/MYH11 was positive by polymerase chain reaction (PCR). The fusion gene of CBFβ/MYH11 was still positive after receiving 3 courses of chemotherapy. The leukemia reached completely molecular biological remission after receiving haploidentical peripheral blood stem cell transplantation. The patient has now survived 1.5 years with leukemia free and in a good performance. Conclusions The t-AML is difficult to treat, but it is heterogeneous. Cytogenetics and molecular biology have important implications for the prognosis of t-AML. Currently, allogeneic hematopoietic stem cell transplantation is the only effective way to cure t-AML.
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Objective To establish a rat model of superior mesenteric vein thrombosis by vein ligation and to simulate the pathological process of the disease, and to provide the basis for studies of its pathogenesis and treatment.Methods Ninety-six SPF male SD rats were randomly divided into three groups: Group A (sham operation group), group B (strangulation group) and group C (simple group), 32 rats in each group.Rats in group A were only opened the abdominal cavity but not blocked the blood supply.The rats were sacrificed at 8, 24, 48 and 72 h after operation.The rats in groups B and C were subjected to establish the strangulation and simple models by superior mesenteric vein thrombosis, respectively, and were sacrificed at 8, 24, 48 and 72 h after modeling.Histological changes (H&E staining) in the rat intestinal tissues were evaluated by a pathological scoring system.The levels of intestinal fatty acid binding protein (IFABP) and α-glutathione S-transferase (α-GST) were detected by ELISA.Results The rat model of mesenteric vein thrombosis was successfully established, with a success rate of 100% (96/96).The pathological analysis revealed that compared with the group A, different degrees of blood stasis and injuries were observed in the intestinal tissues of groups B and C, and the injury were gradually increased in the group B, while gradually reduced in the group C.The degrees of blood stasis and injury were positively correlated with the scope of ligation.The result of ELISA showed that the serum levels of IFABP and α-GST of the rats in groups B and C were significantly higher than those in group A (P < 0.05), and the degree of elevation was positively correlated with the scope of ligation.Conclusions In this study, the rat model of superior mesenteric vein thrombosis is successfully established by vein ligation.This model is simple and easy to operate with a high success rate, and can be used in related research.
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Objective To explore the effect of TNF-αon expression of TROP-2 and to explore the role of TROP-2 in the metastasis and invasion of colon cancer HCT-116 cells. Methods HCT-116 cells were cultured and treated with 0, 10, 20, 30, 50, 100 and 200μg/L TNF-α. Cell viability was assessed by MTT. The expression of TROP-2 was determined by western blot. The effects of 20μg/L TNF-αon cell migration and invasion were investigated by wound healing assay and Transwell method. Small interfering RNA (siRNA) was used to knock down endogenous TROP-2 expression. The transcrip?tion and translation levels of TROP-2 were detected by qPCR and Western blot respectively. The migratory and invasive ca?pability of HCT-116 cells transfected with TROP-2 siRNA were checked by wound healing assay and Transwell method re?spectively. Results There is no significant change of cell viability between HCT-116 cells treated with 0,10, 20, 30 and 50μg/L TNF-α, but cell viability of HCT-116 decreased significantly with treatment of 100μg/L and 200μg/L TNF-α. Low concentration of TNF-α(≤50μg/L) led to increase of TROP-2 protein expression that peaks when 20μg/L TNF-αwas add?ed. High concentration of TNF-α(100, 200μg/L) result in decrease of TROP-2 protein. TROP-2 siRNA significantly down-regulated the expression of TROP-2 at both mRNA and protein levels in colon cancer HCT-116 cells. Compared with con?trol group, silencing TROP-2 by TROP-2 siRNA inhibited the migratory and invasive capability of HCT-116 cells. Wound healing rate and the number of transwell cell both decreased in siRNA group compared with those of control group ( P <0.05). Conclusion The mechanism that low concentration of TNF-α promoted HCT-116 cells migration and invasion might be through up-regulating the expression of TROP-2.
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Objective Through detecting the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in pancreas and lung of rats with severe acute panereatitis,to approach the role of TREM-1 in severe actute pancreatitis pathogenesis,and provid a new molecular target for SAP.Methods Thirty healthy male Wistar rat were randomly divided into two groups:control group(group A),n =15 ; severe acute pancreatitis group (group B),n =15.The model of severe acute pancreatitis of rats was induced by retrograde injection of 5％ sodium taurocholate into the pancreatic duct.Results TREM-1 in pancreatic tissues and lung tissues was significantly higher in group B than group A in three time points(6 h,12 h,24 h) and had significant changes(P ＜ 0.05),and had a positive correlation with pancreatic pathology.Conclusion TREM-1 was significantly expressed in severe acute pancreatitis,and aggravated pancreas damage and systemic inflammatory response syndrome.