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In recent years, the treatment of multiple myeloma (MM) has made great breakthroughs and progress, but most patients still face tumor recurrence and refractory, which is the main cause of death in MM patients. Numerous studies have found that the use of daratumumab (anti-CD38 monoclonal antibody) targeted therapy for MM can significantly improve the patient's response rate and prolong the survival time. Furthermore, the drug is effective both in patients with relapsed/refractory MM and newly diagnosed MM. This article reviews the research progress in the mechanism, efficacy and safety of daratumumab in the treatment of MM.
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Objective:To evaluate the clinical effect of self-made Wenfei-Quyu-Huatan Decoction combined with conventional western medicine in the treatment of acute attack of chronic obstructive pulmonary disease (COPD). Methods:A total of 103 patients with acute attack of COPD who were admitted to our hospital from January 2018 to April 2019 were divided into control group (51 cases) and the intervention group (52 cases) according to the random number table method. The control group was treated with conventional western medicine, and the intervention group was treated with self-made Wenfei-Quyu-Huatan Decoction based on control group. Both groups were treated for 14 days. TCM syndrome scores were recorded before and after the treatment, the FVC, FEV1 and FEV1/FVC were detected by pulmonary function meter, the content of TNF-α, IL-8 and CRP in serum were detected by ELISA, and adverse reactions during the treatment were recorded and clinical efficacy was evaluated. Results:The total effective rate was 88.5% (46/52) in the intervention group and 70.6% (36/51) in the control group, and the difference between the two groups was statistically significant ( χ2=5.067, P=0.024). After the treatment, the TCM syndrome score of the intervention group was significantly lower than the control group (7.3 ± 0.9 vs. 12.9 ± 1.2; t=27.979, P<0.01); FVC (2.69 ± 0.35 L vs. 2.12 ± 0.24 L, t=9.621), FEV1 (1.58 ± 0.22 L vs. 1.13 ± 0.18 L, t=11.349) and FEV1/FVC (0.59 ± 0.07 vs. 0.53 ± 0.08, t=4.053) in the intervention group were significantly higher than the control group ( P<0.01); the serum IL-8 (51.48 ± 6.27 ng/L vs. 69.27 ± 7.32 ng/L, t=13.255), CRP (2.12 ± 0.46 mg/L vs. 3.51 ± 0.53 mg/L, t=14.223) and TNF-α (41.38 ± 6.22 ng/L vs. 52.24 ± 7.29 ng/L, t=8.139) level were significantly lower than the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 11.8% (6/51) in the control group and 15.4% (8/52) in the intervention group, and there was no significant difference between the two groups ( χ2=0.321, P=0.571). Conclusions:The self-made Wenfei-Quyu-Huatan Decoction combined with the conventional western medicine can improve the clinical symptoms, lung function and reduce the level of inflammatory cytokines in patients with COPD acute attack.
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Follicular lymphoma (FL) is usually occult, with a wide range of disease manifestations and prognosis. In recent years, with the combination of anti-CD20 monoclonal antibody and standard chemotherapy methods, as well as the use of immunomodulators and hematopoietic stem cell transplantation, the survival rate of FL patients has been greatly improved, but it is still considered to be an incurable disease. Recent studies have shown that the chimeric antigen receptor T-cell (CAR-T) therapy can improve the survival rate and the prognosis of FL patients. The article will elaborate on the mechanism, clinical research progress, adverse reactions and limitations of CAR-T in the treatment of FL.
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Follicular lymphoma (FL) is usually occult, with a wide range of disease manifestations and prognosis. In recent years, with the combination of anti-CD20 monoclonal antibody and standard chemotherapy methods, as well as the use of immunomodulators and hematopoietic stem cell transplantation, the survival rate of FL patients has been greatly improved, but it is still considered to be an incurable disease. Recent studies have shown that the chimeric antigen receptor T-cell (CAR-T) therapy can improve the survival rate and the prognosis of FL patients. The article will elaborate on the mechanism, clinical research progress, adverse reactions and limitations of CAR-T in the treatment of FL.
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Primary myelofibrosis (PMF) is a type of myeloproliferative neoplasms (MPN) with the worst prognosis in MPN. Immunomodulators, erythropoiesis-stimulating agents, cytoreductive drugs, splenectomy, etc. can significantly reduce the symptoms of patients, but can not improve the prognosis of patients. Allogeneic hematopoietic stem cell transplantation remains the only method that may cure PMF. The marketed JAK kinase inhibitor ruxolitinib and the hypomethylating agents, anti-fibrosis agents and telomerase inhibitorprovide new ideas for the treatment of PMF, made it possible to reverse the natural course of myelofibrosis. This paper reviews the progress of PMF therapy.
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Objective To explore depression and anxiety in nasopharyngeal carcinoma (NPC) patients in Chaoshan region and investigate their influencing factors. Methods Two hundred and one patients newly diagnosed with NPC were included in this study. The status of depression and anxiety during their hospital stay were evaluated using the self-rating depression scale (SDS) and the self-rating anxiety scale (SAS). Data including sex, age, education, history of smoking, course of disease, sleeping quality and oral pain were also collected and their relationships with depression and anxiety were analyzed as well. Results They had significantly higher mean SAS score (36.41 ± 7.41) and SDS score (48.42 ± 7.19), as compared with the healthy population. Single factor analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on the scores of SAS and SDS. Multivariate logistics regression analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on their anxiety and depression. Conclusions Depression and anxiety are common psychological problems in NPC patients. Patients at the middle to elderly age and with low education, history of smoking, bad sleeping quality and oral pain are more susceptible to depression and anxiety.
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Objective to provide the evidence for inducing the SAP model in rats with proper concentration of sodium taurocholate.Methods 60 SD rats were divided into sham operated group, group of 1.5% in concentration, group of 3.5% in concentration and group of 5% in concentration randomly, while the SAP model was induced by the sodium taurocholate concentration of 1.5%,3.5% and 5% with the method of retrograde injection into the biliopancreatic duct.To calculate the mortality of different groups, measure the serum amylase, tumor necrosis factor -α(TNF -α) and interleukin -6 (IL -6),and to observe the pancreatic pathological scores of HE staining in rats.Results The mortality in group of 5% in concentration has a significant ascending compared with group of 1.5% in concentration, while the serum amylase, tumor necrosis factor -α(TNF -α) , interleukin -6( IL -6), pathological score of hemorrhage and acinar necrosis in group of 5% in concentration have a significant ascending compared with group of 1.5% in concentration and group of 3.5% in concentration.Conclusions A better SAP model may be induced by sodium taurocholate with the concentration of 5% by the method of retrograde injection into the biliopancreatic duct, which may accord with the physiological and pathological manifestation of SAP.
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Objective To investigate the etiology spectrum of hand , foot and mouth disease ( HFMD) and to analysis the molecular characteristics of three predominant human enterovirus stains in Qingdao in 2013.Methods The total enterovirus (EV) strains and strains of EV71, CVA16 and CVA6 in throat swabs of HFMD cases were detected by using multiplex real time RT-PCR.The full-length of the viral VP1 genes of the EV strains were amplified and sequenced .The sequences were phylogenetically analyzed by using the MEGA5.0 software package .Results A total of 841 patients with mild HFMD and 107 patients with serious HFMD were recruited in this study and 64 .3%of them were positive for EV .The predominant pathogens were EV71 (44.8%), CVA6 (28.2%) and CVA16 (9.5%) in 2013.CVA6 replaced CVA16 as the second most common pathogen for HFMD , accounting for 42.7% of all pathogens in children aged less than 3 years and 22.2%of all pathogens in the serious patients .The proportions of CVA6 in the etiology spectrum showed a downtrend along with the increasing age of the patients (P<0.001).Phylogenetic analy-sis of the complete VP1 gene sequences showed that all of the EV 71 strains identified in this study belonged to the subgenotype C4 (evolutionary branch C4a) and all of the CVA16 strains belonged to the subgenotype B1 (evolutionary branches B1a and B1b).There were 6 genogroups (A to F) regarding to the VP1 gene of CVA6 and all of the CVA6 strains identified in this study belonged to genogroups A and D .Among the CVA6 strains isolated in Qingdao in 2013, 83.9% belonged to genogroup A, while the rest 16.1% belonged to genogroup D.66.7%of the CVA6 strains isolated in 2012 belonged to genogroup A, while the rest 33.3%belonged to genogroup D .All of the CVA6 strains isolated from year 2008 to 2011 in Qingdao belonged to genogroup D.Conclusion EV71, CVA6 and CVA16 were the prevalent pathogens responsible for the de-velopment of HFMD in Qingdao in 2013.The proportions of CVA6 strains in the etiology spectrum showed a downtrend with the increasing age in children .C4a was the major subtype of EV71 strains circulating in Qingdao in 2013, while B1a and B1b were the major subtypes of CVA16 strains.The pattern of endemic cir-culation of CVA6 strains showed a trend of changing from genogroup D to A from year 2008 to 2013 .
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Objective To investigate the clinical outcomes of flupenthixol melitracen on refractory asthma with anxiety and/or depression.Methods 105 patients with refractory asthma,who were given asthma controlled test (ACT) and comprehensive hospital anxiety and depression scale (HAD)test,were randomly classified into control group and treatment group,the former used recommended classical drugs in the consensus,Salmeterol Xinafoate and Fluticasone Propionate and Montelukast;while the latter used above therapy combining flupentixol melitrace.HAD score,ACT score and pulmonary function were applied to assess therapeutic effect.Results In 105 cases of refractory asthma patients,75 patients were complicated with anxiety and/or depression,with prevalence of 71.42％.With the alleviation of anxiety and/or depression,the degree of asthma controlled was improved.After treatment,HAD score of the treatment group was lower that of control group((10.67±2.32) scores vs (11.94±3.02) scores,t=2.06,P＜0.05),ACT score in treatment group was much higher than that of control group((14.54± 3.14) scores vs (11.25±3.06)scores,t=4.59,P＜0.01),there were statistical significance in FEV1％ pre between two groups ((55.29±5.72) vs (43.36±7.13),t=8.02,P＜0.01).Conclusion Antidepressant treatment can alleviate anxiety and/or depression,improve the clinical curative effect of refractory asthma and help to improve lung function.
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ObjectiveTo detect IL-17 level of bone marrow in patients with multiple myeloma bone disease,and to investigate its clinical significance.MethodsThe bone marrow IL-17 levels were quantified in 33 cases of multiple myeloma patients and 20 normal control by ELISA assay. RANKL mRNA expression were detected by using RT-PCR.ResultsIn bone marrow supernatant,IL-17 was detected in both groups,and RANKL mRNA were detected in both groups too. IL-17 and RANKL mRNA levels in bone marrow of patients with MM were significantly higher than those in the control group(P＜0.05). The bone marrow concentrations of IL-17 and bone marrow mononuclear cells' RANKL mRNA expression in active stage were significantly higher than those in stable stage (P＜0.05).The bone marrow IL-17 and RANKL were significantly correlated (r =690,P＜0.05).ConclusionIL-17 may play an important role in the pathogenesis of MM.
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Objective To analyse expression levels of protein kinase C θ (PKC θ ) and its association with Th1/Th2,Tc1/Tc2 cytokines in peripheral blood mononuclear cells (PBMC) of patients with myelodysplastic syndromes and aplastic anemia (AA),and understand the pathogenesis of MDS and AA.Methods Fourteen patients with MDS-RA, fifteen patients with AA, and thirty health controls of PBMC were collected.mRNA expression levels of PKC θ were measured by RTQ-PCR,and the expression levels of Th1/Th2,Tc1/Tc2 cytokines were measured by the flow cytometry. Results The expression PKC θ mRNA (AA group:23.54±1.01,MDS group:23.76±1.58 ;health control group:27.12±1.12, P=0.004) and Th1and Tc1cytokines were statistically significant of among groups (all P＜0.05). Th2 and Tc2 cytokines were no statistical difference among groups (allP＞0.05). There were no statistical difference in the PBMC of PKC θ mRNA and Th1/Th2,Tc1/Tc2 cell cytokine (allP＞0.05) between MDS and AA.Conclusions The expression levels of PKCθmRNA and Th1,Tc1cells correlated cytokine in MDS and AA patients of PBMC are increases.
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Objective To observe the expression of chemokine (MCP-1) and chemokine receptor (CCR2) in bone marrow cells,bone marrow stromal cells of multiple myeloma (MM) patients.Methods 15 cases were diagnosed by domestic uniform standard for MM patients,7 cases of male,8 cases of female,age range from 38 to 67 years,mean age 53.7 years old.According to the Durie-Salmon staging system,patients were divided into Ⅰ (2 cases),Ⅱ (5 cases) and Ⅲ period(8 cases).Control group were from 10 cases of non-malignant blood disease patients.MCP-1,CCR2 expression were measured by flow cytometry.Results Almost 14 cases of bone marrow cells expressed MCP-1and CCR2 in MM patients,while in the control group,bone marrow cells almost did not express MCP-1and CCR2.Stromal cells had similar MCP-1and CCR2 expression profile (68.17 ％ vs 4.27 ％. P＜0.05).Tumor cells of MCP-1/CCR2 expression rates were 3.25 ％ and 32.76 ％. Compared MCP-1/ CCR2 expression of stromal cells and tumor cells with different stages of disease, the activated stage and the stable stage had similar level (68.71％ and 32.76 ％ vs 70.12 ％ and 53.39 ％. P＞0.05). Conclusion Most patients with MM bone marrow were expressed MCP-1and CCR2.MCP-1and CCR2 are the major MM cell surface expression of chemokine/receptor, which play important roles in the progress of.
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Objective The interleukin-1β (IL-13) expression in serum of acute myeloid leukemia (AML) patients was evaluated. To explore the significance of IL-1β in leukostasis and tissue infiltration by leukemic cells. Methods ELISA was used to investigate the contents of IL-1β in serum of 83 newly diagnosed with AML which contains 16 hyperleukocytic AML patients, and compared the IL-1β level between the hyperleukocytic AML group and non-hyperleukocytic AML group, the infiltrated group and non-infiltrated group. Results The content of IL-1β in AML serum [(88.23±36.30) pg/ml] was higher than that of in the control group[(29.56±15.53) pg/ml], with significant difference (P ＜0.01). There was a higher level for IL-1β in hyperleukocytic AML group[(136.67±65.68) pg/ml] than in non-hyperleukocytic AML group [(69.85±48.35) pg/ml],and there was a significant difference. IL-13 and peripheral blood cells were in linear correlation (r=0.74, P ＜0.01). There was a higher level for IL-1β in infiltrated group[(111.31 ±57.35) pg/ml] than in the other group [(79.68±43.42) pg/ml], and there was a significant difference. Conclusion The IL-1β may play an important role in leukostasis and tissue infiltration by leukemic cells in AML.
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Objective To compare and analyze the differences of blood lipid levels and self-consciousness level between children with moderate to severe obesity and normal children. Methods The subjects were the pupils of Grade 6 from 3 primary schools in Shangqiu city between December 2002 and March 2003. Totally 912 students participated in the measurement of body height and body mass, and 56 of them accorded with the diagnostic standard of obesity for children, 26 children with moderate to severe obesity were taken as the observational group. Another 26 healthy children (control group) of the same grade with normal body height and body mass took part in the study voluntarily. In both groups, blood lipids were detected and Piers-Harris children′s self-concept scale (PHCSS) was given by professional clinicians and professional psychological physicians respectively. Results The blood lipid indexes of TC, TG, LDL-C and HDL-C in the moderate to severe obesity group were obviously different from those in the normal body mass group (P