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Objective@#To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation (HSCT) for the treatment of patients with anaplastic large cell lymphoma (ALCL) .@*Methods@#The clinical records of 33 ALCL patients after HSCT were collected and analyzed retrospectively to evaluate the rates of overall survival (OS) and recurrence after autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT) and the factors influencing prognosis.@*Results@#The median-age of this cohort of 33 ALCL cases at diagnosis was 31 (12-57) years old with a male/female ratio of 23/10, 24 cases (72.7%) were ALK+ and 9 ones (27.3%) ALK-. Of them, 25 patients (19 ALK+ and 6 ALK-) underwent auto-HSCT and 8 cases (5 ALK+ and 3ALK-) allo-HSCT with a median follow-up of 18.7 (4.0-150.0) months. Disease states before HSCT were as follows: only 6 patients achieved CR status and received auto-HSCT, 16 patients achieved PR (14 cases by auto-HSCT and 2 ones allo-HSCT) , the rest 11 cases were refractory/relapse (5 cases by auto-HSCT and 6 ones allo-HSCT) . There were 7 cases died of disease progression (5 after auto-HSCT and 2 allo-HSCT) and 5 cases treatment-related mortality (TRM) (2 after auto-HSCT and 3 allo-HSCT) , TRM of two groups were 8.0% and 37.5%, respectively. Both the median progression-free survival (PFS) and OS were 15 months after auto-HSCT, the median PFS and OS after allo-HSCT were 3.7 (1.0-90.0) and 4.6 (1.0-90.0) months, respectively. There was no statistically significant difference in terms of survival curves between the two groups (OS and PFS, P=0.247 and P=0.317) . The 2-year OS rates in auto-HSCT and allo-HSCT groups were 72% and 50%, respectively. The 5-year OS rates in auto-HSCT and allo-HSCT groups were 36% and 25%, respectively.@*Conclusion@#ALCL treated by chemotherapy produced high rates of overall and complete responses. Chemotherapy followed by auto-HSCT remained to be good choice for patients with poor prognostic factors. High-risk patients should be considered more beneficial from allo-HSCT.
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Objective@#To evaluate clinical outcomes of autologous (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for angioimmunoblastic T-cell lymphoma (AITL) .@*Methods@#From June 2007 to June 2017, clinical data of AITL patients who underwent HSCT in eight hospitals were assessed retrospectively.@*Results@#Of 19 patients, 13 male and 6 female with a median age of 50 (32-60) years old, 12 auto-HSCT and 7 allo-HSCT recipients were enrolled in this study, all donors were HLA-identical siblings. Two of allo-HSCT recipients were relapsed auto-HSCT ones. There were 5 patients (5/12) in complete response (CR) status and 7 (7/12) in partial remission (PR) status before transplantation in auto-HSCT group, and 2 (2/7) in PR status and 3 (3/7) in progression disease (PD) status before transplantation in allo-HSCT group. The median follow-up for the surviving patients was 46.5 months (range, 1-100 months) for the whole series, two patients lost in auto-HSCT group. Three patients developed acute graft-versus-host disease (aGVHD) and 5 chronic graft-versus-host disease (cGVHD) after allo-HSCT. Three patients died of primary disease and 1bleeding in auto-HSCT group. One patient died of primary disease and 2 transplantation-related mortality in allo-HSCT group. The 3-year cumulative overall survival (OS) were 56% (95%CI 32%-100%) and 57% (95%CI 30%-100%) for auto-HSCT and allo-HSCT, respectively (P=0.979) . The 3-year cumulative progression-free survival (PFS) were 34% (95%CI 14%-85%) and 57% (95%CI 30%-100%) for auto-HSCT and allo-HSCT, respectively (P=0.451) .@*Conclusion@#Both auto-HSCT and allo-HSCT were optimal choices for AITL. In clinical practice, which HSCT was better for AITL patients should be based on comprehensive factors including sensitivity to chemotherapy, risk stratification and disease status at transplantation.
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OBJECTIVE:To evaluate the effects and safety of Bencycloquidium bromide nasal spray in the treatment of acute rhinitis after a cold. METHODS:A multicenter,dose parallel controlled,randomized,double-blind,placebo-controlled clinical tri-al was conducted. Two hundred and thirty-eight patients with acute rhinitis after a cold were selected and divided into group A(24 cases),B(24 cases),C(24 cases),D(24 cases),E(23 cases),F(24 cases),G(23 cases),H(24 cases),I(24 cases),J (24 cases). Group A-C were given Bencycloquidium bromide nasal spray 22.5μg,45μg,90μg,respectively,bid,spraying it once for each nostril. Group D-F were given Bencycloquidium bromide nasal spray 22.5 μg,45 μg,90 μg,respectively,tid,spraying it once for each nostril. Group G-I were given Bencycloquidium bromide nasal spray 22.5 μg,45 μg,90 μg,respectively,qid,spray-ing it once for each nostril. Group J was given placebo. All groups were treated for(4±1)d. Rhinorrhea score and continuous rhi-norrhea duration were compared among 10 groups,and the safety was evaluated. RESULTS:The rhinorrhea score and continuous rhinorrhea duration of 10 groups were improved significantly,with statistical significance (P0.05). There was no statistical significance in the incidence of ADR among 10 groups(P>0.05). CONCLUSIONS:Bencycloquidium bromide nasal spray with 90 μg,qid times significantly improves rhinorrhea score and continuous rhinorrhea duration with good safety.
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Objective To observe the clinical safety and efficacy of foscarnet prophylaxis and pre-emptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Ninety-six patients undergoing allo-HSCT from October 2014 to December 2016 were retrospectively analyzed. Plasma CMV-DNA was monitored with real-time quantitative polymerase chain reaction (RQ-PCR) from beginning to 180 days after transplantation. Foscarnet was used not only for prophylaxis but also for first-line pre-emptive therapy when plasma CMV-DNA turned to positive. Foscarnet was given 60 mg·kg-1·d-1 and 120 mg·kg-1·d-1 respectively in prevention and pre-emptive therapy. Incidences of CMV infection and CMV disease were observed, influencing factors on CMV in faction and the efficacy and safety of foscarnet prophylaxis were analyzed, and survival of patients treated by all-HSCT was evaluated. Results Of the total 96 patients, 42 cases (43.8%) had CMV infection with the median time of 42 days after allo-HSCT. CMV-DNA became negative in 36 patients (85.7%, 36/42) after pre-emptive therapy. Six patients (14.3 %, 6/42) developed CMV disease, including 5 patients with CMV negative and 1 patient died for CMV pneumonia. Haploidentical donor and grade Ⅱ-Ⅳacute graft versus host disease (GVHD) were the risk factors for CMV reactivation (χ2 = 3.834, P< 0.05; χ2 = 16.807, P< 0.001). The side effects of foscarnet prophylaxis were mild without hematologic toxicities. 12 patients (28.6 %) died in 42 patients with CMV infection, and 6 patients (11.1 %) died in 54 patients without CMV infection. The difference of survival rates between both groups was not statistically significant. Conclusion Foscarnet is an effective agent for prophylaxis and pre-emptive therapy in CMV infection after allo-HSCT with mild adverse reactions, especially for patients following with hematopoietic recovering.
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Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronary heart disease (CHD), to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI , compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group (P < 0.05). And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI(P < 0.05). The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group (P < 0.05). But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI(P < 0.05). Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.
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Objective To assess the effect of the Asthma Healthy Breathing Center on healthy behaviour of asthma patients . Methods Asthma Healthy Breathing Center management mode including asthma specialist out-patient ,asthma health mission cen-ter and asthma patients club .Doctors ,nurses and patients participated jointly in standard treatment ,systematic education manage-ment on asthma patients .the change of treating patients and self management present situation ,the symptoms and lung ventilation function of 144 asthma patients from January 2010 to January 2011 before and after the management were studied .Results After standardization management treatment ,accept and use of inhaled steroid ,correct use of inhaled drugs method ,insisting on drug treatment ,abuse of antibiotics and composition of unknown traditional Chinese medicine(TCM)of 144 patients have been improved significantly from 41 .67% ,20 .14% ,26 .39% ,68 .75% to 93 .06% ,95 .14% ,94 .44% ,6 .25 respectively (P<0 .05) .Knowledge of asthma self-management ,adhere to the peak current meter monitoring used ,records of asthma diary ,health education activities have been improved significantly from 12 .50% ,5 .56% ,5 .56% ,13 .89% to 75 .00% ,88 .89% ,88 .89% ,95 .83% (P<0 .05) .ACT as-sessment ,FEV1 predicated value ,PEF predicated value have been improved from 15 .00 ± 3 .34 ,60 .2 ± 13 .50 ,63 .65 ± 11 .23 to 23 . 00 ± 2 .23 ,77 .6 ± 8 .30 ,80 .00 ± 6 .50(P<0 .05) .Conclusion Establishing Asthma Healthy Breathing Center can significantly im-prove the patient′s health behavior ,and it indicated that establish Prompt construction area slow disease control and prevention cen-ter is effective and necessary for the treatment of patients with asthma .
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ObjectiveTo explore medical students on the level of awareness of bronchoscopy,bronchoscopy teaching methods and teaching effectiveness. MethodsMaking a analysis of the appraisal questionnaire on the theoretical knowledge bronchoscopy study, bronchoscopy operational training of the intemship system of the clinical course. ResultsAfter clinical teaching of bronchoscopy, medical students have improved significantly. their operation skills and motivation in learning the respiratory system anatomy, pathological features, imaging diagnosis and bronchoscopy technology. ConclusionThe clinical teaching of bronchoscopy can improve the quality of clinical teaching in respiratory medicine, which helps to improve the clinical skills of medical students, and lay the foundation for training medical students in bronchoscopy.
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In order to improve the Interns’ synthetic medical quality of respiratory medicine, based on the teaching practice of respiratory medicine in our hospital, the analysis of admission introduction and requests for high quality medical ability are reviewed in the present article.
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Objective To investigate the influence of hypoxia on leptin expression in serum,CSF and brain tissue of C57BL/6J mice.Methods C57BL/6J mice were divided into 3 groups:the normal control,24-hour hypoxia group and 48-hour hypoxia group.The latter two groups exposed to hypoxia in the man-made auto pressure and hypoxia control cabin(XQ-I).Radioimmunoassay was used to detect the leptin level.Results The leptin level in the serum,CSF and brain tissue of mice exposed to hypoxia were higher than that of normal control,but no difference was found between 24-hour hypoxia group and 48-hour hypoxia group.Conclusion Hypoxia probably induces the increasing of leptin expression in fat tissue,as well as in the central nervous system.
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Nowadays,medical university students' mental quality is a question that shouldn't be ignored.This paper analyzed the causes of mental problems of medical university students,emphasized the importance of mental quality education in clinical practice and put forward methods of mental quality education in clinical practice.