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Objective: To investigate the early effect and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a 10-day decitabine-containing conditioning regimen in the treatment of acute myeloid leukemia (AML) /myelodysplastic syndrome (MDS) . Methods: From April 2021 to May 2022, 31 AML/MDS patients who received allo-HSCT with a 10-day decitabine-containing conditioning regimen were analyzed. Results: AML (n=10), MDS-AML (n=6), CMML-AML (n=1), and MDS (n=14) were identified in 31 patients, 16 males, and 15 females, with a median age of 41 (20-55) yr. Neutrophils and platelets were successfully implanted in 31 patients (100%), with a median implantation duration of 12 (9-30) and 14 (9-42) days, respectively. During the preconditioning period, 16 patients (51.6%) developed oral mucositis, with 15 cases of Ⅰ/Ⅱ grade (48.4%) and one case of Ⅲ grade (3.2%). After transplantation, 13 patients (41.9%) developed CMV viremia, six patients (19.4%) developed hemorrhagic cystitis, and four patients (12.9%) developed a local infection. The median time of acute graft versus host disease (aGVHD) following transplantation was 33 (12-111) days. The cumulative incidence of aGVHD and Ⅲ/Ⅳ grade aGVHD was 41.9% (95% CI 26.9%-61.0%) and 22.9% (95% CI 13.5%-47.5%), respectively. There was no severe cGVHD, and mild and moderate chronic GVHD (cGVHD) incidence was 23.5% (95% CI 12.1%-43.6%). As of November 30, 2022, only one of the 31 patients had relapsed, with a 1-yr cumulative relapse rate (CIR) of 3.2% (95% CI 0.5%-20.7%). There was only one relapse patient death and no non-relapse deaths. The 1-yr overall survival (OS) and disease-free survival (DFS) rates were 92.9% (95% CI 80.3%-100%) and 96.8% (95% CI 90.8%-100%), respectively. Conclusions: A 10-day decitabine-containing conditioning regimen for allo-HSCT reduced relapse and was safe and feasible in treating AML/MDS.
Subject(s)
Male , Female , Humans , Decitabine , Myelodysplastic Syndromes/therapy , Leukemia, Myeloid, Acute/complications , Disease-Free Survival , Hematopoietic Stem Cell Transplantation/adverse effects , Recurrence , Chronic Disease , Graft vs Host Disease/etiology , Transplantation Conditioning/adverse effects , Bronchiolitis Obliterans Syndrome , Retrospective StudiesABSTRACT
Objective:To investigate clinical and histopathological features of mucinous nevi.Methods:Clinical and pathological data were collected from 10 patients with clinically and histopathologically confirmed mucinous nevi in Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2014 to December 2019, and retrospectively analyzed.Results:All cases developed mucinous nevi in childhood, with an average age of onset being 6.5 years. Of the 10 patients, 7 had lesions on the trunk, among whom 4 had lesions on the back; the remaining 2 had lesions on the limbs, and 1 had generalized lesions on the trunk and limbs. The skin lesions were locally arranged in lines, bands or clusters, and skin-colored, reddish or yellow in color, with the texture varying from soft to hard. Histopathological examination showed that 10 patients presented with disordered arrangement of collagen fiber bundles in the dermis and mucin deposition at varying locations and to different degrees among them, 6 with thickened and red-stained collagen fibers in the deposition area, and the remaining 4 with sparse and decreased collagen; focal liquefaction degeneration of the basal layer was observed in 2 cases, and different amounts of mature adipose tissue in the dermis were seen in 3 cases.Conclusions:Mucinous nevus pathologically manifests as mucin deposition of varying degrees among disorderedly arrangd collagen fiber bundles in the dermis, which is similar to some other diseases, and is easily misdiagnosed. Close combination of clinical and pathological features facilitates confirmed diagnosis.
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Objective To observe the clinical efficacy and safety of erlotinib plus temozolomide for recurrence/progression patients with epidermal growth factor receptor (EGFR) gene mutation in non-small cell lung cancer (NSCLC) with brain metastases after whole brain radiotherapy.Methods A total of 68 EGFR gene mutation NSCLC patients with brain metastases of intracranial recurrence/progression after whole brain radiotherapy were selected from August 2013 to June 2018 in Baoji Central Hospital of Shaanxi Province and Xintai People's Hospital of Shandong Province.All the patients were randomly divided into erlotinib group and combined treatment group (erlotinib combined with temozolomide) using random number table method.The patients in erlotinib group (34 cases) were treated with oral erlotinib 150 mg/d until progression or unacceptable adverse reaction,and the patients in combined treatment group (34 cases) were given erlotinib and oral temozolomide 150 mg/(m2 · d) for 1-5 day,every 28 days was a cycle,temozolamide for 6 cycles.Comparison was made on curative effects and occurrence condition of adverse reactions between the two groups.Results The overall response rates in the erlotinib group and combined treatment group were 11.8％ (4/34)and 32.4％ (11/34) respectively,and the disease control rates in the two groups were 35.3％ (12/34) and 64.7％ (22/34) respectively,with significant differences (x2 =4.191,P =0.041;x2 =5.882,P =0.015).The median progression-free survival in the erlotinib group and combined treatment group were 3.22 months and 5.29 months respectively,and the median overall survival in the two groups were 5.60 months and 7.90 months respectively,with significant differences (x2 =9.269,P =0.002;x2 =11.005,P =0.001).The incidence of nausea and vomiting in combined treatment group was significantly higher than that in erlotinib group [67.6％ (23/34) vs.14.7％ (5/34)],with a significant difference (x2 =19.671,P ＜ 0.001),but there were no significant differences in the incidences of other adverse reactions (all P ＞ 0.05).The patients in the two groups had no more than grade Ⅲ of adverse reactions.Conclusion The curative effect of erlotinib combined with temozolomide is better in the treatment of recurrence/progression patients with EGFR gene mutation in NSCLC with brain metastases after whole brain radiotherapy,with mild adverse reactions and good patients' tolerance.
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Objective To explore informatized management of medical consumables in new situation.Methods lntormatized management of medical consumables was executed with the involvement of multi-dimension data analysis,medical consumables supervision and approval system under early warning mechanism,secondary development of sunshine purchase platform as well as big data rebuilding and etc.Results The whole-course supervision from purchase to utilization was realized for medical consumables,which provided data support to medical consumables utilization.Conclusion Wholecourse,professional and informatized management is implemented for medical consumables,which lays a foundation for clinical service and hospital transformation.
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Objective To explore informatized management of medical consumables in new situation.Methods lntormatized management of medical consumables was executed with the involvement of multi-dimension data analysis,medical consumables supervision and approval system under early warning mechanism,secondary development of sunshine purchase platform as well as big data rebuilding and etc.Results The whole-course supervision from purchase to utilization was realized for medical consumables,which provided data support to medical consumables utilization.Conclusion Wholecourse,professional and informatized management is implemented for medical consumables,which lays a foundation for clinical service and hospital transformation.
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Occupational carbon monoxide (CO) poisoning related to diesel motor fumes in an air-raid shelter (ARS) was first identified in Jinan City, China, in June 2015. A total of 17 cases were identified, including 14 possible cases of firemen and 3 confirmed cases of water channel clean-up workers. The overall attack rate (AR) of firemen was 42% (14/33). The firemen had a significantly higher AR with a longer exposure and more protracted time of rescue in the ARS (P < 0.05). All the cases stated that they did not realize the potentially high level of exposure to CO in the ARS. CO poisoning posed a risk to both patients and service providers. Occupational safety and health education should be promoted and enforced in all workplaces where CO sources exist.
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Humans , Accidents, Occupational , Air Pollutants, Occupational , Carbon Monoxide Poisoning , China , Environmental Monitoring , Occupational Exposure , Vehicle Emissions , WorkplaceABSTRACT
Objective To investigate the clinical efficacy of apapatinib-targeted therapy combined with oxaliplatin and tiggio for treatment of gastric cancer. Methods A total of 150 patients with advanced gastric cancer were enrolled from March 2015 to March 2017. According to the random number table method, the patients were divided into the study group (apocitinib combined with oxaliplatin+tiggio) and the control group (oxaliplatin + tiggio), 75 cases each. The recent treatment effects and adverse reactions were compared between the two groups. Results The objective response rate (46.7 % vs. 25.3 %) and disease control rate (76.0 % vs.48.0 %)in the study group and the control group were statistically significant(all P <0.05).There were no statistical differences in the incidence of complications such as myelosuppression, digestive tract reaction, fatigue and oral ulcer between the two groups (all P > 0.05). The incidence of complications such as hypertension, proteinuria and hand-foot syndrome in the study group was higher than those in the control group (all P < 0.05), but it was in a state of grade Ⅰ~Ⅱ and tolerance. Conclusion Apotiphene combined with oxaliplatin and tiggio as a chemotherapy regimen for advanced gastric cancer may have a better effect.
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<p><b>BACKGROUND</b>The postremission therapies for adult patients generally contain consolidation chemotherapy, allogeneic hematopoietic stem cell transplantation and autologous hematopoietic stem cell transplantation (auto-HSCT). Because of the various results from different centers, the optimal therapy for adult acute lymphoblastic leukemia (ALL) patients is still uncertain. This study aimed to better understand predictive factors and role of auto-HSCT in the postremission therapy for adult ALL patients.</p><p><b>METHODS</b>The outcomes of 135 adult patients with ALL, who received the first auto-HSCT in Hematopoietic Stem Cell Transplantation Center of Blood Diseases Hospital, Chinese Academy of Medical Sciences from January 1, 1994 to February 28, 2014, were retrospectively analyzed. Survival curves were estimated using the Kaplan-Meier method and simultaneous effects of multiple covariates were estimated with the Cox model.</p><p><b>RESULTS</b>Overall survival (OS) and disease-free survival (DFS) at 5 years for the whole cohort were 59.1 ± 4.5% and 59.0 ± 4.4%, respectively. The cumulative nonrelapse mortality and relapse rate at 5 years were 4.5 ± 0.03% and 36.6 ± 0.19%. For both OS and DFS, acute T-cell lymphoblastic leukemia, high lactate dehydrogenase (LDH) at diagnosis, blast cell proportion ≥5% on the 15 th day of induction therapy, and extramedullary infiltration before HSCT were the poor prognosis factors. In addition, age ≥35 years predicted poor DFS. Only T-ALL and high LDH were the independent undesirable factors associated with OS and DFS in Cox regression model. For 44 patients who had results of pretransplantation minimal residual disease (MRD), positive MRD (MRD ≥0.01%) indicated poor OS (P = 0.044) and DFS (P = 0.008). Furthermore, for the standard risk group, the patients with negative MRD (MRD <0.01%) had better results (OS at 18 months was 90.0 ± 9.5%, while for the patients with positive MRD OS was 50.0 ± 35.4%, P = 0.003; DFS at 18 months was 90.0 ± 9.5%, while for the positive MRD group DFS was 0%, P < 0.001).</p><p><b>CONCLUSIONS</b>This study confirmed that auto-HSCT combined with posttransplantation maintenance chemotherapy could be an option for adult ALL patients and pretransplantation MRD may play a significant role in the direction of therapy for adult ALL patients.</p>
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , China , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Kaplan-Meier Estimate , Neoplasm, Residual , Mortality , Therapeutics , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Mortality , Therapeutics , Prognosis , Proportional Hazards Models , Retrospective Studies , Transplantation, HomologousABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical efficacy of Shuganyiyang Capsule combined with conventional Western medicine (tamsulosin hydrochloride sustained release tablets + prostat tablets) for the treatment of type III prostatitis complicated by erectile dysfunction (ED).</p><p><b>METHODS</b>Eighty patients with type III prostatitis complicated by ED were equally randomized to an experimental and a control group, the former treated with Shuganyiyang Capsule combined with tamsulosin hydrochloride sustained release tablets and prostat tablets, while the latter with tamsulosin hydrochloride and prostat only, both for 8 weeks. Then the prostatitis symptoms, erectile function and psychological conditions of the patients were evaluated using NIH-CPSI, IIEF-5, and hospital anxiety and depression scale (HADA and HADD) respectively. The rates of recovery, excellence, effectiveness and ineffectiveness were calculated.</p><p><b>RESULTS</b>The scores on NIH-CPSI, IIEF-5, HADA and HADD obtained at 4 and 8 weeks after treatment showed statistically significant differences between the two time points as well as from the baseline (P < 0.01). At 8 weeks, the scores on NIH-CPSI, IIEF-5, HADA and HADD were 6.83 +/- 4.96, 21.03 +/- 2.54, 6.05 +/- 1.62, and 5.35 +/- 3.30 in the experimental group, as compared with 7.55 +/- 4.89, 17.68 +/- 4.15, 6.88 +/- 2.45, and 7.85 +/- 3.77 in the control (P < 0.05). The rate of effectiveness was significantly higher in the experimental than in the control group (90% [36/40] vs 70% [28/40], P < 0.05).</p><p><b>CONCLUSION</b>Shuganyiyang Capsule combined with conventional Western medicine, such as alpha blockers and galenica, produces definite effect on chronic prostatitis complicated by ED, improves the psychological conditions of the patient, and enhances the therapeutic efficiency of chronic prostatits.</p>
Subject(s)
Humans , Male , Capsules , Drugs, Chinese Herbal , Therapeutic Uses , Erectile Dysfunction , Drug Therapy , Phytotherapy , Prostatitis , Drug Therapy , Sulfonamides , Therapeutic Uses , Treatment OutcomeABSTRACT
Objective To find out the status of prevention and control of iodine deficiency disorders and evaluate the iodine nutritional status of Jinan residents,to explore appropriate iodine level in drinking water,and to provide a scientific basis for adjustment of intervention strategies.MethodsAccording to the Monitoring Program of the National Iodine Deficiency Disorders (Trial),qualified iodized salt consumption rate,drinking water iodine content and urinary iodine levels of women of childbearing age were determined in iodine deficiency areas from 2003 to 2010.Salt iodine was detected by direct titrimetry,urinary iodine by As-Ce catalytic spectrophotometric assay and iodine in drinking water by cerous sulfate catalytic spectrophotometric method.Results Intake rate of qualified iodized salt was up to 90％ and above from 2003 to 2010,median water iodine was 13.65 μg/L in the 10 counties(cities,districts),of which less than 100 μg/L accounted for 79.82％(4560/5713 ) and ＞ 150 μg/L accounted for 12.73％(727/5713).With the increase of water iodine(0 ～ ＜ 10,10 ～ ＜ 50,50 ～ ＜ 100,100 ～ ＜ 150,150 ～ ＜ 300 and ≥300 μg/L),urinary iodine levels of women of childbearing age increased successively(median 156.56,175.81,267.04,349.00,524.22,583.20 μg/L,respectively,x2 =121.20,P ＜ 0.05),while the ratio of urinary iodine ＜ 100 μg/L was significantly lower.The ratio of urinary iodine between 100 and 300 μg/L was decreased gradually,but the ratio of great than 300 μg/L was gradually increased.ConclusionsIodine deficiency areas in Jinan have reached the standard of elimination of iodine deficiency disorders.We should insist to carry out our measures to suit local conditions,classified guidances and scientific principals of iodine supplementation.
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Lymphocyte chalone was partially purified by ultrafiltration and chromatography on Sephadex G75. Its inhibitory effect on proliferation of T, B lymphocyte was demonstrated by [3H]-TdR incorporation method. In mouse bone marrow transplantation model, the treatment with lymphocyte chalone in vivo and in vitro was found to significantly improve the 30 d survival rate and prolong mean survival time, suggesting that it has an inhibitory effect on acute GVHD and is beneficial to H-2 incompatible bone marrow transplantation in mice.