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Objective To evaluate the efficacy and safety of DA-EPOCH-R protocol for patients with B-cell non-hodgkin lymphoma (NHL). Methods 43 patients with B-cell NHL received DA-EPOCH-R protocol, and their efficacy and adverse reactions were analyzed. Results 43 patients received a total of 203 cycles of chemotherapy and the median chemotherapy cycle was 6 (2ˉ8 cycles). 32 patients (74.4%) achieved complete remission (CR) after 2ˉ4 cycles of chemotherapy. A further analysis found that age ≤60 years and>60 years, stageⅠ/Ⅱand stageⅢ/Ⅳ, germinal center B-cell (GCB), non-GCB, double expression lymphoma (DEL) and non-DEL patients had no significant differences (P> 0.05). With a median follow-up of 40 months (9ˉ62 mouths), the overall survival (OS) rate of 1-year and 3-year was 97.6 % and 92.8 % respectively. The major toxicity of DA-EPOCH-R protocol was hematologic toxicity. Other toxicities were mild, and no treatment-related deaths occurred. At the end of follow-up, no secondary tumors were found. Conclusions DA-EPOCH-R protocol is an effective and safe protocol for patients with NHL. The result shows that the curative effect of patients in stageⅢandⅣis similar to the patients in stageⅠandⅡ.
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With the full coverage of China 's basic medical insurance, medical costs showed a rapid growth trend. It is becoming more and more important to control the cost of medical treatment. Strengthening the control of medical insurance providers is the experience of international health insurance management and an important direction of China's basic medical insurance system reform. Many areas explore the reform of basic medical insurance payment actively and accumulated a lot of typical experience. When exploring the reform of basic medical insurance payment, the practical experience proposes that we should avoid the shortcomings of the post-payment system and prospective payment system, and push a combination of a variety of payment methods such as the capitation, the Pay per bed day, the DRGs etc. , and the promotion of comprehensive reform of public hospitals to establish a classification diag-nosis and treatment.
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Objective To investigate the role of Th17 cells in chronic myeloid leukemia (CML) pathogenesis. Methods 33 CML patients [15 newly diagnosed (ND)- and 18 chronic-phase (CP)- CML patients] and 15 healthy controls were enrolled. The percentage of Th17 cells in the peripheral blood (PB) of CML and controls were evaluated by flow cytometry. RORC mRNA expressions were examined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). The levels of IL-17 in PB of CML and controls were measured by enzyme-linked immunoadsorbent assay (ELISA). The relationships between Th17 cells and clinical characteristics in CML were analyzed. Results The percentage of Th17 cells in PB of ND-CML patients [(0.71±0.41) %] was significantly lower than that of CP-CML patients [(4.08±0.74) %, P<0.05] and healthy controls [(3.18±1.32) %, P<0.05]. The mRNA level of RORC in PB of ND-CML patients (0.043 3±0.040 5) was significantly decreased compared with that in CP-CML patients (0.086 1±0.052 3, P<0.05) and healthy controls (0.091 0±0.058 4, P<0.05). The levels of IL-17 in PB of ND-CML patients [(1.43±0.22) pg/ml] and CP-CML patients [(1.36±0.19) pg/ml] were slightly higher than that of healthy controls [(1.23±0.14) pg/ml, P< 0.05]. The percentage of Th17 cells had significantly negative correlations with white blood cell counts in PB or bcr-abl (IS). Conclusion Th17 cells may play an important role in CML pathogenesis, which has potential implication for immunotherapy of this malignancy.
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Objective To explore the expression of pituitary tumor transforming gene (PTTG) and c-myc gene in patients with non-Hodgkin lymphoma (NHL),its relationship with NHL and its clinical significance.Methods PTTG mRNA and c-myc mRNA levels in bone marrow mononuclear cell (BMMNC) isolated from 38 NHL patients and 10 chronic lymphadenitis patients were quantified by reverse transcriptionpolymerase chain reaction (RT-PCR).Results mRNA expression of PTTG and c-myc gene in BMMNC was significantly higher in NHL patients than those in normal controls (PTTG:0.567 7±0.270 7 vs 0.071 2± 0.020 1,t =4.706,P ＜ 0.05; c-myc:0.352 6±0.185 4 vs 0.107 3±0.043 5,t =3.303,P =0.002).The expression of PTTG and c-myc gene in peripheral T cell lymphoma and diffuse large B cell lymphoma showed no significant difference (PTTG:0.556 8±0.211 3 vs 0.602 8±0.244 6,t =0.640,P =0.527; c-myc:0.350 1± 0.177 6 vs 0.361 0±0.190 2,t =0.302,P =0.765).Both expression of PTTG and c-myc were positively related to NHL clinical stage and IPI.Expression of PTTG mRNA was positively related to the expression of c-myc mRNA.Conclusion There was overexpression of PTTG and c-myc in NHL,which indicates that PTTG might be involved in tumorigenesis of NHL through direct or indirect activation of c-myc oncogene.
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ObjectiveAssess the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of schizophrenia and its social function .Methods 156 patients with schizophrenia were randomly assigned to a real rTMS treatment group (n=78) or a sham rTMS treatment group(n=78) ,each patient in the real rTMS group received 20 rTMS sessions over 4 weeks .Efficacy was evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at 4 weeks .Social function was evaluated u-sing the Personal and Social Performance Scale(PSP) at baseline and at 4 weeks .Results The study group is better than the control group in PANSS total and negative symptoms and PSP total after treatment (P<0 .05) .There is not serious adverse reactions in the treatment .Conclusion rTMS can reduce the negative symptoms and improve social function in schizophrenia with high safety .
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Objective To observe the expression of interferon gamma receptor on neuron and astrocyte of the hippocampus of depressed rats.Methods The depressed rats were produced by separation raise and unpredictable mild stressors.Their behaviors were evaluated in open-field test.The rats underwent electro-convulsive treatment(ECT)or modified electric convulsive therapy(MECT).The expression of interferon gamma receptor on neuron and astrocyte of the hippocampus was detected by immunofluorescence and in situ hybridization.Results There were significant differences among the stress plus ECT group,the stress plus MECT group,the stress plus sham electroshock group in all the three tests.Conclusion ECT and MECT can both reduce the expression of interferon gamma receptor on neuron and astrocyte of the hippocampus of depressed rats,and MECT shows more stronger therapeutic effect.Cytokine may play an important role in the pathophysiologic mechanism of depression.