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OBJECTIVE To study the clinical characteristics of leflunomide-induced int erstitial pneumonia （Lef-IP），and to provide reference for its clinical diagnosis ，treatment and prevention. METHODS Lef-IP cases published in domestic and foreign journals from January 2004 to June 2021 were collected. Relevant information of patients were extracted and analyzed retrospectively， including basic characteristics ，clinical manifestations ，imaging manifestations ，laboratory examinations ， histopathological examinations ，treatment and outcome. RESULTS A total of 54 Lef-IP patients from case reports of 24 publications were included ，with a median age of 61 years（9-83 years）. Pulmonary symptoms appeared from 3.3 weeks to 132.9 weeks（median time of 14.5 weeks）. Patients with a loading dose of leflunomide have a shorter median time to pulmonary symptoms appearing （7.5 weeks）. The main clinical manifestations were dyspnea （85.2％），cough（57.4％），fever（53.7％）. CT imaging examination showed 19 cases with ground-glass shadow in both lungs ，and 29 cases showed interstitial infiltration in both lungs on chest radiograph；blood gas analysis showed hypoxemia and hypocapnia ；the levels of C-reactive protein and Krebs von Den lungen- 6 （KL-6）increased；histopathological examination mainly showed interstitial pneumonia （8 cases），including 3 cases of diffuse alveolar injury ，4 cases of lymphocytes in bronchoalveolar lavage fluid ，and 1 case of noncaseating granuloma. After discontinued leflunomide and symptomatic treatment （antibiotics，hormones，colecenamine，plasma exchange ），35 patients（64.8％）recovered or improved their lung symptoms. Twelve patients （22.2％）died，and patients with fever may had a higher mortality rate （34.5％， P＝0.02）. CONCLUSIONS The main clinical manifestations of Lef-IP are dyspnea ，cough and fever. Loading doses of leflunomide should be avoided at the beginning of treatment. When lef-IP occurs ，leflunomide is discontinued and corresponding treatment is given，and most of the patients ’pulmonary symptoms can return to normal or be improved.
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Objective@#To retrospectively analyze the efficacy and prognostic factors of postoperative intensity modulated radiotherapy for grade Ⅱ gliomas.@*Methods@#Retrospective analysis was conducted on patients with postoperative grade Ⅱ glioma in our hospital from Jan. 2010 to Dec. 2018. The primary endpoint was progression-free survival, and the secondary endpoint was overall survival. Correlative analyses of prognosis by age, gender, initial resection status, the maximum diameter of the lesions, bi-hemisphere, astrocytoma, chemoradiation, adjuvant chemotherapy were conducted.@*Results@#A total of 109 cases with grade Ⅱ glioma were enrolled. The follow-up rate was 91.75%, including 10 cases dead and 27 relapsed. There were 24 cases (88.9%) of in-field failure, and 3 cases (11.1%) of out-field failure. 14 cases of recurrence occurred in 81 cases of total resection group, accounting for 17.3%, and 13 in 28 cases of subtotal resection group, accounting for 46.4%. The recurrence rate in the subtotal resection group was significantly higher than that in the total resection group (χ 2=9.484, P<0.05). The 1-, 2-, 3-, 4- and 5-year progression-free survival rates were 92.5%, 86.0%, 80.6%, 77.5% and 66.8%, respectively. The 2-, 3-, 4- and 5-year overall survival rates were 97.2%, 90.8%, 87.7% and 84.5%, respectively. Multivariate analysis showed that patients with subtotal resection(HR=3.608, P<0.05) and bi-hemisphere(HR=3.183, P<0.05)were significantly correlated with the progression free survival.@*Conclusions@#Postoperative intensity modulated radiotherapy for grade Ⅱ gliomas can achieve a better PFS. Recurrence in the radiation field is the main failure mode. Initial resection status and bi-hemisphere of tumor are important influential factors for PFS of grade Ⅱ gliomas patients.
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Objective To retrospectively analyze the efficacy and prognostic factors of postoperative intensity modulated radiotherapy for grade Ⅱ gliomas.Methods Retrospective analysis was conducted on patients with postoperative grade Ⅱ glioma in our hospital from Jan.2010 to Dec.2018.The primary endpoint was progression-free survival,and the secondary endpoint was overall survival.Correlative analyses of prognosis by age,gender,initial resection status,the maximum diameter of the lesions,bihemisphere,astrocytoma,chemoradiation,adjuvant chemotherapy were conducted.Results A total of 109 cases with grade Ⅱ glioma were enrolled.The follow-up rate was 91.75％,including 10 cases dead and 27 relapsed.There were 24 cases (88.9％) of in-field failure,and 3 cases (11.1％) of out-field failure.14 cases of recurrence occurred in 81 cases of total resection group,accounting for 17.3％,and 13 in 28 cases of subtotal resection group,accounting for 46.4％.The recurrence rate in the subtotal resection group was significantly higher than that in the total resection group (x2 =9.484,P＜0.05).The 1-,2-,3-,4-and 5-year progression-free survival rates were 92.5％,86.0％,80.6％,77.5％ and 66.8％,respectively.The 2-,3-,4-and 5-year overall survival rates were 97.2％,90.8％,87.7％ and 84.5％,respectively.Multivariate analysis showed that patients with subtotal resection (HR =3.608,P＜ 0.05)and bi-hemisphere (HR =3.183,P＜ 0.05) were significantly correlated with the progression free survival.Conclusions Postoperative intensity modulated radiotherapy for grade Ⅱ gliomas can achieve a better PFS.Recurrence in the radiation field is the main failure mode.Initial resection status and bihemisphere of tumor are important influential factors for PFS of grade Ⅱ gliomas patients.
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Uterine fistula after cesarean section mainly occurs in developing countries.With the development of social economy,the incidence of uterine fistula in China is gradually decreasing.However,in recent years,the incidence of placenta previa–accreta is increasing and the intraoperative injury is increasing.We describe the most common uterine fistula after cesarean section to provide reference and basis for its diagnosis and treatment.
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p53 gene plays an important role in apoptosis, which is necessary for successful invasion of trophoblast cells. The change from an arginine (Arg) to a proline (Pro) at codon 72 can influence the biological activity of p53, which predisposes to an increased risk of recurrent spontaneous abortion (RSA). In order to investigate the association between p53 polymorphism at codon 72 and RSA, we conducted this meta-analysis. Pubmed, Embase and Web of science were used to identify the eligible studies. Odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the strength of the association. Six studies containing 937 cases of RSA and 830 controls were included, and there was one study deviated from Hardy-Weinberg equilibrium (HWE). There was a significant association between p53 polymorphism at codon 72 and RSA in recessive model (Pro/Pro vs. Pro/Arg+Arg/Arg; OR=1.60, 95% CI: 1.14-2.24) and co-dominant model (Pro/Pro vs. Arg/Arg; OR=1.47, 95% CI: 1.02-2.12) whether the study that was deviated from HWE was eliminated or not. A significant association was observed in allelic model (Pro vs. Arg; OR=1.28, 95% CI: 1.04-1.57) after exclusion of the study that was deviated from HWE. No association was noted in recessive model (Pro/Pro+Pro/Arg vs. Arg/Arg; OR=1.05, 95% CI: 0.86-1.30) and co-dominant model (Pro/Arg vs. Arg/Arg; OR=0.96, 95% CI: 0.77-1.19). Subgroup analysis by ethnicity also indicated a significant association between p53 polymorphism at codon 72 and RSA in Caucasian group. No heterogeneity and publication bias were found. Our meta-analysis implied that p53 polymorphism at codon 72 carries high maternal risk of RSA.
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Adult , Female , Humans , Pregnancy , Abortion, Spontaneous , Diagnosis , Ethnology , Genetics , Alleles , Asian People , Case-Control Studies , Codon , White People , Gene Frequency , Genetic Predisposition to Disease , Odds Ratio , Polymorphism, Single Nucleotide , Recurrence , Risk Factors , Tumor Suppressor Protein p53 , Genetics , MetabolismABSTRACT
Severe liver dysfunction in pregnancy (SLDP) is rare but serious complications with high mortality rate. This study compared the effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for the termination of second trimester pregnancy in patients with SLD. A total of 55 patients with indications of labor induction were enrolled and analyzed by retrospective control analysis method. Twenty-three cases adopted Cook double balloon dilation as Cook group, and 32 cases received intra-amniotic injection of ethacridine lactate as EL group. The primary outcome was evaluated by successful abortion rate and the difference in the induction-to-abortion interval. Secondary outcomes included liver function recovery and the frequency of adverse events. Both Cook and EL regimens were effective, with successful abortion rate of 87.0% and 93.8%, respectively (P=0.639). The induction-to-delivery interval was similar between Cook group and EL group (38.1±21.5 vs. 41.3±17.4, P=0.543). The liver disease status was more severe in Cook group than in EL group, but it did not show any significant difference after pregnancy termination between the two groups and the improvement rate also did not show any significant difference. Both treatments were safe and there was no significant difference in bleeding and cervical laceration adverse events between the two groups. Our study firstly compared double-balloon catheter and ethacridine lactate for the induction of labor in women with SLD during second trimester pregnancy.
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Severe liver dysfunction in pregnancy (SLDP) is rare but serious complications with high mortality rate. This study compared the effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for the termination of second trimester pregnancy in patients with SLD. A total of 55 patients with indications of labor induction were enrolled and analyzed by retrospective control analysis method. Twenty-three cases adopted Cook double balloon dilation as Cook group, and 32 cases received intra-amniotic injection of ethacridine lactate as EL group. The primary outcome was evaluated by successful abortion rate and the difference in the induction-to-abortion interval. Secondary outcomes included liver function recovery and the frequency of adverse events. Both Cook and EL regimens were effective, with successful abortion rate of 87.0% and 93.8%, respectively (P=0.639). The induction-to-delivery interval was similar between Cook group and EL group (38.1 ± 21.5 vs. 41.3 ± 17.4, P=0.543). The liver disease status was more severe in Cook group than in EL group, but it did not show any significant difference after pregnancy termination between the two groups and the improvement rate also did not show any significant difference. Both treatments were safe and there was no significant difference in bleeding and cervical laceration adverse events between the two groups. Our study firstly compared double-balloon catheter and ethacridine lactate for the induction of labor in women with SLD during second trimester pregnancy.
Subject(s)
Female , Humans , Pregnancy , Abortion, Induced , Catheters , Ethacridine , Liver Diseases , Pregnancy Trimester, SecondABSTRACT
AIM:To establish the quality standard for Xuesaitong Granule(total saponins of Radix et Rhizoma Notoginseng). METHODS:The contents of notoginsenoside R1,ginsenoside Rg1 and Rb1 were determined on the Shim-Pack C 18 (250 mm?4.6 mm,5 ?m) column,with CH3CN—H2O gradual elution and monitored at 203 nm. RESULTS:The average recovery of notoginsenoside R1 was 100.0% (RSD=1.00%,n=6),the minimum detection quantity cannot be lower than 5% labelled weight. The average recovery of ginsenoside Rg1 was 99.8 % (RSD=0.47%,n=6),the minimum detection quantity cannot be lower than 20% labelled weight. The average recovery of ginsenoside Rb1 was 99.8% (RSD=0.79%,n=6),the minimum detection quantity cannot be lower than 30% labelled weight. CONCLUSION:The method is simple,reliable,accurate and can be applied to the quality control of Xuesaitong Granules.