Clinical Study of Haploid Allogeneic Hematopoietic Stem Cell Transplantation Combined with Post-transplant Cyclophosphamide in Severe Aplastic Anemia Patients / 中国实验血液学杂志

OBJECTIVE@#To evaluate the clinical effect of haploid allogeneic hematopoietic stem cell transplantation(haplo-HSCT) in the treatment of severe aplastic anemia (SAA), and to explore the efficacy different between post-transplant cyclophosphamide (PT/Cy) and standard-dose ATG.@*METHODS@#The clinical data of 38 patients with SAA in our hospital from January 2012 to December 2019 were collected and retrospectively analyzed. The efficacy was evaluated. The patients with haplo-HSCT were divided into low-dose ATG combined with PT/Cy group and standard-dose ATG group, and the blood cell hematopoietic reconstruction time, GVHD incidence, mortality and survival time of the patients in the two groups was compared.@*RESULTS@#Among the 32 patients, hematopoietic reconstitution were detected in 9375%(30/32) recipients. The median time of neutrophil and platelet engraftment was 15(10-22) days and 13(7-30) days, respectively. The incidence of GVHD was 21.89%, the incidence of infection was 93.75%, and the 2-year overall survival rate was 84.38%. The hematopoietic reconstitution time, incidence of GVHD, mortality rate and survival time were no statistical differences between the patients in the two groups(all P>0.05).@*CONCLUSION@#Haplo-HSCT is an effective method for the treatment of SAA，low-dose ATG combined with PT/Cy can lighten the economic burden on patients, it would be a feasible treatment plan for SAA with light side effect.

Network Meta-analysis of Chinese patent medicine in treatment of unstable angina pectoris / 中国中药杂志

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.

Myeloproliferative neoplasm with BCR/ABL and JAK2 mutation: A case report and literature review / 解放军医学杂志

Objective To investigate the diagnosis and treatment method of BCR/ABL myeloproliferative neoplasm (MPN) with JAK2 mutation, and review the literature to improve the diagnosis and treatment level of the disease. Methods A case of MPN with BCR/ABL fusion and JAK2 mutation was reported; combined with relevant literature of 46 similar cases to summarize the clinical features of this disease. Results The reported case was diagnosed as chronic myeloid leukemia with primary myelofibrosis, and a combined treatment of imatinib and lucotinib was effective. A total of 46 similar cases with detailed information were found in literature, and could be divided into three groups based on the genetic status at initial diagnosis, i.e. BCR/ABL(+) rearrangement group, JAK2(+) group and bi-JAK2(+)-BCR/ABL(+) group. No significant difference existed in blood routine indexes among the three groups (leukocyte P=0.349, hemoglobin P=0.247, platelet P=0.944). Conclusions The case of bi-positive BCR/ABL fusion and JAK2 mutation is rare and easy to be miss diagnosed. The pathogenesis of this disease is not yet clear, nevertheless, the sequence of mutation occurrence may show no obvious effect on blood routine indexes. A combined use of relevant targeted drugs for the two genes can improve the therapeutic efficacy to some extent.

Roles of β-cell dedifferentiation in β-cell dysfunction / 中国病理生理杂志

β-cells may turn into other pancreatic islet cells through dedifferentiation.The dedifferentiation cells lose the ability of insulin secretion.Islet β-cell dedifferentiation is the important cause of β-cell dysfunction, which then leads to the occurrence of type 2 diabetes.Rescent research shows that many transcription factors play an important role in β-cell dedifferentiation,including forkhead box protein O1,NKX2.2,NKX6.1,MAFA and MAFB.In this paper, the influence factors of β-cell dedifferentiation and its mechanism were reviewed briefly.The discovery of β-cell dedifferen-tiation provides new thoughts and targets for prevention and treatment of type 2 diabetes.

Clinical features and prognosis of 376 patients with T1micN 0M0, T1aN0M0 and T 1bN0M0 breast cancer / 肿瘤

Objective: To analyze the clinicopathological features and prognosis of patients with T1micN0M0, T1aN 0M0 and T1bN0M0 breast cancer, and to evaluate the survival and independent prognostic factors. Methods: The clinicopathological data from 4 487 patients who could receive surgical operation between January 2002 and December 2005 were collected. The clinicopathological features, recurrence, metastasis and survival of 376 patients with T1micN0M0, T1aN 0M0 and T1bN0M0 breast cancer were retrospectively analyzed. Results: Three hundred and seventy-six eligible patients were identified. Of these 376 patients, 66 patients (17.6%) had T1mic breast cancer (pT≤0.1 cm), 122 patients (32.4%) had T1mic breast cancer (0.1 cm < pT≤0.5 cm), and 188 patients (50.0%) had T1b breast cancer (0.5 cm < pT≤1.0 cm). With the lager tumor size, the histology grade was higher, the positive rate of estrogen receptor was lower, and the incidence of adjuvant chemotherapy was higher (P < 0.05). Univariate analysis showed that the age, hormone receptor and HER-2 status were prognostic factors for 5-year disease-free survival. Multivariate analysis showed that the hormone receptor and HER-2 were prognostic factors for 5-year disease-free survival. The 5-year recurrence risk in the positive hormone receptor group was four times as high as that in the negative hormone receptor group (hazard ratio was 4.995, 95% confidence interval was 1.113-22.424). In negative hormone receptor group, there was no statistically significant difference in the risk of 5-year recurrence between patients with positive HER-2 and negative HER-2 (hazard ratio was 2.757, 95% confidence interval was 0.849-8.955). Conclusion: HR and HER-2 status were independent prognostic factors for 5-year DFS in T1micN0M0, T 1aN0M0 and T1bN0M 0 breast cancer. Hormone receptor positive disease with positive HER-2 status was associated with a high risk of cancer recurrence. Copyright© 2011 by TUMOR.