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Objective:To determine the change in the expression of tumor necrosis factor receptor-associated factor 6 (TRAF6) in lung tissues of rats with pulmonary hypertension (PH).Methods:Sixteen SPF-grade healthy male Sprague-Dawley rats, aged 8 weeks, weighing 200-220 g, were divided into 2 groups ( n=8 each) by the random number table method: control group (group C1) and PH group (group PH1). The model of PH was prepared by subcutaneous injection of monocrotaline. On day 28 after developing the model, the mean pulmonary arterial pressure (mPAP) was measured, and the Fulton index was calculated, and the percentage of media wall thickness of the small and medium pulmonary arteries and percentage of muscularized vessels were also calculated. The expression of TRAF6, transcription-3 (STAT3), phosphorylated STAT3 (p-STAT3) and Cyclin D1 in lung tissues was detected by Western blot, and p-STAT3/STAT3 ratio was calculated. The interaction between TRAF6 and STAT3 was determined by immunoprecipitation assay. Primarily cultured pulmonary artery smooth muscle cells of normal rats (group C2) and pulmonary artery smooth muscle cells of rats with PH (group PH2) were inoculated in 6-well plates ( n=3 each). The expression of TRAF6 mRNA was detected by quantitative polymerase chain reaction. The expression of TRAF6, STAT3, p-STAT3 and Cyclin D1 was detected by Western blot. Results:Compared with group C1, the mPAP, Fulton index, percentage of media wall thickness of the small and medium pulmonary arteries and percentage of muscularized vessels were significantly increased, the expression of TRAF6 and Cyclin D1 in lung tissues was up-regulated, the p-STAT3/STAT3 ratio was increased ( P<0.05 or 0.01), and the results of immunoprecipitation showed that TRAF6 interacted with STAT3 in group PH1. Compared with group C2, the expression of TRAF6 protein and mRNA and Cyclin D1 was significantly up-regulated, and the p-STAT3/STAT3 ratio was increased in group PH2 ( P<0.05 or 0.01). Conclusions:The expression of TRAF6 in the lung tissue is up-regulated in rats with PH, which may be related to pulmonary vascular remodeling by promoting the activation of STAT3.
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Objective To analyze the positive expression levels of p16 ( p16ink4a), cell cycle factor geminin and Ki-67 in low-grade squamous intraepithelial lesions ( LSIL),and to further explore the ability of these indicators to evaluate the progression of LSIL patients. Methods From January 2015 to June 2018,276 cervical specimens from Jiading District Central Hospital of Shanghai were retrospectively studied, and 148 LSIL patients were selected. According to the results of the second examination,LSIL patients were divided into three groups: (1) no lesion (natural regression) group 90 cases; (2) LSIL persistent group 38 cases; (3) high-grade Squamous Intraepithelial Lesion (HSIL) group 20 cases. Immunohistochemistry was performed on the first biopsy tissues and the relative positive ratios of p16, geminin and Ki-67 were calculated. Spearman correlation analysis identified the correlation between the above indicators and the progress of the disease; ROC curve was used to calculate the best diagnostic value of each indicator,and multivariate logistic regression analysis was included to explore the ability of the above indicators to assess the risk of patients progressing to HSIL. Results In the HSIL group, p16 ( 51. 26 ± 17. 15)%, geminin relative positive ratio ( 45. 92 ± 15. 70)% was higher than those in the LSIL group(( 43. 71 ± 11. 84)%, (21. 68± 14. 47)%) and regression group (( 17. 92 ± 9. 60)%, ( 0. 16 ± 0. 03)%) . The difference were statistically significant ( F＝2. 922, 2. 751, all P＜0. 05) . Spearman correlation analysis showed that the relative positive ratio of p16 ( r＝0. 27,P＝0. 014) and geminin ( r＝0. 44,P＜0. 001) presented a notable positive correlation with the progression of the disease. Under the ROC curve,the best diagnostic values of p16, geminin and Ki-67 were 38. 9%, 32. 5% and 18. 6%, respectively. Multivariate logistic regression analysis showed that the relative positive ratio of p16 was higher than 38. 9%(OR＝4. 366,P＝0. 006),and geminin was higher than 32. 5%( OR ＝ 5. 392, P ＝ 0. 011 ) had a higher risk of progression to HSIL. Conclusion p16 and geminin may be effective biomarkers for identifying patients with advanced LSIL.
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Objective · To determine the expression of miRNA-7 in TWEAK-stimulated macrophages and their secreted exosomes;to investigate the role of exosomal miRNA-7 from TWEAK-stimulated macrophages in modulating the metastasis of epithelial ovarian cancer (EOC) cells.Methods · Real-time PCR analysis was used to determine the miRNA-7 expression in TWEAK-stimulated macrophages,their exosomes and recipient HO8910-PM cells.The activity of EGFR signaling pathway in HO8910-PM cells was detected by Western blotting analysis.AntagomiR-7 was used to downregulate the miRNA-7expressions in macrophage exosomes and then their effect on metastasis of HO8910-PM cells was examined by transwell assay.Results ·TWEAK increased the levels of miRNA-7 in macrophages and their secreted exosomes and also resulted in an elevated level of miRNA-7 in recipient HO8910-PM cells,which eventually reduced the activity of EGFR/AKT/ERK1/2 pathway.Pre-transfection of antagomiR-7 remarkably decreased the levels of miRNA-7 in macrophages,their secreted exosomes and the recipient EOC cells,with the enhancement of HO8910-PM metastasis.Conclusion · Exosomal miRNA-7 from TWEAK-stimulated macrophages plays a critical role in suppressing the metastasis of EOC cells by attenuation of EGFR signaling pathway.
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Objective To study the characteristics of neonatal sepsis caused by gram positive (G +) bacteria,gram negative (G+) bacteria and fungi.Method Clinical data of 202 neonates with sepsis hospitalized from Jan.2012 to May.2015 were studied.According to the different pathogens,202 neonates were divided into gram positive bacteria group,gram negative bacteria group and fungi group.The general information,clinical manifestation,laboratory examination and treatment outcome of the three groups were analysed with Chi square analysis,LSD,Fisher exact probability tests.Result A total of 202 cases of neonatal sepsis were recruited.The detection rate of gram positive bacteria,gram negative bacteria and fungi was 35.2％ (71 cases),56.4％ (114 cases) and 8.4％ (17 cases),respectively.Comparing with gram negative group and fungi group,gram positive group had older gestational age (36.0 ± 3.8 w,compared with gram negative 33.0 ± 3.9 w,fungi group 31.2 ± 3.2 w,P ＜ 0.05),larger birth weight (2 620 ± 925 g compared with gram negative group 1 999 ± 849 g,fungi group 1 595 ± 666 g,P ＜ 0.05),lower nosocomial infection rate (29.6％ compared with gram negative group 70.2％,fungi group 94.1％,P ＜0.05),lower rate of shock,blood glucose disturbance and thrombocytopenia (P ＜ 0.05).There was no statistics difference between the gram negative group and fungi group.Comparing with the other two groups,fungi group was older [20.0 (11.5,39.5) d compared with gram positive group 7.0 (2.0,17.0) d,and gram negative 10.0 (6.0,18.2) d,P ＜ 0.05].The rate of deep venous catheterization in fungi group was higher than that in gram positive group and gram negative group (88.2％ compared with gram positive group 25.4％,gram negative group 40.4％,P ＜0.05).The treatment course of fungi group was longer than that of the gram positive group and gram negative group [22.0 (12.0,37.5) d compared with the gram positive group 14.0 (10.0,17.0) d,gram negative group 14.0 (11.0,18.0) d,P ＜0.05].The incidence of apnea in the gram negative group was higher than that in gram positive group and fungi group (P ＜ 0.05).The rate of leukocytosis,leukocytopenia and elevated CRP were higher in gram negative and gram positive group (P ＜ 0.05).Conclusion The clinical manifestations and laboratory examinations in neonatal sepsis caused by different pathogens were different,which can help to early identification of different pathogenic infections.However,there is no specific indicators to differentiate neonatal sepsis caused by different pathogens.Early identification of the pathogen needs clinical acumen.
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Objective To study the clinical features, effects of therapeutic regimen and prognosis of patents with mantle cell lymphoma (MCL). Methods Clinical data of 27 MCL patients admitted in Tianjin Medical University Cancer Institute&Hospital from January 2008 to December 2014 were retrospectively analyzed. Cox regression analysis was used to analyze influencing factors of prognosis of MCL. Results The median age was 68 years old for 27 patients, and the male-to-female ratio was 4.4∶1. Ann Arbor staging showed that 25 cases were stageⅢ-Ⅳ(92.6%), 8 cases were heptosplenomegaly (29.6%), 7 cases showed extranodal involvement (25.9%). ECOG scoring showed that 4 cases with scores of 2-4 (14.8%), 8 cases were 0-3 (29.6%), 14 cases were 4-5 (51.9%) and 5 cases were 6-11 (18.5%). The Ki-67 index≤30%was found in 9 cases (33.3%), and>30%was found in 18 cases (67.7%). Patients with B symptom was found in 10 (37.0%). The elevated lactate dehydrogenase (LDH) was found in 17 cases (63.0%). The increased Beta 2- microglobulin was found in 8 cases (29.6%). Seven patients were found with bone marrow involvement. The total effective rate (ORR) was 81.8%in group with R-CHOP method, and the ORR was 68.8%in group with CHOP method. Multivariate analysis showed that age, LDH and Ki-67 were independent factors influencing the prognosis of MCL (P60 years, elevated LDH and Ki-67 index>30%are with poor prognosis.
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Objective Present study aimed to characterize the alteration of cortical thickness in first-episode, never-medicated, adult patients with major depressive disorder (MDD), and explore whether such deficits were related with their disease duration and clinical symptom severity. Methods Thirty-seven adult MDD patients were recruited from March 2013 to August 2015 as patient group, and 41 healthy volunteers were as control group. All the patients underwent three-dimensional spoiled gradient recalled (3D-SPGR) sequences, and the images were acquired. Constructions of the cortical surface were developed from 3D-SPGR images using FreeSurfer software, and the thickness of the entire cortex was measured according to the automated surface reconstruction, transformation, and high-resolution inter-subject alignment procedures. Finally, cortical thickness was compared between the two groups, and the relativity between clinical symptom severity, disease progression and clinical scores were analyzed using the General Linear Model (GLM). Results Our results revealed a significant increase in cortical thickness(P0.05). Conclusion Excluding the impact of treatment, our study showed that the cortical thickness change was mainly located in the prefrontal-limbic system in the in early course of MDD.
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Objective To prepare a innovative VP3 gene‐loaded ultrasound microbubble decorated with TATp and SDF‐1 , having the extracellular accumulation and intracellular permeation function ,and characterize their property .Methods VP3 gene‐loaded ultrasound microbubbles were prepared with the method of W/O/W double emulsion .SDF‐1 and TATp were covalently con‐gjugated to the surface of poly‐lactic/acid‐glycolic acid(PLGA) microbubble though thioether bonds to prepare gene‐loaded targeted ultrasound mirobubbles .Their particle size ,distribution and surface potential were determined by Malvern measuring instrument . The conjugation status of TATp and SDF‐1 were evaluated by flow cytometry and confocal microscopy .Their DNA protection were identified by digestion reaction test .The vitro targeting capacity was preliminarily assessed by light microscopy and flow cytometry , and the vitro ultrasound imaging was investigated under high frequency imaging condition .Results The gene‐loaded targeted ultra‐sound mirobubbles showed regularly sphericity .The diameter was (536 .00 ± 16 .55)nm ,and showed a narrow distribution .The zeta potential was(-0 .08 ± 0 .08)mV .The average gene loading was 0 .62% ,with the average rate of 36 .13% gene encapsulation effi‐ciency .The DNA protective effect sustained 60 min without damage .Connection rate of TATp and SDF‐1 coupled with PLGA mi‐crobubbles surface was 69 .84% .The vitro targeting study showed that more targeted microbubbles stably clustered together in the tongue SCC‐15 cell membranes with the connection rate of 91 .44% ,while non‐targeted microbubbles combination rate was 12 .96% .Moreover ,the vitro ultrasound imaging was tiny dot ,even high echo .Conclusion TATp‐SDF‐1‐VP3‐PEG‐PLGA micro‐bubbles were prepared successfully ,which can efficiently target to tongue SCC‐15 cells ,and pass through the cell membranes at a short time in company with outstanding ultrasound imagings in vitro .
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Objective:To observe the clinical efficacy and toxicities of bendamustine hydrochloride in patients with rituximab-re-fractory indolent B-cell non-Hodgkin's lymphoma (NHL). Methods:A total of 25 patients with rituximab-refractory NHL received bendamustine hydrochloride 120 mg/m2 intravenously on days 1 and 2 of the 21-day cycle. The short-term response, progression free survival, and toxicities were evaluated. Results:The total number of chemotherapy of the 25 patients was 122 cycles, and the median number was 5 cycles. All patients could be evaluated for efficacy. Among the patients, 6 had complete remission, 13 had partial remis-sion, 3 had stable disease, and 3 had progression disease. The overall response rate and clinical benefit rate were 76%and 88%, respec-tively. Until the deadline, 13 patients had progression disease. The median duration of response was 8 months, and the median progres-sion-free survival (PFS) was 9.3 months. Subgroup analysis showed that PFS is significantly related to bone marrow involvement and serum LDH level (P<0.05). The main adverse effects were myelosuppression, gastrointestinal reactions, and infection. Rash was found in 2 patients, and 1 case of gastric cancer was discovered after 5 cycles of treatment. Conclusion:Bendamustine hydrochloride was ef-fective and tolerable in patients with rituximab-refractory indolent B-cell NHL.
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Objective To evaluate the clinical effect of reversed nasolabial flap pedicled with superior labial artery for the recon-struction of nasal and infraorbital defects .Methods From September 2006 to May 2013 ,13 cases with large nasal and infraorbital defects were reconstructed by the reversed nasolabial flap pedicled with superior labial artery .In all patients these defects were re-sulted by the excision of carcinomas .The disease course ranged from 2 months to 28 years .The size of nasal and infraorbital defects was from 2 .0 cm × 1 .2 cm to 4 .0 cm × 3 .6 cm .All defects were restored by the reversed nasolabial flap pedicled with superior labial artery in 10 cases and by the island flap in 3 cases .The size of flap was similar to that of defects .The donor areas were sutured di-rectly .Results All flaps were completely survived .The incision at the donor and accepted sites healed in the first stage .In 4 pa-tients flap revision was performed after 6-12 months because of mild swelling at the pedicles of skin flaps .Patients were followed up for 4-60 months (the mean was 28 .4 months) .All patients were satisfied with the nasal ventilatory function and appearance , flap texture and color .No obvious scars were found at donor sites .Conclusion Reversed nasolabial flap pedicled with superior labial artery is a better choice to repair the nasal and infraorbital defect after excision of carcinomas .
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Objective:This study was conducted to evaluate and discuss the curative effect and toxicity of gemcitabine, navel-bine, and therarubicin (GNT) regimen for patients with refractory or relapsed T-cell lymphoma (TCL). Methods:A total of 69 patients with refractory or relapsed TCL treated with GNT were enrolled. The treatment protocol was set as follows:800 mg/m2 gemcitabine ad-ministered at 1 and 8 d;25 mg/m2 navelbine administered at 1 d;and 20 mg/m2 therarubicin administered at 1 d. This protocol was re-peated every three weeks. The median cycle was 4 (range:2 to 6). Results:The overall response rate was 65.2%and the achieved com-plete remission was 29.0%. Hematology toxicities were the main adverse reactions observed in all of the patients. The incidence rates of grades 1 and 2 toxicity in leukopenia or neutropenia, anemia, and thrombocytopenia were 50.7%, 33.3%, and 26.1%, respectively. Grades 3 and 4 treatment-associated toxicities were detected in 23.1%of the responding patients. One-, three-, and five-year estimated overall survival (OS) of the whole cohort were 71.7%, 47.3%, and 32.4%, respectively. The median OS was 36 months. Conclusion:GNT was effective and suitable for patients with refractory or relapsed TCL.
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Objectives To investigate the clinical features,diagnosis,treatment and prognosis of primary hepatic lymphoma (PHL).Methods A retrospective study was carried out on the clinical records of 6 patients with primary hepatic lymphoma (PHL) treated at the Tianjin Medical University Cancer Hospital from April 2005 to September 2010.The domestic and foreign medical literatures were reviewed.Results For the 6 patients with PHL,the median age was 57 years (range 31-78 years).The male-to-female ratio was 2: 1.The most common initial symptoms were abdominal pain and fever.Serum transaminase,lactate dehydrogenase and β2-microglobulin levels were elevated in 4 of 6 patients.For the 3 patients who were tested for alpha-fetoprotein and carcinoembryonic antigen levels,the results were normal.None of the patients had a history of hepatitis or cirrhosis.The diagnosis was non-Hodgkin's lymphoma.A R0 resection was carried out in 1 patient who was lost to follow-up soon after surgery.A R2 resection was carried out in another patient.The remaining 4 patients received liver biopsy.Five patients were treated by CHOP or CHOP-like chemotherapy.A patient died of brain metastases after 8 cycles of chemotherapy,and another patient was lost to follow-up after 1 cycle of chemotherapy.Chemotherapy combined with rituximab were given to the other 3 patients.There was a complete remission in 2 patients after chemotherapy and biotherapy,and these patients were still alive at the last follow-up.Partial remission was achieved in the remaining patient after chemotherapy.The patient was given radiotherapy,but he died finally of tumor progression.Conclusions PHL is an extremely rare lymphoma.Its clinical presentations and imaging manifestations are non-specific.PHL should be considered when the patient has abdominal pain or fever,with a mass in the liver.The ultimate diagnosis depends on histopathologic examination.The pathological type is mainly non Hodgkin's lymphoma,with diffuse large B cell lymphoma.There is still no standard treatment.Surgery,chemotherapy,radiotherapy,targeted therapy and biotherapy can be used.
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Chronic lymphocytic leukemia (CLL) remains an incurable disease.Rituximab and fludarabine are two of the most effective agents in CLL update.Despite the widespread use of highly effective chemoimmunotherapy,fludarabine-refractory CLL remains a challenging problem associated with poor overall survival.Approved therapeutic options for these patients remain limited.Fortunately,allogenetic stem cell transplantation (allo-SCT) and several novel targeted therapeutics in clinical trails hold promise of significant benefit for these patients' population.This review discusses the activity of available and novel targeted therapeutics besides allo-SCT in fludarabine-refractory or fludarabine-resistant CLL.
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[Objective] To assess the predilection age,clinical features,treatment and pognostic factors of primary cutaneous B-cell lymphoma (PCBCL).[Methods] A total of 31 patients with PCBCL were registered in Tianjin Cancer Central Registry from January 1970 to September 2010,and 26 patients had complete medical recortds.A retrospective analysis was conducted on the 26 patients.The following indices were analyzed,including gender,age,body sites of initial involvement,extent of cutaneous involvement,pathological subtypes,metastatic sites,treatment,survival and prognosis.Data were processed with SPSS16.0 software,survival analysis was carried out by using Kaplan-Meier method,univariate analysis of prognostic factors by Log-rank test,multivariate analysis of prognostic faetors by COX proportional hazards model,and variables were selected by Forward LR method.[Results] Clinical manifestafions were atypical in these patients.The ratio of man and women was 1:1.6.Of the 26 cases,12 were primary cutaneous follicle-center lymphoma (PCFCL),8 were primary cutaneous marginal zone lymaphoma (PCMZL),and 4 were PCLBCL,leg type.Follow-up revealed lymph node involvement in 8 patients (4 in cervical nodes and 4 in inguinal nodes),distant metastasis of organs in 3 patients ( 1 in lung and pleura,1 in bone marrow and 1 in central nervous system).Most patients received surgical treatment combined with chemotherapy or chemoradiation.The 5-year overall survival rate was 80.8％(21/26).Statistical analysis showed that the prognosis of PCBCL was associated with histological subtype,lactate dehydrogenase (LDH) level and globulin level,but unrelated to gender,age,site of initial involvement,extent of cutaneous involvement,involvement of lymph nodes and organs,presence of B symptoms,treatment strategies,number of relapses,level of β2-globulin and hemoglobin,or lymphocyte absolute value.[Conclusion]s PCBCL,as a kind of rare extra-nodal lymphoma,usually occurs with atypical clinical mainfestations in persons aged from 39 to 66 years.The 5-year overall survival rate was 80.8％ in these patients.The prognosis of PCBCL seems to be related to histological subtypes,LDH and globulin levels.
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Objective To investigate the factors implicated in the outcomes of patients with invasive pulmonary aspergillosis (IPA).Methods During a 5-year period,65 patients with IPA met the criteria set by the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG)in 2008 were retrospectively evaluated. The initial CT findings of eligible patients were reviewed by two senior radiologists who specialized in chest radiology.Patients were divided into the survivor (n =43 ) and non-survivor (n =22) groups according to their survival as long as 3 months after the diagnosis of IPA was made.An initial univariate analysis was used to screen variables that were related to prognosis,followed by a multivariate logistic regression analysis to examine these variables. Results Of the 65 IPA patients analyzed,23 (35％) had a proven diagnosis and 42 (65％) were probable ones.The univariate analysis showed that the rates of extra-pulmonary infection,uncontrolled underlying diseases and invasive mechanical ventilation were significantly different between the 3-month survival group and the non-survival group ( P ＜0.05,respectively),whereas chest CT findings,including air-space consolidation/massive consolidation,macronodules,infarct-like macronodules,halo signs, ground-glass opacities,small nodules,hypodense signs,cavities,crescent signs,small-airway findings,bronchial wall thickening/bronchiectasis,pleural effusion and hydro-pericardium, were not significantly different between the two groups (P ＞ O.05,respectively).Logistic regression analysis revealed that an uncontrolled underlying disease was the only independent predictor of 3-month mortality in patients with IPA (P =0.001,OR:O.024,95 ％ CI:O.003 ～0.223,B =- 3.714,SE =1.129,Wald =10.821 ). Conclusions An uncontrolled co-morbidity was the only independent predictor of mortality within 3 months in patients with IPA.The initial CT findings did not confer any informatioin of implication in predicting the outcomes of IPA patients.
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Gamma amino butyric acid (GABA) is the major inhibitory neurotransmitter in the human brain. Alterations in GABAergic function are associated with a variety of neurological and psychiatric disorders. However, noninvasive in vivo measurement of GABA is difficult because of its low concentration and the presence of overlapping resonances. To study GABA concentration in the occipital cortex in major depressive disorder (MDD), a group of medication-naive, first episode depressed patients (n = 18, HAMD > 17), and a group of healthy controls (n = 23) were investigated using a Point Resolved Spectroscopy (MEGA-PRESS) on a 3.0 T MR scanner. The results showed that occipital GABA levels were significantly lower (P < 0.001) in the patient group than those in the healthy controls, yet the correlations between the severity of MDD (HAMD, BDI) and the GABA concentration is insignificant. Therefore, our data suggest that patients with first episode, unmedicated MDD have changes in cortical concentrations of GABA. This biochemical abnormality may be a marker of a trait vulnerability to mood disorder, and may explain the visual problem of severe MDD patients.
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Adolescent , Adult , Female , Humans , Male , Young Adult , Depressive Disorder, Major , Metabolism , Magnetic Resonance Spectroscopy , Occipital Lobe , Metabolism , gamma-Aminobutyric Acid , MetabolismABSTRACT
Objective To explore changes of gray matter volume in patients with obsessivecompulsive disorder (OCD) in Chinese Han population using optimized voxel-based morphometry (VBM) ,and investigate its relationship with clinical symptoms. Methods Twenty patients with OCD and 20 age,sex and handedness matched healthy controls were scanned using 3D-T1 images on a 3.0 T MR system. The high resolution T1WI was preprocessed according to the optimized VBM protocol in Statistical Parametric Mapping (SPM5). Two-sample t test was performed to characterize the differences of the gray matter volume (GMV) between the OCD patients and healthy controls, and the correlations between the GMV and symptom severity and cumulative illness duration were examined using Pearson correlation in SPSS 16. 0, respectively.Results Compared to controls, OCD patients demonstrated increased GMV in left thalamus, right thalamus and left cerebellum after false discovery rate (FDR) correction. No areas of significantly decreased GMV was observed in OCD patients in relative to healthy controls. The mean eigenvalue ranged from 0. 5782 to 0. 889 representing the left thalamus volume of OCD patients was 0. 6813 ± 0. 0718, and that ranged from 0. 5546 to 0. 9062 was 0. 6869 ± 0. 0808 tor right thalamus. The mean eigenvalues were positively correlated in bilateral thalamus (r = 0. 94, P ＜ 0. 01). Conclusion Using optimized VBM, the current research indicates that the pathophysiology of OCD is associated with GMV abnormalities not only in corticostriato-thalamo-cortical (CSTC) circuit, but also in the cerebellum.
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Objective To investigate the clinical features and prognostic factors of primary thyroid lymphoma. Methods Records of 44 patients with pathologically confirmed primary thyroid lymphoma were reviewed. Detailed clinical and laboratory data were included in univariate analysis, and statistically significant factors in univariate analysis were then included in multivariate analysis.Results In univariate analysis, Ann Arbor stage, performance status, IPI, number of extra-lymphatic site, B symptoms, Hb, LDH and β_2-MG level, therapy model, histology type and tumor mass were found to be the prognostic factors associated with overall survival in primary thyroid lymphoma. In multivariate analysis, performance status, IPI, LDH, β_2-MG level, histology type, and tumor mass were independent prognostic factors of overall survival. Conclusion Performance status, IPI, LDH and β_2-MG level, histology type and tumor mass were demonstrated as independent prognostic factors of the overall survival in primary thyroid lymphoma.
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Objective: To evaluate the efficacy and toxicity of rituximab combined with cyclophosphamide, pirarubicin, vincristine, and prednisone (R-CTOP regimen) for B cell non-Hodgkin's lymphoma and to analyze the influential factors for patient response.Methods: The clinical data of patients with CD20 antigen treated with R-CTOP regimen were reviewed and the influence of sex, age, clinical stage, pathological type, and level of LDH and IPI on patient response was analyzed.Results: A total of 33 patients were evaluated for objective response.The complete response (CR) rate was 51.5%, the par-ticel response (PR) rate was 33.3%, and the overall response rate was 84.8%.For the 23 de novo patients, the CR rate was 56.5 %, the PR rate was 34.8%, and the OR rate was 91.3%.While in the 10 recurrent patients, the CR rate was 40%, the PR rate was 30%, and the OR rate was 70%.Sex, clinical stage, pathological type, and the level of LDH and IPI were not significantly related to clinical response.While patient age was related to clinical response.None of the patients died of therapy-related side effects.The most frequent adverse event was myelosuppression (Ⅲ-Ⅳ decrease of leukocyte account-ed for 32.1%).Cardiotoxicity and alopecia were mostly grade Ⅰ to grade Ⅱ.Other side effects can be tolerated after symp-tomatic treatment.Conclusion: R-CTOP regimen is a highly effective and well-toleraed therapy and should be the first choice in the treatment for B cell non-Hodgkin's lymphoma (NHL), especially for senior patients.
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Objective To evaluate the efficacy and safety of fludarabine and pirarubicin (FT) regimen in the treatment of refractory or relapsed indolent non-Hodgkin lymphoma (NHL). Methods A total of 40 patients with relapsed or refractory indolent NHL were treated with FT regimen, one cycle for 28 days, total 6 cycles. The data of indolent NHL patients treated with fludarabine, noventrene and dexamethasone (FND) regimen were collected as control. Results 40 patients were given 228 cycles chemotherapy, overall response rate was 62.5 %, median progression-free survival was more than 20 months and 2 years overall survival rate was 70.0 %. The main toxicities was leucopenia (80.0 %), but the incidence of WHO Ⅲ-Ⅳ leucopenia and pneumonia was less than that of in the control group, the rate were 12.5 % vs 29.0 % and 2.5 % vs 23.0 % respectively (P <0.05). Conclusion The efficacy of FT regimen was as good as FND regimen, but the incidence of leucopenia and pneumonia by Ⅲ-Ⅳ was lower in FT group than in FND group. So the FT regimen was an effective and safe second-line salvage regimen for relapsed or refractory indolent non-Hodgkin lymphoma.
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Objective To studythe effect of CD+4CD+25 regulatory T(Tr)cells on dendric cells(DC)in peripheral blood and deciduas from unexplained recurrent spontaneous abortion(URSA)patients.Methods Four URSA patients(abortion group)and 4 normal early pregnant women(control group)were enrolled in this study.Tr cells and DC in the peripheral blood and deciduas were isolated using Ficoll density gradient centrifugation and magnetic cell sorting(MACS).DC were cultured alone(DC alone)or in combination with Tr cells(DC+Tr)for 6 days,during which the release of interferon(IFN)-γandinterleukin(IL)-10 in the medium was subsequently measured by enzyme linked immunoadsorbent assay (ELISA).Results(1) Peripheral blood:there was no significant difference in IFN-γlevel between DCalone(23.2±0.7)ng/L and DC+Tr(22.5±3.0)ng/L in abortion group(P>0.05).The similar level of IL-10 was observed between DC alone(37±7)ng/L and DC+Tr(35±4)ng/L in abortion group(P>0.05).IL-10 level,but not IFN-γ,was significantly hisber in DC alone(54±20)ns/L than that in DC+ Tr(36±9)ng/L in control group(P<0.01).(2)Deciduas:there was no significant difference in IFN-γlevel between DC alone(23.4±2.6)ng/L and DC+Tr(24.4±2.5)ng/L in abortion group(P>0.05).Moreover,Similar IL-10 level was found between DC alone(28±7)ng/L and DC+Tr(25±5)ng/L in abortion group(P>0.05).IFN-γlevel in CD alone(30.7±4.6)ng/L was significantly higher than that in DC+Tr(22.6±3.8)ng/L in control group(P<0.01);whereas IL-10 level was much lower in DC alone (27±6)ng/L than that in DC+Tr(31±9)ng/L in control group(P<0.05).Conclusion The decreasing of immunosuppressive funetion of Tr eell of URSA patients affect its regulation on DC.resulting in imbalance of Th1/Th2 and abnormality of maternal-fetal jmmuno-tolerence in URSA.