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Objective:To explore the predictive value of peripheral blood CD34-positive cell count for the stem cell mobilization effect of plerixafor in patients with multiple myeloma (MM).Methods:The clinical data of 12 MM patients who used plerixafor for stem cell mobilization in the First Affiliated Hospital of Guangxi Medical University from December 2019 to February 2021 were retrospectively analyzed. The changes of peripheral blood CD34-positive cell count and the collection status of stem cell in all patients before and after the mobilization of plerixafor were analyzed.Results:Twelve patients were included in this study. These patients were in international staging system (ISS) stage Ⅱ-Ⅲ, and the induction therapy was mainly VRD regimen. The CD34-positive cell count was increased after the use of plerixafor in all patients no matter which mobilization strategies were used before plerixafor. The CD34-positive cell count was 3.63/μl (0.72-13.53/μl) and 32.11/μl (8.52-53.68/μl) before and after the use of plerixafor, and the difference was statistically significant ( Z = -0.40, P<0.001); the median increasing time was 11.50 times (1.61-23.71 times). The mobilization failure occurred in 1 patient. The CD34-positive cell count in his blood was less than 1/μl before the use of plerixafor; though increased 11.83 times after the use of plerixafor, the CD34-positive cell count was still less than 10/μl. Pearson analysis showed that among the patients with CD34-positive cell count less than 4/μl before the use of plerixafor, there was a positive correlation in peripheral blood CD34-positive cell count before and after the use of plerixafor ( r = 0.80, P = 0.032). Conclusions:The peripheral blood CD34-positive cell count has a certain predictive value for the stem cell mobilization effect of plerixafor in MM patients.
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Nowadays, non-alcoholic fatty liver disease (NAFLD) is prevalent all over the world, and its incidence has been increasing year by year in China. The four aspects of intestinal mucosal barrier, including mechanical barrier, chemical barrier, biological barrier and immunological barrier are interrelated closely and related to NAFLD. This article reviewed the influence of intestinal mucosal barrier dysfunction on NAFLD.
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Objective@#To explore the diagnosis, treatment and prognosis of autoimmune hemolytic anemia (AIHA) after allo-HSCT in patients with thalassemia major (TM).@*Methods@#A retrospective analysis of AIHA status after allo-HSCT in 291 TM patients from July 2007 to December 2017 was conducted.@*Results@#Five of the 291 TM patients (1.72%) were diagnosed with post-transplant AIHA. The median time of AIHA was 7 (5-12) months after HSCT. All post-transplant AIHA patients were positive in direct and indirect Coombs test, the main clinical manifestations were dizziness, fatigue, pale complexion, skin and sclera yellow, and soy sauce urine. The incidence of AIHA was higher after unrelated donor transplantation (6.36%, 4/63) compared with that of sibling donor transplantation (0.43%, 1/228). One patient who received only prednison was dead. Four patients who received rituximab combined with prednisolone were alive, Coombs test in two of them were negative.@*Conclusions@#AIHA after allo-HSCT developed in 1.72% patients with TM. Monitoring of Coombs test was important for diagnosis of post-transplant AIHA. The incidence of post-transplant AIHA was higher in unrelated donors compared with that of sibling donors transplantation. Treatment of rituximab combined glucocorticoid was effective strategy for post-transplant AIHA.
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Objective To investigate application effect of strengthened night nursing to the prevent of vascular crisis in patients after finger replantation. Methods A total of 155 patients with finger replantation in Hand surgery from February 2014 to February 2016 were selected as research object, 90 cases from March 2015 to February 2016 with strengthened night nursing were as the observation group,65 cases from February 2014 to February 2015 with routine nursing were as the control group. The two groups were compared of limb replantation success rate, vascular crisis rate and nursing satisfaction. Results The replantation success rate in the observation group was 90.00%(81/90)higher than 76.92%(50/65)in the control group,the occurrence of vascular crisis rate was 11.11%(10/90)lower than 27.69%(18/65)in the control group,the success rate was 7/10 higher than 10/18 in the control group, and the difference was statistically significant (χ2=4.932, 7.013, 4.216, all P<0.05). The nursing satisfaction in the observation group was (94.32 ± 3.57) points, 93.33%(84/90) higher than (91.22 ± 4.48) points, 83.08%(54/65) in the control group, and the difference was statistically significant (t=4.789, χ2=4.071, P<0.05). Conclusions Strengthened night nursing can effectively prevent vascular crisis in patients after finger replantation,improve nursing satisfaction of patients.
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Objective:To investigate the impact of Notch signaling pathway on the migration of human hepatic carcinoma cells and the expression of E-cadherin and COX-2 in these cells.Methods:Cultured hepatic carcinoma cell lines (SMMC-7721,MHCC97H),and normal non tumor liver cell line (HL-7702) in vitro.Transwell cell was used to measure the cell's capacity of invasion and migration.Western blot was used to measure the expression level ofNotch1,E-cadherin,COX-2 protein.DAPT was used to block the Notch signaling pathway,and compared the ability of invasion and migration between hepatic carcinoma cell lines and normal non tumor liver cell line,and the change of expression level of E-cadherin and COX-2 protein in hepatic carcinoma cells.Results:The migration ability of SMMC-7721 cells and MHCC97H cells were higher than HL-7702 cells,the difference was statistically significant (P＜0.05);Compared to HL-7702 cells,the expression level of Notch1 and COX-2 in MHCC97H cells and SMMC-7721 cells significantly increased,the expression level of E-cadherin decreased significantly (P＜0.05);After DAPT treatment,the migration ability of SMMC-7721 cells,MHCC97H cells were weaker than the control group,the difference was statistically significant (P＜0.05);After DAPT treatment,the expression of COX-2 and Notch1 in SMMC-7721 and MHCC97H cells decreased significantly,while the expression of E-cadherin significantly increased (P＜0.05).Conclusion:Notch signaling pathway plays an important role in the process of liver cancer cell migration and invasion,and its mechanism is related to the expression of E-cadherin and COX-2.
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Objective To investigate the effect of allgeneic hematopoietic stem cell transplantation (allo-HSCT) for β-thalassemia major. Methods Twenty-four β-thalassemia major patients with median age of 4 years (range: 2～15 years), 18 boys and 6 girls, received allo-HSCT.They were classified into class Ⅱ-Ⅲ according to Pesaro thalassemia classification. Twenty-three transplantations were from sibling donor and 1 was from mother, either HLA-identical (n = 23) or HLA-mismatched (5/6) (n = 1). Fifteen patients received bone marrow transplantation (BMT) plus peripheral blood stem cell transplantation (PBSCT), and 9 were subjected to umbilical cord blood transplantation (UCBT). The conditioning regimen consisted of busalphan, cyclophosphamide,fludarabine, plus hydroxyurea before transplantation. Graft-versus-host disease (GVHD) prophylaxis included CsA, methotrexate, antilymphpcute globulin, and mycophenolate mofetil. The median follow-up period was 13 months (range: 3～69). Results Of 24 patients, there were 21 cases (87. 5 %) of disease-free survival, 1 (4. 2 %) transplantation-related death, and 2 cases (8. 3 %) of rejection. Three-year overall survival and disease-free survival rate was 91.7 % and 87. 5 %respectively. The cumulative incidence of grade Ⅱ -Ⅳ acute GVHD and chronic GVHD was 16. 7 %and 20. 3 %, particularly cumulative extensive chronic GVHD was 5. 0 %. Conclusion The sibling donor BMT plus PBSCT is an effective and safe way to treat β-thalassemia major. Cord blood is an important source of hematopoietic stem cells for HSCT. The protocol GVHD prophylaxis of CsA,MTX, ATG with a low-dose and short course of MMF can effectively reduce the incidence of severe acute GVHD, improve the outcome of thalassemia transplantation.
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Mesenchymal stem cells (MSCs) have been the hot spot of rehabilitation and tissue engineered medicine.Due to their origination from the adult tissues,the multilineage differentiation potential and immune escape characteristics,MSCs become the ideal seed cells for cell transplant treatment.This article summarizes the biological characteristics of MSCs and its application in the treatment of liver disease.
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Objective To investigate the effectiveness of implantation of homologous cancellous and autologous red marrow under endoscope in the treatment of traumatic bone nonunion or bone defect.MethodsTotally 25 patients with traumatic bone nonunion or bone defect were enrolled in this study.The lesion involved the tibia bone in 9 cases,the femur in 13,and the humerus in 3.The grafts were sized 1 to 6 cm in length(mean,2.7 cm).Before the implantation of the cancellous bones,the scar fibrous tissues within the nonunion were removed completely by endoscopy,and then autologous red marrow obtained from the iliac crest was injected.ResultsAll the patients were followed up for 12 to 36 months(mean,25 months).The surgical wounds healed primarily in all of the cases without injuries to the blood vessels and nerves.Bony union was achieved within 4 to 9 months(mean,5.1 months) in 23 of the patients,the other 2 failed because of breaking and loosing of internal fixators.No patient developed re-nonunion and infection.ConclusionsImplantation of homologous cancellous and autologous red marrow under endoscope is effective for traumatic bone nonunion or bone defect with a low rate of complication and high rate of bony union.Since no need to harvest the ilium bone,the method is minimally invasive for the patients.