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Objective:To analyze the distribution of different SF3B1 genotypes in patients with myelodysplastic syndromes (MDS) and its prognostic value.Methods:Totally, 377MDS patients who were initially diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2014 to January 2022 were included in the retrospective analysis.The patients were divided into three different groups according to mutation stcote of SF3B1, including 317 patients with SF3B1 wild type (SF3B1 WT) (214 males and 103 females, 63(49, 71) years old),39 patients with SF3B1 K700E mutation(SF3B1 K700E(17 males and 22 females, 65(52, 73)years old)) and 21 patients with SF3B1 non-K700E mutation(SF3B1 non-K700E)(13 males and 8 females, 67(63, 73) years old). MDS-related 20 gene mutations were detected using targeted sequencing technology; Survival curves were constructed by the Kaplan-Meier method; Cox proportional hazards model was established to evaluate different factors at diagnosis on survival by univariate and multivariate analyses.. Results:Compared with SF3B1 non-K700E patients, SF3B1 K700E patients had a higher median absolute neutrophil count ( P=0.002) and were likely to be in the low/int-1 International Prognostic Scoring System (IPSS) categories ( P=0.023). A 20-gene targeted sequencing analysis showed that, compared with SF3B1 WT patients, SF3B1 K700E patients were associated with lower frequency of ASXL1 and U2AF1 mutations ( P=0.018 and P=0.003); while compared with SF3B1 non-K700E patients, the frequency of ASXL1 mutation was significantly lower in SF3B1 K700E cases ( P=0.029). Patients with SF3B1 K700E had better overall survival (OS) in comparison with SF3B1 WT and SF3B1 non-K700E in MDS patients ( P<0.001 and P=0.045, respectively). In comparison with SF3B1 WT patients, SF3B1 MUT patients had more favorable OS and progression-free survival (PFS) in MDS without excess blasts ( P<0.001 and P<0.001, respectively), but no significant difference was found in MDS with excess blasts ( P>0.05). Compared with SF3B1 WT patients, SF3B1 K700E patients had superior OS and PFS in the int-1 IPSS category ( P=0.010 and P=0.013, respectively). By multivariable analysis, the presence of SF3B1 K700Ewas an independent predictor of superior OS ( HR=0.461,95% CI 0.262-0.811, P=0.007). Conclusion:SF3B1 K700E and SF3B1 non-K700E patients had significantly improved OS in comparison with SF3B1 WT MDS patients. Furthermore, SF3B1 K700E patients were associated with a better OS compared with SF3B1 non-K700E MDS patients. SF3B1 mutation could not overcome the poor prognostic effect of excess blasts, which highlights the importance of the SF3B1 mutation subtype in risk assessment of MDS without excess blasts.
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Objective To analyze and discuss the epidemiological characteristics and drug resistance of pathogenic bacteria of infective endocarditis in Nanjing in the past five years, and to provide reference for the prevention and treatment of infective endocarditis. Methods A total of 220 infective endocarditis cases in Nanjing area from 2015 to 2020 were included in the analysis. The distribution characteristics of pathogens were collected and analyzed. Information on drug resistance was also collected, and the potential relationship between pathogen distribution and drug resistance was explored. Statistical analysis was performed using SPSS 19.0. Results The ratio of male to female patients included in this study was 143:77, and most of them were aged from 41 to 60 years old. There were 195 patients with underlying cardiac diseases (88.64%). A total of 1132 pathogenic bacteria were detected in the blood samples of all 220 patients, among which 1 007 were mainly gram-positive bacteria (88.96%): 725 strains of Streptococcus viridans (725/1 132, 64.05%), 124 strains of Staphylococcus aureus (124/1 132, 10.95%), 96 strains of Staphylococcus epidermidis (96/1 132, 8.48%), and 62 strains (62/1 132, 5.48%) of others (Staphylococcus human, etc.); the main gram-negative bacteria ( a total of 125 strains , 11.04%) were 73 strains of Pseudomonas aeruginosa (73/1 132, 6.45%) and 52 strains of Escherichia coli (52/1 132, 4.59%). Among the strains isolated from subjects of different ages and genders, the distribution difference was consistent with the total trend, and there was no significant difference (all P>0.05). Among gram-positive bacteria, Streptococcus was sensitive to antibiotics such as penicillin, oxacillin, and vancomycin. Staphylococcus aureus and S. epidermidis were sensitive to vancomycin and resistant to oxacillin and penicillin. Gram-negative bacteria were less resistant to amikacin and meropenem. All these differences were statistically significant (all P<0.05). Conclusion For patients with infective endocarditis, antibiotics should be selected reasonably according to the type of pathogenic bacteria and the corresponding drug resistance characteristics.
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Objective:To investigate the significance of 12 inflammatory cytokines in early detection and treatment guidance of hematologic malignant patients with Cytokine release syndrome (CRS) after Chimeric antigen receptor (CAR)-T cell immunotherapy.Methods:A total of 12 patients, including 6 males and 6 females, aged 53.0 (49.8, 62.5) years old, were treated with CAR-T cell immunotherapy in the First Affiliated Hospital of Nanjing Medical University from 2017 to 2020. Cytometric bead array was used to detect the serum levels of IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12P70, IL-17A, IFN-α, IFN-γ, and TNF-α at different time points after cell infusion in all patients receiving CAR-T cell immunotherapy. C-reactive protein (CRP), D-dimer (D-D), serum ferritin (SF), and lactate dehydrogenase (LDH) were measured at the corresponding period. CRS was classified into four grades according to the diagnostic criteria, from 0 to 3. The differences of the above mentioned parameters between the four groups were compared. The Speedman correlation coefficient was used to analyze the correlation between inflammatory cytokine expression levels and CRS grades. Plot the subject′s receiver operating characterist (ROC) curve to determine the sensitivity and specificity of inflammatory cytokines to predict CRS.Results:CRS grading was performed on day 1, 4, 7, and 11 after CAR-T cell infusion in 12 patients. There are 48 cases in total, including 25 cases of CRS grade 0, 6 cases of CRS grade 1, 9 cases of CRS grade 2, and 8 cases of CRS grade 3. The correlation analysis of 48 cases showed that the expression levels of IL-4, IL-6, IL-10, TNF-α, IFN-γ, IL-1β, and IL-8 were positively correlated with CRS grade ( P<0.05). The correlation coefficients were 0.384, 0.730, 0.632, 0.341, 0.681, 0.319, and 0.622, respectively. 7 inflammatory cytokines (IL-6, IL-10, IFN-γ, IL-8, IL-2, TNF-α, and IFN-α) were elevated in 12 patients, and the average time to start the rise was 3.4, 5.3, 6.1, 2.9, 4.3, 6.0 and 5.8 days, respectively. The time for CRP, D-D, SF, and LDH to begin to rise were 6.6, 7.6, 8.3 and 7.6 days, which were higher than that of the 7 inflammatory cytokines. After effective treatment, except for IL-6, the remaining 6 inflammatory cytokines (IL-10, IFN-γ, IL-8, IL-2, TNF-α and IFN-α) had their recovery times as 7.8, 3.9, 5.1, 8.0, 6.0, and 2.5 day,respectively, which were lower than that of CRP, D-D, SF, and LDH(9.7, 9.2, 13.7, and 13.8 days, respectively). The ROC showed that IL-6, IL-10, IFN-γ, and IL-8 can serve as biomarkers for diagnosis of CRS with high sensitivity and specificity. Conclusion:The monitoring of 12 inflammatory cytokines play an important role in CRS grading after CAR-T cell immunotherapy, which contributes to the early diagnosis of CRS and the prediction of clinical outcome.
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Objective:To investigate the expression pattern of TCR variable region subfamily (Vβ and Vδ) in patients with mature T-cell lymphoma (TCL), and to compare the diagnostic value of TCRVβ and TCRVδ analysis in TCL.Methods:The TCRVβ flow cytometry kit was used to detect the expression of Vβ subtypes of αβT cell in 199 patients with αβ TCL and 398 patients with non-TCL, who hospitalized in Jiangsu Provincial People Hospital from 2011 to 2020. Among them, 185 cases of αβ TCL and 355 cases of non-TCL also underwent TCRβ and TCRγ gene rearrangement detection. The TCRVδ based 10-color protocol was used to detect the expression of Vδ subtypes in 24 cases of γδTCL, 10 cases of normal controls, and 15 cases with reactively higher CD4 and CD8 double-negative ratio from 2017 to 2020, and 24 cases of γδTCL and 15 cases with reactively higher CD4 and CD8 double-negative ratio underwent TCRβ, TCRγ and TCRδ gene rearrangement detection. The diagnostic performance and degree of coincidence for detecting malignant clonality were compared between TCRVβ and TCRVδ analysis and the TCR gene scanning method.Results:In the 199 cases of αβ TCL, 182 cases (91.5%) showed restricted expression or the sum of the positive percentages of the subgroups was less than 30% for the 24 TCRVβ subtypes. Among them, the subfamily members with the highest incidence of clonal T lymphocytes were TCRVβ13.2 (12.6%, 23/182) and TCRVβ3 (8.2%,15/182); the TCRVβ subtypes showed nonclonal results in 99.0% (394/398) of non-TCL. All 24 cases of γδTCL (100%) showed abnormal distribution patterns of Vδ1 and Vδ2, of which 19 cases showed restricted expression of Vδ1, and the remaining 5 cases had negative expression of either Vδ1 or Vδ2, and the positive rate of Vδ1 cells was significantly higher than that of Vδ2 cells (79.9%±10.8% vs 0.7%±0.3%, P<0.001). Among the normal control and cases with reactively higher CD4 and CD8 double-negative ratio, the positive rate of Vδ2 cells was significantly higher than that of Vδ1 cells (73.7%±6.7% vs 15.6%±4.2%, P<0.001), and all cases (25/25) showed a normal distribution pattern. In terms of the diagnostic performance of TCL, there was no significant difference of sensitivity and specificity between TCR variable region subfamily detection by flow cytometry and TCR gene scanning technology (the sensitivity was 92.4% and 91.4% respectively; the specificity was 99.0% and 95.9% respectively, P=0.065), and the coincidence rate of the two diagnostic methods is high (Kappa=0.809, P<0.001). Conclusion:Detection of TCR variable region subfamily by flow cytometry could quickly and effectively diagnose mature TCL.
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Objective To investigate the status of food intolerance of patients with ulcerative colitis,(UC),to provide the basis for directing UC patients diet related nursing.Methods Forty-seven UC patients were selected from September 2013 to August 2014 in General Hospital of Tianjin University.The Southerland Disease Activity Index (DAI) was used to divide the UC patients into remission,mild activity and moderate to severe activity groups.The food-specific IgG antibodies status were tested by enzyme-linked immunosorbent assay in UC patients and healthy people.Relevant clinical parameters were analyzed statistically.Results Food intolerance rate in UC patients was as high as 68.08％(32/47);the food species:egg,wheat and milk ranked the most frequently intolerance food.The food intolerance rates in remission,mild activity and moderate to severe activity groups were 9/16,11/18,12/13,there were significantly different,x2=7.418,P＜0.05.Extraintestinal manifestation group had significantly higher food intolerance rate compareed to non extraintestinal manifestation group:1 1/13 vs.55.88％(19/34),x2=2.234,P＜0.05.No significant difference of food intolerance rate were showed among groups categorized according to sex,age,body mass index,site of lesion,P＞0.05.Conclusions UC patients show higher food intolerance rate than healthy people.UC disease activity and extraintestinal manifestations are correlated to food intolerance,which is of great significance to guide diet related nursing of UC patient.
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Objective To investigate the effect of hyperbaric oxygen treatment on course of different intervention time,cognitive impairment in patients with traumatic brain injury.Methods Ninety cases of cognitive dysfunction in patients with traumatic brain injury after hyperbaric oxygen in different intervention time were divided into group A,group B and group C,with 30 cases in each group.In 7-14 d,15-28 d,＞ 28 d after injury starting hyperbaric oxygen therapy,treatment 1 time a day,12 times for a course.The cognitive function of patients in three groups before and after 1,2,3 courses of treatment was evaluated by U.S.RLA cognition level classification standard evaluation form.Results Three groups after 1 course of treatment there was no statistically significant difference compared with before treatment RLA grading (P ＞ 0.05).Three groups after 2,3 courses of treatment compared with after 1 course of treatment RLA grading difference was statistically significant (P ＜ 0.05),three groups after 3 courses of treatment compared with after 2 courses of treatment RLA grading difference was statistically significant (P ＜ 0.05).Three groups after 1 course of treatment total effectiveness rate was no statistically significant difference(P ＞ 0.05).Group A and group B after 2,3 courses of treatment total effective rate was significantly higher than that in group C [73.33％ (22/30) and 66.67％ (20/30) vs.46.67 ％(14/30),93.33％ (28/30) and 86.67 ％(26/30) vs.60.00 ％ (18/30),P ＜ 0.05],group A was higher than group B,but there was no statistical significance (P ＞ 0.05).Conclusions Hyperbaric oxygen comprehensive therapy can effectively improve cognitive function in patients with traumatic brain injury cognitive impairment.After the injury,the earlier to start the hyperbaric oxygen therapy,the better effect it has,and the longer the course the better curative effect it has.
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Objective To investigate the association between peripheral white blood cell (WBC) count and the carotid intimal-medial thickness (cIMT) in middle-aged and elderly Chinese of suburban area of Shanghai.Methods A total of 2 519 subjects aged 40 years or older from Jiading District,Shanghai were recruited to undergo questionnaire interview,anthropometric measurements,fasting blood sampling,and carotid B-mode ultrasonography.After excluding subjects with biochemical index missing,WBC count ＞ 10× 109/L as well as those with known myocardial infarction,cerebral infarction,coronary heart disease,and those taking lipid-lowing agents,2 239subjects were included in this analysis.Results Increased WBC count was associated with more unfavorable metabolic risk profiles.With the increasing quartiles of WBC count,cIMT were 0.558,0.570,0.573,and 0.587mm respectively(P for trend ＜ 0.01).As compared with participants in the first WBC quartile,the risks of cIMT thickening were increased by 79％,109％ in males and 29％ in females (P＞ 0.05 in females).Multiple linear regression model showed that peripheral WBC count was an independent risk marker for cIMT thickening,especially for neutrophil and monocyte count.Conclusion A high-normal WBC count was significantly associated with cIMT thickening in middle-aged and elderly Chinese of suburban area of Shanghai,especially in males.
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<p><b>OBJECTIVE</b>To explore the relation between the pathogenesis and IL-8 level in the chronic hepatic disease and primary hepatocellular carcinoma.</p><p><b>METHODS</b>5ml venous blood was with drawn from 80 hospitaliged patients with different types of hepatic diseases and 14 healthy people. The serum was separated from the blood and then kept at -40 degrees Centigrade, and finally detected for IL-8 by ELISA.</p><p><b>RESULTS</b>There was an obvious difference among the IL-8 level in the serum from different types of hepatic disease patients. The IL-8 level was 75.80 microg/L 33.39 microg/L in chronic virus hepatitis and it was 89.54 microg/L 13.24 microg/L for primary hepatoma patients (t=10.48 and 4.01, respectively, P<0.01, as compared with control group).</p><p><b>CONCLUSIONS</b>There is a close relation between the level of IL-8 in serum and the state of illness. For patients with chronic hepatic diseases and primary hepatocellular carcinoma, the higher the IL-8 level is, the more serious the patients' condition, the worse the prognosis, and the higher the death rate would be.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Blood , Pathology , Chronic Disease , Enzyme-Linked Immunosorbent Assay , Hepatitis , Blood , Pathology , Hepatitis, Viral, Human , Blood , Pathology , Interleukin-8 , Blood , Liver Diseases , Blood , Pathology , Liver Neoplasms , Blood , PathologyABSTRACT
AIM: To study the effect of peach seed (semen Persicae) on gene expression of mouse with sarcoma 180 by means of DNA microarray. METHODS: DNA microarrays were made by spotting PCR products of 4096 mice cDNA noto a specially treated glass slides. The probes were prepared by labeling experimental and control group tumor tissue mRNA with Cy3 dUTP and Cy5 dUTP separately through reverse transcription. The arrays were then hybridized against the cDNA probe mixture and the fluorescent signals were scanned. The data obtained were analyzed from two repeated experiments. RESULTS: 64 genes were obtained by computer processing. CONCLUSION: These genes identified through this approach are considered as potential candidates for PSPA anti tumor effect.