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Thiopurine is widely used in the management of inflammatory bowel disease (IBD). However, 15% to 30% of patients discontinue therapy because of adverse reactions or lack of clinical efficacy. Guidelines and consensus recommend that therapeutic drug monitoring (TDM) should be performed in thiopurine therapy of IBD, including detection of genetic markers before initiating treatment to predict the occurrence of adverse reactions and monitoring the metabolites to optimize the regimen. This article reviewed the research progress on TDM for thiopurine therapy in IBD.
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Objective: To investigate the value of ADC full volume histogram analysis in differential diagnosis of benign and malignant mass-like breast lesions. Methods: Totally 57 cases of malignant mass-like breast lesions and 31 cases of benign mass-like breast lesions confirmed by pathology were analyzed retrospectively. All patients underwent MR examination including plain scan, dynamic contrast enhanced MR and DWI. Conventional average ADC values and ADC full volume histogram parameters (including multiple percent ADC values, ADCmin, ADCmax, ADCmean, skewness, kurtosis, and standard deviation) were measured and recorded. The conventional average ADC values and ADC histogram parameters were compared between benign and malignant lesions, and the ROC curves were used to evaluate the diagnostic efficacy of each parameter. Results: There were significant differences in the ADC histogram parameters (ADC values, skewness, kurtosis, standard deviation) and conventional average ADC values between benign and malignant lesions (all P<0.05). The 75th ADC and 90th ADC values had the highest AUC in identifying benign and malignant lesions, which was 0.84. The AUC of the ADCmean, 50th ADC values in identifying benign and malignant lesions were statistically different from the AUC of the conventional average ADC values (both P<0.05). Conclusion: ADC full volume histogram can fully reflect the overall information of lesions, and have certain value for identification of benign and malignant mass-like breast lesions.
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Objective: To investigate the nutritional status of children acute lymphoblastic leukemia (ALL) during induced remission stage. The effects of the disease itself, treatment, and complications of malnutrition were all analyzed. Methods: From the medical re-cords of children with ALL in the pediatric hematological department of the Affiliated Hospital of Guizhou Medical University, we col-lected basic information of the children; monitored the height and weight of the children on the first, 15th, and 33rd days of induced remission treatment; and calculated their body mass index (BMI), as well as results of laboratory tests such as serum albumin and se-rum prealbumin. SPSS 23.0 software was used for data analysis. Results: In 40 children with ALL, there were 16 cases of malnutrition on the first day of induced remission treatment accounting for 40%, 14 cases on both the 15th day and the 33rd day of treatment ac-counting for 35%. Among children with malnutrition, 4 cases of moderate to severe malnutrition occurred on the first day of treat-ment accounting for 25.0%, 9 cases on the 15th day accounting for 64.3%, and 12 cases on the 33rd day accounting for 85.7%. Com-pared with day 1 and day 33, the difference was statistically significant (P<0.017). In the induced remission period, the BMI on the first day was (15.98±2.17) kg/m2; on the 15th day, it was (15.65±2.20) kg/m2; and on the 33rd day, it was (15.66±1.92) kg/m2. The differ-ence between the three was not statistically significant (P=0.730). In the single-factor analysis of factors related to the nutritional sta-tus of children, infection, digestive system involvement, and serum albumin levels were related to the occurrence of malnutrition, and we performed multifactor analysis of these three factors. The difference between the level of infection and serum albumin and the oc-currence of malnutrition was statistically significant (P<0.05). Conclusions: During the induced remission, the malnutrition degree of some children with ALL was aggravated. Infection was a high-risk factor for malnutrition in children with ALL. The decrease in serum al-bumin level may indicate the occurrence of malnutrition. Dynamic monitoring of nutritional status in children with ALL is necessary.
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Objective To summarize the clinical characteristics,diagnosis and treatments of 50 chil-dren with no history of anti-coagulation rodenticide poisoning.Methods Fifty children lacking of poisoning history were admitted to our hospital from Feb 2011 to Dec 2015,who were due to hemorrhage and finally di-agnosed as rodenticide poisoning.The clinical manifestation,characteristics of blood coagulation dysfunction, toxicology screening results and treatments of 50 cases were retrospectively analyzed.Results All 50 cases were from rural area,and denied the history of taking rodenticide by mistake.The time from the onset to ad-mission to the hospital was from 1 d to 120 d,with an average of 11.66 d.Major clinical manifestations in-cluded:34 cases(68%)of skin ecchymosis,26 cases(52%)of epistaxis,10 cases(20%)of bleeding gums and 4 cases(8%)of hematoma at the injection site,with PT 20 to over 200 s and APTT 31 to over 200 s (maximal detection value).The children were diagnosed as rodenticide poisoning when one of brodifacoum, bromadiolone,and diphacinone-sodium or combination of brodifacoum and bromadiolone were detected from their blood specimens,with an concentration of 5 to 3 270 μg/L.The diagnosed children were intravenous dripped with specific antagonist vitamin K1 and the critically ill children were added fresh frozen plasma.All children recovered from hemorrhage within 24 hours after treatment.The level of PT,APTT was close to nor-mal after 3 to 7 days of treatment,and the using of vitamin K1 was accumulated about 30 to 70 mg.The chil-dren were given maintenance treatment of vitamin K1 for three months after discharge until the condition was stable.Conclusion Commonly used rodenticide has the characteristics of fat soluble, easy to accumulate, long incubation period,and long treatment period and so on.Children with no bleeding performance have the clinical tendency of acute bleeding,prolonged PT and APTT should be considered the possibility of rodenti-cide poisoning.Blood or urine samples should be screened for toxicology as soon as possible,and meanwhile children should be given antagonist treatment with special antidote vitamin K1 until the coagulation function is stable in normal range to avoid recurrence of the illness.
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Objective To observe the effect of rehabilitation on ADL scores in patients with type 2 diabetes complicated with cerebral stroke.Methods According to the selected order,three hundred and twenty type 2 diabetes patients complicated with cerebral stroke were numbered in Arabic numbers 1,2,3 and so on,the odd number patients were randomly enrolled into the observation group,the even number patients were assigned into the control group.The control group was only given corresponding clinical treatments.In addition to the same clinical treatments,rehabilitation training was given to the observation group at the same time.The ADL scores,change between the two groups were compared after three months.Results After treatment,the ADL score of the observation group was significantly improved,the difference was statistically significant (t =-24.9,P =0.000,P ＜ 0.05).The ADL score of the control group was also improved,and the difference was statistically significant (t =-15.52,P =0.000,P ＜ 0.05).The ADL score between the observation group and the control group had statistically significant difference (t =24.24,P =0.000,P ＜ 0.05).Conclusion Type 2 diabetes patients complicated with cerebral stroke who are early given rehabilitation training actively,car significantly improve the function of hemiplegia limbs,improve the ADL scores and the quality of life.
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For the purpose of thrombocytopenia gene therapy, recombinant RevTet-On and pRevTRE/TPO retrovirus were packaged and transfected to NIH3T3 after selected with G418 and hygromycin, the two inserting recombinant retrovirus cell strain RevTet-On3T3/TPO were established. TPO expression was controlled and regulated by doxycydine (Dox). After using Dox to control the expression of TPO in RevTet-On3T3/TPO cells, the result showed that when Dox is added to the RevTet-On3T3/TPO cells, cell populations expressed TPO highly in the presence of 2 mg/L of Dox, and lowly in the absence of Dox. By using the RevTet-On gene expression system (the retrovirus vector RevTet-On regulation system to control the expression gene by Dox), it could modulate the expression of multiple genes by tetracyline and its derivatives. This system maybe provides a safe and efficacient way for the thrombocy to penia gene therapy.
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The aim of this work was to test the effect of p16 on the proliferation of leukemic cells and its potential in gene therapy for leukemia. The full-length p16 cDNA was transfered by recombinant retrovirus vector into leukemia cell line K562, which is homozygous p16 deletion and retains functional retinoblastoma (RB) protein. The cell proliferation was tested in liquid and in soft agar culture after transduction of p16 retrovirus. The results showed a strong inhibition of cell proliferation. Phosphorylation of RB protein was also inhibited. The findings demonstrated that p16 (MTS/CDKN2) inactivation is a significant factor in the genesis and progression of leukemia and p16 could be a candidate gene for gene therapy in leukemia.