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Objective:To explore the correlation of miRNA-509 (miR-509) expression level with the clinical characteristics and prognosis in acute myeloid leukemia (AML) patients.Methods:The RNA-seq expression data and clinical data of 162 newly diagnosed AML patients (non-M 3 subtype) based on the World Health Organization (WHO) classification were obtained from the Cancer Genome Atlas (TCGA) database (Project ID:TCGA-LAML). The final follow-up time was April 30th, 2013. According to the different treatment methods, all cases were firstly divided into the chemotherapy group and allogeneic hematopoietic stem cell transplantation (allo-HSCT) group. Each group was subdivided into high miR-509 group and low miR-509 group according to the median relative expression of miR-509, respectively; the clinical characteristics of both groups were analyzed. The effects of miR-509 relative expression level on overall survival (OS) and event-free survival (EFS) of AML patients in chemotherapy group and allo-HSCT group were compared. On the other hand, cases were divided into two groups based on the median relative expression level of miR-509, then each group were further divided into the chemotherapy subgroup and allo-HSCT subgroup according to different treatment methods. The differences of OS and EFS of AML patients with different miR-509 expression in chemotherapy and allo-HSCT subgroups were compared. Results:All the 162 AML patients were firstly divided into chemotherapy group (90 cases) and allo-HSCT group (72 cases). Each group was subdivided into high miR-509 and low miR-509 group according to the median relative expression of miR-509 (chemotherapy group: 14.07, allo-HSCT group: 14.85), respectively. There were no statistically significant differences in the proportion of patients with gender, white blood cell count at initial diagnosis, bone marrow blast/naive cells ratio, peripheral blood blast/naive cells ratio and France-America-British (FAB) subtype between high miR-509 and low miR-509 subgroups in chemotherapy subgroup and allo-HSCT subgroup (all P > 0.05). In the chemotherapy group, low miR-509 group comprised more cases with intermediate prognosis compared to high miR-509 group[68.9% (31/45) vs. 42.2% (19/45), χ2 = 6.48, P = 0.011]. No significant differences in the proportion of patients with other risk stratification were found between both subgroups (all P > 0.05). Of the 90 cases in chemotherapy group, the median OS time in low miR-509 group (45 cases) and high miR-509 group (45 cases) was 10.2 months and 6.7 months, respectively. The 5-year OS rates of the two subgroups in chemotherapy group were 17.9% and 17.0%, and the 5-year EFS rates were 16.9% and 18.2%.There were no significant differences in OS and EFS of low miR-509 group and high miR-509 group ( P = 0.575, P = 0.436). In the allo-HSCT group (72 cases), longer OS and EFS were observed in low miR-509 group compared with high miR-509 group, and the differences were statistically significant ( P = 0.006, P = 0.022). All the 162 cases were divided into low miR-509 group (81 cases) and high miR-509 group (81 cases) based on the median expression level of miR-509 (14.19). In the low miR-509 expression group, cases administered allo-HSCT had a better OS in comparison with those administered chemotherapy ( P<0.001). The EFS of the allo-HSCT group was better than that of chemotherapy group, but the difference was not statistically significant ( P = 0.079). In the high miR-509 expression group, the allo-HSCT group had a better OS compared with that of the chemotherapy group ( P = 0.043). There was no significant difference in the EFS between the allo-HSCT group and chemotherapy group in high miR-509 group ( P = 0.154). Conclusions:The expression level of miR-509 may be helpful in the treatment selection of AML patients. Allo-HSCT can improve the prognosis of patients with low expression of miR-509.
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Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.
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Objective:To investigate the changes of disease constitution in general practice outpatients before and after COVID-19 pandemic.Methods:Rank-sum ratio (RSR)method and Pareto method were used to comprehensively analyze the disease composition of patients in general practice outpatients in Huacao Community Health Service Center of Shanghai from January 2019 to December 2021.Results:The number of visits to general practice clinic decreased from 2019 to 2021. The top five diseases in RSR were circulatory system, endocrine, nutrition and metabolism, respiratory system, digestive system, and nervous system(RSR=1.000,0.917,0.896,0.813 and 0.750), all of which were classified as Class A factors, with a cumulative composition ratio of 80.45%. Taking the above 5 categories as the main diseases, and consistency analysis was performed for the annual changes. The coefficient of concordance of the top five diseases was poor, and not statistically significant ( WR=0.956, χ 2=11.47, P>0.01), suggesting that the disease spectrum was changed. The visits of patients with respiratory diseases dropped from the 2nd place to the 3rd after COVID-19 pandemic, with an average annual change rate of-14.31%, the lowest among all diseases. Among the top five diseases, nervous system disease had the highest annual change rate (7.68%). Among the factors affecting health status and contact with health care institutions, eye and appendage diseases ranked the first with the annual change rate of 12.97% and 10.35%,respectively. Conclusions:After the outbreak of COVID-19 pandemic, the disease spectrum in general practice clinics has changed. Measures must be taken in time to meet the needs for medical care.
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Objective:To investigate the quality of life of diabetes patients managed by the“1+1+1”contracted family physician services and to analyze the influencing factors.Methods:A survey on quality of life of diabetic patients in the community was conducted in Shanghai Huacao township from July 2018 to September 2018. A total of 413 residents managed by the contracted family physician services in 3 villages of Huacao township were selected by stratified cluster random sampling as study subjects, including 203 diabetes patients and the 210 healthy subjects (control group). The self-prepared questionnaire was applied for survey of general information and the quality of life was evaluated with the MOS 36-item short form health survey (SF-36) in two groups. The linear stepwise regression model was deployed to analyze the factors related to the quality of life of diabetes patients.Results:The total scores of SF-36 were (711.36±103.40) and (736.72±85.42) in diabetic group and control group, respectively. The total score and the scores of reported health transition, physical function, general health, physiological contents in diabetic group were significantly lower than those of control group ( t=-2.712, -2.326, -4.872, -5.509, -3.504, P<0.05); however, there were no significant differences in role-physical, bodily pain, role-emotional, mental health, vitality, social function, and psychological contents between the two groups ( P>0.05). The univariate regression analysis indicates that age, educational degree, score on the quality of sleep, stressful life event, usual mental state, and the years of contracted family doctor service were associated with the quality of life of diabetes patients ( t/ F=3.373, 3.216, 5.716, 58.146, 28.325, 14.450, P<0.05). Stepwise multiple linear regression analysis showed that stressful life event, usual mental state, and the years of contracted family doctor service were the independent factors related to the quality of life in diabetes patients ( t=7.157, 4.741, -2.779, 2.129, P<0.05). Conclusion:Under the“1+1+1”contracted family doctor service mode, the quality of life of diabetes patients in the community is very close to that of the healthy population in several dimensions. The study has also revealed that the duration of contracted family physician service and other factors can influence the quality of life of diabetic patients.
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Objective:To explore the prognostic influencing factors of adult lymphoma-associated hemophagocytic syndrome (LAHS) based on multicenter data.Methods:The clinical data of 86 LAHS patients diagnosed in 9 medical centers of Huaihai Lymphoma Working Group from January 2015 to August 2020 were retrospectively analyzed. The optimal cut-off value of continuous variables was obtained based on MaxStat algorithm. Cox proportional hazard regression model was used for univariate and multivariate analyses. Kaplan-Meier method was used for survival analysis, and log-rank test was performed.Results:Among the 86 adult LAHS patients, 50 (58.1%) were males and 36 (41.9%) were females, the median age of the patients was 57 years old (19-76 years old), and the median overall survival (OS) time was 1.67 months (95% CI 0.09- 3.24 months). The most common pathologic type was diffuse large B-cell lymphoma (58 cases, 67.44%). Based on MaxStat algorithm, the optimal cut-off values of age, albumin, serum creatinine, lactate dehydrogenase, fibrinogen and platelet count were 64 years old, 30.1 g/L, 67 μmol/L, 1 045 U/L, 4.58 g/L and 72×10 9/L, respectively. Multivariate analysis showed that patient's age, lactate dehydrogenase, albumin and fibrinogen levels were independent influencing factors for OS (all P < 0.05). Conclusions:LAHS is dangerous and progresses quickly. Patients with age ≥ 64 years old, lactate dehydrogenase ≥ 1 045 U/L, fibrinogen ≥ 4.58 g/L and albumin < 30.1 g/L have poor survival.
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Because of the lack of typical clinical manifestations, infection is difficult to be diagnosed in patients with hematological malignancies, resulting in high mortality. Neutrophil CD64 (nCD64) has been used in the early diagnosis of infection for many years and has been proved to be highly sensitive and specific. However, it is rarely used in the diagnosis of hematological malignancies with infection. This paper reviews the main influencing factors and coping methods in the diagnosis of hematological malignancies with infection.
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Objective@#To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma (DLBCL).@*Methods@#Thirty-two patients (22 males, 10 females, age: 22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak filling rate (PFR), summed motion score (SMS) and summed thickening score (STS) as well as left ventricular systolic synchrony indicators including phase bandwidth (BW), phase standard deviation (SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ2 test were used for data analysis.@*Results@#Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8.68)°; SD: (11.65±4.64)° vs (8.79±3.14)°; entropy: (39.84±5.51)% vs (36.19±5.94)%; t values: -9.132 to -3.173, all P<0.05). There were no significant differences in other indicators (t values: -1.161 to 1.750, z values: -1.633 to -0.096, all P>0.05). Of 32 patients, 13 patients (40.62%) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchrony was significantly higher than that of left ventricular dysfunction (15.62%, 5/32; χ2=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssynchrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)% vs (66.79±7.65)%; t=4.087, P<0.01).@*Conclusion@#Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indicator of cardiotoxicity caused by anthracycline chemotherapy.
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Objective To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in pa-tients with diffuse large B-cell lymphoma ( DLBCL) . Methods Thirty-two patients ( 22 males, 10 females, age:22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume ( LVEDV) , left ventricular end-systolic volume ( LVESV) , peak filling rate ( PFR) , summed motion score ( SMS) and summed thickening score ( STS) as well as left ventricular systolic synchrony indicators including phase bandwidth ( BW) , phase standard deviation ( SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ2 test were used for data analysis. Results Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8. 68)°;SD:(11.65±4.64)° vs (8.79±3.14)°;entropy:(39.84±5.51)％ vs (36.19±5.94)％;t values: -9.132 to-3.173, all P<0.05) . There were no significant differences in other indicators ( t values:-1.161 to 1.750, z values:-1.633 to-0.096, all P>0.05). Of 32 patients, 13 patients (40.62％) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchro-ny was significantly higher than that of left ventricular dysfunction (15.62％, 5/32;χ2=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssyn-chrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)％ vs (66.79±7.65)％;t=4.087, P<0.01) . Conclusion Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indi-cator of cardiotoxicity caused by anthracycline chemotherapy.
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A total of 510 patients with type 2 diabetics mellitus (T2DM)from Huacao Township of Shanghai suburb were enrolled in the study. The gender, age, duration for diabetes, HbA1c level, blood pressure level, obesity status and health education of chronic kidney disease (CKD) were recorded. The knowledge, attitude and practice (AKP) of the subjects regarding prevention and treatment of CKD were assessed by using a self-restraint questionnaire. The data were analyzed with logistic regression. The knowledge awareness rate, attitude positive rate and behavior execution rate were 44.1％(225/510), 49.0％(250/510) and 16.5％(84/510), respectively. Scores of knowledge,attitude,behavior and medication compliance of the subjects were 16.8 ± 4.8, 18.3 ± 3.6 and 13.1 ± 4.1, respectively. The attitudes were closely related to educational level, HbA1c level, systolic blood pressure, obesity, health education history, and awareness level of CKD;behaviors were closely related to education level, systolic blood pressure, obesity, health education history and CKD prevention and treatment(P<0.05).
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Huacao Community Health Service Center has established an integrated chronic kidney disease (CKD) management system since 2015,which greatly improved CKD management in the community.From September 2016 to August 2017,4084 residents were screened by the family doctor team,975 were suspected to have CKD (23.87％),among whom 202 (20.72％) were referred to district CKD treatment center,and 197 (97.52％) were confirmed as CKD.The detection rate of suspected CKD among patients with hypertension and diabetes mellitus was the highest,which was much higher than that among outpatients and those with routine health check up.It is suggested that the integrated management of CKD should be widely implemented to cope with the prevalence of CKD,particularly for those with hypertension and diabetes.
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Objective To observe the alteration and clinical significances of blood coagulation indicators in patients with lymphoplasmacytic lymphoma (LPL). Methods Twenty patients who were newly diagnosed LPL in the First People's Hospital of Changzhou from January 2008 to October 2017 and twenty healthy controls were studied. The patients were treated by chemotherapy, plasma exchange, supplement of coagulation factor or other supportive therapy. The parameters of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (D-D), and platelet count (Plt) were detected in LPL group and healthy controls. Results The levels of PT and APTT in LPL group were dramatically higher than those in control group [(12.9±1.2) s vs. (11.6±0.9) s, (41.7±9.8) s vs. (24.7±2.9) s], and the level of Plt in LPL group was lower than that in control group [112×109/L (3×109/L - 379×109/L) vs. 210×109/L (170×109/L - 271×109/L)], and the differences were statistically significant (all P< 0.05). There were no significant differences in FIB, TT and D-D levels between LPL group and control group (all P ＞0.05). There were no statistical differences in PT, APTT, FIB, TT, D-D and Plt levels among LPL patients with different types of immunoglobins (all P ＞ 0.05). After treatment, all the coagulation abnormalities got relieved and no patient died of hemorrhage or thrombosis. Conclusions The LPL patients have coagulation disorders and hypercoagulability, and this is independent of the type of immunoglobulin. Clinical attention should be paid to monitoring coagulation indicators to prevent the occurrence of adverse reactions.
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Objective To analyze the efficacy and safety of tetrandrine in the adjuvant treatment of relapsed/refractory acute leukemia (except M3).Methods A total of 58 patients with relapsed/refractory acute leukemia (except M3) admitted to six tertiary hospitals in Jiangsu Province from January 2015 to December 2017 were included in this study.The tetrandrine-adjuvant standard chemotherapy regimen and standard chemotherapy regimen were given to treatment and control groups respectively.There were 17 and 41 patients in treatment and control groups.The treatment group was given tetrandrine for 5 days before the use of standard chemotherapy.The dose of tetrandrine was 4 mg ·kg-1 ·d-1,and patients had continuous oral administration of 5 days.After that,the patients in the treatment group started chemotherapy immediately.On the other side,the control group received standard chemotherapy without any other multidrug reversal medicine.Then the clinical efficacy and safety outcomes in both groups were analyzed.Results In the treatment group,5,3,and 9 cases achieved complete remission (CR),partial remission (PR),and nonremission (NR) respectively,and the total effective (CR+PR) rate was 47.06 ％ (8/17);in the control group,14,10,and 17 cases achieved CR,PR,and NR,and the total effective rate was 58.54 ％ (24/41).There was no significant difference in the total effective rate between the two groups (x2 =0.64,P =0.424).There was no significant difference in the efficacy between the two groups of patients with different genders (P ＞ 0.05).When the disease duration was 6-11 months,the difference of efficacy between the two groups was statistically significant (P =0.041).There was no significant difference in the proportion of myeloid leukemia cells,white blood cell count,platelet count,red blood cell count,and hemoglobin between the two groups before and after treatment (all P ＞ 0.05).There was no significant difference in clinical safety indicators (urine,faecal routine,liver and kidney function,and electrocardiogram) between the two groups (all P ＞ 0.05).Conclusions Tetrandrine is more effective in patients with relapsed/refractory acute leukemia (except M3) with shorter duration of disease.Compared with chemotherapy alone,the clinical efficacy of adding tetrandrine in chemotherapy cannot be considered superior to the former.
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The PBL and CBL model pays more attention to the cultivation of students' ability than the traditional education model, which is in line with the current demand for clinical pharmacy training. This study has summarized the practice of PBL combined with CBL in clinical pharmacy training for com-munity clinical pharmacists in the Pharmacy Department of the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine. The results show that PBL combined with CBL teaching is superior to traditional teaching in stimulating students' interest in learning, clarifying their learning objectives, en-hancing their ability to analyze and solve problems, autonomous learning, information seeking skills, team cooperation awareness, clinical thinking and so on. This teaching has a good response in community clini-cal pharmacist training, and it is worth promoting.
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Trisomy 8 in myelodysplastic syndrome (MDS) plays an important role in concurrent intestinal Beh?et's disease (BD) pathogenesis.Here,we reported a case of intestinal BD combined with MDS involving trisomy 8.A 48-year-old woman who has had a 20-year history of recurrent oral ulcer,perineal ulcer and iris,was diagnosed as MDS with trisomy 8 four years ago.She developed high fever and acute abdominal pain.Multiple ulcerative perforations in ileum and colon were found by endoscopy,meeting the criteria for intestinal BD.The patient was successfully treated with immunomodulatory drugs.
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Trisomy 8 in myelodysplastic syndrome (MDS) plays an important role in concurrent intestinal Beh?et's disease (BD) pathogenesis.Here,we reported a case of intestinal BD combined with MDS involving trisomy 8.A 48-year-old woman who has had a 20-year history of recurrent oral ulcer,perineal ulcer and iris,was diagnosed as MDS with trisomy 8 four years ago.She developed high fever and acute abdominal pain.Multiple ulcerative perforations in ileum and colon were found by endoscopy,meeting the criteria for intestinal BD.The patient was successfully treated with immunomodulatory drugs.
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Objective To establish a HPLC method for determination of berberine hydrochloride in Dongbai Tonglin Heji.Methods The separation column of Kromasil C18(150 mm×4.6 mm,5 μm) was used.The mobile phase was acetonitrile and 0.05 mol/L NaH2PO4 solution(pH was adjusted to about 3 with phosphoric acid).The flow rate was 1.0 ml/min with the column at room temperature and the detection wavelengths at 345 nm for berberine hydrochloride.Results The linear range of berberine hydrochloride was 1.00~50.00 μg/ml(r=0.999 6).The average recoveries of berberine hydrochloride were 104.70%(RSD 1.60%, n=5).Conclusion This method is accurate, sensitive, selective and reproducible.It provides an alternative method to improve the quality control of Dongbai Tonglin Heji.
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Objective To compare the efficacy and safety between flumatinib and imatinib in patients with newly diagnosed chronic myeloid leukemia (CML). Methods A multi-center, randomized and parallel comparison clinical trial was conducted in 24 newly diagnosed patients with Philadelphia chromosome-positive CML-chronic phase (Ph+ CML-CP) who were treated by flumatinib 400 mg/d, 600 mg/d or imatinib for 6 cycles (24 weeks). The hematology was evaluated at pre-medication and the 2nd, 4th, 6th, 8th, 10th, 12th, 16th, 20th, 24th week of post-medication. The morphology, cytogenetics and molecular biology were evaluated at pre-medication and 12th, 24th week of post-medication. Results In terms of efficacy, the main molecular remission (MMR) rate of flumatinib 600 mg/d group was higher than that of imatinib group after 24 weeks [44.44 % (4/9) vs. 14.29 % (1/7), P=0.017]. The rate of bcr-ablIS≤10 % in flumatinib 600 mg/d group was significantly higher than that in imatinib group (P=0.002). PK/PD analysis also hinted that patients treated by flumatinib 600 mg/d was more likely to get molecular reaction in the early stage compared with those treated by flumatinib 400 mg/d. In terms of safety, there was no significant difference in grade Ⅲ-Ⅳ of adverse events among flumatinib 400 mg/d group, flumatinib 600 mg/d group and imatinib group (P >0.05). The common adverse events in flumatinib group included skin toxicity, gastrointestinal reactions and diarrhea.There was no heart and cardiovascular toxicity in flumatinib group, and incidence of edema in flumatinib group was lower than that in imatinib group. Conclusions Flumatinib is a safe and effective drug for newly diagnosed patients with Ph+ CML-CP, and 600 mg/d is the appropriate clinical starting dose. Flumatinib and imatinib have similar safety in clinic.
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Objective To investigate the characteristics of activation-induced cytidine deaminase (AID) expression level in de novo acute leukemia (AL) patients, chronic myeloid leukemia chronic phase (CML-CP), chronic myeloid leukemia blastic crisis (CML-BC) patients and leukemia cell lines. Methods The expression level of AID mRNA was measured in 89 cases of newly-diagnosed acute lymphoblastic leukemia (ALL) patients, 79 cases of de novo acute myeloid leukemia (AML) patients, 5 cases of CML-BC patients, 5 cases of CML-CP patients and leukemia cell lines NB4, THP-1, KG-1, Raji, K562 by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR), bone marrow mononuclear cells of 16 normal healthy donors were used as the control group. Results The expression levels of AID mRNA in 89 cases of ALL and 79 cases of AML were 0.006-7 463.175 and 0.005-69.107, the median expression levels were 3.785 and 1.812, the expression level of AID mRNA in the normal control group was 0.146-4.707, and the median expression level was 1.483, respectively. The AID expression levels of ALL, B-ALL, Burkitt leukemia, M4 patients and Raji cells were significantly higher than those of the normal control group (all P <0.05). Nevertheless, the AID mRNA expression levels of M3 patients and NB4, KG-1 cells were lower than those of the normal control group (all P <0.05). Furthermore, the AID mRNA expression levels of K562 cell were strikingly higher than that of the CML-CP patients (P<0.001), so were those of CML-BC, chronic myeloid leukemia myeloid blast crisis (CML-MBC), chronic myeloid leukemia lymphoblastic blast crisis (CML-LBC) patients. Conclusion AID gene shows high expression level in B-ALL, Burkitt leukemia and M4, low expression level in M3 and KG-1 cells, and obvious high expression level in CML-BC.
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Objective To investigate the off-label use of antibacterials in out-patient department and emergency depart-mentand give reference for management .Methods About 10% of antibacterials prescriptions in out-patient department and emergency department were randomly extracted .Off-label use was analyzed by assessing off-label use percentage ,reviewing off-label types and evaluating the rationality .Results 23 600 antibacterial prescriptions ,including 43 antibacterials in 9 catego-rieswere analyzed ,and the off-label use percentage of 22 .00% .Cephalosporins contributed most in the amount of off-label use prescriptions ,while nitroimidazoleseries got the highest off-label percentage of 73 .45% .Improper frequency and dosing were the most obvious phenomena ,with the ratio of 55.64% and 52 .60% ,respectively .For oral drugs ,most frequent off-label use type of these drugs was improper dosing (72 .46% ) .For injections ,frequent off-label use type of these drugs were manifested improper frequency (82 .18% ) and improper solvent (38 .80% ) .Conclusion Off-label use of antibacterials in hospital was in a critical situation and most of the prescriptions were lack of rational evidence .Standardized administration should be introduced .
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Objective To compare the clinicopathological characteristics and prognosis of primary Waldeyer's ring non-Hodgkin lymphoma.Methods From Jan 2008 to Dcc 2013, 50 patients with primary Waldeyer's ring non-Hodgkin lymphoma were retrospectively analyzed.Kaplan-Meier method was used for survival analysis.Log-rank method was used for univariate analysis.Results Waldeyer's ring diffuse large B-cell lymphoma (DLBCL) and extranodal nasal-type NK/T-cell lymphoma (ENKTCL) were the common pathological types of primary Waldeyer's ring non-Hodgkin lymphoma accounting for 56 ％ (28/50) DLBCL and 34 ％ (17/50) ENKTCL, respectively.The age at onset of ENKTCL patients was younger than that of DLBCL patients.Two groups had different primary sites, including 50.0 ％ (14/28) of DLBCL with tonsillar disease and 88.2 ％ (15/17) of ENKTCL with nasopharynx disease.The short phase effect of DLBCL group was higher than that of ENKTCL group.The overall survival (OS) and progression-free survival (PFS) rates had significant differences between DLBCL and ENKTCL (x2 =4.45, P =0.035;x2=6.47, P =0.011).Conclusion DLBCL and ENKTCL are different in clinical characteristics.The short phase effect and prognosis of DLBCL are obviously better than those of the ENKTCL.