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Objective:To investigate the impact of malnutrition diagnosed with Global Leadership Initiative on Malnutrition (GLIM) criteria on the outcomes of patients with primary gastrointestinal lymphoma (PGIL).Methods:Patients with PGIL admitted into Gansu Provincial People's Hospital from January 2014 to July 2022 were retrospectively enrolled. Nutritional risk screening was conducted using Nutritional Risk Screening 2002 (NRS 2002) scale, and malnutrition was diagnosed as per GLIM criteria. Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to investigate the effect of malnutrition as per GLIM criteria on the outcomes of PGIL patients.Results:A total of 82 patients were included. The phenotypic parameters, including body mass index (BMI), arm circumference, leg circumference and grip strength, were at significantly lower levels in the 28 malnourished patients, compared with the other non-malnourished patients. The median overall survival of patients with malnutrition as per GLIM criteria was 10 months, while that of patients without malnutrition was 41 months, showing significant differences between groups. The univariate analysis revealed that age, loss of muscle mass, tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the impacting factors for survival in patients with PGIL. The multivariate analysis further demonstrated that tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the independent impacting factors for survival in patients with PGIL.Conclusion:Malnutrition based on GLIM criteria is an independent risk factor for unfavorable outcomes in patients with PGIL and could be utilized as a prognostic indicator.
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Objective:To investigate the efficacy and safety of BeEAM (bendamustine+cytarabine+etoposide+melphalan) regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma.Methods:The clinical data of 15 patients with lymphoma who underwent autologous hematopoietic stem cell transplantation after pretreatment with BeEAM regimen from January 2020 to February 2021 in Gansu Provincial Hospital were retrospectively analyzed. The transplant-related adverse reactions and hematopoietic reconstitution were evaluated.Results:During the pretreatment process of 15 patients, 13 patients had gastrointestinal adverse reactions such as nausea, vomiting and diarrhea, 2 patients had hypokalemia, and 1 patient had abnormal liver function, but all of them were grade 1-2, and no grade 3-4 adverse reactions occurred. One patient had poor platelet implantation, and the remaining 14 patients all achieved hematopoietic reconstruction. After transplantation, the median time of peripheral blood neutrophils and platelets good implantation in patients was 10 d (9-14 d) and 11 d (9-17 d), respectively. Until March 2021, all patients were alive during follow-up.Conclusions:The efficacy of BeEAM regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma is good, and the adverse reactions are tolerable.
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Objective:To investigate the early efficacy and safety of pomalidomide-based regimen in relapsed/refractory multiple myeloma (MM) in the real world.Methods:The clinical data of 15 patients with relapsed/refractory MM treated with pomalidomide-based regimen who were admitted to Gansu Provincial Hospital from January 2021 to July 2021 were retrospectively analyzed, and the early efficacy and safety were also evaluated.Results:There were 8 males and 7 females, and the median age of onset of 15 patients was 60 years (43-83 years); the median time for the diagnosis of relapse and refractory was 15 months (4-84 months). All 15 patients previously received bortezomib-based treatment regimens, 9 patients previously received lenalidomide treatment, and 7 cases received autologous hematopoietic stem cell transplantation. All patients received pomalidomide-based regimen combined with two-drug or three-drug regimen (pomalidomide combined with bortezomib,daratumumab,bendamustine, dexamethasone, cyclophosphamide or lenalidomide). The median treatment cycle was 2 cycles (2-4 cycles). After 2 cycles of treatment, the therapeutic efficacy was evaluated; the overall response rate was 73% (11/15), including 3 cases of complete remission, 3 cases of very good partial remission, and 5 cases of partial remission. Hematological toxicity occurred in 9 patients, of which 5 cases had grade 3-4 hematological toxicity, 4 cases had grade 1-2 hematological toxicity, and other adverse reactions were mild and tolerable.Conclusion:Pomalidomide-based regimen is effective and safe for relapsed/refractory MM patients.
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<p><b>OBJECTIVE</b>To investigate the mechanisms underlying the ability ofheparin-treated dendritic cells (DCs) to promote Th0 to Th1 differentiation in chronic hepatitis B (CHB).</p><p><b>METHODS</b>Peripheral blood mononuclear cells (PBMCs) were isolated from CHB patients and cultured in RPMI-1640 with recombinant GM-CSF and IL-4 with or without heparin to obtain DCs for study. The levels of Toll-like receptors (TLRs) on the DCs were measured using FACS and qPCR techniques.DC subsets with high expression of TLRs were selected for analysis of functional changes by treatment with the corresponding TLR-siRNA. The CD4+ T cell subpopulation was purified from peripheral blood by Dynal immunomagnetic beads, and then the production of IL-12 by DCs in the presence of poly(I:C) or R848 and ofIFN and IL-4 by Th cells co-cultured with DCs was evaluated by ELISA. The t-test was used for statistical analysis.</p><p><b>RESULTS</b>TLR3 expression, and not expression of TLR 7 or TLR8,was significantly increased in heparin-treated DCs as compared to levels detected in the DCs without heparin treatment (t =2.849,P less than 0.05;t =3.027,P less than 0.05). The level of IL-12 produced by heparin-treated DCs stimulated with poly(I:C) was obviously higher than that produced by DCs without heparin treatment and stimulated with poly(I: C) (t =8.68,P less than 0.01) or with R848 (t =19.01,P less than 0.01). However, the IL-12 production by TLR3-siRNA transfected-DCs was significantly reduced (t =31.49, P less than 0.01).When Th cells from allogenic patients with CHB were co-cultured with the TLR3-siRNA transfectedDCs, the frequency ofCD4+ IFN+ cells was significantly reduced (1.64+/-0.57% vs.6.31+/-0.88%,P less than 0.01),as was the capability of Thl to generate IFNg (t =20.83,Pless than 0.01).</p><p><b>CONCLUSION</b>Heparin may have up-regulated the TLR3 expression level of DCs, and sequentially promoted Th0 to Th1 differentiation.</p>
Subject(s)
Humans , CD4-Positive T-Lymphocytes , Cell Biology , Cell Differentiation , Coculture Techniques , Dendritic Cells , Cell Biology , Granulocyte-Macrophage Colony-Stimulating Factor , Pharmacology , Heparin , Pharmacology , Hepatitis B, Chronic , Allergy and Immunology , Interferon-gamma , Metabolism , Interleukin-12 , Metabolism , Interleukin-4 , Pharmacology , Monocytes , Cell Biology , Recombinant Proteins , Pharmacology , Toll-Like Receptor 3 , MetabolismABSTRACT
Objective To investigate the tracking neurofibra pathway from the hippocamlpal neurons to septal nucleus,and to explore the effects and mechanisms of ghrelin on the learning and memory in septal nucleus lesion rats.Methods Retrogradely tracing method was used to observe Fluorogold (FG) reaching sites in hippocampus.The septal nucleus was destructed by direct current using stereotactic technique.Step-down test and morris water maze were used to test the effects of learning and memory ability by means of microinjecting ghrelin into hippocampal CA1 area in rats.Results After injection of FG into septal nucleus,retrogradely labeled neurons and neurofibra were found in the hippocampal neurons with FG.Ghrelin injection of hippocampal CAI area could promoter learning and memory ability in rats.It showed that the escaped latent period was significantly lengthened ( (3.2 ± 0.9) s vs (6.9 ± 1.1 ) s,P ＜ 0.05) and the wrong numbers in 5 min were obviously decreased in escape response test; and the latency of looking for the plat was significantly shorter in morris water maze test ( 1.8 ±0.4vs 0.8 ± 0.1,P ＜ 0.05 ).However the effects above-mentioned on learning and memory was significantly weak after septal nucleus lesioning.It showed that the escaped latent period was markedly shortened ( ( 19.5 ±3.2)s vs ( 10.5 ± 2.1 ) s,P ＜ 0.05 ) and the wrong numbers in 5 min were obviously increased ( ( 3.9 ± 0.8 ) s vs ( 1.8 ±0.5 ) s,P＜0.05 ) in escape response test.The latency of looking for the plat was significantly lengthened in morris water maze (P＜0.05).Conclusion Ghrelin could elevate the learning and memory ability in hippocampus,and the effects may be related to the septal-hippecampus pathway.
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Objective In order know the clinical effects of vitamin B1 point injection combined with Chinese manipulation and Qi Gong therapy on the postoperative urinary retention after hemorrhoid operation. Methods Totally 150 patents with postoperative urinary retention after hemorrhoid operation were divided into the experimental group and the control group with 75 cases in each group randomly.The experimental group were treated with vitamin B1 injection at San Yin Jiao point by disposable ascepfic syringe,at the same time Chinese manipulation and Qi Gong therapy were used to masage the bladder in the lower abdomen.The tradi- tional nuusing cares,such as changes of body position,induction by bicker and foment by hot water bag,were used in the conutrol group.The improving conditions of postoperative urinary retention was compared between them.Results The total effective rate was 93%(44 cases with marked effect,26 cases with drect)in the cxperimental group and 53%(17 cases with marked effect,23 cases with effect)in the control group respectively,with a very significant difference between the two groups,X2=31.7,P＜0.01.The experimental group was significantly better than that of control group in the time of uresis after surgery,P＜0.01.Conclusions Vitamin B1 point injection combined with Chinese manipulation and Qi Gong therapy is an effective mursing measure to alleviate urinary retention after henmrrhoid operation.