ABSTRACT
OBJECTIVE To expl ore the clinical significance of folic acid metabolic gene detection in methotrexate （MTX） treatment of acute myeloid leukemia （AML）. METHODS Therapeutic drug monitoring （TDM）pharmacists participated in the treatment process of an AML patient who had neurotoxic side effects such as dizziness ，headache，and vomiting after intrathecal injection of MTX. According to the results of the test of the folic acid metabolic gene MTHFR C677T（rs1801133）（mutant homozygous）and the results of MTX blood concentration monitoring （＜0.05 μmol/L），combined with clinical manifestations ，it was recommended to stop MTX ，give intravenous drip of calcium folinate for rescue ，and consider using azacytidine for follow-up treatment. RESULTS The doctor took the advice of TDM pharmacist ，and the above symptoms were significantly relieved after the patient rescued for 2 times and successfully discharged from the hospital. CONCLUSIONS For AML patients who meet the indications and receive intrathecal injection of MTX ，drug metabolism genetics testing and MTX drug concentration monitoring can be performed before medication ，which helps doctors and pharmacists evaluate the feasibility of drug treatment options and reduce medical risks.
ABSTRACT
Objective:To explore the correlation of the expression of lymphocyte immunoglobulin-mucin domain 3 (Tim-3) on T lymphocytes and natural killer (NK) cells with hepatic inflammation and hepatic fibrosis in patients with chronic hepatitis B virus (HBV) infection.Methods:A total of 320 patients of chronic HBV infection who visited the Infectious Diseases Department in the Third Affiliated Hospital of Sun Yat-sen University from June 2016 to June 2018 were enrolled. The patients were divided into four groups: immune tolerant group (IT, n=31), immune active group (IA, n=184), inactive carriers group (IC, n=48), and gray zone group (GZ, n=57). And 17 healthy controls (HC group) were included at the same time. Peripheral blood mononuclear cells were separated and the frequency and mean fluorescence intensity (MFI) of Tim-3 on T cells (CD3 + , CD4 + and CD8 + T cells) and NK cells (NK, NK-bright and NK-dim cells) were detected by flow cytometry. The clinical data of patients were collected and aspartate aminotransferase-to-platelet ratio index (APRI) score was calculated. Kruskal-Wallis H test was used for comparing the data of non-normal distribution among groups, and Mann Whitney U test was used for the comparison between two groups. Enumeration data were expressed as cases (percentage) and compared by the Chi-square test. Spearman rank correlation was used for correlation analysis. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of Tim-3 expression on T cells and NK cells in evaluating liver fibrosis in patients with chronic HBV infection. P<0.05 was considered statistically significant. Results:Significant differences were found in the age, aspartate aminotransferase (AST), alanine aminotransferase(ALT), albumin (Alb), total bilirubin (TBil) and liver stiffness measurement (LSM) among IT, IA, IC, GZ and HC groups ( H=12.40, 169.70, 210.70, 25.17, 24.21 and 86.5, all P<0.05). And the differences in APRI score, proportion of HBeAg-positive patients, HBsAg and HBV-DNA among the IT group, IA group, IC group, GZ group were also significant ( H=89.45, 118.00 and 14.81, χ2=148.20, all P<0.05). The frequency and MFI of Tim-3 on CD3 + , CD4 + and CD8 + T cells, NK cells, NK-bright and NK-dim cells among the IT group, IA group, IC group, GZ group and the HC group were significantly different( H=13.57, 51.55, 8.58, 44.25, 20.32, 47.96 and 12.45, 33.69, 4.96, 32.47, 10.63, 30.46, all P<0.05). Both of the frequency and MFI of Tim-3 on CD3 + , CD4 + and CD8 + T cells were positively correlated with ALT and AST levels in patients with chronic HBV infection ( r=0.2134, 0.4733, 0.2090, 0.4333, 0.1771, 0.4417, 0.1780, 0.3956, 0.2618, 0.4671, 0.2614 and 0.4326, all P<0.05). While the frequency and MFI of Tim-3 on CD8 + T cells and MFI on CD3 + and CD4 + T cells were also positively correlated with TBil levels ( r=0.1342, 0.2635, 0.2739 and 0.2526, all P< 0.05). The frequency and MFI of Tim-3 on NK and NK-dim cells were negatively correlated with the levels of ALT, AST and TBil ( r=-0.2671, -0.4093, -0.2451, -0.4099, -0.1807, -0.1823, -0.2733, -0.4224, -0.2576, -0.4206, -0.1798 and -0.1946, all P<0.05). The MFI of Tim-3 on NK-bright cells was also negatively correlated with ALT, AST and TBil ( r=-0.3775, -0.3562 and -0.1633, all P<0.05). Both of the frequency and MFI of Tim-3 on CD3 + , CD4 + and CD8 + T cells were positively correlated with liver fibrosis( r=0.1789, 0.3896, 0.1518, 0.3521, 0.2117 and 0.3579, all P<0.05). Both of the frequency and MFI of Tim-3 on CD4 + and CD8 + T cells and the MFI of Tim-3 on CD3 + T cells were positively correlated with APRI score ( r=0.1487, 0.2604, 0.2296, 0.4858 and 0.2853, all P<0.05). The expression frequency and MFI of Tim-3 on NK and NK-dim cells and MFI of Tim-3 on NK-bright cells were negatively correlated with LSM ( r=-0.2686, -0.3975, -0.2852, -0.3991 and -0.3531, all P<0.05). The expression frequency and MFI of Tim-3 on NK and NK-dim cells and MFI of Tim-3 on NK-bright were negatively correlated with APRI score ( r=-0.3589, -0.4158, -0.3591, -0.4108 and -0.3966, all P<0.05). The ratio of Tim-3 expression on CD3 + T cells to that on NK cells was shown to be able to predict liver fibrosis in chronic HBV infected patients and the area under the ROC curve was 0.783 (95% CI: 0.723~0.843, P< 0.05), and when the cut-off value was 0.612, the sensitivity was 61.9%, and the specificity was 99.3%. Conclusion:The relationship of Tim-3 expression on T cells with liver inflammation and fibrosis is opposite to that on NK cells in patients with chronic HBV infection, indicating that the ratio of Tim-3 expression on T cells to that on NK cells may be valuable in evaluating liver fibrosis in patients.
ABSTRACT
Objective@#To analyze the changes and significance of serum soluble programmed death-1 (sPD-1) in patients with chronic hepatitis C (CHC) and study its role in the progression of CHC.@*Methods@#Serum levels of sPD-1 in CHC patients and healthy controls (HC) were measured using ELISA and compared. Correlations of serum sPD-1 with peripheral hepatitis C virus (HCV) RNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver fibrosis (indicated by APRI) were analyzed.@*Results@#The serum sPD-1 level in the CHC group was significantly higher than that in the HC group (P<0.05), and positively correlated with peripheral HCV RNA, ALT and AST (P<0.05). In addition, the serum sPD-1 levels in patients with APRI greater than 1.2 (indicating severe liver fibrosis) were higher than those in patients without or with mild liver fibrosis (P<0.05).@*Conclusions@#sPD-1 might be involve in the progression of CHC. Measuring serum sPD-1 in CHC patients would assist the prediction of disease progression and help to make the correct diagnosis and appropriate clinical therapy decision.
ABSTRACT
Objective To analyze the changes and significance of serum soluble programmed death-1 (sPD-1) in patients with chronic hepatitis C (CHC) and study its role in the progression of CHC. Methods Serum levels of sPD-1 in CHC patients and healthy controls ( HC) were measured using ELISA and compared. Correlations of serum sPD-1 with peripheral hepatitis C virus ( HCV) RNA, alanine amin-otransferase (ALT), aspartate aminotransferase (AST) and liver fibrosis (indicated by APRI) were ana-lyzed. Results The serum sPD-1 level in the CHC group was significantly higher than that in the HC group (P<0. 05), and positively correlated with peripheral HCV RNA, ALT and AST (P<0. 05). In addition, the serum sPD-1 levels in patients with APRI greater than 1. 2 (indicating severe liver fibrosis) were higher than those in patients without or with mild liver fibrosis (P<0. 05). Conclusions sPD-1 might be involve in the progression of CHC. Measuring serum sPD-1 in CHC patients would assist the prediction of disease progression and help to make the correct diagnosis and appropriate clinical therapy decision.
ABSTRACT
At present, it is very difficult to cure chronic hepatitis B (CHB) with current therapeutic methods. Natural killer (NK) cells are an important part of innate immunity and play an important role in immune surveillance and early anti-infectious immune process. Interleukin-10 (IL-10) is a multifunctional negative regulatory factor and is involved in the biological regulation of immune cells and inflammatory cells. This article introduces the features and functions of IL-10 and NK cells, the association of CHB with IL-10 and NK cells, and the value of IL-10 and NK cells in the treatment of CHB, and points out that in CHB, IL-10 exerts a negative regulatory effect on NK cells. Further investigations are needed to confirm whether the antiviral function of NK cells can be enhanced through blocking the regulatory effect of IL-10 on NK cells, and whether liver immunopathology induced by activation of NK cells can be avoided at the same time.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical characteristics and prognostic factors in patients with primary gastrointestinal non-Hodgkin lymphoma (PGI-NHL).</p><p><b>METHODS</b>The pathological data of 104 PGI-NHL patients diagnosed in our hospital between 2003 and 2013 were analyzed retrospectively.</p><p><b>RESULTS</b>104 patients with PGI-NHL were enrolled, including 58 males and 46 females with a median age of 53 (range:15 to 83) years. 51(49%) cases derived from stomach and the other 53 (51%) patients originated in intestine. The median survival was 35 (range:1 to 30) months. The 1- year, 3- year, and 5-year overall survival (OS) were 88.4%, 80.7% and 78.8%, respectively. Both progress free survival and OS were significantly higher in B-cell GPI-NHL than T- cell GPI-NHL (P=0.000).</p><p><b>CONCLUSION</b>The survival of gastric NHL is superior to intestinal NHL. The sites of origin and pathological type are prognostic factors for survival in PGI-NHL patients.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Disease-Free Survival , Gastrointestinal Neoplasms , Diagnosis , Lymphoma, Non-Hodgkin , Diagnosis , Prognosis , Retrospective StudiesABSTRACT
Objective To investigate the clinical characteristics and prognostic factors in patients with primary gastric non-Hodgkin lymphoma (PG-NHL).Methods The pathological data of 51 PG-NHL patients admitted in our hospital from 2003 to 2013 were analyzed retrospectively.Results In 51 patients with PG-NHL,there were 26 males and 25 females.The patients' age ranged from 18 to 80 years old with median age as 56 years old.The median survival time was 32 months (range from 1 to 114 months).The oneyear overall survival (OS),three-year OS and five-year OS were 90.2 ％,82.4 ％ and 80.4 ％,respectively.The surgery did not significantly improve PG-NHL patients' progress free survival and OS.Only 1 (2.0 ％) patient had gastrointestinal hemorrhage and perforation after chemotherapy.However,6 (46.2 ％) patients suffered from early satiety,gastric emptying disorder,alkaline reflux gastritis and dumping syndrome in surgery group.Conclusions Surgery did not improve the survival of PG-NHL patients.The life quality in chemotherapygroup is better than that in surgical group.
ABSTRACT
OBJECTIVE:To evaluate the safety of Chitosan DCX-16elementarily.METHODS:DCX-16was injected i.p.to observe the acute toxicity in mice.The local irritating effects were observed on tolerance test,cerato-conjunctiva and muscles stimulus test in rabbits.The cell shape and proliferative rate of3T3cells were determinated by MTT in cell culture with DCX-16.RESULTS:It showed that DCX-16had no irritation on the eyes and muscles in rabbits.Tolerance dose of DCX-16in mice was as high as3.0g/kg per day.Cell culture with DCX-16demonstrated that3T3cell's shape and growth were normal.The relative growth rate of3T3cells had no statistical difference between control and DCX-16groups on the2nd,3rd,4th day.CONCLUSION:DCX-16is safe.
ABSTRACT
Therapeutic effects of complex nucleosides were studied by using two models of heart failure caused by either the ligation of the anterior interventricular branch of the coronary ar- tery in anesthetized dogs or iv injection of a mixed solution of verapamil and propranolol (0.5mg/Kg respectively)in anesthetized rats.After iv complex uncleosides 0.5mg/Kg/min for 10 min in the dogs and 5 mg/Kg/min for 4 min in the rats,a positive inotropic effect and an increase of cardiac output were observed,but no influence on the peripheral resistance,myocardial oxygen consumption and heart rate.Complex nucleosides had no effect on the S-T segment elevation due to the myocardial ischemic injury.On a rat model of verapamil and propranolol-induced heart failure dopamine 2 mg/Kg iv showed cardiovascular effects,which is similar to complex nucleosides.
ABSTRACT
In the control rabbits 6 h after smoke inhalation injury, the pulmonary vascular permeability and the circulating platelet aggregation percentage increased distinctly, pathological changes of trachea and lung were marked. In the other 2 groups, ginsenosides (25 mg/kg, iv) or ketoprofen (12 mg/kg, iv) were given 15 min after injury, 6 h after treatment, although both drugs decreased, the aggregation percentage of circulating platelets, only ginsenosides did alleviate the augmented pulmonary vascular permeabil ity and the pathological changes of trachea and lung. In the similar model of smoke inhalation injury in rats, ginsensi-des increased the PGI2 level in arterial blood and reduced the ratio of TXA2/ PGI2 1 h after treatment.
ABSTRACT
The effect of dexamethason ( Dex ) on the rabbit platelet aggregation and release was studided. The results were showed that the platelet aggregation and release induced by collagen were inhibited markedly by Dex, TXA2 production of platelets also reduced, but the platelet activation induced by AA was not affected by Dex. The results were further showed that the PLA2 activity was depressed by Dex, and the action of Dex can be antagonized partly by increase of extracellular Ca2+, it suggests that Dex inhibited the activity of PLA2 with the reduction of Ca2+ inflow into cell. The activity of CaM and AC, the production of cAMP and cGMP were not affected by Dex.
ABSTRACT
The effects of tetrandrine on the aggregation and morphological changes of platelets were studied by using the rabbit platelet-rich plasma prepared with centri-fugation.It was found that tetrandrine could markedly inhibit the platelet aggregation induced by ADP,collagen,and arachidonic acid with an IC50(50% inhibitory concentration) of 38.9,30.3 and 44.3?g/ml respectively.The platelets pretreated with tetrandrine could not be stimulated to initiate morphological changes and granule release,and their normal structures were well preserved.In addition,di-pyridamole could enhance but excessive amount of extracellular calcium could weaken the inhibition of tetrandrine on platelet aggregation.
ABSTRACT
Six hours after inhalation pulmonary injury,the pulmonary microvascular permeability (PMVP),pulmonary malondialdehyde (MDA) level,superoxide dismu-tase activity (SOD),the contents of protein and leucocytes in broncho-alveolar lavage fluid(BALF),and serum MDA level were determined in rats pretreated with allopurinol.In addition,the pathological changes of the lung tissues were also studied.It was found that early administration of allopurinol resulted in marked reduction of PMVP,and the protein content and leucocyte count in BALF.His-topathological examinations revealed that allopurinol could reduce the leucocyte accumulation in pulmonary vessels,interstitial leucocyte infiltration,interstitial and alveolar edema and hemorrhage,and vascular congestion.The serum and pulmonary levels of MDA also markedly decreased.The changes of pulmonary level of MDA were parallel to those of PMVP,and the protein content and leucocyte count in BALF in time course and in degree.The results listed here imply that the mechanism of the therapeutic effects of allopurinol on inhalation pulmonary injury is to reduce the production of superoxide anions through the inhibition of xanthine oxidase,in turn to inhibit the peroxidation of pulmonary lipids to alleviate pulmonary damage.