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ImmunoPET imaging, which combining the specificity of monoclonal antibody and high sensitivity of PET imaging, blazes new trails of molecular imaging modality. In recent years, clinical translation and application of immunoPET imaging strategies have been flourishing, as a result, facilitating early and non-invasive diagnosis of numerous human tumors, patient stratification before monoclonal antibody therapy and radiation dose estimation prior to radioimmunotherapy. Here, we summarize the most recent clinical evidence of immunoPET in tumor diagnosis and therapy.
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Objective:To prepare 89Zr labeled Daratumumab and evaluate its feasibility in the imaging diagnosis of multiple myeloma (MM). Methods:According to the principle of 89Y (p, n) 89Zr nuclear reaction, 89Zr was produced by cyclotron solid target system (30 μA, 1.5 h) and automatic purification module. The radionuclide purity, half-life and impurity metal ion concentration were detected. Desferrioxamine (DFO) was coupled with Daratumumab and then chelated with 89Zr to prepare 89Zr-DFO-Daratumumab. The quality control analyses of three consecutive batches were carried out. Pharmacokinetic evaluation and 89Zr-DFO-Daratumumab microPET/CT imaging were performed in normal rabbits and orthotopic myeloma mouse models, respectively. The SUV in situ myeloma and that in normal bone were compared by independent-sample t test. Results:About 560 MBq of 89Zr was obtained, and there were only two characteristic energy peaks of 89Zr (909 keV and 511 keV) by γ spectrometer. The half-life of 89Zr was 78.2 h, and the content of metal impurities was small. 89Zr-DFO-Daratumumab was prepared with pH of 7.2, radiochemical purity of more than 99%, good stability in vitro, and sterility and endotoxin tests were passed. Pharmacokinetic studies in rabbits showed that 89Zr-DFO-Daratumumab was gradually distributed from blood to liver, spleen, kidney and bone joints over time and metabolism. The results of microPET/CT imaging in orthotopic myeloma mouse models showed that the SUVs of 89Zr-DFO-daratumumab in situ myeloma were significantly higher than those in normal bone (2 h: 0.22±0.02 vs 0.06±0.00; 1 d: 0.38±0.01 vs 0.08±0.00; t values: 8.89, 21.90, both P=0.001). Conclusion:89Zr and 89Zr-DFO-daratumumab are successfully prepared, and relevant quality control and biological evaluation in vivo and in vitro are completed, which verify the feasibility of 89Zr-DFO-Daratumumab in the imaging diagnosis of MM, thus laying a foundation for clinical transformation.
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Objective:To assess the imaging characteristics of muscle FDG metabolism, tumor incidence, and pulmonary interstitial changes in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody positivity in 18F-FDG PET/CT imaging, and the value of 18F-FDG PET/CT in differentiating anti-MDA5 antibody positive dermatomyositis. Methods:From June 2016 to July 2019, the PET/CT images of 75 patients with dermatomyositis (21 males, 54 females, age (52.3±14.3) years; 34 anti-MDA5 antibody positive and 41 anti-MDA5 antibody negative) and 30 healthy controls (10 males, 20 females; age (53.5±11.8) years) were retrospectively analyzed in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. The SUV max of muscle was measured and the mean of SUV max (mSUV max) was calculated. Statistics of patients with dermatomyositis complicated with neoplastic lesions and the SUV max of pneumonia lesions in patients with dermatomyositis complicated with interstitial pneumonia was determined. Independent sample t test, one-way analysis of variance, Student-Newman-Keuls (SNK) test and χ2 test were used to analyze data. The ROC curve analysis was used to analyze the diagnostic efficacy of mSUV max for the differential diagnosis of anti-MDA5 antibody positive dermatomyositis. Results:The muscle mSUV max of the control group, anti-MDA5 antibody positive and negative groups were 0.39±0.05, 0.66±0.21 and 0.87±0.29 ( F=39.93, P<0.001), respectively. The muscle mSUV max of dermatomyositis patients was increased compared with healthy controls ( q values: 6.76, 12.63, both P<0.001), and the muscle mSUV max of anti-MDA5 antibody negative was higher than positive ( q=5.79, P<0.001). The AUC was 0.74, and the cut-off value of muscle mSUV max was 0.75 with the accuracy of 74.7%(56/75). Of 41 patients with negative anti-MDA5 antibody, there were 6 (14.6%) had malignant tumor, while there was no malignant tumor in patients with positive anti-MDA5 antibody (0/34; χ2=5.41, P=0.020). There were 11 patients (26.8%, 11/41) with anti-MDA5 antibody negative dermatomyositis complicated with interstitial pneumonia and 33 patients (97.1%, 33/34) with anti-MDA5 antibody positive dermatomyositis complicated with interstitial pneumonia ( χ2=37.81, P<0.001). FDG metabolism in anti-MDA5 antibody positive patients was higher than that in anti-MDA5 antibody negative patients (lesion SUV max: 3.65±1.83 and 2.38±1.27; t=2.13, P=0.039). Conclusions:The muscle FDG metabolism of anti-MDA5 antibody positive dermatomyositis patients is higher than that of healthy controls, but lower than that of anti-MDA5 antibody negative patients. The incidence of neoplastic lesions in patients with positive anti-MDA5 antibody is lower than that in patients with negative anti-MDA5 antibody. The proportion and severity of interstitial pneumonia are higher in patients with positive anti-MDA5 antibody than in those with negative anti-MDA5 antibody. 18F-FDG PET/CT has certain value on identifying anti-MDA5 antibody positive dermatomyositis.
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Objective:To explore the basic biological characteristics of lncRNA B230352I09 and its role in the process of myocardial injury.Methods:We analyzed the biological characteristics of lncRNA B230352I09 on the UCSC website and predicted the possible binding protein of lncRNA B230352I09 by the catRAPID. Real-time fluorescence quantitative (RT) PCR method was applied to detect the expression of lncRNA B230352I09 in heart tissues at different time points (0, 1, 3, 7d) within 7 days after birth, the organs distribution and expression of lncRNA B230352I09 in neonatal mouse and the expression pattern of lncRNA B230352I09 in the heart of mice with myocardial injury. In addition, we constructed hypoxia model by culturing primary cardiomyocytes to detect the effect of lncRNA 230352I09 overexpression on hypoxic cardiomyocyte apoptosis by Hoechst staining kit, the effect of lncRNA B230352I09 overexpression on ROS content of hypoxic cardiomyocyte by DCFDA probe and changes in mitochondrial membrane potential of hypoxic cardiomyocytes by JC-1 Fluorescent probes.Results:Full-length of mouse B230352I09 was 663bp, located in the chr7:123031415-123066439 forward strand. RBBP6 gene was adjacent to B230352I09, which may be the target of lncRNA B230352I09 by catrapid prediction analysis. With the development of the heart, the expression level of lncRNA B230352I09 showed a gradual downward trend. The main expression organs of lncRNA B230352I09 in 1-day-old mice were heart, brain, kidney and liver. In heart tissue, lncRNA B230352I09 expression in non-cardiomyocytes was significantly less than in cardiomyocytes [ (1.0± 0.03) vs. (9.2± 3.29), P=0.013]. After myocardial injury, the expression level of lncRNA B230352I09 showed an increasing trend compared with the normal developing mice, but there was no statistical significance. Hoechst staining showed that lncRNA B230352I09 could inhibit the apoptosis of hypoxic cardiomyocytes. Detecting the content of ROS in cardiomyocytes showed that compared with the hypoxia group, the generation of ROS was significantly reduced in the lncRNA B230352I09 overexpression group ([(3.8±0.71) vs. (1.65±0.56), P=0.015]). JC-1 fluorescent probe was used to detect the mitochondrial membrane potential, and the results showed that the mitochondrial membrane potential of cardiomyocytes in the lncRNA B230352I09 overexpression group was significantly higher than that in the hypoxia group. Conclusions:In heart tissue, lncRNA B230352I09 was mainly expressed in cardiomyocytes. LncRNA B230352I09 has a protective effect in the process of myocardial injury in mice, mainly by inhibiting apoptosis of cardiomyocytes, reducing ROS production, and protecting mitochondrial membrane potential of cardiomyocytes.
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Metabolic reprogramming is a hallmark of tumors. Tumors own unique metabolic patterns in different stages of their occurrence and development. The stable isotope metabolic flux analysis technology uses stable isotope to trace the metabolites in tumors and crystallize tumor metabolism network. Stable isotope metabolic flux analysis is a useful tool for studying tumor metabolism, which can determine the nutritional sources, find the metabolic liabilities, confirm the metabolic pattern of tumors, and discover new mechanisms of tumor metabolic reprogramming, thus providing theoretical bases for imaging, diagnosis, treatment and evaluation of tumor. This article reviews the applications of stable isotope flux analysis in tumor metabolic reprogramming.
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Objective:To explore the effect of “trinity”co-management mode in prevention of venous thromboembolism（VTE）during perioperative period in patients undergone major orthopedic surgery.Methods:A retrospective case-control study was conducted to analyze the clinical data of 120 patients undergone major orthopedic surgery in Second Affiliated Hospital of Wenzhou Medical University from January 2019 to August 2019，including 46 males and 74 females at age range of 43-89 years［（63.7 ±11.3）years］. Of all，58 patients were with intertrochanteric fracture，52 with femoral neck fracture and 10 with gonarthrosis. Hip fracture operation was performed in 58 patients，total hip replacement in 37，artificial femoral head replacement in 15 and total knee replacement in 10. A total of 60 patients were treated with traditional care，including traditional prevention of thrombosis，conventional VTE risk assessment，treatment and related health education（traditional care group），and 60 patients a with “trinity” co-management care（co-management care group）on the basis of the traditional care，including the trinity of health education，establishing VTE prevention group and VTE tracking table，strengthening postoperative rehabilitation care and exercise，optimization of medicine，nutrition and pain management. Swelling rate of injured limb，D-dimer level on admission and at postoperative days 3 and 7，incidence of VTE at postoperative day 7，length of hospital stay and patient satisfaction were compared between the two groups.Results:Three days and seven days after operation，swelling rate of the injured limb in co-management care group［13%（8/60），8%（5/60）］was significantly lower than that in traditional care group［42%（25/60），30%（18/60）］（ P < 0.05）. There was no significant difference in level of D-dimer between the two groups on admission（ P > 0.05）. Three days and seven days after operation，level of D-dimer［3.40（2.11，6.10）μg/ml，3.70（2.61，6.82）μg/ml］in co-management care group was significantly lower than that in traditional care group［6.37（3.60，9.81）μg/ml，6.42（3.62，9.83）μg/ml］（ P < 0.01）. Seven days after operation，incidence of VTE in co-management care group［3%（2/60）］was significantly lower than that in traditional care group［13%（8/60）］（ P < 0.05）. Length of hospital stay in co-management care group［（10.1 ± 2.2）days］was shorter than that in traditional care group［（11.4 ± 4.3）days］（ P < 0.05）. Nursing satisfaction was 93%（56/60）in co-management care group，higher than 72%（43/69）in traditional care group（ P < 0.05）. Conclusion:For patients undergone major orthopedic surgery，“trinity” co-management mode is effective to reduce the incidence of postoperative limb swelling，level of D-dimer as well as incidence of VTE，shorten the length of hospital stay and improve patients’ satisfaction during perioperative period.
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Objective:To investigate the effects of attention and interpretation therapy on fatigue and sleep quality in patients with gastrointestinal tumor during chemotherapy.Methods:From December 2018 to December 2019, eighty-four patients with gastrointestinal tumor hospitalized in two hospitals (third-grade class-A) in Ningxia were selected as the research objects. According to the random number table, they were divided into the control group and the observation group with 42 cases in each group. Patients in the two groups received routine care. On this basis, the observation group received 10 weeks of attention and interpretation therapy. Cancer patients fatigue scale and Pittsburgh sleep quality index(PSQI) scale were used to evaluate before intervention, 10 weeks after intervention and 3 months after intervention. SPSS 17.0 software was used for statistical analysis. Independent sample t-test and repeated measure analysis of variance were used for comparison between groups. Results:(1) The time effect, inter group effect and interaction effect of fatigue total scores and each dimension score of the two groups were significant (all P<0.01). Further simple effect analysis showed that there were significant differences in the total score and each dimension score of fatigue between the control group and the observation group at 10 weeks after intervention and 3 months after intervention (all P<0.01). (2) The time effect, inter group effect and interaction effect of PSQI total score, sleep quality, sleep time, sleep disorder score were significant (all P<0.01), but the time effect, inter group effect and interaction effect of sleep efficiency, daytime dysfunction and hypnotic drug use score were not significant (all P>0.05). Further simple effect analysis showed that there were significant differences in PSQI total score, sleep quality, sleep time, sleep time and sleep disorder scores between the control group and the observation group 10 weeks after the intervention(PSQI total score (6.83±2.46) vs (10.79±1.01); sleep quality (1.00±0.22) vs (1.24±0.82); sleep time (0.91±0.26) vs (1.40±0.86); sleep time (1.00±0.20) vs (2.02±0.72); sleep disorder (0.79±0.22) vs (1.60±0.59) and 3 months after the intervention(all P<0.01). Conclusion:Attention and interpretation therapy can effectively alleviate the fatigue of gastrointestinal tumor patients during chemotherapy, and improve sleep quality.
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Objective:To compare the diagnostic efficacy of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT and 18F-flurodeoxyglucose (FDG) PET/CT in patients with prostate cancer biochemical recurrence after radical prostatectomy. Methods:A total of 82 patients ((76.7±7.1) years) with clinical diagnosis of biochemical recurrence after radical prostatectomy from June 2018 to August 2019 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University were included. All patients underwent 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT within 2 weeks. The diagnostic efficacy of 2 methods were compared, and the detection rates were also compared among patients with different total prostate specific antigen (tPSA) levels (tPSA≤0.5 μg/L, 0.5 μg/L<tPSA≤1.0 μg/L, 1.0 μg/L<tPSA≤2.0 μg/L, 2.0 μg/L<tPSA≤4.0 μg/L, 4.0 μg/L<tPSA≤10.0 μg/L, tPSA>10.0 μg/L). Logistic regression analysis was applied to analyze the factors affecting the detection rate of 68Ga-PSMA-11 PET/CT. Results:A total of 57 patients (98 regional lesions) were detected by 68Ga-PSMA-11 PET/CT and/or 18F-FDG PET/CT. Patients were followed up for 2-12 months, and 50 patients (81 lesions) were found to have recurrence or metastasis of prostate cancer. The patient-related detection rate, sensitivity and positive predictive value of 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT were 68.29%(56/82) vs 36.59%(30/82), 96.00%(48/50) vs 52.00%(26/50), 85.71%(48/56) vs 86.67%(26/30); the detection rates were significantly different ( χ2=19.756, P<0.05). The patient-related detection rates of 68Ga-PSMA PET/CT were higher than those of 18F-FDG PET/CT under different tPSA levels, especially when 0.5 μg/L<tPSA≤1.0 μg/L (10/18 vs 2/18). The detection rate of 68Ga-PSMA PET/CT was significantly correlated with tPSA level (odds ratio( OR)=1.319, 95% CI: 1.088-1.598), age ( OR=1.141, 95% CI: 1.051-1.238), preoperative staging ( OR=1.357, 95% CI: 1.052-2.439), and postoperative treatment ( OR=1.134, 95% CI: 1.020-1.917) (all P<0.05). Conclusion:68Ga-PSMA PET/CT has better detection advantages than 18F-FDG PET/CT in diagnosing biochemical recurrence after radical prostatectomy.
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Objective@#To clarify the prevalence, clinical features and molecular characteristics of germline GATA2 mutations in pediatric primary myelodysplastic syndromes (MDS) .@*Methods@#Next-generation sequencing technology was used to detect mutations in GATA2 and other myeloid malignancy genes in 129 children with primary MDS from Jan. 2007 to Jan. 2018. The relationship between genotypes and phenotypes was analyzed.@*Results@#Germline GATA2 mutations accounted for 8.5% (11/129) of all primary MDS cases, and 14.0% (11/50) of MDS with excess blasts (MDS-EB) and acute myeloid leukaemia with myelodysplasia-related changes (AML-MRC) . Compared with GATA2 wild-type patients, GATA2 mutated patients were older at diagnosis[8 (1-16) years old vs 6 years old (range: 1 month old-18 years old) , P=0.035]and higher risk of monosomy 7 (72.7%vs 5.2%, P<0.001) and classified into MDS-EB and AML-MRC compared with refractory cytopenia of childhood (RCC) (63.6%vs 36.4%, P=0.111) . The multivariate analysis showed SETBP1 mutation (P=0.041, OR=9.003, 95%CI 1.098-73.787) and isolated monosomy 7 (P=0.002, OR=24.835, 95%CI 3.305-186.620) were significantly associated with germline mutated GATA2. Overall survival (OS) and outcomes of hematopoietic stem cell transplantation (HSCT) were not influenced by GATA2 mutational status.@*Conclusions@#Our data identify germline GATA2 mutations have a high prevalence in older pediatric patients with monosomy 7, and high risk of progression into advanced MDS subtypes. GATA2 mutation status does not affect OS in pediatric primary MDS.
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Objective@#To investigate the clinic-pathological features, diagnosis and treatment of 8p11 myeloproliferative syndrome (EMS) .@*Methods@#Five patients diagnosed as EMS from Jan 2014 to May 2018 at Blood Disease Hospital, Chinese Academy of Medical Sciences were enrolled. The clinical manifestations, laboratory characteristics, treatment and outcome of these patients were summarized.@*Results@#The peripheral blood leukocyte count of 5 patients with EMS increased significantly, accompanied with an elevated absolute eosinophils value (the average as 18.89×109/L) . The hypercellularity of myeloid cells was common in bone marrow, always with the elevated proportion of eosinophils (the average as 17.24%) , but less than 5% of blast cells. The chromosome karyotype of the 5 cases differed from each other, but presenting with the same rearrangement of FGFR1 gene by fluorescence in situ hybridization technology. The average interval between onset and diagnosis was 4.8 months with a median survival of only 14 months.@*Conclusion@#EMS was a rare hematologic malignancy with poor prognosis and short survival. It was commonly to be misdiagnosed. Analysis of cytogenetics and molecular biology were helpful for early diagnosis.
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Objective@#To evaluate the efficacy of the Chinese Children′s Leukemia Group (CCLG) acute lymphoblastic leukemia (ALL) 2008 protocol (CCLG-ALL 2008) in the treatment of children′s T-cell acute lymphoblastic leukemia (T-ALL).@*Methods@#Clinical characteristics and outcomes of 84 newly diagnosed T-ALL children (63 males and 21 females) treated with CCLG-ALL 2008 protocol from April 2008 to April 2015 in the Department of Pediatric Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Kaplan-Meier analysis was used to evaluate the overall survival (OS) and event free survival (EFS), and COX regression was used to evaluate the influencing factors of OS and EFS.@*Results@#(1) Baseline data: 84 children were included, 56 cases (67%) of children were younger than 10 years old. Patients whose white blood cell count≥50×109/L ranked 70% (59/84). Karyotype: 58% (49/84) with normal karyotype, 10% (8/84) with abnormality of chromosome 11, 8%(7/84) with abnormality of chromosome 9, 2%(2/84) with abnormality in both chromosome 11 and chromosome 9, 8% (7/84) with other complex karyotypes. Fusion gene: 33%(28/84) were SIL-TAL1 positive. The patients were grouped by CCLG-ALL 2008 risk score, 40% (34/84) were in the intermediate risk group and 60% (50/84) in the high risk group. (2) Treatment efficacy: 84 cases were followed up until May 30, 2018. The follow-up time was 42.0 (0.3-120.0) months. The sensitivity rate of prednisone treatment was 56% (47/84); the complete response (CR) rate after the induction therapy of vincristine+daunoblastina+L-asparaginase+dexamethasone (VDLD)(d 33) was 88% (74/84); the total CR rate after VDLD induction combined with cyclophosphamide+cytarabine+6-mercaptopurine (CAM) treatment (d80) was 94% (79/84); the recurrence rate was 24% (20/84). Among the 20 recurrent cases, there were 13 cases (65%) with ultra-early recurrence (within 18 months after diagnosis), 6 cases (30%) with early recurrence (18 to 36 months after diagnosis); 1 patient (5%) with late recurrence (over 36 months after diagnosis). During the follow-up period, twenty-eight children (33%) died (22 cases with recurrence or suspending treatment without remission, 2 cases with infection, 1 case of sudden death in chemotherapy, 1 patient failed in transplantation, 1 patient with severe cirrhosis, and 1 patient with unknown cause). (3) Kaplan-Meier analysis: the 5-year OS and EFS of the 84 children were (63±6)% and (60±6)% respectively. (4) Efficacy in different risk groups: prednisone sensitivity rates in the two different risk groups were 100% (34/34) and 26% (13/50), respectively (χ2=3.237, P<0.05). The CR rates at the end of VDLD induction therapy (d 33) were 100% (34/34) and 80% (40/50), respectively (χ2=2.767, P<0.05). The recurrence rate of children in the two groups was 12% (4/34) and 32% (16/50), respectively (χ2=4.245, P<0.05).The mortality rates of the two groups were 21% (7/34) and 42% (21/50), respectively (χ2=3.198, P<0.05). Kaplan-Meier analysis showed that the 5-year OS of the two groups were (77±7)% and (53±8)%; and the 5-year EFS of the two groups were (75±8)% and (49±8)% (χ2=4.235, 3.875, both P<0.05) . (5) COX multivariate regression analysis showed that the classification of risk according to CCLG-ALL 2008 was an important factor influencing the prognosis of children with T-ALL (OR=3.313, 95% CI 1.165-9.422, P=0.025).@*Conclusions@#The results of the risk group treatment according to the CCLG-ALL 2008 protocol showed that the long-term survival of children with middle risk was significantly better than that of children at high risk.
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Objective@#To explore the costs and other information of two different treatment plans for pediatric acute promyelocytic leukemia (APL): one is the traditional intravenous drip arsenic (arsenic trioxide) combined with chemotherapy treatment, and the other is a medication family treatment program based on oral arsenic (Realgar-Indigo naturalis formula), in order to provide a reference for the promotion of pediatric APL family treatment mode and the formulation of medical insurance policies.@*Methods@#The medical record homepage data and drug using of pediatric APL from 2010 to 2018 in Institute of Hematology & Blood Diseases Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively analyzed, and the newly diagnosed pediatric patients (≤14 years old) with APL were included. The hospitalization expenses and hospitalization time of two treatment options were compared. One treatment option was Chinese children APL treatment plan 2010 (CCAPL 2010), which was based on intravenous drip arsenic trioxide. The other was Chinese Children Cancer Group APL treatment plan 2017 (CCCG-APL 2017), which was based on oral Realgar-Indigo naturalis formula.@*Results@#A total of 79 pediatric APL patients were included and grouped according to the treatment plans, 56 patients were treated with CCAPL 2010 plan, and 23 patients were treated with CCCG-APL 2017 plan. The median costs of one single pediatric APL patient in CCAPL 2010 plan was 167 700 yuan (95 800-386 600 yuan), and the median hospital stay time of one single pediatric APL patient was 102 days (14-157 days). The median costs of one single pediatric APL patient in CCCG-APL 2017 plan group was 118 700 yuan(50 800-270 600 yuan), and the median hospital stay time of one single pediatric APL patient was 37 days(5-96 days). The costs and hospital stay time of one single pediatric APL patient with CCCG-APL 2017 plan were remarkably less than those of one single pediatric APL patient with CCAPL 2010 plan (U = 178, P < 0.01; U = 66, P < 0.01).@*Conclusions@#The CCCG-APL 2017 plan simplifies the treatment plan compared with the CCAPL 2010 plan and significantly reduces the patient's medical expenses and shortens the hospitalization days. The CCCG-APL 2017 plan is suitable for family therapy and has good social and economic benefits, which is worthy of clinical promotion.
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Objective To explore the costs and other information of two different treatment plans for pediatric acute promyelocytic leukemia (APL): one is the traditional intravenous drip arsenic (arsenic trioxide) combined with chemotherapy treatment, and the other is a medication family treatment program based on oral arsenic (Realgar-Indigo naturalis formula), in order to provide a reference for the promotion of pediatric APL family treatment mode and the formulation of medical insurance policies. Methods The medical record homepage data and drug using of pediatric APL from 2010 to 2018 in Institute of Hematology & Blood Diseases Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively analyzed, and the newly diagnosed pediatric patients (≤14 years old) with APL were included. The hospitalization expenses and hospitalization time of two treatment options were compared. One treatment option was Chinese children APL treatment plan 2010 (CCAPL 2010), which was based on intravenous drip arsenic trioxide. The other was Chinese Children Cancer Group APL treatment plan 2017 (CCCG-APL 2017), which was based on oral Realgar-Indigo naturalis formula. Results A total of 79 pediatric APL patients were included and grouped according to the treatment plans, 56 patients were treated with CCAPL 2010 plan, and 23 patients were treated with CCCG-APL 2017 plan. The median costs of one single pediatric APL patient in CCAPL 2010 plan was 167 700 yuan (95 800-386 600 yuan), and the median hospital stay time of one single pediatric APL patient was 102 days (14-157 days). The median costs of one single pediatric APL patient in CCCG-APL 2017 plan group was 118 700 yuan(50 800-270 600 yuan), and the median hospital stay time of one single pediatric APL patient was 37 days (5-96 days). The costs and hospital stay time of one single pediatric APL patient with CCCG-APL 2017 plan were remarkably less than those of one single pediatric APL patient with CCAPL 2010 plan (U ＝ 178, P < 0.01; U ＝ 66, P< 0.01). Conclusions The CCCG-APL 2017 plan simplifies the treatment plan compared with the CCAPL 2010 plan and significantly reduces the patient's medical expenses and shortens the hospitalization days. The CCCG-APL 2017 plan is suitable for family therapy and has good social and economic benefits, which is worthy of clinical promotion.
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Objective To observe the effect of emotional resilience group training on fatigue and sleep quality of patients with gastrointestinal cancer.Methods A total of 321 hospitalized patients with gastrointestinal cancer were randomly divided into experimental group (160 cases) and control group (161 cases) by random number table.Two groups of patients were treated with routine nursing care.In addition,the experimental group was given 8 weeks of emotional resilience group training once a week.The effect of intervention was assessed by the cancer fatigue scale (CFS) and Pittsburgh sleep index (PSQI) before and after the intervention.Result There was no significant difference in CFS and PSQI between the two groups before intervention (t=0.18,1.82,P＞0.05).After intervention,there was no significant difference in the total scores and each dimension scores of CFS and PSQI in the control group (P＞0.05).The total scores of CFS and PSQI in the intervention group (13.72± 1.33 and 10.62± 1.01) were significantly lower than those before intervention (25.35 ± 2.07 and 17.38 ± 2.69).The dimensions of CFS,sleep quality,sleeping time,sleep disorder,hypnotic drug use and daytime dysfunction were significantly lower than those before intervention (P＜0.01,P＜0.05).After intervention,there were significant differences in scores of CFS,somatic,cognitive and emotional dimensions between the two groups (t=18.21,-36.94,-13.17,-6.17,P＜0.01),and the scores of PSQI,sleep quality,sleeping time,sleep disorder,hypnotic use and daytime dysfunction were statistically different between the two groups (t=19.96,-82.86,-16.59,-9.39,-28.00,-9.25,P＜ 0.01).Conclusion Emotional resilience group training can effectively reduce the fatigue of patients with gastrointestinal cancer and improve sleep quality.
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Objective@#To investigate the efficacy and the prognostic factors of Chinese Academy of Medical Sciences 2005 (CAMS-2005) regimen in the treatment of pediatric acute myeloid leukemia (AML).@*Methods@#Eighty-eight cases of newly-diagnosed AML patients, who were treated with the CAMS-2005 regimen from April 2005 to July 2009, were enrolled in this case observational study. Clinical characteristics, long-term prognosis and prognostic factors were analyzed retrospectively. Overall survival (OS) and event free survival (EFS) rates were estimated by the Kaplan-Meier method. Rates of survival between the groups were compared by the Log-rank test. Prognostic factors were evaluated by COX regression analysis.@*Results@#A total of 82 cases were enrolled in this study, including 34 core binding factor(CBF)-AML patients and 48 non-CBF-AML patients. There were 45 males and 37 females. The median age at diagnosis was 8.0 (0.7-16.0) years. During the induction therapy, 3 patients (4%) developed treatment-related early-death, while 63 patients (77%) achieved complete remission (CR) and 53 patients (65%) achieved CR after 1 course. Twenty-one patients (33%) had relapsed disease. The CR rates of CBF-AML patients and non-CBF-AML patients were 91% (31/34) and 67% (32/48) (χ2=5.410, P=0.020) , while the relapse rates were 29% (9/31) and 38% (12/32) (χ2=0.508, P=0.476) . The 8-year OS and EFS rates of all 82 patients were 59%(48/82) and 51%(42/82). The 8-year OS rates of CBF-AML patients and non-CBF-AML patients were 74% (25/34) and 48%(23/48) (χ2=5.812, P=0.016), while the 8-year EFS rates of CBF-AML patients and non-CBF-AML patients were 71%(24/34) and 38%(18/48) (χ2=8.682, P=0.003). There were statistically significant differences between groups. The 8-year OS rates of patients who achieved CR after 1 course and other patients were 68% (36/53) and 46% (12/26) (χ2=9.606, P=0.002), while the 8-year EFS rates were 66% (35/53) and 27% (7/26) (χ2=19.471, P=0.000), the differences were all statistically significant. COX multivariate analysis showed that CBF-AML or non-CBF-AML and whether achieved CR after 1 course were independent prognostic factors of OS rates (relative risk: 2.538, 2.561) and EFS rates (relative risk: 3.050, 3.686) (P <0.05).@*Conclusions@#The efficacy of the CAMS-2005 regimen in the treatment of AML patients was well. CBF-AML or non-CBF-AML and whether achieved CR after 1 course were independent prognostic factors for pediatric AML patients.
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Objective To compare the value of interim and end-of-treatment 18F-fluorodeoxyglucose (FDG) PET/CT for the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods A total of 116 DLBCL patients (male ∶female=1 ∶ 1.32,average age:(57.87± 15.89) years) whose initial treatment was rituximab+cyclophosphamide+doxorubicin+vincristine+prednisone(R-CHOP),were enrolled from 2008 to 2016.All patients underwent pre-treatment,interim and end-of-treatment 18F-FDG PET/CT.End points were progression-free survival (PFS) and overall survival (OS).Correlation between metabolic parameters including maximum standardized uptake value (SUVmax),metabolic tumor volume (MTV),total lesion glycolysis (TLG),Deauville score (DS),△SUVmax,△MTV,△TLG in the interim PET/CT and those in the end-of-treatment PET/CT was analyzed with Pearson correlation analysis.The ability of metabolic parameters to assess the prognosis was evaluated by receiver operating characteristic(ROC) curve analysis.The survival was analyzed by Kaplan-Meier method and hazard ratio (HR) was calculated by Cox regression model.Results The r values for △SUVmax,△MTV,△TLG of interim and end-of-treatment PET/CT were 0.630,0.912,0.955,respectively (all P＜0.01).One hundred and four cases (89.7％,104/116)had the same DS in the interim and end-of-treatment PET/CT,and the r value for DS between two PET/CT scans was 0.733 (P＜0.01).The interim metabolic parameters were superior to that at the end of treatment in evaluating the progression.The 5-year PFS (83.1％ vs 35.9％,P＜0.01;HR =5.969,P＜0.01) and OS (95.7％ vs 75.5％,P＜0.01;HR=8.161,P＜0.05) rates were significantly higher in DS 1-3 group than those in DS 4-5 group.Conclusions Interim PET/CT is effective for the prediction of prognosis in DLBCL patients with R-CHOP treatment.Patients with complete remission in the interim can omit the end-of-treatment PET/CT.
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Objective To investigate the relationship between 18F-fluorodeoxyglucose (FDG) PET/CT metabolic parameters of colorectal cancer (CRC) and liver metastasis.Methods A total of 98 CRC patients (66 nales,32 females,average age:(64+13) years) from January 2012 to October 2016 in Shanghai Renji Hospital were enrolled in this retrospective study.All patients underwent 18F-FDG PET/CT and had not received any treatment before surgery.The relationships between clinical pathological results,metabolic parameters and liver metastasis were analyzed.Data were analyzed usingx2 test and logistic regression analysis.Results Patients were divided into two groups,78 without liver metastasis,20 with liver metastasis.Univariate analysis showed that the tumor primary location(x2=5.983),T stage(x2=6.447),serum carcinoembryonic antigen (CEA) levels(x2 =5.501),metabolic tumor volume (MTV;x2 =6.282) and total lesion glycolysis (TLG;x2=9.046) were significantly different between the two groups (all P＜0.05).Multiple factor analysis showed that the tumor primary location,T stage,serum CEA levels,MTV and TLG (odds ratio (OR):0.059-7.575)were independent risk factors of CRC liver metastasis,and MTV and TLG were negatively correlated with liver metastasis.Conclusions Tumor primary location,T stage,serum CEA levels,MTV and TLG are independent risk factors of CRC liver metastasis.MTV and TLG are negatively correlated with liver metastasis.
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Objective To investigate the effect of emotional resilience group training on perceived stress,anxiety and depression in patients with gastrointestinal cancer.Methods 325 cases of patients with gastric cancer were divided into experimental group(n=163) and control group(n=162) by random digital table method.Two groups of patients were treated with chemotherapy and routine treatment and the experimental group was trained once a week for 8 weeks of emotional resilience group training.Chinese version perceived stress(CPSS),SDS and SAS were used to evaluate the effect of intervention before and after intervention.Results After 8 weeks of emotional elastic group training,the CPSS score((39.98±4.82) vs (33.96±5.02)),SAS score((48.83±4.58) vs (42.12±4.01)) and SDS score((49.23±4.12) vs (45.21±3.27))were lower than those before the intervention (all P＜ 0.05).The difference of CPSS ((-6.02 ± 3.74) vs (-0.19±2.78)),SAS((-6.71±3.86) vs (-0.39±5.62)) and SDS((-4.02±2.03) vs (-0.62±2.31)) before and after the intervention of the two groups were statistically significant(t=-9.325,-9.529,-6.132,P＜0.01).Conclusion Emotional resilience group training can effectively reduce the level of perceptual stress in patients with gastrointestinal cancer,and improve depression and anxiety.
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Objective To investigate the depression status and its influencing factors in the patients with uremia before and after the first time hemodialysis.Methods A total of 177 patients with uremia conducted the questionnaire investigation by using the Hamilton Depression Scale and self-made general information questionnaire.Meanwhile,the laboratory indexes were detected and analyzed.Results At one week before dialysis,35% of the patients had different degrees of depression symptoms,11.9% of the patients had depressive symptoms at 1 week after dialysis;the depression scores before and after dialysis were(14.96 ± 8.37) points and(6.52 ± 3.81)points respectively,the difference was statistically significant(t=16.267,P<0.01).The depression score had statistical difference between the patients with complications and patients without complications(t= -2.528,P=0.013);while the depression scores had no statistical difference among the patients with different sexes,ages,cultural levels,types of original dis-eases,whether smoking and drinking(P<0.01).The Spearman correlation analysis showed that the levels of GLU,Cr and BUN were positively correlated with the depression score,while the levels of TC and Alb were negatively correlated with the depression score,the difference was statistically significant(P< 0.01).Conclusion The evaluation of depression status in hemodialysis pa-tients should be emphasized.
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Objective To observe the clinical effect of traditional Chinese medicine fumigation combined with rehabilitation exercise on the recovery of elbow joint function after triad disease of elbow joint. Methods Sixty patients with terrible triad disease of elbow were divided into treatment group and control group according to the random number table. The treatment group was treated with traditional Chinese medicine fumigation combined with rehabilitation exercise. The control group was treated with rehabilitation exercise. The clinical effect rates, elbow activity and De Boer YA elbow function score were observed at 4 weeks and 8 weeks after treatmentt. Results The total effect rate was 83.3% (25/30) in the treatment group and 60.0% (18/30) in the control group, and the difference between the two groups was statistically significant (χ2=4.021, P=0.044).After treatment,the elbow flexion(126.98 ± 10.46°vs.120.86 ± 10.37°,t=2.275),the hyperextension (8.26 ± 1.23° vs. 6.79 ± 1.29°, t=4.517), pronation (80.46 ± 8.60° vs. 73.42 ± 8.20°, t=2.404), and supination (78.53 ± 8.26° vs. 73.42 ± 8.20°, t=2.404) in the treatment group were significantly higher than those in the control group.. The De Boer YA elbow function score pain (27.13 ± 2.56 vs. 24.86 ± 2.42, t=3.529), Daily activities (32.26 ± 4.24 vs. 29.48 ± 4.36, t=2.503), movement (31.46 ± 4.66 vs. 28.74 ± 4.59, t=0.026), total score(90.42 ± 8.76 vs.83.82 ± 8.42,t=2.975)in the treatment group were significantly higher than those in the control group (Ps<0.05). Conclusions Traditional Chinese medicine fumigation combined with rehabilitation exercise can promote the recovery of elbow joint function in triad of elbow joint.