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Objective:To explore risk factors for relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in adult Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia (Ph-ALL).Methods:A retrospective analysis was performed for 65 adult Ph-ALL patients undergoing initial allo-HSCT from 2016 to 2018. The effect of baseline level and treatment pre-transplantation for relapse after allo-HSCT was analyzed.Results:There were 37 males and 28 females with a median age of 25(14-58) years during allo-HSCT. And the median follow-up period was 27 months post-HSCT. The 2-year overall survival (OS) was 78.8%(95%CI 67.8%-89.8%) and the 2-year relapse-free survival (RFS) 70.7% (95%CI 58.2%-83.2%). Pre-transplant chemotherapy was offered for 3 to 7 courses and the median dose of polyethylene glycol-conjugated asparaginase (PEG-ASP) was 3 doses (2 000 IU/m 2 per dose). Multiariate analysis revealed that the regimen included more than 4 doses of PEG-ASP pre-HSCT (HR=4.067, P=0.046) was a protective factor for post-transplant relapse (HR=0.193, P=0.009). High-risk chromosome karyotype was a risk factor for relapse (HR=0.193, P=0.009). The 2-year RFS rate was 90.0%(95%CI 79.2%-100.0%) for intensive PEG-ASP group and 56.9%(95%CI 39.1%-74.7%) for control group ( P=0.01). No significant inter-group difference existed in overall survival (OS)( P=0.079). The 2-year OS was 90.6% (95%CI 80.4%-100.0%) in intensive PEG-ASP group and 72.1% (95%CI 56.6%-87.6%) in control group. Conclusions:For adult ph-ALL patients, a higher dose of PEG-ASP in pretransplant chemotherapy regimens may improve post-transplant RFS and achieve a better outcome.
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Polypoid lesions of the gallbladder (PLG) is a common gallbladder disease in clinical practice. Most patients have non-adenomatous polyps, while adenomatous polyps are observed in a small number of patients. This article summarizes the epidemiology of PLG and related risk factors and points out that PLG is caused by the combined effect of various factors including sex, hepatitis B virus infection, metabolic syndrome, visceral obesity, a low level of low-density lipoprotein, gallbladder wall thickening, and diabetes. With the gradual increase in the incidence rate of PLG, epidemiological data should be used for health screening among the high-risk population, and standardized follow-up should be performed for patients with a confirmed diagnosis. PLG which may progress to cancer should be identified and intervention should be given as early as possible.
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Acute pancreatitis (AP) is an acute inflammatory and cell-damaging process of the pancreas. In this paper, using the AP onset location and its characteristics combined with review of the ancient and modern literatures and summary of the clinical practices, the professor Chen Qiaolin's academic ideas and clinical experiences in treating AP are introduced and demonstrated. Dr. Chen believes that the development of AP is a dynamic process, the key point is to grasp the Shaoyang syndrome complicated with Yangming, the internal administration of the self-modified Dachaihu decoction is the basic therapy accompanied by applying paste-like Traditional Chinese Medicine TCM attached on the acupoints and acupuncture for comprehensive treatment of AP, the therapeutic result is confirmed and its summary is as follows.
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To explore the efficacy of sorafenib combined with chemotherapy and donor lymphocyte infusion (DLI) in patients with FLT3-positive acute myeloid leukemia (AML) relapsed after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Of the 14 patients relapsed after allo-HSCT,9 achieved complete remission after salvage therapy of sorafenib combined with chemotherapy and DLI,6 with complete molecular remission,2 with partial remission,and 3 with no response.With a median follow up of 220 (range,30-1 782) days after post-transplantation relapse,7 patients were still alive and 7 died.Salvage therapy of sorafenib combined with chemotherapy and DLI shows a decent therapeutic effect for FLT3-positive AML relapsed after allo-HSCT.
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Objective To evaluate the therapeutic efficacy and adverse reactions of raltitrexed plus oxaliplatin (RALOX project) and S1 in patients with advanced primary liver cancer.Methods Seventy-one patients with advanced primary liver cancer admitted to 6 cancer centers from July 2013 to July 2015 were divided into 2 groups according to the wishes of the patients and their families:RALOX group (34 patients) and S1 group (37 patients).The therapeutic efficacy such as objective remission rate (ORR),disease control rate (DCR),median overall survival (mOS),median progression free survival (mPFS),one year survival rate (SR),and adverse reactions in these patients were evaluated.Results Thirty-one patients could be evaluated in RALOX group,and 6 patients obtained partial response (PR),10 stable disease (SD) and 15 progressive disease (PD).Thirty-three patients could be evaluated in S1 group,and 3 patients obtained PR,8 patients SD and 22 PD.The ORR,DCR,and one year SR were 19.4％ vs.9.1％,51.6％ vs.33.3％,and 22.6％ vs.12.1％ respectively,and there were no statistically significant differences in the two groups (x2 =1.393,P =0.238;x2 =2.190,P =0.139;x2 =1.229,P =0.268).The mOS and mPFS were 7.2 months vs.6.1 months and 3.4 months vs.2.8 months,and there were statistically significant differences in the two groups (x2 =6.433,P =0.011;x2 =4.078,P =0.043).There was more serious peripheral nerve toxicity (29.0％ vs.3.0％,x2 =6.344,P =0.012) and lighter hand-foot syndrome (9.7％ vs.30.3％,x2 =4.201,P =0.040) in RALOX group than S1 group.But the incidences of other adverse effects were similar in the two groups.Condnsion RALOX project is safe and effective to the patients with advanced primary liver cancer.Compare with S1 project,RALOX project has better curative effects and the majority of adverse reactions are tolerable.The patients have good condition control and survival benefit.
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Objective To investigate the clinical efficacy of open reduction and internal fixation with dynamic anterior plate-screw system for quadrilateral area ( DAPSQ ) in the treatment of elderly patients with acetabular fracture involving medial displacement of the quadrilateral surface. Methods Between January 2007 and December 2014, a series of 18 senile patients with acetabular fractures involving medial displace-ment of the quadrilateral surface were treated at our department. They were 13 men 5 women, with a mean age 67. 8 years ( range, from 61 to 78 years ) . By the Judet-Letournel classification, there were 4 anterior column fractures, 5 anterior column plus posterior hemitransverse fractures, 8 double column fractures and one T-shaped fracture. The delay from injury to surgery averaged 6. 5 days. All were treated with the technique of DAPSQ. Screw internal fixation of the quadrilateral area followed plate moulding via a single ilioinguinal ap-proach. Fixation with lag screws for the posterior column was added if necessary. Results The 18 pa-tients were followed up for 12 to 35 months ( mean, 26 months ) . By the Matta criteria for fracture reduction, 9 cases were rated as excellent, 6 as good and 3 as poor. Bone healing was achieved within 2 to 4 months( mean, 3. 5 months ) . By the modified Merle d'Aubigné & Postel criteria, the affected hips scored 9 to 18 points ( mean, 16. 3 points ) at the final follow-ups, giving 7 excellent, 7 good, 2 fair and 2 poor cases. By the Harris evaluation, the affected hips scored 58 to 98 points ( mean, 87. 6 points ) , giving 7 excellent, 8 good, one fair and 2 poor cases. The postoperative complications included urinary tract infection in one, lesion of lateral femoral cutaneous nerve in one, heterotopic ossification ( Brooker Grade Ⅰ) in one, and traumatic osteoarthritis in 5 cases 2 of whom had to receive total hip arthroplasty. Conclusion The technique of DAPSQ is suitable for the treatment of acetabular fractures involving medial displacement of the quadrilateral surface in elderly patients, because it can provide and maintain stable fixation of the fracture in the quadri-lateral area and preserve hip joint function, leading to fine outcomes.
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Sump syndrome is a rare complication of side-to-side choledochoduodenostomy (CDD) and occasionally occurs after spontaneous gallbladder-bile duct-digestive tract fistula or end-to-side choledochojejunostomy.Before the development of minimally invasive surgery,conventional surgical operation used to be the most important treatment method.This article reviews the research advances in sump syndrome in recent years and points out that endoscopic retrograde cholangiopancreatography is the major diagnostic method for this disease,and endoscopic sphincterotomy combined with bile duct debridement is the most simple and effective measure for the treatment of sump syndrome.Meanwhile,this article briefly reviews sump syndrome with reference to related literature and clinical practice,in order to raise the awareness for sump syndrome.
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Objective:Comparing the influence of colon cancer recurrence of laparoscopic and open operation to evaluate the safety and validity of operation.Methods:The cohort study includes 62 cases of laparoscopic and 83 cases of open colon cancer radical surgery from January 2010 to October 2012.The research aimed at comparing the effects of laparoscopic and open surgery for colon cancer recurrence by analyzing postoperative follow-up ending and GCC-mRNA & CEA.Results:There have no obvious differences in age,sex,BMI,tumor size,stage,grade,pathological types and resection range between laparoscopy and open group(P＞0.05).Postoperative 3-years recurrence of two groups have no difference (P＞0.05),but 1-year recurrence rate of laparoscopic was obviously lower than open operation (3.2％ vs 14.5％,P＜0.05).There have no obvious differences of postoperative overall survival rate and mortality(P＞0.05),but 1-year disease-free survival rate of laparoscopic group was obviously higher than laparotomy group (93.5％ vs 81.3％,P＜0.05).The postoperative GCC-mRNA and CEA positive rate of laparoscopic was significantly lower than laparotomy group.Univariable and Multivariable analysis reveals that laparoscopic colorectal cancer radical can obviously reduce the cancer recurrence within 1 year (P＜0.05).Addition,stage,aspirin and other amino acid drugs are independent risk factors of postoperative recurrence (P＜0.05).Conclusion:Laparoscopic colon cancer radical surgery is a safe and effective operation and can reduce short-term recurrence of colorectal cancer compared to open surgery.
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ObjectiveTo investigate the therapeutic effect and adverse effects of transcatheter arterial chemoembolization (TACE) combined with thalidomide or sorafenib in the treatment of unresectable primary liver cancer. MethodsA total of 102 patients who underwent TACE combined with thalidomide or sorafenib in 215 Hospital of Nuclear Industry of Shaanxi Province from January 2012 to August 2013 were enrolled and divided into TACE-thalidomide group (49 patients) and TACE-sorafenib group (53 patients). The short-term outcome, long-term outcome, changes in related indices, and adverse events were evaluated. The independent-samples t-test was applied for comparison of continuous data between groups, and the paired t-test was applied for comparison of continuous data within one group; the chi-square test was applied for comparison of categorical data between groups; the survival curve was used for survival analysis, and the log-rank test was applied for survival comparison. ResultsThe indices of short-term outcome, objective response rate and disease control rate, showed no significant differences between the two groups. The 2-year survival showed a significant difference between the two groups (χ2=4692, P=0.03). The log-rank test showed that overall survival time and median progression-free survival time showed significant differences between the two groups (χ2=8.267 and 6.896, P=0.004 and 0.009). After treatment, alpha-fetoprotein (AFP) and gamma-glutamyl transpeptidase (GGT) showed significant differences between the two groups (t=2.035 and 2.843, P=0.038 and 0.025). The incidence rates of nausea/vomiting, dizziness/headache, rash/desquamation, and increased blood pressure showed significant differences between the two groups (all P＜0.05). ConclusionTACE combined with thalidomide has the same short-term therapeutic effect as TACE combined with sorafenib and can improve the patient′s long-term outcome and significantly reduce the levels of AFP and GGT, but it has high incidence of nausea/vomiting and dizziness/headache.
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Objective To evaluate the impact of different surgical approach on postoperative renal function in patients with synchronous sporadic bilateral renal cell carcinoma ( SSBRCC) .Methods The medical records of 28 patients with SSBRCC were reviewed.Of all these cases, 21 patients were male and 7 were female, and the mean age was 51 ( 25-63 ) years.None of these cases had family history of renal carcinoma.The treatment and other clinical data were analyzed retrospectively.Results All of the 28 patients underwent bilateral surgeries.Single procedures were performed on 16 patients, of which, one underwent bilateral radical nephrectomy ( RN) , 8 bilateral nephron-sparing surgery ( NSS) and 7 unilateral NSS combined with contralateral RN.Staged procedures were performed on 12 patients, of which bilateral NSS was on 5 patients (NSS-NSS group), NSS followed by RN (NSS-RN group) on 3 patients and RN followed by NSS ( RN-NSS group) on 4 patients.In term of postoperative renal function preservation for SSBRCC patients, the standard NSS was better than RN.Between different staged procedures, NSS-NSS was the preferred choice, and the NSS-RN was superior to the RN-NSS.Conclusions In term of preservation of postoperative renal function, the staged procedures were recommended, and NSS was preferred in the first stage.In deciding the second stage surgical approaches, the surgeons should take the renal function preservation and the tumor size into consideration.
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A military aviation audiovisual information system was constructed using the recent media assets manage-ment technologies according to the audiovisual data in our institute since its establishment,which will realize the scien-tific,standard,digital and network management of audiovisual information,and further improve the audiovisual service.
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Objective To evaluate facial nerve(FN),cochlear nerve(CN)development by magnetic resonance hydrography of the inner ear.Methods 91 cases with normal hearing infants from 0 to 36 months underwent MR head scan and magnetic resonance hydrography of the inner ear.FN,CN long diameter (LD)and short diameter (SD)in oblique sagittal reconstruction imaging were measured.Results 91 cases(182 ears)were divided to 0-12 months as 1st,group (N=35),13-24 months as the 2ed,group (N=36),25-36 months as the 3rd,group (N=20)according to age,in which FN (154 ears,84.6%),CN(170 ears,93.4%)were showed clearly.FN’s LD, SD and Cross-section area(CSA)were 0.76 mm± 0.14 mm,0.50 mm± 0.12 mm,0.30 mm± 0.11 mm,and CN ’s LD,SD and CSA were 0.98 mm± 0.14 mm,0.63 mm± 0.11 mm,0.49 mm± 0.13 mm respectively comparison between groups it was showed that in hearing normal infant growth process,CN,FN development did not vary and change for the left and right side,gender and age.Conclusion MRI measurement of FN,CN diameter and cross-sectional area size provides an important reference on the assess-ment of CN,FN growth condition in infants with normal hearing.
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Objective To investigate the effect of histone deacetylase inhibitor LBH589 on proliferation,apoptosis and drug resistance of chemoresistant acute myeloid leukemia cells HL60/ADM.Methods HL60/ADM cells were treated with LBH589.Proliferation,apoptosis and adriamycin IC50 were evaluated by MTT assay and AnnexinV-FITC/PI stain.The change in MRP1 expression and intercellular adriamycin accumulatiom were analyzed by flow cytometry.Results Effective proliferative inhibition and apoptotic induction in HL60/ADM cells were observed after treatment with 10-80 nmol/L LBH589 with maximal effect detected after treatment with 70 nmol/L LBH589 for 60 hours.However,inhibition ratio remain unchanged with the further increase of drug dose and incubation time (P ＞ 0.05).Downregulation of MRP1 [(93.90±4.20) ％ vs (76.19±6.53) ％],upregulation of adriamycin accumulation [(8.53±0.68) ％ vs (25.67±1.34) ％] and decrease in adriamycin IC50 [(6.833±0.319) μg/ml vs (1.382±0.104) μg/ml] were induced by the treatment with 20 nmol/L LBH589 (P ＜ 0.01),whose reversal fold was 4.9.The expression of acetylated histone 3 after treatment with LBH589 was higher than that before treatment (P ＜ 0.01).However,relative p-Akt levels after treatment for 24 h and 48 h were 1.07±0.09 and 0.59±0.01,respectively,which were lower than that before treatment (2.03±0.12) (P ＜ 0.01).Meanwhile,expression levels of p53 were 0.57±0.04 and 1.31±0.09,respectively,which were higher than that before treatment (0.21 ±0.02) (P ＜ 0.01).Conclusion Treatment with LBH589 has the capability of inhibiting proliferation and inducing apoptosis,as well as increasing intercellular adriamycin accumulation and sensitivity through downregulation of MRP1 expression and inhibition of PI3K-Akt signaling pathway in HL60/ADM cells.
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Objective Using maestro software to analyze the application of electrically elicited stapedius reflex and auditory nerve response in assessing acoustic function intraoperatively .Methods 20 SONATATI100cochlear im-plant patients participated in this study .Both ESRT and ECAP were recorded intraoperatively by using MED -EL Maestro software and analyzed .Results 96 .67% typical ESR and 95 .0% typical ECAP were recorded .Certain properties of ECAP recordings varied depending on the stimulation sites in the cochlea .There was strong relation-ship between ESRT and ECAP thresholds .Conclusion ESR and ART were proved to be most beneficial in assessing the functions of the implanted as well as proving that the auditory pathway is stimulated during the cochlear implan-tation surgery .
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10.3969/j.issn.1008-9691.2013.03.009
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Ibuprofen/ethyl-cellulose (EC)-polyvinylpyrrolidone (PVP) sustained-release composite particles were prepared by using supercritical CO2 anti-solvent technology. With drug loading as the main evaluation index, orthogonal experimental design was used to optimize the preparation process of EC-PVP/ibuprofen composite particles. The experiments such as encapsulation efficiency, particle size distribution, electron microscope analysis, infrared spectrum (IR), differential scanning calorimetry (DSC) and in vitro dissolution were used to analyze the optimal process combination. The orthogonal experimental optimization process conditions were set as follows: crystallization temperature 40 degrees C, crystallization pressure 12 MPa, PVP concentration 4 mgmL(-1), and CO2 velocity 3.5 Lmin(-1). Under the optimal conditions, the drug loading and encapsulation efficiency of ibuprofen/EC-PVP composite particles were 12.14% and 52.21%, and the average particle size of the particles was 27.621 microm. IR and DSC analysis showed that PVP might complex with EC. The experiments of in vitro dissolution showed that ibuprofen/EC-PVP composite particles had good sustained-release effect. Experiment results showed that, ibuprofen/EC-PVP sustained-release composite particles can be prepared by supercritical CO2 anti-solvent technology.
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Based on the structure of 5-fluoroindol-2-one and fragments from thirteen multi-target tyrosine kinase inhibitors which have been marketed or in the phase of clinical research, eleven 3-aromatic Shiff base-5-fluoroindol-2-one derivatives were designed and synthesized. Their structures were identified by 1H NMR, MS and elemental analysis. In vitro antitumor bioactivities evaluation was done by MTT method. It was shown that most of synthesized compounds had antitumor activities and compounds 1b, 1g, 1i and 1h were better than or equal to the antitumor activity of positive control.
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Basing on the market multi-target antitumor agent sorafenib, a series of sixteen 4-[4-(2-methyl-aminoacyl-pyridyl)]oxylphenyl aryl thiourea derivatives were designed and synthesized. Their structures were identified by the spectra of 1H NMR, MS and elemental analysis. The evaluation of antitumor bioactivities in vitro was done by MTT method. It was shown that the synthesized compounds had antitumor activities and compounds 1a, 1d, 1i and 1j showed better or equal antitumor activity on sorafenib.
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Three migrant workers were diagnosed with advanced schistosomiasis in Dongpo District,Meishan City,2005-2009.
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AIM: To investigate and optimize the technology of ultrasonic-assisted extraction of arctiin and arctigenin from Fructus arctii.METHODS: The effects of ultrasonic power,particle size,ratio of liquid to solid,extraction time,extraction temperature and duty factor on the extraction rates of arctiin and arctigenin were investigated,and optimized with orthogonal experiments.RESULTS: The results showed that the optimal extraction conditions were as follows: particle 80 ～ 100 mesh 14 mL/g,ratio of liquid to solid 400 W ultrasonic power,50 ℃ of extraction temperature,and 10 min of extraction time.CONCLUSION: The optimized conditions are reasonable and reliable.