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1.
Article in Chinese | WPRIM | ID: wpr-882511

ABSTRACT

Objective:To compare the survival rate and adverse reactions of patients with advanced hypopharyngeal squamous cell carcinoma undergoing surgery combined with chemoradiotherapy, and to analyze the prognostic factors of patients.Methods:The clinicopathologic data of 78 patients with advanced hypopharyngeal squamous cell carcinoma admitted to the Department of Radiation Oncology of the First Affiliated Hospital of Bengbu Medical University from August 2013 to December 2018 were retrospectively analyzed. The patients were divided into surgery combined with chemoradiotherapy group ( n=27) and chemoradiotherapy group ( n=51) according to different treatment methods. The median follow-up time was 46 months (20-84 months). The main observation indicators were overall survival (OS), progression-free survival (PFS) and local control rate (LCR). Cox regression model was used to analyze the prognostic factors. Results:Until July 31, 2020, 51 of the 78 patients with advanced hypopharyngeal squamous cell carcinoma died, including 6 cases of local recurrence, 11 cases of distant metastasis, and 34 cases of other causes (15 cases of hemorrhage, 15 cases of cachexia, and 4 cases of other diseases). In the surgery combined with chemoradiotherapy group, 12 patients died, accounting for 44.44%. In the chemoradiotherapy group, 39 patients died, accounting for 76.47%. The 1-, 3- and 5-year OS rates of 78 patients were 57.7%, 36.3% and 27.2% respectively, the 1-, 2- and 3-year PFS rates were 49.5%, 38.7% and 32.6% respectively, and the 1-, 2- and 3-year LCR were 53.4%, 40.0% and 34.2% respectively. The 1-, 3- and 5-year OS rates in the surgery combined with chemoradiotherapy group were 74.1%, 50.1% and 44.6%, and those in the chemoradiotherapy group were 49.0%, 29.3% and 12.8%, with a statistically significant difference ( χ2=5.142, P=0.023). The 1-, 2- and 3-year PFS rates in the surgery combined with chemoradiotherapy group were 62.1%, 54.3% and 44.4%, and those in the chemoradiotherapy group were 43.1%, 30.6% and 26.7%, with no statistically significant difference ( χ2=3.222, P=0.073). The 1-, 2- and 3-year LCR of the surgery combined with chemoradiotherapy group were 69.8%, 54.3% and 44.4%, and those in the chemoradiotherapy group were 45.1%, 32.9% and 29.6%, with no statistically significant difference ( χ2=3.576, P=0.059). The results of univariate analysis showed that tumor T stage ( χ2=7.140, P=0.008), N stage ( χ2=4.493, P=0.034) and treatment method ( χ2=5.142, P=0.023) were all independent influencing factors of the OS of patient with advanced hypopharyngeal squamous cell carcinoma; T stage ( χ2=5.807, P=0.016) and N stage ( χ2=6.587, P=0.010) were both independent influencing factors of PFS. The results of multivariate analysis showed that tumor T stage ( HR=2.121, 95% CI: 1.142-3.938, P=0.017), N stage ( HR=2.088, 95% CI: 1.144-3.811, P=0.016) and treatment method ( HR=0.430, 95% CI: 0.226-0.815, P=0.010) were all independent prognostic factors of the OS of patients with advanced hypopharyngeal squamous cell carcinoma; T stage ( HR=1.884, 95% CI: 1.011-3.510, P=0.046) and N stage ( HR=1.904, 95% CI: 1.058-3.429, P=0.032) were both independent prognostic factors of PFS. During the treatment period, there were statistically significant differences in the incidences of radioactive pharyngitis [7.41% (2/27) vs. 39.22% (20/51), χ2=8.821, P=0.003] and radioactive dermatitis [3.70% (1/27) vs. 29.41% (15/51), χ2=7.156, P=0.007] between the surgery combined with chemoradiotherapy group and the chemoradiotherapy group. However, there were no statistically significant differences in the incidences of radioactive oral mucositis [11.11% (3/27) vs. 17.65% (9/51), χ2=0.186, P=0.666], bone marrow suppression [37.04% (10/27) vs. 50.98% (26/51), χ2=1.381, P=0.240], pharynx infection [11.11% (3/27) vs. 5.88% (3/51), χ2=0.143, P=0.706] and tracheal fistula [7.41% (2/27) vs. 0 (0/51), P=0.117] between the two groups. Conclusion:The 1-, 3- and 5-year OS rates in the surgery combined with chemoradiotherapy group are higher than those in the chemoradiotherapy group, and the incidences of adverse reactions are low. T stage, N stage and treatment method are independent prognostic factors for OS of advanced hypopharyngeal squamous cell carcinoma patients, while T stage and N stage are independent prognostic factors for PFS.

2.
Article in Chinese | WPRIM | ID: wpr-905945

ABSTRACT

In view of the current controversy in the clinical evaluation of the terms of 'prohibition' 'contraindication', and 'use with caution', the present study summarized their evaluation elements to provide references for the classification of 'prohibition' 'contraindication', and 'use with caution' and clinical rational medication of drugs. Based on the ancient and modern representative traditional Chinese medicine (TCM) literature, such as the records on herbal medicines and prescriptions, medical classics, pharmacopoeia, clinical monographs, and papers, this study proposed the evaluation elements and the underlying ideas of 'prohibition' 'contraindication', and 'use with caution' around the risks and benefits of medication. The results indicate that the evaluation elements of 'prohibition' 'contraindication', and 'use with caution' include TCM property,syndrome,symptom, TCM compatibility,dosage,and treatment course. When evaluating 'prohibition' 'contraindication', and 'use with caution' of TCM under specific conditions of medication,we can determine the properties of prohibited or contraindicated drugs prior to figuring out the differences in 'prohibition' 'contraindication', and 'use with caution'. It is feasible to evaluate the clinical 'prohibition' 'contraindication', and 'use with caution' in TCM from Chinese medicine, body, and the clinical medication, which are correlated with each other in the practice implementation.

3.
Article in Chinese | WPRIM | ID: wpr-905225

ABSTRACT

Objective:To evaluate the effect of motor imagery training on motor and executive function in the older population. Methods:Articles about the impact of motor imagery training on the motor and cognitive functions of the elderly in the databases of Web of Sciences, PubMed, CNKI, Wanfang data and VIP were searched from 1980 to 2020. The training program, rehabilitation effect and relatec factors of motor image training in the elderly were analyzed and summarized. Results:Twelve articles were included finally. The motor image training that suited the elderly over 60 years old was usually combined with actual exercise training, mostly for four to twelve weeks, two to three times a week and 15 to 60 minutes a time. Motor imagery training was effective on standing balance, postural control, falls and muscle strength, to improve the ability to solve conflict problems, working memory and cognitive flexibility. Conclusion:Motor imagery training is an effective way to delay the decline of physical function and improve the executive function of the elderly. It is needed to construct a reasonable and standard motor imagery training program according to the characteristics of the elderly, to improve the effect.

4.
China Pharmacy ; (12): 358-363, 2021.
Article in Chinese | WPRIM | ID: wpr-872690

ABSTRACT

OBJECTIVE:To understand the current status of clinical understanding of “prohibiting”“avoiding”“using caution ” in the application of TCM ,and to provide reference for standardizing the connotation and rational application of “prohibiting” “avoiding”“using caution ”of TCM. METHODS :Based on the theory of “knowledge-attitude-behavior”,doctor-pharmacist questionnaires and patient questionnaires were designed on the basis of literature research and clinical practice. Through the “Tencent questionnaire ”platform,800 doctor-pharmacist questionnaires were distributed to nearly 300 medical institutions from 32 provinces(cities,autonomous regions )and 800 patient questionnaires were distributed to public patiants who had used TCM nationwide by anonymous online method. After dimensionality reduction of the questionnaire from three dimensions of cognition , attention and behavior ,the cognition ,attention and behavior of “prohibiting”“avoiding”“using caution ”in the application of TCM were evaluated by 10 points system. RESULTS :A total of 703 doctor-pharmacist questionnaires were collected ,including 638 valid questionnaires with recovery rate of 87.9% and effective rate of 90.8%;Cronbach alpha coefficient was 0.90. A total of 644 patient questionnaires were collected ,including 621 valid questionnaires with recovery rate of 80.5% and effective rate of 96.4% . The cognition score of doctors and pharmacists to the terms of “prohibiting”“avoiding”“using caution ”in clinical application of TCM was (7.94±1.21),and that of patients was (5.64±1.54). The score of doctors and pharmacists ’attention to the above terms was (9.47±1.15)(Spearman Rho correlation coefficient with cognition score was 0.077,P>0.05),and the score of behavioral ability of patients was (7.01±1.71)(Spearman Rho correlation coefficient with cognition score was -0.021,P> 0.05). The score of behavior ability was (7.43 ± 1.72) (Spearman Rho correlation coefficient with cognition score was 0.233,P<0.01). TCM textbooks (89.2%),trainingmeetings (66.5%) and herbal prescriptions (58.2%) were the main ways for doctors and pharmacists to learn the above taboos. Medical staff (74.2%)and internet (52.5%)were the main ways for patients to understand the above taboos. CONCLUSIONS :Doctors,pharmacists and patients pay more attention to the terms of “prohibiting”“avoiding”“using caution ”in the clinical application of TCM ,but their cognition and executive power were low. Clinical cognition of “prohibiting”“avoiding”“using caution ”in the application of TCM is relatively vague,and the corresponding clinical practice behavior is lacking. It is yet to establish clinical specialist consensus in the field of TCM and publicize it actively to improve the level of clinical rational drug use.

5.
Article in Chinese | WPRIM | ID: wpr-906449

ABSTRACT

Objective:To investigate the therapeutic mechanism of Wuhutang on respiratory syncytial virus (RSV)-induced asthma in mice and its influence on the expression of signal transducer and activator of transcription 3 (STAT3) in lung tissue. Method:One hundred female BALB/c mice of SPF grade were randomly divided into a normal group and an experimental group. After successful modeling via aerosol inhalation of RSV and ovalbumin (OAV), the mice in the experimental group were further randomized into the following seven groups: model, positive control (dexamethasone, 1.82 mg·kg<sup>-1</sup>), STAT3 inhibitor (STATTIC, 3.75 mg·kg<sup>-1</sup>), STAT3 inducer (colivelin, 1.0 mg·kg<sup>-1</sup>), and low-, medium-, and high-dose (1.6, 3.2, and 6.4 g·kg<sup>-1</sup>, respectively) Wuhutang groups. The corresponding drugs were administered for two weeks, followed by the detection of airway reactivity using a small animal ventilator, the pathological changes in lung tissue, mucus secretion by goblet cells and collagen deposition in airway were observed by hematoxylin-eosin (HE), periodic acid-Schiff (PAS) and Masson staining, the serum levels of interleukin-6 (IL-6), IL-10, and IL-17 were detected by enzyme-linked immunosorbent assay (ELISA). The mRNA expression levels of TGF-<italic>β</italic><sub>1</sub> and <italic>α</italic>-SMA in lung tissue were detected by fluorescence-based real-time polymerase chain reaction (Real-time PCR), autophagosomes present in lung tissue were examined by transmission electron microscopy, the protein expression levels of ATG5 and SQSTM1 in dendritic cells (DCs) and STAT3 and p-STAT3 in lung tissue were detected by Western blot. Result:The airway reactivity of the model group was enhanced in contrast to that in the model group (<italic>P<</italic>0.01), manifested as inflammatory cell infiltration around the lung tissue, excessive metaplasia of goblet cells, and extensive deposition of airway collagen, the expression levels of serum IL-6 and IL-17 were increased (<italic>P<</italic>0.01), while that of IL-10 declined (<italic>P<</italic>0.01), the mRNA expression levels of TGF-<italic>β</italic><sub>1</sub> and <italic>α</italic>-SMA were elevated (<italic>P</italic><0.01), the number of autophagosomes in the lung tissue increased. The protein expression levels of ATG5, STAT3, and p-STAT were up-regulated, while that of SQSTM1 was down-regulated (<italic>P<</italic>0.01). Compared with the model group, Wuhutang and STATTIC significantly reduced the airway hyperresponsiveness of asthmatic mice (<italic>P<</italic>0.05, <italic>P<</italic>0.01), alleviated RSV-induced pathological changes in lung tissue, reduced the contents of serum IL-6 and IL-17 (<italic>P<</italic>0.01), increased serum IL-10 and ATG5 in DCs (<italic>P<</italic>0.01), down-regulated the mRNA expression levels of TGF-<italic>β</italic><sub>1</sub> and <italic>α</italic>-SMA as well as the protein expression levels of SQSTM1, STAT3 and p-STAT3 (<italic>P<</italic>0.05,<italic>P<</italic>0.01), and elevated the number of autophagosomes. Conclusion:Wuhutang relieves airway inflammation, improves airway remodeling and reduces airway hyperresponsiveness in RSV-induced asthmatic mice by inhibiting STAT3 protein and up-regulating DC autophagy in lung tissue.

6.
Article in Chinese | WPRIM | ID: wpr-886107

ABSTRACT

Objective To study the distribution and drug resistance of pathogens in patients with lung cancer,and analyze the prevention strategies. Methods A total of 312 cases of lung cancer patients with infection treated in our hospital from January 2017 to January 2021 were selected as the research objects.The lower respiratory tract secretions,urine and feces were collected for pathogen culture and drug sensitivity test;the distribution and drug resistance of pathogens were analyzed,and the corresponding prevention strategies were formulated. Results Of the 312 patients, 165 (52.88%) had respiratory tract infection, 79 (25.32%) had oropharyngeal infection, and 68 (21.80%) had urinary tract infection.The highest proportion was respiratory infection.Among the 312 patients,398 pathogens were detected of which 212 Gram-positive bacterias (53.27%)were found of which Staphylococcus epidermidis(15.58%)and Staphylococcus aureus(13.07%)accounted for a relatively high proportion. Among 175 Gram-negative strains,Klebsiella pneumoniae(15.94%)and E.coli (10.05% ) accounted for a large proportion.The resistance rate of Gram-positive bacteria,such as Staphylococcus epidermidis and Staphylococcus aureus,to amikacin,gentamicin and penicillin,was more than 50%,which was sensitive to vancomycin. Gram negative bacteria such as Klebsiella pneumoniae and E.coli have high resistance to common antibiotics,and the drug resistance rate to cefepime and cefazolin is more than 50%,and sensitive to imipenem/cilastatin and imipenem/cilastatin.Among 11 fungi,4 cases were resistant to fluconazole , 36.36%,3 to itraconazole,27.27%,0 to ketoconazole and voriconazole,0.00%. Conclusion The distribution and drug resistance of pathogenic bacteria in patients with lung cancer infection in our hospital have certain characteristics,in which Gram-positive bacteria are mainly Staphylococcus epidermidis and Staphylococcus aureus,Gram-negative bacteria are mainly Klebsiella pneumoniae and Escherichia coli,and there are also a small number of fungal infections.Therefore,we should strengthen the monitoring of etiology and drug resistance,and strengthen the management of hospital disinfection Drug sensitivity results of patients,rational use of antibiotics,so as to improve the treatment effect and reduce the risk of infection.

7.
Article in Chinese | WPRIM | ID: wpr-880029

ABSTRACT

OBJECTIVE@#To investigate the predict significance of the high aldehyde dehydrogenase activity (ALDH@*METHODS@#Bone marrow samples of 23 t(8;21) AML patients diagnosis and achieved complete remission in our hospital from April 2015 to June 2016 were collected, then flow cytometry method was used to detect the activity of ALDH, relationship between it and relapse was analyzed.@*RESULTS@#All the patients were followed up for a median of 32 (2-52) months. The median percentage of CD34@*CONCLUSION@#The percentage of CD34


Subject(s)
ADP-ribosyl Cyclase 1 , Antigens, CD34 , Flow Cytometry , Humans , Leukemia, Myeloid, Acute , Neoplastic Stem Cells , Prognosis , Recurrence , Remission Induction
8.
Article in Chinese | WPRIM | ID: wpr-871690

ABSTRACT

Objective:To discuss the diagnostic methods, clinical features and treatment options of bronchogenic cysts.Methods:A total of 86 patients with bronchogenic cysts and 5 patients with esophageal cysts and esophageal cysts were selected from January 2011 to May 2020 in the Affiliated Tumor Hospital of Harbin Medical University. There were 37 males and 49 females with bronchogenic cysts, aged 23 to 70(49.27±10.70)years old. According to the location of the disease, the patients were divided into mediastinal type(65 cases, 75.6%); intrapulmonary type(21 cases, 24.4%); bronchogenic cyst originating from the esophagus(9 cases, 10.5%).Results:The preoperative diagnosis coincidence rate was 9.3% in 8 cases. The rate of thoracoscopic surgery(59.3% in 51 cases), compared with the indwelling time of thoracic drainage tube after thoracotomy[(3.80±1.25) days vs.(4.97±1.54)days, P<0.001] and hospital stay[(7.08±1.75) days vs.(9.60±2.58)days, P<0.001] significantly shortened. 65 cases(71.4%, 65/91) were successfully followed up, with a median follow-up time of 34(2-111) months, and no recurrence was found. Conclusion:Bronchial cysts have no characteristic clinical manifestations, and it is difficult to make a clear diagnosis before surgery. Chest MRI has a great advantage in the diagnosis of cysts. For most cases, thoracoscopic surgery can achieve better clinical treatment results and has minimally invasive advantages. It is difficult to distinguish between bronchogenic cysts that originated in the esophagus and esophageal cysts, and there is no significant difference in clinical characteristics.

9.
Chinese Journal of Oncology ; (12): 94-98, 2020.
Article in Chinese | WPRIM | ID: wpr-799548

ABSTRACT

Globally, cervical cancer continues to be one of the most common cancers among females. Although screening for cervical cancer has been gradually carried out, the incidence and mortality of cervical cancer in China are still at a high level. So the prevention and treatment of cervical cancer in China still has lots of work to do. The International Federation of Obstetrics and Gynecology (FIGO) gynecological oncology committee revised the staging of cervical cancer in 2018. The new staging changed in terms of stage ⅠB and stage Ⅲ compared with previous FIGO staging. FIGO also provided prevention and treatment strategies and the treatment regimens of each stage, which had an important impact on the prevention and treatment of cervical cancer as well as an important enlightenment for China.

10.
Chinese Medical Journal ; (24): 913-919, 2020.
Article in English | WPRIM | ID: wpr-877989

ABSTRACT

BACKGROUND@#Although endovascular therapy has been widely used for focal aortoiliac occlusive disease (AIOD), its performance for extensive AIOD (EAIOD) is not fully evaluated. We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency.@*METHODS@#Between January 2008 and June 2018, patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II (TASC II) C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled. Demographic, diagnosis, procedure characteristics, and follow-up information were reviewed. Univariate analysis was used to identify the correlation between the variables and the primary patency. A multivariate logistic regression model was used to identify the independent risk factors associated with primary patency. Five- and 10-year primary and secondary patency, as well as survival rates, were calculated by Kaplan-Meier analysis.@*RESULTS@#A total of 148 patients underwent endovascular treatment in our center. Of these, 39.2% were classified as having TASC II C lesions and 60.8% as having TASC II D lesions. The technical success rate was 88.5%. The mean follow-up time was 79.2 ± 29.2 months. Primary and secondary patency was 82.1% and 89.4% at 5 years, and 74.8% and 83.1% at 10 years, respectively. The 5-year survival rate was 84.2%. Compared with patients without loss of primary patency, patients with this condition showed significant differences in age, TASC II classification, infrainguinal lesions, critical limb ischemia (CLI), and smoking. Multivariate logistic regression analysis showed age <61 years (adjusted odds ratio [aOR]: 6.47; 95% CI: 1.47-28.36; P = 0.01), CLI (aOR: 7.81; 95% CI: 1.92-31.89; P = 0.04), and smoking (aOR: 10.15; 95% CI: 2.79-36.90; P < 0.01) were independent risk factors for the loss of primary patency.@*CONCLUSION@#Endovascular therapy was an effective treatment for EAIOD with encouraging patency and survival rate. Age <61 years, CLI, and smoking were independent risk factors for the loss of primary patency.


Subject(s)
Arterial Occlusive Diseases/surgery , Endovascular Procedures/methods , Female , Humans , Iliac Artery/surgery , Kaplan-Meier Estimate , Male , Middle Aged , Retrospective Studies , Risk Factors , Stents , Survival Rate , Treatment Outcome , Vascular Patency
11.
Chinese Medical Journal ; (24): 2429-2436, 2020.
Article in English | WPRIM | ID: wpr-877825

ABSTRACT

BACKGROUND@#Endothelial cells play a key role in the cytokine storm caused by influenza A virus. MicroRNA-155 (miR-155) is an important regulator in inflammation. Its role in the inflammatory response to influenza A infection, however, has yet to be elucidated. In this study, we explored the role as well as the underlying mechanism of miR-155 in the cytokine production in influenza A-infected endothelial cells.@*METHODS@#Human pulmonary microvascular endothelial cells (HPMECs) were infected with the influenza A virus strain H1N1. The efficiency of H1N1 infection was confirmed by immunofluorescence. The expression levels of proinflammatory cytokines and miR-155 were determined using real-time polymerase chain reaction. A dual-luciferase reporter assay characterized the interaction between miR-155 and sphingosine-1-phosphate receptor 1 (S1PR1). Changes in the target protein levels were determined using Western blot analysis.@*RESULTS@#MiR-155 was elevated in response to the H1N1 infection in HPMECs (24 h post-infection vs. 0 h post-infection, 3.875 ± 0.062 vs. 1.043 ± 0.013, P = 0.001). Over-expression of miR-155 enhanced inflammatory cytokine production (miR-155 mimic vs. negative control, all P < 0.05 in regard of cytokine levels) and activation of nuclear factor kappa B in infected HPMECs (miR-155 mimic vs. negative control, P = 0.004), and down-regulation of miR-155 had the opposite effect. In addition, S1PR1 was a direct target of miR-155 in the HPMECs. Inhibition of miR-155 enhanced the expression of the S1PR1 protein. Down-regulation of S1PR1 decreased the inhibitory effect of the miR-155 blockade on H1N1-induced cytokine production and nuclear factor kappa B activation in HPMECs.@*CONCLUSION@#MiR-155 maybe modulate influenza A-induced inflammatory response by targeting S1PR1.


Subject(s)
Down-Regulation , Endothelial Cells , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza A virus , Influenza, Human/genetics , MicroRNAs/genetics , Sphingosine-1-Phosphate Receptors
12.
Chinese Journal of Hematology ; (12): 554-560, 2019.
Article in Chinese | WPRIM | ID: wpr-805653

ABSTRACT

Objective@#To explore the significance of minimal residual disease (MRD) in predicting prognosis and guiding therapy of adults with Philadelphia-chromosome negative acute lymphoblastic leukemia (Ph- ALL) in high-risk.@*Methods@#Data of newly diagnosed adults with Ph- ALL in high-risk who achieved CR were reviewed. Variables associated with outcome were identified by COX regression model and Landmark analysis.@*Results@#A total of 177 patients, 99 (56%) cases male with a median age of 40 years (range, 16-65 years) were included in this study. Of them, 95 (54%) patients received allo-HSCT in CR1. Multivariate analyses showed that MRD negativity after the first cycle of consolidation (HR=0.52, 95%CI 0.30-0.89, P=0.017) and achieving CR within 4 weeks (HR=0.43, 95%CI 0.24-0.79, P=0.006) were the factors significantly-associated with longer DFS, and allo-HSCT was associated with both longer DFS (HR=0.13, 95%CI 0.08-0.22, P<0.001) and OS (HR=0.24, 95%CI 0.15-0.41, P<0.001) . Landmark analysis was performed on 121 patients, of 85 patients achieving MRD negativity after the first cycle of consolidation, multivariate analyses showed that MRD negativity after the third cycle of consolidation was significantly-associated with longer DFS (HR=0.18, 95%CI 0.05-0.64, P=0.008) and OS (HR=0.14, 95%CI 0.04-0.50, P=0.003) . For the patients achieving MRD negativity after both the first and the third cycles of consolidation, the 3-year DFS rate in the allo-HSCT cohort had a higher trend compared with that in the chemotherapy cohort (75.2% vs 51.3%, P=0.082) , however, the 3-year OS rates in the 2 cohorts were similar (72.7% vs 68.7%, P=0.992) . In those with MRD positivity after the first and/or the third cycle of consolidation, 3-year DFS (64.8% vs 33.3%, P=0.006) and OS (77.0% vs 33.3%, P=0.028) rates in the allo-HSCT cohort were significantly higher than those in the chemotherapy cohort, and similar to those in the cohort achieving MRD negativity after both the first and the third cycles of consolidation and receiving allo-HSCT.@*Conclusions@#MRD negativity after the first cycle of consolidation was a predictor for better outcome in adults with Ph- ALL in high-risk. The survival advantage of the allo-HSCT cohort was not pronounced compared with that in the chemotherapy cohort even in those with high-risk features but achieving MDR negativity after both the first and third cycles of consolidation. However, allo-HSCT could be a good option for the patients with MRD positivity after the first and/or the third cycle of consolidation.

13.
Chinese Journal of Hematology ; (12): 195-199, 2019.
Article in Chinese | WPRIM | ID: wpr-804916

ABSTRACT

Objective@#To analyze the characteristics of myeloid neoplasms with t (3;21) (q26;q22) .@*Methods@#Clinical data of patients with t (3; 21) (q26; q22) , diagnosed as hematologic malignancies in Peking University people's hospital from January 2011 to March 2018, were collected retrospectively. 19 patients in our hospital and forty-eight patients bearing t (3;21) (q26;q22) with detailed survival data reported in literature were summarized. Kaplan- Meier method was used for survival analysis.@*Results@#Among 19 patients, including 15 males and 4 females with a median age of 36 years (22-68 years) , 4 cases was diagnosed as de novo acute myeloid leukemia (AML) , 4 as myelodysplastic syndromes (MDS) , 3 as MDS-AML and 8 as chronic myelogenous leukemia (CML) in myeloid blast transformation. All of the 19 patients were detected to have t (3;21) (q26;q22) by G-banding technique and 13 carried additional cytogenetic aberrations. 9 of the 19 patients were detected for positive AML1-MDS1 fusion genes. In the 9 patients with detailed follow-up data, 6 patients received chemotherapy and only 2 achieved complete remission (CR) while 4 with no response. During the follow-up period, 8 patients died and the median overall survival (OS) was 6 months (4.5 to 22 months) . Survival analysis of the present 9 patients together with the literature data showed that the prognosis was poor and the median OS was 7 months. In particular, AML/t-AML had the worst prognosis. Hematopoietic stem cell transplantation (HSCT) could significantly improve survival, the median OS in HSCT group and non-HSCT group were 20.9 and 4.7 months respectively (P<0.001) .@*Conclusions@#t (3; 21) (q26; q22) is a rare recurrent chromosomal abnormality which is detected mainly in myeloid neoplasm and confer to poor clinical prognosis. HSCT should be recommended to improve the outcomes.

14.
Article in English | WPRIM | ID: wpr-776647

ABSTRACT

OBJECTIVE@#To examine the effect of the aqueous extract of Ligustrum robustum on tumor growth in vitro and in vivo and explore the possible molecular mechanisms.@*METHODS@#In in vitro study, cell viabilities of human cervical carcinoma cells (HeLa), human breast cancer cells (MCF-7), human prostate cancer cells (PC-3), human hepatoma cells (7721) and human colon carcinoma cells (SW480) were evaluated with cell counting kit-8. For L. robustum-treated Hela cells, early or late apoptosis were evaluated by annexin V/PI staining. Mitochondrial membrane potential was measured by staining cells with JC-1. Apoptosis was monitored by nuclear morphology based on chromatin condensation and fragmentation by 4',6-diamidino-2-phenylinole (DAPI) staining. Caspase-3 and -8 activity levels were measured by a colorimetric assay. In vivo, to evaluate the possible mechanism of L. robustum-mediated antitumor effect, nude mouse xenograft study was also conducted.@*RESULTS@#In in vitro study, L. robustum was found to be toxic to HeLa, MCF-7, PC-3, 7721, SW480, with an half maximal inhibitory concentration value of 2-5 mg/mL (P<0.05). Moreover, externalization of phosphatidylserine, loss of mitochondrial membrane potential, DNA fragmentation and activation of caspase-3 and -8 were detected in L. robustum-treated Hela cells. Using a nude mouse model bearing Hela xenografts, we found that L. robustum reduced tumor volume and tumor weight (P<0.05), but had no effect on body weight and histological damage of important organs. Intraperitoneal injection of L. robustum caused a significant reduction in serum aspartate transaminase and alanine transaminase levels (P<0.05). Furthermore, cleaved caspase-3-positive and terminal nucleotidyl transferase-mediated nick end labeling (TUNEL)-positive cells were observed in L. robustum-treated tumor tissues.@*CONCLUSIONS@#L. robustum inhibits tumor cell growth both in vitro and in vivo by inducing apoptosis in a caspase-dependent way without apparent hepatic toxicity and histological damage, which may offer partial scientific support for the ethnopharmacological claims of L. robustum as a herbal tea for its antitumor activity.

15.
Article in Chinese | WPRIM | ID: wpr-861343

ABSTRACT

Objective: To investigate the risks factors of recurrence of subacromial impingement type Ⅱ syndrome (SIS) in patients treated with ultrasound-guided interventional therapy. Methods: Data of 71 patients with type Ⅱ SIS diagnosed clinically were analyzed retrospectively. According to treatment methods, the patients were divided into simple injection group (n=16, ultrasound-guided subacromial-subdeltoid bursa injection) and combined treatment group (n=55, ultrasound-guided rotator cuff fenestration+subacromial-subdeltoid bursa injection). The factors affecting recurrence after treatment were analyzed by Logistic multivariate regression analysis. Results: The recurrence rate at 1, 3, 6 months after treatment in combined treatment group were significantly lower than those in simple injection (all P<0.001). Multivariate regression analysis showed that age, sex and course of disease had no relationship with recurrence, but treatment method was an independent risk factor for recurrence of patients with type Ⅱ SIS after treatment. Conclusion: Ultrasound-guided rotator cuff fenestration+subacromial-subdeltoid bursa injection can reduce the risk of recurrence in patients with type Ⅱ SIS.

16.
Chinese Journal of Hematology ; (12): 831-836, 2019.
Article in Chinese | WPRIM | ID: wpr-796972

ABSTRACT

Objective@#To investigate the characteristic and prognostic significance of leukemia stem cells associated antigens expressions including CD34, CD38, CD123, CD96 and TIM-3 in t (8;21) AML.@*Methods@#Bone marrow samples of 47 t (8;21) AML patients were collected at diagnosis from October 2015 to April 2018 in Peking University Peoples’ Hospital, then flow cytometry method was performed to detect the expression frequencies of CD34, CD38, CD123, CD96 and TIM-3 to analyze the relationship between leukemia stem cells associated antigens expressions and relapse.@*Results@#Of 47 t (8;21) AML patients tested, the median percentages of CD34+CD38-, CD34+ CD38-CD123+, CD34+CD38- CD96+ and CD34+ CD38- TIM-3+ cells among nucleated cells were 2.37%, 0.24%, 0.27% and 0.06%, respectively. All the frequencies of CD34+CD38-, CD34+CD38-CD123+, CD34+CD38-CD96+ and CD34+ CD38-TIM-3+ cells had no impact on the achievement of CR after the first course of induction. All higher frequencies of CD34+CD38-, CD34+CD38-CD123+, CD34+CD38-CD96+ cells were related to higher 2-year CIR rate. Whereas, the frequency of CD34+ CD38- TIM-3+ cells had no impact on CIR rate. Both high frequency of CD34+ CD38- cells and the high level of minimal residual diseases (patients with <3-log reduction in the RUNX1-RUNX1T1 transcript level after the second consolidation therapy) were independent poor prognostic factors of CIR[P=0.025, HR=6.9 (95%CI 1.3-37.4) ; P=0.031, HR=11.1 (95%CI 1.2-99.2) ].@*Conclusion@#Different leukemia stem cells associated antigens had distinct prognostic significance in t (8;21) AML. High frequencies of CD34+ CD38-, CD34+ CD38- CD123+ and CD34+CD38-CD96+ cells at diagnosis predicted relapse in patients with t (8;21) AML.

17.
Chinese Journal of Hematology ; (12): 812-817, 2019.
Article in Chinese | WPRIM | ID: wpr-796968

ABSTRACT

Objective@#To evaluate the efficacy of consolidation chemotherapy combined with allogeneic natural killer (NK) cell infusion in the treatment of low or intermediate-risk (LIR) acute myeloid leukemia (AML) .@*Methods@#A cohort of 23 LIR AML patients at hematologic complete remission (CR) received NK cell transfusion combined with consolidation chemotherapy after 3 consolidation courses from January 2014 to June 2019 were reviewed. Control group cases were concurrent patients from Department of Hematology, and their gender, age, diagnosis, risk stratification of prognosis, CR and the number of courses of consolidate chemotherapy before NK cell transfusion were matched with LIR AML patients.@*Results@#A total of 45 times of NK cells were injected into 23 LIR AML patients during 4 to 7 courses of chemotherapy. The median NK cell infusion quantity was 7.5 (6.6-8.6) ×109/L, and the median survival rate of NK cells was 95.4% (93.9%-96.9%) . Among them, the median CD3-CD56+ cell number was 5.0 (1.4-6.4) ×109/L, accounting for 76.8% (30.8%-82.9%) ; The number of CD3+ CD56+ cells was 0.55 (0.24-1.74) ×109/L, accounting for 8.8% (4.9%-20.9%) . Before NK cell infusion, the number of patients with positive MRD in the treatment and control groups were 9/23 (39.1%) and 19/46 (41.3%) (χ2=0.030, P=0.862) respectively. After NK infusion, There was no significant difference in terms of MRD that went from negative to positive between the treatment and the control groups (14.3% vs 22.2%, χ2=0.037, P=0.847) . In the treatment group, 66.7% (6/9) of the MRD were converted from positive to negative, which was significantly higher than that in the control group (10.5%, 2/19) (χ2=6.811, P=0.009) . Morphological recurrence occurred in 1 case of MRD negative in the treatment group and 2 cases of MRD positive in the control group. By the end of follow-up, the median follow-up was 35 (10-59) months, the number of patients with morphological recurrence in the treatment group was 30.4% (7/23) , which was significantly lower than that in the control group (50.2%, 24/46) (χ2=2.929, P=0.087) , although there was no statistically significant difference between the two groups. There was no significant difference on MRD-negative between the treatment and the control groups (43.5% vs 43.5%, χ2=1.045, P=0.307) . The 3-year leukemia-free survival was better in the treatment group [ (65.1±11.1) %] than that in the control group [ (50.0±7.4) %] (P=0.047) . The 3-year overall survival in the treatment and control groups were (78.1±10.2) % and (65.8±8.0) % (P=0.212) , respectively.@*Conclusion@#The consolidation of chemotherapy combined with allogeneic NK cell infusion contributed to the further remission of patients with LMR AML and the reduction of long-term recurrence.

18.
Article in Chinese | WPRIM | ID: wpr-796348

ABSTRACT

Periampullary carcinoma includes carcinoma of head of pancreas, carcinoma of lower common bile duct, ampullary carcinoma and adenocarcinoma of duodenum. Most of the periampullary cancers shows the same clinical symptoms their imaging manifestations are overlapping or non-specific. Accurate qualitative positioning and staging of periampullary cancers are of great value in guiding of treatment plan and evaluate postoperative outcomes. CT and MRI examination have made progress in the diagnosis of periampullary carcinoma. CT scan has a good spatial and temporal resolution, while MRI has a good tissue resolution. CT and MRI examination can be used for preoperative assessment of tumor resectability and invasion range, which is of certain value.

19.
Article in Chinese | WPRIM | ID: wpr-791887

ABSTRACT

Periampullary carcinoma includes carcinoma of head of pancreas, carcinoma of lower common bile duct, ampullary carcinoma and adenocarcinoma of duodenum. Most of the periampullary cancers shows the same clinical symptoms their imaging manifestations are overlapping or non-specific . Accurate qualitative positioning and staging of periampullary cancers are of great value in guiding of treatment plan and evaluate postoperative outcomes. CT and MRI examination have made progress in the diagnosis of periampullary carcinoma. CT scan has a good spatial and temporal resolution, while MRI has a good tissue resolution. CT and MRI examination can be used for preoperative assessment of tumor resectability and invasion range, which is of certain value.

20.
Chinese Journal of Hematology ; (12): 398-403, 2019.
Article in Chinese | WPRIM | ID: wpr-810638

ABSTRACT

Objective@#To investigate the efficacy and prognostic factors of induction therapy in FLT3-ITD+ acute myeloid leukemia (AML) in the real world data.@*Methods@#From January 2013 to December 2016, 114 de novo patients with FLT3-ITD+AML were enrolled in this study. Out of 114 cases, 75 were male, and 39 were female. The median age was 42 years old (ranged from 14 to 72 years old) . The chemotherapy regimens were used for induction therapy and all cases were followed up. The treatment response was evaluated by MICM and the comparison of the ratio were analyzed by chi-square test and the survival was estimated by Kaplan-Meier analysis and Cox proportional hazards model was used to identify independent prognostic factors.@*Results@#There were 52 FLT3-ITD+AML patients with favorable prognosis genes (46 cases with NPM1, 5 cases with RUNX1-RUNX1T1, 1 case with CEBPA double mutation) and 62 patients with other types of FLT3-ITD+AML at diagnosis. All patients completed at least one cycle of induction therapy and the clinical curative effect was evaluated, complete remission (CR) rate was 50.0% (57/114) in one cycle and total CR rate was 72.5% (74/104) in two cycles. The CR rate of the FLT3-ITD+ AML patients with favorable prognosis genes was 67.3% (35/52) in one cycle and 83.3% (40/48) in two cycles; for the other types FLT3-ITD+AML patients, the CR rate was 35.5% (22/62) in one cycle and 64.8% (35/54) in two cycles. There was a significant difference in CR rate between the FLT3-ITD+AML patients with and without favorable prognosis genes (P<0.05) . This indicates that the FLT3-ITD+AML patients with favorable prognosis gene had relatively good therapeutic effect. Among other types of FLT3-ITD+AML patients who did not achieve remission from one cycle of chemotherapy, 9 patients were given sorafenib plus chemotherapy and 6 cases (66.7%) achieved CR; 23 patients were given conventional chemotherapy and 7 cases (30.4%) achieved CR. There was a significant difference between sorafenib plus chemotherapy and conventional chemotherapy groups (χ2=4.47, P<0.05) and this indicates that sorafenib plus chemotherapy can significantly improve the CR rate of FLT3-ITD+AML patients. Comparing overall survival (OS) and disease free survival (DFS) , there was no significant difference between sorafenib plus chemotherapy and conventional chemotherapy groups (P values were 0.641 and 0.517, respectively) .@*Conclusion@#The overall prognosis of FLT3-ITD+AML patients is poor, and the stratification therapeutic efficacy of FLT3-ITD+AML without favorable prognosis gene can be improved by sorafenib combined with chemotherapy.

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