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1.
Article in Chinese | WPRIM | ID: wpr-928736

ABSTRACT

OBJECTIVE@#To explore the effect of CXCR4 on the treatment response and prognosis of Carfilzomib (CFZ) in multiple myeloma.@*METHODS@#Dataset GSE69078 based on microarray data from two CFZ-resistant MM cell lines and their corresponding parental cell lines (KMS11-KMS11/CFZ and KMS34-KMS34/CFZ) were downloaded from Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified, and Protein-protein interaction (PPI) network was established to identify the key genes involved in CFZ resistance acquisition. Finally, the prognostic roles of the CFZ risistance key genes in MM using MMRF-CoMMpass data study was verified.@*RESULTS@#44 up-regulated and 46 down-regulated DEGs were identified. Top 10 hub genes (CCND1, CXCR4, HGF, PECAM1, ID1, HEY1, TCF4, HIST1H4J, HIST1H2BD and HIST1H2BH) were identified via Protein-protein interaction (PPI) network analysis. The CoMMpass data showed that high CXCR4 expression showed correlation to relative higher relapse and progress rates and the overall survival was significant decreased in high CXCR4 patients (P=0.013).@*CONCLUSION@#CXCR4 perhaps plays a crucial role in CFZ acquired resistance, which might help identifying potential CFZ-sensitive patients before treatment and providing a new therapeutic target in CFZ-resistant MM.


Subject(s)
Histones , Humans , Multiple Myeloma/genetics , Neoplasm Recurrence, Local , Oligopeptides/therapeutic use , Prognosis , Receptors, CXCR4
2.
Article in Chinese | WPRIM | ID: wpr-928725

ABSTRACT

OBJECTIVE@#To explore the effect of hypoxia on the chemosensitivity of B-acute lymphoblastic leukemia (B-ALL) cells to Vincristine (VCR) and the mechanisms.@*METHODS@#B-ALL cells SUP-B15, Nalm-6 and RS4;11 were selected as the research objects. The cells were divided into the control group and the hypoxia mimic group (CoCl2 pretreatment). The two groups were treated with VCR at different concentrations for 24 hours, CCK-8 was used to detect cell viability, flow cytometry was used to detect cell apoptosis, and Western bolt method was used to detect hypoxia inducible factor (HIF-1α), BAX, Bcl-2 and β-actin protein expression. Quantitative real-time fluorescent PCR (qRT-PCR) was used to detect BAX and β-actin mRNA levels.@*RESULTS@#CoCl2 could simulate hypoxic environment to induce the expression of HIF-1α. The cells SUP-B15 and RS4;11 of the hypoxia mimic group were lower sensitivity to VCR as compared with the control group; the apoptosis rate of the hypoxia mimic group was lower than that of the control group after 80 nmol/L VCR treatment. The expression levels of BAX protein and mRNA in the hypoxia mimic group were lower than those of the control group, and there was no significant difference in the expression levels of Bcl-2 protein between two groups.@*CONCLUSION@#Under hypoxic conditions, HIF-1α may mediate VCR resistance in B-ALL cells by downregulating the pro-apoptotic protein BAX.


Subject(s)
Actins/pharmacology , Apoptosis , Cell Hypoxia , Humans , Hypoxia , Hypoxia-Inducible Factor 1, alpha Subunit , Proto-Oncogene Proteins c-bcl-2 , RNA, Messenger , Vincristine/pharmacology , bcl-2-Associated X Protein/pharmacology
3.
Article in English | WPRIM | ID: wpr-925677

ABSTRACT

Purpose@#The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients. @*Materials and Methods@#From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis. @*Results@#A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481). @*Conclusion@#Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients.

4.
Article in Chinese | WPRIM | ID: wpr-908477

ABSTRACT

Objective:To investigate the diagnosis and treatment of hepatic artery thrombosis (HAT) after adult orthotopic liver transplantation.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 411 patients who underwent adult orthotopic liver transplantation in the First Affiliated Hospital of Xi ′an Jiaotong University from December 2011 to July 2018 were collected. There were 328 males and 83 females, aged from 21 to 66 years, with a median age of 46 years. Observation indicators: (1) incidence of HAT and its clinical characteristics; (2) diagnosis of HAT; (3) treatment of HAT; (4) follow-up. Follow-up using outpatient service, telephone interview or WeChat group communication was conducted to detect the incidence of biliary stricture and survival of patients up to August 2018. Measurement data with normal distribution were represented as Mean± SD, measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages. Survival rate was estimated using the Kaplan-Meier method. Results:(1) Incidence of HAT and its clinical characteristics: 11 of 411 patients had HAT after orthotopic liver transplantation with the incidence of 2.68%(11/411), including 10 males and 1 female, aged 44 years(range, 22-63 years). The time to occurrence of postoperative HAT was 4 days(range, 1-15 days). The etiologies of 11 patients included 6 cases of hepatitis B virus-related cirrhosis, 1 case of hapatitis related cirrhosis, 1 case of hepato-cellular carcinoma, 1 case of liver cirrhosis, 1 case of alcoholic hepatitis related cirrhosis, 1 case of wilson disease. All the 11 patients were ABO compatible. The cold ischemic time and warm ischemic time of donor liver were (316±89)minutes and (13±4)minutes, respectively. Type Ⅰ arterial anasto-mosis was conducted in 11 patients. The clinical manifestations included asymptomatic type in 10 patients and sepsis type in 1 patient. (2) Diagnosis of HAT: all the 11 patients were confirmed with HAT by endovascular angiography, including 7 cases showed no arterial flow under Color Doppler ultrasound, and contrast-enhanced ultrasound indicated HAT. Two patients showed increased hepatic artery resistance index under Color Doppler ultrasound, and contrast-enhanced ultrasound indicated 1 case of HAT and 1 case of anastomotic stenosis. One patient showed slow velocity of hepatic artery blood flow and low resistance index under color Doppler ultrasound, and contrast-enhanced ultrasound indicated HAT. One patient showed slight blood flow signals under Color Doppler ultrasound, and contrast-enhanced ultrasound indicated HAT. (3) Treatment of HAT: 11 patients received endovascular therapy. Six patients had HAT completely disappeared after thrombolytic therapy, 5 patients with residual thrombosis continued thrombolytic therapy with microcatheter urokinase. Six patients with complications were improved after symptomatic treatment. HAT completely disappeared after (6.7±2.6)days of treatment and the clinical success rate was 11/11. (4) Follow-up: 11 patients were followed up for 19-1 722 days, with a median follow-up time of 46 days. During the follow-up, 4 patients had biliary stricture and underwent stent implantation. Nine patients survived with 1-, 3-, 5-year overall survival rates of 75%, 75%, 75%, and 2 patients died.Conclusions:The incidence of HAT after adult orthotopic liver transplantation is low and clinical manifestations are atypical. Contrast enhanced ultrasound can improve diagnosis of suspected thrombosis. Endovascular therapy is safe and effective, which can significantly improve the blood flow of hepatic artery.

5.
Journal of Experimental Hematology ; (6): 1714-1718, 2021.
Article in Chinese | WPRIM | ID: wpr-922323

ABSTRACT

OBJECTIVE@#To investigate the regulation of chronic myelogenous leukemia (CML) imatinib resistant genes, in order to improve the therapeutic effect of CML imatinib resistant patients.@*METHODS@#The human CML cell line K562 and imatinib-resistant K562 cells (K562/G01) were collected, and transcriptome of the cells were achieved by RNA-seq. The sequencing data were analyzed by using standard procedures.@*RESULTS@#Compared with K562 cells, 464 genes were significantly changed in K562/G01 cells, including 163 up-regulated and 301 down-regulated genes. The GO function annotation analysis and KEGG pathway analysis results showed that the differentially expressed genes were mainly involved in biological processes such as oxidative phosphorylation, localization to protein organelle, ribonucleoprotein complex biogenesis and so on. Gene Set Enrichment Analysis (GSEA) plots showed that 5 gene-sets were up-regulated in K562/G01 significantly, including the pathway of TGF-beta, mTOR and CML.@*CONCLUSION@#CML imatinib resistance is associated with oxidative phosphorylation, during which the pathway of TGF-beta and mTOR are significantly up-regulated.


Subject(s)
Drug Resistance, Neoplasm , Gene Expression Profiling , Humans , Imatinib Mesylate/pharmacology , K562 Cells , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
6.
Clinics ; 76: e3069, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345818

ABSTRACT

OBJECTIVES: This study explored the clinical efficacy of VitalStim electrical stimulation combined with swallowing function training for patients with dysphagia following an acute stroke. METHODS: Seventy-two patients with dysphagia following an acute stroke were admitted to our hospital and were further divided into two groups using prospective research methods. There were 36 cases in each group according to the random number table method. The control group received conventional medical treatment and swallowing function training while the experimental group received conventional medical treatment and VitalStim electrical stimulation combined with swallowing function training. RESULTS: The overall response rate of the experimental group (94.44%) was higher than that of the control group (77.78%), and the difference was statistically significant (p<0.05). Compared with before treatment, the upward and forward movement speeds of the hyoid bone, anterior movement speed, the grading score of the Kubota drinking water test, Caiteng's grading score, serum superoxide dismutase, 5-hydroxytryptamine, and norepinephrine levels, Fugl-Meyer Assessment score, and multiple quality of life scores of the two groups showed improvement after treatment. While the standard swallowing assessment score, serum malondialdehyde level, and National Institutes of Health Stroke Scale score decreased, the aforementioned indices showed a significant improvement in the experimental group (p<0.05). CONCLUSION: The results of this study indicate that VitalStim electrical stimulation combined with swallowing function is effective for treating dysphagia following an acute stroke. It can effectively improve swallowing, neurological, and limb motor functions, reduce complications, promote physical recovery, and improve overall quality of life of patients.


Subject(s)
Humans , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Stroke/complications , Stroke/therapy , Quality of Life , United States , Prospective Studies , Deglutition , Electric Stimulation
7.
International Journal of Surgery ; (12): 565-571, 2021.
Article in Chinese | WPRIM | ID: wpr-907482

ABSTRACT

The programmed cell death receptor 1 (PD-1) antibody has been used in the treatment of a variety of malignant tumors, in which colorectal cancer is considered immune " cold" tumor and is not sensitive to anti-PD-1 therapy. The molecular characteristics of mismatch repair deficient (dMMR)/high microsatellite instability (MSI-H) are important molecular markers for screening patients with immune checkpoint inhibitors therapy (ICIs). However, only some patients can benefit from ICIs treatment, and some patients even have disease progression. This article summarizes the research progress of anti-PD-1 immunotherapy of MSI-CRC in recent years, including the mechanisms of resistance, new efficacy biomarkers and treatment options, so as to provide ideas for expanding the application of immunotherapy in colorectal cancer.

8.
Article in Chinese | WPRIM | ID: wpr-906307

ABSTRACT

Objective:To establish a new fast and accurate method for identifying the authenticity and specifications of Fritillariae Cirrhosae Bulbus based on electronic nose technology, and to discuss the feasibility of this technology in the identification of decoction pieces. Method:Fritillariae Cirrhosae Bulbus was used as the research object, 80 batches of samples to be tested were collected, and the olfactory sensory data of the electronic nose were taken as independent variables (<italic>X</italic>), the results of the method contained in the 2020 edition of <italic>Chinese Pharmacopoeia</italic> were taken as the focus, and the traditional empirical identification results were used as benchmarking information (<italic>Y</italic>). Four chemometric methods, including discriminant analysis (DA), least square support vector machine (LS-SVM), principal component analysis-DA (PCA-DA) and partial least squares-DA (PLS-DA), were used to establish the identification model [<italic>Y</italic>=<italic>F</italic>(<italic>X</italic>)] of authenticity and commodity specifications of Fritillariae Cirrhosae Bulbus, respectively. Wherein, the identification accuracy and time-consuming was taken as indicators to discuss the results. Result:After cross-verification by leave-one-out method, the correct rates of the above four models were 93.75%, 91.25%, 95.00% and 95.00%, respectively, and the PCA-DA and PLS-DA identification models were the best in terms of authenticity identification. In specification identification, the correct rates of these four models were 86.67%, 88.00%, 89.33% and 68.00%, respectively, and the PCA-DA identification model was the best. The electronic nose had a high accuracy in the identification of authenticity and specification model, and the time consuming was relatively short. Conclusion:Electronic nose technology can identify Fritillariae Cirrhosae Bulbus accurately and quickly, and has significant advantages in terms of timeliness and correct judgment rate.

9.
Article in Chinese | WPRIM | ID: wpr-905911

ABSTRACT

Objective:To explore the potential targets and pathways of steroid alkaloids<italic> </italic>from<italic> Solanum</italic> <italic>nigrum</italic> (SASN) in the treatment of non-small cell lung cancer (NSCLC) and analyze the possible mechanism. Method:The active SASN against NSCLC were searched from literature. Then potential targets of SASN were screened through SwissTargetPrediction and PharmMapper, and those of NSCLC through GeneCards. Venny was employed to yield the common targets of the two, and Cytoscape to construct the 'medicinal-component-disease-target' network. Metascape was applied to enrich the Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of the common targets, and STRING was used to generate the protein-protein interaction (PPI) network, followed by screening of key targets by Cytoscape. Finally, Western blot was used to verify the effects of the medicinal on key targets. Result:A total of 6 active SASN were screened out: solasonine, solamargine, solasodine, solanocapsine, solanidine, and <italic>N</italic>-methylsolasodine, which had 96 potential anti-NSCLC targets. These targets mainly involved the pathways in cancer, proteoglycans in cancer, and Forkhead box protein O (FoxO) pathway. PPI network analysis demonstrated 15 key anti-NSCLC targets of SASN, such as mitogen-activated protein kinase (MAPK)1, MAPK8, MAPK14, protein kinase B (Akt1), signal transducer and activator of transcription 3 (STAT3), and proto-oncogene tyrosine protein kinase (SRC). Meanwhile, Western blot results showed that SASN could significantly down-regulate the expression of the key proteins Akt1, SRC, and STAT3. Conclusion:We predicted the potential targets and pathways of SASN against NSCLC and obtained 15 key targets, from which we selected three key proteins for validation. The validation results were consistent with the prediction results. This paper is expected to lay a scientific basis for the subsequent in-depth study of the mechanisms of SASN against NSCLC.

10.
Chinese Medical Journal ; (24): 2196-2204, 2021.
Article in English | WPRIM | ID: wpr-921123

ABSTRACT

BACKGROUND@#Previous studies have demonstrated different predominant sites of distant metastasis between patients with and without neoadjuvant chemoradiotherapy (NCRT). This study aimed to explore whether NCRT could influence the metastasis pattern of rectal cancer through a propensity score-matched analysis.@*METHODS@#In total, 1296 patients with NCRT or post-operative chemoradiotherapy (PCRT) were enrolled in this study between January 2008 and December 2015. Propensity score matching was used to correct for differences in baseline characteristics between the two groups. After propensity score matching, the metastasis pattern, including metastasis sites and timing, was compared and analyzed.@*RESULTS@#After propensity score matching, there were 408 patients in the PCRT group and 245 patients in the NCRT group. NCRT significantly reduced local recurrence (4.1% vs. 10.3%, P = 0.004), but not distant metastases (28.2% vs. 27.9%, P = 0.924) compared with PCRT. In both the NCRT and PCRT groups, the most common metastasis site was the lung, followed by the liver. The NCRT group developed local recurrence and distant metastases later than the PCRT group (median time: 29.2 [18.8, 52.0] months vs. 18.7 [13.3, 30.0] months, Z = -2.342, P = 0.019; and 21.2 [12.2, 33.8] vs. 16.4 [9.3, 27.9] months, Z = -1.765, P = 0.035, respectively). The distant metastases occurred mainly in the 2nd year after surgery in both the PCRT group (39/114, 34.2%) and NCRT group (21/69, 30.4%). However, 20.3% (14/69) of the distant metastases appeared in the 3rd year in the NCRT group, while this number was only 13.2% (15/114) in the PCRT group.@*CONCLUSIONS@#The predominant site of distant metastases was the lung, followed by the liver, for both the NCRT group and PCRT group. NCRT did not influence the predominant site of distant metastases, but the NCRT group developed local recurrence and distant metastases later than the PCRT group. The follow-up strategy for patients with NCRT should be adjusted and a longer intensive follow-up is needed.


Subject(s)
Chemoradiotherapy , Humans , Neoadjuvant Therapy , Neoplasm Recurrence, Local , Neoplasm Staging , Propensity Score , Rectal Neoplasms/pathology , Retrospective Studies , Treatment Outcome
11.
Article in Chinese | WPRIM | ID: wpr-911760

ABSTRACT

This article introduces the family medicine residency training program in the University of Toronto, focusing on the residents′ position setting and program distribution, teaching model, the objective framework and tools of evaluation. The strength and advances of their training programs are summarized;in order to promote the development of general practice education and training in China,how to use Canadian successful experiences in combination with China′s conditions is discussed.

12.
Article in Chinese | WPRIM | ID: wpr-911747

ABSTRACT

The general practice course has been conducted for Traditional Chinese Medicine medical students in Shanghai University of Traditional Chinese Medicine since 2017. The sequential teaching mode is applied in the course. The curriculum design, teaching plan, course organization and management, faculty development, students′ satisfaction and effectiveness of teaching are introduced, and the related issues and suggestions for further improvement are also discussed in the paper.

13.
Article in Chinese | WPRIM | ID: wpr-880075

ABSTRACT

OBJECTIVE@#To investigate the efficacy and safety of micro-transplantation in acute myeloid leukemia (AML).@*METHODS@#The clinical data of 13 adult AML patients who received micro-transplantation as consolidation therapy from July 2014 to October 2019 was retrospectively analyzed, and the adverse reactions and efficacy of micro-transplantation were followed up.@*RESULTS@#Eight patients received micro-transpantation were still in complete remission, 5 patients relapsed after micro-transplantation, 1 of them received umbilical cord blood micro-transplantation after remission by reinduction, and all of the 13 patients have survived till now. The median overall survival time was 13 months, and the median relapse-free survival time was 12 months. All 13 patients developed grade 2-4 hematological adverse reactions. The median recovery time of neutrophils and platesets was 13 (11-15) and 15 (13-17) days, respectively. None of the 13 patients developed acute or chronic graft versus host disease. Twelve patients suffered from different infections, however, there were no serious organ function injury complications happened.@*CONCLUSION@#The micro-transplomtation of HLA-incompatible stem cells derived from peripheral blood or umbilical and blood is an effective regimen for the consolidation therapy of AML, especially for the patients suffered from low and moderate risk of AML or the aged AML patients.


Subject(s)
Adult , Aged , Consolidation Chemotherapy , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute/drug therapy , Retrospective Studies , Transplantation Conditioning , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-879420

ABSTRACT

OBJECTIVE@#To investigate the clinical efficacy and superiority of direct lateral interbody fusion combined with posterior percutaneous screw fixation in the treatment of lumbar tuberculosis.@*METHODS@#From June 2013 to August 2016, the clinical data of 83 patients with lumbar tuberculosis were retrospectively analyzed, including 55 males and 28 females, aged from 27 to 72 (49.5±13.5) years. These 83 patients were divided into two groups according to different operation methods, 35 cases in group A were treated with direct lateral interbody fusion combined with posterior percutaneous screw fixation;48 cases in group B were treated with anterior traditional extraperitoneal debridement combined with posterior internal fixation. After operation, regular quadruple antituberculosis drugs were continued for 18 months. The operation time, intraoperative blood loss, hospital stay, bone graft fusion time and complications were compared between the two groups. Visual analogue score (VAS) of lumbar pain, Oswestry Disability Index (ODI), sagittal Cobb angle, erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) values before and after operation were analyzed.@*RESULTS@#The operation was successfully completed in both groups, and the operation mode was not changed during operation. The operation time, intraoperative blood loss and hospital stay were (149.4±13.3) min, (354.3±69.0) ml, (9.4±1.6) d in group A and(116.8±10.0) min, (721.9±172.3) ml, (11.8±1.7) d in group B, respectively, with significant difference between the two groups (@*CONCLUSION@#The two kinds of operation can obtain satisfactory clinical effect. Direct lateral interbody fusion combined with posterior percutaneous screw fixation can reduce intraoperative blood loss and hospital stay, which is conducive to early rehabilitation of patients.


Subject(s)
Aged , Bone Transplantation , Debridement , Female , Humans , Lumbar Vertebrae/surgery , Male , Pedicle Screws , Retrospective Studies , Spinal Fusion , Thoracic Vertebrae , Treatment Outcome , Tuberculosis, Spinal/surgery
17.
Journal of Experimental Hematology ; (6): 1054-1058, 2020.
Article in Chinese | WPRIM | ID: wpr-827162

ABSTRACT

Abstract  Spleen tyrosine kinase (SYK) is not only a key kinase in the B-cell receptor (BCR) signaling pathway, but also a critical component of other signal transduction pathways such as Fc receptor, complement receptor and integrin. Abnormal activation of SYK closely related to the occurrence and development of hematological malignancies, thus targeting SYK has become a research hotspot. Several SYK inhibitors including Fostamatinib, Entospletinib and Cerdulatinib were being evaluated in clincal trials. As a second generation SYK inhibitor, Entospletinib has achieved good efficacy in lymphoid and myeloid hematologic tumors. Furthermore, Entospletinib can significantly relieve hematopoietic stem cell transplantation(HCT) related graft versus host disease (GVHD). In this review the role of SYK inhibitors in treatment of hematological malignancies is summarized brifely.


Subject(s)
Graft vs Host Disease , Hematologic Neoplasms , Humans , Protein Kinase Inhibitors , Spleen , Syk Kinase
18.
Journal of Experimental Hematology ; (6): 1321-1325, 2020.
Article in Chinese | WPRIM | ID: wpr-827118

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristics of essential thrombocytopenia (ET) patients with positive mutations including JAK2, CALR, MPL, or negative mutations.@*METHODS@#A total of 66 newly diagnosed ET cases from January 2016 to December 2018 in Department of Hematology, Huaian No.1 People's Hospital affiliated to Nanjing Medical University were analyzed. Statistical analysis data included the patient's sex, age, symptoms, thrombosis and embolism events, spleen omegaly, platelet count (Plt), leukocyte (WBC) count, hemoglobin (Hb), fibrinogen (FIB), thrombus elastic diagram (TEG), serum potassium, blood glucose (GLU), lactate dehydrogenase (LDH), JAK2, CALR and MPL mutations, treatment options, and efficacy.@*RESULTS@#All the patients were not MPL-positive, and divided in three groups: JAK2 mutation (46 cases, 69.7%), CALR mutation (9 cases, 13.6%) and gene negative mutation (11 cases, 16.7%) group. The average age of patients in the JAK2 mutation group was 63.2 years old, and significantly higher than that in the CALR mutation group (51.8 year) and gene negative group (50.2 year) (P<0.05). Compared with the JAK2 mutation group and gene negative group, the CALR mutation group had lower WBC count (6.3×10/L vs 13.79×10/L) (P=0.003) (6.3×10/L vs 9.70×10/L) (P=0.009). Also the Hb level of patients in CALR mutation group was lower than the JAK2 mutation group (121.22 g/L vs 136.2 g/L) (P=0.036). However, there was higher tumor burden in the CALR mutation group, compared with the gene negative mutation group (300.11 U/L vs 227.4 U/L) (P=0. 033). There was no significant difference among the three groups, such as the Plt counts, serum potassium level, GLU level and FIB level (P>0.05). In addition, thrombus and embolism appeared in 30.3% (20/66) cases. 18.2% (12/66) cases were complicated with hyperkalemia, which significantly correlated with Plt counts (r=0.518). TEG was performed in 34 patients, of which 41.2% (14/34) had abnormal TEG and 55.9% (19/34) were accompanied by Plt count > 1 000 ×10/L, but there was no significant correlation between them (r=0.134). After routine clinical treatment, all the 66 cases achieved partial or complete hematological remission, but the disease usually repeated. Until now 4.5% (3/66) cases had been converted to myelofibrosis (MF) all with JAK2 mutation, but without advancing to acute myeloid leukemia.@*CONCLUSION@#ET patients with JAK2 mutation have higher incidence, moreover were in older age. However, the patients with CALR mutations display lower WBC count and Hb level, but higher tumor burden. In short, the multiple gene mutations of ET showed different clinical features closely relates with the prognosis, thus providing guidance for the clinical diagnosis and treatment.


Subject(s)
Aged , Calreticulin , Genetics , Humans , Janus Kinase 2 , Genetics , Middle Aged , Mutation , Primary Myelofibrosis , Thrombocythemia, Essential , Thrombocytopenia
19.
Article in Chinese | WPRIM | ID: wpr-869284

ABSTRACT

Objective:To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance in patients with COVID-19.Methods:A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, Zhejiang University School of Medicine were recruited. All patients received oral arbidol and combination of lopinavir/ritonavir or darunavir/cobistitat for antiviral therapy, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg -1·d -1) (glucocorticoid treatment group), and 21 patients did not use glucocorticoid (control group). The time of virologic negative conversion in sputum and the time of radiologic recovery in lung since onset were compared between the two groups. The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups. Results:The median ages of the glucocorticoid group and the control group were 52 (45, 62) and 46 (32, 56) years ( χ2=4.365, P<0.05). The clinical conditions at hospital admission were different between the two groups ( P<0.01). The severe cases accounted for 52.0%, while moderate cases in the control group accounted for 71.4%. The median times from the onset to virologic negative conversion in the two groups were 15 (13, 20) and 14 (12, 20) days ( P>0.05). The median times from onset to radiologic recovery were 13 (11, 15) and 13 (12, 17) days in the two groups ( P>0.05). In moderate cases, the median times from the onset to virologic conversion in sputum were 13 (11, 18) days in the glucocorticoid group and 13 (12, 15) days in the control group ( P>0.05). The median times from onset to radiologic recovery in lung were 12 (10, 15) and 13 (12, 17) days, respectively ( P>0.05). Conclusions:Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19, and also no effect on accelerating radiologic recovery in lung, so it is not recommended.

20.
Article in Chinese | WPRIM | ID: wpr-866394

ABSTRACT

Objective:To study ApoE gene polymorphism in patients with intracerebral hemorrhage at different ages and its relationship with blood lipid level.Methods:From December 2017 to December 2019, 360 inpatients with cerebral hemorrhage received by neurosurgery department of Weihai Central Hospital were selected as the cerebral hemorrhage group.According to the age of patients, patients with cerebral hemorrhage were divided into low age group (age<30 years), middle age group (30 years≤age≤60 years) and high age group (age>60 years), with 120 cases in each group.Another 120 healthy persons who received health examination during the same period were selected as control group.The levels of high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and total cholesterol (TC) in peripheral blood were measured.ApoE gene polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results:There were no statistically significant differences in sex, age, body mass index between the cerebral hemorrhage group and the control group (χ 2=0.045, t=0.459, t=0.655, P=0.832, 0.323, 0.256). The systolic blood pressure, diastolic blood pressure, history of hypertension, history of diabetes, smoking and drinking in the cerebral hemorrhage group were significantly higher than those in the control group ( t=12.598, t=13.003, χ 2=49.308, χ 2=10.246, χ 2=45.562, χ 2=8.602, P=0.000, 0.000, 0.000, 0.000, 0.000, 0.003). There were statistically significant differences in TC, TG, LDL and HDL among the control group, the younger group, the middle-aged group and the older group ( F=36.893, 131.263, 808.908, 143.188, all P=0.000). The highest genotype frequency was E3/3 in the control group, the younger group, the middle-aged group and the older group(70.00%, 68.33%, 68.33% and 66.67%). There was no statistically significant difference in genotype frequencies of ApoE among the groups (χ 2=2.025, 1.524, 0.693, 0.308, 0.815, 2.025, P=0.567, 0.677, 0.875, 0.959, 0.856, 0.567). The highest allele frequencies of ApoE in the control group, the younger group, the middle-aged group and the older group were epsilon 3 (81.66%, 81.66%, 79.99%, 80.83%). There was no statistically significant difference in the allele frequencies of ApoE among the groups (χ 2=0.061, 0.125, 0.241, P=0.996, 0.989, 0.971). For patients with E3/3 genotype cerebral hemorrhage, the levels of TC, TG, LDL and HDL in the younger age group were (4.43±0.33)mmol/L, (1.50±0.37)mmol/L, (2.58±0.32)mmol/L and (1.53±0.32)mmol/L, respectively.The TC, TG, LDL and HDL levels in middle-aged group were (4.22±0.34)mmol/L, (1.87±0.32)mmol/L, (3.30±0.31)mmol/L and (1.85±0.35)mmol/L, respectively.The TC, TG, LDL and HDL levels in the elderly group were (3.85±0.35)mmol/L, (2.09±0.35)mmol/L, (3.60±0.33)mmol/L and (2.13±0.34)mmol/L, respectively.There were statistically significant differences in TC, TG, LDL and HDL among all groups ( F=60.289, 59.844, 218.120, 64.364, all P=0.000). Conclusion:There is no significant correlation between ApoE gene polymorphism and the occurrence of widespread intracerebral hemorrhage in different age groups.There is no correlation between E3/3 genotype and blood lipid level in patients with intracerebral hemorrhage in different age groups.

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