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1.
Article in Chinese | WPRIM | ID: wpr-781495

ABSTRACT

OBJECTIVE@#To compare the gene mutational spectrum between elderly and young adults with acute myeloid leukemia(AML) based on next generation sequencing(NGS).@*METHODS@#The specimens of 250 AML patients in first affiliated hospital of Zhengzhou University from January 2018 to November 2018 were collected and analyzed retrospectively. The mutation of 22 related genes were detected by using AML NGS chips. Then, the differences between elderly (≥60 years old) and young adults (<60 years old) were compared.@*RESULTS@#The most frequent mutations of 250 patients were as follows: NPM1(22.4%), FLT3-ITD(18.8%), NRAS(17.2%), DNMT3A(14.4%), TET2(11.6%), IDH2(9.6%), Biallelic CEBPA(8.8%), Moallelic CEBPA(8.4%), KIT(8.4%), RUNX1(7.6%), IDH1(7.6%), ASXL1(6.0%), U2AF1(5.2%), SRSF2 (3.2%), SF3B1(3.2%), TP53(2.4%), KRAS(2.0%). The NPM1, CEBPA, DNMT3A mutation significantly increased in intermediate prognosis group while KIT significantly increased in favourable prognosis group. The TET2 and IDH2 mutation rate in elderly patients were significantly higher than that in young patients (21.8% vs 8.7%) (χ=7.180, P=0.007) and (20.0% vs 6.7%) ( χ=8.788, P=0.003) respectively. Compared with young patients, the frequencies of DNA methylation and demethylation mutations (including DNMT3A, TET2, IDH1, IDH2) and RNA splicing enzyme mutations (inc-luding SRSF2, SF3B1, U2AF1, ZRSR2) in elderly patients significantly increased(67.3% vs 36.4%) (χ=16.653, P=0.000) and (23.6% vs 8.7%)(χ=9.041, P=0.003) respectively.@*CONCLUSION@#The gene mutational spectrum in elderly and young adult AML shows heterogeneity. Compared with young adults, the frequencies of DNA methylation and demethylation mutations and RNA splicing enzyme mutations in elderly patients significantly increase.

2.
Article in Chinese | WPRIM | ID: wpr-743489

ABSTRACT

Vaccination is the most effective way to prevent influenza and severe outcoming caused by influenza viruses.Health care workers(HCW) are exposed to patients with influenza and they are at high risk of occupationally acquired influenza and of causing nosocomial infection among patients,increasing the incidence rate,the risk of severe and death of patients.Improving the influenza immunization in HCW can not only reduce the prevalence of themselves and keep a weel-oiled of health care facilities during the influenza seasons,but also reduce the risk of severe and death among patients and increase the influenza vaccine uptake in whole population.At present,the influenza immunization coverage of HCW is low.The obstacles and myths of influenza vaccine are barriers for vaccine uptake among HCW.The various strategies are critical in order to improve the influenza coverage rates of HCW.

3.
Article in Chinese | WPRIM | ID: wpr-689542

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the expression of long non coding RNA RP11-69I8.3 in acute leukemia and its clinical significance.</p><p><b>METHODS</b>lncRNA RP11-69I8.3 expression was detected by RT-PCR in bone marrow samples from 17 healthy controls, 32 newly diagnosed AML patients and 32 newly diagnosed ALL patients, and 25 ALL patients of complete remission after chemotherapy. Meanwhile, the clinical data were collected and the relation of lncRNA RP11-6918.3 expression with the clinical characteristics was analyzed.</p><p><b>RESULTS</b>Compared with the control group, there was no significant difference in the expression of lncRNA RP11-69I8.3 in AML group(P>0.05). lncRNA RP11-69I8.3 lowly expressed in untreated ALL group(P=0.001). Compared with the de novo ALL group, lncRNA RP11-69I8.3 was highly expressed in complete remission ALL group (P<0.013). In 32 de novo ALL patients,the expression of lncRNA RP11-69I8.3 in children was significantly lower than that in adult(P=0.017). There was no correlation of the expression of lncRNA RP11-69I8.3 with the sex, WBC count, HB level, Plt count, LDH level, T or B type, ratio of bone marrow blast cell, BCR/ABL and WT1 fusion gene expression, chromosome karyotype, extramedullary infiltration, whether complete remission after one chemotherapy, whether relapse. In 26 B-ALL patients, there was no correlation between lncRNA RP11-69I8.3 and the immunophenotype.</p><p><b>CONCLUSION</b>The expression of lncRNA RP11-69I8.3 in the untreated AML is not significantly different from the control group. lncRNA RP11-69I8.3 is low expressed in ALL group, highly expressed in ALL group with complete remission. In untreated ALL, the expression of lncRNA RP11-69I8.3 in children is significantly lower than that in adult. In B-ALL patients, the lncRNA RP11-69I8.3 is not relevant with the immunophenotype.</p>


Subject(s)
Acute Disease , Fusion Proteins, bcr-abl , Humans , Leukemia , RNA, Long Noncoding
4.
Herald of Medicine ; (12): 711-713, 2017.
Article in Chinese | WPRIM | ID: wpr-614281

ABSTRACT

Objective To explore the medication closed-loop management of huangshi central hospital based on electronic medical records.Methods Diversified pharmaceutical information platform was constructed.The full coverage of all aspects of medication information,such as ordering/prescribing,transcribing,distributing,preparing,dispensing,administering,documenting,and monitoring was realized.Results The medication management and use had no information gap,and bias could be controlled to form a closed-loop management.Conclusion Application of the new information technology in the field of pharmaceutical care can improve work efficiency,reduce medication errors,broaden the vision of clinical pharmacists and scope of work,and improve the overall level of pharmaceutical care.

5.
Article in Chinese | WPRIM | ID: wpr-620248

ABSTRACT

Objective To evaluate the dosimetric difference between fixed-field static intensity-modulated radiotherapy (IMRT), fixed-field dynamic multileaf collimator (DMLC), and volumetric modulated arc therapy (VMAT), all of which involve supraclavicular and infraclavicular regions, in breast cancer patients after breast-conserving surgery.Methods This study included 14 female patients with breast cancer who received radiotherapy after breast-conserving surgery in our hospital from October 2012 to April 2016.The radiation field included the chest wall and supraclavicular and infraclavicular regions.IMRT, DMLC, and VMAT plans were generated for each patient while using identical optimization conditions.The doses to planning target volume (PTV) and organs at risk (OARs) were compared based on dose-volume histogram (DVH);one-way analysis of variance or nonparametric Wilcoxon rank test was used for comparison.Results For the dose distribution of PTV, VMAT achieved the best V95, V98, CI, and HI (P<0.009).Concerning the doses to OARs, VMAT achieved the best V5, V20, and Dmean of the ipsilateral lung and the best V5 and Dmean of the contralateral lung (P<0.022).Dmean of the spinal cord was significantly lower in VMAT than in IMRT and DMLC (P=0.004).Conclusions VMAT is preferred for the patients with breast cancer to be treated with radiotherapy involving supraclavicular and infraclavicular regions after breast-conserving surgery.It can improve the dose distribution of target and reduce the doses to organs at risk and radiotherapy toxicities.

6.
The Journal of Practical Medicine ; (24): 3354-3358, 2017.
Article in Chinese | WPRIM | ID: wpr-658479

ABSTRACT

Objective To screen tumor biomarker of breast cancer from expressed differently in breast cancer patients and health by proteomics techniques. Methods Collecting 10 serum cases of breast cancer and healthy respectively,protein spot was separated by two-dimensional electrophoresis,protein expressed differently from breast cancer and healthy was screened by PDQuest software ,and identified by mass spectrometry. Results The 2-DE maps of breast cancer and healthy were established ,22 differentially expressed proteins were analyzed by PDQuest software,took the healthy group as the reference,there were 18 spots with up-regulated serum protein, and 4 spots with down-regulated serum proteins in breast cancer group.12 protein spots were sampled and detected by mass spectrometry. Finally ,4 differentially expressed proteins were identified successfully ,the proteins were confirmed by the database,named as ankyrin-3 isoform X7,keratin,type I cytoskeletal 9,nesprin-2 isoform X11, Dynein heavy chain 10,axonemal isoform X9. Conclusion The 4 differentially expressed proteins in healthy group and breast cancer group can be potential candidate biomarkers for diagnosis of breast cancer.

7.
Journal of Medical Postgraduates ; (12): 1029-1034, 2017.
Article in Chinese | WPRIM | ID: wpr-657680

ABSTRACT

Objective Influenza A(H7N9) virus causes a relatively high mortality in humans and therefore it is of great sig-nificance to know its prevalence in China .This article aimed to study the genetic characteristics and evolution of the hemagglutinin (HA) gene of the influenza A(H7N9) virus prevailing in China between 2013 and 2017. Methods We downloaded the HA se-quences of the influenza A ( H7N9) virus prevailing in China between 2013 and 2017 from The Global Initiative on Sharing All Influen-za Data and National Center for Biotechnology Information .Using the bioinformatics software , we analyzed the homology , molecular characteristics , phyletic evolution , and selective pressure of the HA gene. Results The homology of the HA gene of the influenza A ( H7N9) virus and the reference strain was decreasing each year from 2013 to 2017, 99.0%-99.9%in 2013, 98.7%-99.5%in 2014, 98.4%-99.6%in 2015, 76.8%-99.4%in 2016, and 69.9%-98.2%in 2017.Compared with the reference strain , the HA gene of the influ-enza A(H7N9) virus underwent variations in 21 antigenic sites.The variation of N285D was the highest (23%) in 2015 and that of R148K increased yearly,reaching 65%in 2016 and 78.5% in 2017. Phylogenetic analysis showed a concentrative distribution of the influenza A ( H7N9) virus strains on the phylogenetic tree in the same year from 2013 to 2017.Amino acid substitution of T 140A was observed in most of the influenza A ( H7N9) virus strains from Guang-dong in 2013, and the widest distribution of the virus strains was found in 2014.Positive selective pressure site 65 was obtained in the sequence of 2015 using the FEL and IFEL models, but not in the strains of 2016 or 2017. Conclusion Influenza A(H7N9) virus constantly undergoes variation , which has increased the difficulty in its prevention and control .More importance should be attached to observation of the virus and response to its adaptive mutations .

8.
The Journal of Practical Medicine ; (24): 3354-3358, 2017.
Article in Chinese | WPRIM | ID: wpr-661398

ABSTRACT

Objective To screen tumor biomarker of breast cancer from expressed differently in breast cancer patients and health by proteomics techniques. Methods Collecting 10 serum cases of breast cancer and healthy respectively,protein spot was separated by two-dimensional electrophoresis,protein expressed differently from breast cancer and healthy was screened by PDQuest software ,and identified by mass spectrometry. Results The 2-DE maps of breast cancer and healthy were established ,22 differentially expressed proteins were analyzed by PDQuest software,took the healthy group as the reference,there were 18 spots with up-regulated serum protein, and 4 spots with down-regulated serum proteins in breast cancer group.12 protein spots were sampled and detected by mass spectrometry. Finally ,4 differentially expressed proteins were identified successfully ,the proteins were confirmed by the database,named as ankyrin-3 isoform X7,keratin,type I cytoskeletal 9,nesprin-2 isoform X11, Dynein heavy chain 10,axonemal isoform X9. Conclusion The 4 differentially expressed proteins in healthy group and breast cancer group can be potential candidate biomarkers for diagnosis of breast cancer.

9.
International Eye Science ; (12): 710-712, 2017.
Article in Chinese | WPRIM | ID: wpr-731366

ABSTRACT

@#AIM: To evaluate the clinical effect of pars plana vitrectomy in patients with ocular injuries involving the posterior segment. <p>METHODS:A total of 90 patients(90 eyes)with ocular injuries involving the posterior segment underwent pars plana vitrectomy in our hospital from March 2014 to June 2015 were recruited to carry out a retrospective study. We recorded the age, gender, occurrence site of trauma, visual acuity, anatomical site, nature of injury, wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The Ocular Trauma Score was measured. The minimum follow-up from presentation was 6mo. <p>RESULTS:The mean duration of follow up was 198d, ranged from 182 to 240d. There were 77 males and 13 females of all, with a mean age of 32.7±15.8 years old and 47 patients(52.2%)injured in the workplace, 14 patients(15.6%)at home. The mean visual acuity(LogMAR)of patients were significantly improved from 2.36±0.72 preoperatively to 1.50±1.14 postoperatively. There were 23 patients whose preoperative vision were better than 2.0 LogMAR, the postoperative visual acuity of these patients were significantly better than others(<i>P</i><0.01). No significant difference of visual improvement was found between groups with early vitrectomy(<7d)or delayed vitrectomy(>7d)(<i>P</i>>0.05). There was no significant difference of postoperative visual acuity between patients with injury in Zone I and II(<i>P</i>>0.05), but visual acuity of patients with injury in Zone III were significant poorer(<i>P</i><0.05). The postoperative visual acuity of patients with relative afferent pupillary defect were significant poorer(<i>P</i><0.05). Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visual acuity were significantly different between groups with different ocular trauma scores(<i>P</i><0.01). <p>CONCLUSION:Trauma is more likely to occur in men under 40 years of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of vitrectomy.

10.
Article in Chinese | WPRIM | ID: wpr-311598

ABSTRACT

<p><b>OBJECTIVE</b>To explore the differences of CD146 expression in adult and children's acute B cell lymphoblastic leukemia(B-ALL), and its relation with clinical features, molecular biological and cytogenctic claracteristics.</p><p><b>METHODS</b>The expression of CD146 in bone marrow samples from adult and children's B-ALL patients were detected by flow cytometry (FCM) and the relation of CD146 abnormal high expression with the patients' clinical features, molecular biological and cytogenetical characteristics, as well as other antigens were analyzed.</p><p><b>RESULTS</b>The abnormal high expression rates of CD146 in adult and children's B-ALL patients were 29.17% and 9.09% respectively, showing that the expression rate of CD146 in adult patients was higher than that in children's patients(P<0.05). In adult B-ALL, CD146 was positively related with CD64 and CD117, while in children's B-ALL CD146 was positively related with CD71 and CD58 (P<0.05). After 1 course of standardized chemotherapy, the complete remission rates in adult and children's B-ALL patients with abnormal high expression of CD146 both were low as compared with adult and children's B-ALL without abnormal high expression of CD146 (P<0.05).</p><p><b>CONCLUSION</b>The expression rate of CD146 in adult B-ALL is higher than that in children's B-ALL. The CD146 positively relates with poor prognostic antigens, the CD146 may be one poor prognosis marker.</p>

11.
Article in Chinese | WPRIM | ID: wpr-311535

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the kinase mutation ratio, related factors, effectiveness and safety of the second generation drugs for imatinib-resistant patients with chronic myeloid leukemia(CML).</p><p><b>METHODS</b>COX proportional hazard regression model was used for unvariate and multvariate analysis of various factors affecting the kinase mutation and for evaluating the effectiveness and safety of second generation tyrosine kinase inhibitor(TKI).</p><p><b>RESULTS</b>13 kinds of mutation were detected in 19 out of 42 cases for 22 times, including 4 times of F359V, 3 times of E255K, 2 time for F359C, F317L, T315I, Y253H, 1 time for D256R, C250R, D276G, F486S, M244V, Y256H and G250E, 3 cases with mixed mutations. The main adverse effects of patients receiving nilotinib were skin rash and fluid retention, while that for patients receiving dasatinib were eyelid edema and elevated bilirubin.</p><p><b>CONCLUSION</b>The WBC count, spleen enlargement degree, chromosome karyotypes, disease staging, drug used before treatment and time of acheiving CCyR are the related factors of the kinase mutations, but the patients receiving the second generation TKI can survive well.</p>

12.
Article in Chinese | WPRIM | ID: wpr-311517

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the expression of CC-chemokine receptor 7(CCR7) in patients with multiple myeloma(MM) and its correlation with clinical features of MM.</p><p><b>METHODS</b>The level of CCR7 expression in bone marrow samples from 53 newly diagnosed MM patients was detected by flow cytometry(FCM). Statistical methods were used to analyze the correlation between CCR7 expression and clinical features, such as sex, age, M protein, peripheral blood cell count, biochemical indicators, plasma cell ratio of bone marrow, immunophenotype, osteopathy and extramedullary disease.</p><p><b>RESULTS</b>The plasma cells in 24 out of 53 cases(45.28%) expressed CCR7. The rate of extramedullary disease in CCR7 positive group was significantly higher than that in CCR7 negative group (29.17% vs 3.45%)(P<0.05).</p><p><b>CONCLUSION</b>The expression of CCR7 in patients with MM is high, moreover this high expression correlates with extramedullary disease, thus CCR7 can be used as an effective indicator for prediction of extramedullary disease.</p>

13.
Journal of Medical Postgraduates ; (12): 1029-1034, 2017.
Article in Chinese | WPRIM | ID: wpr-660003

ABSTRACT

Objective Influenza A(H7N9) virus causes a relatively high mortality in humans and therefore it is of great sig-nificance to know its prevalence in China .This article aimed to study the genetic characteristics and evolution of the hemagglutinin (HA) gene of the influenza A(H7N9) virus prevailing in China between 2013 and 2017. Methods We downloaded the HA se-quences of the influenza A ( H7N9) virus prevailing in China between 2013 and 2017 from The Global Initiative on Sharing All Influen-za Data and National Center for Biotechnology Information .Using the bioinformatics software , we analyzed the homology , molecular characteristics , phyletic evolution , and selective pressure of the HA gene. Results The homology of the HA gene of the influenza A ( H7N9) virus and the reference strain was decreasing each year from 2013 to 2017, 99.0%-99.9%in 2013, 98.7%-99.5%in 2014, 98.4%-99.6%in 2015, 76.8%-99.4%in 2016, and 69.9%-98.2%in 2017.Compared with the reference strain , the HA gene of the influ-enza A(H7N9) virus underwent variations in 21 antigenic sites.The variation of N285D was the highest (23%) in 2015 and that of R148K increased yearly,reaching 65%in 2016 and 78.5% in 2017. Phylogenetic analysis showed a concentrative distribution of the influenza A ( H7N9) virus strains on the phylogenetic tree in the same year from 2013 to 2017.Amino acid substitution of T 140A was observed in most of the influenza A ( H7N9) virus strains from Guang-dong in 2013, and the widest distribution of the virus strains was found in 2014.Positive selective pressure site 65 was obtained in the sequence of 2015 using the FEL and IFEL models, but not in the strains of 2016 or 2017. Conclusion Influenza A(H7N9) virus constantly undergoes variation , which has increased the difficulty in its prevention and control .More importance should be attached to observation of the virus and response to its adaptive mutations .

14.
Article in Chinese | WPRIM | ID: wpr-486270

ABSTRACT

BACKGROUND:Traditional studies on foot and ankle biomechanics have limitation. Ankle joint was complicated and had big range of motion, so it is difficult to establish finite element models and to analyze the type of fracture. OBJECTIVE: To construct the finite element models of distal tibial fractures and analyze the stability. METHODS: CT data of ankle were colected from a normal male volunteer and the three-dimensional reconstruction of volunteer was made by Mimics software, and the effectiveness was verified. The ratio of different joint involvement and height of fracture block were assumed with Solidwork software, and finite element models of distal tibial fractures were established. Fracture stability was analyzed by ANSYS software using finite element method. RESULTS AND CONCLUSION:The distal tibia fracture model was consistent with the relevant literature data, and finite element analysis could be further conducted. The ratio of articular surface involved was positively associated with fragment height and fracture displacement, and negatively associated with fracture stability. These results indicate that the three-dimensional finite element models of distal tibial fractures were successfuly established. Fracture stability was associated with the ratio of articular surface involved and fragment height.

15.
Article in Chinese | WPRIM | ID: wpr-731803

ABSTRACT

We use the exploratory experimental teaching mode in the teaching of biochemistry experiment, make the students select experimental subject as to solve scientific problems, and design experimental plan, operate the experiment, record the experimental phenomena and results, and analyze the success or failure units in groups under the teacher’s guidance and supervision. It can cultivate the innovative ability of medical students, stimulate the ability of subjective initiative, improve the students’practical ability.

16.
Article in Chinese | WPRIM | ID: wpr-319959

ABSTRACT

<p><b>OBJECTIVE</b>To compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury.</p><p><b>METHODS</b>Eighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups.</p><p><b>RESULTS</b>The total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P < 0.05). After treatment, the results of the VAS and ODI of the two groups were apparently declined (both P < 0.01), and those in the observation group were decreased more obviously (both P < 0.01).</p><p><b>CONCLUSION</b>The effect of oblique inser-tion at anatomical points for sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.</p>


Subject(s)
Acupuncture Points , Acupuncture Therapy , Adult , Female , Humans , Joint Diseases , Therapeutics , Male , Middle Aged , Sacroiliac Joint , Wounds and Injuries , Young Adult
17.
Article in Chinese | WPRIM | ID: wpr-360094

ABSTRACT

<p><b>OBJECTIVE</b>To explore the expression of CC-chemokine Receptor 7 (CCR7) in adult acute leukemia patients, and to analyze the relationship of CCR7 expression with the clinical characteristics of patients.</p><p><b>METHODS</b>The expression of CCR7 in bone marrow samples from adult acute leukemia patients were detected by flow cytometry (FCM), the relationship of CCR7 expression with the clinical characteristics of patients such as sex, age, WBC count, blast cell ratio, CD56 expression, molecular biology, cell genetics, risk stratification, extramedullary infiltration was analyzed.</p><p><b>RESULTS</b>The expression rate of CCR7 in adult ALL and AML patients was 36.8% and 9.6%, respectively, and the expression level of CCR7 in ALL patients was higher than that in AML patients (P < 0.05). The extramedullary infiltration rate was 100% and 41.7 % for CCR7 positive and negative groups of ALL, respectively (P < 0.05). While the mean fluorescence intensity (MFI) in extramedullary infiltration group of ALL was higher than that in none-extramedullary infiltration group of ALL (50.00 ± 10.42 vs 18.14 ± 1.39), respectively (P < 0.05).</p><p><b>CONCLUSION</b>CCR7 is higher expressed in adult acute leukemia cells, moreover its expression rate in ALL is higher than that in AML, and the expression of CCR7 is related with extramedullary infiltration in ALL.</p>


Subject(s)
Adult , Bone Marrow , Metabolism , Flow Cytometry , Humans , Leukemia, Myeloid, Acute , Genetics , Metabolism , Leukocyte Count , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Genetics , Metabolism , Receptors, CCR7 , Genetics , Metabolism
18.
Article in Chinese | WPRIM | ID: wpr-360064

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical characteristics of multiple myeloma (MM) combined with renal amyloidosis and its curative efficacy and prognosis.</p><p><b>METHODS</b>The clinical data of 22 cases of newly diagnosed multiple myeloma combined with renal amyloidosis treated in our hospital from November 2011 to July 2015 were analyzed retrospectively.</p><p><b>RESULTS</b>According to Intenational Staging System (ISS), among above-menthioned 22 patients the ISS II accounted for 77.2% (17/22), ISS III accounted for 22.8% (5/22). The patients with renal impairment accounted for 36.4% (8/22), with anemia 40.9% (9/22), with serum album < 35 g/L 86.4% (19/22), with urinary protein positive 100% (22/22). The evaluation of the curative efficacy of the 22 cases was as follows: CR 13.6% (3/22); VGPR 4.5% (1/22); PR 22.8% (5/22); SD 45.5% (10/22); PD 13.6% (3/22). Out of 9 patients with effective treatment, 3 cases (3/9, 33.3%) achieved "improved" in renal amyloidosis, 4 cases (4/9, 44.5%) achieved stable in renal amyloidosis, 2 cases (2/9, 2%) achieved "worsened" in renal amyloidosis. Among 17 cases who were followed up, 7 cases died, 10 cases survived, the average duration of follow-up for these cases was 11 (1-37) months, the median overall survival (OS) time was 19 (95% CI 9.2-28.8) months.</p><p><b>CONCLUSION</b>MM with renal amyloidosis is rare, refractory and has a poor prognosis. Whether there is impairment of kidney function or not, renal amyloidosis shall be taken into consideration if the MM patients got massive proteinuria especially nephritic syndrome. Bortezomib may improve the curative efficacy.</p>


Subject(s)
Amyloidosis , Diagnosis , Pathology , Therapeutics , Bortezomib , Therapeutic Uses , Humans , Kidney Diseases , Diagnosis , Pathology , Therapeutics , Multiple Myeloma , Diagnosis , Pathology , Therapeutics , Prognosis , Proteinuria , Diagnosis , Retrospective Studies , Treatment Outcome
19.
Article in Chinese | WPRIM | ID: wpr-360053

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of recombinant human thrombopoietin (rhTPO) for treatment of patients with newly diagnosed immune thrombocytopenia (ITP).</p><p><b>METHODS</b>The clinical data of 96 patients with newly diagnosed ITP from August 2013 to August 2015 were analyzed retrospectively, 96 patients were divided into the rhTPO group (46 cases) and the control group (50 cases). Patients in the rhTPO group received subcutaneous injection of rhTPO at a dose of 300 U/(kg·d) for a maximum of 14 days, and control group was treated with glucocorticoid (standard dose) for 28 days. Then the efficacy and adverse reactions between the 2 groups were compared.</p><p><b>RESULTS</b>Compared with the control group, the patients in rhTPO group achieved higher complete response (CR) rate (56.5% vs 34.0%) (P = 0.03), shorter median time when platelet counts reached 100 × 10(9)/L[10 (5-14) d vs 14 (6-26) d, P < 0.01] and less adverse reactions (4.4% vs 82.0%) (P < 0.01). After the withdrawal of rhTPO, platelet counts gradually decreased. Sex, age and the presence of HP infection had no influence on efficacy of rhTPO (P > 0.10), but when Plt count was too low (≤10 × 10(9)/L), the proportion of patients obtaining CR showed an decreased tendency, as compared with those with Plt>10 × 10(9)/L (38.9% vs 67.9%) (P = 0.06).</p><p><b>CONCLUSION</b>rhTPO has satisfactory therapeutic effect and enough safety for patients with newly diagnosed ITP, however, its long-term efficacy should be furtherly improved.</p>


Subject(s)
Adult , Glucocorticoids , Therapeutic Uses , Humans , Platelet Count , Purpura, Thrombocytopenic, Idiopathic , Drug Therapy , Recombinant Proteins , Therapeutic Uses , Remission Induction , Retrospective Studies , Thrombopoietin , Therapeutic Uses
20.
Article in Chinese | WPRIM | ID: wpr-246860

ABSTRACT

<p><b>OBJECTIVE</b>To compare the expression of C-C chemokine receptor type 5 (CCR5) on T cells between bone marrow grafts (G-BM) and peripheral blood grafts (G-PB) nobilized by recombinant human granulocyte colony-stimulating factor (rhG-CSF), and to analyze the correlation of CCR5+ T lymphocyte expression in the grafts with the occurrence of acute GVHD.</p><p><b>METHODS</b>Forty-six healthy donor and their recipient pairs of related allogeneic hematopoietic stem cell transplantation (allo-HSCT) were enrolled in this study. All the recipients were received the infusion of G-BM and G-PB. The relative proportion and quantity of CCR5+ T cell subset in G-BM and G-PB were detected and compared. Then the correlation of the quantity of infused CCR5+ T cells with the occurrence of acute GVHD was analyzed.</p><p><b>RESULTS</b>After mobilization, the proportions of CD4+ CCR5+ and CD8+ CCR5+ T cells occupying T cells in G-PB were both lower than those in G-BM. However, the absolute counts in G-PB were 15-25 times more than those in the bone marrow. And the absolute counts could not predict the occurrence of acute GVHD after transplantation (P>0.05).</p><p><b>CONCLUSION</b>The difference of CCR5+ subsets between G-PB and G-BM may partially explain that grafts from different sources have different immunologic characteristics. Besides, the quantity of CCR5+ T cells in the grafts are not related with the occurrence of acute GVHD. However, the relative proportion of CCR5+ T cell subset in the grafts may be predictive of acute GVHD.</p>


Subject(s)
Bone Marrow , Metabolism , Bone Marrow Transplantation , Graft vs Host Disease , Pathology , Granulocyte Colony-Stimulating Factor , Pharmacology , Hematopoietic Stem Cell Mobilization , Hematopoietic Stem Cell Transplantation , Humans , Receptors, CCR5 , Metabolism , T-Lymphocyte Subsets , Metabolism , Tissue Donors
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