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1.
Journal of Leukemia & Lymphoma ; (12): 156-160, 2021.
Article in Chinese | WPRIM | ID: wpr-882256

ABSTRACT

Objective:To investigate the effect of miRNA-618 (miR-618) on the cell proliferation and apoptosis of acute monocyte leukemia THP-1 cells.Methods:Real-time polymerase chain reaction (PCR) was used to detect the relative expression level of miR-618 in THP-1 cells and monocytes isolated from peripheral blood of the healthy people. Overexpression of miR-618 plasimid vector was constructed and empty vector was treated as the negative control; and then the two vectors were transfected with THP-1 cells; finally, miR-618 overexpression group and negative control group were set. THP-1 cell proliferation and apoptosis of both groups were detected by using CCK-8 method and flow cytometry, respectively. TargetScan was used to predict the target gene of miR-618 and it was verified by using luciferase reporter assay.Western blot was used to detect the protein levels of THP-1 cells in miR-618 overexpression group and negative control group, and predicted miR-618 target gene in peripheral blood monocytes of the healthy people.Results:PCR showed that the expression level of miR-618 was lower in THP-1 cells compared with that in monocytes isolated from peripheral blood of the healthy people ( P < 0.05). CCK-8 assay showed that compared with the negative control group, the proliferation ability of THP-1 cells in miR-618 overexpression group was decreased (the absorbance values at 0, 24, 48 and 72 h after transfection: 0.20±0.03 vs. 0.20±0.03, 0.28±0.02 vs. 0.35±0.03, 0.34±0.03 vs. 0.43±0.04, 0.39±0.02 vs. 0.53±0.05, all P < 0.05), and the late apoptosis rate was increased [(27.1±0.1)% vs. (14.9±0.1)%, t=2.13, P=0.03]. The target gene of miR-618 was ARPP19 predicted by using TargetScan software. Luciferase reporter assay showed that the relative luciferase activity of THP-1 cells in group transfected with wild-type ARPP19 gene plasmid+miR-618 gene plasmid was higher than that in the blank control group and group transfected with wild-type ARPP19 gene plasmid+miR-618 empty vector (0.170±0.003 vs. 0.100±0.004, 0.100±0.001, all P < 0.05). Western blot indicated the expression level of ARPP19 protein in THP-1 cells of miR-618 overexpression group was lower than that of the negative control group, while the expression levels of ARPP19 protein of peripheral blood monocytes of the healthy people in both groups were similar. Conclusion:miR-618 can inhibit the cell proliferation and promote apoptosis of THP-1 cells by inhibiting the expression of of THP-1 cells ARPP19 in acute monocyte leukemia.

2.
Article in Chinese | WPRIM | ID: wpr-800306

ABSTRACT

Objective@#To summarize the diagnosis and treatment of biliary pancreatic duct dilatation.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 22 patients with biliary pancreatic duct dilatation who were admitted to Renji Hospital of Shanghai Jiaotong University School of Medicine between October 2013 to September 2017 were collected. There were 6 males and 16 females, aged from 33 to 82 years, with an average age of 66 years. Surgical exploration was decided according to clinical symptoms, results of laboratory test and imaging examinations. For patients with space occupying lesions, surgical procedure was selected based on results of pathological examination. Patients without surgical exploration or space occupying lesions were allocated into follow-up. Observation indicators: (1) surgical exploration; (2) relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions; (3) surgical treatment; (4) follow-up. Follow-up using outpatient examination was performed on patients up to October 2018. Follow-up was performed on patients with positive surgical exploration to detect postoperative complications.For patients with positive results of imaging examinations, no jaundice, normal laboratory indicators or mild abnormality, liver function, tumor markers and B-ultrasound were re-examined each month, and computed tomography (CT) and magnetic resonance imaging (MRI) was performed once every 3 months. Surgical exploration was performed when total bilirubin (TBil) or tumor markers showed a progressive increase. Follow-up was performed on patients with negative results of imaging examination, jaundice, and mildly elevated CA19-9. TBil and CA19-9 were re-examined monthly, and if they were progressively elevated, patients were transferred to surgical exploration. For patients with negative results of imaging examination, no symptoms, and negative laboratory test, liver function, tumor markers, and B-ultrasound were re-examined once every 3 months, and enhanced CT and MRI were re-examined once every 6 months within one year. Follow-up was performed once every 6 months during the second year, and once a year after two years. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Count data were descibed as absolute numbers, and they were analyzed using the chi-square test under R×C chart or Fisher exact probability.@*Results@#(1) Surgical exploration: of 22 patients, 11 underwent surgical exploration, and 11 underwent follow-up. Of the 11 patients with surgical exploration, 4 were positive for space occupying lesions including 1 of false negative, and 7 were negative for space occupying lesions. (2) Relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions. ① Relationship of clinical symptoms and laboratory test with surgical exploration positive for space occupying lesions: juandice was significantly associated with surgical exploration positive for space occupying lesions (P<0.05), and elevated TBil and DBil were significantly associated with surgical exploration positive for space occupying lesions (χ2=0, 0, P<0.05), with a sensitivity of 75.0% and specificity of 100.0%. ② Relationship between imaging examination and surgical exploration positive for space occupying lesions: results of CT, MRI, endoscopic retrograde cholangio-pancreatography, endoscopic ultrasonography, PET-CT, and combined imaging examinations had no significant association with surgical exploration positive for space occupying lesions (χ2=0, 0.77, 0, 0, 1.00, 0, 0, 0, 0, P>0.05). PET-CT had no significant association with surgical exploration positive for space occupying lesions (P>0.05). ③ Relationship of imaging examination and laboratory test with surgical exploration positive for space occupying lesions: positive imaging examination combined with elevated TBil and CA19-9 was significantly associated with surgical exploration positive for space occupying lesions (P<0.05), with a sensitivity of 50.0% and specificity of 100.0%. ④ Relationship of preoperative diameters of biliary ducts and pancreatic ducts with surgical exploration positive for space occupying lesions: of 22 patients, the diameters of biliary ducts and pancreatic ducts were (13.8±4.3)mm and (4.6±1.5)mm for patients with positive surgical exploration, (13.0±2.8)mm and (3.5±0.5)mm for patients with negative surgical exploration, (11.6±2.4)mm and (3.2±0.4)mm for patients with follow-up, respectively, showing no significant difference between them (t=0.22, 0.36, P>0.05). (3) Surgical treatment: 9 of 11 patients with surgical exploration followed the standard procedure. Of the 9 patients, 4 were found space-occupying lesions at the choledocho-pancreatico-duodenal junction (3 undergoing pancreaticoduodenectomy and 1 undergoing duodenal papilla partial resection), 5 with negative exploration underwent common bile duct incision and T-tube drainage (one patient was unable to pinch the T-tube one month after operation and detected obstruction at the lower end of the bile duct by radiography, and was confirmed pancreatic head cancer by reoperation 3 months after the first operation). Two patients didn′t follow the exploratory procedure, and underwent the child operation only based on the preoperative imaging findings, without intraoperative pathological examination. Postoperative pathological examination showed chronic ampulla and chronic pancreatitis, respectively. (4) Follow-up: 22 patients were followed up for 12-60 months, with a median follow-up time of 36 months. Two of 11 patients with surgical exploration had postoperative gastroplegia, 1 had bile leakage, 1 had incisional infection, and they were improved after symptomatic treatment. Four patients undergoing surgeries for positive exploration had no recurrence during follow-up. Of 5 patients with negative exploration undergoing common bile duct incision and T-tube drainage, 1 was confirmed pancreatic head cancer and underwent pancreaticoduodenectomy, 4 were removed T-tube after by T-tube cholangiography at 2 months after surgery. During the follow-up, no positive signs showed in laboratory test or imaging examination. No recurrence occurred in the two patients undergoing pancreaticoduodenectomy. Of 11 patients with follow-up, 10 had abdominal pain before surgery, including 3 with pain during follow-up and 7 with symptoms disappeared. There was no abnormalities in the laboratory test.@*Conclusions@#The positive imaging examinations combined with jaundice and elevated CA19-9 is an absolute indication for surgical exploration in patients with biliary duct dilatation. Those patients who do not meet this criteria should be distributed into the follow-up. If no positive pathological results were obtained during the operation, the surgery should be terminated and the patients should be transferred into follow-up. The reckless biliary anastomosis or biliary stents placement is opposed.

3.
Article in Chinese | WPRIM | ID: wpr-733920

ABSTRACT

Objective To study the impact of peripheral blood absolute lymphocyte count ( ALC) on survival in adult patients with acute lymphoblastic leukemia ( ALL ) at the end of induction chemotherapy. Methods 122 adult patients with ALL from January 2011 to December 2017 in the Second Hospital of Shanxi Medical University were retrospectively analyzed. The impact of ALC at the end of induction and ALC ratios for relapse-free( RFS) and overall survival ( OS ) of adult ALL were analyzed. Results The study cohort was divided into the two groups according ALC-28 values ( <675cells/μL and ≥675cells/μL). The median RFS (8 months vs 12 months,P=0. 001),median OS (16 months vs 23 months,P=0. 010) between the two groups had statistically significant differ-ences. ALC-28/ALC-1 was bordered by 43%. The RFS and OS in the low ratio group were significantly shorter than those in the high ratio group (P<0. 05). ALC-28/ALC-8 was compared with 86% cut-off. Longer RFS and OS in the higher ALC-28/ALC-8 group (all P<0. 05). Low ALC-28 was independent risk factor for RFS. Low ALC-28,and low ALC-28/ALC-1 were independent risk factors of OS. Conclusion ALC at the end of induction and ALC ratios are associated with RFS and OS of adult ALL. Higher the value,the longer the survival time.

4.
Journal of Leukemia & Lymphoma ; (12): 404-407, 2019.
Article in Chinese | WPRIM | ID: wpr-751417

ABSTRACT

Objective To explore the role of E2A﹣HLF fusion gene in the prognosis evaluation of B﹣cell acute lymphoblastic leukemia (B﹣ALL), and to improve the accuracy of stratified treatment. Methods The clinical characteristics, treatment effect and survival time of two B﹣ALL patients with E2A﹣HLF fusion gene who were admitted to the Second Hospital of Shanxi Medical University were retrospectively analyzed, and the related literature was reviewed. Results The first patient was an 8 years old girl, developed with fever, abdominal pain, and slightly increased white blood cells (WBC), and also accompanied by hypercalcemia. Another patient was a 27 years old man, developed with jaw pain and anemia, WBC was normal. Precursor B﹣ALL (pre﹣B﹣ALL) was identified by flow cytometry (FCM) in the two cases. E2A﹣HLF fusion gene was screened out at first diagnosis for the girl, but found after relapse for the man. Both patients early received intensive treatment with high﹣dose methotrexate after the first complete remission, but relapsed after 3 and 6 months respectively. The girl did not receive allogeneic hematopoietic stem cell transplantation (allo﹣HSCT) after relapse and died of severe infection. The man received allo﹣HSCT complete remission, and maintained complete remission within 5 months after HSCT, E2A﹣HLF fusion gene was also negative, but eventually died of multiple transplantation﹣related complications. Conclusions E2A﹣HLF fusion gene occurs mostly in the pre﹣B﹣ALL patients with hypercalcemia, and it shows extremely poor prognosis with a high multidrug resistance rate and high early recurrence rate. The allo﹣HSCT can increase the leukemia﹣free survival rate, and the relapse and overall survival may be improved when these patients received allo﹣HSCT in the first complete remission.

5.
Article in Chinese | WPRIM | ID: wpr-823836

ABSTRACT

Objective To summarize the diagnosis and treatment of biliary pancreatic duct dilatation.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients with biliary pancreatic duct dilatation who were admitted to Renji Hospital of Shanghai Jiaotong University School of Medicine between October 2013 to September 2017 were collected.There were 6 males and 16 females,aged from 33 to 82years,with an average age of 66 years.Surgical exploration was decided according to clinical symptoms,results of laboratory test and imaging examinations.For patients with space occupying lesions,surgical procedure was selected based on results of pathological examination.Patients without surgical exploration or space occupying lesions were allocated into follow-up.Observation indicators:(1) surgical exploration;(2) relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions;(3) surgical treatment;(4) follow-up.Follow-up using outpatient examination was performed on patients up to October 2018.Follow-up was performed on patients with positive surgical exploration to detect postoperative complications.For patients with positive results of imaging examinations,no jaundice,normal laboratory indicators or mild abnormality,liver function,tumor markers and B-ultrasound were re-examined each month,and computed tomography (CT) and magnetic resonance imaging (MRI) was performed once every 3 months.Surgical exploration was performed when total bilirubin (TBil) or tumor markers showed a progressive increase.Follow-up was performed on patients with negative results of imaging examination,jaundice,and mildly elevated CA19-9.TBil and CA19-9 were re-examined monthly,and if they were progressively elevated,patients were transferred to surgical exploration.For patients with negative results of imaging examination,no symptoms,and negative laboratory test,liver function,tumor markers,and B-ultrasound were re-examined once every 3 months,and enhanced CT and MRI were re-examined once every 6 months within one year.Follow-up was performed once every 6 months during the second year,and once a year after two years.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed using the t test.Count data were descibed as absolute numbers,and they were analyzed using the chi-square test under R×C chart or Fisher exact probability.Results (1) Surgical exploration:of 22 patients,11 underwent surgical exploration,and 11 underwent followup.Of the 11 patients with surgical exploration,4 were positive for space occupying lesions including 1 of false negative,and 7 were negative for space occupying lesions.(2) Relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions.① Relationship of clinical symptoms and laboratory test with surgical exploration positive for space occupying lesions:juandice was significantly associated with surgical exploration positive for space occupying lesions (P<0.05),and elevated TBil and DBil were significantly associated with surgical exploration positive for space occupying lesions (x2 =0,0,P<0.05),with a sensitivity of 75.0% and specificity of 100.0%.(② Relationship between imaging examination and surgical exploration positive for space occupying lesions:results of CT,MRI,endoscopic retrograde cholangiopancreatography,endoscopic ultrasonography,PET-CT,and combined imaging examinations had no significant association with surgical exploration positive for space occupying lesions (x2 =0,0.77,0,0,1.00,0,0,0,0,P>0.05).PET-CT had no significant association with surgical exploration positive for space occupying lesions (P>0.05).③ Relationship of imaging examination and laboratory test with surgical exploration positive for space occupying lesions:positive imaging examination combined with elevated TBil and CA19-9 was significantly associated with surgical exploration positive for space occupying lesions (P<0.05),with a sensitivity of 50.0% and specificity of 100.0%.④ Relationship of preoperative diameters of biliary ducts and pancreatic ducts with surgical exploration positive for space occupying lesions:of 22 patients,the diameters of biliary ducts and pancreatic ducts were (13.8±4.3)mm and (4.6±1.5)mm for patients with positive surgical exploration,(13.0±2.8)mm and (3.5±0.5) mm for patients with negative surgical exploration,(11.6±2.4) mm and (3.2±0.4) mm for patients with follow-up,respectively,showing no significant difference between them (t =0.22,0.36,P>0.05).(3) Surgical treatment:9 of 11 patients with surgical exploration followed the standard procedure.Of the 9 patients,4 were found space-occupying lesions at the choledocho-pancreatico-duodenal junction (3 undergoing pancreaticoduodenectomy and 1 undergoing duodenal papilla partial resection),5 with negative exploration underwent common bile duct incision and T-tube drainage (one patient was unable to pinch the T-tube one month after operation and detected obstruction at the lower end of the bile duct by radiography,and was confirmed pancreatic head cancer by reoperation 3 months after the first operation).Two patients didn't follow the exploratory procedure,and underwent the child operation only based on the preoperative imaging findings,without intraoperative pathological examination.Postoperative pathological examination showed chronic ampulla and chronic pancreatitis,respectively.(4) Follow-up:22 patients were followed up for 12-60 months,with a median followup time of 36 months.Two of 11 patients with surgical exploration had postoperative gastroplegia,1 had bile leakage,1 had incisional infection,and they were improved after symptomatic treatment.Four patients undergoing surgeries for positive exploration had no recurrence during follow-up.Of 5 patients with negative exploration undergoing common bile duct incision and T-tube drainage,1 was confirmed pancreatic head cancer and underwent pancreaticoduodenectomy,4 were removed T-tube after by T-tube cholangiography at 2 months after surgery.During the follow-up,no positive signs showed in laboratory test or imaging examination.No recurrence occurred in the two patients undergoing pancreaticoduodenectomy.Of 11 patients with follow-up,10 had abdominal pain before surgery,including 3 with pain during follow-up and 7 with symptoms disappeared.There was no abnormalities in the laboratory test.Conclusions The positive imaging examinations combined with jaundice and elevated CA19-9 is an absolute indication for surgical exploration in patients with biliary duct dilatation.Those patients who do not meet this criteria should be distributed into the follow-up.If no positive pathological results were obtained during the operation,the surgery should be terminated and the patients should be transferred into follow-up.The reckless biliary anastomosis or biliary stents placement is opposed.

6.
Article in Chinese | WPRIM | ID: wpr-710908

ABSTRACT

Primary immune thrombocytopenia (ITP) in pregnancy is a special type of ITP,its impact on the mother and fetus cannot be ignored.The correct diagnosis and effective treatment of ITP in pregnancy are the focus of the clinical practice and medical research.This article reviews the progress on the management of the primary immune thrombocytopenia in pregnancy.

7.
Article in Chinese | WPRIM | ID: wpr-710868

ABSTRACT

Objective To examine the influencing factors related to clinical efficacy and outcomes of adult primary immune thrombocytopenia (ITP).Methods The clinical data of 161 cases of ITP admitted in the Second Hospital of Shanxi Medical University from June 2013 to March 2017 were collected.The influencing factors related to clinical efficacy and prognosis of adult ITP patients were analyzed.Results There were 60 males and 101 females with a M/F ratio of 0.59∶1 and a median age of 45 years (18-84 years).There were 109 newly diagnosed ITP cases,14 persistent ITP cases and 38 chronic ITP cases in this series.Seventy nine patients received intravenous immunoglobulin g (IVIg) treatment and 82 patients received high dose-dexamethasone treatment.There were no significant differences in clinical efficacy [91.13%(72/79) vs.87.80%(72/82),x2=0.181,P=0.914] and relapse rate [36.11%(26/72) vs.30.55%(22/72),x2=0.189,P=0.910] between IVIg and high dose-dexamethosone groups.Multivariate regression analysis showed that bleeding score ≥2 was the independent risk factor for the lower clinical efficacy (RR=1.415,95%CI:1.008-1.986,P<0.05).Patients were followed up for a median of 9.0 months (0.5-55.0 months),48 patients relapsed with a relapse rate of 33.33% and a median relapse time of 1.8 months (0.5-24.0 months).Conclusions IVIg and high dose-dexamethasone have the similar clinical efficacy and relapse rate for treatment of adult ITP.The patients with the bleeding score ≥2 are more likely to get lower remission rate.

8.
Chinese Journal of Ultrasonography ; (12): 1075-1079, 2018.
Article in Chinese | WPRIM | ID: wpr-734223

ABSTRACT

Objective To summarize the prenatal ultrasonographic characteristics of unroofed coronary sinus( URCS) for improving the prenatal echocardiography diagnostic accuracy of URCS . Methods The retrospective review for prenatal ultrasonogram of 7 fetuses was applied ,which were diagnosed as URCS . The prenatal ultrasonographic characteristics of 7 fetuses with URCS were reviewed and comparatively analyzed with postpartum autopsy findings or postnatal echocardiography . The relevant literatures referring to the prenatal diagnosis of URCS were reviewed . The experience of prenatal diagnosis of URCS were summarized . Results In 7 cases with URCS ,5 cases of completely URCS were associated with right atrial isomerism syndrome and confirmed by postpartum autopsy ,and 2 cases of partially URCS were only with persistent left superior vena cava and confirmed by postnatal echocardiography . The karyotype analysis of 2 cases of partially URCS on amniotic fluid was normal . Conclusions There are some characteristic signs in ultrasonic features of URCS . URCS can be diagnosed by prenatally ultrasonography . A long axial section of the coronary sinus is the most important view for prenatal ultrasonic diagnosis of U RCS .

9.
Article in Chinese | WPRIM | ID: wpr-707705

ABSTRACT

Objective To summarize the prenatal ultrasonographic characteristics of anomalous origin of one pulmonary artery from the aorta( AOPA ) ,and describe the diagnostic and clinical outcomes of fetal AOPA . Methods Echocardiographic characteristics of 3 fetuses with AOPA were reviewed . The ultrasonographic features were comparatively analyzed with postpartum autopsy findings . The relevant literature were reviewed and the experience of prenatal diagnosis of AOPA were summarized . Results In 3 cases with AOPA ,2 cases were the proximal type and anomalous origin of right pulmonary artery from the aorta ,of them ,one was accompanied with coarctation of the aorta , the other was accompanied with aortopulmonary window . One case was the distal type and anomalous origin of left pulmonary artery from the left innominate aorta ,it was only associated with mirror right aortic arch and right ductus arteriosus . Ultrasound characteristics were no bifurcation in distal pulmonary artery ,main trunk of pulmonary artery extends directly to one branch ,the other branch originated from the ascending aorta or left innominate artery . Three cases were confirmed by postpartum autopsy . Conclusions There are some characteristic signs on ultrasonic features of AOPA . Prenatal ultrasound has important value for diagnosis of AOPA .

10.
Chinese Mental Health Journal ; (12): 166-173, 2018.
Article in Chinese | WPRIM | ID: wpr-703998

ABSTRACT

Objective:To revise the Chinese version of the Parental Psychological Flexibility Questionnaire (PPFQ) and test its validity and reliability.Methods:Totally 1015 parents from 2 primary school of Beijing were recruited and asked to complete the Chinese version of PPFQ.Item analysis was conducted to identify valid items.The parents were randomly allocated into two groups where one subset (n =510) was used for exploratory factor analysis (EFA),and the other (n =505) for confirmatory factor analysis (CFA) and discriminant validity.In addition,responses of 389 participants selected by simple random sampling was assessed in criterion validity with the Cognitive Fusion Questionnaire (CFQ),Acceptance and Action Questionnaire-Second Edition (AAQ-Ⅱ]),Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS),Mindful Attention Awareness Scale (MAAS),Trait Coping Style Questionnaire(TCSQ) and Conners Child Behavior Rating Scale (CBRS).Seven weeks later,225 of the participants were retested.Results:The exploratory factor analysis extracted 3 components,and explained 58.1% of the total variance.The factor loading of items ranged between 0.63 and 0.86.The confirmatory factor analysis verified the 3-factors model (x2/df=1.77,NFI =0.94,IFI =0.97,GFI =0.96,TLI =0.96,CFI =0.97,RMSEA =0.04).Discriminant validity testing demonstrated the three revised factors had adequate discriminant validity in relation to one another (Ps < 0.01).Criterion validity results showed that the total and subscale scores of the PPFQ were negatively correlated with the scores of CFQ,AAQ-Ⅱ,SAS,SDS,TCSQ-NC,CBRS (r =-0.16--0.52,Ps < 0.01),and were positively correlated with the scores of MAAS,TCSQ-PC (r =0.14-0.37,Ps < 0.01).The total and subscale scores of the PPFQ demonstrated good internal consistency Cronbach's α were 0.77-0.86 and test-retest reliability coefficient were 0.55-0.75.Conclusion:It suggests tthe validity and reliability of the adapted Chinese version of the Parental Psychological Flexibility Questionnaire be satisfactory,and could be used in the clinical and research work in China.

11.
Journal of Leukemia & Lymphoma ; (12): 159-163, 2018.
Article in Chinese | WPRIM | ID: wpr-691627

ABSTRACT

Objective To explore the clinical features, curative effects and prognosis of patients with psoriasis related acute leukemia. Methods The clinical data of 39 cases in the Second Hospital Shanxi Medical University from January 2011 to June 2016 were collected, and their clinical features and prognosis were analyzed retrospectively. Results Of 39 patients, 28 were males and 11 were females, with the median age of 42 years (13-76 years), the median time that suffering from psoriasis were 10 years (1-30 years); There were 23 (59.0 %) patients with acute promyelocytic leukemia (APL), 13 (33.3 %) patients with acute myeloid leukemia (AML) and 3 (7.7 %) patients with B-cell acute lymphocytic leukemia (B-ALL). In patients with recurrence, there were 4 patients with APL, 4 patients with AML, and 1 patient with B-ALL. Single factor analysis showed that the type of PML-RARαfusion gene isoform and the time of suffering from psoriasis were the influencing factors of patients with APL recurrence (both P<0.05), but they were not the independent risk factors (both P>0.05) based on multivariate analysis. The complete remission (CR) rates of patients with psoriasis related APL and AML were 96%(22/23) and 46%(6/13), the 3-year overall survival (OS) rates were 96%and 44%, 3-year relapse free survival (RFS) rates were 77%and 38%, respectively. Conclusions In patients with psoriasis related acute leukemia, the largest population is APL patients, and they have a better prognosis. However, patients with psoriasis related AML and ALL have low CR rate and OS rate, and the allogeneic hematopoietic stem cell transplantation should be considered after remission.

12.
Journal of Leukemia & Lymphoma ; (12): 95-97,102, 2018.
Article in Chinese | WPRIM | ID: wpr-691615

ABSTRACT

Objective To evaluate the efficacy and safety of the mobilization and collection of unrelated allogeneic peripheral blood stem cells. Methods The suitable stem cell mobilization plan was made in accordance with the hematopoietic stem cell mobilization plan of China Marrow Donor Program, the ruler of the hospital, and the donor's constitution. The unrelated allogeneic peripheral blood stem cells of 64 healthy donors were collected in the second Hospital of Shanxi Medical University from May 2012 to January 2017. The donor was infected one or several times with the mobilization agent granulocyte colony stimulating factor (G-CSF) by 5-10 μg·kg-1·d-1. After 3-4 days, peripheral blood hematopoietic stem cells were collected using COBE Spectra blood cell separator. Then, the effect and adverse reaction of donors were analyzed from different age and sex. Results It can achieve the acquisition requirements using 3 or 4 days of mobilization programs, mononuclear cells≥5.0×108/kg, CD34+cells≥2.0×106/kg. The single acquisition success rate (the target acquisition of the number of mononuclear cells and CD34+) up to 65 %, collection efficiency reached 52%, which could reduce the risk of donor and the cost of patients. The quality of donor stem cell of young was better than that of older persons. Sixteen donors (25%) had mild adverse reactions, and no special treatment was required. Conclusions Allogeneic stem cell mobilization is safe. Starting from save medical resources and the interests of the donor the 3 day or 4 days of mobilization scheme could improve the success rate of the single mobilization. During the collection process, the condition of donor hypocalcemia should be observed and health education should be given to relieve the tension of donor.

13.
Article in Chinese | WPRIM | ID: wpr-691606

ABSTRACT

Objective To explore the biological characteristics of primary CD5 positive diffuse large B-cell lymphoma (DLBCL) and treatment effects of rituximab combined with different chemotherapy regimens. Methods The clinical features of 2 CD5 positive DLBCL patients (1 case with early report and 1 case with newly treated) in department of hematology of the Second Hospital of Shanxi Medical University were summarized, including bone marrow, lymph nodes morphology, flow cytometry, immunohistochemistry, and molecular biology characteristics. The treatment response of rituximab combined with different chemotherapy regimens was evaluated, and the literatures were reviewed. Results First patient was diagnosed as primary CD5 positive DLBCL with complex karyotype (leukemia stage). After the first induction chemotherapy with rituximab and VCTP regimens (4 weeks), the patient achieved complete remission of bone marrow. Spleen and lymph nodes also were reduced significantly. Eight consolidation therapy including R-VCTP regimen (2 weeks), R-Hyper-CVAD regimens for 3 courses and R-HD-MTX regimens for 4 courses were sequentially given. Cytarabine combined with and methotrexate (MTX) was performed 10 times of intrathecal injection. After the follow-up of 21 months, the disease sustained remission without central nervous system (CNS) invasiveness. Second elderly patient was diagnosed as primary CD5 positive DLBCL (nasal type), who received induction chemotherapy regimen of rituximab combined with vincristine and prednisone for 3 courses. Nasal tumor symptoms completely relieved after subsequent treatments and the local sclerotin restored. However, multiple skin lesions appeared after half a year, which were quickly alleviated after treatment of rituximab combined with COP regimen. Magnetic resonance imaging (MRI) showed that the brain parenchymal infiltration appeared. Related symptoms gradually relieved after radiotherapy and imageology also showed that infiltrates were mostly absorbed. The patient was followed up for 21 months and had the stable disease. Conclusions Primary CD5 positive DLBCL is a unique subset presented with more extranodal lesions, which occur commonly in bone marrow, skin and CNS. Rituximab combined with acute lymphoblastic leukemia chemotherapy and intrathecal chemotherapy may reduce incidence of metastatic central lesions , and improve the disease free survival rate.

14.
Chinese Journal of Hematology ; (12): 404-407, 2018.
Article in Chinese | WPRIM | ID: wpr-809976

ABSTRACT

Objective@#To evaluate the efficacy and safety of a domestic human plasma derived coagulation Factor Ⅸ concentrate (pd-FⅨ) in patients with hemophilia B.@*Methods@#The study was a multicenter, open-label and single-arm study. The efficacy of pd-F Ⅸ was evaluated by objective performance criteria. The doses of pd-FⅨ were calculated according to the bleeding symptom and disease severity. The infusion efficiency of pd-FⅨ and improvement of bleeding symptoms were measured at 30 minutes and (24±4) h after the first infusion, respectively. Adverse events were recorded. Viral infection and FⅨ inhibitor were detected 90 d after the first infusion.@*Results@#All 36 subjects with hemophilia B were enrolled in the study. The median age of these patients was 31 years old and the median injection doses were 4 (1-17) times. The hemostatic effect of 27/36 (75.00%) and 9/36 (25.00%) acute bleeding events were rated as "excellent" and "better" , respectively. The recovery rate was 111.92% (65.55%-194.28%) at 30 minutes after infusion of FⅨ. There was no adverse event related to FⅨ. No reactivation of HBV, HCV or HIV and FⅨ inhibitor was detected at 90-104 d after the first FⅨ infusion.@*Conclusion@#This domestically made human plasma derived FⅨ concentrate is safe and effective in the treatment of acute bleeding in patients with hemophilia B.@*Clinical trial registration@#China food and Durg Administration, 2016L08027.

15.
Chinese Journal of Geriatrics ; (12): 1340-1344, 2017.
Article in Chinese | WPRIM | ID: wpr-664356

ABSTRACT

Objective To analyze the clinical features and risk factors for an emerging infection during the first induction chemotherapy in elderly patients with acute leukemia.Methods A retrospective analysis of clinical data of 79 elderly patients with newly diagnosed acute leukemia was performed in Second Hospital of Shanxi Medical University from January 2014 to May 2016.Results The 70 cases among 79 elderly patients with acute leukemia were suffered from infection with infection incidence rate of 88.6% (70/79)during first induction chemotherapy.The infection-related fatality rate was 8.6 % (6/70).Being clear about sites of infection accounted for 90.0 % (63/70),and the top three infection sites were the lungs,gastrointestinal tract and the bloodstream.113 pathogenic strains were detected,including gram-negative bacilli accounting for 42.5 % (48/113),Gram-positive cocci for 30.1% (34/113),fungi for 24.8% (28/113),the virus for 2.7% (3/113).Based on clinically and confirmatively diagnosis,the invasive fungal diseases mostly as Candida accounted for 30.4 % (24/79),mixed infections accounted for 34.3% (24/70).Univariate analysis showed agranulocytosis and AML were risk factors for infection.Logistic multivariate regression analysis showed that agranulocytosis was a risk factor for infection (OR=12.010,95%CI:2.346-107.973,P=0.000).The infection does not affect a complete remission rate of acute leukemia (x2 =0.001,P=0.983).Conclusions For newly diagnosed elderly acute leukemia patients,an emerging infection during the first induction chemotherapy is characterized by a high incidence,high fungal infection rate,most common site in lung,Gram-negative bacteria as most common pathogen,and an increased infection rate by agranulocytosis.The infection does not affect the remission rate of acute leukemia.

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Article in Chinese | WPRIM | ID: wpr-663664

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Objective To analyze the infection features,risk factors,and the relationship with the efficacy in patients with acute leukemia during initial induction chemotherapy.Methods The clinical data of 200 patients with newly diagnosed acute leukemia from January 2015 to February 2016 in the Second Hospital of Shanxi Medical University were retrospectively analyzed.Results The infection rate of patients with acute leukemia under induction chemotherapy was 84.0% (168/200).Among 168 patients with infection,159 cases (94.6%) had known infection sites,the top three infection sites were the lungs,gastrointestinal tract and the oral cavity.Total 213 strains of pathogens were identified,Gram-negative bacilli accounted for 39.0% (n =83),Gram-positive cocci for 34.3% (n =73),fungi for 23.5% (n =50) and the virus for 3.3% (n =7).Multivariate regression analysis showed that agranulocytosis was the independent risk factor for acute leukemia patients during induction chemotherapy (OR =14.370,95% CI:2.576-116.518,P < 0.01).The rate of complete remission (CR) and CR with incomplete hematologic recovery (CRi) in infection group was 74.4% (125/168),and the rate of CR + CRi in non-infected group was 87.5% (28/32),and there was no significant difference between the two groups.(χ2 =2.564,P =0.109).Conclusion During the induction therapy for acute leukemia patients,the rate of infection and the rate of fungal infection are high;lung is the most common site,Gram-negative bacteria is more common;agranulocytosis increases the chance of infection;and the infection may not affect the disease remission rate.

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Chinese Journal of Hematology ; (12): 1017-1023, 2017.
Article in Chinese | WPRIM | ID: wpr-809710

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Objective@#To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m2, 10 mg/m2 or 12 mg/m2 as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) .@*Methods@#A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m2) as induction chemotherapy in newly diagnosed patients of adult AML.@*Results@#Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m2 group, IDA 10 mg/m2 group and IDA 12 mg/m2 group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m2 group and IDA 12 mg/m2 group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m2 group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m2 was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m2 when compared with the IDA 8 mg/m2 was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×109/L in IDA 8 mg/m2 group, IDA 10 mg/m2 group and IDA 12 mg/m2 group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×109/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) .@*Conclusions@#For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m2 is clinically superior to IDA 8 mg/m2 and IDA 12 mg/m2 in favorable intermediate AML subgroup. However, idarubicin 12 mg/m2 is more suitable to adverse AML subgroup.

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Article in Chinese | WPRIM | ID: wpr-617874

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Thrombotic thrombocytopenic purpura (TTP) is a kind of thrombotic microangiopathies which has low incidence but highly mortality.The outcome of TTP has been improved significantly since last decade due to the application of plasma exchange,however,early relapse occurs in some patients,and for relapsed/refractory patients the prognosis is still poor.This article reviews the recent progress in treatment and relevant influencing factors of TTP.

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Article in Chinese | WPRIM | ID: wpr-502040

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Objective To analyze the safety and effectiveness of ambulatory surgery in inguinal herniorraphy.Methods The clinical data of 3 852 cases of inguinal hernia repair patients admitted from January 2009 to December 2013 in this single center was analyzed retrospectively.Cases of emergency surgery were excluded.Results All patients had long-term follow-up (12-60 months).1 575 patients underwent day-surgery,mean operation time was (43.84 ± 12.35) min,mean time of ambulation was (1.12 ± 0.91) d,mean time of recovery was (5.78 ± 1.12) d,mean hospitalization was (1.34 ± 0.48) d,mean hospitalization cost was (7 546.49 ±2 962.57) RMB.In contrast,there were 511 patients underwent a non day-surgery,mean operation time was (48.59 ± 14.52) min,mean time of ambulation was (2.43 ± 1.38) d,mean time of recovery was (7.46 ± 2.62) d,mean hospitalization was (4.8 ± 2.91) d,mean hospitalization cost was (9 165.16 ± 4 281.83) RMB.Patients with day-surgery were significantly superior to those with non day-surgery in operation time (P =0.000),mean time of ambulation (P =0.000),mean hospitalization (9 =0.000),mean hospitalization cost (P =0.000) and mean time of recovery (P =0.000).Infection and readmission in non day-surgery patients was higher than that in day-surgery (P =0.000).There was no difference in postoperation pain and hernia recurrence.Conclusions Ambulatory surgery in inguinal herniorraphy is safe with similar recurrence rate;but significantly lower cost and shorter hospitalization.

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Article in Chinese | WPRIM | ID: wpr-496759

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Hemophagocytic syndrome is a group of fatal immune function disorder,which can be divided into primary and secondary HPS.The disease is complex,lacking of specificity,difficult in diagnosis with quick progress,high mortality and poor prognosis.The diagnosis is mainly based on the HPS-2004 diagnostic criteria,etoposide,dexamethasone and cyclosporine would be first chosen for treatment.This article reviews the clinical advances on etiology,diagnosis,treatment and prognosis of hemophagocytic syndrome.

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