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1.
Article in Chinese | WPRIM | ID: wpr-885608

ABSTRACT

Objective:To investigate the reliability of a tool based on the International Classification of Functioning, Disability and Health (ICF) in the assessment of functioning despite disability.Methods:A total of 371 patients were assessed using a tool based on the ICF rehabilitation set combined with a numerical rating scale ranging from 0 to 10. The internal consistency, inter-rater reliability and intra-rater reliability were analyzed.Results:The scale′s Cronbach′s alpha coefficient was 0.89. The inter-rater correlation coefficient was 0.85, and the correlations among the items ranged from 0.78 to 0.94. The intra-rater correlation coefficient with the scale was 0.95, with the item correlations ranging from 0.72 to 0.97. Only item b230 Hearing function did not correlate well.Conclusions:The functioning assessment tool based on the ICF rehabilitation set when combined with a numerical rating scale has internal consistency, inter-rater reliability and intra-rater reliability sufficient for use in clinical practice.

2.
Article in Chinese | WPRIM | ID: wpr-885585

ABSTRACT

Objective:To determine the effect of pelvic floor electrical stimulation combined with conventional treatment on neurogenic bladder dysfunction after spinal cord injury.Methods:The Pubmed/Medline, Embase, Cochrane, CINAHL, China National Knowledge Infrastructure, CQVIP and Wanfang databases were electronically searched for reports published before April 2019 of randomized and controlled trials testing the effect of electrical stimulation of the pelvic floor on neurogenic bladder after spinal cord injury. Meta-analysis of all the reports collected was performed.Results:Seven randomized and controlled trials with 319 patients were identified. Together they showed that compared with conventional treatment, pelvic floor muscle stimulation better increased bladder capacity and reduced the volume of residual urine. Average single urination output was increased, while the frequency of urination decreased along with episodes of urinary incontinence. Average lower urinary tract symptoms scores were also significantly better.Conclusions:Electrical stimulation of the pelvic floor combined with conventional therapy may be more effective than conventional therapy alone in alleviating the symptoms of neurogenic bladder.

3.
Article in Chinese | WPRIM | ID: wpr-885582

ABSTRACT

Objective:To investigate the abnormal results of chromosomal microarray analysis (CMA) in the subsequent pregnancy of women with adverse pregnancy history, and explore the applicability of CMA in women with different genetic etiology.Methods:Out of 5 563 pregnant women who received CMA test in Nanjing Drum Tower Hospital during June 2014 and July 2020, 169 cases that underwent prenatal diagnosis due to isolated adverse pregnancy history were retrospectively collected in this study. All the participants were divided into three groups based on the etiology type of probands, genetic origin and expected CMA outcome: high-risk group ( n=19, including 11 cases with inherited pathogenic copy number variations and eight cases with inherited chromosomal abnormalities), low-risk group ( n=113, including six cases with negative whole exome sequencing and/or CMA findings, 31 cases with confirmed monogenic disease, 47 cases with de novo pathogenic copy number variations and 29 cases with de novo chromosomal abnormalities), and unknown risk group ( n=40, none of the cases underwent genetic testing). Descriptive statistical analysis was used to summarize the abnormal detection of each group. Results:There were 169 mothers with 172 fetuses finally enrolled, including two twins and one woman with two singleton pregnancies. A total of nine cases of abnormal fetuses were detected by CMA, accounting for 5.2% (9/172). Among them, eight were in the high-risk group, which were all caused by parental abnormalities, and one case in the low-risk group was detected with a de novo 22q11.22q11.23 microduplication, which was arr[GRCh37]22q11.22q11.23(22,997,928-25,002,659)×3. No abnormality was detected in the 40 patients of unknown risk group. Conclusions:Clarifying the etiology of isolated adverse pregnancy history is crucial to the rational application of CMA. Monogenic disease, unknown cause or negative finding of CMA in probands may not be an indication for prenatal diagnosis of CMA.

4.
Article in Chinese | WPRIM | ID: wpr-885264

ABSTRACT

Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.

5.
Chinese Journal of Dermatology ; (12): 456-458, 2021.
Article in Chinese | WPRIM | ID: wpr-885239

ABSTRACT

Sunscreen products have been widely used with the increase in public awareness of sun protection. As sunscreens are structurally stable and resistant to degradation, the concern for their biotoxicity and impact on marine environment has been heightened increasingly, and several countries and regions have successively issued bans on relevant sunscreen products. However, these bans have not yet affected the key international rules and regulations related to sunscreen products. The risks of different sunscreens to marine ecosystems and potential risks to human themselves still need to be evaluated through further multidisciplinary researches.

6.
Article in Chinese | WPRIM | ID: wpr-885162

ABSTRACT

Objective:To explore the associations of urinary retinol binding protein (RBP) and β 2-microglobulin (β 2-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods:A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min -1·1.73m -2) and the normal eGFR group (≥90 ml·min -1·1.73m -2). Urine RBP and β 2-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β 2-MG. Results:In all patients ( n=1 030), urine RBP and β 2-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β 2-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% ( P<0.001), and 12.9%, 26.7%, 46.8% ( P<0.001), respectively. In the UACR normal group ( n=788), 12.2% of the patients were with eGFR<90 ml·min -1·1.73m -2. The proportion of abnormal β 2-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β 2-MG as dependent variable, and showed that urine RBP was independently associated with UACR ( β=0.0005, P<0.001), serum creatinine ( β=0.006, P<0.001) and glycosylated hemoglobin A1c ( β=0.050, P=0.001), and β 2-MG was independently correlated with UACR ( β=0.000 4, P<0.001), serum creatinine ( β=0.011, P<0.001), systolic blood pressure ( β=0.005, P=0.031) and fasting blood-glucose ( β=0.027, P=0.046). Conclusions:Urine RBP and β 2-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β 2-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.

7.
Article in Chinese | WPRIM | ID: wpr-885128

ABSTRACT

Objective:To investigate the clinical features and treatment outcome of Kallmann syndrome(KS) caused by fibroblast growth factor receptor-1(FGFR1) gene mutation in 4 patients.Methods:Targeted next-generation sequencing(NGS) was performed on thirty KS and normosmic idiopathic hypogonadotropic hypogonadism(nIHH) patients. FGFR1 mutation was identified in four KS patients. The clinical data, laboratory and imaging examinations, and treatment outcome were retrospectively analyzed.Results:Four male patients, aging from 11 to 22 years old, presented as micropenis, and with olfactory dysfunction. Among them, two had history of cryptorchidism, three had history of cleft lip and palate repair surgery. The most severe patient presented with short stature, left microtia and dental agenesis. FGFR1 heterozygous mutation was identified in all four patients, two were point mutation(p.Y374X; p. E670K), and the other was frameshift mutation(p.S346Yfs*61; p.S723*fs*1). One patient, who started treatment of the pulsatile GnRH pump during his youth, succeeded in having two babies.Conclusion:Patients with Kallmann syndrome caused by FGFR1 mutation presents complex clinical manifestations. Besides dysosmia, micropenis, microrchidia, and delayed pubertal development are the main clinical manifestations in male patients. Symptoms such as cleft lip and palate are helpful for early recognition. Genotyping analysis is crucial to confirm the diagnosis. The pulsatile GnRH pump can produce satisfactory therapeutic effect, but the age of initiating therapy should be carefully considered.

8.
Chinese Journal of Rheumatology ; (12): 241-246, 2021.
Article in Chinese | WPRIM | ID: wpr-884392

ABSTRACT

Objective:To analyze bone strength index, osteoporosis and fracture in ankylosing spondylitis (AS) patients with radiologic hip involvement and explore the characteristics of bone strength in these patients.Methods:According to bath ankylosing spondylitis radiology hip index (BASRI-hip) score, 339 AS patients were divided into two groups. The differences of bone strength in each group were analyzed by t-test, Mann-Whitney U test and χ2 test. Logistic regression was used to analyze the risk factors of bone strength index. The correlation between quantitative ultrasound and dualenergy X-ray absorptiometry (DXA) (total hip, g/cm 2) was analyzed. Pearson correlation analysis was used. Results:①Bone strength index of quantitative ultrasound was positively correlated with bone mineral density of DXA (total hip, g/cm 2), r=0.553, P<0.01. ② The age of 27(23, 37) years old in radiographic hip involvement was lower than 37(28, 48) years old in non-radiographic hip involvement, and the difference was statistically significant ( Z=-5.986, P<0.01). There were no differences in gender and course of disease between the two groups ( P>0.05).③ The radiographic hip involvement in AS patients whose ages were younger than 50, when compared with non-radiographic hip involvement patients, the bone strength index was lower (78±18 vs 84±16), while bone strength was lower than patients at the same age (41.0% vs 18.4%), however, the incidences of osteoporosis (42.7% vs 28.8%) and fragility fracture (3.7% vs 0%) were significantly higher ( t=3.028, P<0.01; χ2=16.758, P<0.01; χ2=5.886, P=0.019; χ2=4.67, P=0.038). For AS patients whose ages were ≥50, there were no significant differences between the two groups ( P>0.05). ④ Multivariate analysis showed that radiographic hip involvement [ OR (95% CI)=1.912(1.05, 3.48)], age [ OR (95% CI)=0.94(0.911, 0.97)] and body mass index (BMI) (kg/m 2) [ OR (95% CI) =0.875(0.807, 0.948)] were associated with lower bone strength. Conclusion:There is positive correlation between the bone strength index of quantitative ultrasound and bone mineral density of DXA. AS patients with radiographic hip involvement are characterized by decreased bone strength and are more likely to develop osteoporosis and fragile fractures. The risk factors of low bone strength are radiographic hip involvement, age and BMI.

9.
Article in Chinese | WPRIM | ID: wpr-883573

ABSTRACT

Objective:To explore the application value of problem-based learning (PBL) controlled by closed-loop feedback in the teaching of respiratory medicine.Methods:In PBL teaching, after students' open inquiry, discussion and PBL self-study, closed-loop feedback was given by organizing PPT report, written summary and mechanism diagram display of medical students. The participation of teachers and students, teaching quality, the degree of students' identification of key knowledge points, the breadth and depth of mastering the characteristics of key symptoms and the satisfaction of PBL teaching work were investigated, and the differences were compared before and after the closed-loop feedback. GraphPad Prism 5.01 was used in the analysis.Results:It was found that closed-loop feedback could improve the self-evaluation of tutor's teaching participation [(7.97±0.91) vs. (8.77±0.64), P < 0.001] and students' evaluation on teaching participation of tutor [(8.09±0.79) vs. (8.74±0.45), P < 0.001]. At the same time, students' evaluation on the teaching quality of tutors was also improved [(88.61±6.53) vs. (92.59±5.44), P < 0.001]. After closed-loop feedback, the students' identification of the required knowledge points in the syllabus was significantly increased [(84.00±21.75) vs. (90.22±16.18), P = 0.017]. The overall satisfaction with PBL teaching was also improved obviously [(8.93±0.67) vs. (9.37±0.64), P < 0.001]. Conclusion:Practice has proved that the closed-loop controlled PBL teaching approach has a good effect on the teaching of respiratory medicine, and it's worth popularizing in clinical teaching.

10.
Article in Chinese | WPRIM | ID: wpr-883555

ABSTRACT

Objective:To explore the present situation of medical students' professionalism cognition and provide reference for medical personnel training and medical education.Methods:A cross-sectional survey was conducted on medical students among 2 affiliated hospitals of a medical university in H province by cluster sampling. Exploratory factor analysis and reliability and validity test were carried out and a descriptive analysis of the present situation of professionalism was conducted by SPSS 20.0. Amos21.0 software was used for a confirmatory factor analysis on the samples.Results:The measurement scale had good reliability and validity, and the Cronbach alpha coefficient of the scale was 0.901. The average professionalism score of the medical students was about 80 points. The score of "physical and mental status and self-development ability" was the highest (83.65 points), and the lowest score was "academic ability" (72.21 points). There was a little difference in the professionalism cognition between the two hospitals, with significant differences between the dimension "respect and care" and "responsibility".Conclusion:This study has initially formed a medical professionalism measurement scale with good reliability and validity. The professionalism of medical students in the 2 affiliated hospitals of a medical school in Province H is in good condition as a whole. In the future, medical education should pay more attention to the combination of basic professional knowledge and clinical practice of medical students, and change the training model of medical students in order to improve the academic ability of medical students and medical students' overall cognition of professionalism.

11.
Article in Chinese | WPRIM | ID: wpr-882884

ABSTRACT

A case with the diagnosis of the onset of inflammatory bowel disease (IBD) with chronic granulo-matous disease (CGD) in Children′s Hospital Affiliated to Zhengzhou University in June 2016 was chosen, and the patient′s clinical data and whole treatment process were analyzed.According to the relevant literature from Chinese and foreign databases, the clinical characteristics were analyzed and summarized, principles of diagnosis and treatment for children who had the onset of IBD with CGD.This patient was a child of 1 year and 9 months old, and the initial symptoms included repeated diarrhea and bloody stools.He was diagnosed as " ulcerative colitis" in the local hospital.After admission, the neutrophil respiratory burst test was positive.The genetic analysis result suggested that the CYBB gene was mutated, thus obtaining the diagnosis of CGD.Then, he was given prophylactic antibiotic therapy and symptomatic treatment.After the 3 months of follow-up after discharge, the patient still had intermittent diarrhea and bloody stools.CGD is a rare primary immunodeficiency disease, and current treatment methods of CGD include hematopoietic stem cell transplantation and anti-infection treatment.When IBD patients have complications other than gastrointestinal symptoms, the IBD treatment is not effective, or there are suspected parents who are married to close relatives, or with the family history of IBD, CGD should be considered.

12.
Article in Chinese | WPRIM | ID: wpr-882566

ABSTRACT

Objective:To explore the molecular mechanism of Polygoni Cuspidati Rhizoma in the treatment of rheumatoid arthritis (RA). Methods:TCMSP database was uesed to screen the active ingredients of Polygoni Cuspidati Rhizoma and predict related targets. The therapeutic targets for RA were predicted by GeneCards database. By collecting the intersection of the rapeutic targets of Polygoni Cuspidati Rhizoma and RA, the therapeutic targets of Polygoni Cuspidati Rhizoma for the treatment of RA were obtained. Then Cytoscape 3.7.2 was used to construct a "drug-active ingredient-target-disease" network diagram. The therapeutic targets of Polygoni Cuspidati Rhizoma for treating RA were imported into the STRING database for protein-protein interaction analysis. The core targets of Polygoni Cuspidati Rhizoma for the treatment of RA were screened out by R language. And the DAVID online database and R language were used to perform GO molecular function enrichment analysis and KEGG pathway enrichment analysis. At last, Autodock Vina software was used for molecular docking of active ingredients and the top five targets. Results:The active ingredients of Polygoni Cuspidati Rhizoma were screened and corresponding to 203 targets. 4 424 target genes related to RA were retrieved in GeneCards database, and 139 targets of Polygoni Cuspidati Rhizoma intervening RA were obtained after intersection. Protein interaction analysis suggested that AKT1, TP53, JUN, MAPK1, RELA were the core targets. GO enrichment analysis on common targets obtained 35 molecular functions including ATP binding, zinc ion binding, and transcription factor activity, etc. KEGG enrichment analysis obtained a total of 117 signaling pathways related to Polygoni Cuspidati Rhizoma for RA, including the PI3K-Akt signaling pathway, the TNF signaling pathway, and pathways related to in cancer. Molecular docking showed that the active ingredients were better docked with AKT1, TP53, JUN, MAPK1 and RELA, and physciondiglucoside had a good binding ability with JUN. Conclusion:Based on network pharmacology and molecular docking, the mechanism of Polygoni Cuspidati Rhizoma in the treatment of RA is discussed, which provides a reference for pharmacological experiment and drug developmen of new herbal medicine.

13.
Journal of Leukemia & Lymphoma ; (12): 171-174, 2021.
Article in Chinese | WPRIM | ID: wpr-882259

ABSTRACT

Objective:To investigate the clinical characteristics of children with high-risk acute lymphoblastic leukemia (ALL) receiving lasting remission after severe infection.Methods:The data of 3 children with high-risk ALL who were treated in Children's Hospital Affiliated of Zhengzhou University in 2014, 2015 and 2017 were analyzed retrospectively. The clinical and laboratory characteristics of all patients were also analyzed, and the relevant literatures were reviewed.Results:All 3 children were clinically classified as high-risk ALL with severe infection. A variety of anti-infective drugs and blood products were used in the treatment, and all achieved lasting remission.Conclusions:Children with high-risk ALL after severe infection can acquire lasting remission, which may be related with the production of infection stimulating inflammatory factors and cytokines to activate certain immune pathways, or various kinds of antibiotics, blood products participating in the immune regulation to make the body regain the immune surveillance function of the tumor cells.

14.
International Eye Science ; (12): 1482-1485, 2021.
Article in Chinese | WPRIM | ID: wpr-882118

ABSTRACT

@#AIM:To analyze the treatment of orbital Trapdoor fracture in children and the application of absorbable plate in surgery, so as to accumulate experience for clinical diagnosis and treatment.<p>METHODS: Retrospective analysis of 55 cases(55 eyes)orbital Trapdoor fractures in children. The fracture site was simple orbital floor fracture. All patients were approached by palpebral conjunctiva of lower eyelid. During operations, the embedded extraocular muscles and orbital tissues were returned. A resorbable implant was implanted into the orbit after trimming to proper sizes and shaped according to the fracture defect range. The therapeutic effect was evaluated by preoperative and postoperative ocular examination and orbital CT scan. Repeated measure analysis of variance was used to compare the differences of postoperative outcome evaluation indexes among patients with different operation timing.<p>RESULTS: No serious complications happened during and after surgeries in all patients. The postoperative CT scan showed that the fractures had good anatomical restoration. After the operation, diplopia and limitation of extraocular muscle movement(EOM)recovered obviously. The earlier the operation performed after the injury, the better the postoperative recovery effect was. At the same time, the resorbable implant could repair orbital Trapdoor fracture in children well. It serves as a better material of orbital fracture repairment.<p>CONCLUSION: Operation is an effective method to treat orbital Trapdoor fracture in children, and should be performed as soon as possible after injury. The resorbable implant is a good orbital repair material.

15.
Acta Pharmaceutica Sinica B ; (6): 1329-1340, 2021.
Article in English | WPRIM | ID: wpr-881202

ABSTRACT

5-Aminolevulinic acid (5-ALA) has been approved for clinical photodynamic therapy (PDT) due to its negligible photosensitive toxicity. However, the curative effect of 5-ALA is restricted by intracellular biotransformation inactivation of 5-ALA and potential DNA repair of tumor cells. Inspired by the crucial function of iron ions in 5-ALA transformation and DNA repair, a liposomal nanomedicine (MFLs@5-ALA/DFO) with intracellular iron ion regulation property was developed for boosting the PDT of 5-ALA, which was prepared by co-encapsulating 5-ALA and DFO (deferoxamine, a special iron chelator) into the membrane fusion liposomes (MFLs). MFLs@5-ALA/DFO showed an improved pharmaceutical behavior and rapidly fused with tumor cell membrane for 5-ALA and DFO co-delivery. MFLs@5-ALA/DFO could efficiently reduce iron ion, thus blocking the biotransformation of photosensitive protoporphyrin IX (PpIX) to heme, realizing significant accumulation of photosensitivity. Meanwhile, the activity of DNA repair enzyme was also inhibited with the reduction of iron ion, resulting in the aggravated DNA damage in tumor cells. Our findings showed MFLs@5-ALA/DFO had potential to be applied for enhanced PDT of 5-ALA.

16.
Article in English | WPRIM | ID: wpr-881073

ABSTRACT

Qing-Fei-Pai-Du decoction (QFPDD) is a Chinese medicine compound formula recommended for combating corona virus disease 2019 (COVID-19) by National Health Commission of the People's Republic of China. The latest clinical study showed that early treatment with QFPDD was associated with favorable outcomes for patient recovery, viral shedding, hospital stay, and course of the disease. However, the effective constituents of QFPDD remain unclear. In this study, an UHPLC-Q-Orbitrap HRMS based method was developed to identify the chemical constituents in QFPDD and the absorbed prototypes as well as the metabolites in mice serum and tissues following oral administration of QFPDD. A total of 405 chemicals, including 40 kinds of alkaloids, 162 kinds of flavonoids, 44 kinds of organic acids, 71 kinds of triterpene saponins and 88 kinds of other compounds in the water extract of QFPDD were tentatively identified via comparison with the retention times and MS/MS spectra of the standards or refereed by literature. With the help of the standards and in vitro metabolites, 195 chemical components (including 104 prototypes and 91 metabolites) were identified in mice serum after oral administration of QFPDD. In addition, 165, 177, 112, 120, 44, 53 constituents were identified in the lung, liver, heart, kidney, brain, and spleen of QFPDD-treated mice, respectively. These findings provided key information and guidance for further investigation on the pharmacologically active substances and clinical applications of QFPDD.


Subject(s)
Administration, Oral , Alkaloids/analysis , Animals , COVID-19 , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/pharmacokinetics , Flavonoids/analysis , Mice , SARS-CoV-2 , Saponins/analysis , Triterpenes/analysis
17.
Article in English | WPRIM | ID: wpr-881049

ABSTRACT

Two new triterpenoid saponins, ardisicrenoside R and S (1 and 2), and one new phenylpropanoid glycoside, ardicrephenin (3), along with five known compounds (4-8), were isolated from roots of Ardisia crenata. Their structures were elucidated on the basis of NMR spectroscopic data and chemical methods. Compounds 2-7 were evaluated for their cytotoxic activities against A549, MCF-7, HepG2 and MDA-MB-231 cell lines by MTT assay. Ardicrenin (6) showed significant cytotoxicity, with IC

18.
Article in Chinese | WPRIM | ID: wpr-880446

ABSTRACT

For medical devices, there might have clinical differences in medical device efficacy and safety among different racial and ethnic subgroups. The acceptability of various data generated during the design and development stage of medical devices between different regions and national regulatory agencies faces huge challenges. This study discusses the considerations of racial and ethnic factors in the design and development of medical devices, with a view to improve the quality and availability of safety and effectiveness data under one framework.


Subject(s)
Ethnic Groups , Humans , United States
19.
Article in Chinese | WPRIM | ID: wpr-880135

ABSTRACT

OBJECTIVE@#To observe the clinical efficacy of allogeneic peripheral blood stem cell transplantation(allo-HSCT) on the treatment of adult acute leukemia patients, moreover, to establish and evaluate a Logistic model to predict the risk of relapse in adult acute leukemia patients after allo-HSCT.@*METHODS@#The clinical data of 145 adult acute leukemia patients treated by peripheral blood stem cell transplantation in the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2019 was enrolled and analyzed retrospectively. Complications and survival of patients were observed. The relationship between patients' age, diagnosis, leukocyte count at onset, risk stratification, time of diagnosis to transplantation, HCT-CI, minimal residual disease pre-transplantation, donor-recipient sex relationship, HLA match degree, prophylaxis of graft versus host disease(GVHD), donor age, number of transfused mononuclear cells, CD34 positive cells, engraftment time, acute and chronic GVHD, CMV, EBV infection, and hemorrhagic cystitis and recurrence after transplantation were analyzed by logistic regression. Relapse prediction model was established and evaluated according to the results.@*RESULTS@#Among 145 acute leukemia patients, 81 with acute myeloid leukemia, 64 with acute lymphocytic leukemia, 18 with EBV infection, 2 with post-transplant lymphoproliferative disorder(PTLD), 85 with CMV, 26 with hemorrhagic cystitis, 65 patients developed acute GVHD, 51 patients developed chronic GVHD and 45 patients relapsed. The overall survival (OS) rates in one and three years were 86.4% and 61.8%, and the progress-free survival (PFS) rates in one and three years were 67.5% and 62.4%, respectively. There were significant differences in OS and PFS between relapsed and non-relapsed patients, as well as AML and ALL patients. Univariate analysis revealed that patient's age, risk stratification, time to transplantation, HCT-CI index, ATG based GVHD prophylaxis, minimal residual disease pre-transplantation, GVHD prophylaxis, and acute and chronic GVHD were associated with the relapse of disease, multivariate logistic regression analysis showed that pre-transplantation minimal residual disease showed positively correlation with relapse of the disease, while chronic GVHD showed negatively correlation.@*CONCLUSION@#The relapse rate of adult acute leukemia patients treated with allo-HSCT in our hospital is 31.0%, and OS of AML patients is better than ALL patients'. OS of relapsed patients is significantly lower than non-relapsed patients'. Pre-transplantation minimal residual disease is a risk factor of relapse. The risk of relapse is reduced in patients with chronic GVHD.


Subject(s)
Adult , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute/therapy , Peripheral Blood Stem Cell Transplantation , Recurrence , Retrospective Studies , Transplantation Conditioning
20.
Article in Chinese | WPRIM | ID: wpr-880115

ABSTRACT

OBJECTIVE@#To investigate the factors affecting the chronicity of childhood primary immune thrombo-cytopenia (ITP) and compare the efficiency of different first-line treatment regimens.@*METHODS@#Children with ITP hospitalized in our hospital from September 2013 to October 2018 were retrospectively analyzed.@*RESULTS@#Three hundred and one children (150 males and 151 females) were included in this study, with a median age of 8 (0.17-17) years old, and 110 (36.5%), 92 (30.6%), and 99 (32.9%) cases were grouped into newly diagnosed, persistent, and chronic ITP, respectively. The median of follow-up was 41.92 (1.07-74.03) months. At the end of the follow-up (October 2019), among the 202 newly diagnosed/persistent ITP children, 79 cases (59 newly diagnosed and 20 persistent ITP) achieved remission within 1 year after initial diagnosis, with a remission rate of 39.3%; 122 cases (50 newly diagnosed and 72 persistent ITP) developed chronic disease, with a chronicity rate of 60.7%; one case underwent splenectomy. In 99 cases with chronic ITP, 5 cases underwent splenectomy. Multivariable logistic regression analysis showed that, the insidious onset of symptoms (OR=3.754, 95%CI: 1.882-7.488, P=0.000) increased the risk of chronicity, while the positive antibody to anti-platelet membrane glycoprotein (OR=0.446, 95%CI: 0.224-0.888, P=0.021) might reduce the risk of chronicity. And no difference was found by the analysis of subtype of anti-platelet membrane glycoprotein (P=0.305). The efficacy of the first-line treatment of intravenous immunoglobulin (IVIG) alone or combined with steroid was better than that of steroid alone (P=0.028, 0.028), however, the efficiency was not significantly different between IVIG alone and combined with steroid (P=0.086).@*CONCLUSION@#Insidious onset of symptoms in pediatric ITP increases the risk of chronicity, while the positive titer of anti-platelet membrane glycoprotein may reduce the risk. In the first-line treatment for the newly diagnosed/persistent children. The efficacy of IVIG alone or combined with steroid is better than that of steroid alone.


Subject(s)
Adolescent , Child , Child, Hospitalized , Female , Humans , Immunoglobulins, Intravenous , Male , Purpura, Thrombocytopenic, Idiopathic , Retrospective Studies , Splenectomy
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