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1.
Article in English | WPRIM | ID: wpr-878316

ABSTRACT

Objective@#The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.@*Methods@#The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.@*Results@#A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).@*Conclusion@#An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.


Subject(s)
Aged , Asian Continental Ancestry Group , Blood Glucose/analysis , China/epidemiology , Cohort Studies , Diabetes Mellitus/blood , Female , Glucose Tolerance Test , Glycated Hemoglobin A/analysis , Glycemic Index , Humans , Male , Middle Aged , Uric Acid/blood
2.
Chinese Medical Journal ; (24): 1199-1208, 2021.
Article in English | WPRIM | ID: wpr-878101

ABSTRACT

BACKGROUND@#For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT.@*METHODS@#A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables.@*RESULTS@#All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P  < 0.001, P = 0.004, and P  < 0.001, respectively) and worse LFS (P  < 0.001, P = 0.017, and P  < 0.001, respectively), and OS (P  < 0.001, P = 0.009, and P  < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P  < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score.@*CONCLUSION@#This new risk score system might stratify patients with different risks of relapse, which could guide treatment.


Subject(s)
B-Lymphocytes , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Recurrence , Retrospective Studies , Risk Factors , Stem Cell Transplantation
3.
Article in Chinese | WPRIM | ID: wpr-873335

ABSTRACT

Objective::To study the mechanisms of action of four volatile oil components (safrole, myristicin, methyleugenol and asarone) and the reactive metabolites of safrole and myristicin with CYP1A2. Method::The inhibitory effects of the volatile oil components of Asari Radix et Rhizoma on the human liver microsomal enzymes CYP1A2, CYP2D6, CYP2E1, CYP3A4 and CYP2C19 were screened by the " Cocktail" probe substrate method. The ability of the volatile oil components and intermediates in binding to CYP1A2 enzyme was studied by means of semi-flexible molecular docking. Result::The screening results showed that the components had a strong inhibitory effect on CYP1A2.Molecular docking scores were 3.048 7 kcal·mol-1 (safrole), 6.016 4 kcal·mol-1 (myristicin), 16.969 2 kcal·mol-1 (methyleugenol), 16.013 8 kcal·mol-1 (asarone), 23.923 3 kcal·mol-1 (safrole reactive metabolites) and 25.594 3 kcal·mol-1 (myristicin reactive metabolites). Conclusion::Molecular docking results indicate that safrole metabolic intermediate and myristicin metabolic intermediate have the strongest ability in binding to CYP1A2 enzyme. This study further confirms that safrole and myristicin are the mechanism-based inhibitors of CYP1A2 enzyme, which is consistent with the results of previous IC50-shift and glutathione capture experiments.

4.
Article in English | WPRIM | ID: wpr-829022

ABSTRACT

Objective@#Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease (NAFLD). Peripheral artery disease (PAD) and liver fibrosis share many common metabolic dysfunctions. We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients.@*Methods@#The study recruited 1,610 NAFLD patients aged ≥ 40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015. Fibrosis deterioration was defined as the NAFLD fibrosis score (NFS) status increased to a higher category at the follow-up visit. PAD was defined as an ankle-brachial index of 1.40.@*Results@#During an average of 4.3 years' follow-up, 618 patients progressed to a higher NFS category. PAD was associated with 92% increased risk of fibrosis deterioration [multivariable-adjusted odds ratio ( ): 1.92, 95% confidence interval ( ): 1.24, 2.98]. When stratified by baseline NFS status, the for progression from low to intermediate or high NFS was 1.74 (95% : 1.02, 3.00), and progression from intermediate to high NFS was 2.24 (95% : 1.05, 4.80). There was a significant interaction between PAD and insulin resistance (IR) on fibrosis deterioration ( for interaction = 0.03). As compared with non-PAD and non-IR, the coexistence of PAD and IR was associated with a 3.85-fold (95% : 2.06, 7.18) increased risk of fibrosis deterioration.@*Conclusion@#PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients, especially in those with IR. The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.


Subject(s)
Adult , Aged , Aged, 80 and over , Ankle Brachial Index , China , Epidemiology , Female , Humans , Liver Cirrhosis , Epidemiology , Male , Middle Aged , Non-alcoholic Fatty Liver Disease , Epidemiology , Peripheral Arterial Disease , Prevalence , Prospective Studies , Risk Factors
5.
Article in English | WPRIM | ID: wpr-773432

ABSTRACT

OBJECTIVE@#The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease (CVD) risk in Chinese adults.@*METHODS@#We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography (CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score (FRS) and the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score.@*RESULTS@#Among the 549 participants, 267 (48.6%) had no coronary plaques, 201 (36.6%) had noncalcified coronary plaques, and 81 (14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio (OR) 2.41; 95% confidence interval (CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score (OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment.@*CONCLUSION@#Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.


Subject(s)
Asian Continental Ancestry Group , Cardiovascular Diseases , Epidemiology , Computed Tomography Angiography , Female , Humans , Male , Middle Aged , Odds Ratio , Plaque, Atherosclerotic , Diagnostic Imaging , Epidemiology , Risk Factors
6.
Article in English | WPRIM | ID: wpr-773397

ABSTRACT

OBJECTIVE@#Ideal cardiovascular health (CVH) could predict a lower risk of developing cardiovascular diseases. This study was conducted to investigate the association between ideal CVH and subclinical atherosclerosis in a population cohort of Chinese adults aged ⪖ 40 years.@*METHODS@#This study was designed as a cross-sectional analysis of 8,395 participants who had complete data at baseline and a prospective analysis of 4,879 participants who had complete data at 4.3 years of follow-up. Ideal CVH metrics were defined according to the American Heart Association. Subclinical atherosclerosis was evaluated by plaques in carotid arteries, carotid intima-media thickness (CIMT), brachial-ankle pulse wave velocity (baPWV), and urinary albumin-to-creatinine ratio (UACR).@*RESULTS@#Both the prevalence and incidence of atherosclerosis measures were found to be decreased with increasing numbers of ideal CVH metrics at baseline (all P values for trend < 0.01). The levels of CIMT and UACR at follow-up showed an inverse and significant association with the numbers of ideal CVH metrics at baseline (both P values for trend < 0.05) but a borderline significant association with baPWV (P for trend = 0.0505). Taking participants with 0-1 ideal metric as reference, we found that participants with 5-6 ideal metrics had significantly lower risks of developing carotid plaques (odds ratio, OR = 0.46; 95% confidence interval, CI 0.27-0.79), increased CIMT (OR = 0.60; 95% CI 0.42-0.84), and increased baPWV (OR = 0.57; 95% CI 0.34-0.97) after full adjustments. A significant interactive effect of age and CVH was detected on CIMT and baPWV progression (both P values for interaction < 0.05).@*CONCLUSION@#The numbers of ideal CVH metrics showed a significant and inverse association with the risk of developing subclinical atherosclerosis in middle-aged and elderly Chinese adults, whereas its dose-response effect was attenuated in individuals aged ≥ 60 years and partially weakened in male participants.


Subject(s)
Aged , Atherosclerosis , Epidemiology , China , Epidemiology , Cross-Sectional Studies , Female , Health Status , Humans , Male , Middle Aged , Prospective Studies
7.
Article in English | WPRIM | ID: wpr-773380

ABSTRACT

OBJECTIVE@#The association between lipoprotein (a) [Lp(a)] levels and metabolic syndrome (MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort.@*METHODS@#A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS.@*RESULTS@#In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS (30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio (OR) for prevalent MetS [multivariate-adjusted OR 0.45 (95% confidence interval 0.39-0.51); P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups.@*CONCLUSION@#Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.


Subject(s)
Aged , Asian Continental Ancestry Group , China , Epidemiology , Cross-Sectional Studies , Female , Humans , Lipoprotein(a) , Blood , Male , Metabolic Syndrome , Blood , Epidemiology , Middle Aged
8.
Article in Chinese | WPRIM | ID: wpr-843418

ABSTRACT

Objective • To investigate the effect of different vitreous fillers on the macular blood flow of patients with rhegmatogenous retinal detachment (RRD), and the correlation between the macular blood flow and the best corrected visual acuity (BCVA). Methods • In this retrospective study, 74 eyes in 74 patients with RRD for first time underwent pars plana vitrectomy in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from Dec. 2017 to Jun. 2018 were included. According to different vitreous fillers, the patients were divided into two group, i.e. pars plana vitrectomy with gas tamponade group (gas group) and pars plana vitrectomy with silicone oil tamponade group (silicone oil group). The blood flow in 3 mm×3 mm macular area was detected by optical coherence tomography angiography (OCTA). The blood flow densities of superficial capillary plexus (SCP) and deep capillary plexus (DCP) at foveal and parafoveal area, and the areas and perimeters of foveal avascular zone (FAZ) were calculated. The correlations between the macular blood flow parameters and BCVA were analyzed by partial correlation. Results • Compared with the silicone oil group, the blood flow densities of SCP and DCP in the whole 3 mm×3 mm regions in the gas group were higher at 6 months after surgery (both P=0.000). The partial correlation showed that the improvement of visual acuity was negatively correlated with the change of FAZ area (r=-0.216, P=0.015). Conclusion • Gas is an advantageous tamponade for the patients with RRD in improvement of blood flow density in the macular area. Meanwhile, assessing the macular blood flow density of the patients with retinal detachment by using OCTA after vitrectomy is significant to monitor the changes of structure and function of retina.

9.
Chinese Medical Journal ; (24): 2808-2816, 2018.
Article in English | WPRIM | ID: wpr-772917

ABSTRACT

Background@#Several studies have shown that detection of minimal residual disease (MRD) in acute myeloid leukemia (AML) is an independent prognostic factor. This study aimed to evaluate the significance of dynamic MRD pretransplantation on outcome of AML patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*Methods@#We retrospectively analyzed 145 consecutive AML patients undergoing allo-HSCT in complete remission status between June 2013 and June 2016. MRD was determined with multiparameter flow cytometry after the first and second courses of chemotherapy and pre-HSCT.@*Results@#In matched sibling donor transplantation (MSDT) settings, patients with positive MRD had higher cumulative incidence of relapse (CIR) than those without MRD after the first (32.3 ± 9.7% vs. 7.7 ± 3.1%, χ = 3.661, P = 0.055) or second course of chemotherapy (57.1 ± 3.6% vs. 12.5 ± 2.7%, χ = 8.759, P = 0.003) or pre-HSCT (50.0 ± 9.7% vs. 23.0 ± 3.2%, χ = 5.547, P = 0.019). In haploidentical SCT (haplo-SCT) settings, the MRD status at those timepoints had no significant impact on clinical outcomes. However, patients with persistent positive MRD from chemotherapy to pre-HSCT had higher CIR than those without persistent positive MRD both in MSDT and haplo-SCT settings. Patients with persistent positive MRD underwent MSDT had the highest relapse incidence, followed by those with persistent positive MRD underwent haplo-SCT, those without persistent MRD underwent haplo-SCT, and those without persistent MRD underwent MSDT (66.7 ± 9.2% vs. 38.5 ± 6.0% vs. 18.8 ± 8.7% vs. 12.0 ± 1.0%, χ = 20.763, P < 0.001). Multivariate analysis showed that persistent positive MRD before transplantation was associated with higher CIR (hazard ratio [HR] = 1.69, 95% confidence interval [CI]: 1.200-2.382, P = 0.003), worse leukemia-free survival (HR = 1.812, 95% CI: 1.168-2.812, P = 0.008), and overall survival (HR = 2.354, 95% CI: 1.528-3.627, P < 0.001).@*Conclusion@#Our results suggest that persistent positive MRD before transplantation, rather than positive MRD at single timepoint, could predict poor outcome both in MSDT and haplo-SCT settings.


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Flow Cytometry , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute , Pathology , Therapeutics , Male , Middle Aged , Neoplasm, Residual , Diagnosis , Prognosis , Retrospective Studies , Transplantation, Homologous , Young Adult
10.
Article in English | WPRIM | ID: wpr-776074

ABSTRACT

OBJECTIVE@#To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.@*METHODS@#We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases (ASCVD) among 8,252 participants aged ⪖ 40 years without diabetes from Jiading district, Shanghai, China.@*RESULTS@#Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid (all P trend < 0.05). Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia (all P trend < 0.05). A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios (ORs) [95% confidence intervals (CIs)] for the highest quartiles for high Framingham risk were 3.00 (2.00-4.50) in men and 2.95 (1.08-8.43) in women. The multivariate adjusted ORs (95% CIs) for the highest quartile for high ASCVD risk were 1.93 (1.17-3.17) in men and 4.53 (2.57-7.98) in women.@*CONCLUSION@#Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dyslipidemia, 10-year Framingham risk for coronary heart disease, and 10-year risk for ASCVD among Chinese adults without diabetes.


Subject(s)
Biomarkers , Blood , Blood Glucose , Blood Pressure , Body Mass Index , China , Coronary Disease , Blood , Epidemiology , Cross-Sectional Studies , Female , Glycated Hemoglobin A , Humans , Lipids , Blood , Male , Middle Aged , Predictive Value of Tests , Prevalence , Risk Factors , Sex Factors , Uric Acid , Blood
11.
Article in Chinese | WPRIM | ID: wpr-665326

ABSTRACT

Objective To explore the correlation of disease activity with the primary syndromes of deficiency and excess types of lupus nephritis(LN). Methods A retrospective study was carried out in 134 LN patients,and the LN patients were differentiated into deficiency syndrome(deficiency group)and excess syndrome(excess group). The disease activity related indicators of systemic lupus erythematosus disease activity index(SLEDAI)scores, complements, inflammation indexes, and urine indicators were compared between the two groups. Results Of the 134 LN patients,33 cases were differentiated into excess syndrome,and 101 cases were differentiated into deficiency syndrome. According to the SLEDAI scores, 9.09% of the patients in excess group were inactive, 4.95% of the patients in deficiency group were inactive, and most of the patients in the two groups were at severe active stage. There was no significant difference of SLEDAI scores between the two groups(P>0.05) . The differences of complement C3 and C4 , inflammation indexes of C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),urine protein,and urine occult blood were also insignificant between the two groups (P>0.05). Conclusion There is no correlation between deficiency-excess syndrome differentiation and disease activity of LN. Most of the LN patients with deficiency syndrome are at active stage,but not at remission stage.

12.
Article in Chinese | WPRIM | ID: wpr-699630

ABSTRACT

Rhegmatogenous retinal detachment is a common fundus disease,which severely affects the visual flmction of the patients.In the treatment of rhegmatogenous retinal detachment,a high level of anatomical success is achieved with the development of modern surgical techniques.In contrast to anatomical successful rate,visual function outcome is not satisfactory.The effective factors for the recovery of visual function following rhegmatogenous retinal detachment repair are reviewed in this article to assess prognosis before operation,avoid damage in the operation and preserve visual function after operation.

13.
International Eye Science ; (12): 1359-1361, 2017.
Article in Chinese | WPRIM | ID: wpr-641126

ABSTRACT

AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.METHODS: Retrospective self-controlled study was designed.A total of 15 patients (20 eyes) with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People`s Hospital from January 2015 to June 2016.The changes of central macular thickness (CMT) and best corrected visual acuity (BCVA) were observed at baseline and 2, 4, 8wk after treatment.We also focused on the incidence of complications and relapse.RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively.The differences among them were statistically significant (F=15.467, P<0.05).The BCVA (log MAR) were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them (F=5.208, P<0.05).When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications;and when it came to 2800mg, 5 patients (33%) had methazolamide-related complication.After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients (20%), 5 patients (33%) and 8 patients (53%) relapsed, respectively.CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk.When the cumulative dose is more than 1400mg, we need pay attention to the complications.After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo.So the patients should be followed closely in 3mo after withdrawal of methazolamide.

14.
Article in Chinese | WPRIM | ID: wpr-264938

ABSTRACT

The aim of this study was to develop and investigate the significance of a new multi-factor risk score system to predict the outcome of patients with hematological malignancies received allogeneic hematopoietic stem cell transplantation (allo-HSCT). The impact of pre-, peri-, and post-transplant factors on the outcome including overall survival (OS), disease-free survival (DFS), relapse and transplant-related mortality (TRM) after allo-HSCT were retrospectively analyzed in 122 patients with hematological malignancies at our center. A new risk score system based on the independent risk factors was established and tested. The results showed that absolute monocyte count at day 30 after transplantation (AMC-30, ≥ 536 cells/µl) [hazard ratio (HR) = 0.313, 95% confidential interval (CI):0.156-0.63], WT1( ≥ 1.0%) (HR = 3.268, 95% CI:1.644-6.499), pre-transplant risk grouping (HR = 1.999, 95% CI = 0.993-4.023) were independent prognostic factors of OS and DFS. Patients were divided into 3 groups based on the risk scoring system:group A (no risk factor; score 0), group B (1 risk factor; score 1) and group C (2-3 risk factors; score 2-3). OS at 5 years were 95.1% ± 3.4%, 62.9% ± 6.6% and 36.1% ± 9.6%, respectively (P < 0.0001). DFS at 5 years were 92.6% ± 4.9%, 60.4% ± 6.8% and 15.4% ± 7.1%, respectively (P < 0.0001). The akaike information criterion(AIC) value of the new score system for OS was 331, less than those of AMC-30, WT1, and pre-transplant risk group (346, 343, 346), AIC value for DFS and relapse were 378 and 231, both less than the three single elements(417, 397, 411 and 268, 238, 257). It is concluded that the risk scoring system based on AMC-30, WT1, pre-transplant risk grouping is more highly predictive for clinical outcomes of allo-HSCT than any one of the three single elements.


Subject(s)
Adolescent , Adult , Child , Female , Hematologic Neoplasms , Therapeutics , Hematopoietic Stem Cell Transplantation , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Transplantation, Homologous , Treatment Outcome , Young Adult
15.
Article in Chinese | WPRIM | ID: wpr-271224

ABSTRACT

<p><b>OBJECTIVE</b>To comparatively study the difference of the skin expansion rate and instantly expanded skin retraction rate between implantation of double overlapping expanders and implantation of one single expander.</p><p><b>METHODS</b>From Mar. 2009 to Mar. 2012, 22 cases with 39 sites for skin expansion, received double overlapping expanders in 24 sites, single expander in 15 sites. The area of original skin and expanded skin was measured by "wet-cloth sampling". Then the skin expansion rate was calculated. A distance of 5 cm at the center of expanded skin was re-measured after taking out the expanders. Then the instantly skin retraction rate was calculated.</p><p><b>RESULTS</b>During the same expansion period, the skin expansion rate was (3.5 +/- 0.9)% with the double overlapping expanders and (2.6 +/-0.6)% with one single expander, showing a significant difference between the two groups (P = 0. 002), while the instantly skin retraction rate was not statistically different [(30.3 +/- 0.8)% vs (32.3 +/- 0.9)%; P = 0.47)]. There was a negative relationship between the instantly skin retraction rate and the expansion period (r = -0.768).</p><p><b>CONCLUSIONS</b>The skin expansion rate can be increased with double overlapping expanders, while the instantly skin retraction rate doesn' t decrease. So the skin expansion efficiency is increased to reduce the re-expansion times for the patients with large lesions.</p>


Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Reconstructive Surgical Procedures , Methods , Tissue Expansion , Methods , Tissue Expansion Devices , Young Adult
16.
Chinese Pharmaceutical Journal ; (24): 1464-1470, 2013.
Article in Chinese | WPRIM | ID: wpr-860251

ABSTRACT

OBJECTIVE: To identify a suitable polymer system for iguratimod (T-614), a poorly water-soluble compound with high melting point, and prepare a chemically stable single phase solid dispersion (SD) of T-614 by hot-melt extrusion (HME) technique to enhance its dissolution rate. METHODS: Melting method and adsorption based screening techniques were utilized to screen hydrophilic polymers suitable for immediate release formulations. T-614 SDs were prepared with polymer carriers such as PVP/VA 64, Soluplus, HPMC AS-LF and HPC-SL via HME below the drug melting point, and suitable temperature and plasticizer for HME were chosen. The dissolution behaviors of SD powder and SD tablets were compared with those of T-614 powder and commercial T-614 tablets, respectively. State of T-614 in HME SDs was characterized by X-ray powder diffraction. The homogenous SD tablets were analyzed further for physical stability in an influencing factors test. The bioavailability of SD tablets was assessed in rats. RESULTS: Results of the screening studies demonstrated that PVP/VA 64, Soluplus, HPMC AS-LF and HPC-SL provided higher degree of miscibility and dissolution enhancement. The HWE SD tablets showed significantly enhanced dissolution. The supersaturation state of HME SD powder in water was maintained for at least 120 min, suggesting that PVP/VA 64 had an inhibitory effect on recrystallization of T-614 from a supersaturated solution. Samples prepared via HME at 160°C were substantially amorphous, which were unchanged in the influencing factors test at high temperature and strong light, but recrystallization occurred at high humidity. PEG1500 appeared to be a promising plasticizer. Same bioavailability was achieved when compared with commercial T-614 tablets. CONCLUSION: The polymersas carriers for T-614 SD have significant impact on the dissolution behavior and state of T-614. Using PVP/VA 64 as the carrier, hot-melt extrusion is an effective technology for improving the in vitro dissolution of T-614.

17.
Chinese Medical Journal ; (24): 3048-3052, 2013.
Article in English | WPRIM | ID: wpr-263527

ABSTRACT

<p><b>BACKGROUND</b>Chronic graft-versus-host disease (GVHD), the commonest long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT), has a negative impact on patients' health related quality of life (HRQoL). This study was designed to investigate the HRQoL in patients with chronic GVHD in China.</p><p><b>METHODS</b>Two hundred and sixty-four patients with chronic GVHD who were ≥ 24 months post-HSCT and had been in continuous complete remission since HSCT were enrolled in this retrospective study. HRQoL was evaluated using an SF-36 questionnaire. Multivariate analysis was used to identify the factors that affect HRQoL in patients with chronic GVHD.</p><p><b>RESULTS</b>HRQoL in patients categorized as having mild and moderate chronic GVHD was significantly better than in those in the severe category. In the moderate chronic GVHD category, markedly poorer HRQoL was observed in patients with both multiple organ involvement and more severe organ impairment than in those without these factors. According to multivariate analysis, chronic GVHD severity had the greatest significant negative impact on patients' HRQoL; whereas being female was associated with a negative impact on psychological health.</p><p><b>CONCLUSION</b>Chronic GVHD severity strongly correlates with negative impacts on patients' HRQoL.</p>


Subject(s)
Adult , Chronic Disease , Female , Graft vs Host Disease , Psychology , Humans , Male , Middle Aged , Quality of Life , Retrospective Studies , Severity of Illness Index
18.
Chinese Journal of Hematology ; (12): 113-116, 2013.
Article in Chinese | WPRIM | ID: wpr-323432

ABSTRACT

<p><b>OBJECTIVE</b>To retrospectively review the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelomonocytic leukemia (CMML).</p><p><b>METHODS</b>The engraftment, graft versus host disease (GVHD), infection, relapse and survival of 12 CMML patients received allo-HSCT were observed. The clinical outcome of allo-HSCT for CMML was analyzed.</p><p><b>RESULTS</b>Twelve (7 males and 5 females) CMML patients with a median age of 39 years old received allo-HSCT including 7 from HLA-matched sibling and 5 from haploidentical related donors. All 12 patients achieved engraftment. The median time of neutrophil engraftment and platelet engraftment were 15 (11 - 20) days and 13 (11 - 18) days, respectively. 4 patients occurred acute GVHD, and 3 occurred chronic GVHD. After the median follow-up of 17.5 months (12 - 32 months), the overall survival, disease free survival and relapse rate were 66.7%, 66.7%, and 16.7%, respectively.</p><p><b>CONCLUSION</b>Allo-HSCT can improve the survival of patients with CMML, and is a effective therapy for CMML.</p>


Subject(s)
Adolescent , Adult , Child , Female , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Therapeutics , Male , Middle Aged , Retrospective Studies , Survival Rate , Transplantation, Homologous , Young Adult
19.
Chinese Journal of Hematology ; (12): 651-654, 2013.
Article in Chinese | WPRIM | ID: wpr-272144

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the prevalence of Epstein Barr Virus (EBV) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>We retrospectively analyzed the clinical characteristics of 720 patients received allo-HSCT from January 2010 through December 2011 in the Stem Cell Transplant Center of People's Hospital.</p><p><b>RESULTS</b>Of 720 patients (469 male presented and 251 females), with a median age of 30 years (range, 2 to 67 years) old, 66 patients were presented with EBV reactivation. The cumulative incidence of EBV reactivation was (9.3±1.1)%, with a median days of 54.5 (range, 18 to 253 days). During one- year post-transplantation, the cumulative incidences of EBV reactivation in sibling allo-HSCT, haploidentical HSCT and unrelated donor HSCT were (1.3±0.7)%, (13.7±1.7)%, and (9.1±4.4)%, respectively. In patients with haplo-identical HSCT, the cumulative incidences of EBV viremia, probable EBV disease, and post-transplant lymphoproliferative disease (PTLD) were (5.8±1.1)%, (5.7±1.1)%, and (2.3±0.7)%. The mortality was (33.9±5.9)% in all patients with EBV infection: (63.6±15.8)% in PTLD, (42.3±9.9)% in probable EBV disease, (13.8±6.5)% in EBV viremia. By univariate and multivariate analysis, the use of ATG was an independent risk factor for EBV infection.</p><p><b>CONCLUSION</b>EBV reactivation is a common complication in patients with allo- HSCT, especially high mortality in PTLD and probable EBV disease. The use of ATG was an independent risk factor for EBV infection.</p>


Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Epstein-Barr Virus Infections , Pathology , Female , Hematopoietic Stem Cell Transplantation , Herpesvirus 4, Human , Humans , Lymphoproliferative Disorders , Virology , Male , Middle Aged , Retrospective Studies , Risk Factors , Transplantation, Homologous , Virus Activation , Young Adult
20.
Chinese Medical Journal ; (24): 1096-1102, 2013.
Article in English | WPRIM | ID: wpr-342232

ABSTRACT

<p><b>BACKGROUND</b>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for many hematological diseases, but there are many complications following allo-HSCT, among which neurological complications (NC) are one of the most commonly described ones. However, little is known about idiopathic inflammatory demyelinating diseases (IIDDs) of the central nervous system (CNS) in patients following allo-HSCT.</p><p><b>METHODS</b>A nested case-control study was conducted in a large cohort of 1365 patients, who underwent allo-HSCT at the Institute of Hematology and Peking University People's Hospital, between January 2004 and December 2009, 36 patients of whom developed CNS IIDDs. Kaplan-Meier method, univariate and multivariate Cox regression were applied in our statistical analysis using SPSS 16.0.</p><p><b>RESULTS</b>The cumulative incidence of all cases of IIDDs at 6 years posttransplantation was 3.6%. Thirty-five patients (97.2%) suffered IIDDs after transplantation, 16 patients (44.4%) between day 0 to day 100 post-transplantation, 10 patients (27.8%) between day 100 to 1 year post-transplantation, and 9 patients (25.0%) 1 year post-transplantation. Multivariate regression analysis identified donor type (P = 0.031), infection (P = 0.009), and acute lymphatic leukemia (P = 0.017) as independent risk factors for posttransplantation IIDDs. The median survival time of patients with IIDDs was 514 days after transplantation (95%CI: 223 - 805). Survival at 6 years was significantly lower in patients who developed the diseases compared to those who did not (26.6% vs. 73.5%, P < 0.001). Of the 36 patients experiencing IIDDs, 58.3% (n = 21) died. The causes of death were graft-versus-host disease (GVHD) (n = 4), underlying disease relapse (n = 3), infections (n = 12), and other causes (n = 2).</p><p><b>CONCLUSIONS</b>IIDDs is an uncommon but serious complication of allo-HSCT, especially in patients with a primary diagnosis of acute lymphatic leukemia, mismatched transplants, and infections. Our study results indicate that patients with IIDDs tend toward a poor prognosis following allo-HSCT.</p>


Subject(s)
Adolescent , Adult , Case-Control Studies , Central Nervous System , Child , Child, Preschool , Demyelinating Autoimmune Diseases, CNS , Female , Hematopoietic Stem Cell Transplantation , Humans , Infant , Male , Middle Aged , Retrospective Studies , Risk Factors , Young Adult
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