ABSTRACT
BacKground:The deveIopment of acute pancreatitis( AP ) is often accompanied by pancreatic microcircuIation disturbance and aIterations in bIood coaguIation and fibrinoIytic systems, which resuIts in abnormaIities of pIateIet parameters. Aims:To investigate the changes of pIateIet parameters in eIderIy AP patients and the effect of uIinastatin ( UTI)on pIateIet parameters and disease status. Methods:Two hundred and seventeen eIderIy AP patients(≥60 years) were enroIIed retrospectiveIy from Aug. 2009 to Dec. 2013 at the First AffiIiated HospitaI of Nanjing MedicaI University. According to the severity of the disease,patients were divided into three groups:miId AP( MAP),moderateIy severe AP ( MSAP),and severe AP( SAP). The pIateIet parameters,incIuding PLT,MPV and PDW before and after treatment,as weII as the differences in pIateIet parameters and cIinicaI efficacy between conventionaI therapy and UTI therapy were compared and anaIyzed. Results:In MSAP and SAP groups,PLT at admission was significantIy Iower(P<0. 01),whiIe MPV and PDW were significantIy higher(P<0. 05)than those in MAP group. After 1-week treatment,PLT increased significantIy(P<0. 01)and MPV and PDW decreased significantIy(P<0. 05)in MSAP and SAP groups. UTI therapy was superior to conventionaI therapy in increasing PLT( P <0. 01 ),decreasing MPV and PDW( P <0. 01 ),and improving the overaII efficacy in MSAP and SAP groups( MSAP:92. 3% vs. 81. 2%,P <0. 01;SAP:90. 0% vs. 80. 8%,P<0. 01). Conclusions:Changes of pIateIet parameters in eIderIy MSAP and SAP patients are different from those in MAP patients,which might refIect the disease severity. UTI is effective in reducing the activity of pIateIet and can be used in the treatment and prevention of disease progression in eIderIy AP patients.
ABSTRACT
Objective To retrospectively analyze the engraftment, transplant-related complications and survival after unrelated cord blood transplantation (UCBT) in patients with hematologic malignancies. Methods Fifty consecutive patients with hematological malignancies (median age, 19 years; median weight, 53 kg) were treated with UCBT in single center from April 2000 to August 2009. Thirty-nine patients were high-risk or refractory. Double UCB grafts were used for 26 patients, while single UCB graft for 24 patients. Myeloablative conditioning was given to 45 cases and non-myeloablative regimens to 5 cases. All patients were given a combination of cyclosporin A (CsA) and mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis. Results The median total nucleated cell (TNC) dose was 4.0 (range, 1.95-16.24)×10~7 TNC/ kginfused, and CD34~+ cell dose was 2.74(range, 0.67-29.28)×10~5/kginfused. Forty-two of 50 patients acquired engraftment with implantation rate being 86%. The median time to engraftment (absolute neutrophil count>500/mm~3 and platelets 20 000/L) was 19 and 34 days. The cumulative incidence of neutrophil engraftment by day 42 was 86.3%(95% confidence interval [CI] 0.769-0.957); the cumulative incidence of platelets engraftment by day 120 was 72.3% (95% CI 0.620-0.821). Twenty cases developed acute GVHD, and the incidence of acute GVHD of grades Ⅲ/Ⅳ by day 100 was 7.1%. The incidence of chronic GVHD within 2 years was 17.4%. During a median follow-up period of 22 months (range 4-116), Overall 6-month, 1-year and 2-year survival rate was 66.2%(95% CI 0.590-0.734), 57.4%(95% CI 0.496-0.652), 54.2%(95% CI 0.462-0.622), respectively. For the patients with non-advanced hemotologic malignancies, 6-month, 1-year and 2-year survival rate was 73.2% (95% CI 0.659-0.805), 66.1% (95% CI 0.579-0.743), and 62.2% (95% CI 0.542-0.682) respectively. Five cases relapsed. The cumulative incidence of relapse within 2 years was 16.2% (95% CI 0.099-0.225). Twenty-one cases died mainly due to infection. Conclusion UCBT could be safely and effectively used for adult patients with hematologic malignancies.
ABSTRACT
Objective To investigate clinical characteristics of relapsing polychondritis(RP)and to improve early recognition for it.Methods Clinical and laboratory data of 56 patients with RP were analyzed retrospectively.Results Ratio of number of male patients to female ones was 1.2.Age at onset was(46?11)years(ranging from 27 to 71)and average interval between onset and diagnosis was(21? 35)months,(8?6),(16?31)and(29?37)months for patients initial onset with auricle,respiratory tract and joints involved,respectively.Site involved included airway in 40 patients(71.4%),auricle in 32 (57.1%),joints in 32(57.1%),eyes in 27(48.2%),nasal chondritis in 25(44.6%)and inner ear in 13(23.2%).At initial stage of the course,17 patients were misdiagnosed as respiratory infection (30.4%),nine as perichondritis(16.1%),six as pulmonary tuberculosis(10.7%),five as rheumatoid arthritis(8.9%).Seven of 40 patients with airway involvement received metallic stents for their tracheobronchial stenosis.Four patients whose condition never improved after regular therapy all had respiratory involvement.Conclusions Patients of RP with initial onset at non-auricle,non-nasal sites tended to be misdiagnosed.Prevalence of airway involvement was not so low with a poor prognosis in patients of RP.