Bendamustine combined with pomalidomide and dexamethasone in relapsed multiple myeloma with extramedullary disease: a multicenter study / 中华血液学杂志

Objective: To evaluate the efficacy and safety of bendamustine combined with pomalidomide and dexamethasone (BPD regimen) in the treatment of relapsed multiple myeloma (MM) with extramedullary disease. Methods: This open, single-arm, multicenter prospective cohort study included 30 relapsed MM patients with extramedullary disease diagnosed in seven hospitals including Qingdao Municipal Hospital. The patients were treated with BPD regimen from February 2021 to November 2022. This study analyzed the efficacy and adverse reactions of the BPD regimen. Results: The median age of the 30 patients was 62 (47-72) years, of which 18 (60% ) had first-time recurrence. The overall response rate (ORR) of the 18 patients with first-time recurrence was 100%, of which three (16.7% ) achieved complete remission, 10 (55.5% ) achieved very good partial remission (VGPR), and five (27.8% ) achieved partial remission (PR). The ORR of 12 patients with recurrence after second-line or above treatment was 50%, including zero patients with ≥VGPR and six patients (50% ) with PR. Three cases (25% ) had stable disease, and three cases (25% ) had disease progression. The one-year progression free survival rate of all patients was 65.2% (95% CI 37.2% -83.1% ), and the 1-year overall survival rate was 90.0% (95% CI 76.2% -95.4% ). The common grade 3-4 hematology adverse reactions included two cases (6.7% ) of neutropenia and one case (3.3% ) of thrombocytopenia. The overall adverse reactions are controllable. Conclusions: The BPD regimen has good efficacy and tolerance in relapsed MM patients with extramedullary disease.

Multicenter Prospective Study of Different Induction Regimens of Azacytidine in Treatment of Elderly Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To observe the efficacy and safety of different induction regimens of same total dosage of azacitidine (Aza), including standard dose (standard dose group) and low-dose long-term (adjusted dose group), in the treatment of elderly acute myeloid leukemia (AML).@*METHODS@#A total of 103 elderly patients with AML (non-acute promyelocytic leukemia) from January 2020 to June 2021 were enrolled. Aza was administered at the standard dose of 75 mg/(m2·d) for 7 days in the standard dose group (50 cases), while at 100 mg/d for 7-12 days in the adjusted dose group (53 cases). The administration days in adjusted dose group was calculated based on the total standard dose of the patient's single course of treatment. The efficacy and safety between standard dose group and adjusted dose group were compared. Subgroup analysis were performed in the two groups for Aza alone, Aza combined with BCL-2 inhibitor, and Aza combined with low-dose chemotherapy for efficacy and safety.@*RESULTS@#There were no significant differences in overall response rate (ORR), incidence of adverse reaction, and 1-year overall survival (OS) rate between standard dose group and adjusted dose group (P >0.05). The ORR of combination was higher than that of Aza alone (P < 0.05), while there was no significant difference in ORR between Aza combined with BCL-2 inhibitor and Aza combined with low-dose chemotherapy (P >0.05). The combination of BCL-2 inhibitor did not increase the incidence of adverse reactions compared wtih Aza alone. There was a higher risk of myelosuppression and pulmonary infection with a combination of low-dose chemotherapy than with a combination of BCL-2 inhibitor and Aza alone (P <0.05). No significant difference was observed in 1-year OS between Aza alone, Aza combined with BCL-2 inhibitor, and Aza combined with low-dose chemotherapy (P >0.05).@*CONCLUSIONS@#Both two induction regimens can be used in elderly AML patients who cannot tolerate intensive chemotherapy with similar overall effectiveness and safety. Aza combined with low-dose chemotherapy may result in increased ORR and an increased incidence of serious adverse reactions, and may not result in longer survival compared with Aza alone. Aza combined with BCL-2 inhibitor not only has similar effect in complete remission, objective response rate, and OS compared with Aza combined with low-dose chemotherapy, but also has higher safety.

Application of flipped classroom combined with Mini-CEX teaching for the professional postgraduates integrated with standardized residency training of neurology specialty / 中华医学教育探索杂志

Objective:To investigate the application effects of flipped classroom combined with mini-clinical evaluation exercise (Mini-CEX) evaluation on the cultivation of clinical ability of professional postgraduates majoring in clinical medicine.Methods:A total of 32 trainees, the professional postgraduates majoring in clinical medicine integrated with standardized residency training who rotated in the Department of Neurology, The Southwest Hospital of Army Medical University from January 2019 to January 2020 were selected and divided into control group and the experimental group, with 16 ones in each group. The control group were taught with the traditional standardized residency training program, while the experimental group were assessed by Mini-CEX evaluation once every two weeks combined with flipped classroom in stages on the basis of the control group. At the end of the training, the application effects of these two teaching methods were evaluated by theoretical knowledge and clinical comprehensive ability (including 7 aspects of medical history collection, physical examination, clinical diagnosis, treatment plan, medical ethics, doctor-patient communication and overall evaluation). SPSS 22.0 was used for t test. Results:At the end of the training, the scores of theoretical knowledge in the experimental group were higher than those in the control group [(89.83±3.93) points vs. (85.75±5.34) points], with statistical differences ( P<0.05). For the clinical comprehensive ability, the scores of history collection, physical examination, clinical diagnosis, treatment plan, doctor-patient communication and overall evaluation were higher in the experimental group than in the control group ( P<0.05), except for the medical ethics. Conclusion:The application of flipped classroom combined with Mini-CEX evaluation improves the teaching quality and strengthens the clinical comprehensive ability of students, which is worth promoting in clinical practice.

Clinical Comparation of Two Kinds of Chemotherapy Regimens in the Treatment of Patients with MDS-RAEB/AML-MRC / 中国实验血液学杂志

OBJECTIVE@#To investigate the influence of conventional CAG regimen and decitabine + decreased dose CAG (D+dCAG) regimen on the clinical efficacy and safety of patients with MDS-RAEB/AML-MRC.@*METHODS@#The clinical data of 67 patients with MDS-RAEB/AML-MRC hospitalized in our hospital from March 2012 to July 2017 were analyzed retrospectively. According to chemotherapecctic regimens, 76 patients were divided into 2 groups: 37 patients treated with conventional CAG regimen were enrolled in control group, 30 patients treated with decitabine + decreased dose CAG regimen were enrolled in D+dCAG group. The complete remission (CR) rate, overall remission rate (ORR), OS and PFS time and incidence of adverse reactions in 2 groups were compared.@*RESULTS@#The CR in D+dCAG group was significantly higher than that in control group (P＜0.05). ORR was not significanly different between 2 groups (P＞0.05). There was no significant difference in the cumulative OS rate between 2 groups (P＞0.05). There was no significant difference in the cumulative OS rate and PFS rate in nonimplantation between 2 groups (P＞0.05). The incidence of adverse reactions of hematological system, pulmonary infection, skin and soft tissue infection, agranulocytosic fever and mycotic infection was not significanly different between 2 groups (P＞0.05). The duration of granulocyte deficiency and platelet count less than 20×10/L were not significanly different between 2 groups (P＞0.05).@*CONCLUSION@#Compared with conventional CAG regimen, decitabine + decreased dose CAG regimen in the treatment of patients with MDS-RAEB/AML-MRC can efficiently improve the remission effects and showed the well overall safety, but can not increase the survival rate.

Advances in reproductive toxicity of uranium and its mechanism / 局解手术学杂志

Objective Uranium, as a heavy metal material, has been used in civil and military activities in China, but it has also caused environmental pollution and human injury.In order to understand and mitigate this injury, scholars studied the damage effect of uranium through building animal models, and found that when uranium enters the animal body, it will accumulate in the body and cause damage to the body, among which the main accumulation organs are kidneys, bones, reproductive organs and so on.Sensitive organs of the role of reproductive organs is uranium, which attracted the attention of the experts, and expand the uranium exposed reproductive toxicity research.They found that the degree of toxicity of uranium is related to the time, dose and mode of uranium exposure, under certain exposure conditions, by changing the sex hormone levels in vivo, the expression of genes or proteins related to the reproductive disorders and excessive produce the mechanism, such as oxidative stress on the toxicity effect, decrease of childbirth pregnant, related to germ cell pathological histology change, and produce genetic reproductive toxicity to the offspring etc., which affect the reproductive system function, damage the health of the body.

Diagnosis and treatment of Charcot's osteoarthropathy / 中国骨伤

Charcot foot is a rare disease in clinic, its pathogenesis includes neurotrauma theory, neurovascular theory, comprehensive theory, and inflammatory factor theory. The disease is characterized by progressive joint and bone destruction of foot and ankle joint. Conventional X-ray examination is not sensitive to the early diagnosis of disease, the manifestation of CT and MRI of disease is characteristic and could be used to make a comprehensive evaluation of bone and soft tissue lesions of disease. It is not difficult to make a diagnosis based on characteristic findings of CT and MRI and clinical manifestations such as swelling, pain and skin temperature rising of foot and ankle. Charcot foot has multiple classification methods including anatomy, imaging and clinical classification. Improved Eichenholtz staging classification is most commonly used currently which could make a more comprehensive assessment of disease and guide treatment better. According to the stage of disease, treatment could be carried out including non-weight bearing and brace protection, drugs therapy and surgical treatment, etc. Early diagnosis, brace protection, could protect joint and delaying progression of deformity. There is no clear long-term and generally accepted conclusion about the efficacy of drug therapy. For advanced patients, surgical treatment must be actively performed to preserve a stable and functional ankle joint and reduce amputation rate.

Ratio of Primary Bone Marrow Cells after Induction Chemothrapy for Two Weeks in the Patients with PhALL and Its Influence on Complete Remission and Overall Progrosis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the influence of bone marrow blasts ratio after induction chemotherapy for 2 weeks in patients with PhALL, and it's influence on complete remission (CR) and overall prognosis.</p><p><b>METHODS</b>A total of 172 patients with PhALL in our hospital from March 2012 to February 2016 were selected. The bone marrow blast ratio was analyzed by the receiver-operating characteristic curve (ROC) in patients after induction chemotherapy for 2 weeks, at same time its influence on CR and overall prognosis of PhALL patients was evaluated.</p><p><b>RESULTS</b>The cutoff value of CR was 0.075, its area under ROC was 0.763; the comparison of area under ROC with A=0.5 showed statistically significant difference, therefore 172 patients with PhALL were grouped according to bone marrow blast ratio after induction chemotherapy for 2 weeks: 104 cases (60.5%) with bone marrow blast ratio <0.075, 68 cases (39.5%) with bone marrow blast ratio ≥0.075. The PhALL patinets with bone marrow blast ratio <0.075 who achieved CR and finally achieved CR after induction chemotherapy for 4 weeks acconnted for 89 (85.6%) and 99(95.2%) respectively, which were significantly higher than those in PhALL patients with bone marrow blast ratio≥0.075, [29(42.6%) and 52 (76.5%)](P<0.05). In addition, the influencing factor clinically reducing the OS and DFS rate of patients and enhancing the ralapse rate of patients were mainly chemotherapy, the failure of induction chemotherapy (patients did not achieve CR after induction therapy for 4 weeks), the bone marrow blast ratio≥0.075 after induction treatment for 2 weeks, and CNSL at diagnosis and so on, while the enhaced WBC count at diagnosis was poor factor affecting the DFS rate of patients.</p><p><b>CONCLUSION</b>After induction chemotherapy for 2 weeks, the elevated bone marrow blast ratio in PhALL patients will be infavourable to CR, and the overall prognosis is poor.</p>

Detection of serum IL-6 in patients with esophageal carcinoma and its clinical value / 中国基层医药

Objective To explore the clinical significance of detecting serum interleukin (IL)-6 in patients with esophageal squamous cell carcinoma(ESCC).Methods We detected the serum level of IL -6 in 35 patients with ESCC(observation group)and 35 healthy controls (control group)by double antibody sandwich enzyme -linked immunosorbent assay(ELISA),and then analyzed its clinical value.Results The serum levels of IL -6 in the observation group (27.66 ±2.30)ng/L was significantly higher than (17.72 ±3.62)ng/L in the con-trol group (t =11.63,P <0.01).There was significant difference in the serum level of IL -6 in the observation group preoperation and postoperation [(27.66 ±2.30)ng/L vs (23.62 ±3.27)ng/L,t =5.12,P <0.01].The serum level of IL -6 in the observation group preoperation was relevant with clinical stages(χ2 =11.15,P <0.01).Conclusion The change of serum IL -6 level in patients with ESCC is related to the occurrence and development of ESCC,which is an important indication for diagnosis and prognosis.

Research advances in breast milk-acquired cytomegalovirus infection in premature infants / 中国当代儿科杂志

Breast milk is considered ideal food for premature infants, but it can also be the main source of cytomegalovirus (CMV) infection in premature infants. CMV infection may cause serious clinical symptoms, such as sepsis-like syndrome, thrombocytopenia, neutropenia, jaundice, hepatitis, and pneumonitis. This article reviews the research advances in symptoms, treatment strategies, prognosis and the prevention of breast milk-acquired CMV infection in premature infants.

Electrochemiluminescence Behavior of [ Ru(bpy) 3 ] [4-(Clph) 4 B] 2/N,N,N',N'-Tetrakis(propyl)-pentanediamine Nanopaticles Modified Electrode / 分析化学

A new organic-soluble co-reactant of N,N,N’,N’-tetrakis(propyl)-pentanediamine (TPPD) was synthesized and co-immobilized with tris ( 2, 2’-bipyridine ) ruthenium ditetrakis ( 4-chlorophenyl ) borate ([Ru(bpy)3][4-(Clph)4B]2) on an indium tin oxide (ITO) electrode for electrochemiluminescent (ECL) study. The hydrophobicity of TPPD prevented its leakage from the electrode surface, thus the long-term stability of the ECL electrode was enhanced. The TPPD/[Ru(bpy)3][4-(Clph)4B]2 modified-ITO electrode exhibited strong, stable and reproducible ECL signal. The ECL signal could be quenched efficiently by phenol with a quenching efficiency of 95. 4% in the presence of 0. 1 mmol/L phenol, demonstrating the potential of the modified electrode in determination of phenolic compounds. The transient-state of the electrogenerated chemiluminescence reaction was also investigated, which revealed that the TPPD/[Ru(bpy)3][4-(Clph)4B]2 modified-ITO electrode had a longer lifetime than conventional TPA-Ru(bpy)2+3 co-reactant system.

Analysis on biomechanical properties and hemodynamics of the vena cava filters with different numbers of support bars / 医用生物力学

Objective To investigate the interaction between vessel and vena cava filter (VCF) with different numbers of support poles and the influence on blood flow during its implantation by using finite element method and computational fluid dynamics method, so as to provide more scientific guidance for intervention treatment and design & development of the filter. Methods Three kinds of VCF models with 4, 6, 8 support poles were established by using Solidworks, respectively. The stress distribution and radial support stiffness of the vessel and filter under working condition were then simulated and analyzed by using ABAQUS. The distributions of blood flow velocity, pressure and shear stress after VCF implantation were simulated by using Fluent. Results All the mechanical and fluid properties of the three kinds of VCFs were within the scope of security. The comprehensive mechanical performance of the 6-pole filter was better, while for the 8 pole-filter, it showed larger stress under working condition, larger support intensity, higher exit velocity, larger shear stress on the filter mesh, and the trail of the flow was changed from laminar to transition flow, which might cause some damage to the vessel wall. The 4 pole-filter under working condition had a larger stress on the vessel, while its exit velocity was lower, which could be likely to cause local damage on the vessel wall, and disadvantageous to accurately positioning the filter in diseased region of the vessel. Conclusions The 6 pole-filter has a superior hemodynamic effect and comprehensive mechanical properties, which reduces the potential possibility of damage to the vessel wall caused by implantation of the filter. The simulation analysis on VCF provides a good reference for design of the filter and its intervention treatment in clinic.

Cloning and expression analysis of a hydroxycinnamoyl-CoA shikimate/quinate hydroxycinnamoyl transferasegene(IiHCT) from Isatis indigotica / 中国中药杂志

Based on the transcriptome data, we cloned the open reading frame of IiHCT gene from Isatis indigotica, and then performed bioinformatic analysis of the sequence. Further, we detected expression pattern in specific organs and hairy roots treated methyl jasmonate( MeJA) by RT-PCR. The IiHCT gene contains a 1 290 bp open reading frame( ORF) encoding a polypeptide of 430 amino acids. The predicted isoelectric point( pI) was 5.7, a calculated molecular weight was about 47.68 kDa. IiHCT was mainly expressed in stem and undetectable in young root, leaf and flower bud. After the treatment of MeJA, the relative expression level of IiHCT increased rapidly. The expression level of IiHCT was the highest at 4 h and maintained two fold to control during 24 h. In this study, cloning of IiHCT laid the foundation for illustrating the biosynthesis mechanism of phenylpropanoids in I. indigotica.

NADPH Oxidase Accounts for Changes in Cerebrovascular Redox Status in Hindlimb Unweighting Rats / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The roles of cerebrovascular oxidative stress in vascular functional remodeling have been described in hindlimb-unweighting (HU) rats. However, the underlying mechanism remains to be established.</p><p><b>METHODS</b>We investigated the generation of vascular reactive oxygen species (ROS), Nox2/Nox4 protein and mRNA levels, NADPH oxidase activity, and manganese superoxide dismutase (MnSOD) and glutathione peroxidase-1 (GPx-1) mRNA levels in cerebral and mesenteric smooth muscle cells (VSMCs) of HU rats.</p><p><b>RESULTS</b>ROS production increased in cerebral but not in mesenteric VSMCs of HU rats compared with those in control rats. Nox2 and Nox4 protein and mRNA levels were increased significantly but MnSOD/GPx-1 mRNA levels decreased in HU rat cerebral arteries but not in mesenteric arteries. NADPH oxidases were activated significantly more in cerebral but not in mesenteric arteries of HU rats. NADPH oxidase inhibition with apocynin attenuated cerebrovascular ROS production and partially restored Nox2/Nox4 protein and mRNA levels, NADPH oxidase activity, and MnSOD/GPx-1 mRNA levels in cerebral VSMCs of HU rats.</p><p><b>CONCLUSION</b>These results suggest that vascular NADPH oxidases regulate cerebrovascular redox status and participate in vascular oxidative stress injury during simulated microgravit.</p>

Assessment of myocardial viability by three-dimensional speckle tracking echocardiography / 中华急诊医学杂志

Objective To investigate the role of three-dimensional speckle tracking echocardiography (3D-STE) in providing a novel approach to assessing myocardial viability in patients with myocardial infarction (MI).Methods The subjects from the Department of Cardiology and the Department of Cardiac Surgery admitted from April 2010 through December 2012 were diagnosed as MI by electrocardiogram,myocardial enzymes and angiography.The clear imaging of angiography was selected out and collected.All patients had different degrees of segmental wall motion abnormalities,and some already had percutaneous transluminal coronary angioplasty and coronary stenting or coronary artery bypass grafting.Patients with diabetes,heart disease and severe valvular disease of heart were excluded.A total of 45 MI patients were checked with routine echocardiography,two-dimensional speckle tracking echocardiography (2D-STE) and 3D-STE.Then,radionuclide myocardial perfusion/metabolic imaging was served as a golden standard to distinguish the viable from nonviable myocardium in each patient within a day.In order to determine the most sensitivity and specificity threshold values of circumferential peak-systolic strain (Cs),longitudinal peak-systolic strain (Ls),radial peak-systolic strain (Rs),3D strain and area strain for viability detection from 3D-STE,the receiver operating characteristic curve was used to investigate the sensitivity and specificity of the detection of viable myocardium with strain parameters in the study.Comparisons between viable and non-viable groups were carried out with t test.Data were expressed as the mean value ± standard deviation (-x ± s).Results The ventricular wall motion abnormality by visual assessment was observed in 368 segments from 720 segments in 45 patients.Furthermore,204 segments were confirmed to be viable by radionuclide myocardial perfusion/metabolic imaging whereas the rest 164 segments were identified as nonviable among 368 abnormal segments.There were no significant differences in circumferential peaksystolic strain (Cs),longitudinal peak-systolic strain (Ls) and radial peak-systolic strain (Rs) by 2D-STE between viable and nonviable group.Compared with those in viable group,there wasn' t any difference in Cs,but Rs and Ls decreased significantly by 3D-STE in nonviable group.The 3D strain and area strain in absolute value decreased in nonviable group compared with viable group.According to 3D-STE,when Rs higher than 11.1％,the sensitivity was 95.1％ and the specificity was 53.4％ for identification of viable myocardium,whereas Ls higher than 14.3％ resulted in sensitivity of 65.2％ and a specificity of 65.7％.Besides,3D strain higher than 17.4％ had a sensitivity of 70.6％ and a specificity of 77.2％ for detection of viable myocardium,while area strain higher than 23.2％ allowed a sensitivity of 91.5％ and a specificity of 78.8％.Conclusions The 3D-STE might have potential reliability of myocardial viability detection in the patients with left ventricular dysfunction after MI.

Effects of ultrasound-combined microbubbles on hippocampal AchE fibers in rats

OBJECTIVE@#To investigate the protective effect of ultrasound-combined microbubbles on hippocampal acetylcholinesterase (AchE) fibers in rats.@*METHODS@#According to random digits table, 60 SD rats were divided into two groups, marrow stromal cells (MSCs) intracranial transplantation group and MSCs intracranial transplantation + ultrasonic microbubbles group. Marrow stromal cells were cultivated and isolated in vitro; 12 weeks after transplantation, spatial learning and memorizing abilities of rats were assessed by Morris water maze; AchE staining method was used to observe changes in density and appearance of AchE staining positive fibers in hippocampal CA1 region.@*RESULTS@#There was a significant increase in spatial learning and memorizing abilities of rats in MSCs intracranial transplantation + ultrasonic microbubbles group. Hippocampal AchE staining suggested an increase in the density of AchE staining positive fibers in MSCs intracranial transplantation group; the fibers were regular, intact and dense. Density of hippocampal AchE positive fibers was negatively correlated with the escape latent period and was positively correlated with percentage of the time needed to cross each platform quadrant.@*CONCLUSIONS@#Better promotion of spatial learning and memorizing abilities of rats in MSCs intracranial transplantation + ultrasonic microbubbles group may be related with the protective effect of ultrasound-combined microbubbles on hippocampal acetylcholine fibers.

Recent Chemotherapy Reduces the Maximum-Standardized Uptake Value of 18F-Fluoro-Deoxyglucose Positron Emission Tomography in Colorectal Cancer

BACKGROUND/AIMS: The aim of this study was to evaluate the influence of recent chemotherapy on the patterns of the maximum-standardized uptake value (M-SUV) and sensitivity of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in colorectal cancer. METHODS: We retrospectively analyzed the FDG-PET/CT of 509 patients who underwent surgery for colorectal cancer. Subgroup analysis was performed according to chemotherapy status; 401 patients were not treated with chemotherapy and 108 patients were treated with chemotherapy within 6 months prior to surgery. Pathologic analysis of the surgical specimen was used as the gold standard. RESULTS: The M-SUV was significantly lower in patients treated with chemotherapy than in those not treated with chemotherapy in pathologically confirmed same stages of disease. The difference in the sensitivity of the M-SUV according to chemotherapy status was greatest using a cutoff M-SUV value of 6.4 (p<0.001). The longest diameter of the primary tumor was the most important factor that correlated with M-SUV of the primary tumor irrespective of the chemotherapy effect (p<0.001). The M-SUV of the primary tumor was not an independent predictor of lymph node metastasis in colorectal cancer. CONCLUSIONS: The results indicate that the M-SUV of FDG-PET/CT should be interpreted in the context of concurrent chemotherapy.

Study on morphology and anatomy of Akebia trifoliate seeds / 中国中药杂志

Akebia trifoliate has been reported to have many pharmacological activities and the roots, petioles and seeds are used to different symptoms. However, the structure and anatomy of its seeds was almost not reported until now. In the present study, we investigated the morphological characters of the fruit and seed, and the anatomical characters of the testa, micropyle, embryo and endosperm, which could provide evidences for the study on classification, identification and application of A. trifoliate. Our results showed that the testa of A. trifoliate consisted of an epidermic cell layer, the sclerenchyma cells layer, the parenchyma cells layer and an innermost pigment layer. At the micropylar region, the outermost epidermal cells were specialized the white caruncle-like structure and the testa included a lot of lignified tissues. Endosperm comprises two layer cells. Outermost yellowish-brown layer cells contains lots of fat droplets, and innermost white layer cells contains lots of aleurone grains and crystalloids.

Clinical study of autologous cytokine induced killer cells combined with chemotherapy for elderly patients with acute myeloid leukemia / 中国实验血液学杂志

This study was purposed to evaluate the effectiveness and safety of autologous cytokine induced killer (CIK) cells combined with chemotherapy in treatment of elderly patients with acute myeloid leukemia. Peripheral blood mononuclear cells (PBMNC) were isolated from 5 elderly patients with acute myeloid leukemia, and then augmented by priming with interferon gamma (IFN-γ) followed by IL-2 and monoclonal antibody (mAb) against CD3. The autologous CIK cells thus obtained were infused back to individual patients, 28 days as one cycle. The changes in cellular immune function, incidence of infection, independence of hematoglobin or blood transfusion, and progression of disease were observed and assessed before and after therapy. The results showed that the 46 cycles of CIK cell infusion were performed for 5 patients, no adverse reaction was observed in these patients. The percentages of CD3(+), CD3(+)CD8(+) and CD3(+)CD56(+) increased significantly (P < 0.05), The therapy of CIK could significantly reduce the incidence of infection (P < 0.05) and shorten the time of high fever in AML patients (P < 0.05). CIK also could reduce the volume of erythrocyte infusion to maintenance hematoglobin level (P < 0.05). We found that although CIK could not change the outcome of AML, the combination of CIK and chemotherapy could control patients' condition and prolong their survival during the development and end stage of AML. It is concluded that autologous CIK cells combined with chemotherapy is safe and efficacious for the elderly patients with acute myeloid leukemia.

Quantitative analysis of periodontal pathogens present in the saliva of geriatric subjects

PURPOSE: At present, information regarding periodontal disease in geriatric patients is scarce. The purpose of this study was to quantify the periodontal pathogens present in the saliva of Korean geriatric patients and assess the relationship between the bacterial levels and the periodontal condition. METHODS: Six putative periodontal pathogens were quantified by using a real-time polymerase chain reaction assay in geriatric patient groups (>60 years) with mild chronic periodontitis (MCP), moderate chronic periodontitis (MoCP), and severe chronic periodontitis (SCP). The copy numbers of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured. RESULTS: It was found that the bacterial copy numbers increased as the severity of the disease increased from MCP to SCP, except for P. intermedia. For P. intermedia, it was found that samples in the MCP group yielded the largest amount. It was also found that the quantities of P. gingivalis, T. forsythia, and T. denticola, the so-called "red complex" bacteria, were lower than those of F. nucleatum, A. actinomycetemcomitans, and P. intermedia in all of the samples. CONCLUSIONS: Collectively, the results of this study suggest that the levels of P. gingivalis, T. forsythia, F. nucleatum, and T. denticola present in saliva are associated with the severity of periodontal disease in geriatric patients.

Prolonged Neutropenia after Sunitinib Treatment in a Patient with a Glucagonoma and Multiple Hepatic Metastases / 대한내과학회지

Pancreatic neuroendocrine tumors (PNET) are rare, with approximately 2.2 in 1,000,000 people affected annually. In the classification of neuroendocrine tumors, glucagonomas are a functional PNET and comprise 1.6% of PNET. Glucagonoma syndrome is a paraneoplastic syndrome that is characterized by necrolytic migratory erythema, weight loss, anemia, and diabetes mellitus. Metastatic disease at presentation is common, but is often limited to the liver and regional lymph nodes. Sunitinib malate improves the progression-free and overall survival of PNET. This report presents a 45-year-old Asian woman with prolonged neutropenia after sunitinib treatment of a glucagonoma with multiple hepatic metastases. The severity of the neutropenia after the sunitinib treatment fluctuated from grade 1 to 4 repeatedly, with a non-febrile pattern. Ultimately, the patient did not recover from the neutropenia, even after stopping the sunitinib.