Clinical Characteristics and Prognosis of Patients with Hematological Malignancies Superimposed with Solid Tumors / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics and prognosis of hematological malignancies superimposed patients with solid tumors.@*METHODS@#The clinical data of 30 patients with more than two kinds of malignancy (the second is hematological malignancy) from October 2011 to October 2020 in Department of Hematology, Jiangning Hospital Affiliated to Nanjing Medical University were collected and analyzed retrospectively. The overall survival time was used as the prognostic evaluation standard, and the survival of patients were analyzed by KaplanMeier method. Logrank test and Cox regression model were used to carry out univariate and multivariate retrospective analysis on clinical and laboratory parameters of 30 patients.@*RESULTS@#Among 30 cases, 20 were male, 10 were female, the median age of onset of the second tumor was 70 years old. The common types of the secondary hematological malignancies to solid tumors are myelodysplastic syndrome, acute myeloid leukemia, multiple myeloma. Univariate analysis showed that patients' gender, age, type of solid tumors, the onset of interval between two kinds of tumor, chromosome karyotype were not related to do with the patients' overall survival time. Type of hematologic disease, ECOG score were associated with patients' overall survival time, and the multivariate analysis showed that the type of hematologic disease and ECOG score were independent risk factors for patients with poor prognosis.@*CONCLUSION@#Patients superimposed with solid tumors complicated with myelodysplastic syndrome or acute leukemia and ECOG score ≥3 have poor prognosis and shorter overall survival time, which are independent risk factors influencing the prognosis. Bone marrow injury, immune dysfunction and genetic susceptibility after chemoradiotherapy may be the main causes of these diseases.

Role of physical function in predicting short-term treatment outcome in Egyptian acute myeloid leukemia patients: a single center experience

Abstract Background Acute myeloid leukemia (AML) is a potentially fatal hematological disease. Along with disease-related factors, patient-related factors, in particular age, are a strong predictor of outcome that influence treatment decisions. Many acute myeloid leukemia risk stratification models have been developed to predict the outcome of intensive chemotherapy. However, these models did not include physical function assessments. Methods This study investigated the impact of several factors, namely the performance status, physical function and age on the short-term outcomes of intensive chemotherapy in a cohort of 50 Egyptian patients with de novo acute myeloid leukemia. Results Complete remission after intensive chemotherapy in these myeloid leukemia patients at Day 28 was 56% and the mortality rate was 12% and 34% at Day 28 and Day 60, respectively. The pretreatment Eastern Cooperative Oncology Group score was significantly correlated with outcomes on Day 28 and Day 60 (p-value = 0.041 and p-value = 0.032, respectively). There were significant correlations between the two-minute walk test and outcomes of therapy on Day 28 and 60 (p-value = 0.032 and p-value = 0.047, respectively) and between grip strength test and outcomes of therapy on Day 28 and 60 (p-value = 0.046 and p-value = 0.047 respectively). Furthermore, there was a significant correlation between chair stand test and outcome of therapy on Day 28 (p-value = 0.023). Conclusion Performance status and physical function assessments were strong predictors of outcome of intensive chemotherapy in acute myeloid leukemia and we recommend the incorporation of these variables in risk stratification models for the personalization of therapy before treating acute myeloid leukemia patients with intensive chemotherapy.

A comparative study of comprehensive geriatric assessment in elder patients with non-Hodgkin's lymphoma / 中华内科杂志

Objective To measure the comprehensive geriatric assessment (CGA) in elder non-Hodgkin's Lymphoma (NHL) patients in a cross-sectional study;to compare the differences between Eastern Cooperative Oncology Group (ECOG)-performance status (PS) and CGA.Methods CGA stratification included the following 3 instrument assessments:activity of daily living (ADL);instrumental activity of daily living (IADL);comorbidity score according to the modified cumulative illness rating score for geriatrics (MCIRS-G).According to CGA and age,NHL patients,aged ≥60 years,were classified as "fit","unfit" and "frail" groups.ECOG-PS was evaluated and compared with CGA.Results According to CGA,51.6％ senior NHL patients (33 cases) were classified as "fit",12.5％(8 cases) as " unfit" and 35.9％ (23 cases) as "frail".Several comorbidities were observed in majority patients,such as cardiovascular disease,diabetes nellitus and hypertension.In the "younger aged" patients between 60 to 64ys,25％(3/12) was considered as "frail".However,this proportion increased to 42.9％ (6/14) in patients older than 80ys.Moreover,impaired CGA was observed in 38.9％(21/54) of ECOG-PS ≤1 patient.Conclusions Impaired CGA is as common as approximately half in elderly NHL patients and more than one third even in ECOG-PS ≤ 1 patients.ECOG-PS may underestimate the impaired fitness function in elder NHL patients.

Decoding Saccadic Directions Using Epidural ECoG in Non-Human Primates

A brain-computer interface (BCI) can be used to restore some communication as an alternative interface for patients suffering from locked-in syndrome. However, most BCI systems are based on SSVEP, P300, or motor imagery, and a diversity of BCI protocols would be needed for various types of patients. In this paper, we trained the choice saccade (CS) task in 2 non-human primate monkeys and recorded the brain signal using an epidural electrocorticogram (eECoG) to predict eye movement direction. We successfully predicted the direction of the upcoming eye movement using a support vector machine (SVM) with the brain signals after the directional cue onset and before the saccade execution. The mean accuracies were 80% for 2 directions and 43% for 4 directions. We also quantified the spatial-spectro-temporal contribution ratio using SVM recursive feature elimination (RFE). The channels over the frontal eye field (FEF), supplementary eye field (SEF), and superior parietal lobule (SPL) area were dominantly used for classification. The α-band in the spectral domain and the time bins just after the directional cue onset and just before the saccadic execution were mainly useful for prediction. A saccade based BCI paradigm can be projected in the 2D space, and will hopefully provide an intuitive and convenient communication platform for users.

Phase III multi-centre open-label randomized controlled trial of selective internal radiation therapy (SIRT) versus Sorafenib in locally advanced hepatocellular carcinoma(SIRveNIB) / Монголын Анагаах Ухаан

Background This study is a multi-centre, open-label, randomised controlled trial that will compare the impact of selective internal radiation therapy (SIRT) using SIR-Spheres® yttrium-90 microspheres versus sorafenib on overall survival in patients with locally advanced hepatocellular carcinoma (HCC). A definitive RCT comparing the 2 most promising therapies in locally-advanced HCC will impact on outcomes in a large number of patients and change clinical practice. This will also pave the way for future trials in combined modality therapies in HCC. Methods The study is structured so that patients with locally advanced HCC, who satisfy the study eligibility criteria, will be randomised to receive either: Treatment Arm A: Oral Sorafenib therapy at a dose of 400 mg b.i.d until disease progression, no further response, complete regression or unacceptable toxicity or Treatment Arm B: A single administration of SIR-Spheres into the liver targeted at HCC in the liver by the trans-arterial route. Results Twenty patients treated with 90Y-RE and nineteen patients received Sorafenib at our institution from 14 March 2011, and 30 June 2016 were included. Data from 39 consecutive patients were analyzed. The majority of patients were Child Pugh class B(90%), Barcelona Clinic liver Cancer(BCLC) stage C(58.5%) and Okuda class I (89.5%). Approximately 71% patients diagnosed in IIIa stage and 70% of patients had HBV infection. In the analysis for best response, three of 20 patients in the SIRT group (15%) achieved a partial response 7 of 19 patients (46%) had stable disease, whereas in Sorafenib group, two of 19 patients in the SIRT group (12%) achieved a partial response 9 of 19 patients (39%) had stable disease. Conclusion This study shows the potential efficacy of SIR-Spheres and sorafenib. In summary, selective internal radiation therapy (SIRT) using SIR-Spheres is a promising treatment for well selected patients with unresectable HCC. Sorafenib is effective for the patients with locally advanced HCC without portal vein thrombosis (PVT).

A Comparative Study on the Assessment of the Quality of Life by Older Cancer Patients and Caregivers and Assessment of Performance Status by Medical Staff

BACKGROUND: The study examined the correlations among the results of the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire, Core 30 (QLQ-C30) completed by elderly cancer patients and their family caregivers and the Eastern Cooperative Oncology Group (ECOG)-performance status (PS) evaluated by medical doctors. METHODS: The study sample included 269 persons with cancer aged 55 years or older and their family caregivers recruited from hospitals located in Seoul and Gyeonggi-do. The results of the ECOG-PS evaluated by medical doctors were obtained from medical records. Intra-class correlation analysis was used to assess rater reliability between the elderly cancer patients and their family caregivers. Correlations among the EORTC QLQ-C30 and the ECOG-PS were tested using the Kruskal-Wallis test and Spearmen's correlation. RESULTS: The results showed that four subscales of quality of life (physical functioning, emotional functioning, social functioning, and global health status) and three items under symptoms (fatigue, pain, and financial difficulties) in the EORTC QLQ-C30 were highly consistent between patients and their family caregivers. From the EORTC QLQ-C30 results, social functioning, role functioning, health status, fatigue, pain, and appetite loss (patients results) and physical functioning (family caregivers results) were highly consistent with the results of the ECOG-PS by the physicians. CONCLUSIONS: The findings suggest that when the older persons with cancer have difficulty expressing their own thoughts or feelings, the EORTC QLQ-C30 completed by their family caregivers and the results of the ECOG-PS completed by the physicians could be used as substitutes.

A Study on the Predictive Factors of Sexual Function in Women with Gynecologic Cancer

PURPOSE: This study was to identify predictors of sexual function in gynecologic cancer patients. METHODS: The participants were 154 patients treated at a university medical center in A city, Korea. The data collection was performed through a structured questionnaire from July to December, 2010. The instruments used in this study were Female Sexual Function Index (FSFI) perceived health status scale, Eastern Cooperative Oncology Group (ECOG) performance status, body image, and depression. Data were analyzed using descriptive statistics, Mann-Whitney test, Kruskal-Wallis test and stepwise multiple regression with the SPSS 18.0. RESULTS: The mean score of perceived health status was 8.42 and sexual function was 8.42. The lowest score among sexual function was lubrication. The scores of sexual function was significantly different by age, job, marital status, period after diagnosis of cancer and diagnosis. There were significant correlations between sexual function, perceived health status, ECOG performance, body image and depression. In multiple regression analysis, predictors were identified as ECOG performance, age, diagnosis and period after diagnosis of cancer (Adj.R2=.28). The most powerful predictor of female sexual function was ECOG performance (19.0%). CONCLUSION: The above findings indicate that it is necessary to develop a more effective and personalized sexual function improvement program for gynecologic cancer patient.

Comparison of the presurgical scale ambulatory electroencephalogram and the electrocorticography in epileptics with supratentorial tumor / 重庆医科大学学报

objective:To discuss the characteristics and localizing significance of presurgical scale ambulatory electroencephalo-gram(AEEG)in patients with supratentorial tumor by comparison their electrocorticography(ECOG).Methods:124 subjects were collected in our hospital.All patients were monitored by the scalp AEEG before surgeries and ECOG during oprating.The interictal epileptiform discharges of ECOG were divided into five catalogs.Ⅰ:no spikes.Ⅱ:isolated spikes.Ⅲ:repetitive spike-wave pattern.Ⅳ:intermittent spikes,polyspikes waves burst.Ⅴ:continuous hyper-spikes and sharps.A,B,C,D and E were represented on the scalp AEEG which corresponded the above ECOG classification.Then AEEG and ECOG were analyzed.Re-sults:(1)The scalp AEEG was abnormal in 83.87% of all subjects before surgery.Ⅱ type and Ⅲ type on ECOG did not appear easily on the scalp AEEG(P

Effects of Salicylate on ABR and ECoG in Guinea Pig / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been recognized that salicylate induces ototoxicity in animals and humans. Many studies have been done to identify the mechanisms of ototoxicity of salicylate with histopathological, biochemical and electrophysiological methods. Among these methods, the electrophysiological method is useful for clinical diagnosis and evaluation of therapeutic effect. The studies reported here were aimed at performing electrophysiological effects of salicylate by using Auditory Brainstem Response (ABR) and Electrocochleography (EcoG) through non-invasive approach. MATERIAL AND METHODS: Auditory brainstem response and electrocochleogram were observed by non-invasive approaching method after the intraperitoneal injection of 450 mg/kg of lysine salicylate on 10 ears of 5 guinea pigs. RESULTS: The threshold shifting of ABR and ECoG were less than 10 dB. The latency of ABR waves and Summating Potential were increased after salicylate was administered especially at low intensity sound stimulation. CONCLUSION: The latency of ABR wave and SP would be useful in diagnosing ototoxicity and evaluating the therapeutic effect in ototoxic patients.

Surgery of Cerebrovascular Lesions Causing Intractable Epilepsy

OBJECTIVE: Traditionally, the main indications for surgery in vascular-related lesion were based upon reduction or control of seizures, reversal of symptoms of deficits related to mass effect, and prevention of hemorrhage or recurrent hemorrhage. However, the results of surgical treatment for seizure control are disappointing in some reports. Here we describe surgical strategies and our experience in treating patients with intractable seizures associated with vascular-related lesions according to sophisticated presurgical and intraoperative evaluation. METHODS: Twelve(4.5%) patients were selected for this study out of total 264 patients with resective epilepsy surgery at our epilepsy center during four years since 1992. All were treated with anticonvulsant agents but became refractory. These patients operated on under local or general anesthesia for resection surgery, underwent presurgical and intraoperative evaluation for identification of adjacent, beyond or remote epileptogenic area and the eloquent area. RESULTS: Of these 12 patients, vascular malformations(AVM, cavernous angioma) were 7, overt hemorrhage due to vascular lesion were 2 and intractable ongoing seizure after vascular surgery were 3. Other vascular lesion including occlusive disease, moyamoya disease or previous hemorrhage were excluded in this study. The location of the lesion was mainly temporal and peri-Rolandic areas, and dual pathology was verified in 2 cases of 6 temporal lesion. The surgical outcome(class I;7, II;3, III;1, IV;1) was excellent by Engel's classification. CONCLUSION: Control of seizures related to vascular lesions remains strong indication for surgical resection. For this reason, careful presurgical evaluations are essential to evaluate the remote epileptogenic area, especially in temporal lesion. Intraoperative acute recording(ECoG) and functional mapping by electrical stimulation or SSEP are important for maximal resection of epileptogenic area with minimal sequellae.

Surgery for seizure-related structural lesions of the brain with intraoperative acute recording(ECoG) and functional mapping

Epilepsy surgery has been demonstrated to be an effective alternative treatment for intractable partial or localization related epilepsy. Primary intracranial neoplasms and other structural lesions of the brain are important etiological factors in patients with partial seizure disorders. A neuroimaging identified lesion in patients with seizures, not necessarily medically refractory, may also be an indication for surgery in selected patients. Twelve patients operated on under local or general anesthesia for resection surgery underwent intraoperative recording(electrocorticogram) and/or functional mapping by electrical stimulation or somatosensory evoked potentials-(SSEPs) for identification of the secondary epileptogenic area and/or functional area; 2 meningiomas, 5 astrocytomas, 1 gangliocytoma, 1 abscess, 1 small AVM, 1 cysticercosis and one gliosis by previous intracerebral hemorrhage with middle cerebral artery(MCA) aneurysm. Among these, additional corticectomy or anterior temporal lobectomy was performed in eleven patients. All the patients did well after surgery with good outcomes as seizure free in nine(75%) out of 12 patients with 11.9 months of follow-up period, without any neurological deficits. Intraoperative recording and functional mapping of adjacent areas of the structural lesions of the brain are useful in surgery and can guide the extent of further resection.

Effect of Angong Niuhuang Pill and the heavy metal constituents on EcoG of brain damage in rats caused by LPS / 中成药

AIM:To evaluate the actions of cinnabaris and realgar in arousing brain and opening the orifices of Angong Niuhuang Pill,and to provide experimental basis for the rationality of Angong Niuhuang Pill buildup. METHODS: The brain damage model was made by LPS injection through caudal vein.With quantitative electroencephalogram of medicine methods,effects of Angong Niuhuang Pill,Angong Niuhuang Pill without cinnabaris and realgar,cinnabaris,realgar on the power and relative power of delta and beta waves of electrocorticogram(ECoG) were observed in the brain damage rats caused by LPS. RESULTS: LPS could increase the power and the relative power of the delta waves(0.5-3 Hz),and reduce the power and the relative power of the beta waves(14-30 Hz).All medicines could reduce the power and the relative power of the delta;Angong Niuhuang Pill,cinnabaris and realgar,realgar could increase the power and the relative power of the beta,cinnabaris could increase the relative power of the beta(14-30 Hz),and Angong Niuhuang Pill without cinnabaris and realgar could not. CONCLUSION: Angong Niuhuang Pill has obvious activation on ECoG,and same as cinnabaris and realgar.The results of the present work allow us to put forward the hypothesis that cinnabaris and realgar are most likely one of the important material basis in arousing brain and opening the orifices of Angong Niuhuang Pill.