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Objective:To investigate the pathogenesis and prognosis of transformation of primary myelofibrosis (PMF) to B-cell acute lymphoblastic leukemia (B-ALL).Methods:The diagnosis and treatment process of a patient transferred from PMF to B-ALL in Affiliated Tumor Hospital of Zhengzhou University in November 2018 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient was a 64-year-old female, she was initially diagnosed with PMF, and then she developed B-ALL 17 months later after receiving treatment of prednisone, danazole, levamisole, aspirin, thalidomide and jaktinib. After induction therapy, the patient received 8 months of continuous remission, and then the reexamination showed relapse. There was no remission after reinduction therapy. The patient gave up treatment and was discharged 2 months later. JAK2 V617F gene mutation was positive before and after leukemia transformation.Conclusions:The patients with transformation of PMF to B-ALL have poor clinical prognosis and short survival time. The possible mechanism of its transformation may be related to additional genetic events or certain high-risk genes. However, the specific mechanism is still unclear, and further investigation of the etiology is needed to seek targeted treatment.
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Objective To explore the impacts of intensive nutritional intervention on maternal and infant outcomes in women with gestational diabetes mellitus(GDM). Methods From January 2014 to ecember 2014, a total of 518 women with GDM were stratified by age, height, body mass index (BMI), and were divided into treatment group (n=258) and control group (n=260) according to the random number generated by the computer software. Women in control group underwent conservative treatment while those in treatment group were given intensive nutritional intervention including keeping records of eating habits, measurement of blood glucose and regular follow-up. The incidence of pregnancy-related complications and newborn outcomes in both groups were compared. Results Women of the two groups were similar in basic clinical data. The range of gestational weight gain (GWG) [(12.2 ± 4.7) vs. (13.9 ± 5.0)kg] and birth weight of infants [(3 406.4±495.4) vs. (3 494.9±484.7)g] in the intervention group was significantly lower than those in the control group (P<0.01). The rate of reaching recommended target of GWG was significantly higher in the intervention group (60.9%) than in the control group (51.9%, χ2=4.2, P<0.05). There was a significant reduction in glucose-related parameters in both groups (P<0.01). In the intervention group, fasting blood glucose and postprandial blood glucose were reduced from (5.21 ± 0.71) mmol/L, (6.68 ± 0.90) mmol/L to (4.71 ± 0.73) mmol/L,(6.21 ± 0.71) mmol/L (P<0.01), respectively in comparison with the control group, the intervention group had lower incidence of cesarean section (44.6% vs. 53.8%), postpartum hemorrhage (2.3%vs. 6.2%), polyhydramnios (7.8%vs. 13.5%), neonatal hypoglycemia (3.1%vs. 6.5%) and macrosomia (8.1%vs. 13.8%, P<0.05). Conclusions Strengthening nutritional intervention in women with GDM could increase the rate of reaching recommended target of GWG, improve the glucose-related parameters and reduce the incidence rate of pregnancy complications.
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Objective To investigate the effect of histone deacetylase inhibitor LBH589 on proliferation,apoptosis and drug resistance of chemoresistant acute myeloid leukemia cells HL60/ADM.Methods HL60/ADM cells were treated with LBH589.Proliferation,apoptosis and adriamycin IC50 were evaluated by MTT assay and AnnexinV-FITC/PI stain.The change in MRP1 expression and intercellular adriamycin accumulatiom were analyzed by flow cytometry.Results Effective proliferative inhibition and apoptotic induction in HL60/ADM cells were observed after treatment with 10-80 nmol/L LBH589 with maximal effect detected after treatment with 70 nmol/L LBH589 for 60 hours.However,inhibition ratio remain unchanged with the further increase of drug dose and incubation time (P ＞ 0.05).Downregulation of MRP1 [(93.90±4.20) ％ vs (76.19±6.53) ％],upregulation of adriamycin accumulation [(8.53±0.68) ％ vs (25.67±1.34) ％] and decrease in adriamycin IC50 [(6.833±0.319) μg/ml vs (1.382±0.104) μg/ml] were induced by the treatment with 20 nmol/L LBH589 (P ＜ 0.01),whose reversal fold was 4.9.The expression of acetylated histone 3 after treatment with LBH589 was higher than that before treatment (P ＜ 0.01).However,relative p-Akt levels after treatment for 24 h and 48 h were 1.07±0.09 and 0.59±0.01,respectively,which were lower than that before treatment (2.03±0.12) (P ＜ 0.01).Meanwhile,expression levels of p53 were 0.57±0.04 and 1.31±0.09,respectively,which were higher than that before treatment (0.21 ±0.02) (P ＜ 0.01).Conclusion Treatment with LBH589 has the capability of inhibiting proliferation and inducing apoptosis,as well as increasing intercellular adriamycin accumulation and sensitivity through downregulation of MRP1 expression and inhibition of PI3K-Akt signaling pathway in HL60/ADM cells.