Clinical study on ixazomib-based chemotherapy regimens in treatment of relapsed/refractory multiple myeloma / 白血病·淋巴瘤

Objective:To investigate the clinical efficacy and related adverse reactions of ixazomib-based chemotherapy regimens in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:Twenty-one patients with RRMM who received ≥2 courses of ixazomib-based chemotherapy regimens in Heze Municipal Hospital and Zoucheng People's Hospital of Shandong Province from October 2018 to February 2020 were collected. Among them, 15 patients had previously received the bortezomib-based regimens, 10 patients had received the lenalidomide-based regimens, and 6 patients had received the treatment regimens containing the above two drugs. The patients were treated by a two-drug or three-drug regimen: 4 mg ixazomib was taken orally on day 1, 8 and 15 in combination with other drugs (dexamethasone, cyclophosphamide or lenalidomide). The therapeutic efficacy and safety were evaluated after the 2nd and the 4th treatment cycles.Results:The overall response rate (ORR) of 21 patients with RRMM after 2 treatment cycles was 38.09% (8/21), including 6 cases of partial remission (PR) and 2 cases of very good partial remission (VGPR). After 4 cycles, ORR was 57.14% (12/21), including 7 cases of PR, 4 cases of VGPR, and 1 case of complete remission (CR). The incidence of grade 3-4 adverse reactions of the ixazomib-based chemotherapy regimens was 23.81% (5/21). Hematological adverse reactions included neutropenia, thrombocytopenia and anemia, and other common adverse reactions included the digestive tract reactions, fatigue, hypokalemia, etc., and the peripheral nerve adverse reactions were all grade 2 or below grade 2.Conclusion:The ixazomib-based chemotherapy regimens are effective and safe in treating RRMM.

Expressions of LSD1, MGMT and Ki-67 in high-grade glioma and their influences on prognosis / 国际肿瘤学杂志

Objective To investigate the expressions of histone lysine-specific demethylase 1 (LSD1),O6-methylguanine DNA methyltransferase (MGMT) and cell proliferation-associated antigen Ki-67 in high-grade glioma and their influences on prognosis.Methods Sixty-five cases of grade Ⅲ and Ⅳ glioma confirmed by pathology from January 2011 to June 2017 in the First Affiliated Hospital of Xinjiang Medical University were selected.Immunohistochemistry (SP method) was used to detect the expressions of LSD1,MGMT and Ki-67 in pathological specimens.The therapeutic effect was evaluated by long-term follow-up.The relationships between the three markers and pathological grade,progression-free survival (PFS) and overall survival (OS) were analyzed.Results The overall positive rates of LSD1,MGMT and Ki-67 in the 65 high-grade glioma specimens were 70.8％ (46/65),60.0％ (39/65) and 100.0％ (65/65),respectively.There were no significant differences in the expressions of LSD1 and MGMT in grade Ⅲ and Ⅳ glioma (x2 =1.588,P =0.208,x2 =0.013,P=0.908).Ki-67 expression (+),(++),(+++) in grade Ⅳ glioma were observed in 18,19 and 11 cases,respectively.Ki-67 expression (+),(++) in grade Ⅲ glioma were observed in 11,5 cases,and 1 case was (+++),and the difference in expression intensity between the two groups was statistically significant (Z =-2.083,P =0.037).Log-rank test showed that the positive expressions of LSD1,MGMT and Ki-67 were negatively correlated with the PFS of patients with high-grade glioma (x2 =12.217,P =0.007;x2=4.446,P =0.035;x2=12.536,P =0.002),also were negatively correlated with OS (x2 =11.708,P =O.008;x2 =6.637,P =0.010;x2 =11.807,P =0.003).Grade Ⅳ patients were more likely to have relapse progression than grade Ⅲ patients (x2 =6.573,P =0.010),and OS was shorter (x2 =3.974,P=0.046).Cox proportional hazards model analysis showed that the expressions of LSD1 (HR =1.361,95％CI:1.094-1.694,P=0.006;HR=1.406,95％CI:1.117-1.771,P =0.004) and Ki-67 (HR=1.703,95％ CI:1.175-2.468,P =0.005;HR =1.778,95％ CI:1.209-2.616,P =0.003) were the independent prognostic risk factors for PFS and OS of patients with high-grade glioma.Correlation analysis results showed that the expression of MGMT was positively correlated with the expression of LSD1 (r =0.406,P =0.001).Conclusion LSD1,MGMT and Ki-67 have higher positive expression rates in high-grade glioma.MGMT is a prognostic factor for high-grade glioma,and LSD1 and Ki-67 can be used as independent predictors of prognosis for high-grade gliomas.

Expressions of LSD1, MGMT and Ki-67 in high-grade glioma and their influences on prognosis / 国际肿瘤学杂志

Objective@#To investigate the expressions of histone lysine-specific demethylase 1 (LSD1), O6-methylguanine DNA methyltransferase (MGMT) and cell proliferation-associated antigen Ki-67 in high-grade glioma and their influences on prognosis.@*Methods@#Sixty-five cases of grade Ⅲ and Ⅳ glioma confirmed by pathology from January 2011 to June 2017 in the First Affiliated Hospital of Xinjiang Medical University were selected. Immunohistochemistry (SP method) was used to detect the expressions of LSD1, MGMT and Ki-67 in pathological specimens. The therapeutic effect was evaluated by long-term follow-up. The relationships between the three markers and pathological grade, progression-free survival (PFS) and overall survival (OS) were analyzed.@*Results@#The overall positive rates of LSD1, MGMT and Ki-67 in the 65 high-grade glioma specimens were 70.8% (46/65), 60.0% (39/65) and 100.0% (65/65), respectively. There were no significant differences in the expressions of LSD1 and MGMT in grade Ⅲ and Ⅳ glioma (χ2=1.588, P=0.208, χ2=0.013, P=0.908). Ki-67 expression (+ ), (+ + ), (+ + + ) in grade Ⅳ glioma were observed in 18, 19 and 11 cases, respectively. Ki-67 expression (+ ), (+ + ) in grade Ⅲ glioma were observed in 11, 5 cases, and 1 case was (+ + + ), and the difference in expression intensity between the two groups was statistically significant (Z=-2.083, P=0.037). Log-rank test showed that the positive expressions of LSD1, MGMT and Ki-67 were negatively correlated with the PFS of patients with high-grade glioma (χ2=12.217, P=0.007; χ2=4.446, P=0.035; χ2=12.536, P=0.002), also were negatively correlated with OS (χ2=11.708, P=0.008; χ2=6.637, P=0.010; χ2=11.807, P=0.003). Grade Ⅳ patients were more likely to have relapse progression than grade Ⅲ patients (χ2=6.573, P=0.010), and OS was shorter (χ2=3.974, P=0.046). Cox proportional hazards model analysis showed that the expressions of LSD1 (HR=1.361, 95%CI: 1.094-1.694, P=0.006; HR=1.406, 95%CI: 1.117-1.771, P=0.004) and Ki-67 (HR=1.703, 95%CI: 1.175-2.468, P=0.005; HR=1.778, 95%CI: 1.209-2.616, P=0.003) were the independent prognostic risk factors for PFS and OS of patients with high-grade glioma. Correlation analysis results showed that the expression of MGMT was positively correlated with the expression of LSD1 (r=0.406, P=0.001).@*Conclusion@#LSD1, MGMT and Ki-67 have higher positive expression rates in high-grade glioma. MGMT is a prognostic factor for high-grade glioma, and LSD1 and Ki-67 can be used as independent predictors of prognosis for high-grade gliomas.

Association of IL-17 A gene promoter polymorphism with blood lipid and inflammatory factors in patients with coronary heart disease / 重庆医学

Objective To investigate the association between interleukin-17 A (IL-17 A) gene promoter polymorphism and blood lipid and inflammatory factors in coronary heart disease.Methods A total of 241 patients with coronary heart disease who were admitted to hospital from April 2010 to December 2016 were enrolled in this study.68 cases of healthy subjects were collected.IL-17 gene promoter rs8193036 genotype,blood lipid and inflammatory factors were detected and compared.Results Compared with the control group,the genotype CC,CT and TT of the rs8193036 genotype in the coronary heart disease group were significantly different (P＜0.05),and the frequency of C allele in the coronary heart disease group was significantly higher than that in the control group (P＜0.05).The levels of triglyceride,low-density lipoproteinCholesterol,high density lipoprotein cholesterol,interleukin-17a,interleukin-6,interleukin-8 and tumor necrosis factor alpha in CC genotype of tumor necrosis factor alpha group were significantly higher than those in tumor necrosis factor alpha group (P＜0.05),high density lipoprotein cholesterol decreased significantly (P＜0.05).Total cholesterol and low-density lipoprotein cholesterol had no significant differences (P ＞ 0.05).Conclusion The rs8193036 polymorphism of IL-17A gene promoter is associated with the pathogenesis of coronary heart disease.The C allele is an important genetic marker of coronary heart disease.The polymorphism of IL-17A promoter rs8193036 might affect coronary heart disease by increasing blood lipids and inflammation factors.

Effects of perindopril at different doses on cardiac function and ACE2/Ang-(1-9)/Ang-(1-7) axis of ischemic cardiac dysfunction rabbits / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the different dose of perindopril on cardiac function in the rabbits with ische-mic cardiac dysfunction .METHODS:Male rabbits weighing 2.5~3.0 kg ( n=30) were randomly divided into 3 groups (n=10):high dose perindopril group (HD group), low dose perindopril group (LD group) and cardiac dysfunction group (CD group).The Left anterior descending coronary artery of the rabbits was ligatured for model preparation .In HD group, the rabbits were treated with perindopril split normal saline solution (1 g/L)2 mL· kg-1 · d-1 .In LD group, the rabbits were treated with perindopril split normal saline solution (0.33 g/L)2 mL· kg -1 · d-1.In CD group, the rabbits were treated with normal saline solution 2 mL· kg-1 · d-1 .Four weeks after treatment , the cardiac function was measured via echocardiography , the mRNA expression of angiotensin-converting enzyme 2 ( ACE2 ) and angiotensin type 2 receptor (AT2R) was analyzed by real-time PCR, serum angiotensin (Ang)-(1-9) and Ang-(1-7) levels were detected by ELISA. RESULTS:Compared with CD group , the cardiac function of the 2 groups treated with perindopril was significantly im-proved (P<0.01), and more improvement in HD group was observed than LD group (P<0.05).The serum angiotensin ( Ang)-(1-9) and Ang-(1-7) level and the mRNA expression of ACE 2 and AT2R in the 2 groups treated with perindopril were significantly improved (P<0.01).Compared with LD group, the mRNA expression of ACE2 and AT2R and the ser-um levels of Ang-(1-9) in HD group were significant improved (P<0.05), while no difference of serum Ang-(1-7) level was observed.Correlation analysis revealed that the improvement of the cardiac function was associated with serum Ang -(1-9) level, mRNA expression of ACE2 and AT2R (P<0.01), but has no significant correlation with serum Ang-(1-7) lev-el.CONCLUSION:High dose of perindopril may improve more cardiac function in ischemic cardiac dysfunction model in rabbits.The mechanism may relate to increasing serum Ang-(1-7) level to activate AT2R.

Transplantation of bcl-2 gene-modified bone marrow mesenchymal stem cells improves cardiac function and angiogenesis in rabbit ischemic car-diac insufficiency model / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the effects of transplantation of bone marrow mesenchymal stem cells ( BMSCs) modified by bcl-2 gene on myocardial cell apoptosis, angiogenesis and cardiac function in the rabbit after acute myocardial in-farction ( MI) .METHODS:The rabbit BMSCs were isolated, cultured and purified in vitro.The BMSCs were transfected with adenovirus or adenovirus-Bcl-2.The rabbit model of MI was established by ligation of left anterior descending branch. The rabbits were injected with Ad-Bcl-2-BMSCs ( MI+Bcl-2-BMSCs group) , Ad-BMSCs ( MI+BMSCs group) and DMEM ( MI group) in infarction marginal zone 2 weeks after ligation.The cardiac function was evaluated by echocardiography.The apoptosis of myocardial cells was measured by TUNEL.The mRNA expression of VEGF was detected by real-time PCR.The expression of CD31 was examined by immunohistochemical staining, and new blood capillaries were counted at 4 weeks after BMSCs transplantation.The correlation of the above values with cardiac function was analyzed.RESULTS: The cardiac function was better, the apoptotic rate was lower, the mRNA expression of VEGF and the capillary density were higher in both MI+Bcl-2-BMSCs group and the MI+BMSCs group than those in MI group, and those in MI+Bcl-2-BMSCs group in-creased more obviously .The left ventricular ejection fraction ( LVEF) had a negative correlation with the myocardial cell ap-optosis rate.A positive correlation with the mRNA expression level of VEGF and the capillary density was also observed. CONCLUSION:The transplantation of BMSCs modified by bcl-2 gene significantly reduces the myocardial cell apoptosis, promotes angiogenesis, improves heart function of the rabbits with MI.

Hypoxia inducing factor 1 alpha-transfected cardiac stem cells in repair of necrotic myocardium / 中国组织工程研究

BACKGROUND:Cardiac stem cels transplanted to the myocardial infarction area can effectively improve ventricular remodeling and promote heart function. But the survival rate of transplanted cels is lower in the infracted area under hypoxic microenvironment. Hypoxia inducing factor 1 alpha under anoxic conditions can stably express, and meanwhile increase the activity and survival ability of myocardial cels. OBJECTIVE:To elaborate the research progress in hypoxia inducing factor 1 alpha-transfected cardiac stem cels for treatment of myocardial infarction from the folowing aspects: cardiac stem cel characteristics, mechanism underlying myocardial protection of hypoxia inducing factor 1 alpha, selection of carriers and transplantation approach. METHODS: A computer-based search of CNKI and PubMed was performed for articles related to cardiac stem cels and hypoxia inducing factor 1 alpha published from January 2000 to January 2015. The keywords were “cardiac stem cels, hypoxia inducible factor 1(HIF-1a), gene delivery” in Chinese and English, respectively, which appeared in the title and abstract. Finaly, 37 relevant articles were enroled in result analysis. RESULTS AND CONCLUSION:Several studies have confirmed that hypoxia inducing factor 1 alpha can improve the survival rate of cardiac stem cels under anoxic conditions. Increasing evidences from animal experiments have shown that cardiac stem cels and hypoxia inducing factor 1 alpha exert protective and repairing effects on myocardial infarction. Currently, there is no successful report about hypoxia inducing factor 1 alpha gene transfection of cardiac stem cels, but relevant studies are proceeding. Gene modified cardiac stem cels are expected to be widely used in clinic.

The clinical application of out-of-office blood pressure / 中国实用内科杂志

Office blood pressure has been regarded as a gold standard of blood pressure measurements.It is an important indicator of ensurement of correct diagnosis,management of condition and evaluation of prognosis.But limitations of office blood pressure have led to the increasing use of out-of-office blood pressure.Many evidence show that out-of-office blood pressure could more accurately reflex variability of blood pressure and rhythm of blood pressure.Out-of-office blood pressure could diagnose white-coat hypertensives or masked hypertensives without delay,properly determine the need for antihypertensive treatment and decrease risk of developing blood pressure-related complications.