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OBJECTIVES@#To study the efficacy and safety of rituximab combined with chemotherapy in the treatment of children and adolescents with mature B-cell non-Hodgkin's lymphoma (B-NHL) through a Meta analysis.@*METHODS@#The databases including PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and Weipu were searched to obtain 10 articles on rituximab in the treatment of mature B-NHL in children and adolescents published up to June 2022, with 886 children in total. With 3-year event-free survival (EFS) rate, 3-year overall survival (OS) rate, complete remission rate, mortality rate, and incidence rate of adverse reactions as outcome measures, RevMan 5.4 software was used for Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis.@*RESULTS@#The rituximab+chemotherapy group showed significant increases in the 3-year EFS rate (HR=0.38, 95%CI: 0.25-0.59, P<0.001), 3-year OS rate (HR=0.29, 95%CI: 0.14-0.61, P=0.001), and complete remission rate (OR=3.72, 95%CI: 1.89-7.33, P<0.001) as well as a significant reduction in the mortality rate (OR=0.31, 95%CI: 0.17-0.57, P<0.001), as compared with the chemotherapy group without rituximab. There was no significant difference in the incidence rate of adverse reactions between the two groups (OR=1.28, 95%CI: 0.85-1.92, P=0.24).@*CONCLUSIONS@#The addition of rituximab to the treatment regimen for children and adolescents with mature B-cell non-Hodgkin's lymphoma can bring significant survival benefits without increasing the incidence of adverse reactions.
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Criança , Adolescente , Humanos , Rituximab/efeitos adversos , Linfoma de Células B/tratamento farmacológico , Intervalo Livre de Progressão , Indução de Remissão , China , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêuticoRESUMO
OBJECTIVES@#To study the clinical features and chemotherapy response of Burkitt's lymphoma (BL) in children and the influence of rituximab on the prognosis of children with BL.@*METHODS@#A retrospective analysis was performed for the medical data of 62 children with BL, including clinical features, therapeutic efficacy, and prognostic factors. The Cox regression model was used to identify the factors associated with poor prognosis in children with BL. According to whether rituximab was used, the children with advanced (stage III/IV) BL were divided into two groups: chemotherapy plus rituximab and chemotherapy alone. The prognosis was compared between the two groups.@*RESULTS@#For these 62 children, the median age of onset was 5 years (range 1-14 years), and there were 58 boys (94%) and 4 girls (6%). The primary site was abdominal cavity in 41 children (66%), and head and neck in 16 children (26%). There were 1 child with stage I BL (2%), 8 with stage II BL (13%), 33 with stage III BL (53%), and 20 with stage IV BL (32%). The median follow-up time was 29 months, with progression/recurrence observed in 15 children (24%), and the 3-year overall survival (OS) rate and event-free survival (EFS) rate were 82.8%±5.2% and 77.3%±5.8%, respectively. For the children with stage III/IV BL, there was a significant difference in the 3-year the OS rate between the chemotherapy plus rituximab group (16 children) and the chemotherapy alone group (30 children) (93.3%±6.4% vs 65.6%±9.9%, P=0.042), while there was no significant difference in the 3-year EFS rate between the two groups (86.2%±9.1% vs 61.8%±10.1%, P>0.05). The Cox regression analysis showed that central nervous system involvement, lactate dehydrogenase >1 000 U/L, and early incomplete remission were the factors associated with poor prognosis (P<0.05).@*CONCLUSIONS@#Chemotherapy combined with rituximab can improve the prognosis of children with stage III/IV BL. Central nervous system involvement, elevated lactate dehydrogenase level, and early incomplete remission may indicate a poor prognosis in children with BL.
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma de Burkitt/patologia , Lactato Desidrogenases , Prognóstico , Estudos Retrospectivos , RituximabRESUMO
OBJECTIVE: To explore the value of "priority approach of uncinate process" in laparoscopic pancreaticoduodenectomy. METHODS: The data of 200 patients who underwent laparoscopic pancreaticoduodenectomy in the No.2 Department of Hepatobiliarypancreatic Surgery, the First Hospital of Jilin University from April 2015 to October 2018 were analyzed retrospectively. RESULTS: All the 200 patients successfully completed laparoscopic pancreaticoduodenectomy, including 1 case of laparoscopic pancreaticoduodenectomy combined with right hemicolectomy,2 cases of laparoscopic pancreaticoduodenectomy combined with pancreaticocotailectomy,and 2 cases of laparoscopic pancreaticoduodenectomy combined with portal vein reconstruction(end-to-end anastomosis). The mean operation time was(281±49)min,including the specimen removal time(91±15)min,and the intraoperative blood loss was 50-850 mL(122±53)mL. The mean postoperative hospital stay was(16±9)days. Eight-teen cases(9.0%)had grade B pancreatic fistula and 3 cases(1.5%)had grade C pancreatic fistula. Postoperative anastomotic bleeding in 2 cases(1.0%). Intraperitoneal hemorrhage was found in 14 cases(7.0%), and delayed gastric emptying in 9 cases(4.5%).Biliary fistula was found in 11 cases(5.5%). There were 2 deaths(1.0%). Postoperative pathological diagnosis showed that ductal adenocarcinoma of the head of pancreas was in 33 cases(16.5%),the pancreas intraductal papillary mucinous tumor in 15 cases(7.5%),head of the pancreatic neuroendocrine tumors in 6 cases(3.0%),pancreatic ductal epithelial hyperplasia in 1 case(0.5%),solid pancreatic head fake papilloma in 9 cases(4.5%),pancreatic head capsule adenomas in 5 cases(2.5%),chronic pancreatitis in 1 case(0.5%),duodenal adenocarcinoma in 4 cases(2.0%), duodenal stromal tumor in 2 cases(1.0%), duodenal benign space-occupying lesions in 11 cases(5.5%),periampullary carcinoma of non pancreatic head origin in 105 cases(52.5%)and benign periampullary tumors in 9 cases(4.5%). CONCLUSION: "Priority approach of uncinate process" is safe,rapid and effective in laparoscopic pancreaticoduodenectomy,which is worthy of further promotion and application in clinic.
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OBJECTIVE@#To study the clinical features of Langerhans cell histiocytosis (LCH) involving the oral and maxillofacial region in children.@*METHODS@#A retrospective analysis was performed for the clinical data of 12 children with LCH involving the oral and maxillofacial region who were hospitalized and treated from September 2012 to September 2017, including clinical manifestations, pathological features, treatment and prognosis.@*RESULTS@#Of the 12 children, 8 (67%) had multiple system involvement and 7 (58%) had the involvement of organs at risk. Bone was the most common affected site (11 children, 92%), among whom 7 children had the involvement of the mandible. Oral soft tissue involvement manifested as gingival ulcer or hyperplasia in 4 children, loose teeth in 5 children, oral mucosal lesions in 2 children, and nodular lesions in 1 child. Pathological examination showed positive CDla in 11 children and positive CD207, CD68, S-100, and LCA in 12 children. Surgery combined with chemotherapy was the major treatment method, and surgical resection alone was performed for focal lesions. After treatment, 11 children were cured or improved and 1 gave up treatment and was lost to follow-up. No recurrence was observed.@*CONCLUSIONS@#LCH children with oral and maxillofacial involvement often have the involvement of multiple systems and organs at risk, with the mandible as the most common affected site. These children may also have the involvement of gingiva, oral mucosa and teeth. Surgery combined with chemotherapy is the major treatment method, and the patients generally have a good prognosis without recurrence.
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Criança , Humanos , Histiocitose de Células de Langerhans , Mucosa Bucal , Prognóstico , Recidiva , Estudos RetrospectivosRESUMO
OBJECTIVE@#To study the effects of electroacupuncture (EA) in chronic constrictive injury (CCI) rat model and the expression of N-methyl-D-aspartate receptor type 2B (NR2B) in ipsilateral spinal dorsal horn in rats to explore the analgesic mechanisms of EA.@*METHODS@#According to the random number table, totally 180 rats were evenly divided into a sham group, a CCI group, and an EA group. CCI model was conducted with four 4-0 chromic gut ligatures loosely ligated around the left sciatic nerve 1 cm above the trifurcation. Rats in the EA group received 2 Hz EA therapy bilaterally at acupoints of Zusanli (ST 36) and Sanyinjiao (SP 6) once daily (30 min/d) for 30 days after surgery. Paw withdrawal thresholds (PWTs) were measured on 0 (baseline), 1, 3, 7, 15, 30 days after surgery. Rats were sacrificed on 0, 1, 3, 7, 15 and 30 days after surgery, and the L4-5 segments of spinal cord were removed to detect the expression of NR2B by immunohistochemistry and quantitative polymerase chain reaction.@*RESULTS@#PWTs in the CCI group were significantly lower than the sham group at Day 1-30 after surgery, and reached its lowest at Day 1 (P<0.01). After EA treatment, the PWTs recovered rapidly and were significantly higher than those in the CCI group on 3, 7, 15 and 30 days after surgery (P<0.01). The numbers of NR2B-immunoreactive cells of the CCI group significantly increased after CCI surgery compared with the sham group (P<0.01). Compared with the CCI group, stimulation of EA markedly decreased the numbers of NR2B-immunoreactive cells at Day 3, 7, 15 and 30 (P<0.05). In the sham group, NR2B mRNA was expressed at a low level. It increased after CCI surgery, which increased rapidly at Day 7 (P<0.01) and reached its peak value at Day 15 (P<0.01). After EA stimulation, relative quantity of NR2B mRNA expression was less than that in the CCI group at Day 15 and 30 (P<0.05).@*CONCLUSIONS@#Low frequency of EA had antinociceptive effect in CCI rat model. The analgesic effects of EA might be through the inhibition of NR2B.
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Objective: To observe effect of Tangshenping capsule on lipopolysaccharide (LPS)-stimulated podocytes apoptosis under high glucose conditions of podocyte in rats with diabetic nephropathy (DN), and discuss possible mechanism. Method: With cultured rat podocytes as object of study,the podocytes model was established with high glucose and LPS,and divided into 7 groups:control group,high glucose group,high glucose plus LPS group,irbesartan group,and low,moderate and high-dose Tangshenping capsule groups.Protein and mRNA expressions of CD2-associated protein (CD2AP), nephrin, phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and B-cell lymphoma-2 associated death protein (Bad protein) of podocyte in each group were detected by Western blot and reverse transcription polymerase chain reaction (RT-PCR). Result: Compared with control group,the protein and mRNA expressions of podocyte CD2AP, nephrin, PI3K, Akt decreased definitely (PPPPPPPPPPPPConclusion: Tangshenping capsule can maintain a stable protein expression of Slit diaphragm (SD) in podocyte, inhibit podocyte apoptosis by activating PI3K/Akt signaling pathway. This is one of mechanisms for preventing and treating diabetic nephropathy.
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The aim of the present study is to evaluate the vasodilation effects of Tongmai Yangxin Pills (TMYX) on rat mesenteric artery as well as its mechanism of action. The relaxation effects of TMYX extracts with different concentrations were determined on isolated rat mesenteric artery in normal condition as well as pretreating by phenylephrine and KCl. Vascular relaxation effects of TMTX were also determined in mesenteric artery preincubated with L-ANME and indomethacin or in endothelium denuded mesenteric artery. Moreover, effects of TMYX by 50 mg·L⁻¹ on NO secretion and the phosphorylation of eNOS in a cellular model of human umbilical vein endothelial cell (HUVEC) pretreated with or without L-NAME were also observed. The experimental results showed that TMYX has no obvious effect on vasodilation of arteries in normal or KCl pretreated condition, while it can dose-dependently relax the rat mesenteric artery with intact endothelium stimulated with phenylephrine at a maximal diastolic rate of (64.71±10.03)%. After preincubating with L-NAME for 15 min or removal of mesenteric artery endothelium, the maximal diastolic rate was decreased to (35.77±8.93)% and (25.85±10.84)% respectively. However, preincubating with indomethacin had no inhibitory effect on TMYX induced vascular relaxation. Meanwhile, TMYX at 50 mg·L⁻¹ could increase the expression of P-eNOS and the secretion of NO in HUVEC. L-NAME significantly inhibited NO release and phosphorylation of eNOS induced by TMYX. The results suggested TMYX exerted endothelium-dependent relaxation effects against PE-induced contractions of isolated rat mesenteric artery through NO-cGMP signaling pathway.
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Animais , Humanos , Ratos , Endotélio Vascular , Artérias Mesentéricas , VasodilataçãoRESUMO
<p><b>OBJECTIVE</b>To investigate the clinical features and prognosis of malignancy-associated hemophagocytic lymphohistiocytosis (MAHS) in children.</p><p><b>METHODS</b>A retrospective analysis was performed for the primary diseases, clinical features, and prognosis of 24 children with MAHS.</p><p><b>RESULTS</b>Among the 24 children, 11 (46%) had MAHS induced by tumor and 13 (54%) had chemotherapy-associated MAHS. As for primary diseases, 17 children had acute leukemia, 6 had lymphoma, and 1 had neuroblastoma. The most common clinical manifestations were pyrexia, respiratory symptoms, and hepatosplenomegaly. The most common laboratory abnormalities were hemocytopenia, elevated serum ferritin, and elevated lactate dehydrogenase. Of the 24 children, 22 were treated according to the HLH-2004 protocol and 2 gave up treatment; 18 children died, 1 was lost to follow-up, and 5 survived. The survival time ranged from 3 days to 2 years and 4 months (median 28 days).</p><p><b>CONCLUSIONS</b>Children with MAHS have various clinical features and extremely poor treatment outcomes.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Linfo-Histiocitose Hemofagocítica , Mortalidade , Terapêutica , Neoplasias , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Keratoconus (KC) is a common cornea ectatic disorder characterized by myopia,irregular astigmatism and other visual impairment caused by corneal thinning and cone-shaped protrusion.With a wide range of effects,the etiology of this disease is unknown,and genetic factors may be involved in its pathogenesis.This paper summarizes the research progress on KC genetic etiology for reviewing the selected candidate genes and loci based on traditional/genome-wide linkage studies,genome-wide association studies and central corneal thickness in recent years.Genetic studies on KC pathogenesis will advance our understanding of this disease and further promote the development of potential therapies.
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<p><b>OBJECTIVE</b>To investigate the significance of Th17/Treg imbalance in the development and treatment of primary immune thrombocytopenia (ITP) in children.</p><p><b>METHODS</b>Thirty-two children diagnosed with ITP between May and August, 2015 and 22 healthy children were enrolled. Flow cytometry was used to determine the Th17/Treg ratio in peripheral blood of healthy children and children with ITP before and after treatment with immunoglobulin.</p><p><b>RESULTS</b>Compared with the patients with ITP before treatment, the healthy children and the patients treated with immunoglobulin had a significantly lower percentage of Th17 cells in CD4+ T cells, a significantly lower Th17/Treg ratio, and a significantly higher percentage of Treg cells in CD4+ T cells in peripheral blood (P<0.05). In the 32 ITP children treated with immunoglobulin, 20 had complete response, 4 had response, and 8 had no response. The patients with complete response had a significantly lower percentage of Th17 cells in CD4+ T cells and a significantly lower Th17/Treg ratio in peripheral blood than the patients without response (P<0.05).</p><p><b>CONCLUSIONS</b>The Th17/Treg imbalance can be found in children with ITP. Immunoglobulin can improve the cellular immune function by regulation of the Th17/Treg ratio. The Th17/Treg ratio may serve as an indicator for assessing the therapeutic effects of ITP.</p>
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Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Púrpura Trombocitopênica Idiopática , Alergia e Imunologia , Linfócitos T Reguladores , Alergia e Imunologia , Células Th17 , Alergia e ImunologiaRESUMO
<p><b>OBJECTIVE</b>To investigate the association of childhood hemophagocytic syndrome (HPS) with human parvovirus B19 (HPVB19) infection, and to analyze the clinical features of this disease.</p><p><b>METHODS</b>ELISA and quantitative real-time PCR were used to detect HPVB19-IgM, HPVB19-IgG and HPVB19-DNA in 65 children with HPS (HPS group) and 65 healthy children (control group). The HPS group was divided into HPVB19-infected (n=14) and non-infected (n=51) groups according to the detection results of HPVB19-DNA. The clinical data of two groups were compared.</p><p><b>RESULTS</b>The positive rate of HPVB19-IgM in the HPS group (26%, 17/65) was significantly higher than that in the control group (9%, 6/65) (P=0.011), and there was no significant difference in the positive rate of HPVB19-IgG between the HPS (38%, 25/65) and control groups (29%, 19/65) (P=0.266). The infection rate of HPVB19 in the HPS group (22%, 14/65) was significantly higher than that in the control group (3%, 2/65) (P=0.001). Compared with the non-infected group, the HPVB19-infected group had significantly lower platelet count and hemoglobin level on admission, significantly more severe liver function damage, a significantly earlier onset time, and a significantly longer course of disease (P<0.05).</p><p><b>CONCLUSIONS</b>The pathogenesis of HPS may be associated with HPVBl9 infection. HPVBl9-infected children with HPS have more acute onset, more severe clinical manifestations, and a longer disease duration.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Anticorpos Antivirais , DNA Viral , Linfo-Histiocitose Hemofagocítica , Infecções por Parvoviridae , Parvovirus B19 HumanoRESUMO
<p><b>OBJECTIVE</b>To study the roles of follicular helper T (Tfh) cells and follicular regulatory T (Tfr) cells in the pathogenesis of Henoch-Schönlein purpura (HSP) in children.</p><p><b>METHODS</b>Peripheral blood samples were collected from 40 HSP children and 25 healthy controls. The percentages of Tfh and Tfr cells were measured by flow cytometry; the mRNA expression levels of Bcl-6, c-MAF, Blimp-1, and PD-1 in peripheral blood were measured by real-time polymerase chain reaction.</p><p><b>RESULTS</b>Compared with the controls, the children with HSP had significantly increased percentage of Tfh cells and Tfh/Tfr ratio but a significantly reduced percentage of Tfr cells in the peripheral blood (P<0.05). Compared with the controls, the children with HSP had significantly increased mRNA expression of Bcl-6 and c-MAF but significantly reduced mRNA expression of Blimp-1 in CD4+ T cells (P<0.05), and had significantly increased mRNA expression of PD-1 but significantly reduced mRNA expression of Blimp-1 in CD4+CD25+ regulatory T cells (P<0.05).</p><p><b>CONCLUSIONS</b>Abnormal percentages of Tfh and Tfr cells may be involved in the pathogenesis of HSP in children, and over-expression of Bcl-6, c-MAF, and PD-1 mRNA and inhibited expression of Blimp-1 mRNA may be considered as important reasons for abnormal percentages of Tfh and Tfr cells.</p>
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Adolescente , Criança , Feminino , Humanos , Masculino , Proteínas de Ligação a DNA , Genética , Receptor de Morte Celular Programada 1 , Genética , Proteínas Proto-Oncogênicas c-bcl-6 , Proteínas Proto-Oncogênicas c-maf , Genética , Vasculite por IgA , Alergia e Imunologia , Linfócitos T Auxiliares-Indutores , Alergia e Imunologia , Linfócitos T Reguladores , Alergia e ImunologiaRESUMO
<p><b>OBJECTIVE</b>To study the prognostic significance of CD47 in a NOD/SCID mouse model of acute myeloid leukemia (AML) and the best strategy for targeted therapy for this disease.</p><p><b>METHODS</b>CD34(+)CD38(-) leukemia stem cells (LSCs) were separated and transplanted into NOD/SCID mice to establish a mouse model of acute monocytic leukemia (AMoL). Anti-human CD47 antibody, alone or combined with cytosine arabinoside (Ara-C), was used to treat the mice with AMoL for 7-14 days, and therapeutic efficacy was assessed. LSCs were cultured together with mouse macrophages in culture medium containing anti-CD47 or anti-CD45 monoclonal antibody for 2 hours, to observe the phagocytic ability of macrophages to LSCs.</p><p><b>RESULTS</b>CD34(+)CD38(-) LSCs existed among THP-1 cells, with a content of about (0.12 ± 0.06)%, and a mouse model of AML was successfully established after the purified CD34(+)CD38(-) LSCs (97.0% ± 1.7%) were transplanted into NOD/SCID mice. The in vivo experiment showed that mice with AMoL had the most significant decrease in CD33(+)CD45(+) leukemia cells in peripheral blood and bone marrow and survived the longest after being treated with Ara-C (7 days) plus anti-CD47 monoclonal antibody (14 days) (P < 0.01). After 2 hours of in vitro culture, the phagocytic index in the culture medium containing anti-CD47 monoclonal antibody was significantly higher than in the culture medium containing anti-CD45 monoclonal antibody (76.9% ± 12.2% vs 7.60% ± 2.4%; P < 0.05).</p><p><b>CONCLUSIONS</b>High expression of CD47 is an adverse prognostic factor in AML. Combination therapy with anti-CD47 monoclonal antibody and Ara-C can effectively eliminate leukemia cells and LSCs, demonstrating great clinical significance in curing AML.</p>
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Animais , Feminino , Humanos , Masculino , Camundongos , Anticorpos Monoclonais , Antígeno CD47 , Alergia e Imunologia , Fisiologia , Citarabina , Leucemia Mieloide Aguda , Tratamento Farmacológico , Mortalidade , Patologia , Camundongos Endogâmicos NOD , Camundongos SCID , PrognósticoRESUMO
Objective: To observe the effect of Z-ligustilide on the expression of tumor necrosis factor-α (TNF-α)-induced human umbilical vein endothelial cells (HUVEC) intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and nuclear factor kappa B (NF-κB), and to investigate the protection on endothelial cells injured by inflammatory cytokines and its mechanism. Methods: TNF-α (10 ng/mL) was added to in vitro cultured HUVEC to induce the cell injury. After co-incubated with the different concentration (5, 10, and 20 μmol/L) of Z-ligustilide for 24 h, the cell viability in each group was measured by MTT. The levels of ICAM-1 and VCAM-1 were assayed using enzyme linked immunosorbent assay (ELISA). Western blotting was used to detect the expression of NF-κB protein of cell in each group. Results: TNF-α could induce the obvious injury of HUVEC compared with the control group (P < 0.05, 0.01), and increase the expression of ICAM-1 and VCAM-1 in HUVEC (P < 0.01). Compared with the model group, Z-ligustilide could dose-dependently reduce the expression of ICAM-1 (P < 0.01) and VCAM-1 (P < 0.05) and obviously decrease the NF-κB expression (P < 0.05). Conclusion: Z-ligustilide could attenuate TNF-α-induced injury in HUVEC via suppressing the activation of NF-κB and inhibiting the excessive expression of ICAM-1 and VCAM-1.
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Objective To assay and determine whether the human acute monocytic leukemia cell line THP-1 contains side populations (SP) cells,and to increase the proportion of SP cells using cytarabine (Ara-C).Methods Fluorescent microscope and flow cytometry (FCM) were employed for detecting the percentage of SP cells in THP-1 cells.Then,SP and non-SP (NSP) subpopulations were collected and identified.Finally,THP-1 cells were incubated with different concentrations of Ara-C for 24 hours and detected the proportion of SP cells,respectively.Results The results demonstrated that the percentage of SP cells was (1.81 ± 0.99) % in THP-1 cells.A majority of the SP cells remained in the G0/G1 phase,and the expressions of CD34 + and CD34 + CD38-and the proliferative ability of the SP cells were higher than those of NSP cells (P < 0.05).The mRNA expression of multidrug resistance genes (ABCG2,ABCB1),apoptosis regulation genes (Bcl-2) and the Bcl-2/Bax ratio of SP cells were higher than those of NSP cells.SP cells have been shown to be more tumorigenic than NSP cells.After co-culture with Ara-C,the proportion of SP cells increased significantly and presented in a concentration-dependent manor.Conclusions All of these findings suggest that the THP-1 cell line contains SP cells and the SP cells possess some intrinsic stem cell properties.The proportion of SP cells can be increased when co-cultured with Ara C,and this technique is a useful and important application for the study of LSCs.
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Objective To study the relative factors of relapse in children with aplastic anemia (AA) treated with antithymocyte globulin(ATG) combined with cyclosporine.Methods A retrospective analysis of the risk factors of relapse in children with AA after response to immunosuppressive therapy(IST).All patients received IST from Jan.2007 to Dec.2011 in the First Affiliated Hospital of Zhengzhou University.IST:ATG 3 mg/(kg · d) × 5 d,cyclosporine 5-8 mg/(kg · d).Results (1) The basic cure rate was 29.4% (25/85 cases),remission and obvious progress rate was 47.0% (40/85 cases),and 20 cases were ineffective,the overall incidence of remission was 76.5% (65/85 cases),basic cure,remission and obvious progress were considered as effective.The relapse rate was 12.3% (8/65 cases).(2)Relapse was relative with cyclosporine concentration,infections episodes.And it was not relative with severity of disease,age,sex,duration of AA prior to initial treatment,severity of response.Conclusions A significant proportion of patients subsequently relapsed and required second-line therapy.Early IST,long-time continuation-maintenance of cyclosporine and the reduction of infectious episodes are important to prevent relapse.
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<p><b>OBJECTIVE</b>To study the effectiveness and safety of immunosuppressive therapy (IST) in the treatment of childhood aplastic anemia (AA) and to study the main factors influencing the effectiveness.</p><p><b>METHODS</b>The clinical data of 55 children with severe aplastic anemia (SAA) and 51 children with chronic aplastic anemia (CAA) were retrospectively analyzed. All patients received IST from January 2007 to December 2010.</p><p><b>RESULTS</b>In children with CAA, the effective rate of antithymocyte globulin (ATG) plus cyclosporine A(CsA) combination therapy was significantly higher than that of CsA alone (80% vs 44%; P<0.05); in children with SAA, the effective rate of ATG plus CsA combination therapy was also significantly higher than that of CsA alone (75% vs 40%; P<0.05). No patients developed clonal disease such as myelodysplastic syndrome, paroxysmal nocturn hemoglobinuria or acute myelocytic leukemia. In patients treated with the ATG plus CsA combination therapy, the response rate was relatively high for children whose disease course was less than six months, bone marrow hematopoietic area was more than 40%, had no severe infections, and experienced granulocyte colony stimulating factor (G-CSF) reaction during the early treatment; however, it was not related to AA subtypes and age.</p><p><b>CONCLUSIONS</b>ATG plus CsA combination therapy is effective and safe in the treatment of childhood AA. The disease course, bone marrow hematopoietic area, severe infections and G-CSF reaction to early treatment are the main factors influencing the therapeutic effects.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Anemia Aplástica , Tratamento Farmacológico , Soro Antilinfocitário , Ciclosporina , Quimioterapia Combinada , Fator Estimulador de Colônias de Granulócitos , Usos Terapêuticos , Imunossupressores , Usos Terapêuticos , Estudos RetrospectivosRESUMO
<p><b>OBJECTIVE</b>To investigate the methods and conditions for the isolation, purification and culture of human spermatogonial stem cells (SSCs) on the feeder layer cells of human embryonic fibroblasts (hEFs).</p><p><b>METHODS</b>SSCs isolated and purified from normal human fetal testicular tissues by sequential two-step enzyme digestion and Percoll uncontinuous density gradient centrifugation were cultured on the feeder layer cells of hEFs isolated from 5-9 weeks old human embryos. The surface markers SSEA-1 and OCT4 of the SSCs were detected by immunohistochemistry; the alkaline phosphatase (AKP) activity of the SSC clones measured; and the expressions of the SSC-related genes determined by RT-PCR.</p><p><b>RESULTS</b>SSCs survived, proliferated and formed colonies on the feeder layers, and the colonies were highly positive for SSEA-1 and OCT4, with strong AKP activity and high expressions of the SSC-related genes.</p><p><b>CONCLUSION</b>The feeder layer of hEFs supports the growth of human spermatogonial stem cells.</p>
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Humanos , Masculino , Técnicas de Cultura de Células , Métodos , Diferenciação Celular , Células Cultivadas , Embrião de Mamíferos , Biologia Celular , Fibroblastos , Biologia Celular , Espermatogônias , Biologia Celular , Células-Tronco , Biologia CelularRESUMO
This study was purposed to observe the changes of caspase-3 activity during apoptosis of HL-60 cells induced by an iron chelator, DFO (deferoxamine), and to explore the mechanism underlying apoptosis in HL-60 cells. The HL-60 cells treated with DFO were examined by light microscopy, flow cytometry (FCM) and DNA agarose gel electrophoresis; the activity of caspase-3 was determined by cellular immunohistochemistry; the transcription of the apoptotic gene of bax was detected by hybridization in situ. The results showed that the typical morphological character of apoptosis cells, DNA ladder and FCM assay confirmed that DFO could induce the apoptosis in HL-60 cells. The apoptotic rate increased in dose-and time-dependent manner. When cells had been cultivated with 100 micromol DFO for 12 hours, a few caspase-3 positive cells were found. In the process of time, the rate of caspase-3 positive cells was progressively higher than that in control (P < 0.05), while the level of bax transcription was also higher than that in the control. It is concluded the activation of caspase-3 and gene bax may be involved in the apoptosis of HL-60 cells induced by DFO.