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Objective: To investigate the causative factors of renal function in newly diagnosed multiple myeloma (MM) patients with renal inadequacy. Methods: 181 MM patients with renal impairment from August 2007 to October 2021 at Peking Union Medical College Hospital were recruited, whose baseline chronic kidney disease (CKD) stage was 3-5. Statistical analysis was performed based on laboratory tests, treatment regimens, hematological responses, and survival among various renal function efficacy groups. A logistic regression model was employed in multivariate analysis. Results: A total of 181 patients were recruited, and 277 patients with CKD stages 1-2 were chosen as controls. The majority choose the BCD and VRD regimens. The progression-free survival (PFS) (14.0 months vs 24.8 months, P<0.001) and overall survival (OS) (49.2 months vs 79.7 months, P<0.001) of patients with renal impairment was considerably shorter. Hypercalcemia (P=0.013, OR=5.654) , 1q21 amplification (P=0.018, OR=2.876) , and hematological response over a partial response (P=0.001, OR=4.999) were independent predictive factors for renal function response. After treatment, those with improvement in renal function had a longer PFS than those without (15.6 months vs 10.2 months, P=0.074) , but there was no disparity in OS (56.5 months vs 47.3 months, P=0.665) . Conclusion: Hypercalcemia, 1q21 amplification, and hematologic response were independent predictors of the response of renal function in NDMM patients with renal impairment. MM patients with CKD 3-5 at baseline still have worse survival. Improvement in renal function after treatment is attributed to the improvement in PFS.
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Humanos , Mieloma Múltiple/tratamiento farmacológico , Bortezomib/uso terapéutico , Hipercalcemia , Pronóstico , Aberraciones Cromosómicas , Riñón/fisiología , Insuficiencia Renal Crónica , Estudios Retrospectivos , Protocolos de Quimioterapia Combinada AntineoplásicaRESUMEN
Objective: To evaluate the clinical characteristics, treatment response, and outcomes in patients with classical hairy cell leukemia (cHCL) and HCL variant (HCL-V). Methods: This is a retrospective case series study. Between January 2011 and December 2021, clinical data of 30 patients newly with diagnosed HCL at Peking Union Medical College Hospital were analyzed. The main outcome measures include clinical characteristics, treatment efficacy and survival. The Kaplan-Meier method was used for survival analysis. Results: Twenty-one cases of cHCL and 9 cases of HCL-v were included. The median age at diagnosis was 55.5 (range, 30-86) years, with the ratio of male to female 2.75∶1. The main clinical manifestations included fatigue in 11 cases (36.7%), abdominal distension in 7 cases (23.3%), and infection in 4 cases, while 8 cases were asymptomatic. Splenomegaly was reported in 24 cases (80.0%), including 7 (23.3%) with megalosplenia. The white blood cell count, lymphocyte count, and the proportion of peripheral hairy cells in HCL-v group were significantly higher than those in cHCL group, whereas the development of anemia, thrombocytopenia, and monocytopenia in cHCL group was more remarkable than that in HCL-v group (all P<0.05). The BRAF-V600E gene mutation was detected only in cHCL patients (11/14 vs. 0/9, P<0.001). In terms of immunophenotype, the expression of CD25, CD103, CD123 and CD200 in cHCL group (20/20, 20/20, 4/7, 7/17) were all stronger than those in HCL-v group (3/9, 7/9, 0/4, 2/8). Twenty-two patients were treated, of which 13 cases (12 cases of cHCL and 1 case of HCL-v) with cladribine, and 9 cases (4 cHCL and 5 HCL-v) with interferon. Complete remission rate and overall response rate were comparable between cladribine and interferon treatment groups (both P<0.05). The median follow-up time was 31 (range, 1-125) months, and the median overall survival (OS) of the entire group was 125 months. The 5-year OS rate in HCL-v patients represented a trend of inferior (50.0% vs. 95.0%, P=0.207). Conclusions: The clinical features of HCL are unspecific, which includes fatigue, splenomegaly and recurrent infection. The clinical features, immunophenotype, treatment response and prognosis of HCL-v are different from those of cHCL. BRAF-V600E gene mutation is suggested as a key marker for differential diagnosis. Cladribine is recommended as front-line regimen of cHCL patients with satisfactory efficacy and prognosis. Conversely, response and clinical outcome in HCL-v patients still need to be improved.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Leucemia de Células Pilosas/tratamiento farmacológico , Cladribina/uso terapéutico , Esplenomegalia/tratamiento farmacológico , Estudios Retrospectivos , Proteínas Proto-Oncogénicas B-raf/uso terapéutico , Pronóstico , Interferones/uso terapéutico , Antineoplásicos/uso terapéuticoRESUMEN
Objective: To evaluate the efficacy and prognosis of orthopedic surgical resection surgery in patients with newly diagnosed multiple myeloma (NDMM). Methods: This retrospective cohort study collected clinical data of patients with NDMM who underwent surgery due to spinal cord compression or pathological long-bone fractures at the Peking Union Medical College Hospital from 1 January 2003 to 31 December 2021. Patients who received biopsy or vertebroplasty/kyphoplasty were excluded and patients with the same degree of bone disease and who did not undergo any surgical intervention were selected as controls. Visual analogue scale (VAS) and physical status (ECOG) scores, progression-free survival (PFS), and overall survival (OS) were compared. Statistical analysis included the χ2-test, t-test, and Kaplan-Meier methods. Results: Baseline data were compared between the surgical group (n=40 with 43 interventions) and the non-surgical group (n=80), and included sex, age, paraprotein type, International Staging System (ISS), number of lytic lesions, cytogenetic abnormalities, first-line treatment, and the proportion of patients receiving autologous stem cell transplantation (ASCT) (all P>0.05). Serum M protein levels in the surgical group were significantly lower than those of the non-surgical group [(21.95±16.44) g/L vs. (36.18±20.85) g/L, P=0.005]. The surgical lesions involved the axial skeleton (79.1%, 34/43) or the extremities (20.9%, 9/43). VAS and ECOG scores improved significantly after surgery (VAS: 2.30±0.80 vs. 6.60±1.50, P<0.001; ECOG: 2.09±0.59 vs. 3.09±0.73, P<0.001). The median follow-up time was 51 months. Kaplan-Meier survival analysis suggested that the median PFS (25 vs. 29 months) and OS (46 vs. 60 months) were comparable between the surgical and non-surgical intervention groups (both P>0.05). Subgroup analysis showed that among patients with ISS Ⅰ or those who had received ASCT, PFS in the surgical group was similar to that of the non-surgical intervention group (both P>0.05), while OS was worse (P=0.005, 0.017). Patients with ISS Ⅱ/Ⅲ scores or without ASCT had similar PFS and OS between the surgical and non-surgical intervention groups (all P>0.05). Cox multivariate analysis suggested that ISS and ASCT were independent prognostic factors for OS (ISS: HR=0.42, 95%CI 0.19-0.93, P=0.031; ASCT: HR=0.41, 95%CI 0.18-0.97, P=0.041), while orthopedic surgery did not influence survival (P=0.233). Conclusion: For patients with NDMM, orthopedic surgical resection decreased bone-related complications and improved quality of life, but did not affect survival.
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Humanos , Pronóstico , Mieloma Múltiple/diagnóstico , Trasplante de Células Madre Hematopoyéticas/métodos , Estudios Retrospectivos , Calidad de Vida , Trasplante Autólogo , Procedimientos Ortopédicos , Resultado del TratamientoRESUMEN
The self-renewal and differentiation of hematopoietic stem cells(HSCs)are highly regulated by epigenetic modification,in which histone acetylation can activate or silence gene transcription.Histone deacetylase inhibitors(HDACIs)can inhibit the activity of histone deacetylase in HSCs to increase histone acetylation.A variety of HDACIs,such as trichostatin A and valproic acid,are used to expand HSCs in vitro,especially cord blood HSCs,combined with cytokines in serum-free culture to obtain more long-term repopulating cells.HDACIs promote the transcription of pluripotent genes related to stem cell self-renewal and inhibit the expression of genes related to differentiation,so as to promote the expansion and inhibit differentiation of HSCs.The expansion of cord blood HSCs by small molecular HDACIs in vitro is expected to improve the quantity of cord blood HSCs.The further research will focus on high-throughput screening for the most powerful HDACIs and the highly selective HDACIs,exploring the combination of epigenetic modifiers of different pathways.
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Epigénesis Genética , Sangre Fetal , Células Madre Hematopoyéticas , Inhibidores de Histona Desacetilasas/farmacología , Ácido Valproico/farmacologíaRESUMEN
The aim of this paper is to investigate the effect of patchouli alcohol in enhancing Helicobater pylori's action in eradicating macrophages and its mechanism. H. pylori was co-cultured with macrophages at a ratio of MOI=100 in different concentrations of patchouli alcohol. The effect of patchouli alcohol in eradicating macrophages was detected by agar dilution method. The effect of patchouli alcohol on NO and myeloperoxidase (MPO) levels in macrophages were measured by H. pylori by biochemical methods. Patchouli alcohol effect on H. pylori-induced pro-inflammatory gene expression and protein secretion in macrophages were detected by RT-qPCR and ELISA method. The eradication of H. pylori has significantly enhanced, and the destabilization of lysosomes has been reversed. Meanwhile, patchouli alcohol has an effect in inhibiting pro-inflammation and oxidation. The mechanism of patchouli alcohol in eradicating H. pylori and resisting oxidative stress may be associated to the blocking of bacteria escape lysosome combination procedures.
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Objective: To Evaluate the efficacy and safety of posaconazole as primary prevention of invasive fungal disease (IFD) in patients with severe aplastic anemia (SAA) treated with anti-thymus/lymphocyte immunoglobulin (ATG/ALG) combined with cyclosporine intensive immunosuppressive therapy (IST). Methods: A retrospective analysis of clinical data of 58 SAA patients who received IST of anti-thymocyte immunoglobulin combining cyclosporine and antifungal prophylaxis during April 2013 to May 2017 in Peking Union Medical College Hospital was performed. The patients were divided into posaconazole prophylaxis group and the control group (itraconazole or fluconazole). The disease characteristics, IFD prevention effect and adverse drug reaction, curative effect and prognosis of the two groups were compared. Results: Posaconazole was used to prevent fungal infection in 20 patients. The other 38 patients were used as the control group. Retrospective analysis showed comparable characteristics (gender, age, disease severity, etiology, interval between the onset of disease to treatment, ATG/ALG type) of both groups. The incidence of IFD were 0 and 15.8% in posaconazole prophylaxis group and the control group, respectively (P=0.084). In the control group, there were 6 cases diagnosed as IFD. Of them, 2 were confirmed, 2 suspected and 2 not identified. Five of the 6 cases were pulmonary infection, 1 bloodstream infections. Of the 6 IFD cases, 5 were very severe aplastic anemia (VSAA). There was no obvious adverse reaction in posaconazole prophylaxis group. Conclusion: Posaconazole is safe and effective for primary prevention of fungal infection of SAA patients receiving IST, especially for the VSAA.
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Humanos , Anemia Aplásica , Ciclosporina , Inmunosupresores , Micosis/prevención & control , Prevención Primaria , Estudios Retrospectivos , Resultado del Tratamiento , Triazoles/uso terapéuticoRESUMEN
Objective: To assess the value of immunoglobulin heavy/light chain (HLC) immunoassay on therapeutic response in patients with multiple myeloma(MM). Methods: A total of 45 newly diagnosed MM patients were retrospectively enrolled in Peking Union Medical College Hospital from 2013 to 2016, whose 115 serum samples were consecutively collected. HLC was tested to evaluate response and compare with other methods for M protein detection. Results: ①There were 30 males and 15 females in total of whom the monoclonal immunoglobulin was IgG in 27 (IgGκ∶IgGλ 12∶15) and IgA (IgAκ∶IgAλ 9∶9) in 18. The arerage age of the studied population was 59 (range 43-80) . ② In 34 patients with serum sample at diagnosis, 32 (94.1%) had abnormal HLC ratio (rHLC) while 2 patients with IgG had normal rHLC. The percentages of abnormal rHLC was 81.8% (18/22) at partial response、50.0%(9/18) at very good complete response and 16.0%(4/25) at complete response. ③In 25 patients reaching CR, there were 13 with IgG and 12 with IgA. 4 patients equally split of IgG and IgA had abnormal rHLC at complete response. ④By monitoring the rHLC of some patients consecutively, we found that the remission of rHLC was to some extent behind the remission of SPE and IEF, or even rFLC. Conclusion: Immunoglobulin HLC detection is one feasible method for minimal residual disease detection.
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Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inmunoensayo , Cadenas Pesadas de Inmunoglobulina , Cadenas Ligeras de Inmunoglobulina , Mieloma Múltiple , Estudios RetrospectivosRESUMEN
<p><b>BACKGROUND</b>CD200 and its receptor CD200R are both type-1 membrane glycoproteins, which are members of the immunoglobulin superfamily (IgSF). Besides the inhibitory effect on macrophages, CD200/CD200R also play an important role in regulating the regulatory T cells, allergicreaction, autoimmune diseases, allograft, neurological diseases and other autoimmune-related diseases, etc.</p><p><b>OBJECTIVE</b>To investigate the role of CD200 and its receptor in the graft versus host disease (GVHD).</p><p><b>METHODS</b>Experimental samples were divided into aGVHD group, non-aGVHD group, cGVHD group and non-cGVHD group, the healthy persons were used as normal controls. Firstly, the expression levels of CD200 and CD200R on CD19+ cell, CD3+ cell and dendritic cell (CD19- CD14- CD1c+) surfaces in each group were detected by using flow cytometry, so as to determine whether there were expression differences among each groups. Then, the mRNA levels of each groups were tested by using real-time quantitative polymerase chain reaction for finding the differences of mRNA expression level among each group. Finally, the peripheral blood mononuclear cells of the patients and healthy controls were co-cultured with anti-CD200R1 antibody for 48 hours, and the interleukin-10 level in the co-culture system was tested by using enzyme linked immunosorbent assay for verifying the function of CD200/CD200R.</p><p><b>RESULTS</b>The CD200 expression level on CD19+ cell surface in the aGVHD group and non-aGVHD group was both lower than that in healthy control group; that in the non-aGVHD group was higher than that in the aGVHD group. The CD200 expression level on CD19+ CD200+ cells in the non-cGVHD group were higher than that in the cGVHD group and healthy control group. There were no significant differences of CD200 and CD200R expression levels on CD3 cells and dendritic cells among all groups. The CD200 mRNA expression levels in the aGVHD group and cGVHD group were both lower than the healthy control group. The CD200 mRNA expression level was lower in the aGVHD group than in the non-aGVHD group, and was lower in the cGVHD group than in the non-cGVHD group. There was no significant difference of the CD200R mRNA expression level among all groups. After the peripheral blood mononuclear cells of the patients and healthy controls were co-cultured with anti-CD200R1 antibody for 48 hours, the interleukin-10 concentration decreased with the increasing of anti-CD200R1 antibody concentrations in the co-culture system.</p><p><b>CONCLUSION</b>The CD200/CD200R may play a role in the pathogenesis of GVHD after allo-HSCT.</p>
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Humanos , Antígenos CD , Metabolismo , Técnicas de Cocultivo , Células Dendríticas , Metabolismo , Citometría de Flujo , Enfermedad Injerto contra Huésped , Metabolismo , Trasplante de Células Madre Hematopoyéticas , Interleucina-10 , Metabolismo , Leucocitos Mononucleares , Glicoproteínas de Membrana , Metabolismo , ARN Mensajero , Metabolismo , Receptores de Superficie Celular , Metabolismo , Trasplante HomólogoRESUMEN
Acute Achilles tendon rupture is a common sports injury, is currently the best treatment for acute Achilles tendon rupture there are more controversial programs in the clinical, their treatment is divided into conservative treatment and surgical treatment. Conservative treatment for a long time, and then the higher Achilles tendon rupture rate, postoperative recovery slow. There are a number of complications traditional open surgery, and minimally invasive surgery in recent years developed a new technology that minimizes the exposure of the wound, reduce surgical trauma scope, shorten the operation time and reduce wound infection rate increasing importance in clinical practice, worthy of recommendation.
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<p><b>OBJECTIVE</b>To assess the antibiotic resistance and molecular characterization of cholera strains and to provide basis for clinical treatment and prevention of cholera.</p><p><b>METHODS</b>4 stains isolated from an outbreak of cholera epidemic in Huai'an City in Jiangsu province in September 2010 were characterized using antibiotic susceptibility, biotype analysis, virluence genes detection, ctxB gene sequencing, and PFGE analysis.</p><p><b>RESULTS</b>The 4 strains were all resistant to sulphamethoxazole/trimethoprim, erythromycin, streptomycin. High drug susceptibility of the samples was found to 6 kinds of antibiotics such as amikacin, norfloxacin, ciprofloxacin, gentamicin, chloramphenicol, ampicillin. The isolates expressed phenotypic traits of both serogroup O1 ogawa and El Tor and carried 9 kinds of virulence genes, ctxA, ace, zot, toxR, tcpI, ompU, rtxC, tcpA, and hlyA gene. They were also identified as harboring the classical ctxB genotype based on amino acid residue substitutions. The PFGE profiles of NotI showed a single banding pattern, while SfiI's was 2 banding patterns.</p><p><b>CONCLUSION</b>The bacterium type of Vibrio cholerae causing the epidemic outbreak of cholera belonged to the atypical EL Tor variant which was also identified as toxicogenic strain. The mapping of the strains prompted that there should be the common contamination source. Drug sensitivity test can guide the clinical drug use, in order to reduce the emergence of resistant strains.</p>
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Humanos , Antibacterianos , Cólera , Toxina del Cólera , Brotes de Enfermedades , Farmacorresistencia Bacteriana , Farmacorresistencia Microbiana , Epidemias , Genotipo , Vibrio cholerae , Vibrio cholerae O1 , VirulenciaRESUMEN
<p><b>OBJECTIVE</b>To analyze efficacy of radiotherapy for adult patients with Langerhans cell histiocytosis (LCH).</p><p><b>METHODS</b>Clinical features and efficacy of radiotherapy for biopsy-proven adult patient with LCH from January 2000 to October 2012 in our hospital were retrospectively analyzed.</p><p><b>RESULTS</b>Seventeen (11 male and 6 female) adult LCH patients with a mean age of 31 (18-56) years old were treated by irradiation, all patients presented as single-system disease. The mean duration from diagnosis to irradiation was 8.3 (0-108) months. Although 12 of 17 patients (70.6%) had short-term response to radiotherapy, all patients but one (94.1%) progressed during long-term follow-up, the mean progression-free survival (PFS) was 14 (0-131) months. Of the progressed patients, one relapsed in situ, the remaining 15 patients progressed outside the irradiated region. Thirteen patients (76.5%) eventually progressed to multisystem disease.</p><p><b>CONCLUSION</b>Though radiotherapy for LCH in adults produced a high short-term response up to 70.6%, most of patients eventually progressed in situ or outside the irradiation region during long-term follow-up.</p>
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Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Histiocitosis de Células de Langerhans , Radioterapia , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To determine the relationship between maternal and neonatal vitamin D status and related factors.</p><p><b>METHOD</b>Serum 25-(OH)D levels were measured by ELISA in 499 pregnant women at 30 - 37 weeks gestation and in cord blood of their infants born at term (37 - 42 wk gestation) in Southeastern China at 28.9°N latitude. One-way analysis of variance (ANOVA) was used to explore maternal and neonatal vitamin D levels by season. Pearson linear and linear regression of partial correlation was used to analyze the relationship between maternal and neonatal 25-(OH) D levels. The multiple factors related to maternal vitamin D status was assessed by binary logistic regression.</p><p><b>RESULT</b>The levels of serum 25-(OH)D were (33.0 ± 13.4) nmol/L in mothers and (31.0 ± 12.5) nmol/L in their newborns. Serum 25-(OH)D < 50 nmol/L was shown in 88.8% of mothers and 91.2% of their neonates. Both maternal and neonatal 25-(OH)D levels varied with season (Ps = 0.000). Vitamin D level was the lowest in spring, with the 25-(OH)D concentration < 50 nmol/L in 98.6% of mothers and 99.3% of their neonates. The highest vitamin D level was presented in fall, but there were still 64.0% of mothers and 75.0% of neonates with 25-(OH)D < 50 nmol/L. Except for season, calcium-vitamin D supplement and intake of egg ≥ 600 g per week during pregnancy benefited to improve maternal vitamin D level [25-(OH)D ≥ 50 nmol/L] [OR = 2.3 (95%CI:1.0, 5.3), 3.4 (95%CI:1.2, 9.9) respectively]. There was a positive correlation between maternal and neonatal 25-(OH)D measures in the sample as a whole (r = 0.45, P = 0.000, N = 499), the correlation was of no statistical significance when maternal serum 25-(OH)D was ≤ 25 nmol/L.</p><p><b>CONCLUSION</b>Hypovitaminosis D was common in late pregnant mothers and their newborns in southeastern China, especially in spring. Vitamin D supplement and intake of vitamin D-rich food were beneficial to improvement of maternal vitamin D level. There was a moderate and positive correlation between maternal and neonatal 25-(OH)D concentrations in this population. The correlation was lost when maternal serum 25-(OH)D ≤ 25 nmol/L.</p>
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Adulto , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Adulto Joven , Calcio , Sangre , Suplementos Dietéticos , Sangre Fetal , Química , Metabolismo , Sangre , Fenómenos Fisiologicos Nutricionales Maternos , Estado Nutricional , Sangre , Complicaciones del Embarazo , Sangre , Tercer Trimestre del Embarazo , Análisis de Regresión , Factores de Riesgo , Estaciones del Año , Luz Solar , Vitamina D , Sangre , Deficiencia de Vitamina D , SangreRESUMEN
Objective To explore the distribution of prevalence rates of typhoid and paratyphoid,with drug resistance and molecular types ofSalmonella(S.) typhi and S.paratyphi in Jiangsu province.Methods Data,collected by the national infectious disease reporting system in Jiangsu province from 2007 to 2011,was analyzed.K-B method was used to test the sensibility to 9 kinds of antibiotics among 210 stains of S.typhi and S.paratyphi.81 strains of S.typhi were classified by pulse-field gel electrophoresis (PFGE).Results The annual average incidence of typhoid and paratyphoid was 0.47 per 100 000 in the last five years,showing a decreasing trend.Highest incidence (1.70 per 100 000)was seen in the < 1 year age group,with S.typhi and S.paratyphi A accounted for 66.19% and 23.81% among the 210 stains.The rate of drug resistance to nalidixic acid appeared to be the highest as 66.19%.The drug resistant rates to 6 kinds of antibiotics were on average,lower than 10.00%.The multi-drug resistant rate of S.typhi and S.paratyphi was 30.00%.In the last 3 years,37 types from 81 S.typhi strains had been classified into 4 clusters by PFGE.The predominant type was JPPX01.JS0027,accounted for 11.11%.JPPX01.JS0001 type had a specific regional distribution,but JPPX01.JS0014,JPPX01.JS0018 and JPPX01.JS0024 strains were widely spread.Results from the clustering analysis showed that cases in the 3 events tended to have a clustering nature.Conclusion The morbidity of typhoid and paratyphoid was in a relatively low level in Jiangsu province.Although S.typhi and S.paratyphi were sensitive to most of the commonly used antibiotics,the resistance rates to some kinds of antibiotics were increasing.The distribution of typhoid was sporadic in Jiangsu and without the dominant strain,it was unlikely that typhoid could become epidemic in the future,in Jiangsu.
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<p><b>OBJECTIVE</b>To study the prevalence of iron deficiency in children between 6 months and 7 years and to study the diagnostic value of soluble transferrin receptor (sTfR) for iron deficiency in the children.</p><p><b>METHODS</b>A total of 502 healthy children between 6 months and 7 years from Hangzhou City of Zhejiang Province were enrolled. Serum sTfR, serum ferritin (SF), serum iron (SI), total iron blinding capacity (TIBC), zinc protoporphyrin (ZPP), Hb, MCV and CRP levels were measured.</p><p><b>RESULTS</b>The prevalence rate of iron deficiency was 19.5% in children at ages of 6 months to 7 years. The prevalence rate of iron deficiency was the highest in infants (≤1 year old; 34.7%), followed by in toddlers (1-3 years old; 19.4%) and preschoolers (3-7 years old; 14.0%). The mean serum sTfR level in infants (2.02±0.73 mg/L) was significantly higher than that in toddlers (1.68±0.40 mg/L) and preschoolers (1.67±0.29 mg/L) (P<0.05).The best cut-off value of serum sTfR for the diagnosis of iron deficiency was 2.02 mg/L in infants (sensitivity: 70.3%, specificity: 82.2%). The best cut-off value was 1.85 mg/L in toddlers (sensitivity: 71.7%; specificity: 86.4%), and that was 1.85 mg/L in preschoolers (sensitivity: 77.8%; specificity: 88.6%). Serum sTfR was correlated with SF (r=0.107, P<0.05), TIBC (r=0.276, P<0.01), TS (r=-0.139, P<0.05), ZPP (r=0.175, P<0.01) and MCV (r=-0.140, P<0.01).</p><p><b>CONCLUSIONS</b>Iron deficiency is more prevalent in infants ≤1 year old. The mean serum level and the cut-off value of sTfR in infants are higher than in toddlers and preschoolers. Serum sTfR is an effective index for the diagnosis of iron deficiency in children, especially in infants≤ 1 year old.</p>
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Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Factores de Edad , Hierro , Prevalencia , Receptores de Transferrina , SangreRESUMEN
Hemophagocytic lymphohistiocytosis (HLH) is a lifethreatening disorder due to hyperinflammation resulting in infiltration of different organs with extensive hemophagocytosis. Severe coagulopathy was one of the main reasons for death in HLH. Over secretion of plasminogen activator by activated macrophages leads to hyperfibrinolysis. We reported a 36-year-old woman who was diagnosed as HLH probably secondary to lymphoma. Massive bleeding from gut and retroperitoneal area were not able to be controlled by conventional hemostatic treatments. This patient received one dose recombinant activated factor VII (rFVIIa) 3.6 mg (70 μg/kg). Hemostatic effect was achieved in 0.5 hour and lasted 24 hours. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were quickly corrected to normal ranges. Fibrinogen level elevated from 0.5 g/L before using rFVIIa to 1.8 g/L 20 hours after. Although dexamethasone and etopside were administrated to treat HLH, this patient died from septic shock after persistent neutropenia. This suggests that rFVIIa may be effective in the management of intractable hemorrhage in patients with HLH.
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Adulto , Femenino , Humanos , Coagulación Intravascular Diseminada , Factor VIIa , Usos Terapéuticos , Linfohistiocitosis Hemofagocítica , Quimioterapia , Proteínas Recombinantes , Usos TerapéuticosRESUMEN
<p><b>OBJECTIVE</b>To evaluate the efficacy of porcine anti-human lymphocyte globulin (P-ALG) plus cyclosporine A (CsA) therapy for severe aplastic anemia (SAA).</p><p><b>METHODS</b>Forty-eight SAA patients (31 males, 17 females) including 17 very severe aplastic anemias (vSAA) were treated with ALG plus CsA between 1999 to 2009 in our hospital and the outcomes were analyzed retrospectively for early mortality, response rate and quality, survival rate, toxicity and complications.</p><p><b>RESULTS</b>The median age was 28 (13 - 64) years. The interval from diagnosis to treatment was 45 days. The median neutrophil count at diagnosis was 0.178 × 10(9)/L. Overall response was 83.3% (54.2% complete, 29.2% partial) with a median time of 90 (23 - 380) days. 10.4% died of infection within 30 days mainly of fungi infection. Only 1 patient relapsed 2 years after treatment. No clonal disease was found. The 1.5-year survival rate was 87.5%. vSAAs had less response, higher early mortality and less survival (64.7%, 29.4% and 51.8%, respectively) compared to that of SAA (93.5%, 0, 100%, respectively, P < 0.05). Grouped patients with different age, gender, intervals between diagnosis and treatment and pre-existing infections had similar response. The main side effects were fever and skin rash (52.1%), serum sickness (16.7%), impaired liver function (60.4%) and hemorrhage (2.1%). No treatment-related mortality was found.</p><p><b>CONCLUSION</b>P-ALG plus CsA is an ideal and well tolerated treatment for SAA but not for vSAA.</p>
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Adolescente , Adulto , Animales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Anemia Aplásica , Quimioterapia , Suero Antilinfocítico , Usos Terapéuticos , Ciclosporina , Usos Terapéuticos , Inmunosupresores , Usos Terapéuticos , Linfocitos , Alergia e Inmunología , Estudios Retrospectivos , Porcinos , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To compare the efficacy and adverse effects between arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) in patients with acute promyelocytic leukemia (APL).</p><p><b>METHODS</b>The clinical data of 71 patients with newly diagnosed APL were retrospectively analyzed. Two groups were classified according to the induction regimens, namely ATO group (n = 41) and ATRA group (n = 30). The complete remission (CR) rate and the time to CR were compared between these two groups.</p><p><b>RESULTS</b>The CR rate was 97.5% in ATO group and 93.3% in ATRA group (P > 0.05). The median time to CR was 29 days (21-45 days) in ATO group, which was significantly shorter than 38.5 days (24-63 days) in ATRA group (P < 0.001). Retinoic acid syndrome occurred in 52.9% of patients treated with ATRA, which affected the further use of ATRA.</p><p><b>CONCLUSIONS</b>Both ATO and ATRA have high response rates for newly diagnosed patients with APL. Compared with ATRA, ATO induction therapy has shorter time to achieve CR and less adverse effects, and therefore may be the first-line therapy for APL.</p>
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Arsenicales , Usos Terapéuticos , Leucemia Promielocítica Aguda , Quimioterapia , Óxidos , Usos Terapéuticos , Inducción de Remisión , Estudios Retrospectivos , Resultado del Tratamiento , Tretinoina , Usos TerapéuticosRESUMEN
Six hundred and eight fungi strains were isolated from seventy-eight samples of mangrove plants and soil that collected from Qinglan harbor. Cyctotoxic activity was detected by observing the growth inhibition or killing of the tumor cells under microscope. The result showed that 81 strains (about 13.32% of the total strains isolated) displayed cytotoxic activity against B16 tumor cell. The most fungi strains were isolated from mangrove plant Sonneratia alba, and most of cytotoxic active fungi strains were isolated from mangrove plant Heritiera littoralis.
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Animales , Ratones , China , Pruebas Inmunológicas de Citotoxicidad , Hongos , Fisiología , Melanoma Experimental , Patología , Raíces de Plantas , Microbiología , Rhizophoraceae , Microbiología , Microbiología del Suelo , Células Tumorales CultivadasRESUMEN
The study was aimed to investigate the genetic background and proliferation characteristics of multiple myeloma (MM). Myeloma cells were isolated from bone marrow of 19 MM patients by direct immunomagnetic cell sorting and the DNA content and cell cycle analysis were carried out by flow cytometry. The results showed that in 4 patients the myeloma cells were found to be hyperdiploid and in 15 patients those were found to be diploid respectively by DNA content analysis; the proportion of plasm cells from normal controls in S + G(2)/M phase was (1.15 +/- 0.60)%, and that of myeloma cells from MM patients was (10.06 +/- 12.60)% which was significantly higher than that in the former (p = 0.001). The incidence of hyperdiploid in newly diagnosed patients was 11.76%, and that of treated patients was 100.00% which was significantly higher than that in the former (p = 0.035); the proportion of myeloma cells from newly diagnosed patients in S + G(2)/M phase was (7.12 +/- 4.98)%, and that of treated patients was (35.10 +/- 32.56)% which was also significantly higher than that in the former (p = 0.001). It is concluded that the variety of myeloma cells in DNA content and cell cycle suggests the complicated genetic background and abnormal proliferation of MM, which relate with the course of disease to some extent.
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Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Células de la Médula Ósea , Metabolismo , Patología , Ciclo Celular , Genética , Proliferación Celular , ADN , Genética , Diploidia , Mieloma Múltiple , Genética , PatologíaRESUMEN
<p><b>OBJECTIVE</b>To investigate the clinical significance of the deletion of the long arm of chromosome 13 [del (13 q) ] and translocation of immunoglobulin heavy chain gene [t (14 q) I in multiple myeloma (MM) patients.</p><p><b>METHODS</b>Myeloma cells were isolated from hone marrow by direct immunomagnetic cell sorting and interphase fluorescence in situ hybridization (FISH) was performed in 24 MM patients to detect del (l3q) and t (l4q).</p><p><b>RESULTS</b>The positive rates of del (l3q) and t (l4q) were 45.83% and 37.50% respectively. Five patients (20.83%) had both two abnormalities and 15 patients (62.50%) had at least one abnormality. Univariate analysis showed that the positive rates of del (l3q) were 35.71% and 66.67% in responders and non-responders (P = 0.214) and the positive rates of t (l4q) were 21.43% and 66. 67% in responders and non-responders (P = 0.077). Multivariate analysis showed that del (13q) (OR = 5.761, 95% CI 0.500-66.391, P = 0.160), t (14q) (OR = 6.576, 95% CI 0.580-74.614, P = 0.129), and corrected serum calcium level (OR = 8.080, 95% CI 0.738-88.427, P = 0.087) were relatively independent negative factors for response to therapy, with the corrected serum calcium level being the strongest reversely-correlated factor.</p><p><b>CONCLUSIONS</b>Interphase FISH is a sensitive method to investigate the cytogenetics of MM. Del (13q), t (14q), and corrected serum calcium level can be used to predict treatment response and prognosis.</p>