Higher red blood cell distribution width at diagnose is a simple negative prognostic factor in chronic phase-chronic myeloid leukemia patients treated with tyrosine kinase inhibitors: A retrospective study.

ABSTRACT: The aim of this study was to evaluate the ability of the red blood cell distribution width (RDW) to predict prognosis and treatment response in chronic myeloid leukemia (CML)-chronic phase (CP) patients treated with tyrosine kinase inhibitor (TKIs).We retrospectively enrolled 93 newly diagnosed CML-CP patients treated with TKIs from 2009 to 2018 at the First Hospital of Lanzhou University. Patients were divided into 2 groups using an RDW of 18.65% determined by receiver operating characteristic curve analysis. We analyzed the correlation of treatment responses and the RDW compared to common scoring systems, as well as the correlation of the RDW with disease outcome, including overall survival (OS) and progression-free survival (PFS), and demographic and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used.The median age of patients was 40 years, and 51 patients (54.8%) were men. A high RDW could predict treatment response at 3 months (P = .03) and 6 months (P = .02). The RDW was significantly lower in patients who achieved molecular response by 3 months (P < .001) and complete cytogenetic response by 6 months (P = .001) than in those who did not respond. Patients with a high RDW (>18.65%, n = 35) had significantly worse 5-year OS (77.1% vs 96.6%; P = .008) and PFS (80.0% vs 98.3%; P = .002) than those with a low RDW (≤18.65%, n = 58). Multivariate analysis demonstrated that a high RDW was an adverse predictor of OS (P = .005, HR (hazard ratio) = 9.741) and PFS (P = .009, HR = 16.735).The RDW is a readily available prognostic marker of outcome in patients with CML-CP and can predict treatment response to TKIs. Further larger and prospective studies are required.

[Response of Aggregate Distribution to Input Straw and Their Linkages to Organic Carbon Mineralization in Soils Developed from Five Different Parent Materials].

Development and the dynamics of stable aggregates in many soils are known to be closely related to the cycling as well as accumulation of soil organic carbon (SOC). This study explored the aggregation processes and distributions of soil organic carbon in soils developed from limestone (L), quaternary red earth (Q), granite (G), basalt (B), and tertiary red sandstone (T) subtropical China related to the addition of maize residues during 7 days and 184 days of incubation. The soils were sieved to<0.25 mm before incubation. We aimed to clarify the mechanisms underlying SOC mineralization across soils from the perspective of soil aggregate protection. Fractionation of the water stable aggregates showed that addition of maize straw promoted the formation of>2 mm and 2-1 mm aggregates, while only 1.0-0.5, 0.5-0.25 and <0.25 mm aggregates were detected in the absence maize straw. The proportion of macroaggregates as well as their stability was always higher in L, Q, and B developed soils than those in G and T developed soils. In amended soils, the accumulation of total SOC was much obvious in L, Q, and B developed soils than those in G and T developed soils, and these increases were mainly contributed by the >0.25 mm macroaggregate-associated SOC. This result indicated that>0.25 mm macroaggregates were important spots for SOC sequestration. Furthermore, the proportions of>0.25 mm macroaggregate-associated SOC were also significantly (P<0.05) higher in L, Q, and B developed soils than those in G and T developed soils, and the free light organic carbon (fLOC) followed an inverse parent material pattern as>0.25 mm macroaggregate-associated SOC. Results also demonstrated that ratios of accumulative mineralized CO2-C to total soil organic carbon in L, Q, and B soils were significantly (P<0.05) lower than those in G and T soils. The correlation analysis further suggested that ratios of cumulative respired CO2-C to total soil organic carbon were significantly and positively correlated (P<0.01) with the proportion of fLOC, but inversely correlated (P<0.01) with the proportion of>0.25 mm macroaggregate-associated SOC. By applying 13C-NMR to characterize the inherent chemical composition of soil organic carbon fractions, we noted that fLOC was more deeply decomposed than intra-aggregate light organic carbon (intra-aggregate LOC), and both the fractions were advanced decomposed in G and T developed soils, verifying enhanced protection of added maize residues inside soil aggregates. The findings of the research suggested that the parent material exerts a significant influence on SOC mineralization by controlling the formation of aggregates and location of SOC in the hierarchical structure of the soil aggregate system. We demonstrated that enhanced physical protection of SOC by forming more stable macroaggregates contributes to carbon accumulation in limestone, quaternary red earth, and basalt developed soils treated with organic amendments.

[Clinical Analysis of Serum Calcium Level in 86 Cases of Newly Diagnosed Multiple Myeloma].

OBJECTIVE: To investigate the serum calcium level in 86 patients with newly diagnosed multiple myeloma (MM) and its correlation with clinical features. METHODS: The clinical data of 86 patients with newly diagnosed multiple myeloma in our hospital from 2009 to 2016 were retrospectively analyed. Clinical data of sex, age, hemoglobin, albumin, globulin, creatinine, uric acid, serum phosphorus, ß2-microglobulin, immunophenotyping and disease staging were collected. After the serum calcium level was corrected, the patients were grouped into low serum calcium (<2.20 mmol/L), normal serum calcium (2.20-2.60 mmol/L) and high serum calcium (>2.60 mmol/L). The correlation between the clinical characteristics and the serum calcium level was analysed, the clinical characteristics between the low and non-low calcium group were compared. RESULTS: The number of cases in low, normal and high serum cnlcium groups before correction was 58 (67.4%), 18 (20.9%) and 10 (11.6%) respactively, while the number of cases in 3 group after correction was 34 (39.5%), 36 (41.9%) and 16 (18.6%) respectively. The age, globulin, creatinine, uric acid and serum phosphorus levels were positively correlated with serum calcium level in patients with multiple myeloma, while the sex, hemoglobin,albumin and ß2-microglobulin levels did not correlated with serum calcium level. There was significant difference in the age, globulin, creatinine and serum phosphorus between low calcium and non-low calcium group (P<0.05). However the differences of sex, hemoglobin, albumin, uric acid, ß2-microglobulin, immunophenotyping and clinical stage were not statistically significant (P>0.05). CONCLUSION: Multiple myeloma patients suffered from both hypercalcemia and hypocalcemia, and the incidence of hypocalcemia is not low. The levels of serum calcium in patients with multiple myeloma correlate with age, globulin, creatinine, uric acid, serum phosphorus level and other factors, thus it is necessary to correct the level of ionized calcium with physiological activity.

[Effect of Long-term Fertilizer Application on the Stability of Organic Carbon in Particle Size Fractions of a Paddy Soil in Zhejiang Province, China].

Effects of chemical fertilizers and organic manure on the soil organic carbon (SOC) content in particle size fractions of paddy soil were investigated in a 17-year long-term fertilization field experiment in Zhejiang Province, China. The inherent chemical composition of silt- and clay-associated SOC was evaluated with solid-state 13C-NMR spectroscopy. Compared to CK (no fertilizer treatment), NPKRS (NPK fertilizers plus rice straw) , NPKOM (NPK fertilizers plus organic manure) , NPK (NPK fertilizers) and OM (organic manure alone) treatments significantly (P <0. 05) increased the SOC content of sand- (2-0.02 mm), silt- (0.02-0.002 mm) and clay-sized (< 0.002 mm) fractions. However, no significant difference was observed in the accumulation of silt- and clay-associated SOC between CK and rice straw (RS) treatments. Besides, in comparison with plots applied with NPK fertilizers alone, combined application of organic amendments and NPK fertilizers facilitated the storage of newly sequestered SOC in silt- and clay-sized fractions, which could be more conducive to the stability of SOC. Based on 13C-NMR spectra, both silt and clay fractions were composed of Alkyl-C, O-alkyl-C, Aromatic-C and carbonyl-C. Changes in the relative proportion of different C species were observed between silt and clay fractions: the clay fraction had relatively more Alkyl-C, carbonyl-C and less O-alkyl-C, Aromatic-C than those in the silt fraction. This might be ascribed to the fact that the organic matter complexed with clay was dominated by microbial products, whereas the silt appeared to be rich in aromatic residues derived from plants. The spectra also showed that the relative proportion of different C species was modified by fertilization practices. In comparison with organic amendments alone, the relative proportion of Alkyl-C was decreased by 9.1%-11.9% and 13.7%-19.9% under combined application of organic amendments and chemical fertilizers, for silt and clay, respectively, and that of O-alkyl-C was increased by 2.9%-6.3% and 13.4%-22.1%, respectively. These results indicated that NPKOM and NPKRS treatments reduced the decomposition rate of SOC. The aromaticity, hydrophobicity and, hence, chemical recalcitrance of silt- and clay-associated SOC in the NPK fertilizer treatments were lower than those of the organically amended plots and unfertilized treatments, indicating decreased recalcitrance of SOC against decomposition. We concluded that long-term application of organic manure combined with chemical fertilizers, either through increased accumulation of both recalcitrant compounds and carbohydrates or reduced decomposition of organic matter, was a sustainable strategy for facilitating carbon accumulation of the paddy soil investigated in this study.