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OBJECTIVE: To establish a highly sensitive and quantitative detection method for ABL1 kinase region mutations, provide strong support for the early diagnosis and treatment of chronic myeloid leukemia(CML). METHODS: Sampele from 35 CML patients who were initially tested negative for ABL1 kinase region mutations by Sanger sequencing were collected. The ABL1 kinase region mutation was detected by the fluorescence quantitative detection kit of Shanghai Yuanqi Biopharmaceutical Technology Co., Ltd. The mutation rate was analyzed by â³â³Ct value method. The relative mutation rate of the final ABL1 kinase region was determined by dividing the mutation rate by the expression level of the fusion gene. RESULTS: Among the 35 CML patients initially tested negative for ABL1 mutations by the Sanger sequencing method, 7 cases of T315I mutation, 2 cases of T315A mutation, 2 cases of Y253H mutation, and 1 cases of E255K mutation after detection of the new method. The relative mutation rates range from 0.1% to 19.42%, which could not be detected by Sanger sequencing method. Subsequently, this method was used to detect the ABL1 mutation in 126 CML patients, and the positive rate exceeded that of the Sanger sequencing method. The BCR-ABL1 gene expression significantly reduced or negative after adjusting treatment strategy based on the mutation situation. CONCLUSION: Compared with Sanger sequencing, fluorescence quantitative PCR has higher sensitivity and can screen for low-frequency ABL1 kinase mutations in the early stage. Moreover, it can also perform relative quantitative analysis, so the method has good clinical application prospects for detecting ABL1 mutation.
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Leucemia Mielógena Crónica BCR-ABL Positiva , Mutación , Proteínas Proto-Oncogénicas c-abl , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Proteínas Proto-Oncogénicas c-abl/genética , Proteínas de Fusión bcr-abl/genética , Fluorescencia , Reacción en Cadena de la Polimerasa/métodos , Tasa de MutaciónRESUMEN
Chronic myeloid leukaemia (CML) is caused by BCR::ABL1. Tyrosine kinase-inhibitors (TKIs) are the initial therapy. Several organizations have reported milestones to evaluate response to initial TKI-therapy and suggest when a change of TKI should be considered. Achieving treatment-free remission (TFR) is increasingly recognized as the optimal therapy goal. Which TKI is the best initial therapy for which persons and what depth and duration of molecular remission is needed to achieve TFR are controversial. In this review we discuss these issues and suggest future research directions.
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Leucemia Mielógena Crónica BCR-ABL Positiva , Inhibidores de Proteínas Quinasas , Humanos , Inhibidores de Proteínas Quinasas/uso terapéutico , Proteínas de Fusión bcr-abl/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/etiología , Inducción de Remisión , BiologíaRESUMEN
Sleep deprivation (SD) has become a universal social problem. There is a causal relationship between SD and energy metabolism disorder. Phytochemicals have been demonstrated to have excellent sleep-promoting effects, and studies have shown that ginsenoside Rg5 (Rg5) exerts sedative and hypnotic effects. The present study aimed to investigate the role of Rg5 in regulating energy metabolism and explore the potential mechanism of improving sleep. Sleep-deprived rats were randomly divided into a control group (Ctrl), SD model group (SD), Rg5 group (GRg5), and melatonin group (MT). Sleep-deprived model rats were generated by housing rats in an SD box for 4 weeks. The Ctrl and SD groups were given equal volumes of saline. The Rg5 groups were given 25[Formula: see text]mg/kg Rg5 or 50[Formula: see text]mg/kg Rg5, and the MT group was given 0.27[Formula: see text]g/kg MT. A Western blot analysis and ELISA were used to detect the metabolic levels, mitochondrial functional proteins, AMPK pathway proteins, clock-related proteins, adenosine receptors, and neurotransmitter receptors. The results showed that Rg5 corrected abnormal glucose and lipid metabolism as well as improved ATP levels. In addition, Rg5 alleviated mitochondrial structural damage and improved the expression of proteins involved in mitochondrial biosynthesis, fission, and fusion. Moreover, Rg5 improved the expression of AMPK/PGC-1/Nrf-1 pathway proteins, regulated mitochondrial biological functions, and affected the rhythm characteristics of circadian clock-related proteins. Further, Rg5 improved the expression of A1R and A[Formula: see text]R as well as regulated the expression levels of GABAA1[Formula: see text] and mGluR5 to improve sleep in SD rats.
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OBJECTIVE: To summarize clinical application of the distal island muscle flap of the gastrocnemius muscle for repairing the defects around knee and within the upper 2/3 of lower leg. METHODS: 18 patients with defects around knee and within the upper 2/3 of lower leg, were treated with the distal island muscle flap of the gastrocnemius muscle, including 12 cases with medial muscle head and 6 cases with lateral muscle head. The muscular flaps were covered with meshed split-thickness skin grafts. The wound at donor sites were closed directly. RESULTS: All the skin grafts and muscle flaps survived with superior infection at the wound edge in two cases. The patients were followed up for 8 months to 4.8 years with satisfactory cosmetic and functional results. CONCLUSIONS: The distal island muscle flap of the gastrocnemius muscle has a reliable blood supply, long pedicle and suitable thickness. It is an ideal method for repairing the defects around knee and within the upper 2/3 of lower leg.
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Traumatismos de la Pierna/cirugía , Músculo Esquelético/trasplante , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Colgajos Quirúrgicos/irrigación sanguínea , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To evaluate clinical result of the micro-decompression procedure for lumbar spinal stenosis. METHODS: From September 2001 to May 2006,87 patients (male 60, female 27) with lumbar spinal stenosis underwent micro-decompression. The age of patients were from 43 to 80 years with an average of 51 years. Among them,2 cases with spinal stenosis occured in L(3,4), 47 in L(4,5), 38 in L5S1. RESULTS: All patients were followed up for 18-48 months with an average of 26 months. The results were excellent in 52 cases, good in 28, poor in 7, according to Macnab of back leg pain standard. The rate of excellent and good was 92%. CONCLUSION: Operative treatment for lumbar spinal stenosis is focused at the areas causing symptomatic neural root compression rather than prophylactic decompression at areas of nonsymptomatic disease. The micro-decompression procedures are more likely to be well tolerated by older patients.