RESUMO
To identify relationships between busulfan (Bu) exposure and outcomes of a cohort pediatric patients receiving hematopoietic stem cell transplantation (HSCT), along with a targeted busulfan-based conditioning regimen. We retrospectively evaluated targeted busulfan concentrations in 53 pediatric patients (age 0.4-16 years) who received busulfan 4 times daily according to recommended weight-based doses in a single-center analysis between 2018 and 2020. In this trial, individual busulfan pharmacokinetics were performed following dose 5 of the conditioning regimen. Twenty four of 53 patients (45.3%) studies did not require dose adjustments. Equal number of patients (24/53) required one dose adjustments while two-dose adjustment applied for 5 of 53 (9.4%). Twenty-one percent of the patients exhibited ll-lV aGVHD. The incidence of veno-occlusive disease (VOD) was in 3.8% of the 53 patients, while incidence of hemorrhagic cystitis (II-III) reached to 9.7%. Engraftment was successful in 98% of the 53 patients with relapse in 2% of cases. The probability of overall survival and disease-free survival at day 100 was 96% and 94%, respectively. In conclusion, therapeutic drug monitoring (TDM) and individualization of Bu dosage are essential to improve the efficacy and safety of busulfan-based regimen in Chinese pediatric HSCT recipients.
Assuntos
Bussulfano , Transplante de Células-Tronco Hematopoéticas , Adolescente , Bussulfano/efeitos adversos , Criança , Pré-Escolar , China , Monitoramento de Medicamentos , Humanos , Lactente , Estudos Retrospectivos , Condicionamento Pré-Transplante/efeitos adversosRESUMO
PURPOSE: The meta-analysis aims to investigate the relationship between anti-phospholipase A2 receptor autoantibody (anti-PLA2R) and clinical characteristics and adverse outcomes of idiopathic membranous nephropathy (IMN). METHODS: Related studies published before February 2020 were systematically retrieved from foreign and domestic databases, RevMan5.3 software was used for meta-analysis and subgroup analysis, and STATA 15.0 statistical software was used for its heterogeneity and testing publication bias. RESULTS: Twenty studies were included, involving 2224 patients with IMN. Our results showed that a significant correlation existed between the expression of serum anti-PLA2R and age (MD = 2.91, 95% CI = 2.15-3.67, P < 0.00001), total serum cholesterol (MD = 35.52, 95% CI = 9.52-61.52, P = 0.007), urine protein by creatinine ratio (UPCR) (MD = 2.15, 95% CI = 1.86-2.44, P<0.00001), serum albumin (MD = -0.40, 95% CI = -0.56 to -0.23, P < 0.00001), eGFR (MD = -10.44, 95% CI = -12.19 to -8.68, P < 0.00001), unremission rate (RR = 1.76, 95% CI = 1.37-2.27, P < 0.0001). In addition, the high titer in seropositive group was closely correlated with serum albumin (MD = -0.40, 95% CI = -0.74 to -0.05, P = 0.03), eGFR (MD = -12.40, 95% CI = -16.29 to -8.52, P < 0.00001) and unremission rate (RR = 2.52, 95% CI = 1.79-3.55, P < 0.00001). No significant correlation was found between glomerular anti-PLA2R and clinical manifestations except for serum cholesterol (MD = 0.81, 95% CI = 0.21-1.41, P = 0.008). However, in terms of prognosis, glomerular anti-PLA2R showed a significant relevance to recurrence rate (RR = 2.25, 95% CI = 1.07-4.72, P = 0.03). CONCLUSION: Compared with glomerular anti-PLA2R, serum anti-PLA2R may better reflect the activities of IMN disease, while the glomerular anti-PLA2R might be connected with the recurrence of the disease.
Assuntos
Autoanticorpos/sangue , Glomerulonefrite Membranosa/sangue , Glomerulonefrite Membranosa/diagnóstico , Receptores da Fosfolipase A2/imunologia , Glomerulonefrite Membranosa/imunologia , HumanosRESUMO
OBJECTIVE: We undertook a meta-analysis to compare the efficacy and safety of single versus double door posterior cervical laminoplasty for cervical spondylotic myelopathy. METHODS: PubMed, Embase, and Cochrane Central Register of controlled trials were searched for randomized controlled trials investigating single and double door posterior cervical laminoplasty for cervical spondylotic myelopathy. The Mantel-Haenszel method with the fixed-effects or random-effects model was used to calculate relative risks and 95% confidence intervals (CIs). RESULTS: Seven studies with 224 patients met the eligibility criteria and were included. There was a significant difference in Japanese Orthopedic Association score (MDâ=â0.79, 95%CI [0.09, 1.49], Pâ=â.03; P for heterogeneityâ=â.09, Iâ=â45%), and adverse events (ORâ=â0.32, 95%CI [0.11, 0.95], Pâ=â.04; P for heterogeneityâ=â1.00, Iâ=â0%) between the double door posterior cervical laminoplasty group and the single door posterior cervical laminoplasty group. There was no significance in operative time (MDâ=â0.56, 95%CI [-11.86, 12.98], Pâ=â.93; P for heterogeneityâ=â0.001, Iâ=â73%) and length of hospital stay (ORâ=â-0.75, 95%CI [-1.78, 0.27], Pâ=â.15; P for heterogeneityâ=â1.00, Iâ=â0%) between the 2 groups. CONCLUSION: Double door posterior cervical laminoplasty is more effective and safer than single door laminoplasty in the treatment of cervical spondylotic myelopathy.
Assuntos
Vértebras Cervicais/cirurgia , Laminoplastia/métodos , Espondilose/cirurgia , Adulto , Idoso , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
By ICP-AES, we established a method to quantitatively determine the micro-elements in couplers. We processed the unknown sample with wet digesting method. Nine micro-elements in the couplers can be quantitatively determined at the same time. Using the powerful chem.-station, we have discussed the method to eliminate physical interference and background correction. The results of the experiment showed that the method is accurate, quick, of high performance, and with all RSDs < or = 1.00%. The linear correlation coefficient of the tested elements is over 0.9999.