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Chimeric antigen receptor (CAR)-T cell therapy has been confirmed improving remission rates in refractory patients or relapsed B-cell acute lymphoblastic leukemia (R/R B-ALL). However, the added benefits of undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) following CAR-T therapy remain a subject of debate. In this research we investigated the efficiency and long-term outcomes of CD19 CAR-T bridging with allo-HSCT in R/R B-ALL patients. A total of 42 patients were brought into the cohort studies. Our findings revealed that patients who appected CAR-T followed by HSCT had a 1-year overall survival (OS) rate of 70 % and a 1-year leukemia-free survival (LFS) rate of 95 %. Moreover, patients who underwent this combined treatment had higher OS and LFS rates compared to those who received CAR-T therapy alone. In conclusion, the results of this clinical trial provide compelling evidence for the safety and efficacy of using CAR-T therapy as a bridging strategy to allo-HSCT in patients with R/R B-ALL.
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Hepatocellular carcinoma (HCC) has become an important public health problem, and there are still challenges to overcome in clinical treatment. The nanodrug delivery system (NDDS) has developed tremendously in recent years, and many researchers have explored NDDS for the treatment of HCC. Engineered cell membrane-coated nanoparticles (ECNPs) have emerged, combining the unique functions of cell membranes with the engineering versatility of synthetic nanoparticles (NPs) to effectively deliver therapeutic drugs. It is designed to have the capabilities: specific active targeting, immune evasion, prolonging the circulation blood time, controlled drug release delivery, and reducing drugs systematic toxicity. Thus, ECNPs are a promising bionic tool in the treatment of HCC and have operability to achieve combination and integrated therapy. This review focuses on the mechanism and strategy of ECNPs for the treatment of HCC and summarizes its research progress in the treatment of HCC in recent years.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Nanopartículas , Humanos , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Membrana Celular , Sistemas de Liberação de MedicamentosRESUMO
Reducing carbon emissions is the key to fulfilling the "double carbon commitment" and promoting the green transformation of the economy. The financial sector is the forerunner of change in economic development. The rapid development of digital finance has disrupted the traditional financial operation mode and has had a significant impact on economic development and environmental quality. This paper explores the impact of digital finance development on carbon emissions using carbon emission data from 2011 to 2017 in China's counties and combining it with the Digital Inclusive Finance Index of Peking University. The findings are as follows: (1) The development of digital finance can curb carbon emissions, and this causal relationship still holds through a series of robustness tests. The greater the carbon emissions, the better the carbon suppression effect of the development of digital finance. (2) When regions face strict financial regulation and environmental constraints, the development of digital finance can be more effective in reducing carbon emissions. The existence of a digital divide in general can weaken the disincentive effect of the development of digital finance on carbon emissions. (3) The development of digital finance can promote the development of green finance, enhance the level of green technological innovation, improve green total factor productivity, and transform energy structures, thus curbing carbon emissions. This paper not only enriches the literature on the development of digital finance and the environment but also provides a reference for government departments to improve the development strategy of digital finance and achieve "carbon peaking and carbon neutrality."
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Carbono , Desenvolvimento Econômico , Humanos , China , Condições Sociais , Universidades , Dióxido de CarbonoRESUMO
The overall therapeutic outcome of acute myeloid leukemia (AML) is poor, and relapse and refractory are the main reasons for treatment failure. Leukemia cells of relapsed and refractory AML (R/R-AML) patients are usually resistant to conventional chemotherapy, and new treatment regimens are urgently needed to further improve the survival rate and prolong the survival time of these patients.There are no recommended unified treatment regimens other than entering clinical trials.At present,the main options are salvage chemotherapy and hematopoietic stem cell transplantation (HSCT), and HSCT is the only possible cure for R/R-AML, but the prognosis of most of these patients is still poor.In recent years,the treatment status of AML has progressed rapidly, and the new therapies are emerging, many new drugs have become the research focus. Some progress has been made in improving chemosensitivity and overcoming chemoresistance by combining the new drugs with the original chemotherapeutic drugs, which provide a new treatment option and improve the overall prognosis for R/R-AML patients. This article will review the current treatment status and the latest progress in new drug research of R/R-AML.
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Leucemia Mieloide Aguda , Humanos , Leucemia Mieloide Aguda/tratamento farmacológicoRESUMO
Background: Population aging accompanied by multimorbidity imposes a great burden on households and the healthcare system. This study aimed to determine the incidence and determinants of catastrophic health expenditure (CHE) in the households of old people with multimorbidity in China. Methods: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018, with 3,511 old people (≥60 years) with multimorbidity responding to the survey on behalf of their households. CHE was identified using two thresholds: ≥10% of out-of-pocket (OOP) health spending in total household expenditure (THE) and ≥40% of OOP health spending in household capacity to pay (CTP) measured by non-food household expenditure. Logistic regression models were established to identify the individual and household characteristics associated with CHE incidence. Results: The median values of THE, OOP health spending, and CTP reached 19,900, 1,500, and 10,520 Yuan, respectively. The CHE incidence reached 31.5% using the ≥40% CTP threshold and 45.6% using the ≥10% THE threshold. It increased by the number of chronic conditions reported by the respondents (aOR = 1.293-1.855, p < 0.05) and decreased with increasing household economic status (aOR = 1.622-4.595 relative the highest quartile, p < 0.001). Hospital admissions over the past year (aOR = 6.707, 95% CI: 5.186 to 8.674) and outpatient visits over the past month (aOR = 4.891, 95% CI: 3.822 to 6.259) of the respondents were the strongest predictors of CHE incidence. The respondents who were male (aOR = 1.266, 95% CI: 1.054 to 1.521), married (OR = 1.502, 95% CI: 1.211 to 1.862), older than 70 years (aOR = 1.288-1.458 relative to 60-69 years, p < 0.05), completed primary (aOR = 1.328 relative to illiterate, 95% CI: 1.079 to 1.635) or secondary school education (aOR = 1.305 relative to illiterate, 95% CI: 1.002 to 1.701), lived in a small (≤2 members) household (aOR = 2.207, 95% CI: 1.825 to 2.669), and resided in the northeast region (aOR = 1.935 relative to eastern, 95% CI: 1.396 to 2.682) were more likely to incur CHE. Conclusion: Multimorbidity is a significant risk of CHE. Household CHE incidence increases with the number of reported chronic conditions. Socioeconomic and regional disparities in CHE incidence persist in China.
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Doença Catastrófica , Gastos em Saúde , Feminino , Humanos , Masculino , Doença Catastrófica/epidemiologia , China/epidemiologia , Doença Crônica , Estudos Longitudinais , Multimorbidade , AposentadoriaRESUMO
Acute promyelocytic leukemia (APL) patients with progressive leukocytosis are more likely to have various complications and poor outcomes. However, the regulatory roles of microRNAs in the leukocytosis of APL have not been clarified. Our study aims to evaluate the effects of miRNAs on leukocytosis during induction therapy of APL patients and explore its potential mechanisms. During induction treatment, patients with white blood cell count higher than 10 × 109/L were divided into leukocytosis group and others were nonleukocytosis group. Using microarray assays, we found that miR-139-5p was significantly downregulated in the leukocytosis group. Elevated expression of miR-139-5p inhibited the proliferation of NB4 cells by arresting the cell cycle and inducing apoptosis. We further identified that MNT was a target of miR-139-5p. miR-139-5p significantly inhibited the proliferation, invasion, and migration function of NB4 cells through targeting MNT. Strategies for regulating miR-139-5p or MNT expression might provide new therapeutic approaches for progressive leukocytosis in APL.
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Objective: Hypertension is one of the most common public health issues worldwide. However, few existing studies examining health-related quality of life (HRQoL) were conducted on elderly patients with hypertension in China. Hence, this study aimed to assess the HRQoL of elderly patients with hypertension and its influencing factors using EuroQol five-dimensional-three-level (EQ-5D-3L) in China. Methods: Data were obtained from the 6th National Health Service Survey in Heilongjiang province from June to July 2018, with a stratified multistage random cluster sampling method. All eligible participants were interviewed using a standardized questionnaire, which included the EQ-5D-3L, socio-demographics characteristics, clinical and lifestyle characteristics. The mean EQ-5D index scores for the different subgroups were evaluated using ANOVA. A Tobit regression model was also employed to analyze the potential factors influencing HRQoL. Results: A total of 705 elderly patients with hypertension were included in this study. The mean EQ-5D utility score was 0.79 [standard deviation (SD) = 0.23]. The proportion of participants reporting pain/discomfort problems was the highest (57.0%), while problems in self-care was the lowest (17.2%). Influencing factors of HRQoL for elderly patients with hypertension included gender, age, income, education level, physical activity, health examination and coexisting diseases. Specifically, the female gender, being above 80 years old, having a lower education and/or higher income, and the presence of coexisting diseases were associated with lower utility index. In contrast, regular physical activity and medical examination had a positive impact on the HRQoL of elderly hypertension patients. Conclusion: Overall, elderly patients with hypertension in China have a lower HRQoL than the general population. To improve the HRQoL of elderly patients with hypertension, it is imperative that better public health education is provided to enhance the knowledge of hypertension, encourage the adoption of healthy habits such as regular physical activity and medical examination, and improve the management of coexisting diseases. More care should also be directed to males with hypertension who are above 80 years old.
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Hipertensão , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Medicina Estatal , Inquéritos e QuestionáriosRESUMO
We recompute the 26-yr weekly Geocentre Motion (GCM) time-series from 1994 to 2020 through the network shift approach using Satellite Laser Ranging (SLR) observations to LAGEOS1/2. Then the Singular Spectrum Analysis (SSA) is applied for the first time to separate and investigate the geophysical signals from the GCM time-series. The Principal Components (PCs) of the embedded covariance matrix of SSA from the GCM time-series are determined based on the w-correlation criterion and two PCs with large w-correlation are regarded as one periodic signal pair. The results indicate that the annual signal in all three coordinate components and semi-annual signal in both X and Z components are detected. The annual signal from this study agrees well in both amplitude and phase with those derived by the Astronomical Institute of the University of Bern and the Center for Space Research, especially for the Y and Z components. Besides, the other periodic signals with the periods of (1043.6, 85, 28), (570, 280, 222.7) and (14.1, 15.3) days are also quantitatively explored for the first time from the GCM time-series by using SSA, interpreting the corresponding geophysical and astrodynamic sources of aliasing effects of K1/O1, T2 and Mm tides, draconitic effects, and overlapping effects of the ground-track repeatability of LAGEOS1/2.
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OBJECTIVES: This study aimed to assess the health utility of leukemia patients in China using the EQ-5D-5L, compare it with the population norms, and identify the potential factors associated with health utility. METHODS: A hospital based cross-sectional survey was conducted in three tertiary hospitals from July 2015 to February 2016. A total of 186 patients with leukemia completed the EQ-5D-5L and their health utility scores were calculated using the Chinese value set. EQ-5D-5L utility and dimensions scores of leukemia patients were compared with China's population norms using Kruskal-Wallis test and chi square test. Potential factors associated with health utility were identified using Tobit regression. RESULTS: The mean EQ-5D-5L utility scores of patients with leukemia, grouped by either gender or age, were significantly lower than those of the general population (p < 0.001). The same results were found for individual dimensions of EQ-5D-5L, where leukemia patients reported more health problems than the general population (p < 0.001). The utility score of leukemia patients was found to be significantly related to medical insurance, religious belief, comorbidities, social support and ECOG performance status. CONCLUSION: This study indicated that leukemia patients have worse health status compared to the general population of China and that multiple factors affect the health utility of the patients. The utility scores reported in this study could be useful in future cost-utility analysis.
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Nível de Saúde , Leucemia/psicologia , Qualidade de Vida , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Social , Inquéritos e QuestionáriosRESUMO
PURPOSE: This study aimed to compare the measurement properties of EQ-5D-3L(3L) and EQ-5D-5L(5L) in patients with acute myeloid leukemia (AML) in China. METHODS: We consecutively recruited 168 patients with AML from three tertiary hospitals to complete two rounds of interviews using the two versions of the EQ-5D. We compared (i) the ceiling effect using the McNemar's test, (ii) test-retest reliability using intraclass correlation coefficient (ICC) and Cohen's weighted Kappa, (iii) convergent validity using Spearman's rank correlation coefficient (r) and iv) discriminatory ability using F statistic and area under the receiver operating characteristics curve (AUROC) of the 5L and the 3L. RESULTS: The 5L descriptive system showed significantly lower ceiling effects in comparison to the 3L descriptive system (p < 0.001). While 5L showed superior reproducibility (Cohen's weighted Kappa = 0.56-0.67 and ICC = 0.89), both instruments exhibited good test-retest reliability. Even though both 3L and 5L showed good convergent and known-groups validity, 5L showed better convergent validity and discriminatory ability. CONCLUSION: The current study found both 3L and 5L to be suitable for use in AML patients. However, 5L showed superior measurement properties compared to 3L. Thus, 5L could be the preferred instrument over 3L for use in AML patients.
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Leucemia Mieloide Aguda/epidemiologia , Psicometria/métodos , Qualidade de Vida/psicologia , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: This study aimed to compare the measurement properties of the EQ-5D-3L (3L) and EQ-5D-5L (5L) in cancer patients. METHODS: A consecutive sample of inpatients with lung, breast, colorectal, liver, gastric, or thyroid cancer were interviewed using the 3L, 5L, and Functional Assessment of Cancer Therapy-General (FACT-G) questionnaires, and a subgroup was invited to complete the 3L and 5L again. Kappa and intraclass correlation coefficient were used to assess test-retest reliability, and Spearman's correlation between the EQ-5D and FACT-G was evaluated to assess convergent validity. Comparison of subgroups defined using Eastern Cooperative Oncology Group status and cancer stage were performed to assess known-group validity and discriminatory power using the F-statistic and area under the receiver-operating characteristics curve. All analyses were also performed for each subgroup of cancer patients. RESULTS: A total of 416 cancer patients completed the baseline questionnaire and 90 patients also completed the follow-up survey after 2 days. Ceiling effects were smaller in 5L (10.1%) than in 3L (17.8%). The test-retest reliability and convergent validity of the 5L were slightly better than those of the 3L. Both the 3L and 5L showed known-group validity; however, the 5L index showed better discriminatory power. Similar trends were found in the six types of cancers. CONCLUSION: In general, 5L appears to have better measurement properties than 3L for measuring the health-related quality of life of cancer patients. While both the 3L and 5L are suitable, 5L should be preferable to 3L for use in cancer outcomes research.
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Neoplasias , Qualidade de Vida , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Leukemia can create a significant economic burden on the patients and their families. The objective of this study is to assess the medical expenditure and compensation of pediatric leukemia, and to explore the incidence and determinants of catastrophic health expenditure (CHE) among households with pediatric leukemia patients in China. METHODS: A cross-sectional interview was conducted among households living with pediatric leukemia using a questionnaire in two tertiary hospitals. CHE was defined as out-of-pocket (OOP) payments that were greater than or equal to 40% of a household's capacity to pay (CTP). Chi-square tests and logistic regression analysis were performed to identify the determinants of CHE. RESULTS: Among 242 households living with pediatric leukemia, the mean OOP payment for pediatric leukemia healthcare was $9860, which accounted for approximately 35.7% of the mean household's CTP. The overall incidence of CHE was 43.4% and showed a downward trend with the lowest income group at 69.0% to the highest income group at 16.1%. The logistic regression model found that medical insurance, frequency of hospital admissions, charity assistance, and income level were significant predictors of CHE. CONCLUSION: The results revealed that pediatric leukemia had a significant catastrophic effect on families, especially those with lower economic status. The occurrence of CHE in households living with pediatric leukemia could be reduced by addressing income disparity. In addition, extending coverage and improving compensation from medical insurance could also alleviate CHE. Some other measures that can be implemented are to address the barriers of charity assistance for vulnerable groups.
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Estresse Financeiro/economia , Custos de Cuidados de Saúde , Gastos em Saúde , Renda , Leucemia/economia , Leucemia/terapia , Adolescente , Adulto , Idade de Início , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Estresse Financeiro/epidemiologia , Humanos , Incidência , Lactente , Entrevistas como Assunto , Leucemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de RiscoRESUMO
This study aimed to evaluate treatment response, survival, safety profiles, and predictive factors to chimeric antigen receptor T cell (CAR-T) therapy in Chinese patients with relapsed or refractory B cell acute lymphoblast leukemia (R/R B-ALL). 39R/R B-ALL patients who underwent CAR-T therapy were included. Baseline data were collected from patients' electronic medical records. Patients' peripheral bloods, bone marrow aspirates, and biopsies were obtained for routine examination, and treatment response and survival profiles as well as adverse events were evaluated. The rates of complete remission (CR), CR with minimal residual disease (MRD) negative/positive, and bridging to hematopoietic stem-cell transplantation (HSCT) were 92.3%, 76.9%, 15.4%, and 43.6%, respectively. The median event-free survival (EFS) was 11.6 months (95% confidence interval (CI): 4.0-19.2 months) and median overall survival (OS) was 14.0 months (95% CI: 10.9-17.1 months). Bridging to HSCT independently predicted better EFS and OS, while high bone marrow blasts level independently predicted worse EFS. The incidence of cytokine release syndrome (CRS) was 97.4%, and refractory disease as well as decreased white blood cell independently predicted higher risk of severe CRS. Other common adverse events included hematologic toxicities (grade I: 5.1%, grade II: 7.7%, grade III: 17.9%, grade IV: 69.2%), neurotoxicity (28.2%), infection (38.5%), and admission for intensive care unit (10.3%). In conclusion, CAR-T therapy presents with promising treatment response, survival and safety profiles, and higher disease burden predicts worse survival as well as increased risk of severe CRS in Chinese R/R B-ALL patients.
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Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Receptores de Antígenos Quiméricos/uso terapêutico , Adolescente , Adulto , Povo Asiático , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Recidiva , Análise de Sobrevida , Adulto JovemRESUMO
PURPOSE: This study aimed to test the validity and reliability of the five-level EuroQol five-dimensional (EQ-5D-5 L) instrument in family caregivers (FCs) of leukemia patients in Heilongjiang of China. METHODS: A cross-sectional survey was conducted on 298 family caregivers (FCs) of leukemia patients from three major cancer centers in the capital city of Heilongjiang province of China. Their dimensional scores of the EQ-5D-5 L were compared with those of the WHOQOL-BREF to test the convergent validity (constructs measuring the same concept) and divergent validity (constructs measuring different concepts) of the EQ-5D-5 L. Repeated surveys were conducted on 271 participants to determine the test-retest reliability of the EQ-5D-5 L. RESULTS: The four physical dimensions (mobility, self-care, usual activities, and pain/discomfort) of the EQ-5D-5 L had moderate or high correlations with the physical health domain of the WHOQOL-BREF, with a correlation coefficient (r) ranging from 0.459 to 0.559. The anxiety/depression dimension of the EQ-5D-5 L had a high correlation (r = 0.667) with the psychological domain of the WHOQOL-BREF. By contrast, lower but still significant physical-to-psychological correlations were found between the two instruments (r ranging from 0.219 to 0.396). In addition, the EQ-5D-5 L dimensional scores showed no or weak correlations with the environment and social domains of the WHOQOL-BREF (r ranging from 0.016 to 0.207). High test-retest reliability (> 0.7) was evident. CONCLUSION: The Chinese version of the EQ-5D-5 L has satisfactory reliability and validity in FCs of leukemia patients. It can be used to elicit utility of health-related quality of life in FCs of leukemia.
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Cuidadores/psicologia , Leucemia/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adulto , Cuidadores/estatística & dados numéricos , China , Estudos Transversais , Feminino , Indicadores Básicos de Saúde , Humanos , Leucemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Relapsed and refractory acute myeloid leukemia (RR-AML) still poses major treatment concerns. Current treatments include high doses of cytarabine or fludarabine in combination with cytarabine and G-CSF (FLAG), but provide mixed results. Low-dose decitabine, a hypomethylating drug, in combination with aclarubicin and cytarabine (DAC) has shown safety and efficacy in the treatment of AML; however, clinical data are limited for the treatment of RR-AML. METHODS: In this study, we retrospectively compared the response and safety of DAC vs FLAG for RR-AML patients. RESULTS: For the 35 patients with RR-AML enrolled in this study, the overall response rates reached 100% and 55.6% in the DAC group and FLAG group, respectively (P=0.002). Complete response rates after DAC and FLAG treatment were 64.7% and 33.3%, respectively (P=0.002). Median overall survival (95% CI) of the DAC treatment group was significantly higher than for the FLAG group (median not achieved vs 16.8 months, P=0.021). CONCLUSION: DAC treatment was also more effective in those patients with poor prognosis, suggesting that DAC resulted in a better outcome for RR-AML treatment. In conclusion, in our study, DAC therapy provided more safety and effectiveness and lower toxicity in the treatment of RR-AML compared to FLAG therapy.
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BACKGROUND: This study assessed the health related quality of life of family caregivers (FCs) of leukemia patients by using the health utility scores derived from the EuroQol five-dimensional (EQ-5D) questionnaire. METHODS: A cross-sectional survey was undertaken on 306 family caregivers of leukemia patients to assess their health utility using the EQ-5D-3L. Participants were recruited from three hospitals in China's Heilongjiang province. The health utility scores of the participants were estimated based on the Chinese EQ-5D-3L value set and compared with those of the local general population. Factors predicting the health utility scores were identified through the Kruskal-Wallis analysis of variance and median regression analyses. RESULTS: FCs had lower health utility scores than the general population (p < 0.001). The participants with a lower socioeconomic status had lower utility scores and reported more problems than those with a higher socio-economic status. Better family function and higher social support were associated with higher health utility scores. The type of leukemia, household income, and social support are significant predictors of health utility scores of the FCs. Chronic lymphocytic leukemia, low socio-economic status, and low social support are associated with lower health utility scores of the FCs. CONCLUSIONS: FCs for leukemia patients have lower health utility scores than the local general population, as measured by the EQ-5D-3L. There is an immediate need to address the health concerns of FCs, who play an important role in the Chinese health care system.
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Cuidadores , Família , Leucemia/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância em Saúde Pública , Qualidade de Vida , Apoio Social , Fatores SocioeconômicosRESUMO
Parasite infections of humans and animals remain a major global health problem, with limited choice of drugs being available to the treatment of parasitosis in the clinic. Sophora moorcroftiana (S. moorcroftiana) is a shrub that grows in Tibet Plateau of China. Decoction of the seeds has been used as a traditional Tibetan medicine to treat parasitosis for years. But the anti-parasitic effects of water-soluble fractions in the seeds need further investigation. In the present study, the water-soluble alkaloid fractions (E2) were obtained from S. moorcroftiana seeds by refluxing extraction with 60% ethanol and low polarity fraction (E2-a) and high polarity fraction (E2-b) were subsequently isolated from E2 using column chromatography. As a parasite model, Caenorhabditis elegans (C. elegans) were treated with different fractions and their survivals were recorded. The results showed that that E2-a induced a lower survival rate in C. elegans than E2-b and E2. The protoscoleces of Echinococcus granulosus (E. granulosus) were cultured in the presence of E2-a. Compared with E2-b and E2, protoscoleces exhibited decreased survival rate following E2-a treatment. Furtherly, the effects of E2-a on the behavior, brood size, and lifespan of the worms were investigated. Body bend frequencies of the worms treated with the high concentration of E2-a were reduced by two-thirds compared with the control group (P < 0.01). Compared with non-E2-a-treated group, exposure of nematodes to E2-a led to a decrease in head thrashes and pharyngeal pumps frequency (P < 0.01). E2-a treatment resulted in a significantly lower brood size (P < 0.01). Additional E2-a treatment induced a significantly shortened lifespan, compared with the control (P < 0.05). These findings indicated that water-soluble fraction E2-a from S. moorcroftiana seeds was a potential helminthic agent.
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Anti-Helmínticos/administração & dosagem , Caenorhabditis elegans/efeitos dos fármacos , Medicamentos de Ervas Chinesas/administração & dosagem , Equinococose/tratamento farmacológico , Echinococcus granulosus/efeitos dos fármacos , Sophora/química , Animais , Anti-Helmínticos/isolamento & purificação , Caenorhabditis elegans/fisiologia , China , Medicamentos de Ervas Chinesas/isolamento & purificação , Equinococose/parasitologia , Echinococcus granulosus/fisiologia , Humanos , Sementes/químicaRESUMO
In this study, Mtb8.4 and HspX, which are expressed at proliferating and dormant stages of Mycobacterium tuberculosis (M. tuberculosis), respectively, were chosen to construct two fusion proteins, Mtb8.4-HspX (8.4H) and HspX-Mtb8.4 (H8.4), and we investigated whether the antigen dose and protein sequential order could impact the immunogenicity and protective efficacy of these fusion protein vaccines against M. tuberculosis. C57BL/6 mice were vaccinated with new constructions containing a fusion protein with adjuvant of N, N'-dimethyl-N, N'-dioctadecylammonium bromide (DDA) or a mixed adjuvant composed of DDA, polyribocytidylic acid and gelatin (DPG), and the antigen specific immune responses and protective efficacy against M. tuberculosis H37Rv were evaluated. The results showed that both antigens, Mtb8.4-HspX and HspX-Mtb8.4, could elicit strong human T cell responses. With the existing of DDA adjuvant, HspX-Mtb8.4 induced significantly higher secretion level of IFN-γ and TNF-α in spleen cells than Mtb8.4-HspX (p<0.05). In its protective efficacy study, the isolated bacterial Colony Form Unit (CFU) in H8.4-DPG group was significantly reduced compared to 8.4H-DPG group (p<0.05). Furthermore, with the stimulation of Mtb8.4 in vitro, the secretion of IFN-γ and TNF-α from mice immunized with 20µg of H8.4 exhibited relative higher level than the group immunized by 7µg of H8.4 (p<0.05), whereas, IL-2 secreting showed contrary result. The data suggest that the antigen sequential order and dose selection should be considered when a tuberculosis protein vaccine is to be constructed and its immune strategy is to be planned.
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Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Leucócitos Mononucleares/imunologia , Mycobacterium tuberculosis/fisiologia , Vacinas contra a Tuberculose/genética , Tuberculose/imunologia , Adjuvantes Imunológicos/administração & dosagem , Animais , Células Cultivadas , Feminino , Imunização , Interferon gama/metabolismo , Leucócitos Mononucleares/microbiologia , Camundongos , Camundongos Endogâmicos C57BL , Compostos de Amônio Quaternário/administração & dosagem , Vacinas contra a Tuberculose/imunologia , Fator de Necrose Tumoral alfa/metabolismo , Vacinas de Subunidades AntigênicasRESUMO
BACKGROUND: The leukemia affects not only the quality of life (QOL) of patients with the disease but also that of their family caregivers (FCs). The research studies on QOL of FCs for leukemia patients are limited. This study aimed to evaluate the QOL of FCs for leukemia patients in Heilongjiang province, China. METHODS: A cross-sectional questionnaire survey was undertaken with 309 FCs for leukemia patients recruited from three hospitals in Heilongjiang province. The QOL of the participants was assessed using the Chinese version of WHOQOL-BREF. Multivariate regression models were established to determine the predictors of the QOL of FCs, including the socio-economic characteristics of patients and FCs, and the emotional distress, social support and family functions of FCs. RESULTS: The FCs had low QOL scores in all four domains: 12.7 ± 2.8 for physical, 12.2 ± 2.5 for psychological, 13.2 ± 2.9 for social and 11.3 ± 2.5 for environment. Social support is a major predictor of the QOL of FCs, with a standardized ß coefficient of "high support" ranging from 0.41 to 0.58 for the four domains, followed by family function (ß = 0.37 ~ 0.44 for psychological, social and environmental domains). The FCs who were older, highly educated, had no religious belief, suffered from a higher level of emotional distress, and provided care to younger patients and the patients without insurance coverage had lower QOL than the others. CONCLUSION: The study provides some important insights into the QOL of FCs for leukemia patients. The QOL of FCs for leukemia patients is low and low levels of support to FCs are a major predictor of low QOL of FCs.
Assuntos
Cuidadores/psicologia , Assistência Domiciliar/psicologia , Leucemia/psicologia , Cuidados Paliativos/psicologia , Qualidade de Vida/psicologia , Adaptação Psicológica , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Leucemia/terapia , Masculino , Pessoa de Meia-Idade , Apoio Social , Inquéritos e QuestionáriosRESUMO
This study aimed to assess health-related quality of life (HRQOL) of Heilongjiang adult populations by using the EuroQol five-dimension three-level (EQ-5D-3L) questionnaire and to identify factors associated with HRQOL. Data from the National Health Services Survey (NHSS) 2008 in Heilongjiang province were obtained. Results of EQ-5D-3L questionnaires completed by 11,523 adult respondents (18 years or older) were converted to health index scores using a recently developed Chinese value set. Multivariate linear regression and logistic regression models were established to determine demographic, socioeconomic, health, and lifestyle factors that were associated with HRQOL and reported problems in the five dimensions of EQ-5D-3L. The Heilongjiang population had a mean EQ-5D-3L index score of 0.959. Lower EQ-5D-3L index scores were associated with older age, lower levels of education, chronic conditions, temporary accommodation, poverty, unemployment, and lack of regular physical activities. Older respondents and those who were unemployed, had chronic conditions, and lived in poverty were more likely to report problems in all of the five health dimensions. Higher educational attainment was associated with lower odds of reporting health problems in mobility, pain/discomfort, and anxiety/depression. Low socioeconomic status is associated with poor HRQOL. Regional population norms for EQ-5D-3L are needed for health economic studies due to great socioeconomic disparities across regions in China. Overall, the Heilongjiang population has a similar level of HRQOL compared with the national average.