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Objective:To explore the clinical efficacy of lenalidomide combined with second-line immunochemotherapy as a salvage regimen in the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 37 relapsed/refractory DLBCL patients receiving lenalidomide combined with second-line immunochemotherapy as a salvage regimen who had recurrence after autologous hematopoietic stem cell transplantation or who were not eligible for transplantation or had no intention to transplant between January 2016 and December 2020 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. Among 37 patients, 6 cases with primary central nervous system (CNS) lymphoma and 3 cases with secondary CNS lymphoma. The short-term efficacy after treatment was evaluated. Kaplan-Meier method was used to analyze the overall survival (OS) and progression-free survival (PFS), and log-rank test was used for subgroup comparison.Results:The median follow-up time of 37 patients was 20.4 months (2.7-37.0 months). At the end of treatment, the overall response rate (ORR) of all patients was 64.9% (24/37), the complete response (CR) rate was 45.9% (17/37), and the median duration of response (DOR) of 24 patients who responded to treatment was 17.7 months (3.6-33.6 months). The median PFS time of all patients was 11.2 months, and the 1-year PFS rate was 48.6% (95% CI 32.5%-64.7%). The median OS time of all patients was not reached, and the 1-year OS was 67.6% (95% CI 52.5%-82.7%). Among 24 responding patients, 17 cases who received lenalidomide maintenance therapy after remission tended to have a better response compared with 7 cases who did not receive lenalidomide maintenance therapy after remission, although there was no significant difference in OS and PFS between both groups (both P > 0.05). Additionally, neutropenia was the most common adverse reaction with an incidence of 81.1% (30/37). Conclusions:Lenalidomide combined with the second-line immunochemotherapy may be an effective salvage therapy for patients with relapsed/refractory DLBCL, especially for patients with CNS involvement. The patients achieving remission after salvage therapy continue to receive lenalidomide maintenance therapy and could have a better prognosis.
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Objective: to assess the necessity of prophylactic antibiotic therapy in HCC patients undergoing transcatheter arterial chemoembolization [TACE]
Study Design: descriptive study
Place and Duration of Study: the First Affliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, from August 2016 to August 2017
Methodology: retrospective TACE-treated cases were analysed in this study. The basic characteristics of the patients, the days in hospital, the laboratory data and fever after the procedure were assessed and compared. A review of literature of published studies and our present study were further conducted to determine the necessity of prophylactic antibiotic therapy
Results: in 159 cases, there were no significant difference in the leukocyte count [p=0.552], neutrophil count [p=0.573] and fever [p=0.31] with and without prophylactic antibiotic therapy groups. The hospital stay was significantly increased in the prophylactic antibiotic group [p<0.001]. The fever of previous and the present results showed no significant difference [p=0.25] between the groups
Conclusion: prophylactic antibiotic therapy is not routinely necessary in the procedure of TACE for HCC patients
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OBJECTIVE:To investigate the effects of loading-dose rosuvastain before early percutaneous coronary intervention (PCI) on reperfusion arrhythmias in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI).METHODS:A total of 136 patients with NSTEMI were randomly divided into loading-dose group (68 cases) and control group (68 cases).Both groups who were not given anti-platelet drugs were given loading-dose of Aspirin enteric-coated tablets 300 mg+Clopidogrel sulfate tablets 600 mg immediately after admission.The patients who were given aspirin regularly were given loading-dose of Clopidogrel sulfate tablets 600 mg only once after admission.The patients who were given clopidogrel regularly were given loading-dose of Aspirin enteric-coated tablets 300 mg only once.Those received PCI 12-24 h after medication.After PCI,they took Aspirin enteric-coated tablets 100 mg for life+Clopidogrel bisulfate tablets 75 mg at least 12 months.Loading-dose group was given loading-dose of Rosuvastatin calcium tablets 20 mg orally,12 h before surgery.All patients began to take Rosuvastatin calcium tablets 10 mg,once a day,since the night after the operation.Coronary angiography and the occurrence of reperfusion arrhythmia were observed in 2 groups.The levels of CK-MB and cTnT,major adverse cardiovascular events (MACE) were observed before and after surgery.RESULTS:There was no statistical significance in the number of diseased vessels,culprit vessels,the degree of culprit vessels stenosis or the incidence of MACE between 2 groups (P＞ 0.05).The incidence of reperfusion arrhythmia in loading-dose group was significantly lower than control group,with statistical significance (P＜0.01).There was no statistical significance in the degree of culprit vessels stenosis between 2 groups (P＞0.05).Before surgery,there was no statistical significance in the levels of CK-MB or cTnT between 2 groups (P＞0.05).After surgery,the levels of CK-MB and cTnT in 2 groups were significantly higher than before surgery,but the loading-dose group was significantly lower than the control group,with statistical significance (P＜0.01).CONCLUSIONS:Preoperative loading-dose of rosuvastatin before PCI can reduce the incidence of reperfusion arrhythmias in NSTEMI patients.
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Objective To observe the efficacy of enalapril folic acid in the treatment of H type hypertension. Methods 196 H type hypertension patients with carotid atherosclerosis were randomly divided into the enalapril folic acid tablets group(leaf group 99 cases)and the control group(enalapril group 97 cases),respectively,enalapril folic acid tablets and enalapril,once a day.Continuous administration of 10 months,before and after treatment,the blood pressure control level,plasma homocysteine levels and carotid intima media thickness were compared between the two groups.Results ,Before and after treatment,the systolic blood pressure in the leaf group were (159.51 ±8.55)mmHg, (138.68 ±7.82)mmHg,and the diastolic blood pressure were (98.11 ±7.44)mmHg,(82.98 ±5.22)mmHg.In the enalapril group,before and after treatment,the systolic blood pressure were (160.10 ±9.12)mmHg,(139.47 ± 7.99)mmHg,and the diastolic blood pressure were (97.88 ±7.62)mmHg,(83.12 ±5.57)mmHg.Blood pressure before and after treatment in the two groups were significantly different(all P 0.05).In the leaf group,before and after treatment,the plasma homocysteine concentrations were (16.89 ±5.62)μmol/L,(10.37 ±3.06)μmol/L,there was significant difference(P 0.05).In the leaf group,before and after treatment the carotid artery intima media thickness were (1.28 ±0.33)mm,(1.08 ±0.36)mm,there was sig-nificant difference(P 0.05).Conclusion Enalapril folic acid tablets in treatment of H type hypertension has significant efficacy,it can reduce blood pressure and plasma homocysteine levels and delay the progression of atherosclerosis.
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Objective To evaluate the clinic effect of reverse less invasive stabilization system (LISS) in treatment of femoral intertrochanteric fracture.Methods The study enrolled 22 cases of femoral intertrochanteric fractures treated with reverse LISS from January 2007 to January 2011.Twelve out of the cases were males and 10 were females,with age ranging from 44 to 86 years (mean,72.5 years).Left fracture occurred in 8 cases and right in 14 cases.Causes of injury included fall on the ground in 15 cases,vehicle accidents in 4 cases,and fall from height in 3 cases.There were 15 cases of type Ⅲ and 9 of type Ⅳ according to Evans-Jensen classification and all fractures were closed injuries.Time from injury to operation was 3-14 days (mean,5.3 days).Results Intraoperative hemorrhage was (130.5 ± 60) ml and operation time was (55 ± 15) min.All cases were followed up for 12-30 months (mean,14.8 months).Fracture healing time was 10-27 weeks (mean,13.4 weeks).Harris hip score was excellent in 11 cases,good in 8,fair in 2,and poor in 1,with excellent and good rate of 86％.Two cases felt greater trochanter pain at follow-up ; one presented with plate breakage and malunion at 6 months postoperatively,but may need no further treatment; the rest healed without complications of surgical site infection,varus deformity of the hip,implant breakage,fracture redisplacement,screw drawing pullout or cutout.Conclusion Reverse LISS plating is an effective treatment for femoral intertrochanteric fractures,but the procedure can not assure 100％ success.
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Objective To evaluate effects of minimally invasive dynamic hip screw(DHS)in treatment of intertrochanteric femoral fractures.Methods The study involved 98 patients with intertrochanteric femoral fractures treated by closed reduction and C-arm fluoroscopy guided minimally invasive DHS from January 2004 to January 2010.According to AO classification,there were 38 patients with type A1 fractures and 60 with type A2 fractures.According to Evans classification,there were nine patients with typeⅠ?fractures,29 with type Ⅱ,36 with typeⅢ?and 24 with type V.Intraoperative blood loss,operation time and incision length were recorded.Results The intraoperative hemorrhage,operation time and incision length were average 250 ml(range,150-450 ml),54.3 minutes(range,45-70 minutes),and 5.2 cm(range,4-7 cm),respectively.All the patients were followed up for 12-38 months(mean 16.8 months).Fracture healing time was 10-14 weeks(average 11.5 weeks).According to Zuekerman functional scoring for hip joint,the results were excellent in 61 patients,good in 30,fair in four and poor in three,with excellence rate of 92.9％.Varus deformity of hip occurred in four patients.No patient presented surgical site infection,implant failure or displacement of fractures.Conclusion Minimally invasive DHS is an effective means in treating intertrochanteric femoral fractures,but the key point of successful treatment is to strictly grasp the correct operative procedures.
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<p><b>OBJECTIVE</b>To investigate short term clinical therapeutic effect of fupiyiwei decoction (FPYWD) combined with chemotherapy in treating postoperational large intestine carcinoma and the effect on immune function.</p><p><b>METHOD</b>The 58 cases of postoperational large intestine carcinoma were randomly divided into the traditional Chinese medicine (TCM) group (33 cases) and the control group (25 cases). The toxic and adverse reaction, Karnofsky score and clinical therapeutic effect during chemotherapy were observed, and the level of subgroup of T cells CD3, CD4, CD8 and NK cells were detected. Before and after treatment 28 healthy adult were regarded as normal group.</p><p><b>RESULT</b>There was no significant difference in clinic therapeutic effect between the TCM group and the control group after 12 chemotherapy treatment courses. But the quality of life the TCM group remarkably better than in the control group (P < 0.05), while the incidence rate of toxic and adverse reaction of chemotherapy in the former group was lower than in the latter (P < 0.05). The level of CD3+, CD4+ T cell and the viability of NK cells in all patients decreased during the chemotherapy treatment course while the level of CD8+ T cell increased, the level of CD3+ T cell and NK cells in peripheral blood in patients increased after treatment, but was lower than in normal group. The level of CD8+ T cell was decreased and was lower than in normal group. There was no significant difference (P < 0.05). The level of CD4 T cell after TCM group, there was significant different in CD4+ T cell between TCM group and control group, normal group (P < 0.05). The viability of NK cell increased but there was no significant difference between the two group.</p><p><b>CONCLUSION</b>Fupiyiwei decoction (FPYWD) is effective in prevention and treatment of the toxic and adverse effects of chemotherapy of postoperational large intestine carcinoma, and can improve quality of life and immune function of patients. increase the effective of chemotherapy.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Colorectal Neoplasms , Drug Therapy , Combined Modality Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Killer Cells, Natural , Medicine, Chinese Traditional , Methods , Neoplasm Staging , Phytotherapy , T-Lymphocyte Subsets , Allergy and Immunology , T-Lymphocytes , Allergy and ImmunologyABSTRACT
; Objective; To observe the preventive and therapeutic effects of Jieduquyuziyin methods in treating corticosteroid osteoporosis in systemic lupus erythematosus (SLE) and investigate into its mechanism. Method; 147 cases of SLE were randomly divided into the integrated traditional Chinese and western medicine group (79 cases) and the western medicine group (68 cases). There 21 cases which were diagnosed primarily among all 147 cases. 30 healthy cases were taken as the normal control group. The western medicine group (68 cases) was treated mainly with prednisone only, while the integrated traditional Chinese and western medicine group (79 cases) with Jieduquyuyiyin methods on the basis of normal western medicine. Both groups were treated for 3 months as a course. 16 cases in the western medicine group and 25 cases in the integrated traditional Chinese and western medicine group were kept on being treated and observed for 2 years. The lever of serum Ca, P, ALP, BGP, IPTH, 25-(OH) D3 and urinary Ca, P and BMD were checked and observed. Result; The levers of serum P, 25-(OH) D3, BGP and BMD in the normal group, primary diagnosis group, integrated traditional Chinese and western medicine group were higher than those in the western medicine group significantly ( P
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Objective:To study on effects of Chinese herbs for removing toxic substances,nourishing Yin and removing blood stasis on activity of disease in the patient of systemic lupus erythematosus(SLE).Methods:65 cases of SLE were divided into a Chinese medicine group and a control group,and their cumulative scores of SLE disease activity index and changes of doses of prednisone were observed before and after treatment of 2 courses,respectively.Results:At the end of the second treatment course,there was significant difference in the number of case at the active stage and the resting stage between the two groups(P