Risk Factors and Prognosis of Cardiovascular Damage in Hypereosinophilia / 中国实验血液学杂志

OBJECTIVE@#To investigate the risk factors and prognosis of cardiovascular damage in hypereosinophilia (HE).@*METHODS@#The clinical data of 62 patients with HE in Gansu Provincial Hospital from January 2015 to December 2020 were retrospectively analyzed, including clinical characteristics and laboratory indicators, and the influencing factors of survival and prognosis were also analyzed.@*RESULTS@#In this study, there were 34 males and 28 females, with a median age of 53.5 (20-79) years, 35 patients without cardiovascular damage, 27 patients with cardiovascular damage, including 22 patients with abnormal electrocardiogram (ECG) (81.5%), 18 patients with abnormal echocardiography (ECHO) (66.7%), 9 patients with single ECG abnormality, 5 patients with single ECHO abnormality, and other 13 patients with multiple abnormalities. In cardiovascular damage group, peripheral white blood cell count, absolute value of eosinophils, troponin T (TNT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), interleukin (IL)-4 and IL-5 levels at initial diagnosis were significantly higher than those in the non-cardiovascular damage group (P <0.01), while hemoglobin, IL-2 and interferon-γ levels were significantly lower (P <0.01). There were no significant differences in age, sex, course of disease, etiological classification, platelet count, serum creatine kinase, serum creatine kinase isoenzyme and lactate dehydrogenase between the two groups (P >0.05). The 5-year overal survival rate of patients with cardiovascular damage was 88.9%, and that of patients without cardiovascular damage was 100%, the difference was statistically significant (P =0.012). The 5-year event-free survival (EFS) rate of patients with cardiovascular damage was 59.3%, and the median time was 37 (21-52) months, while that of patients without cardiovascular damage was 80%, and the median time was 63 (51-74) months (P =0.002). Age (>60 years old), course of disease (>24 months), NT-proBNP (>3 000 pg/ml), TNT (>100 ng/L), elevated IL-4 and IL-5 were associated with EFS shortening in patients with cardiovascular damage, which were independent risk factors for EFS.@*CONCLUSION@#The EFS rate in HE patients without cardiovascular damage is significantly higher than patients with cardiovascular damage. Age, course of disease, NT-proBNP, TNT, IL-4 and IL-5 are independent risk factors affecting EFS of patients with cardiovascular damage.

Clinical Features and Prognosis of Patients with Castleman's Disease / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical features and prognosis of patients with Castleman's disease (CD) and improve the diagnosis and treatment of CD.@*METHODS@#Clinical data of patients diagnosed with CD by pathological biopsy in Gansu Provincial Hospital from January 2009 to November 2020 were retrospectively analyzed. According to clinical classification, the patients were divided into two groups: UCD (unicentric CD) group (n=20) and MCD (multicentric CD) group (n=9). The clinical manifestations, laboratory examination, treatment regimens, pathological examination and follow-up data were statistically analyzed.@*RESULTS@#There were no significant differences in average age and gender ratio between UCD group and MCD group. In UCD patients, 80.0% were hyaline vascular type, and 20.0% were plasma cell type. In MCD patients, 33.3% were hyaline vascular type, 55.6% were plasma cell type, and 11.1% were mixed type. There was significant difference in pathological classification between the two groups (P=0.039). The UCD patients usually presented asymptomatic single lymph node enlargement with mild clinical symptoms, while the MCD patients were characterized by multiple superficial and deep lymph node enlargement throughout the body. The incidences of asthenia, splenomegaly, serous effusion in MCD group were higher than those in UCD group (P<0.05). Meanwhile, the incidences of anemia, hypoproteinemia, increased ESR, elevated serum globulin and elevated β2-microglobulin were significantly higher than those in UCD group too (P<0.05). There was no significant difference in the incidences of abnormal WBC, PLT and elevated LDH between the two groups (P>0.05). Among 20 patients with UCD, 13 cases reached complete remission (CR), 1 case achieved partial remission (PR). Among 9 patients with MCD, 3 cases received CR and 4 cases received PR.@*CONCLUSION@#Patients with CD requires pathological examination for diagnosis. Patients with UCD show mild clinical symptoms, good surgical treatment effect and good prognosis. Patients with MCD have diversified clinical manifestations and relatively poor prognosis, and these patients require comprehensive treatment.

Clinical Characteristics and Prognosis of Patients with Primary Bone Diffuse Large B-Cell Lymphoma / 中国实验血液学杂志

METHODS@#The clinical data of 15 patients with primary diffuse large B-cell lymphoma treated in our hospital from January 2013 to December 2020 were collected, the clinical data and prognosis of the patients were analyzed retrospectively.@*RESULTS@#The median age of the 15 patients was 59 (19-89) years old; among the patients, 7 were males and 8 were females, ostealgia was the initial symptom. The pathological types of the 15 patients were diffuse large B-cell lymphoma (DLBCL), 5 cases of Has type GCB subtype (5/15), and 10 cases of Non-GCB subtype (10/15). After 15 patients were diagnosed, 11 patients (11/15) received chemotherapy, 3 patients (3/15) received surgery, and 1 patient was untreated (1/15), median chemotherapy courses was 5 (1-9). 8 patients have achieved complete remission (8/15), 3 patients achieved partial remission (3/15), and 1 patient achieved stable disease (1/15), 1 patient was lost to follow-up (1/15), 1 patient was untreated (1/15), and 1 patient was progression of disease (1/15). Age, pathological subtype, sex, stage, β2-MG level, LDH level, and the using of rituximab were not correlated with the complete remission rate of the patients(P>0.05), while the IPI score was correlated with the recent complete remission rate (P<0.05). The median follow-up time was 19 (1-38) months, 10 patients survived, in which 6 cases were still in complete remission, and the median time to progression-free survival was 15 (1-38) months.@*CONCLUSION@#The first symptom of primary bone diffuse large B-cell lymphoma is bone pain, the main pathological subtype is Non-GCB, the optimal treatment is combined chemotherapy, and the IPI score is related to the prognosis of the treatment.

Coagulation Indexes and Their Prognostic Significance in Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To analyze the relationship between coagulation indexes and prognosis of patients with multiple myeloma (MM).@*METHODS@#A total of 99 newly diagnosed MM patients treated in Gansu Provincial Hospital from October 2017 to October 2019 were enrolled. Plasma thromboplastin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT), and other laboratory indexes were detected. The relationship between coagulation indexes and clinical characteristics of MM patients was analyzed. The differences in survival rates among MM patients with different levels of coagulation indexes were compared, and the effect of each clinical index on the prognosis of MM patients was analyzed by univariate and multivariate.@*RESULTS@#Each coagulation index was correlated to sex, disease classification and stage, and β@*CONCLUSION@#Coagulation function is correlated with multiple clinical indicators of patients with MM and plays an important role in their prognosis.

The Influence of Serum Homocysteine Level to the Prognosis of Newly Diagnosed Multiple Myeloma Patients and Analysis of Related Factors / 中国实验血液学杂志

OBJECTIVE@#To analyze the influence of serum homocysteine (Hcy) levels to the prognosis of newly diagnosed multiple myeloma (MM) patients, and to explore related factors affecting the prognosis of the patients.@*METHODS@#The clinical pathological data of 180 newly diagnosed MM patients treated in our hospital from March 2013 to February 2015 were collected, and the patients were divided into high and low Hcy groups based on the median Hcy. The survival curves of the patients in the two groups were drawn to compare the differences of the survival; univariate and multivariate survival analysis was used to observe the influence of serum cysteine to the prognosis of newly diagnosed MM patients; the clinicopathological data of the patients with high and low Hcy in the two groups was compared, Pearson test was used to further analyzes the relationship between Hcy and different factors, and explores the related factors of Hcy affecting the prognosis of the patients.@*RESULTS@#The median survival times of patients in the high and low Hcy groups were 32 (5-59) and 41 (7-71) months, respectively. The 3-year survival rate of the patients in high Hcy group was significantly lower than those in low Hcy group, and the difference shows statistically significant (P<0.05). The results of univariate survival analysis showed that the OS of newly diagnosed MM patients whom with advanced age, high bone disease grade, high-level bone marrow plasma cell count, LDH, C-reactive protein, Cr, β@*CONCLUSION@#Serum Hcy level has a correlation trend with the survival of newly diagnosed MM, which is affected by factors such as Hb.

Analysis on Related Factors of Pulmonary Infection in Patients with Multiple Myeloma Treated with Bortezomib / 中国实验血液学杂志

OBJECTIVE@#To analyze the risk factors, distribution of pathogenic strains and tolerance of pulmonary infection in patients with multiple myeloma(MM) during bortezomib chemotherapy.@*METHODS@#The clinical data of 85 patients with multiple myeloma treated by bortezomib in our hospital from January 2015 to January 2019 was analyzed. The patients were divided into infection group and control group according to whether they were infected. The tolerance, pathogen distribution, and related risk factors were retrospectively analyzed.@*RESULTS@#Pulmonary infection rate was 55.29% in 85 MM patients. The proportions of the patients with anemia, neutropenia, and ECOG score ≥2 points in the infection group were significantly higher than those in the control group (P<0.05). In this study, 30 strains of pathogenic bacteria were detected, with gram-negative bacteria accounting for 60%, gram-positive bacteria for 33.33%, fungi for 3.3% and tuberculosis bacteria for 3.3%. Pseudomonas aeruginosa, klebsiella pneumoniae, streptococcus pneumoniae, staphylococcus aureus accounted showed the highest proportion. Most of MM patients with pulmonary infection showed a heterprognosis after two weeks antibiotic treatment, while 3 patients died. About 30 percent of early deaths were due to pulmonary infections.@*CONCLUSION@#Anemia, neutropenia, ECOG score ≥2 points are the major clinical characteristics of the multiple myeloma patients with pulmonary infections. Pulmonary infection is an important cause of early death in patients with multiple myeloma. Pathogenic bacteria are mainly composed of gram-negative bacteria. Beta-lacta/ beta-lactamase inhibitor combinations or Carbapenems are effective empiric treatment for controlling the progression of pulmonary infection.

Value of Neutrophil/Lymphocyte Ratio and Monocyte/Lymphocyte Ratio in the Prognosis of Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of neutrophil/lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) in the valuation prognosis of patients with multiple myeloma (MM).@*METHODS@#The clinical data of 82 patients with initially diagnosed MM admitted to Gansu Provincial People's Hospital was analyzed retrospectively. NLR and MLR were calculated based on blood routine results respectively. The optimal cut-off point of NLR and MLR was determined according to the ROC curve, and the patients were divided into the high NLR/MLR group and the low NLR/MLR group. The general data, biochemical indicators and prognosis of the patients in each groups were compared respectively. The prognostic significance of the high NLR/MLR group and the low NLR/MLR group in patients between different treatment regimens and different clinical characteristics were analyzed. Risk stratification was designed based on NLR and high MLR as two risk factors, and the effect of risk factors, on the prognosis of MM patients were compared.@*RESULTS@#ROC curve analysis determined that the optimal cut-off point of NLR was 3.1 (sensitivity 75%, specificity 70.7%) and the optimal cut-off point of MLR was 0.34 (sensitivity 83.3%, specificity 53.4%). The lactate dehydrogenase (LDH) and mean platelet volume (MPV) were correlated to NLR and MLR (P<0.05). There were no significant difference in age, sex, serum calcium (Ca), β @*CONCLUSION@#Elevated NLR and MLR are associated with poor prognosis in MM patients and may serve as the cost-effective and readily available prognostic biomarkers.

Correlation of Body Mass Index, ABO Blood Group with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To explore the correlation of body mass index (BMI), ABO blood group with multiple myeloma (MM).@*METHODS@#70 MM patients (MM group) and 10 healthy people (control group) were selected in the same period, the BMI of patients was calculated according to the height and weight, and the differences of BMI in 2 groups was compared. The distribution of age, sex, albumin (Alb), serum creatinine (Cr), hemoglobin (Hb) and red blood cell (RBC) in the two groups were analyzed. Differences in red blood cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), disease stage and lactate dehydrogenase (LDH) level, survival rate of MM patients with different BMI values and blood group were compared between two groups, and the differences in follow-up outcomes of MM patients were analyzed by univariate and multivariate logistic regression analysis.@*RESULTS@#BMI level of MM patients was higher than that of control group (t=2.706, P＜0.01), but the difference of blood group was not significant (P＞0.05); The NLR value in obese patients was higher than that in non-obese patients, the staging was later and the Alb level was lower in obese patients than those in non-obese patients. the differences were statistically significant between obese patients and non-obese patients (P＜0.05). Univariate and multivariate analysis showed that BMI, Alb and LDH level could influence the follow-up outcome of MM patients, the patients with elevated BMI and LDH level had worse prognosis, while patients with elevated Alb had better prognosis. which means that all the three factors are independent factors affecting the prognosis of MM patrents.@*CONCLUSION@#Increased BMI in MM patients can affect the outcome of follow-up, which is an independent influencing factor.

Analysis of Risk Factors of Herpes Zoster in Patients with Multiple Myeloma Treated with Bortezomib / 中国实验血液学杂志

OBJECTIVE@#To explore and analyze the risk factors of herpes zoster in patients with multiple myeloma (MM) during the chemotherapy with bortezomib.@*METHODS@#Clinical data of 85 MM patients treated with bontizomib from January 2015 to January 2019 were selected and divided into case group and control group accroding to the occurred of herpes zoster. The clinical characteristic, treatment outcome and related factor of herpes zoster were retrospective analyzed.@*RESULTS@#Twenty of the 85 patients with MM treated with bortezomib developed herpes zoster occurred (23.5%). Single-factor analysis showed that age≥65 years, lymphocytopenia occurred before treatment, neutropenia occurred before treatment, ECOG score≥2, application of cyclophosphamide, absence of preventive antiviral therapy were associated with the genesis of herpes zoster (P＜0.05). Multivariate logistic regression analysis showed that lymphocytopenia occurred before treatment, the application of cyclophosphamide and the absence of preventive antiviral therapy were the independent risk factors for herpes zoster (P＜0.05).@*CONCLUSION@#The incidence of herpes zoster is high in the multiple myeloma patients treated with bortezomib. Lymphocytopenia occurred before treatment, the application of cyclophosphamide, and the absence of prophylactic antiviral therapy are the important risk factors for herpes zoster, for which the clinicians should attach great importance.

Significance of Neutrophil/Lymphocyte Ratio in the Prognosis of Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To study the value of neutrophil/lymphocyte ratio (NLR) in the evaluation of prognosis of patients with multiple myeloma (MM).@*METHODS@#NLR was calculated on the basis of the blood routine examination results of 65 patients with primary MM (MM group) and 83 persons receiving physical examination as control group, and the difference in 2 group was compared; moreover according to the median as threshold, the patients were divided into low NLR group (NLR＜2.34) and high NLR group (NLR≥2.34); the differences of age, sex, serum calcium β (Ca), microglobulin (β-MG), albumin (Alb), serum creatinine (Cr), hemoglobin (Hb), red blood cell distribution width (RDW) and lactate dehydrogenase (LDH) in 2 group were analyzed, and the survival rate was compared between the high and low-NLR group.@*RESULTS@#the NLR of MM patients was statistically significantly higher than that of the control group (z=-2.415, P＜0.05). Compared with the low NLR group, the β-MG and Cr levels of patients in the high NLR group seemed higher, but the difference was not statistically significant. The single-factor analysis showed that NLR, β-MG and Alb levels were risk factors for the prognosis of MM patients, and the multi-factor analysis showed that NLR and Alb level were independent risk factors influencing the prognosis of MM patients.@*CONCLUSION@#NLR elevation in patients with primary diagnosis of MM indicates a poor prognosis, which is an independent risk factor affecting the prognosis.

Expression of motilin and its precursor mRNA in normal parenchyma, benign and malignant tumors of human thyroid / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the expression of motilin and its precursor mRNA in normal human thyroid. To compare the expression differences of motilin and it precursor mRNA between normal thyroid and intestines. To study the expression of motilin and its precursor mRNA in human thyroid tumors and their clinical implications.</p><p><b>METHODS</b>RT-PCR, Southern blot and molecular cloning were used to detect motilin transcript expression in human thyroid and mucous membrane of small intestine. Real-time PCR and immunohistochemical techniques were used to quantify motilin precursor mRNA and motilin peptide in thyroid tissue samples including adenoma, medullary carcinoma, follicular carcinoma, papillary carcinoma and nodular goiter.</p><p><b>RESULTS</b>(1) The expression of motilin and its precursor mRNA in normal human thyroid was primarily in the thyroid C cells. (2) RT-PCR and Southern blot showed that motilin mRNA expressed in human thyroid was identical to that expressed in duodenum with identical sequence deposited in NCBI Genbank of America. (3) Immunohistochemistry, Western blot research and real-time PCR studies showed that motilin and its precursor mRNA were expressed in normal and tumor tissues of human thyroid. Thyroid tumors (acidophilic adenoma, medullary carcinoma, follicular carcinoma, papillary carcinoma and nodular goiter) showed intense and diffuse immunostaining for motilin peptide. Moreover, the expression of motilin and its precursor mRNA in thyroid medullar carcinoma and acidophilic adenoma were significantly higher than those of normal thyroid tissue (P < 0.05). The expression in thyroid follicular and papillary carcinomas were significantly lower than those of normal thyroid tissue (P < 0.05). There was no difference of the expression between nodular goiter and normal thyroid tissue (P > 0.05).</p><p><b>CONCLUSIONS</b>Motilin peptide and its precursor mRNA are expressed in C cells of human thyroid. The sequence of motilin is identical to that expressed in duodenum from NCBI Genbank of America. The expressions of both motilin and its precursor mRNA in thyroid medullary carcinoma and acidophilic adenoma are significantly increased. In contrast, their expressions in thyroid follicular and papillary carcinomas are significantly decreased. Motilin may regulate physiological functions of the thyroid through parafollicular cells. Motilin may be involved in the pathogenesis of medullary carcinoma and acidophilic adenoma of the thyroid.</p>

The development and clinical application of papillomavirus genotyping by HPV DNA suspension array the development and clinical application of papillomavirus genotyping by HPV DNA suspension array / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To develop a new platform for genotyping human papillomavirus(HPV) and to investigate its effect in clinical application.</p><p><b>METHODS</b>By combining L1 consensus PCR and multiplex hybridization using a Luminex xMAP system-based suspension array, we developed a rapid high-throughput assay,the HPV DNA suspension array (HPV-SA), capable of simultaneously typing 30 HPVs, including 18 high-risk HPV genotypes and 12 low-risk HPV genotypes. 810 clinical specimens were used to investigate the effect of HPV-SA. Veracity of the genotyping result was verified by E7 type-specific PCR-DNA sequencing.</p><p><b>RESULTS</b>Among the 810 clinical specimens, 243 were found to be HPV positive,including high-risk HPV subtypes 16, 18, 26, 31, 33, 39, 45, 51, 53, 56, 58, 59, 66, 68, 73 and 82,and low-risk HPV6, 11, 34, 54, 61, 67, 70 and 84. The sensitivity tested by standard samples was up to 10 copies of HPV DNA.</p><p><b>CONCLUSION</b>The HPV-SA developed here showed high sensitivity and specificity, suitable to be applied in clinical practice for HPV diagnosis and investigation on the prevalence of HPV sub-types.</p>