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1.
Chinese Journal of Cardiology ; (12): 257-262, 2022.
Article in Chinese | WPRIM | ID: wpr-935137

ABSTRACT

Objective: To analyze the safety and efficacy of combined left atrial appendage (LAA) and patent foramen ovale (PFO) closure in adult atrial fibrillation (AF) patients complicating with PFO. Methods: This study is a retrospective and cross-sectional study. Seven patients with AF complicated with PFO diagnosed by transesophageal echocardiography (TEE) in Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences from June 2017 to October 2020 were selected. Basic data such as age, gender and medical history were collected. The atrial septal defect or PFO occluder and LAA occluder were selected according to the size of PFO, the ostia width and depth of LAA. Four patients underwent left atrial appendage closure(LAAC) and PFO closure at the same time. PFO closure was performed during a one-stop procedure of cryoablation combined with LAAC in 2 patients. One patient underwent PFO closure at 10 weeks after one-stop procedure because of recurrent transient ischemic attack (TIA). All patients continued to take oral anticoagulants. TEE was repeated 8-12 weeks after intervention. In case of device related thrombus(DRT), TEE shall be rechecked 6 months after adjusting anticoagulant and antiplatelet drug treatment. Patients were follow-up at 1, 3, 6, 12, 24 months by telephone call, and the occurrence of cardio-cerebrovascular events was recorded. Results: Among the 7 patients with AF, 2 were male, aged (68.0±9.4) years, and 3 had a history of recurrent cerebral infarction and TIA. Average PFO diameter was (3.5±0.8)mm. Three patients were implanted with Watchman LAA occluder (30, 30, 33 mm) and atrial septal defect occluder (8, 9, 16 mm). 2 patients were implanted with LAmbre LAA occluder (34/38, 18/32 mm) and PFO occluder (PF1825, PF2525). 2 patients were implanted with LACbes LAA occluder (24, 28 mm) and PFO occluder (PF2525, PF1825) respectively. The patients were followed up for 12 (11, 24) months after operation. TEE reexamination showed that the position of LAA occluder and atrial septal defect occluder or PFO occluder was normal in all patients. DRT was detected in 1 patient, and anticoagulant therapy was adjusted in this patient. 6 months later, TEE showed that DRT disappeared. No cardiovascular and cerebrovascular events occurred in all patients with AF during follow-up. Conclusions: In AF patients complicated with PFO, LAAC combined with PFO closure may have good safety and effectiveness.


Subject(s)
Adult , Aged , Atrial Appendage/surgery , Atrial Fibrillation/surgery , Cardiac Catheterization/methods , China , Cross-Sectional Studies , Foramen Ovale, Patent/surgery , Humans , Male , Middle Aged , Retrospective Studies
2.
Chinese Journal of Geriatrics ; (12): 11-14, 2022.
Article in Chinese | WPRIM | ID: wpr-933024

ABSTRACT

Objective:To analyze the safety and efficacy of left atrial appendage closure(LAAC)with Watchman in patients ≥85 years with atrial fibrillation(AF).Methods:515 elderly patients with atrial fibrillation, including 73 patients aged 85 years or older(85~91), who had undergone Watchman LAAC at Zhoupu Hospital affiliated to Shanghai Health Medical College from August 2016 to December 2020, were retrospectively analyzed.Of those ≥85 years, 44(60.3%)with transesophageal echocardiography records were assigned to the elderly group.Fifty-three patients aged 60 to 65 were selected as the control group.Differences in baseline data, intraoperative conditions, antithrombotic treatment plans and 1-year follow-up prognosis were compared between the two groups.Results:Compared with the control group, there was no difference in AF types, history of ischemic stroke/transient ischaemic attack(all P>0.05), but there were higher incidences of coronary heart disease and renal insufficiency, more severe heart failure, higher CHA 2DS 2-VASC(6.0±1.5 vs.3.6±1.5), HAS-BLED(3.2±1.2 vs.2.3±1.3)scores( t values were 7.682 and 3.871, respectively, P<0.05), and a lower one-stop surgery rate(6 cases or 13.6% vs. 27 cases or 50.9%, χ2=10.517, P<0.05)in the advanced age group.There was no difference in the diameter of the Watchman device, rate of device replacement, compression percentage and residual flow between the two groups during the perioperative period.The incidences of device-related thrombosis were 4.5%(2/44)and 3.8%(2/53)for the advanced age group and the control group, respectively, but the difference was not statistically significant( P>0.05). During the 12-month follow-up, there were no cases of ischemic stroke or intracerebral hemorrhage.Three died of heart failure and 1 died of cancer. Conclusions:LAAC with Watchman is safe and effective for patients over 85 years with AF, but the decision on the procedure should be based on careful assessment of patients' cardiac and renal function and general health.

3.
Acta Pharmaceutica Sinica ; (12): 1845-1848, 2022.
Article in Chinese | WPRIM | ID: wpr-929426

ABSTRACT

Four compounds were isolated from the 70% EtOH extract of Ardisia crispa by using various chromatographic techniques, including silica gel, ODS and semi-preparative HPLC. The structures of 1-4 were elucidated based on physicochemical properties and spectroscopic data. These compounds were defined as crispalactone A (1), (+)-pinoresinol (2), 3,5-dimethoxy-4- hydroxyphenol-1-O-β-D-glucopyranoside (3) and (+)-schizandriside (4). Compound 1 is a new γ-valerolactone derivative, and compounds 2-4 are firstly isolated from Ardisia crispa.

4.
Article in English | WPRIM | ID: wpr-928651

ABSTRACT

To compare the performance of generalized additive model (GAM) and long short-term memory recurrent neural network (LSTM-RNN) on the prediction of daily admissions of respiratory diseases with comorbid diabetes. Daily data on air pollutants, meteorological factors and hospital admissions for respiratory diseases from Jan 1st, 2014 to Dec 31st, 2019 in Beijing were collected. LSTM-RNN was used to predict the daily admissions of respiratory diseases with comorbid diabetes, and the results were compared with those of GAM. The evaluation indexes were calculated by five-fold cross validation. Compared with the GAM, the prediction errors of LSTM-RNN were significantly lower [root mean squared error (RMSE): 21.21±3.30 vs. 46.13±7.60, <0.01; mean absolute error (MAE): 14.64±1.99 vs. 36.08±6.20, <0.01], and the value was significantly higher (0.79±0.06 vs. 0.57±0.12, <0.01). In gender stratification, RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting female admission (all <0.05), but there were no significant difference in predicting male admission between two models (all >0.05). In seasonal stratification, RMSE and MAE of LSTM-RNN were lower than those of GAM in predicting warm season admission (all <0.05), but there was no significant difference in value (>0.05). There were no significant difference in RMSE, MAE and between the two models in predicting cold season admission (all >0.05). In the stratification of functional areas, the RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting core area admission (all <0.05). has lower prediction errors and better fitting than the GAM, which can provide scientific basis for precise allocation of medical resources in polluted weather in advance.


Subject(s)
Beijing/epidemiology , Diabetes Mellitus/epidemiology , Female , Hospitalization , Humans , Male , Memory, Short-Term , Neural Networks, Computer
5.
Article in Chinese | WPRIM | ID: wpr-928383

ABSTRACT

OBJECTIVE@#To prepare a quality control sample for non-invasive prenatal screening (NIPS) and evaluate its quality and stability.@*METHODS@#According to the biological characteristics of cell-free fetal DNA derived from the plasma of pregnant women, the simulated samples were prepared by mixing genomic DNA fragments derived from individuals with trisomy 21, trisomy 18 and trisomy 13 and background plasma. The samples were then compared with commercially made quality control products tested on various NIPS platforms and stored at -80℃, -20℃, 4℃, 24℃ and 37℃ for various periods of time.@*RESULTS@#The simulated samples have attained the expected results and could be detected on various platforms and stored at -80℃and -20℃ for at least 30 days.@*CONCLUSION@#A simulated sample was successfully prepared and possessed good stability. It can be used as the quality control sample for NIPS.


Subject(s)
Aneuploidy , Down Syndrome/genetics , Female , Humans , Noninvasive Prenatal Testing , Pregnancy , Prenatal Diagnosis , Trisomy/genetics
6.
Article in Chinese | WPRIM | ID: wpr-924048

ABSTRACT

As an increasingly mature analytical technique, surface-enhanced Raman spectroscopy has the ability to identify, detect, and even quantitatively measure many single substances in nature. However, in the actual sample analysis, the tested samples were often a mixed system of various substances, and it was impossible to accurately characterize the components of the mixed system only by relying on SERS technology. Therefore, SERS combined with other techniques to accurately determine the measured substances has become an inevitable trend. Through the combination, the deficiency of SERS in detection and characterization was improved, and the purpose of efficient, sensitive and accurate determination of substances to be measured was achieved.

7.
Neuroscience Bulletin ; (6): 113-134, 2022.
Article in English | WPRIM | ID: wpr-922681

ABSTRACT

Mutations of the X-linked methyl-CpG-binding protein 2 (MECP2) gene in humans are responsible for most cases of Rett syndrome (RTT), an X-linked progressive neurological disorder. While genome-wide screens in clinical trials have revealed several putative RTT-associated mutations in MECP2, their causal relevance regarding the functional regulation of MeCP2 at the etiologic sites at the protein level requires more evidence. In this study, we demonstrated that MeCP2 was dynamically modified by O-linked-β-N-acetylglucosamine (O-GlcNAc) at threonine 203 (T203), an etiologic site in RTT patients. Disruption of the O-GlcNAcylation of MeCP2 specifically at T203 impaired dendrite development and spine maturation in cultured hippocampal neurons, and disrupted neuronal migration, dendritic spine morphogenesis, and caused dysfunction of synaptic transmission in the developing and juvenile mouse cerebral cortex. Mechanistically, genetic disruption of O-GlcNAcylation at T203 on MeCP2 decreased the neuronal activity-induced induction of Bdnf transcription. Our study highlights the critical role of MeCP2 T203 O-GlcNAcylation in neural development and synaptic transmission potentially via brain-derived neurotrophic factor.


Subject(s)
Animals , Humans , Methyl-CpG-Binding Protein 2/metabolism , Mice , Neurodevelopmental Disorders/genetics , Rett Syndrome/genetics , Synaptic Transmission , Threonine
8.
Journal of Experimental Hematology ; (6): 1752-1756, 2021.
Article in Chinese | WPRIM | ID: wpr-922329

ABSTRACT

OBJECTIVE@#To observe the curative efficacy of tyrosine kinase inhibitors (TKIs) in the treatment of e19a2 transcript (P230) CML chronic phase (CML-CP) patients.@*METHODS@#The clinical data of 11 P230 CML-CP patients were collected from July 2008 to December 2019. Blood routine examination, bone marrow cytology, chromosome, and BCR-ABL qualitative and quantitative tests were performed at initial diagnosis. After TKIs treatment, BCR-ABL (P230)/ABL in peripheral blood was regularly detected to evaluate molecular response by real-time quantitative PCR.@*RESULTS@#There were 11 patients (7 males and 4 females) in chronic phase from 6 domestic hospitals enrolled, their median age was 46 years old (range from 19 to 56 years old). Among 4 patients treated with imatinib (400 mg, qd) firstly, 3 cases switched to nilotinib (400 mg, bid) and 1 case switched to dasatinib (100 mg, qd) due to failure to achieve best molecular response at the landmark time or mutation of ABL kinase. Then major molecular response (MMR) was obtained within 1 year. In addition, 5 patients were treated with nilotinib (300 mg, bid) and 2 patients with dasatinib (100 mg, qd) as first-line treatment, all of them got MMR within 6 months.@*CONCLUSION@#For intolerance or resistance to imatinib, second-generation TKIs can enable P230 CML patients to achieve deeper molecular response, and MMR in a short time.


Subject(s)
Adult , Dasatinib , Female , Fusion Proteins, bcr-abl/genetics , Humans , Imatinib Mesylate , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Male , Middle Aged , Protein Kinase Inhibitors , Young Adult
9.
Journal of Experimental Hematology ; (6): 1858-1863, 2021.
Article in Chinese | WPRIM | ID: wpr-922213

ABSTRACT

OBJECTIVE@#To investigate the effect of U2AF1 gene mutation to inflammatory cytokine in SKM-1 cell of human myelodysplastic syndromes (MDS), and whether the above effects were mediated by FOXO3a-Bim signaling pathway.@*METHODS@#Wide-type U2AF1 and mutant U2AF1 (the serine residue 34 was replaced by phenylalanine, and named as S34F) recombinant expression plasmids were constructed. Lentiviruses were packaged and transfected into SKM-1 cells. The expression of FOXO3a was up-regulated by lentiviruses, and its transfection rate was investigated. The cell proliferation was detected by CCK-8 method. Flow cytometry was used to detect the apoptosis and cycle of the cells. The expression pro-inflammatory cytokine IL-1β, IL-6, TNF-α and anti-inflammatory cytokine IL-4 were detected by qRT-PCR. FOXO3a, Bim, Bcl-2 and Bax protein expression levels were detected by Western blot.@*RESULTS@#Compared with the control group, the cell apoptosis rate, pro-inflammatory cytokine IL-1β and TNF-α transcription levels were significantly increased in the S34F group (P<0.05); cell cycle was blocked at the G@*CONCLUSION@#U2AF1 S34F mutation can regulate inflammatory phenotype in SKM-1 cells, which may be mediated through FOXO3a-Bim signaling pathway.


Subject(s)
Cytokines , Forkhead Box Protein O3/metabolism , Humans , Mutation , Signal Transduction , Splicing Factor U2AF
10.
Article in Chinese | WPRIM | ID: wpr-908201

ABSTRACT

Objective:To explore a new training mode for nursing professionals suitable for the 1+X certificate system, and realize the training goal of "one specialty and multi-ability" compound technical nursing talents.Methods:To take the "1+ X" certificate standard as the basis for the construction of nursing specialty, to reconstruct the talent training program of integration of graduation certificate and certificate. To take the content of "1+X" certificate as the basis for the construction of professional courses, construct the core curriculum system of integration of curriculum and certificate. To build a "new double-qualified" teaching staff and constructing of new double-qualified teachers and accelerate the development of quality resources.Results:The talent training mode of integration of graduation certificate and certificate under the 1+X certificate system was constructed. The curriculum structure has been optimized. The teachers′ability of teaching, training and examination was improved.Conclusions:The new mode of training nursing professionals under the 1+X certificate system meets 1 degree education and X vocational training of nursing students and achieve a "1" and "X" seamless convergence. It provides innovative ideas for the promotion and implementation of 1+X certificate system pilot work in the field of nursing education nationwide.

11.
Article in Chinese | WPRIM | ID: wpr-905223

ABSTRACT

Objective:To observe the effect of braces combined with insoles on scoliosis and walking performance in patients with adolescent idiopathic scoliosis (AIS). Methods:From September, 2019 to September, 2020, 42 subjects with AIS were selected and randomly divided into brace group (n = 21) and brace combined with insole group (n = 21). Both groups received two-month routine rehabilitation, including braces for 22 to 23 hours a day and gymnastics for 30 minutes a day. The brace combined with insole group additionally wore insoles, at least eight hours a day for two months. Meanwhile, 32 even-aged adolescents were recruited as healthy controls. Firstly, gait and plantar pressure of 42 patients and 32 healthy adolescents were compared to find out abnormal indicators. Secondly, the scoliosis and above abnormal indicators were compared between the brace group and the brace combined with insole group Results:The center of pressure excursion index (CPEI) was higher in AIS group than in the healthy group (F = 3.120, P < 0.05), and there was no significant difference in walking speed, gait cycle and phase between two groups (P>0.05). An obvious imbalanced pressure was observed between the medial and lateral heel of the single foot and the bilateral foot in AIS patients (P < 0.05). After treatment, the Cobb's angle decreased in AIS patients (t > 7.552, P < 0.001), however, no difference was found between the brace group and the brace combined with insole group (t = 0.459, P > 0.05); the CPEI decreased (t = 2.209, P < 0.05), and the pressure in medial and lateral heel as well as the left and right foot tended to be balanced (t > 2.306, P < 0.05) in the brace combined with insole group, and were better than that of the brace group (|t| > 2.319, P < 0.05). Conclusion:Plantar pressure distribution shows obvious local and global asymmetric changes in AIS patients. The efficacy of insoles on the scoliosis is limited, but the insole can effectively improve the abnormal biomechanics and balance the force.

12.
Journal of Clinical Hepatology ; (12): 2444-2447, 2021.
Article in Chinese | WPRIM | ID: wpr-904967

ABSTRACT

The launch of direct-acting antiviral agents is a milestone in the treatment of hepatitis C, but further studies are needed to explore its specific timing and effectiveness in liver transplantation for HCV-related hepatocellular carcinoma (HCC). This article summarizes related guidelines, consensus statements, and recommendations in China and globally and the advantages of different treatment timing strategies. Furthermore, a retrospective analysis of related studies is performed to investigate the controversial topic of the impact of direct-acting antiviral agents on the recurrence rate of HCV-related HCC after liver transplantation, and it is pointed that direct-acting antiviral agents can reduce the risk of HCC recurrence in liver transplant recipients with HCV-related HCC. The selection of treatment timing should consider various factors such as liver function, waiting time for donors, and utilization of HCV-positive organs.

13.
Journal of Clinical Hepatology ; (12): 2444-2447, 2021.
Article in Chinese | WPRIM | ID: wpr-904917

ABSTRACT

The launch of direct-acting antiviral agents is a milestone in the treatment of hepatitis C, but further studies are needed to explore its specific timing and effectiveness in liver transplantation for HCV-related hepatocellular carcinoma (HCC). This article summarizes related guidelines, consensus statements, and recommendations in China and globally and the advantages of different treatment timing strategies. Furthermore, a retrospective analysis of related studies is performed to investigate the controversial topic of the impact of direct-acting antiviral agents on the recurrence rate of HCV-related HCC after liver transplantation, and it is pointed that direct-acting antiviral agents can reduce the risk of HCC recurrence in liver transplant recipients with HCV-related HCC. The selection of treatment timing should consider various factors such as liver function, waiting time for donors, and utilization of HCV-positive organs.

14.
Article in Chinese | WPRIM | ID: wpr-921992

ABSTRACT

Clinical practice of Medical Genetics involves application of various genetic techniques for the diagnosis of genetic disorders and subsequent genetic counseling and treatment. The principles of Medical Ethics must be fully taken into account when applying genetic knowledge for medical practice. Medical Ethics education is therefore essential for the standardized training of resident doctors in medical genetics department. With a basic system of Medical Genetics Physician Training established, our hospital has made a preliminary exploration for the development of Medical Ethics teaching in resident training through various teaching practices including seminar, network teaching, case study, scene teaching and outpatient teaching, with an aim to strengthen Medical Ethnics knowledge, professionalism and communication skills, and implement Medical Ethics principles throughout clinical practice.


Subject(s)
Curriculum , Educational Status , Ethics, Medical , Genetics, Medical , Humans
15.
Article in Chinese | WPRIM | ID: wpr-920740

ABSTRACT

Objective To understand the real prevalence of Clonorchis sinensis infections in the freshwater fish in mainland China, so as to provide insights into clonorchiasis control and detection of freshwater fish. Methods All literatures reporting the prevalence of C. sinensis infections in the freshwater fish, the second intermediate host of the parasite, were jointly retrieved in Chinese and English electronic databases from January 1, 2010 to December 31, 2020, including Wanfang Data, CNKI, PubMed, Web of Science, Embase and Cochrane Library. All studies were screened based on inclusion and exclusion criteria, and the quality of all enrolled literatures was evaluated. The pooled prevalence of C. sinensis infections in freshwater fish and its 95% confidence interval (CI) were estimated using the software Stata version 15.0, and subgroup analyses were performed to investigate the region-, season- and sample source-specific pooled prevalence of C. sinensis infections in freshwater fish. In addition, the sensitivity and publication bias of all included studies were analyzed. Results A total of 40 eligible literatures were included in this study, including 37 Chinese literatures and 3 English literatures, and there were 10 high-quality literatures, 27 moderate-quality literatures and 3 low-quality literatures. A total of 53 species containing 37 959 freshwater fish were reported in these 40 studies, and 73.58% (39/53) of freshwater fish species were identified with C. sinensis infections. Meta-analysis showed 23.5% [95% CI: (0.19, 0.28)] pooled prevalence of C. sinensis infections in freshwater fish in mainland China, and subgroup analyses higher prevalence of C. sinensis infections in freshwater fish in northeastern China [35.7%, 95% CI: (0.22, 0.50)] than in central [25.9%, 95% CI: (0.04, 0.48)] and southern China [20.6%, 95% CI: (0.09, 0.32)], higher prevalence of C. sinensis infections in freshwater fish sampled in spring [44.1%, 95% CI: (0.35, 0.53)] than in autumn [6.7%, 95% CI: (0.05, 0.08)] and summer [3.3%, 95% CI: (−0.01, 0.07)], and higher prevalence of C. sinensis infections in freshwater fish sampled from natural water [25.2%, 95% CI: (0.17, 0.33)] than from retail trades [22.2%, 95% CI: (0.17, 0.28)] and breeding chain [12.3%, 95% CI: (0.03, 0.22)]. However, all included studies had a publication bias with a low sensitivity. Conclusions The prevalence of C. sinensis infections is high in freshwater fish in mainland China, and there are still challenges for clonorchiasis control. Reinforcement of health education, diagnostics development and food safety supervision is recommended in future clonorchiasis control programs.

16.
Article in Chinese | WPRIM | ID: wpr-911691

ABSTRACT

Objective:To examine the efficacy of haploidentical stem-cell transplantation (haplo-SCT) for patients with refractory relapsed (R/R) non-Hodgkin lymphoma (NHL) by comparing with those contemporaneously undergoing HLA-matched SCT in myeloablative conditioning settings.Methods:Between January 2006 and December 2018, a total of 151 patients undergoing haplo-SCT ( n=81) or HLA-matched SCT ( n=70, sibling or unrelated) were enrolled. Median age of alloSCT was 30(5-59) years. And 150 patients received myeloablative conditioning (MAC) consisting of total body irradiation (12 Gy) plus cyclophosphamide or busulfan plus cyclophosphamide. Only one case had reduced intensity conditioning (RIC) with R-FBA (fludarabine, busulfan & cytarabina). It was followed by an infusion of granulocyte-colony stimulating factor-primed bone marrow (G-BM) and/or peripheral blood stem cells without in vitro T cell depletion. In haplo-SCT and HLA-matched unrelated donor for SCT, GVHD prophylaxis consisted of antithymocyte globulin, cyclosporine A, mycophenolate mofetil and a short course of methotrexate. Clinical efficacy, hematopoietic reconstitution and transplant-related complications were retrospectively analyzed. Results:Among them, 146(96%) patients engrafted with a median time to neutrophil and platelet recovery of 12 and 15 days respectively. During a median follow-up period of 19 months, 66 of them survived (43.7%) and 67 (44.4%) died (39 disease recurrence, 27 transplantation-related mortality). Between haplo-SCT and HLA-matched SCT groups, progression-free survival (PFS) rate was 49.4% and 50.5% ( P=0.577); overall survival (OS) rate 56.7% and 57.4% respectively ( P=0.963). The cumulative incidences of relapse (CIR) were 36.6% and 37.7% ( P=0.836) and those of cumulative incidences of non-relapse mortality (NRM) 22.0% and 24.7% ( P=0.530). And the cumulative incidences of chronic GVHD were 42.3% and 39.6% ( P=0.46) respectively. Conclusions:No inter-group difference exists in each major HSCT endpoint. Multivariate analysis reveals that occurrence of grade Ⅲ-Ⅳ aGVHD has a significantly worse prognosis. And primary chemorefractoriness is a strongest relapsing factor.

17.
Cancer Research and Clinic ; (6): 9-13, 2021.
Article in Chinese | WPRIM | ID: wpr-886011

ABSTRACT

Objective:To investigate the progression pattern of acquired resistance to osimertinib and the treatment method as well as the therapeutic effect of salvage therapy in advanced lung cancer patients with epidermal growth factor receptor (EGFR) sensitive mutation or T790M mutation after the treatment of tyrosine-kinase inhibitor (TKI).Methods:The data of 145 patients with advanced lung cancer treated with osimertinib in Jiangsu Cancer Hospital between April 2017 (the approval time of osimertinib in China) and May 2019 were collected. At the last follow-up (December 2019), a total of 87 (60.0%) patients had acquired resistance to osimertinib, 61 (70.1%) of whom received salvage treatment; for patients with dramatic progression after resistance, chemotherapy was mainly given in the salvage therapy; for patients with gradual or local progression after resistance, the continuing targeted drug therapy and the local therapy were given. Imaging evaluation and Kaplan-Meier method were used to analyze the progression pattern of acquired resistance to osimertinib and the survival status, and to compare the salvage treatment results among subgroups.Results:The median follow-up time of 61 patients receiving salvage therapy was 11 months (4-32 months), among which 58 (95.1%) patients again had resistance to osimertinib, and 24 (39.3%) patients died of lung cancer. The median progression-free survival (PFS) time and overall survival (OS) time for the whole cohort was 2.5 months (95% CI 2.1-3.0 months) and 19.0 months (95% CI 13.7-26.3 months), respectively. The 1-year and 2-year OS rate was 72.1% and 41.7%, respectively. Among 61 patients receiving salvage therapy, 8 (13.1%) , 30 (49.2%) and 23 (37.7%) cases had dramatic progression, gradual progression and local progression, respectively; when given timely and proper salvage treatment, there were no statistically differences in PFS and OS of the patients in the above three subgroups (all P>0.05). There were no statistically differences in PFS and OS between patients receiving local therapy (24 cases) and patients not receiving local therapy (37 cases) after the progression occurred (all P>0.05). Among 58 patients with resistance to osimertinib again after the salvage therapy, 6 patients with gradual or local progression had more than 6-mouth PFS after the salvage therapy. Conclusions:Dramatic, gradual and local progression are the main patterns in patients with acquired resistance to osimertinib. The therapeutic efficacy of salvage therapy still shows some disappointing results.

18.
Journal of Leukemia & Lymphoma ; (12): 144-150, 2021.
Article in Chinese | WPRIM | ID: wpr-882254

ABSTRACT

Objective:To investigate the effect and prognostic factors of rituximab-containing chemotherapy regimen in treatment of patients with mantle cell lymphoma (MCL).Methods:The clinical data of 56 patients aged ≤65 years in the First Affiliated Hospital of Soochow University from June 2007 to November 2018 were retrospectively analyzed. Rituximab-containing chemotherapy regimen was used, and the effects of clinical features, treatment regimen and biological indexes on overall survival (OS) and progression-free survival (PFS) were observed.Results:The median age of 56 patients was 57 years old, including 43 males and 13 females. Among these cases, 24 patients received R-CHOP chemotherapy regimen; 29 patients received cytarabine-containing chemotherapy regimen, including R-hyper CVAD/R-MA regimen used in 15 patients and R-CHOP alternating with R-DAHP regimen used in 14 patients; and 3 patients received other treatment regimens. Among 56 patients, 19 patients received autologous hematopoietic stem cell transplantation (ASCT) consolidation therapy. The median OS time was 74 months, 2-year OS rate was 83.8%, 3-year OS rate was 70.9%, 2-year PFS rate was 72.0% and 3-year PFS rate was 49.7%. International prognostic index (IPI) high-risk and receiving ASCT or not during the treatment were independent influencing factors of OS and PFS in MCL patients. The overall response rate (ORR) in cytarabine-containing regimen group was higher compared with that in R-CHOP regimen group (93.1% vs. 83.3%), and there was no statistically significant difference ( χ2=0.465, P=0.495). In addition, there were no significant differences between two groups in both OS ( χ2=0.291, P=0.590) and PFS ( χ2=0.912, P=0.339). ASCT consolidation prolonged the median OS time (72 months vs.124 months, χ2=3.973, P=0.040) and the median PFS time (34 months vs. 90 months, χ2=3.984, P=0.046) in MCL patients achieving remission after induction therapy. Among patients in simplified MCL IPI (sMIPI) score middle-high risk group, compared with those not receiving ASCT, patients receiving ASCT therapy could obtain better OS and PFS (OS: χ2=5.037, P=0.025; PFS: χ2=6.787, P=0.009); among patients of sMIPI score low risk, there were no statistically significant differences in OS and PFS between the group receiving ASCT and not (all P > 0.05). Conclusions:Cytarabine-containing chemotherapy regimen has no predicatively satisfactory value in improving the prognosis and survival for MCL patients. For MCL patients who have achieved remission after reduction therapy and those in sMIPI score middle-high risk group, ASCT consolidation therapy can improve the prognosis and can be taken as the first-line consolidation treatment in young patients.

19.
Article in Chinese | WPRIM | ID: wpr-866623

ABSTRACT

Objective:To explore the construction and application in kidney-transplant recipients of accelerated rehabilitation surgery scheme.Methods:From February 2017 to January 2018, 49 kidney-transplant recipients who received routine preoperative management in the First Affiliated Hospital of Wenzhou Medical University were selected as regular group, while another 49 kidney-transplant recipients who received accelerated rehabilitation surgery scheme in our hospital from February 2018 to June 2019 were selected as observation group.The incidences of complications such as postoperative bleeding, infection of incisional wound and urinary tract, pulmonary infection, rejection reaction and urine leakage between the two groups were compared.The early rehabilitation progress such as preserved time of dwelling catheter, leaving bed time and first defecation time between the two groups were compared.The postoperative hospitalization time, hospitalization expense and the rate of readmission within 30 days were compared.Results:The incidence of complications of the observation group was 4.08%(2/49), which was significantly lower than that of the regular group[22.45%(11/49)](χ 2=7.184, P=0.007). The preserved time of dwelling catheter[(2.51±1.12)d], leaving bed time[(1.96±1.08 )d] and the first defecation time[(2.56±1.16)d] of the observation group were significantly better than those of the regular group[(4.96±1.40)d, (4.82±1.36)d and (4.84±1.38)d]( t=9.663, 11.650, 8.943, all P=0.000). The postoperative hospitalization time[(19.53±2.38)d] and hospitalization expense[(35.7±3.2)thousand CNY] of the observation group were significantly lower than those of the regular group[(26.49±3.42)d and (49.8±8.2)thousand CNY]( t=11.812, 11.327, all P=0.000). The readmission rate within 30 days of the observation group[2.04%(1/49)] was significantly lower than that of the regular group[18.37%(9/49)], the difference was statistically significant(χ 2=7.127, P=0.008). Conclusion:The construction and effective application of accelerated rehabilitation surgery scheme in kidney-transplant recipients can reduce the incidence of complication in recipients after transplantation, accelerate their rehabilitation in early stage, shorten the hospitalization time, reduce the hospitalization expense and lower the readmission rate after 30 days.

20.
Article in Chinese | WPRIM | ID: wpr-843251

ABSTRACT

N6-methyladenosine (m6A) has been identified as the most common epigenetic modification of eukaryote mRNA. It can not only mediate multiple processes of RNA metabolism such as RNA splicing, translation and decay under the catalytic regulation of m6A-related enzymes, but also affect the development of bone marrow hematopoiesis by regulating the self-renewal, proliferation and differentiation of pluripotent stem cells in the hematopoietic microenvironment of bone marrow. In recent years, many studies have reported that m6A methylation modification plays an important role in the development and progression of hematological malignancies. Targeting inhibition of m6A-related factors contributes to increase the sensitivity of patients with hematological malignancies to therapeutic drugs. This review describes the biological characteristics and hematopoietic regulation mechanisms of m6A methylation modification, and its role in the pathogenesis of hematological malignancies.

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