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Objective:To investigate the clinical efficacy of ginkgo ketone ester dropping pills combined with agatroban injection in the treatment of acute cerebral infarction.Methods:This prospective case-control study was conducted on 120 patients with acute cerebral infarction who were treated at The Hospital of Shanxi University of Chinese Medicine between April 2020 and April 2022. These patients were randomly divided into a control group and a study group using the random number table method, with 60 patients in each group. The control group received intravenous injections of agatroban based on conventional treatment, while the study group received treatment with ginkgo ketone ester dropping pills combined with agatroban injection based on conventional treatment. The treatment duration was 2 weeks. Clinical efficacy was evaluated after continuous treatment for 2 weeks.Results:The overall response rate in the study group was 95.0% (57/60), which was significantly higher than 80.0% (48/60) in the control group ( χ2 = 6.17, P = 0.012). After treatment, the Barthel index in the study group was (65.3 ± 7.3) points, which was significantly higher than (59.8 ± 7.5) points in the control group ( t = -4.07, P < 0.001). The modified Rankin Scale score and the National Institutes of Health Stroke Scale score in the study group were (1.2 ± 0.4) points and (4.6 ± 0.7) points, which were significantly lower than (2.4 ± 0.6) points and (7.6 ± 1.1) points, respectively, in the control group ( t = 12.89, 17.82, both P < 0.001). Interleukin-6, hypersensitive C-reactive protein, and tumor necrosis factor-α levels in the study group were significantly lower than those in the control group ( t = 10.10, 18.25, 14.15, all P < 0.001). The nitric oxide levels in the study group were significantly higher than those in the control group, while endothelin 1 and thromboxane A2 levels in the study group were significantly lower than those in the control group ( t = -7.65, 10.77, 21.90, all P < 0.001). There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:The combination of ginkgo ketone ester dropping pills and agatroban injection has a remarkable therapeutic effect on acute cerebral infarction. The combined therapy can reduce the severity of neurological deficits in patients, promote brain function recovery, improve quality of life, adjust serum inflammatory factors, and thereby be worthy of clinical application.
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Objective:To analyze the effect of donepezil hydrochloride combined with memantine on cognitive function in patients with Alzheimer's disease (AD).Methods:A randomized controlled trial was conducted among 90 patients with AD who were treated at the Zaozhuang Mental Health Center from January 2021 to March 2023. The patients were divided into a donepezil group and a combination group using a random number table grouping method, with 45 patients in each group. The donepezil hydrochloride group received only oral administration of donepezil hydrochloride tablets, while the combination group received oral administration of both donepezil hydrochloride tablets and memantine tablets. The two groups were continuously treated for 12 weeks. Before and after treatment, the Activities of Daily Living scale (ADL) score, the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) score, the Mini-Mental State Scale (MMSE) score, and biochemical indicators (homocysteine, neuron-specific enolase, and S100 β) were compared between the two groups. Adverse drug reactions were observed in each group.Results:After treatment, the ADL, BEHAVE-AD, and MMSE scores in the combination group were (78.9 ± 6.1) points, (5.2 ± 0.5) points, and (22.8 ± 2.2) points, respectively, and they were (65.2 ± 5.9) points, (9.6 ± 0.9) points, and (19.4 ± 2.4) points, respectively, in the donepezil hydrochloride group. The ADL and MMSE scores in the combination group were significantly higher than those in the donepezil hydrochloride group ( t = 10.83, 7.01, both P < 0.001). The BEHAVE-AD score in the combination group was significantly lower than that in the donepezil hydrochloride group ( t = -28.67, P < 0.001). After treatment, serum levels of homocysteine, neuron-specific enolase, and S100 β in the combination group were (17.8 ± 3.6) μmol/L, (16.8 ± 2.7) μg/L, and (17.4 ± 7.5) μg/L, respectively, which were significantly lower than (21.5 ± 3.3) μmol/L, (20.4 ± 3.7) μg/L, and (23.5 ± 5.1) μg/L in the donepezil hydrochloride group ( t = -5.08, -5.27, -4.51, all P < 0.001). The incidence of adverse drug reactions in the combination group was 13.3% (6/45), which was slightly, but not significantly, higher than 8.9% (4/45) in the donepezil group ( χ2 = 0.45, P = 0.502). Conclusion:The combination of donepezil hydrochloride and memantine can effectively improve the mental and behavioral symptoms and cognitive function of patients with AD, improve daily living ability, and do not increase adverse reactions. The combined therapy has high clinical application value.
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Objective:To investigate the efficacy of the combination of semaglutide, insulin degludec, and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity.Methods:A total of 160 patients with type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity were included in this case-control study after receiving treatment at Bayannur Hospital from April 2022 to March 2023. These patients were divided into a control group and an observation group based on different treatment regimens, with 80 patients in each group. The control group was treated with degludec insulin combined with metformin, while the observation group was treated with semaglutide, degludec insulin, and metformin. The treatment lasted for 12 weeks in both groups. The changes in fasting plasma glucose, 2-hour postprandial blood glucose (2 h PG), glycosylated hemoglobin, time in range for 2 h PG, fasting insulin, Homeostatic Model Assessment for Insulin Resistance index, body mass index, and visceral fat area and adverse reactions were monitored.Results:The overall response rate in the observation group was 100% (80/80), which was significantly higher than 97.5% (78/80) in the control group (χ 2 = 11.03, P < 0.05). After treatment, the levels of 2 h PG, glycosylated hemoglobin, fasting insulin, Homeostatic Model Assessment for Insulin Resistance index, body mass index, visceral fat area in the observation group were (7.35 ± 0.17) mmol/L, (6.08 ± 0.24)%, (10.30 ± 2.58) μU/mL,(2.69 ± 0.66), (24.40 ± 0.68) kg/m 2, (80.20 ± 8.94) cm 2, respectively, which were significantly lower than (7.92 ± 0.24) mmol/L, (6.34 ± 0.27)%,(13.71 ± 3.13) μU/mL,(3.57 ± 0.83), (26.77 ± 3.49) kg/m 2, (116.12 ± 34.09) cm 2 respectively in the control group ( t = -0.73, -3.74, -4.20, -4.15, -3.35, -5.10, all P < 0.05). The time in range for 2 h PG in the observation group was (72.68 ± 4.09)%, which was significantly higher than (50.16 ± 10.00)% in the control group ( t = -10.42, P < 0.05). The incidence of adverse reactions in the observation group was 3.8% (3/80), which was slightly, but not significantly, higher than 2.5% (2/80) in the control group ( P > 0.05). Conclusion:The combination of semaglutide, degludec insulin, and metformin demonstrates an ideal clinical effect in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity. This combined approach can effectively regulate fasting and postprandial blood glucose levels, markedly decrease the body mass index and visceral fat levels, and improve insulin resistance while not significantly increasing the incidence of adverse reactions.
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Objective:To explore the effects of amlodipine combined with different doses of atorvastatin and simvastatin on hypertension complicated by atherosclerosis.Methods:A retrospective analysis was conducted on the clinical data of 100 patients with hypertension complicated by atherosclerosis who were diagnosed and treated at Jinan 2 nd People's Hospital from August 2019 to August 2020. These patients were divided into control group ( n = 32, amlodipine combined with simvastatin), study group 1 ( n = 34, amlodipine combined with 10 mg/day atorvastatin), and study group 2 ( n = 34, amlodipine combined with 20 mg/day atorvastatin) according to different treatment schemes. All three groups were treated for 6 months. The clinical efficacy, blood lipid level, blood pressure, oxidative stress level, carotid intima-media thickness and plaque area were compared among the three groups. Results:The overall response rates of the control group, study group 1, and study group 2 were 71.88% (23/32), 82.35% (28/34), and 91.18% (31/34), respectively. The difference in overall response rate among the three groups was statistically significant ( χ2 = 4.16, P < 0.05). After treatment, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, 24-hour dynamic blood pressure, diurnal blood pressure, nighttime blood pressure, malondialdehyde, superoxide dismutase, glutathione peroxidase, carotid intima-media thickness and plaque area were statistically different among the three groups ( F = -19.54, -76.61, 11.15, -56.83, -147.35, -23.10, -11.47, -11.65, -128.36, -15.60, -24.52, 25.61, 118.99, -59.23, -81.64, all P < 0.05). The incidence rates of adverse reactions in the control group, study group 1, and study group 2 were 12.50% (4/32), 8.82% (3/34), and 11.76% (4/34), respectively. There was no statistically significant difference among the three groups ( χ2 = 0.25, P = 0.611). Conclusion:Amlodipine combined with atorvastatin is more effective in the treatment of hypertension complicated by atherosclerosis than the amlodipine combined with simvastatin. High-dose atorvastatin is more effective in reducing lipid, controlling blood pressure, improving the level of oxidative stress and clinical symptoms compared with low-dose atorvastatin.
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Objective:To explore the effect of bismuth containing triple therapy on serum gastrin (Gas), transforming growth factor-α (TGF-α), and high-sensitivity C-reactive protein (hs-CRP) levels in children with Helicobacter pylori (Hp) positive peptic ulcers.Methods:A total of 96 children with Hp positive peptic ulcers admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as the study subjects. They were randomly divided into two groups using the remainder of a random number table. The control group (48 cases) received treatment with omeprazole, clarithromycin, and amoxicillin, while the observation group (48 cases) received treatment with bismuth containing triple therapy (amoxicillin+ metronidazole+ bismuth potassium citrate). After 10 days of treatment, the clinical efficacy of the two groups was evaluated The improvement time of clinical symptoms, Hp conversion rate, serum indicators (Gas, TGF-α, hs-CRP) before and after treatment, and incidence of adverse reactions were observed.Results:The total effective rate and Hp conversion rate of the observation group were significantly higher than those of the control group [95.83%(46/48) vs 81.25%(39/48), 97.92%(47/48) vs 83.33%(40/48), P<0.05]. The improvement time of upper abdominal pain, heartburn, and acid reflux symptoms was significantly shorter than that of the control group (all P<0.05). After 10 days of treatment, the serum Gas and hs-CRP levels in both groups significantly decreased compared to before treatment (all P<0.05), and the observation group was lower than the control group after treatment ( P<0.05); The levels of TGF-α in both groups increased compared to before treatment (all P<0.05), and the observation group was higher than the control group after treatment ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups [4.17%(2/48) vs 2.08%(1/48), P>0.05]. Conclusions:The triple therapy with bismuth containing agents has a better therapeutic effect on children with Hp positive peptic ulcers, and can promote ulcer mucosal repair by improving inflammatory response, with good safety.
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Fundamento: la anemia constituye una de las toxicidades más frecuentes con factores de riesgo intrínsecos en el paciente. La anemia por toxicidad debido a la quimioterapia se considera una disfunción hematopoyética de una sola estirpe de causa iatrogénica por su relación al tratamiento. Objetivo: caracterizar el comportamiento de la anemia por toxicidad a la quimioterapia en los pacientes con cáncer de pulmón. Método: se realizó un estudio descriptivo y retrospectivo en pacientes con cáncer de pulmón que recibieron tratamiento con quimioterapia en el Hospital Provincial Docente Oncológico María Curie de la provincia Camagüey, en el período de enero del 2020 a diciembre del 2022. La población objeto de estudio estuvo constituida por 101 pacientes que cumplieron con los criterios de inclusión. Las variables estudiadas fueron: edad, sexo, estadiamiento, condición al egreso y anemia por toxicidad. Se empleó como método el análisis documental, a través de la revisión de las historias clínicas. Resultados: predominó el sexo masculino con 73,3 % de los casos de cáncer de pulmón, no se evidenciaron diferencias en cuanto a la edad acorde al sexo. La mayor parte de los pacientes se encontraron en los estadios IIIA 36,6 % y IIIB 33,6 %. El 56,4 % egresaron en condición de vivo y el 21,8 % de los pacientes que recibieron quimioterapia desarrollaron anemia por toxicidad. Conclusiones: predominó el sexo masculino, la mayoría de los pacientes se encontraron en los estadios IIIA y IIIB, el mayor porciento de pacientes egresó vivo y un número considerable de los que recibieron quimioterapia desarrollaron anemia por toxicidad.
Foundation: anemia constitutes one of the most frequent toxicities with intrinsic risk factors in the patient. Anemia due to toxicity due to chemotherapy is considered a single-line hematopoietic dysfunction of iatrogenic cause due to its relationship to treatment. Objective: to characterize the behavior of anemia due to toxicity to chemotherapy in patients with lung cancer. Method: a descriptive and retrospective study was carried out in patients with lung cancer who received chemotherapy treatment at the María Curie Provincial Teaching Oncology Hospital in Camagüey province, from January 2020 to December 2022. The population under study the study consisted of 101 patients who met the inclusion criteria. The variables studied were: age, sex, staging, condition at discharge and anemia due to toxicity. Documentary analysis was used as a method, through the review of medical records. Results: the male sex predominated with 73.3 % of the cases of lung cancer, there were no differences in terms of age according to sex. Most of the patients were found in stages IIIA 36.6 % and IIIB 33.6 %. 56.4 % were discharged alive and 21.8 % of the patients who received chemotherapy developed anemia due to toxicity. Conclusions: the male sex predominated, most of the patients were in stages IIIA and IIIB, the highest percentage of patients were discharged alive and a considerable number of those who received chemotherapy developed anemia due to toxicity.
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Objective:To investigate the relationship between ATPase Family AAA Domain Containing 3A (ATAD3A) expression level in gastric cancer tissue and chemotherapy sensitivity and prognosis.Methods:Eighty-six patients with advanced gastric cancer admitted to Shandong Second Rehabilitation Hospital from June 2020 to July 2021 were included in this study. Gastric cancer tissue and paracancer tissue samples were collected. ATAD3A expression level in gastric cancer tissue was detected using immunohistochemical staining with the SP method. ATAD3A expression was compared between gastric cancer tissue and paracancer tissue. The relationship between ATAD3A expression and clinical pathological parameters was analyzed. The relationship between ATAD3A expression level in gastric cancer tissue and chemotherapy sensitivity and prognosis was analyzed.Results:The ATAD3A-positive expression rate in the gastric cancer tissue was 75.58% (65/86), which was significantly higher than 43.02% (37/86) in the paracancer tissue ( χ2 = 18.89, P < 0.001). The expression level of ATAD3A in gastric cancer tissues was not correlated with gender, age, tumor diameter, clinical stage or lymph node metastasis (all P > 0.05). The proportion of low differentiation and distant metastasis in patients with ATAD3A-positive expression was significantly higher than that in patients with ATAD3A-negative expression ( χ2 = 5.71, 6.17, both P < 0.05). The total response rate of chemotherapy in patients with ATAD3A-positive expression was 60.00% (39/65), which was significantly lower than 85.71% (18/21) in patients with ATAD3A-negative expression ( χ2 = 4.55, P = 0.033). Of 86 patients, 59 were sensitive to paclitaxel and 56 to capecitabine. The sensitivity of paclitaxel and capecitabine in the ATAD3A-positive group was lower than that in the blank control group ( χ2 = 6.17, 5.19, both P < 0.05). After 1 year of follow-up, the cumulative survival rate in patients with ATAD3A-positive expression was 43.08% (28/65), which was significantly lower than 71.43% (15/21) in patients with ATAD3A-negative expression ( χ2 = 5.24, P < 0.05). The survival time of patients with ATAD3A-positive expression was (8.47 ± 2.13) months, which was significantly shorter than (13.62 ± 1.49) months for patients with ATAD3A-negative expression ( t = 6.29, P < 0.05). Cox multivariate regression analysis showed low differentiation ( HR = 6.22, 95% CI: 1.537-25.240), distant metastasis ( HR = 2.57, 95% CI: 1.396-4.742), and positive expression of ATAD3A ( HR = 10.60, 95% CI: 2.631-42.715) were independent factors that affect the survival time of patients with gastric cancer after chemotherapy ( P < 0.05). Conclusion:ATAD3A is expressed in gastric cancer tissue. Its expression level is closely related to chemotherapy sensitivity and prognosis. It provides an important reference value for the evaluation of chemotherapy efficacy and prognosis.
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Objective:To investigate the clinical efficacy of cyclophosphamide combined with leflunomide in the treatment of lupus nephritis.Methods:The clinical data of 90 patients with lupus nephritis who received treatment in The Second People's Hospital of Liaocheng from January 2019 to June 2020 were retrospectively analyzed. These patients were divided into two groups according to different treatment methods. The single drug group ( n = 45) was treated with cyclophosphamide alone, and the combined drug group ( n = 45) was treated with cyclophosphamide combined with leflunomide. All patients were treated for 6 months. Total response rate, inflammatory factor level, immune function, renal function, and adverse reactions were compared between the two groups. Results:Total response rate in the combined drug group was 95.56% (43/45), which was significantly higher than 82.22% (37/45) in the single drug group ( χ2 = 4.05, P < 0.05). After treatment, interleukin-6, C-reactive protein, and rheumatoid factor in the combined drug group were (45.21 ± 5.07) ng/L, (3.13 ± 1.01) mg/L, (43.37 ± 18.20) IU/mL, respectively, which were significantly lower than (60.20 ± 6.13) ng/L, (6.23 ± 1.31) mg/L, (73.19 ± 19.17) IU/mL in the single drug group ( t = 12.64, 12.57, 7.56, all P < 0.001). Immunoglobulin A and immunoglobulin G levels in the combined drug group were significantly lower than those in the single drug group ( t = 13.05, 13.40, both P < 0.001), but immunoglobulin M level in the combined drug group was significantly higher than that in the single drug group ( t = 13.51, P < 0.001). Serum creatinine and 24-hour urine protein levels in the combined drug group were (78.23 ± 19.13) μmol/L and (1.15 ± 0.33) g/24 hours, respectively, which were significantly lower than (92.19 ± 20.19) μmol/L and (3.15 ± 0.81) g/24 hours in the single drug group ( t = 3.36, 15.33, both P < 0.001). The incidence of adverse reactions in the combined drug group was 6.67% (3/45), which was significantly lower than 22.22% (10/45) in the single drug group ( χ2 = 4.40, P < 0.05). Conclusion:Cyclophosphamide combined with leflunomide is effective against lupus nephritis. The combined therapy can regulate the inflammatory reaction, improve the immune function, promote the recovery of renal function, and be safe.
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Objective:To investigate the clinical efficacy of oxcarbazepine versus carbamazepine combined with baclofen in the treatment of trigeminal neuralgia. Methods:A total of 74 patients with trigeminal neuralgia who received treatment in Haiyang People's Hospital from May 2019 to May 2021 were prospectively included in this study. They were randomly divided into an observation group and a control group ( n = 37 per group). The observation group was treated with oxcarbazepine combined with baclofen, while the control group was treated with carbamazepine combined with baclofen. Both groups were treated for 4 successive weeks. Clinical efficacy, adverse reactions, Visual Analogue Scale (VAS) scores before and after treatment, levels of pain transmitters [substance P (SP), 5-hydroxytryptamine (5-HT), β-endorphin (β-EP)], and quality of life were compared between the two groups. Results:The total effective rate in the observation group was 97.3% (36/37), which was significantly higher than 83.8% (31/37) in the control group (χ 2 = 3.95, P < 0.05). Before treatment, there were no significant differences in VAS score, SP, 5-HT, β-EP levels, and EQ-5D Health-Related Quality of Life Questionnaire (EQ-5D) score between the two groups (all P > 0.05). After treatment, VAS score, SP, 5-HT levels, and EQ-5D score in each group were significantly decreased compared with those before treatment. After treatment, VAS score, SP and 5-HT levels in the observation group were significantly lower than those in the control group [(3.1±0.8) points vs. (4.2±0.9) points, (240.1 ± 34.1) ng/L vs. (314.1±40.1) ng/L, (38.2 ± 6.1) ng/L vs. (52.1±9.1) ng/L, all P < 0.001]. After treatment, β-EP level in each group was significantly increased compared with that before treatment ( P < 0.001). After treatment, β-EP level in the observation group was significantly higher than that in the control group [(268.1 ± 38.1) ng/L vs. (214.1 ± 29.0) ng/L, P < 0.001]. After treatment, EQ-5D scores in the observation group were significantly lower than those in the control group (all P < 0.001). There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Oxcarbazepine combined with baclofen has superior efficacy in the treatment of trigeminal neuralgia to carbamazepine combined with baclofen. The former can more obviously relieve pain, reduce pain neurotransmitter levels, improve quality of life, and has less adverse reactions.
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Objective:To evaluate and compare the efficacies of ganciclovir plus foscarnet and a single agent for the treatment of cytomegalovirus (CMV) infection after haploidentical hematopoietic stem cell transplantation.Methods:This study was a non-randomized clinical controlled trial. The data of patients who underwent haploidentical transplantation and developed CMV infection between January 1, 2021, and June 30, 2021, were retrospectively analyzed. Follow-up was conducted through telephone, inpatient consultations, and the review of outpatient medical records. The observed indicators included the incidence of CMV infection (including CMV disease), rate of recurrence of CMV infection, overall survival (OS), and disease-free survival (DFS).Results:A total of 242 patients were diagnosed with post-transplantation CMV infection; 116 patients tested positive for CMV DNA for more than 14 days ( P=0.011). Of the 242 patients with CMV infection, 65 were treated with ganciclovir plus foscarnet, and 156 patients were treated with a single antiviral drug; the median durations of CMV seroconversion were 21 (3-60) and 14 (3-32) days for the combination and single-drug groups, respectively. There were no significant differences between their incidence of CMV infections and 1-year OS and DFS. Of the patients with refractory CMV infections, 53 (45.7%) were treated with ganciclovir plus foscarnet, and 63 (54.3%) were treated with a single antiviral agent. The median durations of CMV seroconversion for the combination and single-drug groups were 21 (15-60) days and 20 (15-45) days, respectively ( P=0.472). Two patients in each group progressed to CMV disease ( P=0.860). During follow-up, 12 patients (22.6%) in the combination group and 8 patients (12.7%) in the single-drug group experienced recurrent episode(s) of CMV infection ( P=0.158). The 1-year OS of the combination and single-drug groups were 92.0% and 87.1%, respectively ( P=0.543); the 1-year DFS were 90.3% and 85.7%, respectively ( P=0.665). Univariate analysis revealed no associations between the antiviral agents used and OS and DFS (OS: HR=0.644, P=0.547; DFS: HR=0.757, P=0.666). Conclusions:There were no significant differences in the duration of CMV infection, incidence of CMV disease, rate of recurrence of CMV infection, and survival of the patients treated with the combination of antiviral drugs and a single antiviral drug.
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Objective:To measure the skin thickness in patients with erysipelas by high-frequency ultrasonography (HF-USG), and to compare the clinical efficacy of systemic antibiotics alone versus their combination with glucocorticoids in the treatment of erysipelas.Methods:Hospitalized patients with erysipelas were enrolled from Zhongda Hospital, Southeast University from January to December in 2021, and randomly divided into the study group and control group according to the order of visits. The study group was treated with systemic cefathiamidine for 7 days followed by oral methylprednisolone at a dose of 0.4 mg·kg -1·d -1, while the control group was treated with cefathiamidine alone. Before and after the treatment for 10 days, the thicknesses of the epidermis-dermis layers and subcutaneous tissues were measured by HF-USG at the sites of the most severe skin lesions on the affected limbs and at the corresponding sites on the healthy limbs, and white blood cell (WBC) counts, neutrophil (NEU) counts, as well as C-reaction protein (CRP) levels were determined. The t test and non-parametric test were used to compare the efficacy between two groups. Results:A total of 23 patients with erysipelas were enrolled. Among the 12 patients in the study group, 8 were males and 4 were females, and their age was 71.4 ± 11.4 years. Among the 11 patients in the control group, 7 were males and 4 were females, and their age was 67.4 ± 11.1 years. Before treatment, the thicknesses of the epidermis-dermis layers (0.33 ± 0.12 cm) and subcutaneous tissues (1.08 ± 0.49 cm) in the study group were not significantly different from those in the control group (0.25 ± 0.09 cm, 0.98 ± 0.46 cm; t = -1.83, -0.49, P = 0.081, 0.626, respectively). After the 10-day treatment, the thicknesses of the epidermis-dermis layers and subcutaneous tissues of the skin lesions on the affected limbs significantly decreased in both groups compared with those before treatment (both P < 0.05), and the decrease in the thicknesses of subcutaneous tissues was significantly stronger in the study group (0.32 ± 0.33 cm) than in the control group (0.10 ± 0.07 cm; t = 2.20, P = 0.039). Before treatment, the WBC counts ([11.16 ± 4.42] × 10 9/L), NEU counts ([8.26 ± 4.16] × 10 9/L) and CRP levels (median [ Q1, Q3]: 72.20 [19.28, 140.50] mg/L) in the study group were not significantly different from those in the control group ([10.10 ± 4.53] × 10 9/L, [7.21 ± 3.00] × 10 9/L, 34.40 [8.00, 74.20] mg/L, respectively; t or Z = 0.60, 0.71, -0.85, P = 0.578, 0.496, 0.196, respectively). After the 10-day treatment, the WBC counts, NEU counts, and CRP levels significantly decreased in both groups compared with those before treatment (all P < 0.05) . Conclusion:The combined treatment with systemic antibiotics and glucocorticoids could effectively alleviate skin inflammation, and more rapidly reduce the thicknesses of inflamed subcutaneous tissues in patients with erysipelas compared with systemic antibiotics alone.
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Multiple myeloma (MM) is a plasma cell malignant proliferative hematological tumor. At present, a variety of drugs including immunomodulators (IMiD) and proteasome inhibitors (PI) have been used to treat MM, and the progression-free survival time of patients has been significantly prolonged. Because the immune dysfunction of MM patients has not been fundamentally corrected, most of them will eventually relapse and develop drug resistance. Pomalidomide, a third-generation IMiD, has achieved a high response rate in clinical trials of patients with relapsed/refractory multiple myeloma (RRMM) who did not respond to lenalidomide or bortezomib. This article reviews the mechanism of pomalidomide and the efficacy and safety of relevant clinical trials, so as to investigate the treatment measures for RRMM.
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Objective:To investigate the clinical effect of CAG stimulating regimen for refractory adult early T cell precursor acute lymphoblastic leukemia (ETP-ALL) complicated with fusarium infection and the clinical features as well as antifungal strategy of cutaneous fusarium infection.Methods:The diagnosis and treatment of 1 adult patient diagnosed as ETP-ALL complicated with cutaneous fusarium infection in the First Hospital of Jilin University in September 2020 were retrospectively analyzed, and related literatures were reviewed.Results:VICP chemotherapy regimen showed no effectiveness in this patient who was presented with persistent agranulocytosis complicated with cutaneous fusariosis infection. After amphotericin B therapy for infection, he achieved the stable disease and successfully underwent CAG stimulating regimen salvage treatment. The minimal residual disease turned into negative after consolidation chemotherapy based on the myeloid regimen. Finally this patient survived from haploid allogeneic hematopoietic stem cell transplantation after consolidation chemotherapy and fusarium was under the control by using posaconazole as secondary prevention therapy.Conclusions:CAG stimulating regimen can be recommended as reinduction therapy for relapsed/refractory ETP-ALL. Sequential therapy of amphotericin B followed by posaconazole can be a useful antifungal strategy for fusarium infection.
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Objective:To investigate the efficacy and safety of SIMPLE regimen in the treatment of extranodal NK/T-cell lymphoma (ENKTCL).Methods:The clinical data of 11 patients with ENKTCL who were admitted to the University of Hong Kong-Shenzhen Hospital from January 2012 to January 2022 were retrospectively analyzed. The patients received 4-6 courses of SIMPLE (cisplatin, gemcitabine, ifosfamide, etoposide, dexamethasone, and pegasparaginase) regimen chemotherapy, and stage Ⅰ and Ⅱ patients who also received local radiotherapy after 2 or 3 courses of chemotherapy. Patients were evaluated for mid-treatment and end-of-treatment outcomes, and the adverse effects of patients were evaluated in each treatment cycle. The Kaplan-Meier method was used to analyze the progression-free survival (PFS) and overall survival (OS) of the 11 patients.Results:All 11 patients were nasal type, with the median age of 41 years old (26-67 years old), including 5 males and 6 females, 3 relapsed cases and 8 newly treated cases. Of the 10 patients evaluated for efficacy, 9 achieved complete remission and 1 achieved at least partial remission (efficacy was assessed based on follow-up). All 11 patients were followed up for a median time of 50 months (15-72 months) and 2 relapsed patients died due to disease progression. The expected 5-year PFS rate and OS rate of 11 patients were both 90.0%, and the expected 5-year OS rate was 100.0% and 66.6% in newly treated and relapsed patients, respectively. Common adverse effects were hematologic adverse reactions, infections, gastrointestinal symptoms, elevated transaminases, and hypofibrinogenemia, all of which were curable. There is no treatment-related death.Conclusions:The SIMPLE regimen for the treatment of ENKTCL has a high remission rate, the patients have long survival time, and the regimen is moderately well tolerated.
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Objective:To investigate the effectiveness and safety of bortezomib combined with conventional chemotherapy regimens for treatment of relapsed/refractory acute B lymphoblastic leukemia (B-ALL).Methods:Twenty patients with relapsed/refractory B-ALL treated with bortezomib combined with chemotherapy in Jiaozuo People's Hospital Affiliated to Xinxiang Medical College, Jiaozuo Coal Industry Group Central Hospital and the Second People's Hospital of Jiaozuo from September 2021 to June 2022 were collected, and their treatment response and prognosis were retrospectively analyzed.Results:The median age of the 20 patients was 49.5 years old (25.0-58.5 years old); 12 were male and 8 were female; 12 were relapsed and 8 were refractory. All patients completed 1 course of bortezomib (1.6 mg/m 2, subcutaneous injection on days 2 and 16) combined with chemotherapy. Before bortezomib treatment, there were 0 case of complete remission (CR), 7 cases of partial remission (PR) and 13 cases of non-remission (NR) in 20 patients, the objective remission rate (ORR) was 35% (7/20), and all were positive for minimal residual disease (MRD). After bortezomib treatment, there were 13 cases of CR, 3 cases of PR and 4 cases of NR, and the ORR was 80% (16/20); the MRD of all patients decreased, among which 13 cases (65%) turned to negative; the differences were statistically significant when comparing CR rate, ORR and MRD negative conversion rate before and after bortezomib treatment ( χ2 values were 65.41, 8.83 and 19.30, all P < 0.05). Four of the 20 patients developed central nervous system infiltration despite bone marrow remission, and one died from post-chemotherapy infection. Myelosuppression occurred in all patients, the incidence of infection was 90% (18/20), and the incidence of digestive system adverse effects was 75% (15/20). Conclusions:Bortezomib combined with conventional chemotherapy regimens is effective and well tolerated in the treatment of relapsed/refractory ALL, and has the potential to enable patients with multi-drug resistant relapse to overcome resistance and to achieve deep remission.
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The incidence of hematologic malignancies is increasing, and although new drugs and treatments have made great progress, relapse and drug resistance are still urgent problems to be solved. Exosomes are tiny membrane vesicles secreted in cells that carry lipid bilayer membrane structures including mRNA, microRNA and proteins. It carries and transmits important signaling molecules, forming an entirely new intercellular information transfer system that exhibits a wide range of biological properties and functions in organisms. Tumor cell exosomes are confirmed to contribute to cancer cell proliferation, angiogenesis, invasiveness, distant metastasis and drug resistance. Multiple studies have shown that exosomes from some malignant hematological tumor cells are closely related to tumor resistance. This review summarizes the research progress of exosomes in the mechanism of drug resistance of hematologic malignancies, in order to provide a theoretical basis for the clinical treatment of hematologic malignancies.
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Objective:To investigate clinical efficacy and safety of venetoclax (VEN)-based regimens in the treatment of acute myeloid leukemia (AML).Methods:The clinical data of 41 AML patients treated with venetoclax-based regimens from January 2021 to December 2021 in Ruijin Hospital North of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The treatment regimens included VEN+demethylating drugs ± gene mutation inhibitors or VEN+chemotherapy with a median number of 2 courses (1- 5 courses).Results:The median age of all patients was 60 years (18-73 years), and there were 24 males and 17 females. After 1 course of VEN-based therapy, 22 (53.7%) patients achieved complete remission (CR) or morphological complete remission without complete blood count recovery (CRi), including 5 patients achieving minimal residual disease (MRD) negative. After 2 courses of treatment, of 17 patients available for efficacy evaluation, 7 patients achieved MRD negative. Among 20 relapsed/refractory AML patients, 9 cases achieved CR/CRi after 1 course of treatment, of which 1 patient had MRD negative. Among 21 patients initially treated and re-treated, 13 cases achieved CR/CRi and 1 case achieved partial remission after 1 course of treatment, of which 4 cases had MRD negative.Conclusions:VEN-based treatment regimens for AML have a high remission rate and tolerable adverse effects.
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Compared with single therapy, radiotherapy combined with chemotherapy, endocrine therapy, molecular targeted therapy and immunological therapy can not only shorten the treatment cycle, but also improve the local control rate and prolong the survival of patients. However, the safety of combined therapy still needs to be further clarified to comprehensively evaluate the feasibility. Therefore, exploring the efficacy and safety of radiotherapy combined with systematic therapy will provide evidence for clinical benefits.
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Objective:To investigate the clinical efficacy of adjuvant therapy with Yinhuang Qingfei Capsule in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) caused by accumulation of phlegm and heat in the lung. Methods:A total of 300 patients with AECOPD admitted to Wenling Hospital of Traditional Chinese Medicine from January 2019 to December 2020 were included in this study. They were randomly divided into observation and control groups ( n = 150/group). The control group was treated with conventional therapy, and the observation group was treated with adjuvant therapy with Yinhuang Qingfei Capsule based on conventional therapy. All patients were treated for 14 consecutive days. The clinical efficacy, lung function indexes and serum inflammatory factors pre- and post-treatment as well as adverse reactions were compared between the two groups. Results:Total response rate was significantly higher in the observation group than the control group [88.0% (132/150) vs. 75.3% (113/150), χ2 = 8.04, P < 0.05]. After treatment, cough score [(2.31 ± 0.49) points], sputum score [(1.93 ± 0.35) points] and wheezing score [(0.91 ± 0.22) points] in the observation group were lower compared with the control group [(2.89 ± 0.54) points, (2.22 ± 0.43) points, (1.36 ± 0.27) points, t = 9.30, 6.41, 15.82, all P < 0.001]. Serum interleukin-6 (IL-6) [(3.04 ± 1.25) μg/L], C-reactive protein [(26.44 ± 2.31) mg/L] and procalcitonin [(1.25 ± 0.97) μg/L] in the observation group were lower compared with the control group [(3.66 ± 1.32) μg/L, (31.39 ± 2.26) mg/L, (1.79 ± 1.06) μg/L, t = 4.18, 11.18, 4.60, all P < 0.001]. Forced vital capacity [(1.89 ± 0.54) L], forced expiratory volume in 1 second (FEV 1) [(64.22 ± 5.80)%] and FEV 1/FVC value [(59.16 ± 5.52)%] in the observation group were higher compared with the control group [(1.58 ± 0.57) L, (60.13 ± 5.77)%pred, (54.43 ± 5.37)%, t = 4.84, 6.12, 7.52, all P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Yinhuang Qingfei Capsule can effectively relieve the clinical symptoms of patients with AECOPD caused by accumulation of phlegm and heat in the lung, improves lung function, reduces inflammatory response, and has no obvious adverse reactions. This study is innovative and scientific and deserves clinical promotion.
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Objective:To investigate the efficacy of levodopa and benserazide hydrochloride combined with pramipexole in the treatment of Parkinson's disease in 30 patients and their effects on neurotransmitters and oxidative stress response.Methods:A total of 90 patients with Parkinson's disease admitted to Jinhua People's Hospital from January 2020 to February 2022 were included in this study. They were randomly assigned to undergo treatment with levodopa and benserazide hydrochloride (levodopa and benserazide hydrochloride group), pramipexole (pramipexole group), or their combination (combined therapy group), with 30 patients in each group. All patients were treated for 12 consecutive weeks. Clinical efficacy, levels of brain neurotransmitters (dopamine, 5-hydroxytryptamine, norepinephrine, and substance P), and oxidative stress response (superoxide dismutase, malondialdehyde, homocysteine levels) were compared among the three groups.Results:Total response rate in the combined therapy group was 96.67% (29/30), which was significantly higher than 66.67% (20/30) in the levodopa and benserazide hydrochloride group and 76.67% (23/30) in the pramipexole group ( χ2 = 8.65, P < 0.05). After treatment, dopamine, 5-hydroxytryptamine, norepinephrine, substance P, superoxide dismutase, malondialdehyde, and homocysteine levels in the combined therapy group were (9.05 ± 1.24) ng/mg, (89.49 ± 10.69) μg/L, (15.16 ± 1.36) ng/mg, (102.8 ± 15.36) μg/L, (88.40 ± 10.04) kU/L, (5.5 ± 2.31) μmol/L, and (9.20 ± 3.36) μmol/L, respectively, which were superior to (6.61 ± 1.02) ng/mg, (68.52 ± 9.52) μg/L, (12.33 ± 1.24) ng/mg, (151.64 ± 16.03) μg/L, (74.99 ± 7.28) kU/L, (9.27 ± 3.07) μmol/L, and (13.52 ± 3.64) μmol/L in the levodopa and benserazide hydrochloride group and (7.22 ± 1.09) ng/mg, (79.52 ± 10.20) μg/L, (13.92 ± 1.31) ng/mg, (131.30 ± 15.65) μg/L, (80.59 ± 8.24) kU/L, (7.53 ± 2.93) μmol/L, (11.35 ± 3.71) μmol/L in the pramipexole group ( F = 38.53, 32.05, 35.49, -73.42, 18.42, -22.65, -12.13, all P < 0.05). Conclusion:Levodopa and benserazide hydrochloride combined with pramipexole are highly effective on Parkinson's disease. The combined therapy can effectively improve brain neurotransmitters and regulate oxidative stress response.