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Objective:To investigate the clinical efficacy and safety of ixazomib-based therapy in patients with relapsed or refractory multiple myeloma (RRMM) .Methods:A retrospective analysis was performed on the efficacy and adverse reactions of 53 RRMM patients treated with a combined regimen containing ixazomib in the Hematology Department of Beijing Jishuitan Hospital from July 8, 2018 to November 30, 2020. Among them, 6 patients received ID regimen (ixazomib + dexamethasone) , 30 patients received ID regimen + immunomodulator, and 17 patients received ID regimen + other chemotherapy drugs.Results:Fifty-three patients with RRMM received ixazomib-based therapy. The median previous treatment line was 3, the median treatment course was 6 (2-30) , and the median follow-up time was 21 months (2-32 months) . The overall response rate (ORR) was 54.7% (29/53) after 2 courses of treatment. Among them, 26.4% (14/53) had very good partial response (VGPR) and 28.3% (15/53) had partial response (PR) . The ORR of the ID regimen group, ID regimen + immunomodulator group and ID regimen + other chemotherapy group were 83.3% (5/6) , 56.7% (17/30) and 41.2% (7/17) respectively, with no statistically significant difference among the three groups ( P=0.208) . The median time to progression (TTP) of 53 patients was 8 months (1-24 months) . The most frequent adverse events of ixazomib treatment were gastrointestinal reactions such as nausea, vomit and diarrhea, with an incidence of 37.7% (20/53) , and the incidence of grade 3-4 was 5.7% (3/53) . The most common hematological adverse events were thrombocytopenia (15.1%, 8/53) , neutropenia (11.3%, 6/53) and anemia (9.4%, 5/53) . Grade 1-2 peripheral neurotoxicity occurred in only 7.5% (4/53) of patients. Conclusion:Ixazomib has good efficacy and safety for the patients with RRMM in the real world.
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Objective:To investigate the significance of expression of serum soluble HLA-G (sHLA-G), alpha-hydroxybutyrate dehydrogenase (α-HBDH) and signal transducer and activator of transcription 1 (STAT1) in acute myeloid leukemia (AML) and their relationship with prognosis.Methods:A total of 107 patients with AML who received treatment in Xiaoshan Hospital, Wenzhou Medical University, from June 2016 to June 2019 were included in the AML group. An additional 100 healthy controls who concurrently received physical health examination in the same hospital were included in the control group. Serum samples were collected from both patients with AML and healthy controls. Serum concentration of sHLA-G concentration was determined using the double-antibody sandwich enzyme-linked immunosorbent assay. Serum α-HBDH concentration was determined using the rate method. Peripheral blood was collected from patients with AML and healthy controls. The relative expression of STAT1 was determined by quantitative real-time polymerase chain reaction.Results:sHLA-G and α-HBDH concentrations in the AML group were (13.26 ± 2.19) μg/L and (362.17 ± 38.47) U/L, respectively, which were significantly higher than those in the control group [(5.08 ± 0.43) μg/L, (108.94 ± 12.19) U/L, t = 36.69, 62.93, both P < 0.05]. The relative expression of STAT1 in the AML group was significantly higher than that in the control group [(3.17 ± 0.25) vs. (1.01 ± 0.01), t = 86.32, P < 0.05] Among patients with Hb ≤ 80 g/L, the number of patients with high sHLA-G expression was higher than that of patients with low sHLA-G expression ( χ2 = 7.15, P < 0.05). The number of patients with white blood cells > 10 × 10 9/L was significantly higher than that of patients with low sHLA-G expression ( χ2 = 17.31, P < 0.05). Among patients with Hb ≤ 80 g/L, the number of patients with high α-HBDH expression was significantly higher than that of patients with low α-HBDH expression ( χ2 = 10.76, P < 0.05). The number of patients with white blood cells > 10 × 10 9/L was significantly higher than that with low α-HBDH expression ( χ2 = 13.17, P < 0.05). Among patients with Hb ≤ 80 g/L, the number of patients with high STAT1 expression was significantly higher than that of patients with low STAT1 expression ( χ2 = 18.14, P < 0.05). The number of patients with white blood cells > 10 × 10 9/L was significantly higher than that of patients with low STAT1 expression ( χ2 = 18.51, P < 0.05). The overall survival time in patients with high sHLA-G, α-HBDH expression and STAT1 expression was (17.92 ± 1.72) months, (19.34 ± 1.57) months, and (16.36 ± 2.08) months, respectively, which were significantly lower than those in patients with low sHLA-G, α-HBDH and STAT1 expression [(28.93 ± 1.46) months, (27.53 ± 1.89) months, (30.48 ± 1.12) months, t = 35.08, 24.07, 38.32, all P < 0.05]. Conclusion:sHLA-G, α-HBDH and STAT1 are abnormally expressed in patients with AML. Higher sHLA-G, α-HBDH and STAT1 expression indicates poorer prognosis of AML. Therefore, sHLA-G, α-HBDH and STAT1 can be used as the potential targets for AML treatment and prognosis prediction. Findings from this study are highly innovative and scientific.
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Objective To investigate the effect of comprehensive nursing intervention on improving the cognitive level in patients with chronic heart failure and the prognosis, to provide basis for clinical nursing. Methods In our hospital from June 2012 to June 2014, 60 cases patients with chronic heart failure according to the nursing methods were divid-ed into control group and intervention group, 30 cases in each group, the control group was given routine nursing, the observation group based on routine nursing application of comprehensive nursing intervention. The psychological nurs-ing, exercise intervention, body position intervention, dietary intervention, medication nursing, health education, cogni-tive function level quality of life, the score before and after intervention, and the prognosis were compared between the two groups. Results After 3 months intervention, intervention time directional force, disorientation, immediate memory, attention and calculation, delayed memory, language, visuospatial scores of observation group were (8.97±0.59), (8.39±1.14), (2.93±0.82), (4.45±0.64), (2.26±0.14), (8.83±1.26), (2.62±0.34), significantly higher than the control group, the difference was statistically significant (P<0.05). 3 months after the intervention, the intervention group patients physical function, emotional function, role function, cognitive function, social function, the overall quality of life scores were (95.37±3.62) and (91.40±3.97), (89.42±4.13), (81.33±4.64), (59.01±3.92), (89.47±4.18), significantly higher than the control group, the difference was statistical significance (P<0.05). The intervention group's worsening rehospitalization for heart failure or emergency department visits and ratio were significantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion The implementation of comprehensive nursing intervention on pa-tients with chronic heart failure, can raise the level of awareness of the disease of the patients, the quality of life of the patients and the prognosis is significantly improved.
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Objective To analyze influencing factors of recurrence in patients with cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP).Methods CIN patients who diagnosed by cervical cytology and cervical pathologic examination were treated with LEEP.Follow-up by cervical cytology and colposcope examination,patients with abnormal cytology were given colposcope pathologic examination.High risk human papilloma virus (HPV) was examined by hybrid capture HPV DNA method HC-2.Recurrent disease was defined when the same or higher level of lesion 6 months after LEEP were found.Results A total of 451 LEEP was performed during the study period,the age was 19-68 (39.0 ±7.4) years.Pathological grading:CIN Ⅰ was in 122 patients,CIN Ⅱ-Ⅲ was in 329 patients.Ninety-eight patients were recurrent,the rate of recurrence was 21.73％ (98/451),the rate of recurrence in CIN Ⅰ was 14.75％(18/122),in CIN Ⅱ-Ⅲ was 24.32％(80/329).Single factor analysis showed that high risk HPV infection,surgical margin,pathological grading,cervical cytology abnormal changes were the influencing factors of recurrence after LEEP (P＜0.01 or ＜0.05).Multi-factor analysis showed that the influencing factors of recurrence after LEEP were followed by high risk HPV infection,cervical cytology abnormal changes,surgical margin and pathological grading.Conclusions High risk HPV infection is an important influencing factor of recurrence after LEEP in patients with CIN,and cervical cytology abnormal changes,surgical margin and pathological grading are also influencing factor of recurrence after LEEP.