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Objective To explore the role of breast/ovarian cancer susceptibility gene 1 associated protein 1(BAP1)in the occurrence and progression of human malignant glioma and the feasibility of BAP1 as a clinical diagnostic marker for malignant glioma.Methods The differential expression of BAP1 in normal and glioma tissue was analyzed based on the GSE4290 and GSE90598 sub-datasets from the gene expression omnibus(GEO)database.Receiver operating characteristic(ROC)curve analysis was conducted to assess the early diagnostic value of BAP1 for malignant glioma.Primary lesion tissues from 28 nonpaired malignant glioma patients and non-tumor brain tissues removed by internal decompression surgery in 5 patients with traumatic brain injury collected independently were collected,and the expression levels of BAP1 were measured using quantitative real-time polymerase chain reaction(qRT-PCR).Specific small interfering RNAs(siRNAs)targeting BAP1 were transiently transfected into U251 cells to further evaluate their interference efficiency.Flow cytometry was employed to analyze changes in the cell cycle and apoptosis of U251 cells with BAP1 knockdown.Results The results of bioinformatics showed that the expression of BAP1 in malignant glioma tissues was lower than that in normal brain tissues(GSE 4290:1 209±18.49 vs 1 476±53.90,GSE 90598:5.19±0.10 vs 5.65±0.21),and the differences were significant(t=5.115,2.267,all P<0.05).ROC curve showed that BAP1 could efficiently differentiate malignant glioma tissue from normal brain tissue(GSE4290:AUC=0.78,GSE90598:AUC=0.75,all P<0.05).The expression level of BAP1 in primary malignant glioma tissue was lower than that in normal brain tissue(0.27±0.04 vs 1.06±0.07),and the difference was significant(t=10.22,P<0.001).After down-regulating the expression of BAP1 in U251 cells,the proportion of S phase cells increased from 17.59%to 27.21%(siBAP1-1)and 25.79%(siBAP1-2),respectively,and the differences were significant(t=6.576,6.642,all P<0.01).However,the apoptosis levels decreased from 10.17%to 2.70%(siBAP-1)and 3.00%(siBAP-2),respectively,and the differences were significant(t=10.31,9.428,all P<0.01).Conclusion Histone H2A deubiquitinase BAP1 could exert the function of tumor suppressor genes by inhibiting rapid cell cycle progression and promoting apoptosis in malignant glioma,and could serve as a potential clinical diagnostic biomarker for malignant glioma.
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@#Objective: To explore the balance of peripheral blood T helper 17 cells/regulatory T cell (Th17/Treg) ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans (ASO). Methods: A rat model of lower extremity ASO was established, and blood samples from patients with lower extremity ASO before and after surgery were obtained. ELISA was used to detect interleukin 6 (IL-6), IL-10, and IL-17. Real-time RCR and Western blot analyses were used to detect Foxp3, IL-6, IL-10, and IL-17 expression. Moreover, flow cytometry was applied to detect the Th17/Treg ratio and M1/M2 ratio. Results: Compared with the control group, the iliac artery wall of ASO rats showed significant hyperplasia, and the concentrations of cholesterol and triglyceride were significantly increased (P<0.01), indicating the successful establishment of ASO. Moreover, the levels of IL-6 and IL-17 in ASO rats were pronouncedly increased (P<0.05), while the IL-10 level was significantly decreased (P<0.05). In addition to increased IL-6 and IL-17 levels, the mRNA and protein levels of Foxp3 and IL-10 in ASO rats were significantly decreased compared with the control group. The Th17/Treg and M1/M2 ratios in the ASO group were markedly increased (P<0.05). These alternations were also observed in ASO patients. After endovascular surgery (such as percutaneous transluminal angioplasty and arterial stenting), all these changes were significantly improved (P<0.05). Conclusions: The Th17/Treg and M1/M2 ratios were significantly increased in ASO, and surgery can effectively improve the balance of Th17/Treg, and reduce the ratio of M1/M2, and the expression of inflammatory factors.
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OBJECTIVE@#Here, we explored molecular changes that could potentially mediate healing effects of Gua Sha - a method employed by the Chinese traditional medicine with proven track records of safe and efficient applications dating back to ancient times as well as support from randomized controlled trials performed by modern medical studies - yet remaining almost entirely unexplored by the modern-day high-throughput methods of the -omics sciences.@*METHODS@#We investigated transcriptome changes occurring shortly after Gua Sha treatment in the whole blood of healthy volunteers using bulk RNA-seq analysis. We applied various analytical tools to identify genes with consistent expression changes in multiple individuals in response to Gua Sha and their networks.@*RESULTS@#We found that while the changes were very subtle and individual-specific, we could identify consistent upregulation of three histone genes. Further analysis of the potential regulatory networks of these histone genes revealed the enrichment of functions involved in the immune response and inflammation.@*CONCLUSION@#The significance of these results in the context of potential effects of Gua Sha and the next steps in exploring the molecular mechanisms of action of this technique are discussed.
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Humanos , Medicina Tradicional Chinesa/métodos , Histonas , Expressão GênicaRESUMO
BACKGROUND@#Health literacy is a public health goal which can be used as an independent factor of health outcomes. This study aimed to assess the association between health literacy and health status, as well as the two mediating factors of behavior and self-efficacy among residents aged 15-69 years in Qingdao.@*METHODS@#A cross-sectional survey was implemented among residents aged 15-69 years (N = 3793) in Qingdao, China. A combination of stratified cluster random and proportional probability sampling methods was used to select subjects for this study. Data were collected using "The Chinese Citizen Health Literacy Questionnaire (2019)". We proposed a hypothetical model for the relationship between sociodemographic characteristics, health literacy, self-efficacy, health behavior, and health status, and used path analysis to validate the hypothesis.@*RESULTS@#The path analysis showed that higher education (β = 0.293) and income (β = 0.135) are positively and directly associated with greater health literacy, which was positively associated with health status (β = 0.057). Health literacy is a direct influencing factor of health behavior (β = 0.070) and self-efficacy (β = 0.099). Health behavior (β = 0.041) and self-efficacy (β = 0.173) exerted a positive direct effect on health status. The model explained 14.1% of variance for health literacy, 3.8% for self-efficacy, 5.7% for health behavior, and 15.0% for health status.@*CONCLUSIONS@#Health literacy was identified to be a critical factor in health status. The results emphasized that the dissemination of health knowledge, development of healthy behavior, and cultivation of self-efficacy should be jointly promoted to reinforce the level of health status among residents in future work.
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , China , Estudos Transversais , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/estatística & dados numéricos , Nível de SaúdeRESUMO
OBJECTIVE@#To analyze the effect of clinical features, routine laboratory examination and related gene mutation on the OS of patients with myelodysplastic syndrome (MDS) after hematopoietic stem cell transplantation (HSCT).@*METHODS@#121 patients diagnosed as MDS and underwent hematopoietic stem cell transplantation in the First Affiliated Hospital of Soochow University from October 2013 to August 2018 were selected. Basic information of the patients was collected, and blood cells, bone marrow blasts at initial diagnosis, chromosomal karyotypes and gene mutations of the patients were detected.The effect of different factors on overall survival (OS) was analyzed by statistical method.@*RESULTS@#Kaplan-Meier univariate analysis shows that OS was significanly different among different age groups. The 3-year OS rate of patients aged 0-29 years was (83.3±7.7) %, the 3-year OS rate in patients aged 30-49 years was (58.1±7.7 %), and the 3-year OS rate of patients aged 50-69 years was (31.0±22.6) %, which was statistically different (P<0.05) between different groups. There were also significant differences in OS among patients with different transplantation types. 3-year OS rate: HLA-matched sibling HSCT>unrelated HLA-matched HSCT>haploidentical HSCT>micro HSCT. The OS rate of patients with bone marrow blasts≥10% seems lower than blasts<10%, but there was no statistical difference.The 3-year OS rate of patients with chromosomal karyotype complex abnormality was (47.7±11.5) %, and that of patients without complex abnormality was (80±4.2) % which was statistical difference (P<0.05). Patients with DNMT3A, NRAS, TP53 and GATA2 mutations had shorter OS time compared with patients without mutation of these genes, which shows statistically significant (P<0.05). COX multivariate analysis showed that age, chromosome karyotype, DNMT3A, TET2, GATA2 and NRAS were the independent factors influencing OS of patients after HSCT, with statistically significant difference.@*CONCLUSION@#age of patients, donor selection of HSCT, chromosome karyotype, DNMT3A, NRAS, TP53, GATA2 and TET2 gene mutations are all independent factors affecting the OS of patients after HSCT. Therefore, the assessment of the OS of MDS patients with transplantation requires comprehensive consideration.
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Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Adulto Jovem , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas , Síndromes Mielodisplásicas , Prognóstico , Estudos Retrospectivos , Irmãos , Análise de SobrevidaRESUMO
Objective:To analyze the clinical characteristics, survival outcome and prognostic factors of patients with extra-upper aerodigestive tract extranodal NK/T-cell lymphoma (EUADT-ENKTCL).Methods:We collected the clinical data of 779 patients with ENKTCL who were registered in SEER (Surveillance, Epidemiology, and End Results) database from 2000 to 2015 including 622 cases diagnosed with upper-aerodigestive tract extranodal NK/T-cell lymphoma (UADT-ENKTCL) and 157 cases with EUADT-ENKTCL. Clinical characteristics, survival outcome and prognostic factors were analyzed in EUADT-ENKTCL patients.Results:The median age of patients with EUADT-ENKTCL was 55. The ratio of male to female was 1.85∶1. Compared with UADT-ENKTCL, patients with EUADT-ENKTCL accounted a higher proportion of malignant T-cell origin ( χ2=18.916, P<0.001), advanced stage disease ( χ2=63.669, P<0.001), accompanied B symptoms ( χ2=14.657, P=0.001) and receiving chemotherapy alone ( χ2=71.412, P<0.001). EUADT-ENKTCL could be originated in different organs and tissues throughout the body, among which the skin or subcutaneous soft tissues was the most common locations (38.2%, 60/157), followed by gastrointestinal tract (18.5%, 29/157), lung/pleura (13.4%, 21/157), testis (6.4%, 10/157), orbit (5.1%, 8/157) and others. The median overall survival (OS) was 8.0 months and 5-year OS rate was 24.0% for the EUADT-ENKTCL cohort, which were much inferior to those of UADT-ENKTCL patients (31.0 months and 43.5%; χ2=32.080, P<0.001). Univariate analysis showed that patients with advanced stage or primary lung disease of EUADT-ENKTCL had unfavorable OS. Stage was a prognostic factor of OS via multivariate analysis (Ⅲ/Ⅳ vs. Ⅰ/Ⅱ, HR=2.078, 95% CI: 1.335-3.234, P=0.001). Conclusion:EUADT-ENKTCL is a highly aggressive malignancy. Compared with UADT-ENKTCL, EUADT-ENKTCL patients have different clinical characteristics and significantly inferior OS.
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Objective:To explore the effectiveness of the treatment modality among western localized extranodal NK/T-cell lymphoma (ENKTCL) patients based on the Surveillance, Epidemiology and End Result (SEER) database.Methods:A total of 448 cases of early stage ENKTCL, diagnosed from 2000 to 2016, were identified from the SEER database: 108 received chemotherapy alone, 100 received radiation alone, and 240 had combined chemoradiotherapy. Overall survival (OS) were compared between different modalities using univariate, multivariate and propensity-score matched (PSM) method.Results:The median overall survival (OS) and 5-year OS rate were 59.0 months and 49.0% for the whole cohort, respectively. Different treatment modalities were significantly associated with OS of patients with localized ENKTCL. Patients who received chemoradiotherapy had the highest 5-year OS rate followed by those who received radiation alone and chemotherapy alone (62.1% vs. 41.5% vs. 28.5%, χ2=41.727, P<0.001). Patients who received radiation with/without chemotherapy had significant superior survival outcome compared with those who received chemotherapy alone (5-year OS rate, 55.9% vs. 28.5%, χ2=10.823, P<0.001). Furthermore, compared with radiation alone, additional chemother-apy to radiation provided survival benefit and reduced death hazard for localized ENKTCL ( HR 0.578, 95% CI: 0.413~0.808, P=0.001). After baseline prognostic factors adjustment using PSM method, similar survival benefit was still observed among patients treated with chemoradiotherapy over those treated with radiation alone (5-year OS, 61.3% vs. 40.5%, HR 0.592, 95% CI: 0.369~0.885, P=0.012). Conclusions:These results based on SEER database indicate that compared with radiation or chemotherapy alone, chemoradiotherapy is more preferable treatment option for patients with early stage ENKTCL.
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Purpose@#Fractionated radiotherapy as well as concomitant and adjuvant chemotherapy such astemozolomide for postoperative high-grade glioma (HGG) patients improves progressionfreesurvival and overall survival. Multiple factors such as chemotherapy, radiotherapy,tumor grade, residual tumor volume, and genetic modifications might play a role in the formationof cognitive impairment. The risk factors of cognitive impairment in postoperativepatients with HGG receiving radiotherapy and chemotherapy remains a concern in this population.The purpose of this study was to identify risk factors for cognitive impairment inpatients of postoperative HGG. @*Materials and Methods@#A total of 229 patients with HGG who underwent surgery were analyzed. Cognitive impairmentwas defined as a decrease of Cognitive Assessment Montreal (MoCA)’s score in atleast two cognitive domains or any MoCA’s score of less than 26 points at the time of studycompared with baseline level. Multiple potential risk factors including methylated status ofthe O6-methylguanine-DNA methyltransferase (MGMT) promoter, glioma World HealthOrganization (WHO) grade, residual tumor volume, education, and sex were analyzed. Coxunivariate and multivariate regression analysis was used to detect the significant risk factorsfor cognitive impairment. @*Results@#At the end of follow-up among the 229 patients, 147 patients (67%) developed cognitiveimpairment. 82 patients (36%) remained in normal cognitive condition. In multivariate analysis,unmethylated MGMT promoter (hazard ratio [HR], 1.679; 95% confidence interval [CI],1.212 to 2.326; p=0.002), glioblastoma (HR, 1.550; 95% CI, 1.117 to 2.149; p=0.009),and residual tumor volume > 5.58 cm3 (HR, 1.454; 95% CI, 1.047 to 2.020; p=0.026) wereindependent risk factors for cognitive impairment. @*Conclusion@#Methylated status of the MGMT promoter, glioma WHO grade, and residual tumor volumemight be risk factors for the cognitive impairment in postoperative patients with HGG.
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OBJECTIVE@#To evaluate the effect of Pien Tze Huang (, PZH) on breast cancer chemoresistance and related epithelial-mesenchymal transition (EMT) and investigate the underlying mechanisms.@*METHODS@#3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay was used to determine the cell viability. Adriamycin (ADR) staining observed by fluorescence microscope was performed to detect the accumulation of ADR. Transwell assay was used to analyze the cell migration and invasion. Western-blot was performed to detect the protein expression of related genes.@*RESULTS@#MCF-7/ADR cells were resistant to ADR treatment, and PZH treatment inhibited the viability of MCF-7/ADR cells in a dose-dependent manner. PZH treatment also increased the intercellular accumulation of ADR and down-regulated the expression of ABCG2 and ABCB1 in MCF-7/ADR cells (P<0.05). In addition, PZH treatment inhibited EMT, migration and invasion of MCF-7/ADR cells (P<0.05). Moreover, PZH suppressed activation of transforming growth factor β1 (TGF-β) signaling in MCF-7/ADR cells (P<0.05).@*CONCLUSION@#PZH treatment can effectively overcome chemoresistance via down regulating ABCG2, ABCB1 and inhibit EMT in ADR resistant human breast cancer cells via suppression of the TGF-β1 pathway.
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@# Objective To analyze the status of health literacy and its relationship with chronic diseases and self-reported health among residents in Qingdao, discuss the influence of health literacy on health status and provide the scientific basis for the development of health education strategies and measures. Methods The stratified multistage and probability proportionate to population size sampling(PPS sampling) method was adopted in this investigation. In 2017, a questionnaire survey was conducted among 16 700 permanent residents aged 15-69 from 10 districts in Qingdao. Results The overall level of health literacy status was 15.92%, the prevalence rate of chronic diseases was 19.31%, the self-reported health proportion of good, fair and poor were 81.68%, 12.12% and 1.71% among residents in Qingdao. Logistic regression analysis showed that, after adjusting for urban and rural areas, gender, age, education, income and occupation, health literacy was a protective factor for people with chronic diseases and self-evaluated health(OR=1.232,P=0.003;OR=1.159,P=0.033). Three aspects of health literacy were correlated with chronic diseases and self-reported health among people (all P<0.05). Conclusions Health literacy is positively correlated with the health status of residents. The improvement of health literacy is an important way to enhance the health status of residents.
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OBJECTIVE: To offer some important insights into clinical decision-making by evaluating endorectal ultrasound and rectal MRI when they were used to predict pathological complete response for rectal cancer patients who were performed neoadjuvant therapy. METHODS: The study was a prospective cohort study which was conducted at a single tertiary care center. Patients diagnosed with mid-low rectal cancer between May 2014 and June 2018 in Peking Union Medical College Hospital were collected in the study. Both of their endorectal ultrasound and rectal MRI were performed to evaluate the tumor stage before their preoperative chemoradiation and were reevaluated at the 6 to 7 th weeks after their preoperative radiation treatment. The pathological preoperative tumor staging achieved by endorectal ultrasound and rectal MRI was compared with postoperative staging by pathologic examination. Sensitivity,specificity,accuracy and Youden index of each evaluation method and their combination were calculated. The ROC curve was administered likewise. RESULTS: A total of 247 patients were enrolled in the study. The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index for ypT0 N0 separate evaluation of for whom was qualified as compete endorectal ultrasound(163 patients) and of rectal MRI(212 patients) was15.9% and 23.1%,94.0% and 94.9%,77.8% and 83.4%,0.1 and 0.2. Combined two methods,the data were recorded as 13.6%,98.1%,83.6% and 0.1.Area under curve ROC for ultrasound and MRI when using specifically for ypT0 N0 measurement was 0.656 and 0.742.The two modalities showed 0.517 and 0.667 in terms of AUC when comparing with each other. CONCLUSION: The sensitivity of MRI and ERUS as terms of diagnosing complete response is rather unsatisfactory,although they all bear a relatively good specificity. For the patients not diagnosed with clinical response by one of the two methods,radical operations were strongly recommended. For the patients confirmed as complete response by both modalities,there still exists possibilities that residual tumor persists,“watch and wait”approach can be taken cautiously and the patient must be followed up intensely.
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Neuromyelitis optica is an autoimmune astrocytopathy of the central nervous system mainly characterized by recurrent episodes of optic neuritis and acute transverse myelitis. Although the exact etiology and pathogenesis of NMO remain to be established, complex interactions between genetic and environmental factors are thought to be involved in its development. Studies have shown that the pathogenesis of NMO is closely related to gut microbiome, and the content of clostridium perfringens in gut microbiome of NMO patients was significantly increased. This article mainly reviews the correlation between the neuromyelitis optica and clostridium perfringens, in order to further clarify the pathogenesis of NMO and provide reference for clinical treatment.
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Objective To evaluate the value of virtual monoenergetic(monoE)using dual-layer detector spectrum CT in detecting small lesions in rabbit VX2 liver cancer models.Methods Hepatic VX2 double tumor models were established in 24 New Zealand white rabbits by CT-guided puncture. All the rabbits underwent CT scans by using dual-layer detector CT to generate conventional 120-keV polychromatic images and monoE images with energy levels ranging from 40 to 100 keV during the arterial phase. The quantity of the lesion and measurement of the lesion length as well as the objective evaluations[signal noise ratio(SNR)and contrast noise ratio(CNR)] and the subjective evaluations(overall image quality score)of the image quality were independently measured by two radiologists. The results were compared with pathological findings.Results Pathology confirmed that 30 lesions were successfully established,with an average size of(3.99±0.91)mm. Eighteen(47.40%)and 30(100%)lesions were detected by conventional images and monoE images with energy levels from 40 to 65 keV,respectively. The correlation between the length diameter of fresh pathological specimens and the measurements of lesion length diameter on 40(r=0.948,P=0.000),45(r=0.958,P=0.000),50(r=0.972,P=0.000),55(r=0.952,P=0.000),60(r=0.921,P=0.000),65 keV(r=0.917,P=0.000)monoE images was better than that on conventional images(r=0.206,P=0.270). The subjective evaluation scores of the quality of the 40,45,50,and 55 keV monoE images were 4.50(4.00,4.50)(P=0.000),5.00(5.00,5.00)(P=0.000),5.00(4.50,5.00)(P=0.000),and 4.00(4.00,4.50)(P=0.002),respectively,which were significantly higher than the conventional mixed energy images[3.00(2.50,3.00)]. The objective evaluation of image quality showed that the SNR and CNR of monoE images decreased with the increase of the energy level of the monoE image. The CNR of monoE images with 40(P=0.000),45(P=0.002),and 50 keV(P=0.011)were higher than that of the conventional image. The CNR of monoE images with 40(P=0.000),45(P=0.000),50(P=0.000),and 55 keV(P=0.002)were higher than that of the conventional images.Conclusion Dual-layer detector spectrum CT monoE image in the low-energy state of 45-50 keV can improve the detection rate of small lesions in rabbit hepatic VX2 tumor models with better noise control and provide better image quality compared with conventional polychromatic images.
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Chenodeoxycholic acid (CDCA) is a primary bile acid and is involved in the digestion,transportation,and absorption of nutriments in the hepatobiliary system.Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily.In vivo and in vitro studies have demonstrated that CDCA is the natural ligand for FXR and involved in many cell signaling pathways,and it can inhibit the proliferation and induce the apoptosis of hepatobiliary tumor cells.This article reviews the association between CDCA and hepatobiliary tumor.
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Neuregulin-1 (NRG-1) and the ErbBs family of receptor tyrosine kinases are widely expressed in the cardiovascular system.NRG-1/ErbBs signaling plays an essential role in physiology and pathophysiology of the heart,including stabilization of cardiac myocyte structure and function,promotion of cardiac myocyte proliferation and survival,inhibition of cardiac myocyte apoptosis,reduction of myocardial interstitial fibrosis,regulation of energy utilization,and enhancement of angiogenesis and so on.Therefore,NRG-1/ErbBs signaling is involved in the development and treatment of chronic heart failure(CHF).In this review,we bring the growing literature on NRG-1/ErbBs signaling and its significance in cardiovascular development and heart failure.
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<p><b>OBJECTIVE</b>To explore the differentiation-inducing potentiality of Pulsatilla saponin A on K562 cells.</p><p><b>METHODS</b>Pulsatilla saponin A of different concentrations was used to treat K562 cells; the benzidine staining and the hemoglobinometry were applied to measure the change of hemoglobin content; the flow cytometry (FCM) was used to detect the expression of CD71 and GPA on K562 cells.</p><p><b>RESULTS</b>K562 cells treated with 4 µg/ml pulsatilla saponin A differentiated into the erythroid lineage. With the treatment of pulsatilla saponin A, the hemoglobin content in K562 cells increased significantly; CD71 and GPA expression on the K562 cell surface were up-regulated.</p><p><b>CONCLUSION</b>Pulsatilla saponin A can induce K562 cells to differentiate into erythroid lineage.</p>
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Humanos , Antineoplásicos , Diferenciação Celular , Linhagem da Célula , Células Eritroides , Células K562 , SaponinasRESUMO
Objective To evaluate the efficacy of first-line CHOP or CHOP-like regimen on patients with advanced staged angioimmunoblastic T-cell lymphoma (AITL).Methods Between Aug 2006 and Sep 2014,twenty-nine AITL patients who were newly diagnosed without prior treatment were included in study.The clinical features,efficacy and survival were analyzed retrospectively.Results Median age of these patients was 59 years old.All patients had stage Ⅲ/Ⅳ disease.17 (58.6 %) cases presented with B symptoms.26 (89.7 %) cases had an international prognostic index (IPI) score ≥2,and 20 (69.0 %) cases had elevated LDH,9 (31.0 %) cases had ≥2 extranodal involvements.The median follow-up time was 20 months.Overall response rate was 69.0 % (20/29).Five (17.2 %) patients achieved complete remission (CR+CRu),15 (51.7 %) patients achieved partial remission,and 3 (10.3 %) patients had stable disease (SD),6 (20.7 %) patients had progressive diseases(PD).Median progression-free survival (PFS) was 6 months.1-and 2-year PFS rates were 39.0 % and 20.0 %.1-,2-and 5-year overall survival (OS) rates for all patients were 76.8 %,53.4 % and 17.1%,respectively.PFS was significantly better in chemotherapy-sensitive patients (P < 0.001).The responses to chemotherapy had a tendency of affecting the OS,but it failed to reach statistical significance (P > 0.05).Conclusions The CHOP or CHOP-like regimen maybe induce unfavorable efficacy in AITL patients.Further therapeutic options are required to improve the outcome.
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<p><b>BACKGROUND</b>Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis.</p><p><b>METHODS</b>Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk).</p><p><b>RESULTS</b>Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP.</p><p><b>CONCLUSION</b>Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acinetobacter baumannii , Virulência , Antibacterianos , Usos Terapêuticos , Infecções Comunitárias Adquiridas , Tratamento Farmacológico , Microbiologia , Patologia , Mortalidade Hospitalar , Hospitalização , Pneumonia , Tratamento Farmacológico , Microbiologia , Patologia , Pseudomonas aeruginosa , Virulência , Estudos Retrospectivos , Staphylococcus aureus , VirulênciaRESUMO
<p><b>OBJECTIVE</b>To analyze retrospectively the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelomonocytic leukemia (CMML).</p><p><b>METHODS</b>The engraftment, graft versus host disease (GVHD), infection, relapse, and survival of 13 CMML patients received allo-HSCT were observed. The clinical outcome of allo-HSCT for CMML was analyzed.</p><p><b>RESULTS</b>Thirteen (10 males and 3 females) CMML patients with a median age of 38 years old received allo-HSCT including 4 from HLA-matched unrelated donors, 6 from HLA-matched sibling donors and 3 from haploidentical related donors. All 13 patients achieved engraftment, and the median time of neutrophil engraftment and platelet engraftment were 12 (11-18) days and 15 (10-55) days respectively, acute GVHD occurred in 8 patients. After the median follow-up of 13 (6-29) months, the overall survival, disease free survival and relapse were 53.8%, 53.8%, 7.7%, respectively.</p><p><b>CONCLUSION</b>Allo-HSCT can improve the survival of patients with CMML, and is a effective method for treatment of CMML.</p>
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Adulto , Feminino , Humanos , Masculino , Intervalo Livre de Doença , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Leucemia Mielomonocítica Crônica , Estudos Retrospectivos , Irmãos , Doadores de Tecidos , Transplante HomólogoRESUMO
Objective To investigate the effect of butylphthalide combined with nimodipine in the treatment of vascular cognitive impairment.Methods 160 patients with vascular cognitive impairment were divided into the control group and the observation group according to treatment methods,80 cases in each group.The control group was treated with nimodipine,and the observation group was given butylphthalide combined with nimodipine treatment.The therapeutic effect and cognitive function were compared.Results The obvious effective rate of the observation group was 58.75 % (47/80),which was significantly higher than that of control group 45 % (36/80) (P =0.03).After treatment,MoCA score of the observation group was (24.83 ± 9.48),which was significantly higher than that of the control group(21.64 ±9.52) (P =0.04).ADL score of the observation group was(58.31 ± 11.27),which was significantly higher than(53.28 ± 10.32) of the control group (P =0.04).After treatment,directional force,visual spatial and executive function,delayed memory and attention of the observation group were higher than those of the control group (P =0.03,0.02,0.04,0.02).Conclusion Butylphthalide combined with nimodipine in the treatment of patients with vascular cognitive impairment has good effect.