摘要
Objective: To investigate the clinical features and long-term prognostic factors of diabetic patients with low or intermediate complexity coronary artery disease (CAD) post percutaneous coronary intervention (PCI). Methods: This was a prospective, single-centre observational study. Consecutive diabetic patients with SYNTAX score (SS)≤32 undergoing PCI between January and December 2013 in Fuwai hospital were included in this analysis. The patients were divided into two groups based on SS, namely SS≤22 group and SS 23-32 group. Multivariate Cox regression analysis was performed to identify independent factors related to poor 5-year prognosis. The primary outcomes were cardiac death and recurrent myocardial infarction, the secondary outcomes were all cause death and revascularization. Results: Of the 3 899 patients included in the study, 2 888 were men (74.1%); mean age was 59.4±9.8 years. There were 3 450 patients in the SS≤22 group and 449 patients in the SS 23-32 group. Compared with SS≤22 group, the incidence of revascularization was higher in SS 23-32 group (18.9% (85/449) vs. 15.2% (524/3450), log-rank P=0.019). There was no significant difference in all-cause death, cardiac death and recurrent myocardial infarction between the two groups (log-rank P>0.05). Multivariate Cox regression analysis showed that age (HR=1.05, 95%CI 1.02-1.08, P<0.001), chronic obstructive pulmonary disease (HR=3.12, 95%CI 1.37-7.07, P=0.007) and creatinine clearance rate (CCr)<60 ml/min (HR=3.67, 95%CI 2.05-6.58, P<0.001) were independent risk factors for 5-year cardiac death, while left ventricular ejection fraction (HR=0.94, 95%CI 0.91-0.96, P<0.001) was a protective factor. Previous PCI (HR=2.04, 95%CI 1.38-3.00, P<0.001), blood glucose level≥11.1 mmol/L on admission (HR=2.49, 95%CI 1.32-4.70, P=0.005) and CCr<60 ml/min (HR=1.85, 95%CI 1.14-2.99, P=0.012) were independent risk factors for 5-year recurrent myocardial infarction. The SS of 23-32 was independently associated with risk of revascularization (HR=1.54, 95%CI 1.09-2.16, P=0.014), after adjusting for residual SS. Residual SS was not a risk factor for 5-year prognosis. Conclusions: In diabetic patients with low-or intermediate complexity CAD, SS 23-32 is associated with increased risk of 5-year revascularization; the clinical characteristics of the patients are associated with the long-term mortality and recurrent myocardial infarction, but not related to revascularization.
Subject(s)
Male , Humans , Middle Aged , Aged , Female , Coronary Artery Disease/surgery , Stroke Volume , Percutaneous Coronary Intervention , Prospective Studies , Treatment Outcome , Ventricular Function, Left , Prognosis , Risk Factors , Myocardial Infarction/etiology , Diabetes Mellitus摘要
Objective@#The present study was undertaken to evaluate the subchronic oral toxicity of sodium dehydroacetate (DHA-Na) and to determine the point of departure (POD), which is a critical factor in the establishment of an acceptable dietary intake.@*Methods@#DHA-Na was administered once daily by gavage to Sprague-Dawley rats at dose levels of 0.0, 31.0, 62.0, and 124.0 mg/kg BW per day for 90 days, followed by a recovery period of 4 weeks in the control and 124.0 mg/kg BW per day groups. The outcome parameters were mortality, clinical observations, body weights, food consumption, hematology and clinical biochemistry, endocrine hormone levels, and ophthalmic, urinary, and histopathologic indicators. The benchmark dose (BMD) approach was applied to estimate the POD.@*Results@#Significant decreases were found in the 62.0 and 124.0 mg/kg BW groups in terms of the body weight and food utilization rate, whereas a significant increase was found in the thyroid stimulating hormone levels of the 124.0 mg/kg BW group. Importantly, the 95% lower confidence limit on the BMD of 51.7 mg/kg BW was modeled for a reduction in body weight.@*Conclusion@#The repeated-dose study indicated the slight systemic toxicity of DHA-Na at certain levels (62.0 and 124.0 mg/kg BW) after a 90-day oral exposure.
Subject(s)
Animals , Rats , Body Weight , Organ Size , Pyrones , Rats, Sprague-Dawley摘要
Objective: In Chinese herbal medicine (CHM) history, Lonicerae Japonicae Flos and Lonicerae Flos were used clinically as one drug, but now they are admitted as two herbal medicines in Chinese Pharmacopoeia (2010 edition). This study used network pharmacology to investigate whether the two can be used interchangeably for the treatment of inflammatory diseases in TCM clinical practice. Methods: Lonicerae Japonicae Flos and Lonicerae Flos were compared in the inflammation mechanism including core targets, Gene Ontology (GO), pathway and principle chemical components by the method of network pharmacology. Results: Lonicerae Japonicae Flos and Lonicerae Flos shared in six targets accounting for 66.7% of the entire core targets and more than half of the GO terms and pathways are similar. Organic acids are dominent compounds responsible for anti-inflammatory effects. Three of the compounds that bind to core targets including luteolin, quercetin and kaempferol, are shared in both herbs. Conclusion: Due to high similarity between Lonicerae Japonicae Flos and Lonicerae Flos, we believe that they can be used interchangeably for the inflammation in clinical treatment.
摘要
Cathepsin S is a cysteine protease which is closely related to autoimmune diseases,psoriasis and other diseases. In this study,we used virtual screening method to screen compounds,which from the natural product library of traditional Chinese medicine,with potential inhibitory effect on cathepsin S. The work involved in study on inhibitory mechanism of representative compounds,then analysis of the distribution of these compounds in traditional Chinese medicine and the correlation with disease,so as to provide a new drug research and data-base for cathepsin S. The complex crystal structure of cathepsin S,2FQ9,was used to establish the pharmacophore model of cathepsin S inhibitor,and the best pharmacophore model was selected. As a result,fifty compounds were selected from TCMD database. After molecular docking,65 potential inhibitors were identified. Potential inhibitors can produce multiple intermolecular interactions with targets,resulting in inhibition. There are 58 kinds of traditional Chinese medicines which include 65 natural inhibitors. Data collection and analysis of the nature,flavor xing,channel entry and modern pharmacological effects of these traditional Chinese medicines showed that most of them were related to the biological activity of cathepsin S,which supported the validity of the screening results. Cathepsin S has a certain correlation with autoimmune diseases and can be used as a target for further study of traditional Chinese medicine.
Subject(s)
Cathepsins , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Molecular Docking Simulation摘要
Objective CARD9 can activate several pathways involved in immunity, such as NF-ΚB, MAPK, etc. However the mechanism of this process has not yet been elucidated. For conducting relevant experiments in vitro, a prokaryotic expression vector of CARD9-MBP fusion protein has to been construct, and the fusion protein need to be expressed and purified. Methods The coding sequence of CARD9 and MBP genes were amplified by PCR and the recombinant plasmid was correctly inserted into the pET-30a(+) vector. The recombinant plasmid was transformed into E.coli DH5α competent cells and proceeded PCR identification, restriction analysis and gene sequencing. The correct recombinant plasmid was transformed into E.coli BL21(DE3) competent cells. The target protein was induced to express by IPTG under different conditions. Relative molecular weight of the target protein was detected by SDS-PAGE electrophoresis. The CARD9-MBP fusion protein was purified by MBP maltose chromatography column and gel filtration chromatography column, and identificated by MALDI-TOF mass spectrometry after MBP-tag to be removed by HRV3C enzyme. Results The CARD9-MBP fusion protein was successfully constructed and confirmed by PCR and restriction analysis. The result of gene sequencing was consistent with the target sequence. The SDS-PAGE electrophoresis showed that the target protein with molecular mass (MR) about 105 000 was successfully induced to express in E.coli BL21 (DE3). A quite pure CARD9-MBP fusion protein was obtained by purification of MBP maltose chromatography column. Identification by MALDI-TOF mass spectrometry demonstrated that the target protein after MBP-tag to be removed by HRV3C enzyme is CARD9 protein. In the later stage, gel filtration chromatography column was used to obtain further pure CARD9-MBP fusion protein. Conclusion The prokaryotic expression vector of CARD9-MBP fusion protein was successfully constructed and a large number of soluble protein expressed. The purified target protein can be obtained by purification with MBP maltose chromatography column and gel filtration chromatography column.
摘要
OBJECTIVE@#To investigate the safety and clinical efficacy of autologous DC-CIK cells combined with other immune cells for patients with hematological malignancies and analyze patient prognosis.@*METHODS@#50 patients with hematological malignancies who received cellular immunotherapy from September 2014 to April 2016 were retrospectively studied in the First Affiliated Hospital of Xi'an Jiaotong University, 115 cases times of cellular immunotherapy were performed. According to the selected treatment, the patients were divided into the dual cell group (DC-CIK cell treatment) and the multi-cell group (DC-CIK cell combined with other immune cells); According to the treatment course, the patients were divided into the single course group (completed by <3 times) and the multiple course group. The changes of T lymphocyte subsets, blood routine indicators and KPS scores as well as the overall survival time before and after treatment were compared and analyzed.@*RESULTS@#[WTB1]The difference of general conditions before treatment including the number of patients, sex, age, T lymphocyte subsets, blood routine indicators, KPS scores and so on in 2 groups divided according to 2 kinds of treatment methods were not statistically significant, indicating that the 2 groups were comparable. Grouped by selected treatment, the CD4/CD8 ratio, Hb and Plt levels decreased in the dual cell group, compared with those before treatment(P<0.05). The CD3CD4 ratio after treatment in multiple cell group decreased, compared with that before treatment (P<0.05). The 3-year survival rate of patients in dual cell and multiple cell groups was 61.3% vs 69.8%, the overall survival time of patients in 2 groups was 32.4 months vs 39.6 months, there were no statisticall differences between 2 groups(P>0.05). Grouped by treatment course, the CD3 ratio after treatment increased, while the Hb level after treatment decreased in single course group, compared with level before treatment(P<0.05). The CD3CD4 ratio, Plt level decreased, while the KPS scores increased after treatment in multiple course group, compared with those before treatment(P<0.05). The 3-year survival rate in single course and multiple course groups was 52% vs 76.4%, the overall survival time was 28.7 months vs 40.9 months respectively, statistically significant with difference (P<0.05).@*CONCLUSION@#Autologous DC-CIK cells combined with other immune cells in the treatment of hematological malignancies can change the immune function of the patients and improve the antitumor activity. The multi-course treatment can improve the quality of life, prolong the overall survival time, thus worthing clinical promotion.
Subject(s)
Humans , Cytokine-Induced Killer Cells , Dendritic Cells , Hematologic Neoplasms , Immunotherapy, Adoptive , Quality of Life , Retrospective Studies , Treatment Outcome摘要
OBJECTIVE@#Primary mediastinal yolk sac tumor, which is also known as endodermal sinus tumor, is a rare but lethal neoplasm and its prognosis is very dismal. The current treatment for this tumor is controversial, and chemotherapy combined with resection of residual lesions is adopted sometimes. We summarized the experience of seven primary mediastinal yolk sac tumors treated with platinum-based chemotherapy and extended resection in Peking University First Hospital.@*METHODS@#Clinicopathological data of the patients with primary mediastinal yolk sac tumor who received operation in Peking University First Hospital between August 2014 and August 2018 were collected and analyzed retrospectively.@*RESULTS@#We experienced seven primary mediastinal yolk sac tumors during this period. Computed tomography scan revealed an anterior mediastinal tumor in all the patients and all of them had markedly raised alphafetoprotein (AFP) and normal β-human chorion gonadotropin (β-HCG). Five patients underwent needle core biopsy before treatment, which showed a mediastinal yolk sac tumor. All of these patients received preoperative platinum-based chemotherapy and they all presented partial response according to computed tomography. Two other patients did not receive preoperative biopsy, so they directly underwent extended resection. All of the seven patients underwent operation successfully and two of them experienced postoperative complications, including one with pneumonia and the other with atelectasis. R0 resection was achieved in six patients and R1 resection was achieved in the other patient. According to postoperative pathology, there were one microcyst subtype, one adenoid subtye, one giant capsule subtype and two hybrid subtypes. Surprisingly, there were no yolk sac tumor tissue in the other two patients after preoperative chemotherapy. All the patients received postoperative chemotherapy, excluded one patient who was unable to tolerate chemotherapy after operation. Three patients experienced postoperative pulmonary metastases within one year and two of them died soon. The other patient received chemotherapy and immunotherapy after recurrence and he was alive at the time of writing. Four other patients were alive without recurrence and metastasis.@*CONCLUSION@#Primary mediastinal yolk sac tumor is rare and its prognosis is poor. A multimodality approach including adjuvant chemotherapy and resection of residual lesions is the optimal treatment and it may lead to long-term survival.
Subject(s)
Humans , Male , Endodermal Sinus Tumor , Mediastinal Neoplasms , Mediastinum , Neoplasm Recurrence, Local , Retrospective Studies摘要
Objective: To compare the prognosis of intra-aortic balloon pump (IABP) supported primary percutaneous coronary intervention (PPCI) between very elderly (age ≥ 80 years) and elderly (age < 80 years) patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 288 STEMI patients received IABP supported PPCI in our hospital from 2004-01 to 2015-12 were retrospectively studied. Clinical condition, coronary angiography and follow-up data were analyzed; the patients with pre-operative cardiac shock, mechanical complication and non ST-segment elevation acute coronary syndrome were excluded. Eligible patients were divided into 2 groups: Very elderly group, n=51 and Elderly group, n=237. Major adverse cardiac and cerebral events (MACCE) as death, cardiac shock, new or worsen heart failure, re-MI and stroke were studied at 1 month and 1, 2 years after PPCI. Independent predictors for MACCE occurrence were investigated by Cox proportional hazard model analysis.Results: Compared with Elderly group, Very elderly group had increased incidence of MACCE at 1 month after PPCI (41.2% vs 24.5%), P=0.029 and obviously elevated incidence of stroke (9.8% vs 0.8%), P<0.001. Mortalities were similar between 2 groups at 1 month and 1 year after PPCI (17.6% vs 15.2%) and (25.5% vs 16.9%), both P>0.05; mortality was higher in Very elderly group at 2 years after PPCI (35.3% vs 20.7%), Log-rank P=0.037. Cox proportional hazard model analysis indicated that post-operative TIMI flow < 3 was the strong independent predictor for MACCE occurrence (HR=3.41, 95% CI 2.09-5.56, P<0.001), which was also the strongest predictor for death at different time points as at 1 month after PPCI (HR=9.51, 95% CI 5.23-17.29), at 1 year after PPCI (HR=7.24, 95% CI 4.13-12.69) and at 2 years after PPCI (HR=5.85, 95% CI 3.45-9.94), all P<0.001. Patients ≥ 80 years had no obvious predictors for end point event occurrence. Conclusion: Very elderly STEMI patients had the higher mortality at 2 years after IABP supported PPCI and increased incidence of MACCE at 1 month after PPCI. Patients≥80 years had no obvious predictors for end point event occurrence.
摘要
The function of health care and rehabilitation in Tai Chi has been recognized by the world.Studies on the mechanism of health care in Tai Chi have been conducted by domestic and international experts using the methods of sports biomechanics,most of which focus on human lower extremity.Twenty research literatures (15articles in English and 5 articles in Chinese) during the year 2007-2015 about biomechanics of the lower extremity in Tai Chi were searched.According to the research purpose and evaluation index,this paper mainly reviewed from 3 aspects:the kinematic & kinetic characteristics of Tai Chi and its influence on the lower extremity,the effect of Tai Chi on muscle activity of the lower extremity,and the impact of Tai Chi movement on interaction between biomechanical parameters of the lower extremity and other system parameters.The prospects and limitations in biomechanical studies on the lower extremity in Tai Chi were also summarized.
摘要
The function of health care and rehabilitation in Tai Chi has been recognized by the world.Studies on the mechanism of health care in Tai Chi have been conducted by domestic and international experts using the methods of sports biomechanics,most of which focus on human lower extremity.Twenty research literatures (15articles in English and 5 articles in Chinese) during the year 2007-2015 about biomechanics of the lower extremity in Tai Chi were searched.According to the research purpose and evaluation index,this paper mainly reviewed from 3 aspects:the kinematic & kinetic characteristics of Tai Chi and its influence on the lower extremity,the effect of Tai Chi on muscle activity of the lower extremity,and the impact of Tai Chi movement on interaction between biomechanical parameters of the lower extremity and other system parameters.The prospects and limitations in biomechanical studies on the lower extremity in Tai Chi were also summarized.
摘要
High flexion squat is extremely common in the daily activities of Asian countries and certain occupations.In this paper,different types of deep squats and their motion characteristics were summarized,and recent research progress of squat biomechanics was reviewed.Different research methods on squats such as in vitro experiment,in vivo test and computer simulation were also classified and represented.Biomechanical studies on deep squat of the knee can benefit establishment of reasonable rehabilitation training,prevention of sports risks as well as provide some references for optimization of knee prosthesis design.
摘要
The function of health care and rehabilitation in Tai Chi has been recognized by the world. Studies on the mechanism of health care in Tai Chi have been conducted by domestic and international experts using the methods of sports biomechanics, most of which focus on human lower extremity. Twenty research literatures (15 articles in English and 5 articles in Chinese) during the year 2007-2015 about biomechanics of the lower extremity in Tai Chi were searched. According to the research purpose and evaluation index, this paper mainly reviewed from 3 aspects: the kinematic & kinetic characteristics of Tai Chi and its influence on the lower extremity, the effect of Tai Chi on muscle activity of the lower extremity, and the impact of Tai Chi movement on interaction between biomechanical parameters of the lower extremity and other system parameters. The prospects and limitations in biomechanical studies on the lower extremity in Tai Chi were also summarized.
摘要
High flexion squat is extremely common in the daily activities of Asian countries and certain occupations. In this paper, different types of deep squats and their motion characteristics were summarized, and recent research progress of squat biomechanics was reviewed. Different research methods on squats such as in vitro experiment, in vivo test and computer simulation were also classified and represented. Biomechanical studies on deep squat of the knee can benefit establishment of reasonable rehabilitation training, prevention of sports risks as well as provide some references for optimization of knee prosthesis design.
摘要
<p><b>OBJECTIVE</b>To compare the efficacy and drug resistance of imatinib in patients with chronic myeloid leukemia (CML) at chronic phase (CP) and advanced phase (accelerated phase and blast crisis (AP+BC).</p><p><b>METHODS</b>Forty-two patients with CML were treated with imatinib of different doses(CP 400 mg/d, AP+BC 600 mg/d), and the efficacy and drug resistance of the 2 groups were compared. The median follow-up time was 24 months (3-42 months).</p><p><b>RESULTS</b>The complete hematological remission rate (CHR), the major cytogenetic remission rate (MCyR) and complete molecular remission rate (CMoR) in the CP group were 100%, 89.6% and 20.1% respectively, while those in advanced phase group were 46.2%, 308% and 0; survival rate of 42 months in CP patients was 76.7%, and that in advanced phase group was 39.2%, the difference between them was statistically significant (P<0.05). The incidence of severe hematologic adverse reaction in advanced phase group was higher than that in CP Group; among 42 cases of CML, the drug-resistance happened in 13 cases, out of them 9 cases was CML in advanced phase; the drug resistance rate in CML in advanced phase group (69.2%) was significantly higher than that in CML-CP group(13.8%). The correlation factor analysis showed that the effects of the advanced phase and the lower dose of the drug were statistically significant.</p><p><b>CONCLUSION</b>Imatinib can provide certain curative effect for CML patients at different phases, especially for the patients at chronic phase; the early MCyR for patients with CML is an important factor in long-term survival; drug resistance is an important factor affecting the efficacy of imatinib; The incidence of imatinib drug resistance at the late stage has been found to be higher.</p>
Subject(s)
Humans , Antineoplastic Agents , Blast Crisis , Cytogenetics , Drug Resistance, Neoplasm , Imatinib Mesylate , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Remission Induction , Survival Rate摘要
Objective To establish 5 different finite element models of the proximal femur based on CT images, and analyze the influences of element size on materials distribution and biomechanical behavior of the proximal femur model. Methods The proximal femur was scanned by spiral CT. The images, stored as DICOM format, were extracted by Mimics to obtain 3D geometric data, and then meshed separately by Mimics, 3-Matic and ICEM software to establa voxel element model, a tetrahedral element model and 3 hexahedral element model (with element size of 2, 1, 0.5 mm). These meshed models were assigned materials by Mimics, and their mechanical behavior was analyzed by Abaqus eventually. Results For the proximal femur model with material assignment based on CT images, the influence of element size on the total mass of all the 5 models was not significant. The nodal Mises stress and nodal displacement along the same path in 5 models showed a similar tendency, while the Mises stress at each node displayed an obvious deviation. The nodal Mises stress in the hexahedral element model with the element size of 0.5 mm showed accordance with the voxel element model. Conclusions The element size has a small influence on the total mass and nodal displacement when the material assignment is attributed to the model based on CT gray values, while decrease in the element size will affect the materials distributions and stress distributions of the model. When the element size of the proximal femur model is close to its voxel size, the mass distributions and mechanical behavior of the femur can be preferably reflected.
摘要
OBJECTIVES@#To investigate the single nucleotide polymorphism (SNP) and haplotypes in differentially methylated region (DMR) upstream of H19 gene in Guangdong Han population.@*METHODS@#The PIA typing and restriction enzyme McrBC and HpaⅡ were used to digest the genomic DNA and obtain the individual uniparental DNA template strand. The data of uniparental SNP alleles, genotypes and haplotypes in DMR upstream of H19 gene were obtained by sequencing.@*RESULTS@#A total of 13 SNPs (rs10840167, rs2525883, rs12417375, rs4930101, rs2525882, rs2735970, rs2735971, rs11042170, rs2735972, rs10732516, rs2071094, rs2107425, and rs4930098) and one mutation locus (g7351c) were found. All loci followed the Hardy-Weinberg equilibrium (P>0.05) by statistical analysis. Except for rs12417375 (DP=0.279) locus, the DP of remaining 12 SNPs were 0.446-0.614, and the g7351c mutation locus (DP=0.013) was the particular loci of the Southern Chinese Han population. Eight haplotypes (designated as haplotype 1-8) were detected, in which 3 haplotypes had not yet been reported and the DP, PIC, PE and H were 0.891, 0.714, 0.524 and 0.758, respectively.@*CONCLUSIONS@#Obtained by PIA typing, the SNP in DMR upstream of H19 gene and its haplotypes genetic marker system have a high determination power and show a good practical value in forensic identification.
Subject(s)
Humans , Alleles , Asian People/genetics , China , DNA , Gene Frequency , Genetic Markers , Genetics, Population , Genotype , Haplotypes/genetics , Polymorphism, Single Nucleotide摘要
OBJECTIVES@#To investigate the genetic polymorphism of SNP located in the 5' region of the vascular endothelial growth factor (VEGF) gene in Han population in Guangdong and provide basic data for forensic application and population genetics research.@*METHODS@#The genetic polymorphisms of 4 SNP loci (rs699947, rs1570360, rs833061, rs2010963) within 5' region of VEGF gene of 184 unrelated individuals in Han population in Guangdong were analyzed by DNA micro sequencing technology SNaPshot. The statistical analysis was carried out by PowerMarker v3.25 software.@*RESULTS@#The genotype distributions of the 4 SNP loci within 5' region of VEGF gene of 184 unrelated individuals in Han population in Guangdong were in accordance with Hardy-Weinberg equilibrium (P>0.05) and 3 kinds of genotypes were detected from each loci. There was high linkage disequilibrium between the rs833061 and rs699947 SNP loci. Six haplotypes were observed, while the frequency of C-G-T-C, C-G-T-G, A-A-C-G and A-G-C-G were more than 10%, which were the main haplotypes. The discrimination probabilities (DP) of rs699947, rs833061, and rs2010963 loci were between 0.583 and 0.634, with the power of exclusion (PE) between 0.133 and 0.144. The DP and PE of haplotypes of 4 SNP were 0.868 and 0.438, respectively.@*CONCLUSIONS@#There are great polymorphisms in the 5' region of VEGF gene in Han population in Guangdong, which could be used as genetic indexes for individual identification and paternity testing, as well as association analysis of the related diseases.
Subject(s)
Humans , Asian People/genetics , China , Genetics, Population , Genotype , Haplotypes , Linkage Disequilibrium , Polymorphism, Single Nucleotide , Vascular Endothelial Growth Factor A/genetics摘要
<p><b>OBJECTIVE</b>To evaluate the efficacy and adverse effects of low dose thalidomide (TD) combined with modified VCMP (vincristine+cyclophosphamide+melphalan+prednisone) (TD+mVCMP) and VAD (vincristine+doxorubicin+dexamethsone) (TD+VAD) regimens for treating aged patients with MM.</p><p><b>METHODS</b>A total of 47 patients with newly diagnosed MM were enrolled in this study. Among them 27 cases were treated with TD+mVCMP regimen (TD+mVCMP group), 20 cases were treated with TD+VAD regimen (TD+VAD group). The dose of TD in 2 groups all was 100 mg/d. Each patient received 4 or more courses of treatment.</p><p><b>RESULTS</b>Out of 27 cases in TD+mVCMP group, 9 cases achieved complete remission (CR), 5 cases-very good partial remission (VGPR), 6 cases-partial remission (PR); among 20 cases in TD+VAD group, 3 cases achieved CR, 3 cases achieved VGPR, 4 cases achieved PR. The total effective rate in 2 group was 74.1% and 50% respectively, there was statistical difference between 2 groups (P<0.05). The differences of Hb level, plasmocytic ratio of bone marrow and M protein level in 2 groups before and after treatment were significant (P<0.05). The 5 years survival rate of patients in TD+mVCMP and TD+VAD group was 72.8% and 66.9% respectively, there was no statistical difference (P>0.05). The incidence of adverse reactions including caxdiac toxicity, severe leucopenia and thrombocytopenia in TD+mVCMP group was lower than that in TD+VAD group.</p><p><b>CONCLUSION</b>Low dose TD combined with modified VCMP regimen for treatment of newly diagnosed aged patients with MM is safe and effective, which may be used as the first line treatment regimen for population in aged MM patients.</p>
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cyclophosphamide , Therapeutic Uses , Cytarabine , Therapeutic Uses , Dexamethasone , Therapeutic Uses , Melphalan , Therapeutic Uses , Multiple Myeloma , Drug Therapy , Prednisone , Therapeutic Uses , Remission Induction , Survival Rate , Thalidomide , Therapeutic Uses , Thrombocytopenia , Vincristine , Therapeutic Uses摘要
<p><b>OBJECTIVE</b>To explore the clinical efficacy and safety of lenalidomide plus low dose dexamethasone for treating patients with multiple myeloma (MM).</p><p><b>METHODS</b>A total of 19 MM patients were enrolled to receive the therapeutic schedule of lenalidomide plus dexamethasone in our hospital from May 2013 to June 2015. Lenalidomide 25 mg was taken orally daily for 21 days and resting for 7 days, and dexamethasone 10 mg was taken orally daily on the day 1-4, 7-10 and 13-16. The regimens were Rd (lenalidomide and dexamethasone, n = 12), and RCd (lenalidomide, ifosfamide and dexamethasone, n = 7).</p><p><b>RESULTS</b>Among 19 patients received 1 cycle of treatment 3 patients achieved complete remission (CR), 3 patients achieved very good partial remission (VGPR), 10 patients achieved partial remission (PR) and 3 patients in stable disease (SD) with an overall response rate (ORR = CR + VGPR + PR) of 84%; their ORR rate was 89% after 2 cycles of treatment. In the early stage of treatment, the renal function was improved in 4 out of 5 patients with renal dysfunction. And the common adverse reactions were hematologic toxicity in 4 patients, 1 degree rash in 5 patients, and gastrointestinal side effects in 4 patients.</p><p><b>CONCLUSION</b>The lenalidomide plus dexamethasone regimen has a good anti-multiple myeloma effect, which can control the disease rapidly and overcome the multidrug resistance in MM, improving the poor prognosis with renal dysfunction, and showing high remission rate in the patients exposed to bortezomib with low toxicity.</p>
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols , Dexamethasone , Therapeutic Uses , Ifosfamide , Therapeutic Uses , Multiple Myeloma , Drug Therapy , Remission Induction , Thalidomide , Therapeutic Uses摘要
PURPOSE: Cutaneous lymphocyte-associated antigen (CLA)-expressing CD8+T cells have been known to play an important role in the pathogenesis of atopic dermatitis (AD). However, the mechanisms underlying the loss of self-tolerance remain unclear. Regulatory T cells (Tregs) play a key role in the development of homeostasis in the immune system. We, therefore, hypothesized that a reduced ability of Tregs to inhibit autologous CD8+CLA+T cells might be underlying mechanism in AD. MATERIALS AND METHODS: CD8+CLA+T cells and Tregs were obtained from the peripheral blood of AD patients and control volunteers. The frequencies of CD8+CLA+T cells were evaluated. The proliferative responses of CD8+CLA+T cells were assessed by flow cytometry, and the levels of transforming growth factor-beta1 (TGF-beta1) and interleukin-10 (IL-10) in culture supernatants were detected by enzyme-linked immunosorbent assay. RESULTS: Our results revealed higher frequency and increased expression of perforin and granzyme-B in peripheral CD8+CLA+T cells in AD, and lower inhibitory ability of Tregs on proliferation of CD8+CLA+T cells in AD. Meanwhile, the levels of TGF-beta1 produced by Tregs were significantly lower in AD, and anti-TGF-beta1 abolished such suppression. CONCLUSION: The attenuated inhibitory ability of Tregs on hyper-activated autologous CD8+CLA+T cells, mediated by TGF-beta1, plays an important role in the pathogenesis of AD.