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A single-center retrospective was performed with consecutive de novo BCR-ABL1-positive acute lymphoblastic leukemia (ALL) patients who received TKI-containing therapy between January 2010 and December 2018 to review the incidence, treatment, and outcome of the T315I mutation. A total of 38 (18%) patients harbored the T315I mutation in this period. According to the type of salvage therapy, patients were divided into subgroups of hematopoietic stem cell transplantation (HSCT) recipients (n = 9) and HSCT nonrecipients (n = 29). In the latter subgroup, there were 7 patients who newly acquired the T315I mutation after HSCT, and the median time was 10.8 months. In addition to these 7 cases, 5 out of 22 patients were managed with chimeric antigen receptor (CAR) T cells and ponatinib. There were 4 patients in the HSCT recipient subgroup who were treated with CAR-T cells or ponatinib before HSCT. The complete molecular remission (CMR) and recurrence rate of HSCT recipients were both 67%, and the median recurrence time was 3.6 months. A better overall survival (OS) was observed in the HSCT recipient subgroup than in the HSCT nonrecipient subgroup (median of 12.3 months vs 3.3 months, respectively; p = 0.004). Compared with patients who were not bridging to HSCT, the patients who were treated with CAR-T cells and/or ponatinib and bridged to HSCT tended to have a better OS (median of 3.3 months vs 13.3, respectively; p = 0.09). In conclusion, the outcomes in ALL patients with the T315I BCR-ABL1 mutation were poor. A better OS can be achieved through ponatinib, CAR-T cells, and bridging to HSCT, but it also has a higher risk of recurrence.
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Antineoplastic Agents/therapeutic use , Fusion Proteins, bcr-abl/genetics , Genes, abl , Imidazoles/therapeutic use , Molecular Targeted Therapy , Mutation, Missense , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Protein Kinase Inhibitors/therapeutic use , Pyridazines/therapeutic use , Adolescent , Adult , Amino Acid Substitution , Combined Modality Therapy , Dasatinib/therapeutic use , Disease-Free Survival , Female , Fusion Proteins, bcr-abl/antagonists & inhibitors , Hematopoietic Stem Cell Transplantation , Humans , Immunotherapy, Adoptive , Incidence , Kaplan-Meier Estimate , Male , Middle Aged , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Prognosis , Recurrence , Remission Induction , Risk , Salvage Therapy , Young AdultABSTRACT
ABSTRACT OBJECTIVE:To establish a method for simultaneous determination of 8 components in the lyophilized product of Chaihu shugan san decoction. METHODS:UPLC method was adopted to determine the contents of albiflorin,paeoniflorin,ferulic acid,naringin,hesperidin,benzoyl paeoniflorin,glycyrrhizic acid and α-cyperone in 6 batches of lyophilized product of Chaihu shugan san decoction. The determination was performed on Phenomenex column with mobile phase consisted of 0.1% formic acid water-acetonitrile at the flow rate of 1 mL/min,the sample volume was 10 μL. The detection wavelength was set at 250 nm,and column temperature was 30 ℃. RESULTS:The linear range of albiflorin,paeoniflorin,ferulic acid,naringin,hesperidin,benzoyl paeoniflorin,glycyrrhizic acid and α-cyperone were 3.606-8.414,23.988-55.972,1.218-2.842,35.964-83.916,12.009-28.021, 1.194-2.786,3.609-8.421,5.294-12.352 μg/mL,respectively(r=0.999 5-0.999 9). The limits of quantitation were 0.206,0.178, 0.256,0.168,0.196,0.242,0.268,0.157 μg/mL,respectively. RSDs of precision,stability(12 h)and repeatability tests were all lower than 2%(n=5 or 6);the recoveries were 97.93%,98.18%,96.57%,97.61%,98.51%,97.45%,98.14%,96.91%(all RSD<2% ). The average contents of albiflorin, paeoniflorin, ferulic acid, naringin, hesperidin, benzoyl guanosine, and glycyrrhizic acid in 6 batches of samples were 59.258,429.237,23.173,625.847,200.424,15.048,67.620 μg/g,respectively. α-cyperone was not detected because of its volatility. CONCLUSIONS:The method is simple,stable,reliable and accurate. It could provide reference for quality control of the lyophilized product of Chaihu shugan san decoction
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Objective@#To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7+ in AML patients with wild-type (WT) or mutant-type (MT) CEBPA.@*Methods@#The clinical data of 298 newly diagnosed non-M3 AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7+ and CD7- patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7+ group by Kaplan-Meier method.@*Results@#In CD7+ group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7- group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7+ group comparing to those of CD7- group in AML patients with wild type CEBPA. There were no statistical difference between CD7+ group and CD7- group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7+ group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7+-CEBPA MT group, CD7- and CD7+-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) .@*Conclusion@#The CEBPA mutation rate was higher in CD7+ AML patients then that of CD7- patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.
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OBJECTIVE@#To investigate the expression of Wilms'tumor 1 () gene in patients with acute myeloid leukemia (AML), and to explore its application in predicting prognosis of AML in patients with wild or mutated nucleophosmin 1() and Fms-like tyrosine kinase 3-internal tandem duplication ().@*METHODS@#One hundred and sixty-seven newly diagnosed AML patients(exclued M3 type) were enrolled in this study. The survival of patients were analyzed with Kaplan-Meier method. The clinical data, laboratory findings and the survival of patients were analyzed and compared between patients with high expression (high- group) and those with low expression (low- group), as well as among the patients with or wild type and mutants.@*RESULTS@#The overall response rates (ORR) in high- and low- groups were 65.9% (83/126) and 95.1% (39/41), respectively (0.05). In patients with wild type, the high- group had inferior ORR and 2-y OS rate (all 0.05).@*CONCLUSIONS@# gene overexpression indicated poor prognosis of AML patients; the patients with decreased gene expression ≥ 1 log after the first induction therapy show better prognosis than those with<1 log. The gene expression level at diagnosis can be used as an unfavorable prognostic factor for AML patients with or wild types.
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Humans , Disease-Free Survival , Gene Expression Profiling , Kaplan-Meier Estimate , Leukemia, Myeloid, Acute , Diagnosis , Genetics , Mortality , Mutation , Nuclear Proteins , Genetics , Prognosis , WT1 Proteins , Genetics , fms-Like Tyrosine Kinase 3 , GeneticsABSTRACT
Objective To investigate the clinical effect of psychological intervention combined with insulin and glimepiride on the the treatment of elderly patients with diabetes. Methods 150 cases of elderly patients with diabetes in our hospital from July 2012 to March 2017 were treated as the research object, the single and double number (hospital admission order) 150 cases of elderly patients with diabetes were randomly divided into study group (n=75) and control group (n=75). The control group of elderly diabetic patients receiving insulin combined with glimepiride treatment in the study group received the basic treatment combined with psychological intervention. Results After treatement, 2 hPG, FBG and HbAlc were better than those in the control group (P<0.05). HAMD score in the study group after treatment decreased significantly than that before treatment(P<0.05). The difference of HAMD score in the control group had no statistically significant. Conclusion Psychological intervention combined with insulin and glimepiride on the treatment of elderly patients with diabetes can improve the depression, has a positive significance to improve the effect of blood glucose.
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Objective To establish the quality standards system of A system to multiple evaluation on Yinxing huonao capusle,and discuss the feasibility of the method whether A system to multiple evaluation to be used for traditional Chinese medicine quality standard.Methods Identification of the Yinxing huonao capusle by TLC method was established by one thin layer chromatography system.HPLC was used to detect 6 types of the primary active components in Yinxing huonao capusle.Results 5 types of the primary active components were synchronize identified by one thin layer system.The color of spots was clear and had a good separation effect.6 kinds of the primary active components were synchronize detected by one system with high accuracy.Conclusion The established method A system to multiple evaluation can be used for the study of the quality standards system of Yinxing huonao capusle.
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The occurrence and development of acute myeloid leukemia (AML) is not only related to gene mutations, but also influenced by abnormal epigenetic regulation, in which DNA methylation is one of the most important mechanisms. Abnormal DNA methylation may lead to the activation of oncogene and the inactivation of tumor suppressor gene, resulting in the occurrence of leukemia. The mutations of DNA methylation enzymes associated with AML may have certain characteristics. The AML with recurrent cytogenetic abnormalities is also related to abnormal methylation. Some fusion genes can alter DNA methylation status to participate in the pathogenesis of leukemia. In addition, chemotherapy drug resistance in patients with AML is associated with the change of gene methylation status. Considering the reversibility of the epigenetic modification, targeted methylation therapy has become a hotspot of AML research.
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Humans , DNA Methylation , Genetics , Physiology , DNA Modification Methylases , Genetics , Physiology , Drug Resistance, Neoplasm , Genetics , Epigenesis, Genetic , Genetics , Physiology , Leukemia, Myeloid, Acute , Genetics , Pathology , Mutation , GeneticsABSTRACT
OBJECTIVE:To explore the effects and safety of atorvastatin combined with probucol on the vascular elasticity in patienits with hypertension. METHODS:246 hypertensive patients were randomly divided into control group and observation group,123 cases in each group. All patients received conventional antigypertensive treatment,based on it,control group was given 10 mg Atorvastatin tablet,qd;observation group was additionally given 0.25 g Probucol tablet,qd,on the basis of control group. They were treated for 1 year. Clinical efficacy,lipid levels(total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol),cystatin C (Cys-C),C-reactive protein (CRP),elastic parameters of common carotid artery and lower limb artery(stiffness,pressure-strain elastic modulus,compliance,augmentation index,pulse wave velocity)before and af-ter treatment in 2 groups were observed,and the incidence of adverse reactions was compared. RESULTS:Before treatment,there were no significant differences in lipid levels,Cys-C,CRP and elastic parameters of common carotid artery and lower between 2 groups (P>0.05);after treatment,the above-mentioned indexes were significantly improved,and the improvement degree in ob-servation group was superior to control group,the differences were statistically significant(P<0.05). And there were no severe ad-verse reactions during treatment in both 2 groups. CONCLUSIONS:Atorvastatin combined with probucol can improve lipid level and elasticity of common carotid artery and lower limb artery,with good safety.
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<p><b>OBJECTIVE</b>To observe the short- term effects of hemogram in donors after peripheral blood stem cell(PBSC)collection and donors' tolerance.</p><p><b>METHODS</b>A total of 166 related allogeneic donors were selected from The First Affiliated Hospital of Medical School of Zhejiang University between January 2013 and December 2014, including 86 male and 80 female. All donors accepted granulocytecolony- stimulating factor(G-CSF)5-10 μg·kg⁻¹·d⁻¹ until collection finished and were measured by blood cells count before and after PBSC collection.</p><p><b>RESULTS</b>After PBSC collection, the hemoglobin level decreased from 145(94-181)g/L to 138(93-167)g/L, and the platelet counts decreased in all donors from 231(105- 490)× 10⁹/L to 95(39- 210)× 10⁹/L. The amount of hemoglobin contamination in collection products was weak correlated with the decreased hemoglobin in peripheral blood(r=0.297, P=0.017), and the platelet contamination was high correlated with that decreased in peripheral blood(r=0.719, P<0.001). The decline of hemoglobin level after twice PBSC collection was of no significant difference between four groups in different ages(P≥0.05). The decline of platelet counts was out of a significant difference(P> 0.05). In addition, the decline of hemoglobin level after once and twice PBSC collection was of a significant difference between four groups in different body mass index(BMI)(P=0.003 and P<0.001), especially in thinner group with obvious decrease. But the decline of platelet counts was out of a significant difference (P>0.05).</p><p><b>CONCLUSION</b>The hemoglobin level decreased mildly in healthy allogeneic hematopoietic stem cell donors after PBSC collection and it is better to adjust parameters every time to ensure their safety for thinner donors. However, it will increase the risk of platelet decline, which is unrelated with ages and BMI and can be tolerated.</p>
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Female , Humans , Male , Blood Donors , Blood Platelets , Granulocyte Colony-Stimulating Factor , Pharmacology , Hematopoietic Stem Cells , Cell Biology , Hemoglobins , Platelet CountABSTRACT
Objective Negative pressure wound therapy (NPWT) and moist wound therapy (MWT) are two new methods for wound care .Whether the united is better than the single .The study was to observe and compare the effects of using negative pres-sure wound therapy ( NPWT) combined with moist wound therapy ( MWT) and simple MWT in the treatment of traffic crush injuries . Methods 32 cases were randomly divided into two groups:intervention group and control group , 16 cases for each group .In interven-tion group, wounds were first treated by NPWT for 21 days, followed by standardized MWT till healing .In control group, wounds were treated by standardized MWT till healing .Consensus methods were applied in the measurements before treatment , 7 days, 14 days and 21 days after treatment .The measurements were involved in wound size , depth, undermined edge and the ratio of granulation tissue covering wound bed .Calculation were made on the construction rates of wound size , depth, volume and undermined edge along with re-cords of the time 100%granulation tissue covering wound bed and healing .The database was set up and statistical analysis were done by SPSS 16.0 software. Results The healing rate was 100%for both groups.During 21 days of treatment, the construction rates of wound size, volume, depth and undermined edge of intervention group were better than those of control group (P<0.05).The time 100%granulation tissue covering wound bed of intervention group was shorter than that of control group ([25.00 ±5.77] d vs [41.25 ±18.32]d, P=0.000).The healing time of intervention group was about two weeks shorter than of control group , but with no significance([67.63 ±22.38]d vs [83.56 ±55.31]d, P=0.597). Conclusion NPWT is applicable to traffic crush injuries in combination with MWT , which could promote the growth of granulation tissue and help construct and heal the wounds .NPWT combined with MWT has prior effects to simple MWT .
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One hundred children aged 8-10 years and 100 adults aged 18-45 from their families in three townships Baoshan,Mingcheng,and Yantongshan of Panshi city,Jilin province were selected in April 2009. In addition,50 pregnant or lactating women,and their 50 infants aged 0-2 years were selected.The median level of iodine in salt at household was 30.2 mg/kg and that of drinking water was 2.8 μg/L.The median levels of urine iodine in school age chidren ( 196.5 μg/L),during pregnancy( 198.5 μag/L),lactation( 224.9 μg/L),and in infants (209.0 μg/L) all were optimal according to World Health Organization criteria.Only the median urine iodine in adults ( 269.0 μg/L) was more than adequate.The prevalence of goiter evaluated by B-ultrasound was 1.8% in 8-10year-old children.The incidences of various thyroid dysfunctions were low in these residents,such as subclinical hyperthyroidism ( 2.1% ),subclinical hypothyroidism ( 1.5% ),and hyperthyroidism ( 1.2% ). Subclinical hypothyroidism occurred mostly in adults (2.7%),pregnant women ( 1.7% ),and lactating women ( 1.8% ) ; and subclinical hyperthyroidism occurred mostly in 8-10 years old school chidren (4.5%) and lactating women (3.6%).These results show that the current iodized salt content has no harmful effect on thyroid function of rural residents in Jilin province.
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To translate the Kolcaba brief general comfort questionnaire (GCQ) to Chinese and measure the applicability under the Chinese culture background. Methods This study was composed by two phases, the first phase was to measure the content validity of brief GCQ by 5 nursing specialist after GCQ was translated into Chinese. The second phase was to testing the reliability of the brief GCQ by investigating patients when they had undergone chest surgery operation before 48 hours. Results The overall CVI of brief GCQ was 0.86, the Cronbach's a was 0.92, the subscale ? was from 0.53 to 0.85. The total GCQ score about patients with chest surgery was 91.27?8.63. The lowest mean score was physical subscale: 2. 50?0. 47, the highest mean score was psychological sub-scale: 3.26?0.35. Conclusion The Kolcaba brief GCQ fit to use in China, but its content validity and the internal consistency should be tested in future study.
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Aim To study the protection of tetrandrine(Tet) from the excitotoxicity of quinolinic acid(QA) on the cultured hippocampal neurons of new-borne rats.Method Excitoxocity injury was induced by QA in cultured hippocampal neurons.The cell viability was measured by MTT assay, extracellular LDH contents were also measured and the pathomorphology of neurons was observed. Result Tet with 10 -6 mol?L -1 and 10 -7 mol?L -1 could significantly blunt the death of the primary hippocampal neurons induced by QA,prevent leakage of LDH and improve the pathomorphology of neurons. Conclusion Tet (10 -6 mol?L -1 and 10 -7 mol?L -1)provids protection on QA induced cytotoxicity in cultured hippocampal neurons of new-borne rats.
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The paper first sums up the types of clinical nursing ward rounds and points out that at present two types play a dominant role in China, viz. the problem-based nursing ward round and the nursing procedure-oriented nursing ward round. Then it expounds the goal of clinical nursing ward rounds, introduces the forms, participants, and schedules of nursing ward rounds, and analyzes the major problems that currently exist in this aspect. The paper argues that it is imperative for the hospital to reinforce the management of nursing ward rounds and ensure that they are well planned and prepared and highly standardized and focused so as to improve their quality.
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AIM To study the effects of PDB on blood glucose. METHODS 3 groups of health mice and 3 groups of model mice were administered with high, mean and low doses of PDB compatibility groups (combined with glibenclamide 0.66 mg?kg -1) respectively for 15 days. The blood goucose variation of health and model mice was observed. RESULTS A low dose of PDB compatibility group decreased obviously blood glucose in the health mice. Its mean value was(3.10?0.14), while control group's blood glucose was 4.46?0.12, P
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20 adult healthy rats were used for microelectropheretic delivery of horseradish peroxidase (HRP). The diameter of the tip of the glass electrode was around 20~50?. It was inserted into nucleus raphe magnus, 20% HRP was delivered microelectrophoretically(5 ?A for 30 min; 10 ?A for 10 min). In eight rats the microelectrode was withdrawn immediately after the delivery and in the rest it was removed 10~20 minutes after delivery. Afterward the animals were allowed to survive for 40 hrs before decapitation, except 2 for 20 and 2 for 60 hrs. The brains were dissected out for cryostat sections and DAB reaction for peroxidase.The tip of the electrode was located in the nucleus raphe magnus, at the level of nucleus facialis. The diameter of the brain tissues occupied by HRP at the points of microelectophoretic delivery was 0.2~0.4mm and the maximum reached 0.6~0.7mm. The exogenous HRP granules were not visible in the cases with electrodes withdrawn immeditely after delivery and in the survivors of 60 hrs. In most cases the electrodes were left inside for more than 10 minutes after the delivery. The exogenous HRP granules were large, coarse, brown, steroscopic and distributed evenly in the perikaryon of some neurons in several levels of the brain. Those in the axon and dentrite were distributed just like strings of pearls. There were much more neurons with exogenous HRP positive granules dispersed in the reticular formation of the medula oblongata, most of them were polydendritic. Small and fusiformed HRP-positive cells are observed occasionally in the gray substance of subventriculum, reticular formation pontis and ventrolateral side of locus coeruleus. Weaker reactions were found in a few cells in the periaquaductous gray substance of the midbrain, nucleus raphe centro-superior, substantia nigra pars compacta and in the area around the nucleus supraopticus. Besides no HRP-positive cells were discovered in thalamus and subcortex structure.There were two types of cells with HRP positive granules around some blood vessels in reticular formation and subventricular gray substance: One was a small protoplasmic astrocyte with broad cytoplasma, small nucleus, and thick, short and irregular processes and another kind was polydendritic neurons filling with brown positive granules in perikarya and cytoprocesses, in the latter, the HRP positive granules were arranged as strips of pearls.