Meta-analysis of efficacy and safety of cabozantinib in the treatment of advanced thyroid cancer / 中国药房

OBJECTIVE To review the efficacy and safety of cabozantinib in the treatment of advanced thyroid cancer. METHODS Retrieved from PubMed， the Cochrane Library， Embase， ClinicalTrials.gov， Wanfang data， VIP， CNKI and China Clinical Trials Registry， randomized controlled trials （RCTs） about cabozantinib （trial group） versus placebo （control group） were collected from the inception to Nov. 2022. After literature screening， data extraction and quality evaluation， meta-analysis was performed by using RevMan 5.4 software. RESULTS A total of 4 RCTs were included involving 588 patients. The results of the meta-analysis showed that the progression free survival （PFS） [HR＝0.24， 95%CI （0.19，0.31）， P＜0.000 01]， objective response rate （ORR） [RR＝31.46， 95%CI （6.32，156.75）， P＜0.000 1]， the incidence of grade 3-4 adverse event （AE） [RR＝2.15，95%CI （1.76，2.61），P＜0.000 01]， severe adverse event [RR＝1.78，95%CI （1.11，2.83），P＝0.02]， diarrhea [RR＝3.29，95%CI（1.62， 6.66），P＝0.001]， palmar-plantar erythrodysesthesia syndrome [RR＝28.19，95%CI （12.25，64.88），P＜0.000 01]， and hypertension [RR＝6.50，95%CI （3.90，10.83），P＜0.000 01] in trial group were significantly higher than control group； there was no statistical significance in overall survival （OS） [HR＝0.83，95%CI （0.67，1.02）， P＝0.07] or the incidence of fatigue [RR＝1.25，95%CI （0.78，1.98），P＝0.35] between the two groups. Subgroup analysis showed that PFS and ORR in patients with differentiated thyroid carcinoma （DTC） and medullary thyroid carcinoma （MTC） in the trial group were significantly higher than control group （P＜ 0.05）. There was no significant difference in OS of DTC and MTC patients in the trial group compared with the control group （P＞ 0.05）. CONCLUSIONS Cabozantinib can prolong PFS and increase ORR in patients with advanced thyroid cancer， but the incidence of AE is high.

Effect of consolidation before allogeneic hematopoietic stem cell transplantation for non-favorable acute myeloid leukemia patients with first complete remisson and negative minimal residual disease / 中华血液学杂志

Objective@#To probe the prognostic value of consolidation chemotherapy in non-favorable acute myeloid leukemia (AML) patients who were candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT) with first complete remission (CR1) and negative minimal residual disease (MRD-) .@*Methods@#A retrospective analysis was conducted on 155 patients with non-favorable AML who received allo-HSCT in CR1/MRD- from January 2010 to March 2019. The survival data were compared between patients who received and those not received pre-transplant consolidation chemotherapy.@*Results@#A total of 102 patients received pre-transplant consolidation chemotherapy (consolidation group) , and 53 cases directly proceeded to allo-HSCT when CR1/MRD- was achieved (nonconsolidation group) . The median ages were 39 (18-56) years old and 38 (19-67) years old, respectively. Five-year post-transplant overall survival [ (59.3±7.5) % vs (62.2±6.9) %, P=0.919] and relapse-free survival [ (53.0±8.9) % vs (61.6±7.0) %, P=0.936] were not significantly different between the two groups (consolidation vs nonconsolidation) . There was a weak relationship between consolidation therapy and cumulative incidence of relapse [consolidation: (21.9±5.4) % vs nonconsolidation: (18.3±6.0) %, P=0.942], as well as non-relapse mortality [consolidation: (22.4±4.3) % vs nonconsolidation: (28.4±6.5) %,P=0.464]. Multivariate analysis indicated that pre-transplant consolidation and the consolidation courses (< 2 vs ≥2 courses) did not have an impact on allo-HSCT outcomes.@*Conclusion@#Allo-HSCT for candidate patients without further consolidation when CR1/MRD- was attained was feasible.

Relationship between peripheral blood thyroxine levels and cardiac function in patients with chronic heart failure / 中华老年医学杂志

Objective To investigate the relationship between peripheral blood thyroxine levels and cardiac function in elderly patients with chronic heart failure.Methods Seventy patients with chronic heart failure admitted into our hospital from January 2016 to December 2017 were enrolled as the study group,and 70 healthy subjects were collected as the control group.Left ventricular ejection fraction(LVEF)and serum thyroxine levels were measured in both groups.Results LVEF,serum levels of total triiodothyronine(TT3)and total thyroxine(TT4)were lower in the study group than in the control group[(37.3±2.4)％ vs.(58.5 ± 5.3) ％,(87.4 ± 8.7) mmol/L vs.(120.8±10.4) mmol/L,(8.6±1.7)mmol/L vs.(10.1 ± 1.3)mmol/L,t =30.486,20.609 and 5.864,P =0.000].LVEF,TT3 and TT4 in patients with grade lⅡ 、grade Ⅲ and grade Ⅳ Cardiac insufficiency were [(42.3±2.2)％、(37.9± 1.0)％ and(31.8±1.5)％,(104.2± 15.4) mmol/L、(89.7±4.6) mmol/L and(72.0±7.2)mmol/L,(9.3± 1.8)mmol/L、(8.8± 1.3) mmol/L and (8.1 ± 0.9) mmol/L]respectively.Serum levels of TT3 and TT4 and LVEF steadily declined as cardiac dysfunction grew more severe in patients with chronic heart failure(P =0.000).Conclusions Patients with chronic cardiac insufficiency are often combined with euthyroid sick syndrome,and serum levels of TT3 and TT4 can indicate the degree of abnormal cardiac systolic function.Therefore,low serum levels of T3 and T4 can be used as indicators for poor prognosis in patients with chronic heart failure.

Prognostic value of donor chimerism at +90 days after allogeneic hematopoietic stem cell transplantation in young patients with intermediate-risk acute myeloid leukemia / 中华血液学杂志

Objective@#To investigate the relationship between donor chimerism and relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#The clinical data of 105 patients with acute myeloid leukemia (AML) who underwent allo-HSCT and recurrence-free survival>90 days from January 2010 to January 2019 were retrospectively analyzed. The bone marrow samples were collected at 15, 30, 60, 90, 180, 270, 360 days after transplantation. Donor chimerism was detected by single nucleotide polymorphism (SNP) -PCR.@*Results@#Of the 105 patients, 43 cases were male and 62 cases were female, with a median age of 38 (16-60) years. Till April 2019, the median follow-up was 843 (94-3 261) days. Ninety days after transplantation, 18 cases relapsed, 33 cases died, and 72 cases survived. The 3-year overall survival (OS) rate was (66.8±5.1) %, and the recurrence-free survival (RFS) rate was (65.1±5.0) %. Pre-transplant disease status, pre-transplant minimal residual disease (MRD) , and 90 day post-transplantation chimerism were independent risk factors related to RFS. The risk of recurrence was significantly increased in patients with a donor chimerism rate ≤97.24% at 90 days after transplantation[HR=6.921 (95%CI 2.669-17.950) , P<0.001], which was considered as a sign of early relapse.@*Conclusion@#SNP-PCR is an applicable method for detecting donor chimerism in patients after allo-HSCT. Chimerism rate equal or less than 97.24% at 90 days after transplantation predicts a higher risk of relapse.

Efficacy and safety of different doses of Rosuvastatin calcium in treating elderly patients with coronary heart disease complicated with hyperlipidemia / 中华老年医学杂志

Objective To investigate the efficacy and safety of different doses of Rosuvastatin calcium in treating elderly patients with coronary heart disease complicated with hyperlipidemia.Methods A total of 130 patients with coronary heart disease in combination with hyperlipidemia admitted into our hospital from January 2015 to December 2017 were enrolled.They were randomly divided into the control group(with Rosuvastatin calcium 10 mg per day,n=65)and the study group (with Rosuvastatin calcium 20 mg per day,n=65).Clinical efficacy,changes of blood lipid levels and adverse reactions after treatment were compared between the two groups.Results In the study group,25 cases had obvious effects,35 cases had effects and 5 cases had noeffect.In the control group,21 cases with obvious effects,31 cases with effects and 13 cases without effect were found.The total effective rates were 92.3％ in the study group and 80.0％ in control group(x2 =4.127,P =0.042).The blood levels of total cholesterol (TC),triglyceride(TG)and low-density lipoprotein cholesterol (LDL-C) in the study group were decreased in post-vs.pre-treatment,and were lower in treatment group than in control group(all P =0.000).Nausea and vomiting in 1 case,and muscle ache in 1 case were found in the control group.In the study group,2 cases of nausea and vomiting,2 cases of skin rash,1 case of muscle ache,and 2 cases of joint ache were found.The incidences of adverse reactions were 10.8％ and 3.1％ in the study and control group respectively,with no significant difference between the two groups (x2 =2.984,P =0.084).Conclusions The high-dose of Rosuvastatin calcium(20 mg daily)has significant clinical efficacy and improve the blood lipid levels in elderly patients with coronary heart disease complicated with hyperlipidemia,with no significant difference in incidence of adverse reactions between 10 mg daily versus 20 mg daily Rosuvastatin calcium.

Rosai-Dorfman disease: a clinicopathologic analysis and whole exome sequencing in 23 cases / 中华血液学杂志

Objective@#To evaluate the clinicopathologic features of Rosai-Dorfman disease (RDD) , and elucidate the potential pathogenesis by whole exome sequencing (WES) .@*Methods@#Clinico-pathological data of 23 RDD patients diagnosed between 2010 and 2018 in Changhai hospital were reviewed, and 9 paraffin-embedded specimens were performed for WES.@*Results@#The median age of 23 RDD patients was 47 (10-79) years. Of them, 19 cases had extranodal lesions, 3 had nodal lesions, and 1 had nodal and extranodal lesions coincidently. All patients received surgery for lesion resection. Histiocytosis in lymph node sinuses or in extranodal tissues accompanied by lymphocyte phagocytosis are typical pathological features of RDD. Immunohistochemical staining shows histocytes are positive for S100, CD68 and CDl63, and negative for CD1a. mTOR, KMT2D and NOTCH1 mutations were detected with WES in these cases.@*Conclusion@#Mutations in mTOR, KMT2D and NOTCH1 genes may be involved in the pathogenesis of RDD, and their clinical significance needs to be further studied.

Efficacy of Hyper-CVAD/MA and CHALL-01 regimens in the treatment of Philadelphia chromosome-positive adult acute lymphoblastic leukemia patients under 60 years old / 中华血液学杂志

Objective@#To compare the difference of efficacy between traditional Hyper-CVAD/MA regimen and the adolescents inspired chemotherapy regimen, CH ALL-01, in treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) .@*Methods@#In this study we retrospectively analyzed 158 Ph+ ALL patients receiving Hyper-CVAD/MA regimen (n=63) or CHALL-01 regimen (n=95) in our center and Changzheng hospital from January 2007 to December 2017, excluding patients with chronic myeloid leukemia in blast crisis. Tyrosine kinase inhibitor (TKI) was administered during induction and consolidation chemotherapy. Patients who underwent hematopoietic stem cell transplantation received TKI as maintenance therapy.@*Results@#Of them, 91.1% (144/158) patients achieved complete remission (CR) after 1-2 courses of induction. CR rate was 90.5% (57/63) for patients in Hyper-CVAD/MA group and 91.6% (87/95) for patients in CHALL-01 group. There was no difference in CR rates between the two groups (χ2=0.057, P=0.811) . The last follow-up was June 2018. A cohort of 134 CR patients could be used for further analysis, among them, 53 patients received Hyper-CVAD/MA regimen and other 81 patients received CHALL-01 regimen. The molecular remission rates were significantly higher in CHALL-01 group (complete molecular response: 44.4%vs 22.6%; major molecular response: 9.9% vs 18.9%) (χ2=7.216, P=0.027) . For the patients in Hyper-CVAD/MA group, the 4-year overall survival (OS) was 44.81% (95%CI: 30.80%-57.86%) and the 4-year disease free survival (DFS) was 37.95% (95%CI: 24.87%-50.93%) . For patients received CHALL-01 regimen, the 4-year OS was 55.63% (95%CI: 39.07%-69.36%) (P=0.037) and 4 year DFS was 49.06% (95%CI: 34.24%-62.29%) (P=0.015) , while there was no significant difference in 4 year cumulative incidence of relapse (CIR) (P=0.328) or cumulative incidence of nonrelapse mortality (CI-NRM) (P=0.138) . The rate of pulmonary infection was lower in patients received CHALL-01 regimen compared with patients received Hyper-CVAD regimen (43.4% vs 67.9%, χ2=7.908, P=0.005) .@*Conclusions@#Outcome with CHALL-01 regimen appeared better than that with the Hyper-CVAD/MA regimen in Ph+ ALL, which has lower incidence of pulmonary infection, higher molecular remission rate and better OS and DFS.

Clinical and prognostic values of TP53 mutation in patients with acute myeloid leukemia / 中华血液学杂志

Objective@#To explore the clinical and prognostic values of TP53 gene mutation in patients with acute myeloid leukemia (AML) .@*Methods@#A retrospective analysis of 265 newly diagnosed AML patients with next-generation sequencing (NGS) data in the Hematology Department of Changhai Hospital from January 2010 to January 2019 was performed. Mutation analysis was carried out by targeted sequencing technology including 200 hematological malignancy related genes. The association of TP53 mutation with clinical features was analyzed.@*Results@#Alterations in TP53 were found in 20 (7.5%) patients, including 17 case (6.4%) of missense mutations, 2 cases (0.7%) of frame-shift deletion mutations and 1 case (0.4%) of splicing sites mutation. A total of 23 kinds of TP53 mutations were detected, most of them (16, 69.6%) were located in the DNA binding domain of exon 5-8, 4 in the DNA binding domain of exon 3-4, 2 in exon 10 and 1 in splice site, respectively. The median age of patients with TP53 alterations was higher than those without [52 (26-72) years old vs 45 (14-75) years old, P= 0.008]. The frequency of complex karyotypes was higher in patients with TP53 alterations than those without [45.0% (9/20) vs 6.1% (15/245) , P<0.001]. Median overall survival (OS) of patients with TP53 alterations was shorter than those without[14.1 (95%CI 6.78-21.42) months vs 31.4 (95%CI 13.20-49.59) months, P=0.029]. The OS of patients treated with "Decitabine + CAG" was superior than that of patients treated with "3 + 7" regimen [30.0 (95%CI 27.35-38.84) months vs 12.5 (95%CI 5.80-19.19) months, P=0.018]. Multivariate analysis indicated that TP53, DNMT3A and USH2A alterations, WBC ≥ 12.45×109/L had negative impacts on OS.@*Conclusion@#The frequency of TP53 mutation was 7.5% in our cohort. Most mutations were located in the DNA binding domain. TP53 alterations were strongly associated with older age, complex karyotype and shorter OS. Decitabine-based induction chemotherapy and hematopoietic stem cell transplantation may improve OS, more cases and/or multicenter randomized studies are needed for further confirmation.

Correlation between osteocalcin and blood glucose and blood lipid in type 2 diabetes mellitus / 国际检验医学杂志

Objective To understand the changes in the level of osteocalcin (OC) in patients with type 2 di-abetes mellitus (T2DM) and discuss the correlation between the changes and glycated hemoglobin (HbA1c), fasting blood glucose (FBG),thyroid globulin (TG),total cholesterol (TC),high-density lipoprotein (HDL C),low density lipoprotein (LDL C),fasting insulin (FINS),and fasting C peptide (FCP) and so on.Methods 108 cases of T2DM patients were collected from group T2DM and 92 healthy subjects as healthy control group.Fasting venous blood was taken from the subjects and serum levels of OC were detected by chemilumi-nescence.HbA1c,FBG,TG,TC,HDL-C,LDL-C,FINS and FCP levels were detected,and Pearson correlation and logistic regression were used to analyze the relationship between OC and other indicators.Results The level of OC in the T2DM group was significantly lower than that in the control group,and the difference was statistically significant [(14.98 ± 10.16)ng/mL vs.(18.20 ± 6.67)ng/mL,P<0.05].There was a signifi-cant negative correlation between OC and HbA 1c and FBG in T2DM patients (P< 0.01),and a significant positive correlation with HDL C(P< 0.01);Logistic regression analysis showed that HbA 1c was an inde-pendent influence factor of serum OC(P<0.01).Conclusion The level of OC in peripheral blood of T2DM patients was significantly decreased.OC level was closely related to blood glucose and blood lipids,and it had a certain effect on the prevention and evaluation of T2DM.

Myeloid neoplasms with eosinophilia and abnormal PDGFRA/B: report of three cases and review of literature / 白血病·淋巴瘤

Objective To investigate clinical and hematological features of myeloid neoplasms with eosinophilia and abnormal PDGFRA/B and the effect of imatinib. Methods The data of three eosinophilia patients with abnormal PDGFRA/B fusion gene in Changhai Hospital, the Second Military Medical University and 22 Chinese cases reported in Chinese medical journals were analyzed. Thirty-one cases of idiopathic hypereosinophilic syndrome from Changhai Hospital, the Second Military Medical University were used as the controls. Results Compared with idiopathic hypereosinophilic syndrome, no differences were found in age, percentage of bone marrow eosinophils and counts of platelets in peripheral blood in myeloid neoplasms with eosinophilia and abnormal PDGFRA/B (all P ＞0.05), but statistical differences were found in gender (χ2＝5.080, P ＝ 0.016), peripheral blood white blood cell count (t ＝ 4.908, P ＝ 0.001), eosinophilic granulocyte absolute value (χ2＝ 17.230, P ＝ 0.001) and hemoglobin concentration (t ＝ 2.770, P ＝ 0.013). The median follow-up time was 17 months (3-108 months) in 24 myeloid neoplasms patients with eosinophilia and abnormal PDGFRA/B from Chinese report. Complete hematopoietic remission (CHR) rate was 91.7 % (22/24) after the treatment of imatinib. The total complete molecular remission (CMR) rate was 75.0 % (18/24). The median time of remission was 3 months (1-8 months). CMR in patients with PDGFRA and with PDGFRB was 76.5 % (13/17) and 85.7 % (6/7), respectively. Only one patient (4.2 %) died of disease relapse. Conclusion Imatinib has a favorable effect on myeloid neoplasms with eosinophilia and abnormal PDGFRA/B featured by distinct hematologic and clinical manifestations.

A analysis of clinical value about endoscopic nipple modified resection in duodenal papillary adenoma resection / 中国医学装备

Objective: To analyze the clinical value of modified endoscopic nipple resection in duodenal papillary adenoma resection Methods: 40 patients with duodenal papillary adenoma were randomly divided into observation group (20 cases) and control group (20 cases)according to the random number table. The patients of control group were treated by conventional resection of papillary adenoma, while the patients of observation group were treated by modified endoscopic nipple resection. The resection rate and the implantation of stent between the two groups were compared. Besides, the occurrence rate of complication and postoperative follow-up between the two groups also were compared. Results: The complete resection rate of observation group (95.00%) was not significant difference with that of control group (90.00%), while en bloc resection rate of observation group (85.00%) significant higher than that of control group (55.00%) (x2=4.28, P0.05). In postoperative three months, the difference of recently complication between the two groups was significant (x2=6.14, P0.05) in more than postoperative three months. After the follow-up of one year, the recurrence rate of observation group (10.34%) was no significant with that of control group (14.29%)(x2=0.17, P>0.05). Conclusion: The modified endoscopic nipple resection can enhance the en bloc resection rate, and reduce the incidence of complications and the recurrence rate. Besides, it has many dominances including higher feasibility in clinical practices. Therefore, its promotion is worthy.

The study of expression and prognostic value of CD123 in acute myeloid leukemia bone marrow blasts / 中华血液学杂志

Objective@#To study the expression of CD123 in bone marrow (BM) blasts of acute myeloid leukemia (AML) patients to explore the relationship between CD123 expression and therapeutic response and prognosis.@*Methods@#This study retrospectively analyzed expression and distribution of CD123 in BM blasts in 137 cases of newly diagnosed AML (excluded M3) , CD123 detected by flow cytometry≥20% was defined as positive, including 84 CD123+ AML and 53 CD123- AML, efficacy and prognosis were compared between the two groups.@*Results@#① Among 137 patients, 84 were in group CD123+ (61.3%) , and 53 in group CD123- (38.7%) . All 137 patients were classified into risk groups based on cytogenetic and molecular biology abnormalities. No significant differences were seen between the three risk groups with regard to their CD123 levels (χ2=0.861, P=0.650) . Compared with CD123- group, the CD123+ group had higher WBC[47.7 (1.0-264.0) vs 22.4 (0.7-211.0) , z=-2.592, P=0.010]. ② The rates of first complete remission (CR1) and recurrence of CD123+ group were 54.8% (46/84) and 50.8% (32/63) , respectively; and CD123- group were 73.6% (39/53) and 41.7% (20/48) , respectively. There was significant difference of CR1 between the two groups (χ2=5.121, P=0.027) , whereas no significant difference of the recurrence rate (χ2=0.911, P=0.340) . ③ The median dutations of OS between CD123+ group and CD123- group were 20.0 (95%CI 13.1-26.9) months vs 44.0 (95%CI 23.6-47.3) months, respectively (χ2=5.874, P=0.015) ; The median durations of DFS were 7.8 (95%CI 1.4-14.1) months vs 18.6 (95%CI 0-39.7) months, respectively, no differences were observed between the two groups (χ2=2.939, P=0.086) . ④ CD123 retained an adverse prognosis value on DFS and OS within the intermediate group and patients ≤ 50 years older.@*Conclusions@#CD123 widely expressed in AML patients, which was an independent risk factor for CR1 and OS, which implicating its important role in evaluating the induction chemotherapy response and prognosis of AML.

Comparison of the short-term and long-term outcomes of laparoscopic surgery and open surgery for early-stage cervical cancer / 中华肿瘤杂志

Objective@#To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer.@*Methods@#We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ2 test were used to compare the short-term and long-term outcomes. The short-term outcomes included surgical related outcomes and operative complications, and the long-term outcomes included quality of life (pelvic floor functions and sexual functions), survival and recurrence. Pelvic floor function and sexual function were assessed with the International Consultation on Incontinence Quesonnaire Female Lower Urinary tract(ICIQ-FLUTS) and the Female Sexual Function Inventory (FSFI), respectively. Survival rates were estimated by Kaplan-Meier analysis. The survival curves were compared with Log-rank test. Cox regression analysis was used to evaluaterisk factors for prognosis.@*Results@#(1)The short-term outcomes : There were significant difference in operative time([(257±69) vs(238±56)min], estimated blood loss[(358±314) vs(707±431)ml], anus exhausting time[(2.5±0.9) vs (2.9±0.8)d], preserved days of catheter[(15±7) vs(18±9)d], and post-operative length of stay[(19±16) vs (30±21)d] between the laparoscopic surgery group and the opensurgery group(P<0.05). There was no significant difference in lymph nodes yielded[(21±9) vs (21±11)], left parametrial width[(2.5±0.8) vs (2.7±0.7)cm], right parametrial width [(2.6±0.3) vs (2.7±0.2)cm], vaginal cuff length[(2.4±0.7) vs (2.2±0.7)cm] between the laparoscopic surgery group and the opensurgery group(P>0.05). The intra-operative complications occurred in 8.1%(87/1 071)in the laparoscopic surgery group and in 10.7%(85/792)in the open surgery group(P>0.05). However, the complications of vascular injury in the laparoscopic surgery group[2.6%(28/1 071)]was lower than that in the open surgery group[7.7%(61/792), P<0.001]. The laparoscopic surgery exhibited lower post- operative complication rate [33.8%(362/1 071)vs 40.2%(318/792), P<0.05] and poorer wound healing rate [0.7%(7/1 071)vs 4.0%(32/792), P<0.05]. (2)The long-term outcomes(Hierarchical analysis): The overall incontinence in ICIQ-FLUTS questionnaire in nerve-sparing laparoscopic group [28.4%(67/236)] was lower than that in the open surgery group [35.9%(71/198), P=0.004] . However, There was no significant difference in degree of incontinence between the two groups(P>0.05). The overall sexual dysfunction in FSFI questionnaire after 12 months of postoperative in the nerve-sparing laparoscopic group [47.0%(111/236)]was lower than that in the open surgery group [58.6%(116/198), P=0.001], and the six different dimension scores in the laparoscopic surgery group were higher than that in the open surgery group (P<0.05). The recurrence rate was 3.5%(35/1 007)in the laparoscopicsurgery group and 4.7%(35/740)in the open surgery group(P>0.05). The 5-year OS was 94.0% for the laparoscopic surgery group and 90.2% for the open surgery group(P>0.05), and the 5-year DFS was 93.9% for the laparoscopic surgery group and 89.1% for the open surgery group(P>0.05). (3) Prognostic fators: In univariate analysis, tumor dimension, clinical stage, deep stromal invasion, LVSI, and retroperitoneal lymph node metastasis signficantly affected 5-year OS and 5-year DFS(P<0.05); In multivariate analyses, LVSI, deep stromal invasion and LN metastasis were independent prognostic factors(P<0.05).@*Conclusions@#Laparoscopy can reduceestimated blood loss, accelerate postoperative recovery and improve the quality of life after surgery compared to laparotomy, and it ensures the same oncological results as open surgery. Laparoscopic approach is a safe and effective treatment for early-stage cervical cancer.

Efficacy of transvaginal cesarean scar pregnancy debridement surgery and the analysis of related factors / 重庆医学

Objective Compare the efficacy of transvaginal cesarean scar pregnancy debridement surgery(treatment group) and the uterine artery embolization company with the curettage(control group) in the treatment of cesarean scar pregnancy and ana-lyze the related factors of the failure of the surgery .Methods Postoperative vaginal bleeding ,incidence of postoperative scar preg-nancy again ,and time of hospital stays after surgery were compared in two groups .Relationships between gestational age ,cesarean section ,the value of serum HCG ,B-mass size ,live births and surgical success rate were discussed .Results The mean amount of blood bleeding during operation of the treatment group was(85 .38 ± 13 .27)mL ,the rate of continue pregnancy after surgery was 2 .56% ,mean time of hospital stays was(5 .13 ± 0 .77)d ,Significantly lower than the control group[(163 .11 ± 34 .87)mL ,11 .90% , (8 .12 ± 1 .88)d ,all P 0 .05) .Conclusion Tansvaginal cesarean scar pregnancy debridement surgery showed less damage on the treatment of cesarean scar pregnancy ,and re-duced the recurrence rate of the patient ,who had high blood HCG levels ,embryo survival and larger volume .

Acute promyelocytic leukaemia with translocations of t(15;17)(q22;q21) and rob(13;21): a case report and literatures review / 中华血液学杂志

<p><b>OBJECTIVE</b>To report an acute promyelocytic leukaemia (APL) case with translocation of rob (13;21) t(15;17) (q22;q21) and review its clinical and laboratory characteristics.</p><p><b>METHODS</b>Based on routine karyotype analysis and bone marrow morphology, we further used double color double fluorescent in situ hybridization (DCDF-FISH) and reverse transcriptase PCR (RT-PCR) to examine the patient's abnormities on cytogenetic and molecular biology, and reveal the clinical characteristics of this rare translocation also from the related literatures.</p><p><b>RESULTS</b>The clinical manifestation and bone marrow morphology examination of this patient were in accordance with pathologic feature of APL. On first visit, immunophenotyping analysis showed positive myeloid markers. Through R-banding, the patient's karyotype was confirmed as 45, XX, rob(13;21) t(15;17) (q22;q21) [6]/45, XX, rob(13;21) [14]. FISH results showed that 68.9% cells were typical t(15;17) pattern. The positive rates of fusion gene of PML-RARα detected by RT-PCR was 25.8%. Patient was treated by induction and consolidation therapy, the karyotype was 45, XX, rob(13;21 )[20] after complete remission. The positive rate of fusion gene of PML-RARα by FISH and its level were 2.5% and 0.003% respectively.</p><p><b>CONCLUSION</b>APL with rob (13;21) t(15;17) (q22;q21) was very rare, which was accorded with clinical and laboratory characteristics of APL. The value of chromosome abnormality as a prognostic marker in APL needs to be further observed..</p>

Effects of decitabine against acute T lymphoblastic leukemia cell line Molt4 / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the effects and possible mechanisms of decitabine on Molt4 in vitro.</p><p><b>METHODS</b>Effects of decitabine on cells proliferation were detected by using CCK-8, the apoptosis by Annexin V-FITC, cell cycles by propidium iodide-FACS. Discrepancy genes were screened by RNA-seq technique. The CpG methylation of lactoferrin (LTF) gene in Molt4 cells were identified by Bisulfite sequencing PCR (BSP). The expression of LTF mRNA in Molt4 by RT-PCR and LTF protein expression were analyzed by Western blot.</p><p><b>RESULTS</b>Decitabine effectively inhibited proliferation and induced apoptosis for Molt4 cells by an time- and dose-dependent manners. Cell cycles were arrested at the G₀/G₁ phase. The promoter methylation degree of LTF gene in Molt4 cells was 72.3% before decitabine treatment and decreased to 45.0% after treatment with 0.50 μmol/L decitabine for 72 h. After the reduction of methylation, expression of its mRNA and protein increased, meanwhile caspase 3 and caspase 9 protein expression levels increased.</p><p><b>CONCLUSION</b>The demethylating drug decitabine can induce apoptosis, detain cell cycle at phase G₀/G₁, inhibit proliferation and up-regulate LTF gene expression in Molt4 cells. LTF may become a new target for acute T lymphoblastic leukemia.</p>

Construction of CD19-CAR retroviral vector and modification of its transduction of human T-lymphocytes / 中华血液学杂志

<p><b>OBJECTIVE</b>To improve the MigR1-CD19-CAR (chimeric antigen receptor) that contains a single chain variable region (scFv) which targeted to CD19 through a retroviral vector transduction efficiency of T-lymphocytes.</p><p><b>METHODS</b>Insert the CD19-CAR fragment into the retroviral vector (MigR1) through recombinant DNA technology, after transfecting plat-A packaging cell lines, viral supernatant was collected to transduce K562 cell line and activated human T-lymphocytes. We used flow cytometry to determine the transduction efficiency and RT-PCR to confirm the transcription of CD19-CAR gene. The ability of the transduced T cells to produce IFN-γ and TNF-α in a CD19-specific manner was measured in an enzyme-linked immunosorbent (ELISA) assay.</p><p><b>RESULTS</b>(1)Using MigR1-CD19-CAR retroviral vector to produce the high titer retrovirus. (2)MigR1-CD19-CAR transduction efficiency of K562 cell line was significantly higher than human T-lymphocytes (P<0.01). (3)120 min centrifugation could significantly improve transduction efficiency of T-lymphocytes to (54.5±14.6)%. (4)Transduction efficiency could be improved by deciding transduce time according to T-lymphocytes proliferation fold in vitro individually, and the highest transduction efficiency in the study was 69.3%. The CD19-CAR gene sequence was transcripted specificly with high efficiency. (5) IFN-γ and TNF-α released by CD19-CAR transduced T-lymphocytes significantly increased to (13 230±1 543) pg/ml and (4 217±211) pg/ml when coculture with CD19-K562 cells.</p><p><b>CONCLUSION</b>We have successfully constructed a second generation CAR which targeted to CD19 through a retroviral vector called MigR1 (MigR1-CD19-CAR). Deciding transduce time according to T-lymphocytes proliferation fold in vitro individually and 120 min centrifugation could improve the CAR transduction efficiency of T-lymphocytes. RT-PCR confirmed that the CD19-CAR gene was specificly transcripted with high efficiency. IFN-γ and TNF-α released by CD19-CAR transduced T-lymphocytes significantly increased when activated by target cells.</p>

Expression of miR-218 in cervical cancer tissues and bioinformatics analysis of predicted target genes / 肿瘤研究与临床

Objective To investigate the expression of miR-218 in cervical cancer tissues and bioinformatically analyze the target genes of miR-218 to provide theoretical basis on further studies of miR-218 functions in cervical cancer.Methods miRNA array was applied to detect miRNA expression profile in cervical cancer tissues,and real-time RT-PCR was used for validation.The bioinformatic analysis of the target genes of miR-218 involved gene ontology and signal transduction pathway enrichment was performed.Results miR-218 expression significantly decreased in cervical cancer tissues compared with that of normal cervical tissues.The functions of predicted target genes of miR-218 were enriched in biological regulation,adhesion and motion,proteometabolism,cellular differentiation,protein binding and other biological processes and molecular functions.According KEGG pathway database,the predicted target genes involved in pathway in cancer,adherent junction,focal adhesion,prostate cancer,chronic myeloid leukemia,melanoma,and other signal transduction pathways.Conclusions miR-218 expression significantly decreases in cervical cancer tissues.Some of the predicted target genes of miR-218 are significantly enriched in tumor related with signaling pathways.

Impact of graft versus host disease on outcome of allogeneic peripherial blood stem cell transplantation for leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the impact of the occurrence and severity of acute and chronic graft versus host disease (GVHD) on the long-term outcome of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for leukemia.</p><p><b>METHODS</b>A total of 231 patients with leukemia, who underwent allo-HSCT in Changhai Hospital from Jan 1st, 2001 to Dec 31th, 2011, were retrospectively analyzed. The overall survival (OS), disease-free survival (DFS), transplantation-related mortality (TRM) and relapse rate (RR) were estimated according to the degree of acute and chronic GVHD.</p><p><b>RESULTS</b>(1) Among the 224 assessable patients, aGVHD was observed in 85 patients, in which 46 developed grade I, 25 grade II and 14 grade III-IV. A total of 213 patients who survived beyond 100 days, cGVHD was observed in 109 patients, in which 84 developed limited cGVHD and 25 extensive cGVHD. (2)The incidence of 3-year OS and EFS of patients with aGVHD grade 0-I was significantly higher than that of grade II-IV (69.5% vs 33.6%, P<0.01; 60.7% vs 33.7%, P<0.01). The 3-year TRM of patients with 0-I grade aGVHD was significantly lower than that of the grade II-IV group (15.0% vs 56.7%, P<0.01). (3)The 5-year OS of patients with limited cGVHD was higher than patients without or with extensive cGVHD (79.8% vs 55.6% and 56.4%, P<0.01 and P=0.038, respectively). The 5-year TRM in patients with extensive cGVHD was higher than patients with limited cGVHD (14.1% vs 41.1%, P=0.018). However, the 5-year RR in patients without cGVHD was higher than patients with limited cGVHD or extensive cGVHD (47.2% vs 10.9% and 12.4%, P<0.01 and P=0.007, respectively). (4) The COX analysis showed that unrelated donor and myeloablative conditioning regimen were main factors affecting aGVHD; Meanwhile, aGVHD was the only factor affecting the cGVHD.</p><p><b>CONCLUSION</b>Our results showed that the patients with acute GVHD tended to have poor outcomes, especially with grade III-IV. On the contrary, the patients with limited cGVHD had lower RR and a long-term DFS.</p>

The analysis on risk factors associated with deep vein thrombosis after stroke / 中国医学装备

Objective: To investigate the risk factors of deep vein thrombosis after stroke. Methods: A retrospective analysis was made on the 420 cases patients with stroke in our hospital, according to the situation thrombosis were divided into thrombosis group and non-thrombosis group, compared two groups of patients with general information, and many factors with the significant indexes were retrospectively analyzed. Results: Age≥70 years old, bedridden, Wells score≥2 points lower limb NHSS score≥3, anticoagulant therapy, higher admission D-2 dimer, lower BI score and non-rehabilitation therapy were independent risk factor for stroke in patients with acute DVT. Age≥70 years old, bedridden, leg NHSS score≥3 points, the acute stage of DVT and BI score were the independent risk factor for stroke patients follow-up period of DVT. Conclusion:There are many related risk factors for stroke in patients with deep vein thrombosis, these factors should be used to carry out monitoring and preventing deep vein thrombosis, active rehabilitation and anticoagulant therapy should be taken to improve the prognosis of patients with stroke.