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1.
Eur J Hosp Pharm ; 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472817

RESUMO

BACKGROUND: In the neonatal population, individual calculation and adjustment of vancomycin (VCM) doses has been recommended based on population pharmacokinetics (PPK) methods. OBJECTIVE: Our previous study established a Chinese neonatal VCM PPK model. The main goal of this study was to evaluate the predictive performance of this PPK model for VCM trough concentration. METHODS: The data on neonatal severe infection patients treated with VCM were retrospectively collected. The predictive performance of this PPK model was expressed using mean prediction error (MPE), mean absolute prediction error (MAPE), sensitivity and specificity. Linear regression analysis was used to compare predicted and measured VCM concentrations. We drew the receiver operating characteristic (ROC) curve to evaluate the predictive efficacy of the ratio of area under the concentration-time curve over 24 hours to minimum inhibitory concentration (AUC0-24/MIC) and trough concentration for clinical efficacy. RESULTS: A total of 40 neonates with Gram-positive bacterial sepsis were included. After VCM treatment, 32 (80%) neonates were clinically cured. Eight cases were a clinical failure: the trough concentrations and AUC0-24 were lower than that of the clinical cure patients (8.70±4.30 vs 14.30±4.50 mg/L, p=0.003; 404.30±122.80 vs 515.40±131.70, p=0.037). The measured and predicted trough concentration were 11.16 (5.96, 16.53) mg/L and 10.13 (6.61, 15.73) mg/L, respectively. The MPE and MAPE were 4.62% and 13.26% (5.30%, 25.88%), respectively. The proportion of MAPE <30% in the adjusted regimen was higher than the initial regimen (89.66% vs 65.00%, p=0.039). Predictions of sensitivity and specificity by this PPK model were 88.24% and 94.29%, respectively. The coefficients of determination of linear regression analysis were 0.9171 and 0.9009 for the initial and adjusted regimen, respectively. The AUC0-24 was correlated with the trough concentration (r=0.587, p<0.001). The ROC curve indicated that the optimal cut-off points for predicting clinical efficacy were AUC0-24/MIC >425.47 and trough concentration >9.45 mg/L. CONCLUSION: This PPK model has good predictive performance in Chinese neonatal patients. Both AUC0-24/MIC and trough concentration can predict the clinical efficacy of antibacterial treatment.

2.
Eur J Hosp Pharm ; 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33414258

RESUMO

BACKGROUND: There is a significant correlation between augmented renal clearance (ARC) and lower serum trough concentrations of vancomycin (VCM) during therapy. There is a need to evaluate the predictive performance of the population pharmacokinetic (PPK) model used for individual calculation of dosage regimens in ARC patients. OBJECTIVE: Our study aimed to estimate the predictive performance differences of the reported VCM PPK software JPKD-vancomycin and SmartDose in patients with varying renal function status, especially those with ARC. METHODS: Patients receiving VCM treatment from May 2014 to December 2019 were enrolled, and divided into the ARC group, the normal renal function (NRF) group, and the impaired renal function (IRF) group. VCM dosage, trough concentration, area under the curve (AUC) and pharmacokinetic parameters were compared among the three groups. The predictive performance of PPK software was expressed using absolute prediction error (APE), sensitivity, specificity, and regression coefficient (r2) of linear regression analysis between the measured VCM trough concentration and the predicted trough concentration. RESULTS: A total of 388 patients were included: 86 patients in the ARC group, 241 patients in the NRF group, and 61 patients in the IRF group. The daily dose of the adjusted regimen in the ARC group was higher than in the NRF group, but the trough concentration was significantly lower than in the NRF group (2.8±0.6 g vs 1.9±0.6 g, p<0.001; 10.5±5.1 mg/L vs 12.9±6.8 mg/L, p=0.030). The percentage of trough concentrations lower than 10 mg/L was 84.9% in the ARC group. Compared with the APE of the initial dosage regimen, the APE of the adjusted regimen calculated by JPKD was lower in the ARC group (p=0.041) and the NRF group (p<0.001). Specificity of JPKD and SmartDose in the ARC group was higher than in the NRF group (p<0.001; p<0.001). According to the linear regression analysis, the coefficients of determination (r2) were all >0.6 for the initial regimen and adjusted regimen of VCM in the ARC and NRF groups, and the r2 of the adjusted regimen of JPKD was >0.8 in the ARC and NRF groups. In the IRF group, 31.1% of patients had a change in serum creatinine (Scr) level of >50%. The r2 increased from 0.527 to 0.7347 in SmartDose and from 0.55 to 0.7802 in JPKD when using Scr at the sampling time. The ARC group showed a significant decrease in AUC (p<0.001) and an increase in clearance rate (p<0.001) when compared to the NRF group. CONCLUSION: ARC was significantly associated with subtherapeutic serum VCM concentration. The pharmacokinetic parameters of VCM were diverse in patients with different renal function status. The PPK model JPKD and SmartDose had a good predictive performance for predicting VCM trough concentrations of the ARC and NRF patients, especially using JPKD for prediction of the adjusted regimen. The change of Scr is a main factor affecting the accuracy of software prediction.

3.
Aging (Albany NY) ; 12(16): 16410-16419, 2020 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-32862152

RESUMO

Although it is known that inflammation is involved in Parkinson's disease (PD) pathogenesis and vitamin K2 (VK2) has anti-inflammatory effects, to date few studies have been reported on the relationship between VK2 and PD development. Herein we presented a case-control study involving 93 PD patients and 95 healthy controls. Overall, the serum VK2 level of PD patients (3.49 ± 1.68 ng/ml) was significantly lower than that of healthy controls (5.77 ± 2.71 ng/ml). When the PD patients were stratified by disease progression, we observed that the serum VK2 level of late stage patients was further decreased to 3.15 ± 1.18 ng/ml while the serum VK2 level of early stage patients was 3.92 ± 2.09 ng/ml. Furthermore, the curve analysis showed that the serum VK2 level decreased gradually with the increment of PD Hoehn-Yahr (H-Y) stage. We also confirmed the dysregulated inflammatory responses and coagulation cascades in PD patients by public dataset, which are associated to the decreased VK2 level. In summary, we found the serum VK2 level in PD patients is lower than that in healthy controls. The decrease of VK2 level may be related to the occurrence and progression of PD by loosening the regulation of inflammatory responses and coagulation cascades signal.

4.
Respiration ; 95(6): 469-477, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29539604

RESUMO

BACKGROUND: The concentration assay of pleural effusion interleukin-27 (IL-27) has raised concern for diagnosing tuberculous pleurisy. Compared with malignant pleural effusion (MPE), the concentration of IL-27 in tuberculous pleural effusion (TPE) increased significantly. Accurate differentiating diagnosis is essential for choosing treatment for pleural effusion. OBJECTIVE: The present meta-analysis is aimed at determining the accuracy of IL-27 in the differential diagnosis between TPE and MPE. MATERIAL AND METHOD: After having retrieved the published studies, we combined the sensibility (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of IL-27 in the diagnosis of TPE compared to MPE using a fixed-effect model. The summary receiver operating characteristic curve was applied to estimate the overall test performance. RESULTS: In total, 550 patients (285 patients with TPE and 265 patients with MPE), included in 7 case-control studies, were enrolled. The summary assessments for IL-27 in the diagnosis between TPE and MPE were: SEN 0.93 (95% CI 0.90-0.96), SPE 0.97 (95% CI 0.94-0.98), PLR 25.88 (95% CI 13.84-48.39), NLR 0.07 (95% CI 0.05-0.11), and DOR 333.26 (95% CI 146.10-760.19), respectively. The maximal joint SEN and SPE was 0.95; the area under the curve was 0.99. CONCLUSION: IL-27 determination is a relatively accurate test for the diagnosis of TPE, which has very high SEN and SPE for discriminating TPE from MPE. The results of IL-27 assays should be interpreted in parallel with clinical findings and the results of conventional tests.


Assuntos
Interleucinas/metabolismo , Derrame Pleural Maligno/diagnóstico , Tuberculose/diagnóstico , Diagnóstico Diferencial , Humanos , Derrame Pleural Maligno/metabolismo , Tuberculose/metabolismo
5.
Acta Pharmacol Sin ; 39(4): 597-606, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29219947

RESUMO

Dendritic cell nuclear protein-1 (DCNP1) is a protein associated with major depression. In the brains of depression patients, DCNP1 is up-regulated. However, how DCNP1 participates in the pathogenesis of major depression remains unknown. In this study, we first transfected HEK293 cells with EGFP-DCNP1 and demonstrated that the full-length DCNP1 protein was localized in the nucleus, and RRK (the residues 117-119) composed its nuclear localization signal (NLS). An RRK-deletion form of DCNP1 (DCNP1ΔRRK) and truncated form (DCNP11-116), each lacking the RRK residues, did not show the specific nuclear localization like full-length DCNP1 in the cells. A rat glioma cell line C6 can synthesize melatonin, a hormone that plays important roles in both sleep and depression. We then revealed that transfection of C6 cells with full-length DCNP1 but not DCNP1ΔRRK or DCNP11-116 significantly decreased the levels of melatonin. Furthermore, overexpression of full-length DCNP1, but not DCNP1ΔRRK or DCNP11-116, in C6 cells significantly decreased both the mRNA and protein levels of N-acetyltransferase (NAT), a key enzyme in melatonin synthesis. Full-length DCNP1 but not DCNP1ΔRRK or DCNP11-116 was detected to interact with the Nat promoter and inhibited its activity through its E-box motif. Furthermore, full-length DCNP1 but not the mutants interacted with and repressed the transcriptional activity of BMAL1, a transcription factor that transactivates Nat through the E-box motif. In conclusion, we have shown that RRK (the residues 117-119) are the NLS responsible for DCNP1 nuclear localization. Nuclear DCNP1 represses NAT expression and melatonin biosynthesis by interacting with BMAL1 and repressing its transcriptional activity. Our study reveals a connection between the major depression candidate protein DCNP1, circadian system and melatonin biosynthesis, which may contribute to the pathogenesis of depression.


Assuntos
Fatores de Transcrição ARNTL/metabolismo , Acetiltransferases/antagonistas & inibidores , Melatonina/biossíntese , Proteínas Nucleares/metabolismo , Proteínas Repressoras/metabolismo , Fatores de Transcrição ARNTL/genética , Acetiltransferases/genética , Sequência de Aminoácidos , Animais , Linhagem Celular Tumoral , Núcleo Celular/metabolismo , Regulação da Expressão Gênica , Técnicas de Silenciamento de Genes , Células HEK293 , Humanos , Sinais de Localização Nuclear , Proteínas Nucleares/genética , Regiões Promotoras Genéticas , Ligação Proteica , RNA Mensageiro/metabolismo , Ratos , Proteínas Repressoras/genética , Deleção de Sequência , Transcrição Genética
6.
Am J Cancer Res ; 7(11): 2144-2156, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29218239

RESUMO

Therapeutic antibodies targeting colony stimulating factor 1 receptor (CSF-1R) to block colony stimulating factor-1/colony stimulating factor 1 receptor (CSF-1/CSF-R) signaling axis have exhibit remarkable efficacy in the treatment of malignant tumor. Yet, little is known about the effects of intrinsic CSF-1R in human non-small-cell carcinoma (NSCLC). Here we demonstrated that NSCLC cell-intrinsic CSF-1R promoted cells growth and metastasis both in vitro and in vivo. CSF-1R knocked-down by transfecting with shRNA target CSF-1R suppressed NSCLC cells proliferation and tumor growth in nude mice. Conversely, ectopic expression of CSF-1R promoted cells proliferation and accelerated tumor growth. Mechanistically, the NSCLC CSF-1R modulated downstream effectors of phosphatidylinositol 3-kinase (PI3K) signaling. In addition, CSF-1R overexpression significantly enhanced NSCLC cells mobility, invasion and epithelial-mesenchymal transition (EMT) process, whereas silencing CSF-1R inhibits these phenotypes. Microarray analysis suggested that Wnt family member 3a (Wnt3a) function as a downstream factor of CSF-1R. On account of this, we future identified CSF-1R/Wnt3a a signaling pathway sustained NSCLC cells metastasis. Finally, in patients, CSF-1R and Wnt3a expression positively correlated with the of NSCLC patients. Our results identify NSCLC cell intrinsic functions of CSF-1R/Wnt3a axis in dissemination of NSCLC.

7.
Am J Transl Res ; 9(7): 3304-3314, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28804548

RESUMO

Studies have demonstrated that the abnormal expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) is associated with multiple malignancies, but its functional role in non-small-cell lung carcinoma (NSCLC) metastasis remains to be elucidated. In the present study, we investigated the role of PTEN in regulating proliferation, migration, and invasion of NSCLC cells by establishing NSCLC cell strains with constitutively silenced or elevated PTEN expression. We demonstrated that ectopic expression of PTEN inhibits migration and invasion of NSCLC cells in vitro through wound healing and Transwell invasion assays. Furthermore, PTEN overexpression in NSCLC cells greatly inhibits cell viability and colony formation, which was confirmed by MTT and colony formation assays. Conversely, further analysis indicated that suppression of PTEN expression via shRNA promotes metastasis and growth of NSCLC cells. Finally, our findings demonstrate that PTEN promotes invasion and migration of NSCLC cells through the integrin αVß6 signaling pathway. Overall, this study provides novel insights into the role of PTEN as a crucial regulator of NSCLC cell metastasis, and suggests that targeted treatment of PTEN-expressing tumors serves as a new therapeutic target for NSCLC.

8.
Am J Transl Res ; 9(6): 2760-2774, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28670367

RESUMO

Non-small cell lung cancer (NSCLC) constitutes the main cases of lung cancer and is the world's most common and lethal cancer owing to regional invasion or distant metastasis. Growing morbidity and lethality demonstrates that valid molecular target in management of NSCLC metastasis is still absence. The receptor of advanced glycation end-products (RAGE) has been identified as an oncogenic gene and appears to promote the growth and metastasis of various cancers. Here, we investigated if RAGE targeted by RNA interference (RNAi) might have certain effect on the restraint of the growth of NSCLC and tumor metastasis. Wound healing and Transwell invasion assays indicated that RAGE favored the metastatic capabilities of NSCLC H1975 cells. Besides, soft-agar colony assay revealed that silencing RAGE significantly blocked colony-forming capability of H1975 cells in vitro. Furthermore, we observed that RAGE participated in H1975 cells growth, metastasis and epithelial-mesenchymal transition (EMT) by regulating interdict crux intracellular signaling pathways, including phosphatidylinositol-3 kinase/serine-threonine kinase (PI3K/AKT) and V-Ki-ras2 kirsten rat sarcoma viral oncogene homolog/RAF proto-oncogene serine/threonine-protein kinase (KRAS/RAF-1). In xenograft model, significantly reduction intumor growth and Ki67 expression was demonstrated in nude mice inoculation with RAGE down-regulation H1975 cells. To conclude, our study demonstrated that RAGE played a crucial role in the metastasis and growth of NSCLC by regulating PI3K/AKT and KRAS/RAF-1 signaling pathways, thereby might be a promising therapeutic target for NSCLC.

9.
Acta Pharmacol Sin ; 37(9): 1178-89, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27498777

RESUMO

AIM: Increasing evidence has shown that environmental factors such as rotenone and paraquat induce neuroinflammation, which contributes to the pathogenesis of Parkinson's disease (PD). In this study, we investigated the molecular mechanisms underlying the repression by menaquinone-4 (MK-4), a subtype of vitamin K2, of rotenone-induced microglial activation in vitro. METHODS: A microglial cell line (BV2) was exposed to rotenone (1 µmol/L) with or without MK-4 treatment. The levels of TNF-α or IL-1ß in 100 µL of cultured media of BV2 cells were measured using ELISA kits. BV2 cells treated with rotenone with or without MK4 were subjected to mitochondrial membrane potential, ROS production, immunofluorescence or immunoblot assays. The neuroblastoma SH-SY5Y cells were treated with conditioned media (CM) of BV2 cells that were exposed to rotenone with or without MK-4 treatment, and the cell viability was assessed using MTT assay. RESULTS: In rotenone-treated BV2 cells, MK-4 (0.5-20 µmol/L) dose-dependently suppressed the upregulation in the expression of iNOS and COX-2 in the cells, as well as the production of TNF-α and IL-1ß in the cultured media. MK-4 (5-20 µmol/L) significantly inhibited rotenone-induced nuclear translocation of NF-κB in BV2 cells. MK-4 (5-20 µmol/L) significantly inhibited rotenone-induced p38 activation, ROS production, and caspase-1 activation in BV2 cells. MK-4 (5-20 µmol/L) also restored the mitochondrial membrane potential that had been damaged by rotenone. Exposure to CM from rotenone-treated BV2 cells markedly decreased the viability of SH-SY5Y cells. However, this rotenone-activated microglia-mediated death of SH-SY5Y cells was significantly attenuated when the BV2 cells were co-treated with MK-4 (5-20 µmol/L). CONCLUSION: Vitamin K2 can directly suppress rotenone-induced activation of microglial BV2 cells in vitro by repressing ROS production and p38 activation.


Assuntos
Poluentes Ambientais/toxicidade , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Microglia/efeitos dos fármacos , Rotenona/toxicidade , Vitamina K 2/análogos & derivados , Animais , Técnicas de Cultura de Células , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Interleucina-1beta/metabolismo , Camundongos , Microglia/imunologia , NF-kappa B/metabolismo , Neuroimunomodulação/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Vitamina K 2/farmacologia
10.
Huan Jing Ke Xue ; 35(10): 3782-8, 2014 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-25693383

RESUMO

Hydrated ferric oxide was successfully impregnated onto tea waste by precipitation to obtain a new sorbent named HFO-TW, the adsorption characteristics of which toward Pb(II) in aqueous solution was investigated by evaluating the effects of pH value, contact time, coexisting ion, temperature, and initial concentration of Pb(II). The Pb(II) sorption onto HFO-TW was pH- dependent, and the higher pH value was more helpful for Pb(II) adsorption onto HFO-TW in the pH range of 2.5-7. Lead sorption speed was quick and could reach equilibrium within 100 min, and the kinetics curve could be fitted well by both pseudo-first and pseudo-second models. The related coefficient was 98.8%. HFO-TW exhibited highly selective lead retention and the adsorption capacity of Pb(II) onto HFO-TW was declined by only 12.1 mg · g(-1) and 8.1 mg · g(-1) in the presence of competing Ca(II), Mg(II) at 50 times of the target ion. In addition, Pb(II) sorption onto HFO-TW could be described satisfactorily by Langmuir model, and the maximal sorption capacity calculated by Langmuir equation was 89.43 mg · g(-1), which was much higher than the unmodified tea waste and other bio-sorbents. All the results validated that HFO-TW was a promising sorbent for removal of lead from waters.


Assuntos
Compostos Férricos/química , Chumbo/química , Chá , Poluentes Químicos da Água/química , Purificação da Água/métodos , Adsorção , Concentração de Íons de Hidrogênio , Cinética , Temperatura , Água/química
11.
Chin Med J (Engl) ; 123(14): 1915-23, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20819578

RESUMO

BACKGROUND: Ursolic acid (UA) is a ubiquitous molecule in the plant kingdom with specific anticancer effects that have been shown in vitro and in vivo. Although UA can inhibit the proliferation of liver cancer cells and induce apoptosis of many types of tumor cells, the molecular mechanism of its anti-hepatoma activity is still not well defined. The objective of this study was to investigate the inhibitory effect and mechanisms of UA on the human hepatoma cell line SMMC-7721. METHODS: After treatment with UA, the growth inhibition of SMMC-7721 cells was assessed by MTT assay. Cells were also evaluated by flow cytometric analysis, Wright-Giemasa staining, Hoechst 33258 staining and transmission electron microscope after they were induced by UA. DNA microarray technology was used to investigate the gene expression pattern of SMMC-7721 cells exposed to UA 40 micromol/L. The molecular mechanism of cells death was analyzed by real-time RT-PCR and Western blotting. RESULTS: The proliferation of SMMC-7721 cells was significantly inhibited in a dose- and time-dependent manner after UA treatment. UA induced cell cycle arrest and apoptosis. The DNA microarray analysis indicated that 64 genes were found to be markedly up- or down-expressed, including GDF15, SOD2, ATF3, and fos. The result of Western blotting showed the apoptotic proteins p53 and Bax were up-regulated while the anti-apoptotic protein Bcl-2 was down-regulated. Real-time RT-PCR confirmed UA could up-regulate the mRNA expressions of GDF15, SOD2, ATF3 and down-regulate the mRAN expression of fos. Meanwhile these effects were partly blocked by pretreatment with the p53 inhibitor Pft-alpha. CONCLUSION: Activation of the p53 pathway is involved in UA inhibition of SMMC-7721 human hepatocellular carcinoma cell growth and induction of apoptosis.


Assuntos
Apoptose/efeitos dos fármacos , Carcinoma Hepatocelular/tratamento farmacológico , Triterpenos/uso terapêutico , Proteína Supressora de Tumor p53/metabolismo , Western Blotting , Carcinoma Hepatocelular/metabolismo , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Citometria de Fluxo , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/metabolismo , Microscopia Eletrônica de Transmissão , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais/efeitos dos fármacos
12.
Zhonghua Jie He He Hu Xi Za Zhi ; 33(4): 273-5, 2010 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-20646458

RESUMO

OBJECTIVE: To investigate the clinical value of pleural fluid adenosine deaminase (ADA) activity in differentiating tuberculous pleural effusions (TPE) from malignant effusions. METHODS: The serum and pleural adenosine deaminase activity of 91 cases confirmed by pleural biopsy through medical thoracoscopy were retrospectively analyzed. TPE was confirmed in 49 cases and malignant effusion in 42 cases. The optimal cutoff for TPE was determined by using the ROC curve. RESULTS: The mean pleural ADA was significantly (t = 7.383, P < 0.01) higher in PTE (46 +/- 26) U/L as compared to malignancy (16 +/- 8) U/L, so was the pleural fluid/serum ADA ratio (4.1 +/- 4.0 vs 1.76 +/- 1.2, t = 3.852, P < 0.01), but there was no statistically significant difference between malignant and tuberculous effusion in serum ADA activity [(13 +/- 5) U/L vs (12 +/- 6) U/L, t = 1.582, P > 0.05]. The cutoff value of pleural ADA for PTE was 28.7 U/L, with a sensitivity of 75.5% and a specificity of 95.2%. CONCLUSIONS: Pleural fluid, but not serum, ADA activity, can be used for the differentiation between tuberculous and malignant pleural effusions.


Assuntos
Adenosina Desaminase/análise , Tuberculose Pleural/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/enzimologia , Estudos Retrospectivos , Tuberculose Pleural/enzimologia , Adulto Jovem
13.
Zhonghua Yi Xue Za Zhi ; 87(38): 2714-6, 2007 Oct 16.
Artigo em Chinês | MEDLINE | ID: mdl-18167252

RESUMO

OBJECTIVE: To summarize the clinical features and treatment outcomes of peripheral T-cell lymphoma, unspecified (PTCL-US). METHODS: The medical records of 78 patients with PTCL-US classified according to the revised European and American lymphoma (REAL) or WHO criteria, 58 males and 20 females, aged 39 (9 - 75), 46 of them (59%) being at the stages III/VI and 40 cases (51.2%) with extranodal involvement), treated from Jan 1994 to Dec 2004 in the Cancer Hospital/Institute, Chinese Academy of Medical Sciences, were retrospectively analyzed. The patients were followed up for 58 months. RESULTS: Thirty patients (38%) were with high level lactate dehydrogenase (LDH). 34 cases (43. 7%) were treated with chemoradiotherapy, and 43 (55%) with chemotherapy alone. After the first line treatment the complete recovery (CR) rate and partial recovery (PR) rate were 55.1% (43/78) and 25.6% (20/78) respectively. 15 cases (19.2%) showed progressive disease (PD) or stable disease (SD). Achieving CR or PR after first-line treatment, 13 cases received autologous peripheral blood stem cell transplantation (APBSCT). The 5-year overall survival rate (OS) and 5-year progressive-free survival rate (PFS) were 41.4% and 33.8% respectively. The 5-year OS of the CR, PR, and PD/SD groups were 65.1%, 21.9%, and 0% respectively. The 5-year OS for the patients treated with first-line APBSCT was 61.5%, not significantly different from that of the patients treated with conventional dose therapy alone (52.3%, P = 0.894). Univariate analysis showed that the factors associated with a worse OS included stage III/IV (P = 0.001), high LDH (P = 0.0001), behavior state score >or= 2 (P = 0.001), and bone marrow involvement (P = 0.011). Multivariate analysis showed that LDH level was an independent factor predictive of survival (P = 0.001). International prognostic index and prognostic index for peripheral T-cell lymphoma both predicted the overall survival. CONCLUSION: A rare lymphoma with aggressive presentation, PTCL-US responds poorly to conventional treatment. The prognosis of the cases with high risk is bad. APBSCT is safe and feasible when CR or PR is achieved after first line treatment.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma de Células T Periférico/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Linfoma de Células T Periférico/mortalidade , Linfoma de Células T Periférico/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
14.
Ai Zheng ; 25(4): 481-5, 2006 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-16613685

RESUMO

BACKGROUND & OBJECTIVE: Head and neck lymphoma develops predominantly in the tonsil. This study was to investigate the clinical features of primary non-Hodgkin's lymphoma (NHL) of the tonsil, and to explore possible ways to improve the prognosis and quality of life of the patients after treatment. METHODS: Clinical data of 89 naive patients with NHL of the tonsil, treated from May 1990 to Jan. 2003, were retrospectively reviewed. All patients were confirmed pathologically and classified according to revised European-American Lymphoid Neoplasms and World Health Organization Classification, and staged according to the Ann Arbor classification. Stage I-II patients received radiochemotherapy-predominant treatment, whereas stage III-IV patients received chemotherapy-predominant treatment. RESULTS: Of the 89 cases, 60 (67%) were diffuse large B-cell subtype, 11 (12%) were peripheral T-cell subtype, 5 (6%) were indolent lymphoma, 1 was anaplastic large T-cell lymphoma, and 1 was T lymphoblastic lymphoma; 81 (91%) were stage I-II disease. Of the 89 patients, 58 (72%) received radiochemotherapy, 19 (21%) received radiotherapy alone, 3 received chemotherapy alone, and 1 received radiochemotherapy combined with rituximab. The 5-year overall survival rate was 80%, that of stage I-II patients was 84%. Cox regression multivariate analysis showed that the survival rate was correlated to the value of international prognostic index (IPI), and whether the patient had primary refractory or relapsed disease, but was not correlated to sex, age, pathologic subtype, B symptoms, and bulky disease. CONCLUSIONS: Most patients with NHL of the tonsil are at early stages, with good prognosis. Diffuse large B-cell lymphoma is the most common pathologic subtype. Primary refractory, relapse, and IPI>1 are independent prognostic factors.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma não Hodgkin , Neoplasias Tonsilares , Adolescente , Adulto , Idoso , Criança , Terapia Combinada , Ciclofosfamida/uso terapêutico , Intervalo Livre de Doença , Doxorrubicina/uso terapêutico , Resistencia a Medicamentos Antineoplásicos , Feminino , Seguimentos , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/radioterapia , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/radioterapia , Linfoma de Células T Periférico/tratamento farmacológico , Linfoma de Células T Periférico/patologia , Linfoma de Células T Periférico/radioterapia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prednisona/uso terapêutico , Qualidade de Vida , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias Tonsilares/tratamento farmacológico , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/radioterapia , Vincristina/uso terapêutico , Adulto Jovem
16.
Zhonghua Yi Xue Za Zhi ; 85(44): 3110-4, 2005 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-16405813

RESUMO

OBJECTIVE: To study the pharyngeal cross-sectional area and collapsibility among the patients with obstructive sleep apnea hypopnea syndrome (OSAHS), simple snorers, and normal persons. METHODS: 171 patients with OSAHS, 44 with mild, 51 with moderate, and 56 with severe OSAHS, 47 simple snorers, and 47 healthy subjects underwent upper airway cross-sectional area measurement using acoustic pharyngometer at the conditions of functional residual capacity (FRC) and residual volume (RV) in the upright sitting position. RESULTS: When the lung volume decreased from the condition of FRC to the condition of RV the pharyngeal cross-sectional area decreased from 2.63 cm(2) +/- 0.42 cm(2) to 1.96 cm(2) +/- 0.35 cm(2) for the simple snorers, 2.70 cm(2) +/- 0.44 cm(2) to 1.78 cm(2) +/- 0.39 cm(2) for the mild OSAHS patients, from 2.62 cm(2) +/- 0.52 cm(2) to 1.79 cm(2) +/- 0.37 cm(2) for the moderate OSAHS patients, and from 2.57 cm(2) +/- 0.46 cm(2) to 1.75 cm(2) +/- 0.40 cm(2) for the severe OSAHS patients, all with higher decrease rates (33.93% +/- 11.81%, 31.13% +/- 10.76%, and 31.31% +/- 13.44%) than that of the normal persons (25.07% +/- 10.39%), smaller than that for the normal persons (21.11% +/- 8.19%, from 3.05 cm(2) +/- 0.6 cm(2) to 2.38 cm(2) +/- 0. 47 cm(2), all P < 0.05). The change ratios of the 3 OSAHS groups were significantly higher than that of the simple snorer group (all P < 0.01). This indicated that the pharynges of OSAHS patients were more collapsible. CONCLUSION: Snorers with or without apnea have smaller pharyngeal cross-sectional area than nonsnorers. The collapsibility of the upper airway is greater in both OSHAS patients and simple snorers than in healthy subjects.


Assuntos
Faringe/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Faringe/patologia , Polissonografia , Rinometria Acústica , Apneia Obstrutiva do Sono/patologia , Capacidade Pulmonar Total
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