Objective: To understand clinical effects of thread-embedding method in treating hypertension.Method: A total of 170 patients were randomized into treatment group and control group on average.Changes of syndrome and blood pressure were observed after four months.Result: Thread-embedding method can obviously lower blood pressure,it showed P0.01 compared with control group;it could improve syndrome of patients,which demonstrated P0.05 compared with control group.Conclusion: Thread-embedding method is an effective method for hypertension in clinic.
PDGFRB fusions in acute lymphoblastic leukemia (ALL) is rare. The authors identified 28 pediatric PDGFRB-positive ALL. They analyzed the features, outcomes, and prognostic factors of this disease.
Nonsmall cell lung cancer (NSCLC), which accounts for the majority of cancer-related deaths globally, remains refractory to available therapies despite advancements in treatment modalities. Hence, there is a pressing need for the development of safer and more efficacious combination therapeutic strategies. Barbiturate derivatives have emerged as promising candidates for cancer chemotherapy. In this study, we introduced JL1-MOF/PNIPAM (JMP), a nanomedicine platform that encapsulates JL1, a barbituric acid derivative, within poly(N-isopropylacrylamide) (PNIPAM) and hafnium-based metal–organic frameworks (Hf-MOF), conferring pH- and temperature-responsive properties. When combined with radiotherapy, JMP demonstrated remarkable antitumor efficacy and extended survival in mice bearing NSCLC xenografts. The mechanisms underlying the antitumor action of JMP encompass several key aspects: (1) suppression of cellular activity, leading to the inhibition of migratory and proliferative capacities of NSCLC cells; (2) induction of apoptosis through the reduction of mitochondrial membrane potential (MMP), disrupting the balance between cell survival and death; and (3) augmentation of reactive oxygen species (ROS) levels, thereby eliciting oxidative stress within NSCLC cells and promoting cellular damage. Notably, JMP exhibited superior efficacy against lung squamous cell carcinoma, a subtype of NSCLC. This study presents a strategy for the synergistic treatment of NSCLC through the use of a nanomedicine formulated from barbiturate derivatives. By optimizing drug bioavailability and elucidating the synergistic mechanisms underlying the enhancement of NSCLC sensitivity through the combination of radiotherapy and chemotherapy, this strategy facilitates the encapsulation and delivery of antineoplastic agents, thereby opening up avenues for the therapeutic intervention of this fatal malignancy.
Objective To investigate the serum IL-18 level in patients with hepatitis B virus infection. Methods The patients were divided into 3 groups: HBsAg+, HBeAg+ and HBcAb+(A), HBsAg+,HBeAb+ and HBcAb+(B), healthy individuals with HBsAb+(as normal controls).Serum IL-18,IL-4,IL-12,IFN-γ level were determined by ELISA method in hepatitis patients and normal controls,ALT,AST,TBIL,gamm GT and HBV DNA were also determined.Results Concentration of serum IL-18 in patients with different types of viral hepatitis was significantly higher than that in healthy volunteers(P0.01).The level of IL-18 in patients with A was the highest among those groups.Moreover,there was a close positive correlations among concentrations of serum ALT,TBIL,HBV DNA and other serum interleukins and IL-18,while HBV DNA and ALT were not.Conclusions The results show that IL-18 and other interleukins construct net effection and participate in live damage in patients with hepatitis B virus infection.
Clostridium difficile can cause pseudomembranous colitis (PMC). Antimicrobial agent exposure is a risk factor for Clostridium difficile-associated disease, whereas the use of antituberculous (anti-TB) agents is not. We herein report a case of PMC-associated with antituberculous therapy. A 63-year-old woman with tuberculous pericarditis treated with anti-TB agents was admitted for abdominal pain and diarrhea. On colonoscopy, mucoid exudate and yellowish plaque lesions were observed. The anti-TB agents were discontinued, and the patient was treated with metronidazole and clostridium butyricum. Her symptoms were relieved and did not recur when the anti-TB agents were restarted. In this report, we review the literature and discuss the pathogenesis, clinical manifestations, diagnosis and treatment of this case.
Background: HLA matched sibling donor HSCT (SDT) had been proved as first selection for thalassemia major (TM) and results of alternative donor (AD) HSCT (ADT) including unrelated donor HSCT (UDT), cord blood transplantation (CBT) and parent donor HSCT (PDT) continuously improved in practice of leukemia HSCT in the last decade, but outcome of ADT in TM were not both the idea or in small-size study. Aims: to fine out a protocol to improve outcomes of ADT for TM patients. Methods: Total 586 consecutive (2008-12-1 to 2016-6-30)TM patients from four pediatric HSCT centers in China were analyzed with median follow-up of 57 (21–116) months. Ratio of male to female was 378 to 208, Median age was 6 (range, 1–23) years old. 10/10 and 9/10 HLA mismatch were defined as full-match (FM) and well-match (WM), respectively. 224 patients underwent SDT (221 FM, 3 WM), 47 FM-CBT, 315 ADT including 275 UDTs (214 FM, 61 WM) and 40 PDTs (21 FM, 19 WM). G-CSF mobilized peripheral blood stem cells was adopted as stem cell source in almost HSCTs but CBTs. All patients received a uniform conditioning with Cyclophosphamide (Cy), Fludarabine, Thiotepa and intravenous Busulfan (Bu). Prophylaxis of GVHD included ATG and Sirolimus or Tacrolimus or Cyclosporine A. Particularity of the protocol was Bu following Cy, a constant target dose (8.0 x108/kg) and multi-drugs combining. Results: 9-year OS, TFS, GR and TRM were 94.4%, 91.6%, 3.9% and 5.6%, respectively, in total 586 HSCTs (Fig.1); 95.9%, 95.5%, 1.4% and 4.1%, respectively, in 224 SDTs, 92.7%, 88.9%, 5.3% and 7.3%, respectively, in 315 ADTs; 92.4%, 88.1%, 6% and 7.6%, respectively, in 275 UDTs (Fig.2); 97.9%, 95.4%, 2.6% and 2.1%, respectively, in 47 sibling CBTs; and 95%, 95%, 0 % and 5%,respectively, in 40 PDTs. ADT had more III-IV aGVHD than MST (7% vs. 1.5%). Likewise, To compare matched HSCT, well-matched HSCT had more ≥ II cGVHD (5.1% vs. 0.8%). Incidence of VOD and cytopenia after engraftment were 2.7%. was 14.5 in total, respectively.Summary/Conclusion: A Bu following Cy, constant target dose and multi-drug combining protocol improved markedly the results in ADT although ADT had more III-IV aGVHD than SDT. When compared with FM-ADT, WM-ADT had more ≥II cGVHD in spite of similar OS, TFS, TRM and GR. We don’t suggest, therefor, to use well matched ADT in TM HSCT.
The rapid determination of pathogenic agent is very important to clinician for guiding their clinical medication. However, current diagnostic methods are of limitation in many aspects, such as detecting range, time-consuming, specificity and sensitivity. In this report, we apply our new-developing pathogen detection method to clarify that Propionibacterium acnes is the causative agent of a two-year-old boy with juvenile myelomonocytic leukemia presenting clinical symptoms including serious rash and hyperpyrexia while traditional clinical methods of diagnosis fail to detect the pathogenic agent and multiple antimicrobial drugs are almost ineffective Propionibacterium acnes is confirmed to be the infectious agent by quantitative real-time polymerase chain reaction. After haploidentical hematopoietic stem cell transplantation, a two-year-old boy with juvenile myelomonocytic leukemia presented to a pediatrist in a medical facility with hyperpyrexia and red skin rash which later changed to black skin rash all over his body. Traditional diagnostic assays were unrevealing, and several routine antimicrobial treatments were ineffective, including the vancomycin, meropenem, tobramycin, cefepime and rifampin. In this case, pediatrist resorted to the next-generation sequencing technology for uncovering potential pathogens so as to direct their use of specific drugs against pathogenic bacteria. Therefore, based on the BGISEQ100 (Ion Proton System) which performed sequencing-by-synthesis, with electrochemical detection of synthesis, and each such reaction coupled to its own sensor, which are in turn organized into a massively parallel sensor array on a complementary metal-oxidesemiconductor chip, we detect and identify the potential pathogens. As a result, we detected a significantly higher abundance of skin bacteria Propionibacterium acnes in patient's blood than controls. It had been reported that patients infected by Propionibacterium acnes almost always had history of immunodeficiency, trauma or surgery. Considering this possible cause, antimicrobial treatment was adjusted to target this rare opportunistic pathogen. Fever and black skin rashes were rapidly reduced after administrating specific drugs against Propionibacterium acnes. This case showed our new-developing pathogen detection method was a powerful tool in assisting clinical diagnosis and treatment. And it should be paid more attention to Propionibacterium acnes infection in clinical cases.
e15130 Background: Immune checkpoint inhibitor(ICI) -associated myocarditis is rare, but it could account for a very high mortality rate. This study reviewed the occurrence of ICI-associated myocarditis in Chinese cancer patients. Methods: A retrospective analysis was made on the occurrence of ICI-associated myocarditis in cancer centers of 12 3A-grade hospitals in China from January 1, 2018 to December 31, 2019. More than 100 patients were treated with ICIs in each center. Results: A total of 2373 patients were treated with ICI alone or in combination. The incidence of ICI-associated myocarditis was 1.05% (25/2373). Of all the data elicited from 16 patients in this study, the tumor types were listed, including: melanoma, lung cancer, renal cancer, urothelial cancer, liver cancer, gastric cancer, colorectal cancer, etc. The 16 patients included 8 male and 8 female with a median age of 65 (36-80). 3 of them had coronary heart disease. The ICI drugs included nivolumab, pembrolizumab and toripalimab, camrelizumab, sintilimab, tislelizumab, atezolizumab. Among them, there were 10 cases of PD-1 inhibitor, 1 case of PD-L1 inhibitor, 5 cases of PD-1 inhibitor combined with chemotherapy or molecular targeted drug. ICI-associated myocarditis occurred in a median of 38 days (2-420) after treatment during which 81.2% (13/16) of them received ICI 1-2 infusions. The common clinical symptoms were palpitation, chest distress and dyspnea, in addition to 8 cases with asthenia, 4 cases with respiratory failure, 2 cases without symptoms. ECG abnormality accounted for 87.5% (14/16). The common abnormalities included: 6 cases of atrial premature contraction, 4 cases of ventricular premature contraction, 3 cases of sinus tachycardia, 1 case of Grade 3 atrioventricular, 1 case of complete right bundle block, and 1 case of acute myocardial infarction. 15 cases of abnormal troponin I or T were observed, followed by CK, CK-MB, MYO and BNP increased. 14 patients were treated with glucocorticoid. 6 patients died with the mortality rate 37.5%(6/16) and 66.7% (4/6) were over 70 years old. Conclusions: The incidence of ICI-associated myocarditis in Chinese patients is low, but the mortality rate is high. Regular monitoring of cardiac biomarkers and ECG is helpful for early diagnosis.
Abstract Background Mecapegfilgrastim, a long‐acting granulocyte‐colony stimulating factor has been approved for reducing the incidence of infection, particularly febrile neutropenia (FN), in China. Objective We conducted a multicenter prospective observational study to examine the safety and effectiveness of mecapegfilgrastim in preventing neutropenia in gastrointestinal patients receiving the chemotherapy, including S‐1/capecitabine‐based regimens or the fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI)/fluorouracil, leucovorin, and oxaliplatin (FOLFOX)/fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFIRINOX) regimens. Method Five hundred and sixty‐one gastrointestinal patients from 40 sites across China, between May 2019 and November 2021, were included. The administration of mecapegfilgrastim was prescribed at the discretion of local physicians. Results The most common adverse drug reactions (ADRs) of any grade for all patients was increased white blood cells (2.9%). Grade 3/4 ADRs were observed for anemia (0.2%), decreased white blood cells (0.2%), and decreased neutrophil count (0.2%). Among the 116 patients who received S‐1/capecitabine‐based chemotherapy throughout all cycles, ADRs of any grade included anemia (1.7%), myalgia (0.9%), and increased alanine aminotransferase (0.9%). No grade 3/4 ADRs were observed. In 414 cycles of patients who underwent S‐1/capecitabine‐based regimens, only one (0.2%) cycle experienced grade 4 neutropenia. In the FOLFIRINOX, FOLFOXIRI, and FOLFOX chemotherapy regimens, grade 4 neutropenia occurred in one (2.7%) of 37 cycles, four (4.7%) of 85 cycles, and two (1.2%) of 167 cycles, respectively. Conclusion In a real‐world setting, mecapegfilgrastim has proven effective in preventing severe neutropenia in gastrointestinal patients following chemotherapy. This includes commonly used moderate or high‐risk FN regimens or regimens containing S1/capecitabine, all of which have demonstrated favorable efficacy and safety profiles.
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