Objective To evaluate the treatment efficacy of leukocyte reduction in hyperleukocytic acute myeloid leukemia (HAML) patients with leukostasis grading score (LGS).Methods The data of 54 HAML patients were analyzed retrospectively.The relationship between LGS and leukocyte stasis symptoms or early mortality was observed, and the impact of leukapheresis on LGS was analyzed.Results Among 54 patients with HAML, there were 1 case of M1, 16 cases of M2, 10 cases of M4, 20 cases of M5 and 7 cases of unclassified AML.Based on clinical symptoms and LGS system, 3 cases were LGS 0, 15 cases LGS 1, 17 cases LGS 2, and 19 cases LGS 3.In patients with LGS ≤ 2, the rates of type Ⅰ respiratory failure, central nevers system (CNS) symptoms and early mortality caused by leukostasis were significantly lower than those in patients with LGS 3 (P ＜ 0.05).The LGS of HAML patients was reduced by leukocyte reduction therapy (P ＜ 0.000 1).The LGS of HAML patients treated by leukapheresis and low dose chemotherapy was improved significantly than that of patients treated without leukapheresis (P =0.008).Among 37 cases receiving induction chemotherapy, 20 cases reached complete remission (CR) after the first cycle of induction chemotherapy.CR rate of patients with LGS ≤ 2 was no significantly different compared with that of patients with LGS 3 (P =0.703).Conclusions LGS can be used to evaluate the degree and the improvement status of leukostasis after treatment in HAML patients.The early death often occurres in patients with high LGS.Leukapheresis combined with low-dose chemotherapy can effectively improve the LGS of HAML patients.

BACKGROUND: It is confirmed that pathogenicity of biomaterials-centered infection is positive correlated to bacterial biofilm formation of Staphylococcus epidermidis on the surface of catheter-related materials. OBJECTIVE: To analyze the relations between expressions of central venous catheter-related Staphylococcus epidermidis icaA, icaD, transforming growth factor β1 (TGF-β1) and formation of bacterial biofilm. METHODS: The type of Staphylococcus epidermidis in lung cancer cases with catheter-related bloodstream infections (CRBSI) was indentified, followed by bacterial genomic DNA extraction. The expression of biofilm formation-related genes icaA, icaD mRNA and phenotype of biofilm were detected by PCR. The serum TGF-β1 levels in cases with or without CRBSI were measured by enzyme-linked immunosorbent assay.RESULTS AND CONCLUSION: The expression of Staphylococcus epidermidis operon icaA and icaD gene was positive correlated to biofilm formation in lung cancer cases with CRBSI (P < 0.01); particularly, the TGF-β1 levels in CRBSI cases were greater than that of non-CRBSI cases (P < 0.05). The results demonstrated that, central venous catheter infection causes positive Staphylococcus epidermidis icaA and icaD gene expressions in lung cancer cases and is prone to form biofilm, high level of peripheral TGF-β1 may play a positive role in bacterial biofilm formation.

Objective To explore the expression and clinical significance of proliferation associated antigen Ki-67 in acute myeloid leukemia (AML). Methods A total of 45 AML patients (including 36 newly diagnosed AML patients and 9 recurrent AML patients) and 20 healthy volunteers (healthy group) were enrolled from October 2012 to January 2016 in Department of Hematology in Fuxing Hospital. The expression of Ki-67 in bone marrow blast cells were detected by flow cytometry (FCM). The relation between Ki-67 level and clinical characteristics, and the prognostic significance of Ki-67 were studied. Results The positive rate of Ki-67 in newly diagnosed AML, recurrent AML patients and healthy controls were (10.38±8.41)%, (20.99± 11.49) % and (40.77±11.97) %, respectively. The positive rate of Ki-67 in newly diagnosed AML patients or recurrent AML patients were significantly lower than that in healthy controls (all P<0.05). The positive rate of Ki-67 in newly diagnosed AML patients was significantly lower than that in recurrent AML patients (P=0.006). The level of Ki-67 in newly diagnosed AML patients did not significantly correlated with age, FAB subtype, white blood cell count, a history of myelodysplastic syndrome (MDS), level of lactate dehydrogenase (LDH), proportion of blats cells, NPM1 gene mutation, FLT3-internal tandem duplication (ITD) gene mutation, chromosome karyotype and response to induction therapy (all P>0.05). There was no significant difference of overall survival between high Ki-67 expression group and low Ki-67 expression group in newly diagnosed AML patients [(780±110) d vs. (788±118) d, P=0.927]. Conclusions The proliferation of blast cells in AML patients is lower than that in healthy controls. Detecting the level of Ki-67 may provide a reference for choosing the cell cycle specific chemotherapy drugs in clinical practice. Monitoring Ki-67 during AML process contributes to monitoring disease progression and predicting recurrence.

Acute myeloid leukemia(AML)is a heterogeneous myeloid malignancy.Currently,chemotherapy combined with hematopoietic stem cell transplantation is the primary treatment option;however,over-all prognosis remains poor.Gemtuzumab ozogamicin(GO)is a hu-manized CD33 monoclonal antibody conjugated with calicheamicins.It is primarily used to treat CD33-positive AML.Although studies have found that GO can improve the prognosis of patients with CD33-positive AML,some patients with AML do not benefit from it.Recent stud-ies have found that the effect of GO on AML is primarily associated with the expression of CD33 and its single nucleotide polymorphism(SNP),ATP-binding cassette subfamily B member 1(ABCB1)gene and SNP,as well as specific molecular biology and cytogenetics.This paper reviews the research progress on the factors influencing efficacy of GO for treating AML.

Triterpenoid saponins is an important secondary metabolites in medicinal plants, and the tetracyclic triterpenoid saponins, as one of the main categories, have very high medicinal value and market demand. However, there is no systematic review on the research. Thus, the elucidation of the biosynthetic pathway and metabolism of the medicinal plant tetracyclic triterpenoid saponins has important theoretical significance and broad application prospects.In this review, the biosynthetic pathway and metabolic regulation of medicinal plant of tetracyclic triterpenoid saponins were discussed. My focus in this paper was to introduce the research development of several metabolic biosynthetic pathways of tetracyclic triterpenoid saponins centered on dammarane type, and the gene improvement by methods such as metabolic pathway and other technological methods. This study provides references on secondary metabolic framework of medicinal plants of tetracyclic triterpenoid saponins, accurately locating secondary metabolism and its key enzymes, and promoting the sustainable uses of medicinal plant resources.

Lung cancer, as one of the malignant tumors with the fastest increasing morbidity and mortality in the world, has a serious impact on people's health. With the continuous advancement of medical technology, more and more medical methods are applied to lung cancer screening, which has gradually increased the detection rate of early lung cancer. At present, the standard operation for the treatment of early non-small cell lung cancer (NSCLC) is still lobectomy and mediastinal lymph node dissection. There is a growing trend to use segmentectomy for the treatment of early stage lung cancer. Anatomical segmentectomy not only removes the lesions to the maximum extent, but also preserves the lung function to the greatest extent, and its advantages are also obvious. This article reviews the progress of anatomical segmentectomy in the treatment of early NSCLC.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*