1.ALLOGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION(PBSCT) FOR CHRONIC MYELOGENOUS LEUKEMIA
Xianmin SONG ; Jianmin WANG ; Xiaoping JU
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
20?10 9/L on day 16 (range 9~35).Over grade Ⅱ acute GVHD occurred in three patients(25%) and chronic GVHD occurred in five patients, including three patients with localized chronic GVHD and two with extensive chronic GVHD . The incidence of acute GVHD in allo-PBSCT is similar to allo-BMT, while care should be taken for the occurrence of chronic GVHD.
2.ALLOGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION FOR HEMATOLOGICAL MALIGNANCIES:AN ANALYSIS OF 41 CASES
Xianmin SONG ; Jianmin WANG ; Shupen TONG
Medical Journal of Chinese People's Liberation Army 1982;0(03):-
To analyze the outcome of allogeneic peripheral blood stem cell transplantation(allo PBSCT) for hematological malignancies and prevention of complications, forty one patients with hematological malignancies were treated with allo PBSCT. One regimen of prophylaxis for acute graft versus host disease(GVHD) was the combination of cyclosporine(CsA)and methotrexate(MTX),another mycophenolate mofetil(MMF) with cyclosporine and methotrexate .The results showed that all patients were successfully engrafted .The incidence of over grade Ⅱ acute GVHD after HLA matched transplantation was 21 05%(8/38). Chronic GVHD occurred in 19/25(76%) patients. Three of thirty four patients with acute leukemia(CR 1 ) and CML(CP) after HLA matched transplantation relapsed(8 82%). The disease free survival was 71 43%(10/14) after follow up for more than 2 years. The results suggest that the incidence of acute GVHD in allo PBSCT appears to be similar to allo BMT, but the incidence of chronic GVHD in allo PBSCT is higher than that in allo BMT. Infection and interstitial pneumonitis are the main cause of death.
3.The expression of LIGHT and HVEM in T lymphocytes post allo-HSCT and its relation to the development of GVHD
Xiaoli ZHENG ; Weiping ZHANG ; Jianmin YANG ; Xianmin SONG ; Hong ZHOU ; Lei GAO ; Xiaochen BAO ; Jianmin WANG
Chinese Journal of Organ Transplantation 2010;31(2):89-92
Objective To explore the relationship between the expression of LIGHT/HVEM in patients after allo-HSCT and the development of GVHD. Methods The expression of LIGHT and HVEM in T lymphocytes was detected by FACS Calibur. Results All patients achieved engraftment and hematopoiesis reconstitution, aGVHD occurred in 9 of 26 patients (34.6%) with grade Ⅲ-Ⅳ aGVHD in 3 cases. Seven cases developed cGVHD (26.9%). LIGHT was not expressed in T lymphocytes from healthy donors and patients without GVHD, while constitutive expression of HVEM was detected. When aGVHD occurred, the expression levels of LIGHT in T lymphocytes were significantly increased, while those of HVEM decreased. After GVHD was controlled, the expression levels of those co-stimulators went back to normal On the day 15 after transplantation, the expression of LIGHT in T lymphocytes of patients with aGVHD later was significantly higher, while that of HVEM lower than in those without aGVHD. The patients with aGVHD of grades Ⅲ-Ⅳ demonstrated higher LIGHT expression than in those with aGVHD of grades Ⅰ-Ⅱ. Conclusion The expression of LIGHT and HVEM might be involved in the development of GVHD after allo-HSCT and could be used as one of the useful indicators in predicting aGVHD.
4.A clinical analysis of myelodysplastic syndrome and aplastic anemia combined with autoimmune disease
Xiaoqian XU ; Jianmin WANG ; Shuqing Lü ; Jianmin YANG ; Li CHEN ; Xianmin SONG ; Weiping ZHANG ; Jun HOU
Journal of Leukemia & Lymphoma 2009;18(1):26-28
Objective To investigate the characteristics of pathogenesis and therapeutics of myelodysplastic syndrome(MDS)and aplastic anemia(AA)combined with autoimmune disease(AID).Methods Retrospective analysis and follow-up visit of 111 patients with MDS and 56 patients with AA in our hospital were studied.Results There were 9(8.1%)of 111 patients with MDS and 2 (3.6%)of 55 patients with AA coexistent with AID.Autoimmune hemolytic anemia(36.4%)and Behcet Disease(18.2%)were common among those combined with AID.5 patients had AID proceeding to the occurrence of MDS/AA.4 patients had simultaneous occurrence of AID and MDS/AA.2 patients developed AID three years later after the diagnosis of MDS.Conclusion There was a certain intrinsic relationship between MDS/AA and AID.
5.Constructing laboratory with biosafety conception
Na SHI ; Li SONG ; Jue YE ; Dongqing LIU ; Yanwan ZHANG ; Xianmin MENG
Chinese Journal of Medical Science Research Management 2008;21(2):107-109,85
During the reform of scientific research system the financial and the material resources were centralized and the central laboratory was constructed in cardiovascular Institute & Fu Wai Hospital.The biosafety was implemented thoroughly in this construction process.The brand-new concept war established and the strict rules were formulated through comprehensively study and repeatedly practice.In the meantime,the advanced management and the operation mode were established.A new biosafety lab was constructed under these conditions.
6.Multimodality imaging evaluation of the treatment effect and mechanism of bone marrow mesenchy-mal stem cells transplantation in swine with acute myocardial infarction
Min CAI ; Rui SHEN ; Lei SONG ; Minjie LU ; Shihua ZHAO ; Yue TANG ; Xianmin MENG ; Guisheng FENG ; Zongjin LI ; Zuoxiang HE
Chinese Journal of Nuclear Medicine and Molecular Imaging 2015;(6):420-427
Objective To evaluate the effect and mechanism of bone morrow MSCs transplantation in swine with AMI by cell biology and molecular imaging methods including PET/CT, SPECT, and MRI. Methods Twenty?four Chinese mini?swine ( ( 25 ± 5 ) kg ) were randomly divided into 2 groups: MSCs group ( n=12) and control group ( n=12) . Myocardial infarction was induced in swine hearts by occlusion of the LAD. Thirty minutes later, the MSCs group received autologous MSCs transplantation through in?tramyocardial injection into the peri?infarcted areas (2×107,2 ml) and the control group was subjected to cell culture medium in the same way. At the 1st and 4th weeks after MSCs transplantation, myocardial glu?cose metabolism, myocardial perfusion and cardiac function were evaluated in the two groups through PET/CT, SPECT and MRI. The minimum FDG mean signal intensity ( MSI ) , summed MSI, SRS, SRS%, LVEF, ESV, stroke volume ( SV) and cardiac output ( CO) were calculated. On the 4th week, HE and Masson′s Trichrome stains were performed. Mann?Whitney u test and non?parametric Wilcoxon test were used. Results (1) As evaluated by PET in the 1st week, the MSI and summed MSI in MSCs group were less than those in control group ( 22. 10 ± 3. 18 vs 35. 70 ± 3. 02, z=-2. 65; 1 013. 50 ± 29. 37 vs 1 084. 00 ± 21?15, z=-1.97;both P<0.05) . Compared to the minimum MSI and summed MSI in the 1st week, those in MSCs group increased significantly (34.00±4.25, z=-2.81;1 075.50±28.30, z=-2.80;both P<0?01) in the 4th week. SRS and SRS% decreased in the 4th week compared to those in the 1st week (20.20±2.24 vs 23.80±1.58, (29.80±3.31)% vs (35.10±2.34)%;both z=-2.08, both P<0.05). The averaged MSI in left ventricular infarction area (MSI<70) also increased (56.25±3.54 vs 48.14±2.71;z=-2.80, P<0.01). The a?bove?mentioned parameters had no statistically significant differences in the 4th week compared to those in the 1st week in the control group (all P>0.05). (2) In the 1st week, the perfusion variables had no signifi?cant differences between the two groups ( P>0.05) . There was no significant difference in any perfusion vari?ables between the 1st and 4th weeks in the two groups, respectively (P>0.05). (3) As evaluated by MRI, the cardiac functional parameters had no significant differences between the two groups at the 1st week. In the MSCs groups, LVEF increased significantly ((54.41±2.62)% vs (47.54±2.43)%;z=-2.60, P<0.01) and ESV reduced significantly ((22.85±1.91) vs (27.07±1.67) ml;z=-2.70, P<0.01) in the 4th week com?pared to those in the 1st week; SV and cardiac CO in the 4th week also increased significantly ((29.35± 1?84) vs (26.52±1.46) ml, (2.23±0.14) vs (1.96±0.13) L/min;z=-2.09 and -1.99, both P<0?05). In the control group, there were no significant differences in the cardiac functional parameters between the 1st and 4th weeks ( all P>0.05) . Conclusions Four weeks after MSCs transplantation for AMI, cardiac func?tion and myocardial glucose metabolism improved significantly but without significant myocardial perfusion improvement. Therefore, the cardiac function improvement might be associated with increased myocardial glucose metabolism.
7.Value of circulating galactomannan screening for early diagnosis of invasive aspergillosis in hematological patients
Lili LI ; Jianmin WANG ; Weiping ZHANG ; Jun HOU ; Hui CHENG ; Jianmin YANG ; Xianmin SONG ; Li CHEN ; Shuqing Lü
Journal of Leukemia & Lymphoma 2011;20(7):418-421
Objective To detect the value of serum galactomannan (GM) for diagnosis of invasive aspergillosis (IA) in hematological patients. Methods We prospectively evaluated the diagnostic value of twice-weekly screening for circulating Aspergillus fumigatus with sanditch enzyme linked immunosorbent assay. Results On the basis of the analysis of 472 serum samples from 113 episodes of 92 patients, the sensitivity, specificity, positive and negative predictive values of the sandwich ELISA for proven and probable IA cases were 83.3 %, 91.1 %, 78.9 % and 93.1 %, respectively, when samples with 2 consecutive positive results≥0.7 were used. Furthermore, GM antigenemia was detected before the onset of radiologic signs with a median of 7 days (range, 1-14 days), before isolation of Aspergillus with a median of 4 days (range, 1-7 days),and before anti-fungal therapy with a median of 6 days (range, 1-15 days). Conclusion The sandwich ELISA for GM detection is a reliable method for early diagnosis of IA in patients with haematological diseases.
8. Treatment of 30 elderly patients with advanced myeloid neoplasm by allogeneic hematopoietic stem cell transplantation
Juan YANG ; Yu CAI ; Jieling JIANG ; Liping WAN ; Haitao BAI ; Jun ZHU ; Su LI ; Xianmin SONG ; Chun WANG
Chinese Journal of Hematology 2018;39(8):629-633
Objective:
To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for elderly patients with advanced myeloid neoplasm.
Methods:
From September 2014 to September 2017, 30 consecutive hospitalized 50-plus-year-old myeloid neoplasm patients were retrospectively analyzed. At the time of transplantation, 6 patients reached complete remission and the others remained no remission after treatment. The donors were identical sibling (12), matched unrelated (6) and haploidentical family member (12), respectively. 18 patients received RIC while 12 patients received MAC conditioning regiments consisted of Busulfan, cytarabine, fludarabine or clarithromycin±TBI, respectively.
Results:
Five patients died early in the conditioning stage, 24 patients successfully engrafted. The median time of neutrophil engraftment was 14(10-18) d, whereas platelet engraftment was 15(10-19) d. Six cases (25%) experienced aGVHD grades Ⅱ, 8 cases (32%) cGVHD, including moderate to severe cGVHD in 2 cases (8%). Seven, 7 and 5 cases developed CMV viremia, pneumonia and herpeszoster, respectively after transplantation, but no patients died of infections. The median follow-up time of the patients was 7(0.5-38) months. Twenty-one patients were still alive. The estimated 2 years OS and LFS were 62.5% (95%
9.Analysis of the trend of medication use in patients with ulcerative colitis in a single center from 2010 to 2019
Xianmin XUE ; Song SU ; He ZHOU ; Yujie ZHANG ; Jiayao WANG ; Yirong JIN ; Yongquan SHI ; Kaichun WU ; Jie LIANG
Chinese Journal of Digestion 2021;41(9):624-628
Objective:To analyze the trend of medication use in patients with ulcerative colitis (UC) in recent ten years in at Xijing Hospital, Air Force Military Medical University.Methods:From 2010 to 2019, the clinical data of 1 425 patients diagnosed with UC in the Department of Gastroenterology at Xijing Hospital, Air Force Medical University, were retrospectively collected. According to the period of medication, the UC patients were divided into year 2010 to 2014 group and year 2015 to 2019 group. The general information and the medication trend of year 2010 to 2014 group and year 2015 to 2019 group were analyzed. And then according to gender and age (<40 years old and ≥40 years old), patients were divided into subgroups and analyzed. Independent sample t test and chi-square test were used for statistical analysis. Results:The number of UC patients of year 2010 to 2014 group and year 2015 to 2019 group was 369 and 1 056, respectively. The percentages of patients in remission of the two groups were 9.5% (35/369) and 12.0% (127/1 056), respectively; the percentages of mild patients were 40.4% (149/369) and 41.6% (439/1 056), respectively; the percentages of moderate patients were 37.4% (138/369) and 28.9% (305/1 056), respectively; the percentages of severe patients were 12.7% (47/369) and 17.5% (185/1 056), respectively. There was no significant difference in the proportion of UC patients with different degrees between year 2010 to 2014 group and year 2015 to 2019 group ( P>0.05). There were no significant differences in the age and proportion of female between the year 2010 to 2014 group and year 2015 to 2019 group ((46.2±15.3) years old vs. (44.6±30.6) years old; 45.8%, 169/369 vs. 44.8%, 473/1 056; both P>0.05). The utilization rates of 5-aminosalicylic acid (5-ASA), glucocorticoid, immunosuppressants, and biological agents of the year 2015 to 2019 group were all higher than those of the year 2010 to 2014 group (96.8%, 1 022/1 056 vs. 90.0%, 332/369; 29.9%, 316/1 056 vs. 14.6%, 54/369; 8.4%, 89/1 056 vs. 2.4%, 9/369; 4.8%, 51/1 056 vs. 0.5%, 2/369, respectively), and the differences were all statistically significant ( χ2=26.766, 33.256, 15.315 and 14.038, all P<0.01). Within each of the year 2010 to 2014 group and the year 2015 to 2019 group, there were no significant differences between the female and male in the age, utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents ((47.2±13.6) years old vs. (45.3±16.5) years old, (43.1±12.9) years old vs. (45.8±39.5) years old, 88.8%, 150/169 vs. 91.0%, 182/200; 96.8%, 458/473 vs. 96.7%, 564/583; 13.6%, 23/169 vs. 15.5%, 31/200; 28.3%, 134/473 vs. 31.2%, 182/583; 2.4%, 4/169 vs. 2.5%, 5/200; 7.0%, 33/473 vs. 9.6%, 56/583; 0 vs. 1.0%, 2/200; 5.3%, 25/473 vs. 4.5%, 26/583; all P>0.05). In the patients aged≥40 years old of the year 2010 to 2014 group, the proportion of females was higher than that of the patients aged <40 years old (50.2%, 121/241 vs. 37.5%, 48/128), and the utilization rate of 5-ASA in patients aged ≥40 years old was lower than that of patients aged <40 years old (85.9%, 207/241 vs. 97.7%, 125/128), and the differences were statistically significant ( χ2=5.438 and 12.824, P=0.020 and P<0.01). In the year 2010 to 2014 group, there were no statistically significant differences in the utilization rates of glucocorticoid, immunosuppressants and biological agents between patients aged ≥40 years old and patients aged <40 years old (13.7%, 33/241 vs. 16.4%, 21/128; 2.1%, 5/241 vs. 3.1%, 4/128; 0 vs. 1.6%, 2/128; all P>0.05). In the year 2015 to 2019 group, the utilization rate of biological agents in patients aged≥40 years old was lower than that in patients aged<40 years old (3.7%, 23/630 vs. 46.5%, 198/426), and the difference was statistically significant ( χ2=4.721, P=0.030). In the year 2015 to 2019 group, there were no statistically significant differences in female proportion, utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents between patients aged≥40 years old and patients aged <40 years old (43.7%, 275/630 vs. 46.5%, 198/426; 96.0%, 605/630 vs. 97.9%, 417/426; 29.7%, 187/630 vs. 30.3%, 129/426; 8.6%, 54/630 vs. 8.2%, 35/426; all P>0.05). Conclusions:Compared with year 2010 to 2014, the number of UC patients remarkably increased in the year 2015 to 2019 in the Department of Gastroenterology, Xijing Hospiatal, Air Force Medical University. The utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents all increased in UC patients. The medication trends of UC patients with different gender were almost the same. The medication trends of UC patients with different age were different.
10.Clinical study of 23 cases with pneumocystis pneumonia after allogeneic hematopoietic stem cell transplantation
Zaihong SHEN ; Su LI ; Jun YANG ; Chongmei HUANG ; Huiying QIU ; Kun ZHOU ; Liping WAN ; Xianmin SONG ; Yin TONG
Chinese Journal of Emergency Medicine 2021;30(10):1248-1253
Objective:To analyze the risk factors,clinical characteristics and prognosis of the pneumocystis pneumonia(PCP) that is one of the severe pulmonary complications after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:The clinical features,laboratory data,treatment and outcomes of patients with PCP after allo-HSCT in our hospital from January,2016 to January,2021 were retrospectively collected and analyzed.Results:Twenty three cases who met the clinical diagnostic criteria of PCP were enrolled. The median time of diagnosed as PCP after transplantation was 221 days. The computed tomography (CT) of chest indicated diffuse ground glass opacity.The median of β-1,3-D glucan consentration was 894.25 ng/L, and 91.3% of the cases were over 60 ng/L.The lymphocyte count in 60.9% cases was lower than 1×10 9/L;CD4 +T lymphocyte count in 65.2% of patients was less than 200/μL. Pneumocytis sequences of mNGS were positive in all 21 cases.15 patients were complicated with mixed infection.All patients were treated with TMP-SMX,18 patients were cured and 5 patients died. Conclusions:Patients with PCP after allo-HSCT progresses rapidly, and which is usually with multiple infections. Serum β-1,3-D glucan concentration increase contributes to the diagnosis of PCP.And mNGS in alveolar lavage fluid is highly sensitive to Pneumocystis, which helps patients get treatment in time, so as to reduce mortality.Patients with respiratory failure progressing to a need for mechanical ventilation and high flow oxygen inhalation suggest a poor prognosis.