Purpose: To evaluate the clinical efficacy of V AD regimen in the treatment of newly diagnosed stage III multiple myeloma (MM). Methods:26 patients with newly diagnosed stage Ⅲ multiple myel oma were treated with VAD regimen. VAD solution consisted of vincristine (VCR) , doxorubicin(ADR),dexamethasone (Dex).Three continuous treatments in one treatm ent course were considered evaluable.Evaluation included results of serum myelom a protein(M-protein); renal function; proteinuria of 24-hours; bone marrow ; per ipheral blood et al.The side reactions were recorded. The clinical efficacy eval uation was divide into complete response(CR),partial response(PR),minimal-respon se(MR), no change(NC) , plateau progression.Results:5 cases achieved CR(19.3%), 13 cases PR(50%),6 case s MR (23%), 2 cases no change (7.7%). Overall response rate was 92.3%, median su rvival duration was 7 to 84 months (29.6?17months). Conclusions:Achieved marked clinical efficacy with VAD agent in newly diagnosed stage III multiple myeloma. Especially,the patients with renal failure and serious clinical manifestation improved rapidly and significantly.

Objective To observe the effect of modified Qinghao Biejia Decoction ( QBD) on Th17 cells and renal pathology of MRL/lpr mice with spontaneous systemic lupus erythematosus. Methods Thirty-two female MRL/lpr mice aged 8 to 10 weeks were divided into 4 groups: model group, Chinese medicine group, prednisone group, and combination group, 8 mice in each group. Eight female C57BL/6 mice aged 8 to 10 weeks served as normal control. Mice in Chinese medicine group were given concentrated solution of modified QBD (19.25 g·kg-1·d-1), mice in the prednisone group were given water solution of prednisone acetate (8.75 mg·kg-1·d-1) , mice in the combination group were given the above two kinds of medicine, and mice in the model group and normal control group were given physiological saline. After medication for 7 weeks, spleens and kidneys in all of the groups were taken out for the experiment. Th17 cells in splenic mononuclear cell suspension were detected by flow cytometry, the pathological changes of renal tissue were observed under light microscope, and activity index (AI) of renal tissue in lupus nephritis mice was scored. Results The proportion of Th17 cells in the model group was significantly higher than that of normal control group ( P<0.05) . The proportion of Th17 cells in Chinese medicine group and combination group was lower than that of the model group ( P<0.05) , and prednisone group had higher proportion of Th17 cells than Chinese medicine group ( P<0.05) . Compared with the model group, pathological changes of renal tissue were relieved, and AI scores were decreased in Chinese medicine group, the prednisone group and the combination group ( P<0.05) . Except for the normal control group , AI scores in all groups were positively correlated with the proportion of Th17 cells ( r=0.77, P<0.01) . Conclusion Modified QBD can inhibit the expression of Th17 cells and improve the pathological changes of MRL/lpr mice with lupus nephritis.

Objective To evaluate the clinical efficacy and adverse effects of CAG regimen in treatment of primary, refractory and relapsed acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS), and analyse the factors influencing long-term survival. Methods Sixty-one patients with AML ( primary, n = 27; refractory, n = 18; relapsed, n = 16) and 9 patients with MDS were treated with CAG regimen. Examinations on liver and renal function, electrocardiogram and bone marrow cytology were performed before and after treatment, and adverse effects of CAG were observed. Short-term efficacy was evaluated based on clinical manifestation, peripheral blood and bone marrow cytologic examinations. Patients were followed up, overall survival ( OS) and disease free survival ( DFS) were analysed, and long-term efficacy of CAG regimen was evaluated. The factors influencing long-term survival were analysed by Log-rank test of survival curve. Results After a course of treatment by CAG regimen, the total effective rate was 71% , and 34 patients (49%) experienced complete remission. The median time of follow up was 45 months, the median OS was 28 months, and the median DFS was 23 months. Age, level of lactate dehydrogenase (LDH), remission condition after a course of treatment by CAG regimen and adoption of HD-Ara-C regimen as consolidation treatment were influencing factors for OS and DFS. The dominant clinical adverse effects were bone marrow depression, with 13 d as the median duration of agranulocytosis ( neutrophil <0.5 ×10~9/L) and 9 d as the median duration of thrombocytopenia (platelet <20 ×10~9/L). Conclusion CAG regimen may lead to favourable therapeutic effects in treatment of primary, refractory and relapsed AML and high risk MDS, and may yield less adverse effects and better long-term therapeutic effects. Age, level of LDH, remission condition after a course of treatment and adoption of HD-Ara-C regimen as consolidation treatment are dominant influencing factors for survival.

Adolescent ; Adult ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Poisoning ; epidemiology ; Young Adult

Purpose To reconstruct perfusion computerized tomography angiography (PCTA) images from the volume data of low-dose brain CT perfusion scan with iterative reconstruction algorithm, to analyze the capability of PCTA on the display of brain arteries, and to explore the methods to reduce the radiation dose for stroke CT examinations. Materials and Methods This was a prospective study, 55 patients (605 arterial segments) with clinical diagnosis of ischemic cerebrovascular disease underwent cranial CT scan, iterative algorithm low-dose brain CT perfusion scan and conventional cranial CTA examinations using a 256-slice spiral CT. 11 segments of the cerebral artery in each case were analyzed using conventional CTA results as the reference standard to assess the display of brain arteries in PCTA. Results Effective dose of CT perfusion scan was 2.12 mSv. Among the 580 vessel segments which CTA showed no stenosis or stenosis<30%, only one vessel segment of PCTA was inconsistent with CTA; among the 19 vessel segments which CTA showed stenosis≥30%but not occluded, results of 12 vessel segments in PCTA were consistent with CTA, while the stenosis states were exaggerated by PCTA in the other seven vessel segments;results of the two methods were consistent in six vessel segments which was found occluded by CTA. Kw values were >0.75 for the consistency test between PCTA and CTA on the display of brain arteries. Conclusion Radiation dose of iterative algorithm cranial CT perfusion scan is significantly lower, and the images reconstructed from the volume data of perfusion CT are highly consistent with the CTA results, thus are able to meet the needs of the clinical diagnosis.

Abstract: Objective　To identify the species of Mycobacteroides abscessus complex (MABC) in patients with pulmonary infection from the Second Affiliated Hospital of Hainan Medical University, and to investigate the species types, drug sensitivity and population distribution of MABC in pulmonary infection in Hainan. Methods　Respiratory tract specimens were collected from suspected tuberculosis patients who visited the Second Affiliated Hospital of Hainan Medical University from January 2014 to December 2021 and cultured for Mycobacterium isolation. Non-tuberculous mycobacteria (NTM) strains were preliminarily identified by p-nitrobenzoic acid/thiophen-2-carbohydrazide (PNB/TCH) medium and DNA microarray chip, and then MABC and its subspecies were identified by hsp65 and rpoB gene sequencing. In vitro antimicrobial susceptibility test was performed by broth microdilution method. Results　A total of 3 025 respiratory specimens from suspected pulmonary tuberculosis patients were collected during the study period. Among the 123 patients with identified MABC isolates, 124 MABC strains were isolated and identified, including 74 strains of Mycobacteroides abscessus subsp. abscessus, 38 strains of Mycobacteroides abscessus subsp. massiliense and 12 strains of Mycobacteroides abscessus subsp. bolletii. Among them, 118 patients had single MABC subspecies infection, one patient had mixed infection with two MABC subspecies, two patients had mixed infection with MABC and other NTM, and two cases had mixed infection with MABC and M.tuberculosis. There were more female patients than male patients with a ratio of 1:0.64, and those aged 50 and above amounted to 76.42% (94/123, 95%CI: 67.93%-83.61%). There was no significant difference in age distribution between male and female patients (Z=-0.944, P=0.347). The drug susceptibility results showed that all MABC strains were sensitive to Tigecycline (TGC), with a resistance rate of 0.81% (1/124) to Amikacin (AK), and resistance rates of 6.45% (8/124), 32.26% (40/124), and 74.19% (92/124) to Cefoxitin (FOX), Linezolid (LZD), and Imipenem (IPM), respectively. For Clarithromycin (CLR), MABC showed induced resistance , and there was a statistically significant difference in the CLR (14D) resistance rates among the three subspecies (χ2=66.335, P<0.001). The resistance rates to Tobramycin (TOB), Doxycycline (DOX), Moxifloxacin (MFX), Ciprofoxacin (CIP), Trimethoprim/Sulfamethoxazole (TMP-SMX), and Amoxicillin/Clavulanic acid (AMC) were high, all >80%. Conclusion　 In Hainan Province, pulmonary infections with MABC are mainly caused by Mycobacteroides abscessus subsp. Abscessus, which show high rates of inducible resistance to CLR. Timely and accurate identification of MABC to subspecies and drug susceptibility testing are of significant important for clinical decision-making.

Objective To analysis long-term effects and safety of arsenic trioxide (ATO)-based induction and maintenance therapy in newly diagnosed acute promyelocytic leukemia (APL). Methods Retrospective analysis induction remission and post-remission treatment of 62 newly diagnosed APL patients was performed. These cases were followed up for 5 and 7 years. Results The complete remission (CR) rate was similar in ATO/all-trans retinoic acid (ATRA) induction group and ATRA/chemotherapy induction group.However, the former group has the shorter time to CR. The negative rate of PML-RARα fusion gene after induction without ATO was less than that of ATO group (86.2 % vs 56.3 %, P ＜0.05). After CR, the 5-year overall survival (OS) between ATO-base rotation maintenance group and chemotherapy-base rotation maintenance group showed that the former was (94.4±5.4) %, the latter is (45.5±10.2) %; 7-year OS was (52.5±23.7) % and (27.3±9.3) %; 5-year disease free survivals (DFS) was (94.7±5,5) % and (41.3±10.1) %; 7-year DFS was (52.6±23.7) % and (27.5±9.4) %. There was significant different in 5-year or 7-year OS and DFS between two groups (P ＜0.05). The relapse rates of the two groups in post-remission treatment were 14.7 % and 37.0 % (P ＜0.05). Conclusion ATO combined ATRA induction therapy increased the negative rate of PML-RARα fusion gene. ATO-base rotation maintenance improved long-term outcome and decreased the rate of relapse. Furthermore, ATO appeared to be generally safe and well tolerated.

OBJECTIVETo investigate the effects of red orpiment on cell morphology, expression of promyelocytic leukemia (PML) mRNA and its protein localization in NB4 and HL-60 cell lines.

METHODSCell morphology was assayed by Wright's staining and fluorescence staining, while PML mRNA expression was determined by RT-PCR. PML protein localization by evaluated by immunofluorescence staining.

RESULTSThe typical apoptosis was found in NB4 and HL-60 cells after treatment with red orpiment. The fusion protein was no longer observed in NB4 cells, PML protein was relocated, and then degraded. In HL-60 cells, PML protein underwent a similar progress. The expression of promyelocytic leukemia (PML) mRNA was not changed in the treated cells.

CONCLUSIONRed orpiment inhibits the proliferation of leukemia cells by inducing them to undergo apoptosis.

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Arsenicals ; pharmacology ; HL-60 Cells ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; metabolism ; pathology ; Medicine, Chinese Traditional ; Neoplasm Proteins ; analysis ; genetics ; Nuclear Proteins ; Promyelocytic Leukemia Protein ; RNA, Messenger ; analysis ; Transcription Factors ; analysis ; genetics ; Tumor Cells, Cultured ; Tumor Suppressor Proteins

OBJECTIVETo investigate PML gene and protein expression and localization in leukemia cell lines.

METHODSCell morphology was assayed by Wright and fluorescence stain, PML mRNA expression by RT-PCR, and PML protein localization by immunofluorescence.

RESULTS(1) Differentiation was observed by morphology in NB4 and HL-60 cells after treatment with all-trans retinoic acid (ATRA) while K562 cells did not show. Apoptosis was found in each cell line after treatment with quercetin. (2) After treatment with ATRA, the fusion protein disappeared and PML protein resumed in NB4 cells, while in HL-60 and K562 cells there was no difference from control cells. After treatment with quercetin, the fusion protein disappeared in NB4 cells, then degraded, and so did in HL-60 cells and K562 cells. (3) The expression of PML mRNA had no change in all the three cell lines after treatment with ATRA or quercetin.

CONCLUSIONPML plays a role of differentiation and apoptosis induction in leukemia cells at the translational level. PML in POD plays a role of apoptosis induction and growth control of leukemia cells.

Cell Division ; drug effects ; Dose-Response Relationship, Drug ; Gene Expression Regulation, Neoplastic ; drug effects ; HL-60 Cells ; Humans ; K562 Cells ; Leukemia ; genetics ; metabolism ; pathology ; Neoplasm Proteins ; genetics ; metabolism ; Nuclear Proteins ; Promyelocytic Leukemia Protein ; Quercetin ; pharmacology ; RNA, Messenger ; drug effects ; genetics ; metabolism ; Time Factors ; Transcription Factors ; genetics ; metabolism ; Tretinoin ; pharmacology ; Tumor Cells, Cultured ; Tumor Suppressor Proteins