Adult ; Ear Neoplasms ; Eustachian Tube ; Humans ; Male ; Neurilemmoma

OBJECTIVETo study the alteration and significance of IL-6, vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1) in MM progression and the interaction between the three cytokines.

METHODSBone marrow samples from 28 patients with multiple myeloma (MM) (evolution group and steady group), 10 iron deficiency anemia (as normal control) and 2 monoclonal gammopathy of undetermined significance (MGUS) were studied. Bone marrow stromal cells (BMSCs) were established from the bone marrow MNCs. ELISA was performed to detect the concentration of IL-6, VEGF, IGF-1 in culture supernates.

RESULTS(1) The levels of IL-6 and VEGF secreted by BMSCs were increased in an order from normal control to steady group to evolution group (P < 0.05). However, the concentration of IGF-1 did not increase in MM patients (P > 0.05). (2) The levels of IL-6, VEGF and IGF-1 in the coculture supernates of U266 and BMSCs were increased significantly (P < 0.05), being in an ascending order from normal control to steady group to evolution group (P < 0.05). (3) BMSCs stimulated by exogenous IL-6, VEGF or IGF-1, secreted more VEGF, IGF-1/IL-6, IGF-1/VEGF, IL-6 than unstimulated (P < 0.05). (4) The levels of IL-6, VEGF, IGF-1 secreted by BMSCs from MGUS were similar to that from control group.

CONCLUSIONSIL-6, VEGF, IGF-1 levels associate with evolution of MM; IL-6, VEGF and IGF-1 induce an increase in cytokines secretion of BMSCs.

Anemia, Iron-Deficiency ; blood ; pathology ; Bone Marrow Cells ; metabolism ; pathology ; Cells, Cultured ; Female ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Interleukin-6 ; blood ; Male ; Middle Aged ; Multiple Myeloma ; blood ; pathology ; Paraproteinemias ; blood ; pathology ; Stromal Cells ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; blood

OBJECTIVETo evaluate the effect of treatments with the molecular adsorbents recirculating system (MARS) on liver failure patients of severe hepatitis B, in order to seek a safe and effective therapeutic method which contribute to the improved survival rate for severe hepatitis patients.

METHODS52 liver failure patients of severe hepatitis B were performed intermittent MARS therapy for 6 to 8 hours per time in addition to standard medical treatment. Parameters in blood chemical data were collected before and after every treatment and analyzed in comparison with those parameters from controlled groups by means of plasma exchange and standard medical therapy.

RESULTSMARS therapy achieved a remarkable improvement in clinical symptoms and physic signs, accompanied with a significant decrease in serum bilirubin, ammonia, urea nitrogen, fragrant amino acid, endotoxin, IL-6, and TNF-alpha levels (0.05); at the 72 hours bilirubin rebounding analysis. MARS treatments resulted in a significant decrease of bilirubin rebounding level in comparison with what PE did (0.01 ), though the bilirubin removal efficiency between two groups was not statistically significant. The overall survival rate of MARS therapy was 50% (26/52), which was better than that of standard medical therapy (40.5%, 17/42, P less than 0.05).

CONCLUSIONThe results indicated that MARS was a safe and promising technology in the field of liver support therapy. It might be associated with considerable improved survival rate for liver failure patients.

Adult ; Female ; Hepatitis B ; complications ; Humans ; Liver Failure ; blood ; mortality ; therapy ; Male ; Renal Dialysis ; Sorption Detoxification ; Survival Rate

The aim of this study was to explore the clinical effect and toxicity of bortezomib combined with methylprednisolone in treatment of relapsed or refractory multiple myeloma (MM). Clinical data of 33 patients (23 male, 10 female; aged from 38 to 85 years old) were analyzed retrospectively. The median diagnosis time was 25 (2 - 120) months. 33 patients received bortezomib (0.9 - 1.1) mg/m(2) on days 1, 4, 8, 11, in combination with methylprednisolone 40 mg/d (4 cases), 80mg/d (13 cases), 120 mg/d (2 cases), 200 mg/d (9 cases), 300 mg/d (5 cases) respectively. The median follow-up time was 10(3-60) months. The used therapy courses were 1 - 8 (mean 4 courses). The results indicated that 24 cases showed the response of different degree, the overall response rate (ORR) was 72.7% (24/33). 32 patients received ≥ 2 therapy courses, and ORR was 71.9% (23/32). 16 patients received 4 therapy courses, and ORR was 93.8% (15/16 cases). 7 patients received 6 therapy courses and the ORR was 100% (7/7 cases). Main side-effects were thrombocytopenia, infection and peripheral neuropathy. The median survival time was 41.5 (2 - 120) months and the 2-year, 3-year and 5-year overall survival rate were 80%, 59.1% and 21.1%, respectively. It is concluded that bortezomib combined with methylprednisolone is an effective therapy with higher response rate, and safe in treatment of relapsed or refractory multiple myeloma.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Boronic Acids ; administration & dosage ; Bortezomib ; Female ; Humans ; Male ; Methylprednisolone ; administration & dosage ; Middle Aged ; Multiple Myeloma ; drug therapy ; pathology ; Neoplasm Recurrence, Local ; drug therapy ; Pyrazines ; administration & dosage ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the application of flow cytometry in the differential diagnosis of lymphoma/leukemia with aberrant antigen expression.

METHODSThe results of flow cytometry of 30 lymphoma/leukemia cases with aberrant antigen expression, of which 3 cases being lymphomas, 8 B-cell leukemia, 1 T-cell leukemia, 17 acute non-lymphoid leukemia and 1 acute non-lymphoid leukemia involving lymph nodes were analyzed. Immunohistochemistry (EnVision) for CD79a, CD3 and MPO was performed on all cases.

RESULTSEleven cases of B-cell lymphoma/leukemia were cytoplasmic CD79a (cCD79a)-positive, cytoplasmic CD3 (cCD3epsilon) and cytoplasmic MPO (cMPO)-negative. Five of these cases were positive for CD5 and 2 for CD5, 1 or 2 for myeloid marker(s). The T-cell leukemia cases were cCD3epsilon-positive, cCD79a and cMPO-negative, they also co-expressed CD13 and CD33. The mantle cell lymphoma cases were positive for CD3, CD13 and CD33. Of the 8 B-cell leukemia cases, 4 were positive for CD5, 3 for CD13 and 1 for CD13 and CD33. The 18 acute non-lymphoid leukemia cases (including 1 acute non-lymphoid leukemia case involving lymph nodes) were cMPO-positive and cCD79a and cCD3epsilon-negative. Eight of the 18 expressed T-cell markers (including 1 case of acute non-lymphoid leukemia involving lymph nodes), 8 expressed B-cell markers, 2 expressed both T and B-cell markers.

CONCLUSIONSFlow cytometry can demonstrate aberrant antigen expression in lymphoma/leukemia cells and is helpful in delineating their cell origin. The technique is thus useful in the differential diagnosis of lymphoma/leukemia.

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; CD13 Antigens ; metabolism ; CD3 Complex ; metabolism ; CD5 Antigens ; metabolism ; CD79 Antigens ; metabolism ; Diagnosis, Differential ; Flow Cytometry ; Humans ; Leukemia, B-Cell ; diagnosis ; immunology ; Leukemia, T-Cell ; diagnosis ; immunology ; Lymphoma, Mantle-Cell ; diagnosis ; immunology ; Peroxidase ; metabolism ; Retrospective Studies ; Sialic Acid Binding Ig-like Lectin 3

OBJECTIVETo study the anti-myeloma activity of interleukin-2 activated bone marrow (ABM).

METHODSBone marrow mononuclear cells (BMMNC) from multiple myeloma and iron-deficiency anemia patients were cultured in the presence of rIL-2. The anti-myeloma activity of ABM against U266 cells, cells expressing surface CD45, CD38, CD138, the levels of TNF-alpha and IFN-gamma in ABM culture supernatant were measured with MTT method, flow cytometry and ELISA method respectively after bone marrow was activated with rIL-2 for 24 and 72 hours.

RESULTSThe tumor-killing activities against U266 cells of ABM were significantly increased compared with that of non-activated bone marrow (NBM) at 72 hours [(69.70 +/- 26.57)% vs (43.20 +/- 12.39)%, P < 0.05] and 24 hours [(34.25 +/- 11.93)% vs (26.53 +/- 5.48)%]. The CD45(-)CD38(+)CD138(+) cells of ABM from myeloma group at 72 hours were decreased from (8.46 +/- 3.66)% to (4.79 +/- 1.56)% (P < 0.05). TNF-alpha and IFN-gamma were detectable after cultured for 24 hours in both normal control group and myeloma group and went higher at 72 hours. The level of TNF-alpha and IFN-gamma were significantly increased in ABM compared with that in NBM (P < 0.05). Meanwhile, there was a positive relationship between the level of TNF-alpha, IFN-gamma and cytotoxicity of ABM from normal control group at 24 hours and 72 hours (P < 0.05), and was a negative relationship between TNF-alpha and IFN-gamma levels and the CD45(-)CD38(+)CD138(+) cells in myeloma group at 72 hours (P < 0.05).

CONCLUSIONNormal BMMNCs activated with rIL-2 have tumor-killing activities against U266 cells. Myeloma cells and tumor burden were decreased in myeloma bone marrow after the marrow was activated with rIL-2. Production of TNF-alpha and IFN-gamma from bone marrow cells including T cells, monocyte-macrophages and NK cells activated with rIL-2 might be involved in anti-myeloma activity of ABM.

Adult ; Aged ; Bone Marrow Cells ; drug effects ; immunology ; metabolism ; Cell Line, Tumor ; Cells, Cultured ; Cytotoxicity, Immunologic ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Humans ; Interferon-gamma ; biosynthesis ; Interleukin-2 ; immunology ; pharmacology ; Male ; Middle Aged ; Multiple Myeloma ; blood ; immunology ; pathology ; Tumor Necrosis Factor-alpha ; biosynthesis

The aim of this study was to investigate the efficacy and safety of bortezomib-combined with dexamethasone, methylprednisolone and other drugs in the treatment of patients with multiple myeloma (MM). 60 MM patients including 19 de novo patients, out of them 14 patients received the treatment using regimen of bortezomib in combination with thalidomide (BT), 5 patients received bortezomib-methylprednisolone regimen (BMP). Out of 41 patients with refractory or relapsed myeloma 26 cases of MM received the treatment using regimen of bortezomib combined with methylpreamsolone (BMP), 6 cases received the treatment using regimen of bortezomib combined with cyclophosphamide, prednisone and thalidomide (BCPT), 5 cases received the treatment using regimen of bortezomib combined with cis-diaminodichloroplatimm, etoposide, cydophosphomide and dexamethasone (BDECD), 4 cases received the treatment using regimen of bortezomib combined with dexamethasone (BD). Each patient received treatment of 2-8 courses at least. Response was assessed according to the criteria of the Bladè. Adverse events were graded according to the common Toxicity Criteria, version 3.0 (NCI CTCAE, USA). The median follow-up from the start of bortezomib treatment was 9 months. The results showed that out of 19 newly diagnosed patients, 6 cares achieved CR, 6 cases achieved nearly CR, 5 cases achieved PR, 1 case achieved MR, resulting in an ORR of 94.7%. Out of 41 refractory or relapsed patients, 5 cases achieved CR, 10 cases got nearly CR, 14 cases were PR and 5 cases were MR, resulting in an ORR of 82.92%. The main toxicities were fatigue, gastrointestinal disorders, peripheral neuropathy, thrombocytopenia, herpes zoster, skin rash. All adverse events were diminished by using routine ways. In conclusion, bortezomib combined with or the drugs is a very effective regimen, its side effects are predictable and manageable.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Methylprednisolone ; administration & dosage ; therapeutic use ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use ; Thalidomide ; administration & dosage ; therapeutic use ; Treatment Outcome

Adsorption ; Adult ; Female ; Humans ; Hyperthyroidism ; complications ; therapy ; Liver Diseases ; complications ; therapy ; Liver, Artificial ; Male ; Middle Aged

Objective:To solve the symptoms of achalasia complicated with osteogensis imperfecta through peroral endoscopic myotomy(POEM).Methods: The 21-year-old male patient,being diagnosed as achalasia complicated with osteogensis imperfecta,underwent POEM under general anesthesia after preoperative assessment of achalasia(Eckardt score of 7).The mucosal incision was made at a distance of 28 cm from the incisor,then the gastroscope entered the submucosal layer and tunnel in it,and myotomy was performed about 29 cm from the incisor extending 2 cm into the cardia.Electrocoagulation was performed to stop bleeding and the mucosal incision was then closed.Results:The operation was completed successfully in about 28 minutes.The stomach tube was removed 30 h after surgery.The patient was discharged in a stable condition on the fourth postoperative day.The follow-up result showed no recurrence in symptom with Eckardt score of 0 two weeks after operation.Conclusions:POEM is a feasible and effective way for achalasia of cardia complicated with osteogenesis imperfecta.

OBJECTIVETo investigate the effect of arsenic trioxide on multiple myeloma (MM) cell gene expression and explore the molecular mechanism of arsenic trioxide therapy for MM.

METHODSU266 cells were divided into two groups, group A as control group and group B as test group. Cells were cultured for 48 hours, and total RNA and mRNA were extracted. Suppression subtractive hybridization (SSHs) was performed to distinguish the differentially expressed genes. The products were cloned into pGEM-T Easy Vector, and transfected into the competent host JM109 to construct two subtractive libraries. Positive colonies were selected by blue-white screening, and the plasmids were extracted. Homologous comparison was conducted in GenBank.

RESULTSFive downregulated clones were isolated in the first SSH: (1) Aminopeptidase N, (2) Homosapiens tumor translationally-controlled protein 1, (3) Human ATP synthetase A chain, (4) Signal recognition particle A10, (5) Mitochondrial ATP synthetase/ATPase subunit 6. Four upregulated clones were isolated in the second SSH: (1) Calcium-binding protein A10, (2) Keratin 6A, (3) 45 kD MIP repetitive element containing splicing factor and (4) poly(A)-binding protein.

CONCLUSIONSArsenic trioxide exerts proliferation inhibition and apoptosis induction on MM cells by regulating genes expression.

Antineoplastic Agents ; pharmacology ; Arsenicals ; pharmacology ; Cell Line, Tumor ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; drug effects ; Gene Library ; Humans ; Multiple Myeloma ; genetics ; pathology ; Oxides ; pharmacology ; Plasmids ; genetics ; Transformation, Bacterial