1.The role of CYP2E1 in trichloroethylene-induced skin sensitization and liver damage in guinea pigs
Lijuan WU ; Xiangrong SONG ; Fengrong LU ; Hongling LI ; Jiaheng HE ; Xiao ZHANG ; Hailan WANG
China Occupational Medicine 2025;52(3):249-256
Objective To investigate the role of cytochrome P450 2E1 (CYP2E1) in trichloroethylene (TCE)-induced skin sensitization and liver damage in guinea pigs, using diallyl sulfide (DAS), a CYP2E1 inhibitor, as an intervention. Methods Specific pathogen-free female guinea pigs were randomly divided into blank control group, solvent control group, positive control (2,4-dinitrochlorobenzene) group, TCE-exposure group, and DAS-intervention group. Skin sensitization experiments were conducted using the guinea pig TCE maximal dose-skin sensitization test. Urinary trichloroacetic acid levels were determined following TCE induction and challenge. At 48 hours after the final challenge, serum liver function markers and inflammatory cytokines levels were detected. Histopathological examination on skin and liver tissues was performed, and hepatic CYP2E1 protein expression and oxidative stress indicators were assessed. Results The sensitization rates of guinea pigs were 100.0%, 75.0%, and 33.3% in the positive control, TCE-exposure, and DAS-intervention groups, respectively, while the blank control and solvent control groups were both 0.0%. Compared with the guinea pigs in TCE-exposure group, those in the DAS-intervention group had lower urinary trichloroacetic acid levels at intradermal induction, local induction, first challenge, and 24 hours after the final challenge time point (all P<0.05). Histopathology of guinea pigs showed dermal inflammatory infiltration and basal keratinocyte necrosis in the TCE-exposure group, whereas only mild dermal inflammation was observed in the DAS-intervention group. The guinea pigs in TCE-exposure group exhibited diffuse hepatocellular necrosis, while hepatic damage in the DAS-intervention group was alleviated, characterized by only mild hepatocellular steatosis and hepatocyte swelling around the central vein. The skin sensitization rate of guinea pigs in the TCE-exposure group increased (all P<0.01), the serum alanine aminotransferase (ALT )activity, the levels of interleukin (IL)-2, IL-17, and tumor necrosis factor-α (TNF- α) increased (all P<0.05), the relative expression of CYP2E1 protein, the activity of superoxide dismutase (SOD), and the level of malondialdehyde in liver tissue increased (all P<0.05), while the activity of catalase decreased (P<0.05), compared with the blank control and solvent control groups. The serum ALT activity and the levels of IL-2, IL-17, and TNF-α of guinea pigs in DAS-intervention group reduced (all P<0.05), as well as CYP2E1 protein expression, SOD activity, and malondialdehyde level in liver tissue reduced (all P<0.05), compared with the TCE-exposure group. Conclusion TCE can induce hepatic CYP2E1 expression, thereby promoting oxidative stress and inflammatory responses, which contributes to skin sensitization and liver damage. DAS alleviates TCE-induced toxic effects on skin and liver by inhibiting CYP2E1 expression.
2.Correlation between transabdominal bowel ultrasonography parameters and disease activity of ulcerative colitis
Hongzhen CHEN ; Cuijing LIU ; Dong WANG ; Jinbo GUO ; Jia SONG ; Fenghua LI ; Fengrong YIN ; Xiaodong SHI ; Chenyang LI ; Xiaolan ZHANG
Chinese Journal of Digestion 2025;45(5):324-330
Objective:To investigate the correlation between transabdominal bowel ultrasongraphy (TBUS) parameters and disease activity of ulcerative colitis (UC).Methods:The results of TBUS, endoscopy and laboratory tests of 68 UC patients (108 examinations) who visited the Department of Gastroenterology of the Second Hospital (Eastern Campus) of Hebei Medical University From January 2022 to February 2024 were retrospectively analyzed. According to Mayo endoscopic score (MES), there were 10 cases of remission (MES=0) and 98 cases of active phase (MES>0); patients in active phase further classified into 16 cases of mild (MES=1), 19 cases of moderate (MES=2), and 63 cases of severe (MES=3). The TAUS parameters were compared between patients in remission and active phases. Spearman rank correlation analysis was used to analyze the correlation between the TBUS parameters including bowel wall thickness (BWT), Limberg score, wall layer stratification, fat wrapping and endoscopic activity score, laboratory inflammatory indicators. Receiver operating characteristic curve (ROC) analysis was applied to evaluate the predictive efficacy of the TBUS parameters and laboratory inflammatory indicators in identifying remission under endoscopy. Independent sample t-test and Fisher′s exact probability method were used to compare the two groups. Results:The BWT of patients in remission was significantly thinner than that of patients in active phase ((2.99±0.41) mm vs. (5.66±1.57) mm, t=-5.34, P<0.001). The proportions of patients in remisson with Limberg score ≤2, normal wall layer stratification, and absence of fat wrapping were significantly higher than those of patients in active phase (10/10 vs. 34/98, 10/10 vs. 48/98, 10/10 vs. 41/98, Fisher′s exact test, P<0.001, =0.002, =0.001). BWT, Limberg score, wall layer stratification, and fat wrapping were positively correlated with MES ( r=0.676, 0.677, 0.441, and 0.493, all P<0.001). BWT and Limberg score were moderate positively correlated with C-hypersensitive reactive protein, erythrocyte sedimentation rate and fecal calprotectin (BWT: r=0.561, 0.420 and 0.458, all P<0.001; Limberg score: r=0.576, 0.469 and 0.403, all P<0.001), and were negatively correlated with serum albumin and hemoglobin (BWT: r=-0.604 and -0.453, both P<0.001; Limberg score: r=-0.573 and -0.532, both P<0.001). The results of ROC analysis showed that BWT achieved the best predictive efficacy in identifying endoscopic remission, and the best cut-off value was 3.45 mm (area under the curve was 0.972, 95% confidence interval: 0.944 to 1.000, P<0.001), with a sensitivity of 93.9% and specificity of 100.0%. Conclusions:TBUS parameters can accurately reflect disease activity in UC. It is a powerful tool for UC monitoring. The BWT<3.45 mm is the best cut-off value in prediction of endoscopic remission.
3.Study on the"Properties-efficacy"of Foreign Medicinal Resource Moringa oleifera Leaves Based on Different"Xiang"
Yanwen LI ; Caifeng LI ; Qingqing LI ; Fengrong ZHANG ; Luming QIU ; Zhiyong LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(8):122-130
Objective To predict and analyze the"properties-efficacy"of foreign medicinal resource Moringa oleifera leaves by taking"Xiang"based on plant phylogenetic relationships and component structural characteristics.Methods The properties of Moringa oleifera were determined by screening plants with its genetic relationship.Network pharmacology was used to study the biological network characteristics of Moringa oleifera leaves and related Chinese materia medica,and the"properties-efficacy"of Moringa oleifera leaves was studied based on the"xiang"of medicinal plants.Using"the relationship chart between the efficacy of Chinese materia medica and 12 types of chemical components",the possible efficacy and distribution of medicinal properties of Moringa oleifera leaves were predicted,and a study on the"properties-efficacy"characteristics of Moringa oleifera leaves was conducted based on the structural features of the components.Results Moringaceae and Caricaceae had a genetic relationship in plant classification;Moringa oleifera leaves,Carica papaya and Carica papaya leaves had a relatively high number of common targets,common clinical phenotypes and signaling pathways.The large proportion of coincidence showed that Moringa oleifera leaves might have similar functional performance and mechanism to Carica papaya and Carica papaya leaves;Moringa oleifera leaves contain flavonoids,tannins,monophenols,which were related to the efficacy of Chinese materia medica on tonifying qi,dispersing wind heat,cooling blood and regulating qi.Clustering analysis method was used to get the corresponding"properties-efficacy"relationship,and the results indicated that Moringa oleifera leaves were cool in property and sweet in taste,which belonged to lung meridian and had the efficacy of dispersing wind heat.Conclusion It is feasible to predict and analyze the"properties-efficacy"of foreign medicinal resources by taking"xiang".
4.Correlation between transabdominal bowel ultrasonography parameters and disease activity of ulcerative colitis
Hongzhen CHEN ; Cuijing LIU ; Dong WANG ; Jinbo GUO ; Jia SONG ; Fenghua LI ; Fengrong YIN ; Xiaodong SHI ; Chenyang LI ; Xiaolan ZHANG
Chinese Journal of Digestion 2025;45(5):324-330
Objective:To investigate the correlation between transabdominal bowel ultrasongraphy (TBUS) parameters and disease activity of ulcerative colitis (UC).Methods:The results of TBUS, endoscopy and laboratory tests of 68 UC patients (108 examinations) who visited the Department of Gastroenterology of the Second Hospital (Eastern Campus) of Hebei Medical University From January 2022 to February 2024 were retrospectively analyzed. According to Mayo endoscopic score (MES), there were 10 cases of remission (MES=0) and 98 cases of active phase (MES>0); patients in active phase further classified into 16 cases of mild (MES=1), 19 cases of moderate (MES=2), and 63 cases of severe (MES=3). The TAUS parameters were compared between patients in remission and active phases. Spearman rank correlation analysis was used to analyze the correlation between the TBUS parameters including bowel wall thickness (BWT), Limberg score, wall layer stratification, fat wrapping and endoscopic activity score, laboratory inflammatory indicators. Receiver operating characteristic curve (ROC) analysis was applied to evaluate the predictive efficacy of the TBUS parameters and laboratory inflammatory indicators in identifying remission under endoscopy. Independent sample t-test and Fisher′s exact probability method were used to compare the two groups. Results:The BWT of patients in remission was significantly thinner than that of patients in active phase ((2.99±0.41) mm vs. (5.66±1.57) mm, t=-5.34, P<0.001). The proportions of patients in remisson with Limberg score ≤2, normal wall layer stratification, and absence of fat wrapping were significantly higher than those of patients in active phase (10/10 vs. 34/98, 10/10 vs. 48/98, 10/10 vs. 41/98, Fisher′s exact test, P<0.001, =0.002, =0.001). BWT, Limberg score, wall layer stratification, and fat wrapping were positively correlated with MES ( r=0.676, 0.677, 0.441, and 0.493, all P<0.001). BWT and Limberg score were moderate positively correlated with C-hypersensitive reactive protein, erythrocyte sedimentation rate and fecal calprotectin (BWT: r=0.561, 0.420 and 0.458, all P<0.001; Limberg score: r=0.576, 0.469 and 0.403, all P<0.001), and were negatively correlated with serum albumin and hemoglobin (BWT: r=-0.604 and -0.453, both P<0.001; Limberg score: r=-0.573 and -0.532, both P<0.001). The results of ROC analysis showed that BWT achieved the best predictive efficacy in identifying endoscopic remission, and the best cut-off value was 3.45 mm (area under the curve was 0.972, 95% confidence interval: 0.944 to 1.000, P<0.001), with a sensitivity of 93.9% and specificity of 100.0%. Conclusions:TBUS parameters can accurately reflect disease activity in UC. It is a powerful tool for UC monitoring. The BWT<3.45 mm is the best cut-off value in prediction of endoscopic remission.
5.Clinical case analysis of dissociative symptoms caused by esketamine hydrochloride nasal spray in treatment of treatment-resistant depression
Qiying DENG ; Shanshan TIAN ; Tingfang WU ; Anning LI ; Fengrong AN ; Gang WANG
Adverse Drug Reactions Journal 2025;27(5):296-302
Objective:To analyze the clinical characteristics of dissociative symptoms induced by esketamine hydrochloride nasal spray in patients with treatment-resistant depression (TRD).Methods:The medical records of patients in phase Ⅲ clinical trials for the treatment of TRD who received esketamine hydrochloride nasal spray in Beijing Anding Hospital, Capital Medical University from June 2018 to February 2021 were collected. The general situation of patients (age, gender, comorbid diseases, etc.), the medication of esketamine hydrochloride nasal spray, the combined use of antidepressants, the time from medication to the occurrence of dissociative symptoms each time, duration, severity, evaluation results of causal relationship with esketamine application, intervention and prognosis were recorded, and a retrospective descriptive statistical analysis was performed.Results:A total of 21 patients with TRD were enrolled in the study, including 17 (81.0%) with dissociative symptoms, 10 males and 7 females; the age ranged from 20 to 53 years, with a median age of 36 years. All patients were treated with esketamine hydrochloride by nasal spray. The first dose was 56 mg, and the other seven doses were 56 mg or 84 mg, twice a week, lasting for 4 weeks. The 17 patients were all given combination treatment with oral antidepressants. A total of 88 times of dissociative symptoms occurred in the 17 patients. The time from medication to the onset of dissociative symptoms ranged from 4 to 128 min, with a median time of 15 min. The duration of dissociative symptoms ranged from 12 to 326 minutes, with a median time of 70 minutes. The dissociative symptoms were mostly mild. The causal relationship analysis between the esketamine hydrochloride nasal spray and the dissociative symptoms showed that it was definitely related in 6 cases, probably in 1 case, and possibly in 10 cases. The dissociative symptoms in all patients were subsided without intervention.Conclusions:Esketamine hydrochloride nasal spray can cause dissociative symptoms in patients with TRD, most of which occur within 30 minutes after the treatment. The duration of symptoms in most patients is less than 120 minutes, most of which are mild and can subside on their own, and the prognosis is good.
6.Clinical case analysis of dissociative symptoms caused by esketamine hydrochloride nasal spray in treatment of treatment-resistant depression
Qiying DENG ; Shanshan TIAN ; Tingfang WU ; Anning LI ; Fengrong AN ; Gang WANG
Adverse Drug Reactions Journal 2025;27(5):296-302
Objective:To analyze the clinical characteristics of dissociative symptoms induced by esketamine hydrochloride nasal spray in patients with treatment-resistant depression (TRD).Methods:The medical records of patients in phase Ⅲ clinical trials for the treatment of TRD who received esketamine hydrochloride nasal spray in Beijing Anding Hospital, Capital Medical University from June 2018 to February 2021 were collected. The general situation of patients (age, gender, comorbid diseases, etc.), the medication of esketamine hydrochloride nasal spray, the combined use of antidepressants, the time from medication to the occurrence of dissociative symptoms each time, duration, severity, evaluation results of causal relationship with esketamine application, intervention and prognosis were recorded, and a retrospective descriptive statistical analysis was performed.Results:A total of 21 patients with TRD were enrolled in the study, including 17 (81.0%) with dissociative symptoms, 10 males and 7 females; the age ranged from 20 to 53 years, with a median age of 36 years. All patients were treated with esketamine hydrochloride by nasal spray. The first dose was 56 mg, and the other seven doses were 56 mg or 84 mg, twice a week, lasting for 4 weeks. The 17 patients were all given combination treatment with oral antidepressants. A total of 88 times of dissociative symptoms occurred in the 17 patients. The time from medication to the onset of dissociative symptoms ranged from 4 to 128 min, with a median time of 15 min. The duration of dissociative symptoms ranged from 12 to 326 minutes, with a median time of 70 minutes. The dissociative symptoms were mostly mild. The causal relationship analysis between the esketamine hydrochloride nasal spray and the dissociative symptoms showed that it was definitely related in 6 cases, probably in 1 case, and possibly in 10 cases. The dissociative symptoms in all patients were subsided without intervention.Conclusions:Esketamine hydrochloride nasal spray can cause dissociative symptoms in patients with TRD, most of which occur within 30 minutes after the treatment. The duration of symptoms in most patients is less than 120 minutes, most of which are mild and can subside on their own, and the prognosis is good.
7.Study on the"Properties-efficacy"of Foreign Medicinal Resource Moringa oleifera Leaves Based on Different"Xiang"
Yanwen LI ; Caifeng LI ; Qingqing LI ; Fengrong ZHANG ; Luming QIU ; Zhiyong LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(8):122-130
Objective To predict and analyze the"properties-efficacy"of foreign medicinal resource Moringa oleifera leaves by taking"Xiang"based on plant phylogenetic relationships and component structural characteristics.Methods The properties of Moringa oleifera were determined by screening plants with its genetic relationship.Network pharmacology was used to study the biological network characteristics of Moringa oleifera leaves and related Chinese materia medica,and the"properties-efficacy"of Moringa oleifera leaves was studied based on the"xiang"of medicinal plants.Using"the relationship chart between the efficacy of Chinese materia medica and 12 types of chemical components",the possible efficacy and distribution of medicinal properties of Moringa oleifera leaves were predicted,and a study on the"properties-efficacy"characteristics of Moringa oleifera leaves was conducted based on the structural features of the components.Results Moringaceae and Caricaceae had a genetic relationship in plant classification;Moringa oleifera leaves,Carica papaya and Carica papaya leaves had a relatively high number of common targets,common clinical phenotypes and signaling pathways.The large proportion of coincidence showed that Moringa oleifera leaves might have similar functional performance and mechanism to Carica papaya and Carica papaya leaves;Moringa oleifera leaves contain flavonoids,tannins,monophenols,which were related to the efficacy of Chinese materia medica on tonifying qi,dispersing wind heat,cooling blood and regulating qi.Clustering analysis method was used to get the corresponding"properties-efficacy"relationship,and the results indicated that Moringa oleifera leaves were cool in property and sweet in taste,which belonged to lung meridian and had the efficacy of dispersing wind heat.Conclusion It is feasible to predict and analyze the"properties-efficacy"of foreign medicinal resources by taking"xiang".
8.Screening of Core Prescriptions for Tremors Based on Integrated Strategy of "Empirical Prescriptions in Ancient Books-medical Cases by Prestigious Doctors-computational Analysis"
Huanhuan WANG ; Mengli CHANG ; Yu LI ; Fengrong ZHANG ; He XU ; Yi ZHANG ; Shihuan TANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):194-202
ObjectiveBased on the integrated strategy of "empirical prescriptions in ancient books-medical cases by prestigious doctors-computational analysis", this study aims to explore and analyze the prescriptions and medical cases for treating tremors in traditional Chinese medicine (TCM), predict their efficacy, and obtain the core prescriptions for treating tremors in TCM, providing references for clinical application and new drug development. MethodThe Chinese Medicine Prescription Database and the China National Knowledge Infrastructure (CNKI) were searched for relevant prescriptions and medical cases for treating tremors in TCM to establish a database of prescriptions for tremors. The Traditional Chinese Medicine Inheritance Computer System (V3.0) was used to analyze and explore the medication rules including drug frequency, properties, flavor, meridian tropism, and pharmacological effects, as well as core drugs and formula associations. A multi-target drug efficacy prediction platform based on network robustness was used to evaluate the predicted efficacy of the core prescriptions obtained. Based on the integration of ancient prescriptions, prestigious doctors' medical cases, and network analysis results, the priority level of the developed prescriptions was determined through comprehensive evaluation. ResultA total of 81 ancient prescriptions were screened, involving 246 drugs, and 171 prescriptions were screened from prestigious doctors' medical cases, involving 278 drugs. The frequently used TCM drugs were mostly warm in nature and sweet in flavor, mainly acting on the liver, spleen, and kidney meridians. In terms of efficacy, they were mainly effective in tonifying deficiency, soothing liver and extinguishing wind, activating blood and resolving blood stasis, clearing heat, and resolving exterior. Through association rules and K-means clustering, the core prescriptions were composed of high-frequency drugs such as Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma, Astragali Radix, Atractylodis Macrocephalae Rhizoma, Angelicae Sinensis Radix, Poria, Gastrodiae Rhizoma, and Uncariae Ramulus Cum Uncis. Drug combinations mainly focused on tonifying Qi and nourishing blood, with the additional functions of calming wind and dredging collaterals. Clustering analysis of core prescriptions from ancient prescriptions and prestigious doctors' medical cases, as well as multi-target drug efficacy prediction, showed that Combination 1 had the highest disturbance score on the disease network. Furthermore, comparative analysis revealed consistent results with both the analysis of ancient prescriptions and prestigious doctors' medical cases, indicating its optimal development potential based on theoretical inheritance and empirical practice. In comparison, Combinations 3, 2, and 4 were less utilized in contemporary clinical practice, with lower rankings in network disturbance scores, suggesting that their development value still warranted further exploration. ConclusionTCM clinical treatment of tremors emphasizes the regulation of the liver, spleen, and kidney. In line of syndrome differentiation, drugs potent in soothing liver, extinguishing wind, activating blood, and resolving blood stasis are added based on deficiency-tonifying drugs. The core prescriptions based on Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, Astragali Radix, Poria, and Atractylodis Macrocephalae Rhizoma (combination 1) have the highest potential development value. The integrated strategy "empirical prescriptions in ancient books-medical cases by prestigious doctors-computational analysis" can be used for the screening of candidate prescriptions for new TCM drugs.
9.Effects of long-term exposure to new types of light emitting diode sources on neurobehavior of rats
Fengrong LU ; Zhaoyang FENG ; Yihua SHI ; Guoliang LI ; Jiewei ZHENG ; Yuli ZENG ; Xiangrong SONG ; Xiao ZHANG ; Hongling LI ; Lihai ZENG ; Zhiwei XIE ; Jin WU ; Wenliang ZHOU ; Hailan WANG
China Occupational Medicine 2024;51(6):614-621
Objective To investigate the effects of long-term exposure to three new types of light emitting diode (LED) sources on the behavior, learning, and memory of rats. Methods A total of 160 specific pathogen-free SD rats were divided into eight groups as followed, trichromatic fluorescent lamps color temperature control group, violet-chip full-spectrum white LED group, blue-chip white LED group, and blue-chip full-spectrum white LED group based on the light sources types, with color temperature of 4 000 K and 6 500 K groups in each group using the 4×2 factorial design. There were 20 rats in each group, with half of the rats were males and half females. Rats were exposed to artificial lighting, and the illumination was set at 750 lx. The rats in each group were exposed to different lighting environments for 12 hours per day for 24 weeks. The open-field and step-down tests were conducted in rats after 24 weeks exposure, followed by sacrifice of rats and measurement of organ coefficients. Differences in body weight, organ coefficients, and neurobehavioral indexes of rats in different groups were compared. Results The spleen coefficient of female rats decreased in blue-chip white LED of 6 500 K color temperature group, and the liver coefficient of male rats decreased in the violet-chip full-spectrum white LED of 4 000 K color temperature, blue-chip full-spectrum white LED of 4 000 K color temperature, and blue-chip full-spectrum white LED of 6 500 K color temperature groups, compared with the same-sex rats in trichromatic fluorescent lamps with same-color temperature control group (all P<0.05). The result of different types of light sources compared in the open-field test showed that the index of total distance and movement speed of female rats in the blue-chip full-spectrum white LED group were lower than those in the other three groups, and the time cost to the central area was longer than that in the blue-chip white LED group and the violet-chip full-spectrum white LED group (all P<0.05). The total distance and movement speed of male rats in the blue-chip full-spectrum white LED group were longer or higher than those in the violet-chip full-spectrum white LED group (all P<0.05). Based on the comparison of color temperature, the time and total distance of male rats in 6 500 K color temperature group were lower than that in the 4 000 K color temperature group (both P<0.05). In the step-down test, both male and female rats in the blue-chip full-spectrum white LED group made more errors compared with other three groups with the same gender (all P<0.05). Conclusion Based on the experimental conditions of this study, the blue-chip full-spectrum white light LED affects behavior, learning and memory of the rats, and trichromatic fluorescent lamp has the lowest effect on neurobehavior. The color temperature also affects behavior of the rats, and high color temperature has higher risk.
10.Clinical features and risk factors for invasive fungal sinusitis after allogeneic hematopoietic stem cell transplantation
Haixia FU ; Jiajia LI ; Yuanyuan ZHANG ; Yuqian SUN ; Xiaodong MO ; Tingting HAN ; Jun KONG ; Meng LYU ; Wei HAN ; Huan CHEN ; Yuhong CHEN ; Fengrong WANG ; Chenhua YAN ; Yao CHEN ; Jingzhi WANG ; Yu WANG ; Lanping XU ; Xiaojun HUANG ; Xiaohui ZHANG
Chinese Journal of Hematology 2024;45(1):22-27
Objective:To analyze the clinical characteristics and outcomes of patients with invasive fungal sinusitis (invasive fungal rhinosinusitis, IFR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and explored the risk factors for IFR after allo-HSCT.Methods:Nineteen patients with IFR after allo-HSCT at Peking University People’s Hospital from January 2012 to December 2021 were selected as the study group, and 95 patients without IFR after allo-HSCT during this period were randomly selected as the control group (1:5 ratio) .Results:Nineteen patients, including 10 males and 9 females, had IFR after allo-HSCT. The median age was 36 (10–59) years. The median IFR onset time was 68 (9–880) days after allo-HSCT. There were seven patients with acute myeloid leukemia, five with acute lymphoblastic leukemia, two with myelodysplastic syndrome, two with chronic myeloid leukemia, one with acute mixed-cell leukemia, one with multiple myeloma, and one with T-lymphoblastic lymph node tumor. There were 13 confirmed cases and 6 clinically diagnosed cases. The responsible fungus was Mucor in two cases, Rhizopus in four, Aspergillus in four, and Candida in three. Five patients received combined treatment comprising amphotericin B and posaconazole, one patient received combined treatment comprising voriconazole and posaconazole, nine patients received voriconazole, and four patients received amphotericin B. In addition to antifungal treatment, 10 patients underwent surgery. After antifungal treatment and surgery, 15 patients achieved a response, including 13 patients with a complete response and 2 patients with a partial response. Multivariate analysis revealed that neutropenia before transplantation ( P=0.021) , hemorrhagic cystitis after transplantation ( P=0.012) , delayed platelet engraftment ( P=0.008) , and lower transplant mononuclear cell count ( P=0.012) were independent risk factors for IFR after allo-HSCT. The 5-year overall survival rates in the IFR and control groups after transplantation were 29.00%±0.12% and 91.00%±0.03%, respectively ( P<0.01) . Conclusion:Although IFR is rare, it is associated with poor outcomes in patients undergoing allo-HSCT. The combination of antifungal treatment and surgery might be effective.

Result Analysis
Print
Save
E-mail