Objective: Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a recently recognized high-risk T lymphoblastic leukemia subgroup. The optimal therapeutic approaches to adult patients with ETP-ALL are poorly characterized. In this study, we explore the efficacy and outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for ETP-ALL. Methods: The clinical data of 23 patients with ETP-ALL receiving allo-HSCT from 2010 to 2018 were retrospectively analyzed. Patients with ETP-ALL were diagnosed based on the characteristic immunophenotypes. Second-generation sequencing was done in all patients. As to the donors, 12 patients had haploidentical donors (Haplo-HSCT) , 7 HLA-matched sibling donors (Sib-HSCT) and 4 HLA-matched unrelated donors (URD-HSCT) . Before transplantation, 19 patients achieved complete remission (CR) and 4 patients without. Results: The main clinical features of ETP-ALL included high white blood cell counts in 5 patients, splenomegaly in 14, lymphadenopathy in 19, and thymus masses in 5. According to cytogenetic and molecular characteristics, 11 patients had gene mutations related to myeloid tumors, and 7 with high risk Karyotype. After first induction regimen, 14/23 patients achieved CR. 5 patients reached CR after more than 2 cycles of chemotherapy, while another 4 patients did not reach CR. After allo-HSCT, 22 patients were successfully implanted. The median time of granulocyte and platelet reconstitution was +12 and +19 days. One patient died of transplant-related infection at +14 days. The estimated 18-month overall survival (OS) and relapse-free survival (RFS) rates were (55.0±14.4) % and (48.1±14.7) % respectively. Transplant-related mortality was 4.3%. The median OS in patients achieving CR before transplantation was 20 months, however, that in patients without CR was only 13 months. OS and RFS between haplo-HSCT and sib-HSCT were comparable (P=0.460 and 0.420 respectively) . Conclusions: Allo-HSCT is an effective therapy in some patients with ETP-ALL. Salvage HSCT cannot overcome the poor outcome. Haplo-HSCT and sib-HSCT in ETP-ALL patients have the similar clinical outcome.
Adult ; Hematopoietic Stem Cell Transplantation ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cells, T-Lymphoid ; Remission Induction ; Retrospective Studies

BACKGROUND: Previous Caucasian studies have described venous thromboembolism in pregnancy; however, little is known about its incidence during pregnancy and early postpartum period in the Chinese population. We investigated the risk of venous thromboembolism in a “real-world” cohort of pregnant Chinese women with no prior history of venous thromboembolism. METHODS: In this observational study, 15,325 pregnancies were identified in 14,162 Chinese women at Queen Mary Hospital, Hong Kong between January 2004 and September 2016. Demographic data, obstetric information, and laboratory and imaging data were retrieved and reviewed. RESULTS: The mean age at pregnancy was 32.4±5.3 years, and the median age was 33 years (interquartile range, 29–36 yr). Pre-existing or newly diagnosed diabetes mellitus was present in 627 women (4.1%); 359 (0.7%) women had pre-existing or newly detected hypertension. There was a small number of women with pre-existing heart disease and/or rheumatic conditions. Most deliveries (86.0%) were normal vaginal; the remaining were Cesarean section 2,146 (14.0%). The incidence of venous thromboembolism was 0.4 per 1,000 pregnancies, of which 83.3% were deep vein thrombosis and 16.7% were pulmonary embolism. In contrast to previous studies, 66.7% of venous thrombosis occurred in the first trimester. CONCLUSION: Chinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization.
Asian Continental Ancestry Group ; Cesarean Section ; Cohort Studies ; Diabetes Mellitus ; Early Ambulation ; Female ; Heart Diseases ; Hong Kong ; Humans ; Hypertension ; Incidence ; Observational Study ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, First ; Pregnant Women ; Pulmonary Embolism ; Venous Thromboembolism ; Venous Thrombosis

BACKGROUND: Iliac screw implantation has no unified standard. Because of the large individual differences, preoperative pelvic three-dimensional (3D) CT reconstruction can measure the diameter, depth and angle of the screws, which increases the placement accuracy. OBJECTIVE: To measure the screw placement-related data by pelvic 3D CT reconstruction, so as to guide the screw placement and improve its accuracy. METHODS: Fifty patients with pelvic lesions or fractures admitted in Shandong Provincial Third Hospital from January 2013 to December 2016 were selected, and the pelvis was scanned with CT and then was reconstructed. The point A (the intersection of S1posterior sacral posterior wall and posterior superior iliac spine) was as the screw placement point, and three paths were measured on the point: posterior superior iliac spine path (AD path); anterior inferior iliac spine path (AC path); top of greater sciatic notch to the acetabular roof (AB path). On the plane of these three pathes, the section was made on the iliac bone, respectively; in each section, the channel for iliac nail was designed. RESULTS AND CONCLUSION: (1) In the same path, there was no significant difference in the path length of the screw between male and female patients (P > 0.05). Paired t test showed that the diameter and length depth and angle of the screws were significantly different between AD and AC paths, AC and AD (P < 0.05). (2) There was no significant difference in the inclination angle of the spiral channel between male and female patients (P > 0.05). The inclination angle of the spiral channel and lateral angle at different paths showed significant difference between male and female patients (P < 0.05). (3) To conclude, 3D reconstruction of pelvis CT can be used to measure the length, diameter and angle of the iliac screw, and to guide the surgical treatment.

[Objective]To investigate the feasibility of making the protocol with computed tomography data for total knee arthroplasty using patient-specific femoral and tibial cutting blocks.[Methods]54 consecutive patients diagnosed with osteoarthritis were divided randomly into two groups. Every patients accepted 3-dimentional computed tomography scan for bilateral legs before operation,the protocol were made for every patients before operation.When making the pre-operative protocol,we accepted the prothesis surpass the osteotomy edge finitely,tibia prothesis rotational orientation according to the outline of the tibial osteotomy. The thickness of the posterior condyle of femur resected was as the same with the prothesis posterior condyle as possible. The patients in trial group undergone total knee arthroplasty(TKA) using patient-specific instruments(PSI)according to the preoperative protocol,while the patients in the control group undergone TKA using custom instruments(CI).The operation time,the times that the scale of the prosthesis were altered intraoperation,the mean thickness of the posterior condyle of femur resected in the operation,AKS score 3 months and 1 year after the operation were recorded and compared between the two groups. Plain film radiography after the operation were analyzed.[Results]No significant differences were found between two groups with respect to the operation time. 8 patients altered to a lesser prosthesis in the CI group during the operation,all in bibia contrast to no one need alteration in the PSI group.The thickness of the osteotomy on the posterior condyle of femur in the PSI group is bigger than that of CI group as a result.The AKS score of the patients in the PSI group is higher than that of CI group 3 months after the opera-tion,whereas no significant difference was found 1 year after the operation.[Conclusion]The reconstructed image by thin layer CT can be used for preoperation protocol for TKA,which might be helpful in deciding the size of femour prosthesis;the implants can surpass the edge of the osteotomy finitely in TKA,which is not necessarily cause any complain.We can orient the tibia prosthesis rotation according to the outline of the osteotomy of the patients'tibia.

Finding the novel drug from the effective components of traditional Chinese herbal medicine is a hotspot of the modern pharmacological research.Hyperoside (HYP) belongs to flavonoid glycosides,and it has various properties,such as anti-inflammation,anti-spasm,anti-diuretic,antitussive,lowering blood pressure,and lowering cholesterol effects as well as protective effects for the cardiac and cerebral blood vessels.The purpose of this study was to investigate the effects of HYP on inflammatory and apoptotic responses in vascular endothelial cells stimulated by lipopolysaccharide (LPS) and further to identify the possible mechanisms underlying these effects.In our study,human umbilical vein endothelial cells (HUVECs) were stimulated with 1 μg/mL LPS in the presence or absence of HYP (10,20 and 50 μrnol/L).Our results indicated that HYP alone exerted no cytotoxicity on HUVECs,while it had an up-regulatory effect on the viability of HUVECs induced by LPS in a dose-dependent manner;increased mRNA expression of IL-1β,IL-6,TNFα and iNOS induced by LPS was attenuated after treatment with HYP both in a dose-and time-dependent manner;LPS-induced HUVECs apoptosis and cleaved-caspase 8,9,3 were all significantly reduced by HYP.Furthermore,the possible pathway involved in apoptosis and inflammation by HYP was detected,and the results showed that when treated with HYP,LPS-induced mitochondrial membrane instability was significantly inhibited through up-regulation of Bcl-2 and down-regulation of Bax.Furthermore,the expression of TLR4 and the phosphorylation of Iκ Bα and p65 in LPS-treated cells were blocked by HYP.Our results suggested that HYP treatment prevented HUVECs from LPS-induced inflammation and apoptosis responses,which might be mediated by inhibiting TLR4/NFκB pathway.