Objective: To explore the efficacy and safety of Venetoclax combined with multidrug chemotherapy in patients with relapsed or refractory early T-cell precursor acute lymphoblastic leukemia (R/R ETP-ALL) . Methods: This study retrospectively analyzed 15 patients with R/R ETP-ALL who received Venetoclax combined with multidrug chemotherapy from December 2018 to February 2022. Among them, eight cases were combined with demethylated drugs, four cases were combined with demethylated drugs and HAAG chemotherapy regimen, two cases were combined with demethylated drugs and CAG regimen, and one case was combined with Cladribine. Specific usage and dosage of Venetoclax: 100 mg on day 1, 200 mg on day 2, 400 mg on day 3-28, orally; when combined with azole antifungal drugs, dosage was reduced to 100 mg/d. Results: Fifteen patients (10 males and 5 females) with R/R ETP-ALL were treated with Venetoclax and multidrug chemotherapy with a median age of 35 (12-42) years old. Of 4 refractory and 11 relapsed patients, the efficacy was evaluated on the 21th day following combined chemotherapy: the overall response rate, the complete response (CR) rate, and the CR with incomplete hematological recovery (CRi) rate were 67.7% (10/15), 60.0% (9/15), and 6.7% (1/15), respectively. For the overall study population, the 12-month overall survival (OS) rate was 60.0%, and the median OS was 17.7 months. The disease-free survival (DFS) rate of all CR patients at 12 months was 60.0%, and the median DFS did not reach. About 14 patients had Ⅲ-Ⅳ hematological toxicity, but these adverse reactions were all controllable. No adverse reaction in the nervous system and tumor lysis syndrome occurred in this study, and no adverse reaction of organs above grade Ⅲ occurred. Conclusion: Venetoclax combined with multidrug chemotherapy may be a safe and promising treatment option for patients with R/R ETP-ALL.
Male ; Female ; Humans ; Adult ; Retrospective Studies ; Treatment Outcome ; Bridged Bicyclo Compounds, Heterocyclic/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Precursor Cells, T-Lymphoid ; Leukemia, Myeloid, Acute/drug therapy*

Asian Continental Ancestry Group/genetics* ; Charcot-Marie-Tooth Disease/genetics* ; China ; Genetic Profile ; Humans ; Pedigree

BACKGROUND: The endoscopic transnasal approach has been proven to have advantages on the removal of the tumors in pterygopalatine fossa (PPF) and infratemporal fossa (ITF). Herein, this study aimed to describe a modified approach for resection of the tumors in these areas, both in cadaveric specimen and clinical patients. METHODS: The 20 adult cadaveric specimens and five patients with tumors in PPF and ITF were enrolled in this study. For the cadaveric specimens, ten were simulated anterior transmaxillary approach and ten were performed modified endoscopic transnasal transmaxillary approach. The exposure areas were compared between two groups and main anatomic structure were measured. Surgery was operated in the five patients with tumors of PPF and ITF to verify the experience from the anatomy. Perioperative management, intraoperative findings and postoperative complications were recorded and analyzed. RESULTS: The modified endoscopic transnasal transmaxillary approach provided as enough surgical exposure and high operability to the PPF and ITF as the anterior transmaxillary approach did. The diameter of maxillary artery in the PPF was 3.77 ± 0.78 mm (range: 2.06-4.82 mm), the diameter of middle meningeal artery in the ITF was 2.79 ± 0.61 mm (range: 1.54-3.78 mm). Four patients who suffered schwannoma got total removal and one of adenocystic carcinoma got subtotal removal. The main complications were facial numbness and pericoronitis of the wisdom tooth. No permanent complication was found. CONCLUSIONS With the widespread use of neuroendoscopy, the modified endoscopic transnasal transmaxillary approach is feasible and effective for the resection of tumors located in PPF and ITF, which has significant advantages on less trauma and complications to the patients.
Adult ; Female ; Humans ; Infratentorial Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neuroendoscopy ; Perioperative Care ; Postoperative Complications ; Pterygopalatine Fossa ; pathology ; surgery

Objective: To provide the new quality control means for Alumen by investigating the elemental differences between calcined Alumen and its counterfeit processed products of ammonium alum, and establishing their characteristic chromatogram. Method: The contents of 22 inorganic elements both in calcined Alumen and processed products of ammonium alum were determined by means of inductively coupled plasma (ICP)-optical emission spectrometer-mass spectrometry (ICP-OES/ICP-MS),SPSS 16.0 was used for cluster analysis (CA) while SIMCA-P 13.0 with t-test and Rank-Sum test was used to identify the differential inorganic elements. In addition, the characteristic spectrum of the inorganic elements for calcined Alumen and counterfeit calcined alumen were established. Result: Calcined Alumen had highest contents of K and Al while counterfeit calcined Alumen has highest contents of Al and Fe;Cr,Sr,and Mn contents in calcined Alumen were relatively higher,while Mn,Ti,and Ga contents in processed products of ammonium alum were relatively higher. The content of K in calcined Alumen was about 205 times of that of counterfeit products. On the contrary,the average contents of Fe,Ti,Mn and Ga in counterfeit products of ammonium alum were much higher than those in calcined Alumen,33,46,38, 27 times, respectively. A total of 18 samples were clustered into two categories in CA:calcined Alumen and processed products of ammonium alum. 18 inorganic elements showed significant difference in contents(P<0.05),Be, Mg,Al,K,Ti,V,Mn,Fe,Co,Ni,Cu,Ga,As,Sn,Sb,Hg,Tl,and Pb respectively. Characteristic spectrum of 21 inorganic elements in calcined Alumen and counterfeit calcined Alumen were established. Conclusion: This method can be used for quality control of calcined Alumen.

Objective The treatment methods for blood blister-like aneurysm remain controversial due to its special patholog-ical structure,the risk of post-operative rebleeding and the high rate of recurrence. The arm of this paper is to access the feasibility and effectiveness of overlapping stent-assisted coiling in the treatment of blood blister-like aneurysms of the internal carotid artery. Methods Form January 2014 to December 2016,we treated 15 patients with blood blister-like aneurysm of the internal carotid artery by stent-assisted coiling in the Department of Neurosurgery,5 with two Enterprise tents,3 with three Enterprise tents,4 with Enter-prise+LVIS tents,and 3 with two LVIS tents. We determined the rate of immediate embolization of aneurysms by Raymond-Roy Occlu-sion Classification(RROC)and analyzed the clinical characteristics,postoperative complications,and follow-up data. Results All the coils and stents were successfully implanted. RROC showed 9 cases of gradeⅠ(60%),4 cases of gradeⅡ(27%),and 2 cases of gradeⅢimmediate occlusion(13%),with the parent arteries unobstructed in all the cases. Thrombosis in the stent was found in 2 cases intraoperatively,slight stent migration in 1 case,and internal carotid artery dissection in the petrous segment in another,but no cer-ebral vasospasm or aneurysm rupture in any case.Delayed cerebral in-farct was observed in 2 cases postoperatively. The patients were fol-lowed up for 2 weeks to 28 months,which showed that 11 of them were cured,2 remained stable and 2 developed further thrombosis,with an MRS score of 0-2 in 12 cases,4 in 1 case,5 in 1 case, and 6 in 1case. Conclusion Overlapping stent-assisted coiling is effective for the treatment of blood blister-like aneurysm by reduc-ing the risks of rebleeding and recurrence.

Objective To investigate the effects of peritoneal lavage and dialysis by flexible endoscope in patients with early phase severe acute pancreatitis (SAP) complicated with intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS). Methods 32 patients with early phase SAP complicated with IAH/ACS were received peritoneal lavage and dialysis by flexible endoscope in base of routine treatment. The release time of peritoneal irritation sign, the duration of intra-abdominal hypertension (IAP), bowel sound, APACHE-II scores and prognosis of the patients were evaluated. The levels of TNF-α and IL-6 in serum, also, the concentrations of TNF-α, IL-6 and amylase in ascites/peritoneal lavage fluid were measured. Results 30 patients were all cured after treatment, with an average hospital stay of (16.53 ± 5.30) d, and, 2 patients underwent surgical treatment. The difference between before and after treatment was significance in peritoneal irritation sign scores, bowel sound, IAP and APACHE-II scores of the patients (P < 0.05). The levels of testing items in serum and ascites/peritoneal lavage fluid were decreased significantly during peritoneal lavage and dialysis. Conclusion Continuous peritoneal lavage and dialysis by flexible endoscope is a safe and effective method for patients with SAP complicated with IAH/ACS, especially in the early stage of disease.

Rotator cuff injury is a common shoulder disease,which often results in pain and limited motion of shoulder and reduces the quality of life.There are some limitations for current treatments,which often lead to repair failure or reinjury of rotator cuff.Therefore,a novel repair technique is needed.Biologic repair represents a novel technique in the management of rotator cuff injury,and has the potential to restore the normal histological structure of rotator cuff.Biologic repair involves the application of growth factors and/or cells to promote the regeneration of rotator cuff tendons. This study reviewed the literatures on biologic repair of rotator cuff injury,and presented the research progress.

Background: Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study. Methods: TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54). Results: Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning. Conclusions: Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China. Trial Registration ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.
China ; Crotonates ; administration & dosage ; adverse effects ; therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Multicenter Studies as Topic ; Multiple Sclerosis ; drug therapy ; metabolism ; Proportional Hazards Models ; Toluidines ; administration & dosage ; adverse effects ; therapeutic use

Objective To compare the clinical efficacy and safety of docetaxel combined with carboplatin (TP) and epirubicin combined with cyclophosphamide sequential docetaxel (EC-T) adjuvant in the treatment of three negative breast cancer in phase III . Methods 62 cases of three negative breast cancer patients in phase III from May 2012 to October 2016 were selected and randomly divided into the control group and the experimental group, with 31 patients in each group. The control group was treated with epirubicin combined with cyclophosphamide and sequential docetaxel, and the experimental group was treated with docetaxel and carboplatin. The clinical indicators were compared and analyzed. Results There was no significant difference in the recent remission rate (77.42%) between the experimental group and the control group (74.19%). Two groups of patients with adverse reactions were restored within one month. There were 10 cases of WBC decrease in the experimental group, with the incidence rate of 32.25%. There were 18 cases of WBC decrease in the control group, the incidence rate was 58.06%, the difference was statistically significant (P<0.05). Conclusion Docetaxel combined with carboplatin and epirubicin adjuvant combined with cyclophosphamide than star sequential docetaxel in the treatment of three patients with negative breast cancer stage III were tolerated, TP occurred leukopenia and alopecia with low probability.