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Table of Content

    20 June 2019, Volume 34 Issue 6
    Demethylation therapy for lymphoma
    Wu Feifei, Ma Jie
    2019, 34(6):  485-488.  doi:10.3969/j.issn.1004-583X.2019.06.001
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    Epigenetics is the study of the heritable changes in gene expression without changes in the nucleotide sequence of genes, including DNA methylation, histone modification, miRNA, chromosome remodeling, etc.Studies have shown that DNA methylation plays an important role in the pathogenesis of lymphoma, and demethylation therapy plays an important role in overcoming drug resistance and recurrence of lymphoma.This article reviews the role of DNA methylation to the development of lymphoma and the application of demethylated drugs to the treatment of lymphoma.
    Diagnosis and treatment  of Waldenstrm's macroglobulinaemia
    Li Lili, Liu Qinhua, Xia Ruixiang
    2019, 34(6):  489-495.  doi:10.3969/j.issn.1004-583X.2019.06.002
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    Waldenstrm's macroglobulinemia (WM)/lymphoplasmictic lymphoma (LPL) is a rare,  incurable Bcell lymphoma. Its clinical course  is characterized by elevated immunoglobulinM (IgM) levels,  lymphoplasmacytic bone marrow  infiltration with cytopenia,  hepatomegaly,  splenomegaly,  and lymphadenopathy.Recently,  great progress has been made to better explain the pathobiology of WM,  which has  identified several clinical and genetic markers that serve prognosticate disease course and  patient outcomes. This article reviews some of the recent advance with  respect to prognostic markers and new treatments that are currently in progress.
    The role of body composition indicators in evaluating the treatment and prognosis of patients with lymphoma
    Huang Shanshan, Niu Yang, Wu Jiang
    2019, 34(6):  496-501.  doi:10.3969/j.issn.1004-583X.2019.06.003
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    Body composition indicators include height, weight, fat content and skeletal muscle content and etc. These indicators, which change during different stages of treatment in cancer patient, are not only closely related to the treatment efficacy but also play an important role in prognosis evaluation. This article details the changes of various body composition indicators during the treatment in lymphoma patients, as well as their indicating effects on prognosis, and focuses on the role of these indicators in lymphoma patients receiving hematopoietic stem cell transplantation.
    Diagnosis and treatment of primary central nervous system lymphoma
    Wang Fei, Yue Yanhua, Lu Luo, Gu Weiying
    2019, 34(6):  502-507.  doi:10.3969/j.issn.1004-583X.2019.06.004
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    Primary central nervous system lymphoma refers to a special type of nonHodgkin's lymphoma that is confined to the central nervous system without evidence of systemic spread. Its relatively low incidence and the limited pathological specimens  bring certain difficulties for further research. Genetic and molecular biology studies have confirmed its specific genetic background and molecular biological characteristics,  but the sample size of these studies is relatively small. Although the administration of highdose methotrexate has significantly improved the prognosis of the patients,  there is still no uniform optimal treatment, for most of the clinical studies are focused on phase Ⅱ singlecenter clinical trials and the sample size is relatively limited. Besides, there are no enough data to support clinical studies for treatment of the elderly and relapsed refractory patients. This article reviews the clinical and molecular biological characteristics and the treatment of primary central nervous system lymphoma.
    Lenalidomide in  treatment of relapsed/refractory nonHodgkin's Bcell lymphoma
    Bei Liye1, 2, Shi Yuye1, 2, Wang Chunling1, 2
    2019, 34(6):  508-513.  doi:10.3969/j.issn.1004-583X.2019.06.005
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    Patients with relapsed/refractory nonHodgkin's lymphoma (R/R NHL) have poor overall prognosis. More and more new drugs and targeted drugs are applied to improve the survival of R/R NHL. Lenalidomide has been used in various subtypes of NHL to improve the therapeutic effect,  especially in Bcell lymphoma,  due to its immunomodulatory effects,  inhibition of angiogenesis and direct antitumor activity. Based on the existing evidence,  this review summarizes the application of lenalidomide to R/R NHL.
    Treatment of  relapsed or refractory  mantle cell lymphoma
    Miao Yuqing, Xu Hao
    2019, 34(6):  514-518.  doi:10.3969/j.issn.1004-583X.2019.06.006
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    Mantle cell lymphoma(MCL) is an aggressive Bcell nonHodgkin's lymphoma with a variety of clinical manifestations in the elderly. At present,  there is no standard specific treatment for the relapsed patients. Recently,  several new drugs have been developed,  which can improve the prognosis of relapsed and refractory MCL. This article reviews the new drugs that have been introduced to the treatment of these patients in recent years.
    The application of 18FFDG PET/CT to the treatment of Hodgkin's lymphoma
    Jia Xiting, Jia Tao
    2019, 34(6):  519-524.  doi:10.3969/j.issn.1004-583X.2019.06.007
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    Functional imaging using 18fluorodeoxyglycose (18FFDG) positron emission tomography combined with computed tomography (PET/CT) has become a major imaging modality in Hodgkin lymphoma with a definite role in the staging of Hodgkin lymphoma. It is a predictive treatment tool that is constantly evolving through the use of responseadaptive therapies. A large number of clinical studies have shown that 18FFDG PET/CT has a very high prognostic value for HL,  which can improve the accuracy of staging and identify residual tumors and fibrotic tissues. The responseadaptive treatment in HL can reduce the toxicity to lowrisk patients by reducing the dose, and also improve the prognosis by increasing the intensity of treatment for highrisk patients. This review describes the application of 18FFDG PET/CT to the diagnosis, staging and end of treatment in HL, and explores the new functional prognostic factors for total metabolic tumor volume.
    Drug resistance mechanisms of lymphoma
    Jiao Jun, Sang Wei, Xu Kailin
    2019, 34(6):  525-529.  doi:10.3969/j.issn.1004-583X.2019.06.008
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    Lymphoma is a hematological malignant tumor originating from lymphocytes. Its clinical manifestations are complex and diverse, and it is highly heterogeneous. Deapite the fact that the survival rate of lymphoma patients is significantly improved in the era of immunochemotherapy,, around 40% of patients still suffer from primary resistance, and relapse after medication and treatment. The mechanism of drug resistance in lymphoma cells is extremely complex, which is associated with lymphoma autoheterogeneity, immune evasion, and microenvironmentrelated immune escape and epigenetics. This article reviews the progress of research on the mechanism of lymphoma resistance.
    The efficacy and safety of assessmentbased treatment models in patients with schizophrenia
    Xi Lingyan1, Huang Xiuqin1, Zhang Suyun1, Li Ziyu1, Xu Congen1, Jin Guixing2
    2019, 34(6):  530-534.  doi:10.3969/j.issn.1004-583X.2019.06.009
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    Objective  To investigate the efficacy and safety of an assessmentbased treatment model in patients with schizophrenia.Methods  A total of 120 patients with schizophrenia who met the DSMV diagnostic criteria in our hospital from March 2017 to March 2018 were randomly divided into the study group and the control group,  for each group 60 patients.The study group adopted an assessmentbased treatment model to take the secondgeneration antipsychotic risperidone tablets at a maximum dose of 46 mg/day. An assessment was performed at the end of   the  second week  according to the negative and positive scales (PANSS). Should the rate of decreasebe less than 20%, replace it with olanzapine  in a crossed way. The control group,  however, adopted a conventional treatment plan,  that is,  administering  the maximum dose of risperidone from the very beginning to the  end of the study.PANSS and the Personal and Social Performance Scale (PSP) were evaluated before treatment,  at the end of  the 2nd weekend,  the 4th weekend,  and the 8th week to observe the patient's mental symptoms and social function,  a sixmonth followup was carried out. Results  In the study group,  9 cases were withdrawn due to intramuscular injection of haloperidol injection or other secondgeneration antipsychotic drugs,  1 case due to the adverse reactions,  and 1 case  due  to  the withdrawal of informed consent. In the control group,  a total of 7 cases were withdrawn due to intramuscular injection of haloperidol injection or other the secondgeneration antipsychotic drugs,  3 cases due to adverse reactions,  and 3 cases due to the withdrawl of the informed consent. At the end of the 4th and 8th week of treatment,  the positive symptom score [the 4th weekend (15.65±3.23  vs 18.04±2.50),  the  8th weekend (13.35±2.90  vs 14.68±2.25)],  and the PANSS total score [the 4th weekend (69.22±5.29 vs 72.04±5.53),  the 8th weekend (58.33±4.44 vs 61.47±5.63)] of the study group were significantly lower thanthose of the control group, and the difference was statistically significant (P<0.05);There was no significant difference in the negative symptoms between the two groups at any time point (P>0.05). The general psychopathological scores (31.94±2.40 vs 33.36±4.10) were only statistically significant at the 8th week of treatment (P<0.05),  and that  of the study group was even lower. At the 4th week and the 8th week of treatment,  the PSP scores of the study group [the 4th weekend (52.37±5.40 vs 49.36±4.91), the 8th weekend (61.33±5.81 vs 57.49±5.64)]  were significantly higher than that of the control group,  and the differences were statistically significant (P<0.05); the PSP score (70.45±6.23 vs 65.83±5.97) of the  study group was significantly higher than the other group during 6 months of followup (P<0.01).Conclusion   The assessmentbased treatment models can control mental symptoms in patients with schizophrenia at an early stage and help improve their social function.
    Effect of load dosage rosuvastatin on src homology2containing inositol phosphatase 1  level and prognosis in patients with nonST segment elevation myocardial  infarction before and after percutaneous coronary intervention
    Zeng Lingwei1, Yang Jing1, Zhang Liang1, Ding Yue2
    2019, 34(6):  535-540.  doi:10.3969/j.issn.1004-583X.2019.06.010
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    Objective  To investigate the effect of load dosage rosuvastatin on src homology2containing inositol phosphatase 1 level (SHIP1) and prognosis in patients with nonST segment elevation myocardial infarction (NSTEMI) before and after percutaneous coronary intervention (PCI). Methods  A total of 96 patients with NSTEMI in Wuwei people's Hospital between June 2015 and April 2018 was randomly enrolled into the treatment group (48 cases) and the control group (48 cases). All patients in both groups were treated by PCI while patients in treatment group were treated by load dosage rosuvastatin (20 mg 12 h and 2 h before PCI,  respectively),  both groups were followedup for 180 days. The cTnI,  CKMB,  IL6,  TNFα,  IFNγ,  SHIP1,  miR155,  MACE and adverse drug reaction of both groups were comparatively analyzed. Results  No significant difference in cTnI and CKMB levels between the both groups was found before PCI (P>0.05); at 12h after PCI,  the levels of cTnI and CKMB in both groups increased,  and decreased significantly at 24 hours after PCI,  among which,  the cTnI and CKMB of the treatment group was significantly lower than those of control group (P<0.01). No significant difference in IL6,  TNFαand IFNγ levels was found between the two groups before PCI (P>0.05),  at 24 h after PCI,  the levels of IL6,  TNFαand  IFNγ in in both groups increased while these indexes in the treatment group were significantly lower than those of the control group(P=0.000). No significant difference in relative expression of miR155 and SHIP1 was found between the two groups before PCI (P>0.05),  the level of miR155 increased in both groups while it was lower in the treatment group than in the control group (P<0.01) and the level of SHIP1 in the treatment group was higher than that of the control group(P<0.01). The incidence of MACE within 180 days after PCI in the treatment group and in the control group was 16.67% (8/48) and 37.50% (18/48),  respectively,  while the risk of MACE of inpatients in the treatment group was significantly lower than that of control group (P=0.038). No significant difference existed in the total rate of  adverse drug reaction between the two groups (10.41% vs 14.59%, P=0.757). Conclusion   The preoperative load dosage of PCI can restore the myocardial enzyme level of NSTEMI patients after PCI treatment by inhibiting miR155/SHIP1 signal transduction pathway,  reduce inflammatory response and improve the prognosis of NSTEMI patients.
    Urine UbA52 and urine VDBP detection and significance in patients with diabetic nephropathy
    Wang Jiangli1, Liu Maodong2, Chi Yanqing2, Zhang Yimin3, Li Ying2
    2019, 34(6):  541-544.  doi:10.3969/j.issn.1004-583X.2019.06.011
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    Objective  To explore the value of urine ubiquitin 52 amino acid fusion protein(UbA52) and urine vitamin D binding protein(VDBP) in diabetic nephropathy(DN) diagnosis by detecting urine UbA52 and urine VDBP concentrations.Methods  A total of 46 patients with DN and 38 patients with type 2 diabetes mellitus were treated as  DN  group and diabetic group.ELISA was used to detect UbA52 and VDBP in urine. Analysis of differences between three groups, the differences on DN diagnostic specificity and sensitivity in urine UbA52 and urine VDBP,  urinary protein quantitative and urinary creatinine ratio (ACR) were compared.Results  Urine UbA52 and urine VDBP of  three groups were significantly different from each other(P<0.05). Urine UbA52 and urine VDBP of DN group were significantly higher than those of diabetes group and normal control group.Urine UbA52 and urine VDBP of DN group and normal control group were not significantly different (P>0.05).  The area under the ROC curve of  urine UbA52,  urine VDBP,24hour urine protein quantification,ACR,urine UbA52 combined urine VDBP in diagnosis of  DN were 0.729, 0.776,0.629, 0.657,0.779,respectively.Conclusion  The detection of  urine UbA52 and urine VDBP levels have certain reference value in evaluating the condition of  DN. The combined detection of urine UbA52 and urine VDBP has important  clinical significance in  diagnosis of  DN.
    Logistic regression analysis of related factors of nonalcoholic fatty liver combined with metabolic syndrome
    Zhang Lifen, Wang Peiyu, Liu Ling
    2019, 34(6):  545-548.  doi:10.3969/j.issn.1004-583X.2019.06.012
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    Objective  To investigate the related factors of nonalcoholic fatty liver (NAFLD) with metabolic syndrome (MS). Methods  A total of 422 patients with NAFLD who were examined and diagnosed in our outpatient clinic from January 2015 to December 2016  were divided into the control group (n=176 cases) and the study group (n=246 cases) according to whether MS was combined. Binary logistic was adopted. Regression analysis of the relevant influencing factors of NAFLD combined with MS was performed. Results  There were significant differences in age,  gender,  alcohol consumption,  body weight,  BMI index,  TC,  UA,  FPG,  Fins,  HOMAIR and GSH between the two groups (P<0.05). Binary logistic regression analysis showed that age,  BMI index,  HOMAIR,  GSH were the relevant influencing factors of NAFLD combined with MS. Conclusion  NAFLD is closely related to MS. Age,  BMI index,  HOMAIR and GSH can be used as predictors of NAFLD combined with MS.
    Effect of nutritional status on nausea and vomiting caused by chemotherapy in patients with lung cancer
    Qiu Yi, Chen Lu, Qu Meidi, Zhang Min, Gu Hongliu, Sha Qi
    2019, 34(6):  549-552.  doi:10.3969/j.issn.1004-583X.2019.06.013
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    Objective  To investigate the effect of nutritional status on chemotherapyinduced nausea and vomiting by cisplatinbased chemotherapy in patients with lung cancer. Methods  A total of 200 patients with lung cancer who received cisplatin chemotherapy in the First People's Hospital of Changzhou was selected, and ondansetron was used as antiemetic drug. All patients  are divided into a malnutrition group and a nonmalnutrition group according to PGSGAscore, and the clinical data, nutritionrelated indicators, and CINV were analysed. Nutritional intervention was performed on malnourished patients, and the duration of CINV before and after nutritional intervention was compared. Results  Among  the 200 patients included, the PGSGA score was ≥4 points in 122 cases, which indicated  that 61% of  the 200 patients had malnutrition. There were no significant differences in clinical data between the two groups in terms of gender, age, tumor type, tumor stage, and chemotherapy regimen (P>0.05). Multivariate regression analysis showed that malnutrition was an independent risk factor for CINV(P<0.01). After nutritional intervention in patients with malnutrition, the duration of nausea and vomiting was improved (P<0.01). Conclusion  Malnutritionisan is independent risk factor for CINV, and nutritional intervention can improve the duration of CINV.
    Clinical features of aspergillus tracheobronchitis in two patients without immune compromise and literature review
    Cai Zhiming1, Huang Songping1, Lin Yichuan1,LI Baochun2, LIU Darui2
    2019, 34(6):  553-558.  doi:10.3969/j.issn.1004-583X.2019.06.014
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    Objective  To analyze the clinical features of aspergillus tracheobronchitis( ATB) in patients without immune compromise. Methods  A retrospective analysis was carried out on clinical data of 2 case of ATB patient without immune compromise who were admitted in 2018.Relevant literatures reported between 2000 and 2018 were reviewed. Results  Combined with the cases mentioned in this article,  there were altogether 14 cases without immune compromise diagnosed as ATB included into the analysis. Among them,  9 were male and 5 were female,  with their average age being 48±17 years old (2178 years old). The symptoms of fever,  dyspnea attacked most of the patients. Abnormal presentation of the tracheal wall or lumen were found more frequently than other signs in  abnormal pulmonary imaging(10/14,71.4%). Pseudomembranous lesions were the most frequent form observed by broncoscopy(11/14,78.6%). However,  there was no ulcer lesion showed by broncoscopy. All of the 14 cases have been misdiagnosed as pneumonia,  and failed to respond to antibiotic treatment. And among them,  11 cases were discharged with improvement while 3 cases died. Conclusion  Our pooled analysis shows that ATB,though remaining a rare infection,can be presented in patients without immunocompressed. Fever and dyspnoea resistant to corticosteroids and appropriate antibiotics with or without abnormal chest film should raise the suspicion of ATB in immunocompetent patients. Early diagnosis of ATB is based on bronchoscopic examination.
    Effect of aspirin on reducing the incidence of ARDS: a metaanalysis
    Lv Jianlei, Li Yanfen, Dai Yao, Lv Ailian
    2019, 34(6):  559-563.  doi:10.3969/j.issn.1004-583X.2019.06.015
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    Objective  Growing evidence suggests that platelets play an  important role in the pathogenesis of acute respiratory distress syndrome(ARDS).  Previous basic studies have also confirmed that platelet inhibitor  aspirin  plays an important role in the occurrence and progression of  ARDS. This study aims to  metaanalyze  whether aspirin can reduce  the incidence of ARDS  in patients. Methods  A comprehensive search was conducted on PubMed, EMbase, Cochrane, WANFANG database and CNKI from 2011 to 2016 for the literature on the effect of aspirin on the incidence of ARDS.The literatures were screened according to the inclusion and exclusion criteria, and the data were extracted for metaanalysis using Stata15.0 software.Results  A total of 4 literatures were included, including 3 observational literatures and 1 multicenter randomized controlled trial.A total of 5 555 patients with high  risk factors for  ARDS  were enrolled, among which 1 537  patients took aspirin. The results showed that  aspirin significantly reduced the incidence of ARDS compared with those who did not take aspirin(OR=0.709,  95%CI=0.5620.896, P=0.004).Conclusion  Prehospital aspirin administration significantly reduces  the incidence of ARDS,but a large number of multicenter randomized controlled trials are needed.
    Literature review of one case of isolated myeloid sarcoma received hematopoietic stem cell transplantation
    Yang Tingting1, Wang Yanyan1, Liu Lili1, Hua Lei1, Wang Baohong2
    2019, 34(6):  564-566.  doi:10.3969/j.issn.1004-583X.2019.06.016
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    To enhance the  understanding of isolated myeloid sarcoma, an analysis combined with the review of literatures was conducted on the clinical manifestations, immunohistochemistry, treatment  and prognosis of one case of myeloid sarcoma .Should IMS occur in a rare site with poor differentiation and without immunohistocemistry  or light green appearance,  it would be  easily misdiagnosed as lymphoma,  rhabdomyosarcoma and so on,  which decides the diagnosis based on pathology and immunohistochemistry. There  is a high risk of IMS transforming into acute leukemia.Despite the localized nature of tumor, intensive antileukemia chemotherapy is necessary.Conditions permitting,  hematopoietic stem cell transplantation should be carried out in time to delay disease recurrence,  prolong  the period of survival and improve  prognosis.