Comparison of microtransplantation,chemotherapy and allogeneic transplantation in post-remission therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia

Patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph⁺ ALL) have poor prognosis, and the efficacy of chemotherapy plus tyrosine kinase inhibitors (TKIs) followed by mismatched donor stem cell infusion (microtransplantation, MST) has not been determined. We retrospectively summarized 45 patients including 11 undergoing MST with TKIs, 17 receiving allogeneic transplant and 17 undergoing chemotherapy with TKIs. Improved 4-year overall survival rate was observed in the MST group (91%) compared with either transplant group (31%, P = .005) or chemotherapy group (36%, P = .013). The MST group also had higher 2-year and 4-year leukemia-free survival rates (91% and 72%, respectively) compared with either transplant group (33%, P = .005 and 33%, P = .021, respectively) or chemotherapy group (41%, P = .017 and 31%, P = .023, respectively). 2-year and 4-year cumulative incidences of hematologic relapse were lower in the MST group (9% and 28%, respectively) compared with those in the chemotherapy group (56%, P = .025 and 67%, P = .034, respectively). In patients undergoing MST, donor microchimerism was detected (1.07 × 10^-5 to 6.6 × 10^-4 copies from 9 to 1499 days) in 7 patients, and donor/patient-derived HLA*0201/2402⁺WT1⁺CD8⁺ T cells were found from 0.05% to 0.67% in 6 patients. MST may provide a favorable treatment for patients with Ph⁺ ALL.     

血液系统恶性肿瘤患者化疗后合并中性粒细胞减少性肠炎的诊治研究

目的分析成人血液系统恶性肿瘤患者接受强烈化疗后中性粒细胞减少性肠炎（NE）的发生率、危险因素及预后情况。方法收集2004至2013年接受化疗的1804例血液系统恶性肿瘤患者，记录患者血常规、凝血检测和血液生化检测结果，并记录患者年龄、性别、原发病、既往化疗次数、既往化疗方案中是否使用阿糖胞苷、临床症状、肠壁厚度、中性粒细胞最低计数、中性粒细胞缺乏持续时间、NE的治疗方法和预后等，探讨NE起病诱因、临床特征、腹部B超特点、症状的预后意义及化疗药物对发病的影响等。结果1804例患者中226例（12.5%）化疗后合并NE，化疗后10~19d起病，中位起病时间为化疗后第14天。发生NE后26例患者死亡，病死率11.5%。化疗药物包括阿糖胞苷、临床症状≥4项、中性粒细胞缺乏持续超过7d以及B超下肠壁厚度≥10mm的患者病死率相对较高。结论NE是接受强烈化疗的血液系统肿瘤患者的严重的并发症，发生NE后患者病死率较高。     

低密度脂蛋白在2型糖尿病骨质疏松中的作用研究进展

2型糖尿病及骨质疏松已成为我国最主要的慢性代谢性疾病。2型糖尿病常伴有血脂紊乱，常表现为低密度脂蛋白升高，而越来越多的研究表明血脂通过不同的方式影响骨代谢，其机制可能是通过抑制骨髓间充质干细胞成骨分化，通过RANK/RNAKL/OPG信号通路及炎症反应调节破骨细胞等方式调节骨代谢。     

HIV-negative children’s experiences and opinions towards parental HIV disclosure: a qualitative study in China

In HIV/AIDS research, few studies to date have evaluated ways to improve parental HIV disclosure practices using feedback from HIV-negative children who have recently experienced this event. We conducted semi-structured in-depth interviews with 20 children (aged 6–15) who were partially to fully aware of their parents’ HIV status in rural Guangxi, China. Of the 20 children, eight children who were of older age (11.38 years in average) endorsed parental HIV disclosure, five discouraged it and seven expressed uncertainty. Children’s different experiences and attitudes towards disclosure were seen to be associated with their family dynamics (especially the parent–child relationship), social support and care, experiences of stigma and discrimination, psychosocial suffering, comprehension of the disease and the children’s age. Our study contributes to building a child-centered comprehensive understanding for Chinese parental HIV disclosure. It is imperative that counselors and community advocates assess and help parents achieve optimal readiness preceding disclosure of their illness to their HIV-negative children.     

基于自动勾画和快速蒙特卡罗计算的放射治疗全身器官剂量数据库平台的可行性研究

目的:探讨建立一种放射治疗全身器官剂量数据库平台的可行性。方法:使用基于深度学习的自动勾画软件DeepViewer?1例食管癌患者的全身CT上勾画全身器官，然后利用基于GPU加速的蒙特卡罗软件ARCHER计算相应的器官剂量分布，最后利用Lyman-Kutcher-Burman（LKB）模型评估放疗患者正常组织并发症概率（NTCP）。结果:针对该病例，成功建立基于DeepViewer?ARCHER和LKB模型的全身器官剂量数据库，发现距离靶区越近的器官剂量越大，其中心脏与靶区间距离最小，剂量为14.11 Gy，但因其模型参数特殊，通过LKB模型计算的NTCP为0.00%；左、右肺的剂量分别为3.19和1.16 Gy，但是NTCP值却很大，分别为2.13%和1.60%。对于距离靶区较远的头颈部器官（视交叉、视神经和眼）和腹部器官（直肠、膀胱和股骨头）剂量分别约为9和2 mGy，并且NTCP均近似为0.00%。结论:研究结果证明通过自动勾画软件DeepViewer?蒙特卡罗软件ARCHER和LKB模型建立全身器官剂量数据库的可行性。     

Health-Related Quality of Life in KEYNOTE-010: a Phase II/III Study of Pembrolizumab Versus Docetaxel in Patients With Previously Treated Advanced,Programmed Death Ligand 1–Expressing NSCLC

Introduction

In the phase II/III KEYNOTE-010 study (ClinicalTrials.gov, NCT01905657), pembrolizumab significantly prolonged overall survival over docetaxel in patients with previously treated, programmed death ligand 1–expressing (tumor proportion score ≥ 1%), advanced NSCLC. Health-related quality of life (HRQoL) results are reported here.

益母草制剂的开发与应用

益母草制剂在临床中应用广泛,主要用于多种妇产科疾病的治疗,且效果显著。其中,益母草注射剂、益母草颗粒、益母草片是临床上最常见的益母草剂型,其有效性和安全性在长期的临床实践中得到认可。本论文结合项目组对益母草制剂的二次开发研究思路,对上述具有代表性的益母草制剂的制剂工艺、质量控制和临床应用进行介绍,以期为益母草制剂的现代研究和临床安全应用提供一定的参考。     

HDAC1和CDK1在结肠癌组织中的表达及其临床意义

目的:研究组蛋白去乙酰化酶1（histone deacetylase 1,HDAC1）和细胞周期蛋白依赖性激酶1（cyclin-dependent kinase 1,CDK1）在结肠癌组织中的表达水平及其与患者临床病理特征及预后的关系。方法:收集2012年2月至2013年6月在本院普外科进行手术切除的51例结肠癌患者的肿瘤组织和癌旁非肿瘤组织，采用qRT-PCR法检测组织中HDAC1和CDK1 mRNA相对表达量，采用免疫组织化学染色法检测HDAC1和CDK1蛋白阳性表达率，分析肿瘤组织中HDAC1和CDK1表达的相关性及其与患者肿瘤直径、淋巴结转移等临床病理特征的关系，采用Kaplan-Meier生存函数分析HDAC1和CDK1不同表达情况与患者5年总生存率的关系。结果:肿瘤组织中HDAC1和CDK1 mRNA表达水平和蛋白阳性表达率均高于癌旁非肿瘤组织（P＜0.05）；肿瘤组织中HDAC1表达水平与CDK1表达水平呈显著正相关（P=0.012）；肿瘤组织中HDAC1表达与患者肿瘤直径和组织分化程度有关（P＜0.05），CDK1与肿瘤直径、TNM分期、分化程度、淋巴结转移有关（P＜0.05）；HDAC1、CDK1阳性表达患者5年总生存率均低于其相应阴性表达患者（P＜0.05），HDAC1和CDK1共阳性表达患者5年总生存率低于HDAC1和（或）CDK1阴性患者（P＜0.05）。结论:HDAC1和CDK1在结肠癌组织中高表达，与患者不良预后有关且两者呈正相关，推测两者在促进结肠癌进展中可能存在协同作用。