Role of induction and consolidation chemotherapy in elderly acute myeloid leukemia patients

The present study sought to elucidate the role of induction and consolidation therapy in elderly patients. We retrospectively collected data of 477 patients who were aged over 60 years at the time of acute myeloid leukemia (AML) diagnosis. The median overall survival (OS) was 339 days in the induction group (n = 266) and 86 days in the best supportive care group (n = 211) (P < 0.001). In the induction group, the complete remission (CR) rate was 58.3 %, and treatment-related death was 15.4 %. Successful induction was related to good performance [Eastern Cooperative Oncology Group (ECOG <2)] [hazard ratio (HR) 3.215; P = 0.002]. Mortality correlated with failure to achieve CR (HR 4.059; P < 0.001) and poor performance status (ECOG >2) (HR 2.731; P = 0.035). In CR patients, poor karyotype and absence of consolidation (HR 2.313; P = 0.003) correlated with mortality. More than one cycle of consolidation was associated with better OS (P < 0.001). Lack of salvage therapy was associated with mortality in patients who did not achieve CR (HR 3.223; P = 0.005). Intensive induction in patients with good performance and >1 cycle of consolidation after CR may be the best strategy for improving OS in elderly AML patients.     

一例巨长胸椎管内血管脂肪瘤报道

患者女,24岁,主因“双下肢无力7年,加重3个月”于2013年8月25日人院。患者7年前出现双下肢无力,并进行性加重,半年后双下肢瘫痪伴感觉障碍,就诊多家当地医院,行胸椎核磁提示椎管内占位（T1-11）,因手术困难,未行手术治疗,后服中药治疗（具体不详）,症状逐渐缓解至正常。3个月前患者再次出现双下肢无力,自述乳头水平以下无感觉,症状进行性加重,1个月前患者无法行走,伴乳头水平以下感觉减退,以右侧显著,为进一步治疗收住院。     

电极间距与电极直径对恒功率下双极射频熔脂效果影响的研究

在双极射频应用于局部脂肪堆积的无创治疗的过程中,关于双极射频设备的部分设计参数目前还没有形成统一的规范。采用有限元方法和离体实验,分析双极射频熔脂时不同参数对组织熔脂效果的影响,寻求在双极射频尽量不会对皮肤层造成热损伤的同时,实现较大范围熔脂效果的熔脂参数配置。采用COMSOLMultiphysics进行生物组织热电耦合的有限元分析;为验证模型有效性,采用一种自研的单路双极射频输出设备,对离体猪腹部组织进行实验。有限元分析结果显示:经双极射频加热30min后,在功率为10W,电极球直径分别为3、5、8mm,电极间距分别为2和3cm的熔脂参数配置下,皮肤层的最终温度低于热损伤阈值温度,且部分脂肪层在热损伤区域内;域点探针所显示的脂肪层热损伤区域内的温度变化曲线满足熔脂温度要求。不同熔脂参数配置,对双极射频加热下组织内的温度分布具有显著影响。在10W功率下,采用直径为8mm的球型电极,电极按压皮肤的深度为1mm,在电极间距分别为2和3cm的条件下,脂肪层内产生最大面积的连续热损伤区域和点状热损伤区域,热损伤区域的面积分别为2.84和2.55cm²。相同熔脂参数配置的离体实验表明,与组织模型相同位置处的热电偶探针的最终温度和对应的域点探针相差0.92℃±0.43℃。有限元分析结果和实验结果基本一致。由仿真结果和实验结果可知,上述熔脂参数配置可使双极射频不会对皮肤层造成热损伤,同时在脂肪层内产生有效的热损伤区域,并且热损伤区域内的温度达到了熔脂要求。合理的熔脂参数配置是决定双极射频熔脂是否成功的一项关键因素。     

Cross-regulation by TLR4 and T cell Ig mucin-3 determines severity of liver injury in a CCl4-induced mouse model

Acute liver injury is a common pathological basis for a variety of acute liver diseases in the clinic, which can eventually lead to liver fibrosis and even liver failure. In this study, we found that T cell Ig and mucin domain protein 3 (Tim-3) and TLR4 receptors play important roles in CCl4-induced acute liver injury. Tim-3 is a negative regulator that is expressed by T cells and macrophages. Using antibodies against Tim-3 (anti-Tim-3 Ab), we studied the Tim-3 signal in an animal model of acute liver injury and found that a large number of inflammatory factors were upregulated. In vitro experimental data shown that anti-Tim-3 Ab treatment increased interferon-ɣ production by concanavalin A (ConA)-stimulated spleen T cells, and we found that the expression level of interleukin (IL)-6 was increased in a macrophage/spleen T cell coculture system, while administration of galectin-9 (Gal-9, a Tim-3 ligand) reduced the IL-6 production. This indicates the importance of the Tim-3/Gal-9 signalling pathway in maintaining hepatic homeostasis. The Tim-3 signalling pathway inhibits TLR4-mediated NF-κB activity, and an anti-Tim-3 Ab does not affect the liver injury in TLR4-deficient mice. Regulation between Tim-3 and TLR4 determines the severity of liver damage. The negative regulation of Tim-3 reflects the protective mechanisms of patients with impaired liver function, and these results provide important information about innate and adaptive responses in the regulation of liver damage. This finding is potentially important for the study of early liver injury.     

三七皂苷R1保护四氯化碳诱导肝纤维化模型大鼠的作用

背景：前期研究发现,三七总皂苷对小鼠免疫性肝损伤具有一定的保护作用。 目的：探究三七皂苷R1对四氯化碳诱导的肝纤维化模型大鼠的治疗作用。 方法：用四氯化碳诱导SD雄性大鼠制备肝纤维化模型,给药组按照60 mg/kg的剂量给予30 g/L三七皂苷R1溶液, 1次/d,连续4周和6周。对照组及模型组给予同体积的生理盐水,采用苏木精-伊红染色及Masson染色观察肝脏组织结构和纤维化程度分期;反转录-定量聚合酶链反应(qRT-PCR)检测法检测Ⅰ型胶原、α-平滑肌激动蛋白和转化生长因子β1表达水平。实验方案经昆明医科大学动物实验伦理委员会批准(批准号为approval No. KMMU2018018)。 结果与结论：①肝组织病理学显示,与模型组相比,三七皂苷R1能显著减轻纤维增生程度;②与模型组相比,三七皂苷R1组Ⅰ型胶原、α-平滑肌激动蛋白和转化生长因子β1表达水平显著降低(P < 0.05),三七皂苷R1给药4周与6周组比较差异无显著性意义;③结果提示,三七皂苷R1对四氯化碳诱导的肝纤维化模型大鼠具有一定的治疗作用。 ORCID: 0000-0002-0755-1476(吴朕) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Increased expression of the lncRNA PVT1 promotes tumorigenesis in non-small cell lung cancer

Introduction: Non-small cell lung cancer (NSCLC) is the major cause of cancer death worldwide. Increasing evidence shows that long non coding RNAs (lncRNAs) are widely involved in the development and progression of NSCLC. lncRNA PVT1 in several cancers has been studied, its role in lung cancer remains unknown. Our studies were designed to investigate the expression, biological role and clinical significance of PVT1 in lung cancer. Methods: lncRNA PVT1 expression in 82 NSCLC tissues and 3 lung cancer cell lines was measured by quantitative Real-time PCR (qRT-PCR). Its association with overall survival of patients was analyzed by statistical analysis. RNA interference (RNAi) approaches were used to investigate the biological functions of PVT1. The effect of PVT1 on proliferation was evaluated by MTT, cell migration and invasion ability was evaluated by cell migration and invasion assays. Results: lncRNA PVT1 expression was significantly upregulated in NSCLC tissues and lung cancer cells when compared with corresponding adjacent normal tissues and normal bronchial epithelial cells. Increased PVT1 expression was significantly correlated with histological grade and lymph node metastasis. In addition, NSCLC patients with PVT1 higher expression have shown significantly poorer overall survival than those with lower PVT1 expression. And PVT1 expression was an independent prognostic marker of overall survival in a multivariate analysis. In vitro assays our results indicated that knockdown of PVT1 inhibited cell proliferation, migration, and invasion. Conclusions: Our data indicated that lncRNA PVT1 is significantly upregulated in NSCLC tissues and may represent a new biomarker and a potential therapeutic target for NSCLC intervention.     

Mild degenerative changes of hip cartilage in elderly patients: an available sample representative of early osteoarthritis

This study investigated the cellular and molecular changes which occur in cartilage from adults with femoral neck fracture (FNF) and osteoarthritis (OA), and explored the similarities in hip cartilage obtained from elderly patients and patients with early OA. Femoral heads were retrieved from 23 female patients undergoing total hip arthroplasty (THA). This group included 7 healthy patients with FNF (hFNF), 8 elderly adults with FNF (eFNF), and 8 elderly patients with hip OA (OA). After high-field MRI T2 mapping, osteochondral plugs were harvested from the weight-bearing area of femoral heads for subsequent macroscopic, histologic, and immunochemical evaluation. Additionally, the contents of cartilage matrix were analyzed, and gene expression was detected. The surface of cartilage from hFNF and eFNF patients appeared smooth, regular, and elastic, whereas it showed irregularities, thinning, and defects in OA patients. Elevated T2 values and decreased accumulation of glycosaminoglycans (GAGs) were detected in cartilage from eFNF patients. Furthermore, type I collagen accumulation was slightly increased and type X collagen concentration was obviously elevated in eFNF patients; however, type II collagen distribution and the contents and anisotropy of collagen fibrils in eFNF patients showed no significant changes. Consistent with histology and immunohistochemical results, aggrecan was downregulated and type X collagen was upregulated, while collagens types I and II showed no significant changes in eFNF patients. The cellular and molecular characteristics of hip cartilage in eFNF patients who showed no symptoms of OA were similar to those in patients with mild OA. Thus, eFNF cartilage can serve as a comparative specimen for use in studies investigating early OA.     

氟哌啶醇预防危重症患者谵妄发生的Meta分析

目的系统评价氟哌啶醇预防危重患者发生谵妄的疗效和安全性。 方法计算机检索Medline、EMbase、The Cochrane Library、维普数据库、中国知网、中国生物医学文献数据库数据库从建库至2018年9月的关于氟哌啶醇预防危重症患者谵妄疗效的随机对照试验（RCT）。由2位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用RevMan 5.2软件进行Meta分析。 结果共纳入4个RCT,2 455例患者。Meta分析结果显示,试验组与对照组危重症患者间28 d谵妄发病率[相对危险度（RR） = 0.96,95%置信区间（CI）（0.65,1.43）,Z = 0.19,P = 0.85]、28 d无谵妄及无昏迷时间[均数差（MD） = 0.05,95%CI（-0.06,0.15）,Z = 0.88,P = 0.38]、28 d存活率[RR = 1.00,95%CI（0.97,1.04）,Z = 0.23,P = 0.82]、ICU住院时间[MD = -0.18,95%CI（-2.00,1.64）,Z = 0.20,P = 0.84]的比较,差异均无统计学意义。且在严重不良反应方面,两组患者间QTc间期延长[RR = 1.18,95%CI（0.83,1.67）,Z = 0.92,P = 0.36]、锥体外系症状[RR = 1.07,95%CI（0.69,1.67）,Z = 0.31,P = 0.76]、过度镇静[RR = 1.90,95%CI（0.77,4.66）,Z = 1.40,P = 0.16]发生的比较,差异也均无统计学意义。 结论氟哌啶醇不能预防危重症患者谵妄的发生,且对预后也没有明显改善作用。