Clinical observation of low‐dose combination chemotherapy in refractory/recurrent paroxysmal nocturnal hemoglobinuria patients: A single‐center retrospective analysis

BackgroundWe performed a retrospective analysis to investigate the clinical characteristics and therapeutic strategies of 20 refractory/recurrent PNH patients, including the clinical efficacy of chemotherapy treatment, safety, and survival.MethodsThe clinical data of 20 classic PNH patients who were refractory/recurrent or had glucocorticoid dependence in our hospital were analyzed, including clinical manifestations, laboratory examinations, treatment efficacy, and survival.ResultsSeventeen patients had a marked improvement in anemia after chemotherapy, 14 patients acquired blood transfusion independence, and the Hb of 3 patients increased to normal levels. Although 6 patients still needed blood transfusion, the transfusion interval was significantly prolonged. The percentages of LDH, TBIL, and RET, which are indicators of hemolysis, were significantly lower than those before chemotherapy. The dosage of adrenal glucocorticoids was reduced by more than half compared with that before chemotherapy.ConclusionsChemotherapy can reduce PNH clones, promote normal hematopoiesis, and control hemolytic attack. It is a promising and widely used therapeutic method.     

喘可治注射液联合化疗治疗老年非小细胞肺癌近期疗效观察

目的 观察喘可治注射液联合化疗治疗Ⅲ、Ⅳ期老年非小细胞肺癌（NSCLC）的近期疗效。方法 采用前瞻性、随机、对照的临床研究方法,将62例老年NSCLC病例按1∶1比例分为试验组（喘可治注射液+中医辨证论治+化疗）和对照组（中医辨证论治+化疗）,其中试验组32例,对照组30例。观察喘可治注射液联合化疗对瘤体大小、临床症状、体力状况（PS）评分、体质量的影响及化疗副反应。结果 试验组、对照组瘤体大小疗效评价：有效率（ORR）分别为31.3 %、16.7 %,稳定率（DCR）分别为84.4 %、73.3 %,两组比较差异均无统计学意义（P＞0.05）。试验组咳嗽、咯痰、夜尿频多、畏寒肢冷等临床症状缓解率优于对照组（P＜0.05）;试验组的PS评分改善优于对照组（P＜0.05）;试验组治疗后体质量增加率及稳定率均高于对照组（P＜0.05）;试验组骨髓抑制程度较对照组轻,其中白细胞及中性粒细胞变化有统计学意义（P＜0.05）。结论 喘可治注射液应用于Ⅲ、Ⅳ期老年NSCLC化疗患者具有增效减毒的协同作用,能明显改善临床症状、提高PS评分,维持体质量及有效减轻骨髓抑制。     

Iguratimod in treatment of primary Sjögren’s syndrome concomitant with autoimmune hemolytic anemia: A case report

BACKGROUNDPrimary Sjögren''s syndrome (pSS) concomitant with autoimmune hemolytic anemia (AIHA) but without eye and mouth dryness is exceedingly rare. Iguratimod (IGU) has been widely used in the treatment of pSS. However, there are few reports about the application of IGU in pSS concomitant with AIHA. CASE SUMMARYHere, we present the case of a patient with pSS concomitant with AIHA but without eye and mouth dryness. The patient was initially diagnosed with hyperplastic anemia and AIHA while pSS was missed, and was finally diagnosed with pSS concomitant with AIHA. The patient was treated with IGU along with prednisone and hydroxychloroquine, and her hemoglobin, reticulocytes and IgG returned to normal levels.CONCLUSIONIGU was effective for and well tolerated by our patient with pSS concomitant with AIHA, and may be a promising therapy for the treatment of this disease.     

部队救援人员认知情绪调节与抑郁的早期筛查模型

目的调查某部1324名救援人员认知情绪调节策略及抑郁自评结果,探索认知情绪调节策略与抑郁的预测模型。方法采取整群抽样方式,现场调查某部救援人员共1324名,采用患者健康问卷抑郁量表(PHQ-9)、认知情绪调节量表(CERQ)进行调查。运用二元logistic回归分析建立抑郁筛查预测模型。结果某部救援人员抑郁筛查阳性率为11.3%,筛出抑郁状态150名。Logistic回归分析结果显示,灾难化(P=0.000)、积极重新评价(P=0.001)、接受(P=0.000)三种认知情绪调节策略可显著预测抑郁筛查阳性,OR及95%CI分别为:1.509(1.348~1.689)、1.197(1.079~1.329)及0.817(0.739~0.903)。灾难化、接受与抑郁情绪呈正相关。结论灾难化、接受积极重新评价这三种认知情绪调节策略对该部救援人员抑郁自评结果有预测作用。     

外源性信号通路JAK/STAT在ALA-光动力诱导人SCC细胞凋亡中的作用

目的：明确外源性凋亡机制(JAK/STAT信号通路)在5-ALA-PDT诱导人鳞状细胞癌细胞(SCC)凋亡中的作用。方法：体外培养鳞状细胞癌细胞系A431和COLO-16,分为空白对照组、转染阴性对照组、光动力组、转染阴性+光动力组、STAT3高表达载体组、STAT3-siRNA组、STAT3高表达载体+光动力组,STAT3-siRNA组+光动力组。CCK-8,流式细胞术（FCM）法分别检测各组细胞的存活率和凋亡率,qRT-PCR和Western Blot检测STAT3及其下游基因Bax和Bcl-2的mRNA和蛋白水平。结果：5-ALA-PDT组A431和COLO-16凋亡率为24%和22%高于STAT3高表达载体+光动力组(11%和10.5%),低于 STAT3-siRNA+光动力组（36%和39%）;5-ALA-PDT组STAT3和Bcl-2 mRNA水平和蛋白水平低于高表达载体+光动力组,高于STAT3-siRNA组。5-ALA-PDT组Bax mRNA和蛋白的水平高于高表达载体+光动力组,低于STAT3-siRNA组。结论：外源性凋亡通路JAK-STAT3可能参与5-ALA-PDT诱导的上皮鳞癌细胞的凋亡过程。     

Larger regional volume of the thalamus in diarrhea-predominant irritable bowel syndrome: a cross-sectional study

Brain Imaging and Behavior - As a relay center between the cerebral cortex and various subcortical brain areas, the thalamus is repeatedly associated with the dysfunction of brain-gut interaction...     

33 例非免疫性胎儿水肿临床特征及转归

目的探讨非免疫性胎儿水肿(NIHF)临床特征及转归。方法回顾分析2014年1月—2016年12月收治的33例NIHF新生儿的临床资料,将其分为死亡组和治愈组,进行两组间各因素的比较分析。结果 33例患儿中,男16例、女17例,中位胎龄33.4周(31.2～35.1周),出生体质量(2 714±712)g,死亡20例。死亡组出生体质量、1分钟及5分钟Apgar评分低于治愈组,差异均有统计学意义(P0.05)。新生儿产时复苏插管组和未插管组的母亲孕期合并症发生率及宫内干预率的差异有统计学意义(P0.05)。宫内干预是导致新生儿需产时复苏的独立危险因素(OR=15.30,95%CI:2.46～95.19);1分钟Apgar评分是NIHF疾病转归的独立危险因素(OR=1.75,95%CI:1.20～2.53),评分越低、死亡率越高。结论宫内干预与产时需要复苏有关,而1分钟Apgar评分是影响NIHF结局的重要因素。