Hedgehog pathway inhibition as a therapeutic target in acute myeloid leukemia

Introduction: The Hedgehog (HH) pathway constitutes a collection of signaling molecules which critically influence embryogenesis. In adults, however, the HH pathway remains integral to the proliferation, maintenance, and apoptosis of adult stem cells including hematopoietic stem cells.

Areas covered: We discuss the current understanding of the HH pathway as it relates to normal hematopoiesis, the pathology of acute myeloid leukemia (AML), the rationale for and data from combination therapies including HH pathway inhibitors, and ultimately the prospects that might offer promise in targeting this pathway in AML.

Expert opinion: Efforts to target the HH pathway have been focused on impeding this disposition and restoring chemosensitivity to conventional myeloid neoplasm therapies. The year 2018 saw the first approval of a HH pathway inhibitor (glasdegib) for AML, though for an older population and in combination with an uncommonly-used therapy. Several other clinical trials with agents targeting modulators of HH signaling in AML and MDS are underway. Further study and understanding of the interplay between the numerous aspects of HH signaling and how it relates to the augmented survival of AML will provide a more reliable substrate for therapeutic strategies in patients with this poor-risk disease.     

The interaction between pain and movement

Study DesignClinical commentary.Introduction/PurposePain and movement are universally relevant phenomena that influence human experiences in readily observable ways. Improved understanding of pain-movement relationships can guide medical and rehabilitative approaches to recovery and decrease risk of dysfunctional long-term consequences of otherwise normal neuromuscular responses. Therefore, the overall intent of this article is to elucidate the relationships between pain and movement as they relate to clinical decision making.ConclusionsMotor output is highly adaptable, can be influenced by multiple mechanisms at various levels along the nervous system, and may vary between individuals despite similar diagnoses. Therefore, interventions need to be individualized and consider both the types of motor response observed (ie, whether the response is protective or maladaptive), and the patient's acute physical activity tolerance when prescribing exercise/movement.     

甲磺酸伊马替尼联合VDLD化疗方案治疗急性淋巴细胞白血病患儿的长期随访研究

目的探究甲磺酸伊马替尼联合VDLD化疗方案治疗急性淋巴细胞白血病(ALL)患儿的应用价值。方法选取2015年5月~2018年6月收治的74例ALL患儿,按照治疗方案不同分组。对照组(37例)实施VDLD方案治疗,联合组(37例)实施甲磺酸伊马替尼+VDLD化疗方案治疗。对比两组疗效、不良反应发生率、随访1年无复发生存率(RFS)及治疗前、治疗2个疗程后血清B淋巴细胞刺激因子(BAFF)、增殖诱导配体(APRIL)水平。结果联合组总有效率(91.89%)高于对照组(72.97%)(P<0.05);联合组治疗2个疗程后血清BAFF、APRIL水平低于对照组(P<0.05);两组不良反应发生率、随访1年RFS对比无显著差异(P>0.05)。结论甲磺酸伊马替尼联合VDLD化疗方案治疗ALL,疗效确切,能显著降低血清BAFF、APRIL水平,且安全性高。     

护士分层级管理对急性肝炎患者护理满意度的影响

目的分析护士分层级管理的实施对急性肝炎患者护理满意度的影响。方法该院自2018年3月起实施护士分层级管理,以该院10名肝病科护理人员为研究对象,其中2017年3月—2018年2月实施前(对照组)及2018年3月—2019年2月实施后(研究组)的管理效果。结果与对照组比较,研究组患者的病房管理、患者护理、文书书写、基础护理、入院宣教方面的护理质量评分均明显升高(P<0.05);与对照组82.29%的护理总满意率比较,研究组护理总满意率显著升高,达到了97.92%(P<0.05);与对照组工作自我满意度比较,研究组患者的自我价值体现等方面的工作自我满意度评分均明显升高(P<0.05)。结论护士分层级管理策略的实施,有效提高了急性肝炎患者护理满意度,提升了科室护理质量。     

Pharmacotherapeutic strategies for critical asthma syndrome: a look at the state of the art

ABSTRACT

Introduction

‘Critical Asthma Syndrome’ (CAS) is an umbrella term proposed to include several forms of asthma, responsible for acute and life-threatening exacerbations. CAS requires urgent and adequate supportive and pharmacological treatments to prevent serious outcomes.     

前列地尔联合长春西汀治疗急性脑梗死的疗效观察

目的探讨前列地尔联合长春西汀治疗急性脑梗死的疗效。方法选取2015年3-12月在我科接受治疗的90例急性脑梗死患者,随机分为治疗组(45例)和对照组(45例)。两组患者均给予抗血小板、降血脂等常规对症治疗,11 d为1个疗程。对照组给予长春西汀静脉输液治疗,治疗组在对照组基础上加以前列地尔治疗。比较两组临床治疗效果,治疗前后神经功能恢复情况、日常生活能力恢复情况、并发症发生率及安全性。结果治疗组总有效率为93.3%,对照组为71.1%,治疗组明显高于对照组,差异有统计学意义(P<0.05)。两组患者用药11 d后,神经功能缺损评分均高于治疗前,且治疗组明显高于对照组,差异均有统计学意义(P<0.05)。治疗组患者用药11d及90 d后日常生活能力恢复情况优于对照组,差异有统计学意义(P<0.05)。两组均无严重药物不良反应。结论前列地尔联合长春西汀治疗急性脑梗死疗效显著,值得临床推广应用。