ObjectiveTo explore the risk factors of nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy.MethodsThe children with acute lymphoblastic leukemia who were admitted to the Department of Pediatrics, Huai’an First Hospital Affiliated to Nanjing Medical University between December 2012 and December 2018 were divided into the infection group (including the severe infection subgroup and the non-severe infection subgroup) and the non-infection group according to whether nosocomial infection occurred during induction and remission chemotherapy. The clinical data of patients were collected. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of nosocomial infection during induction remission chemotherapy in children with acute lymphoblastic leukemia.ResultsA total of 96 patients were included. There were 67 cases in the infection group (26 in the severe infection subgroup and 41 in the non-severe infection subgroup) and 29 cases in the non-infection group. Univariate analysis showed that the granulocyte deficiency time and the prevalence of skin and mucosal damage in the infection group were significantly higher than those in the non-infection group, and the infection group had significantly lower laminar bed use and serum albumin level than the non-infection group did (P< 0.05). Multivariate logistic regression analysis showed that prolonged agranulocytosis [odds ratio (OR)=23.075, 95% confidence interval (CI) (3.682, 144.617), P=0.001], skin and mucosal lesions [OR=12.376, 95%CI (1.211, 126.507), P=0.034], hypoalbuminemia [OR=5.249, 95%CI (1.246, 22.113), P=0.024] were independent risk factors for nosocomial infection during induction and remission of childhood acute lymphoblastic leukemia, while laminar bed [OR=0.268, 95%CI (0.084, 0.854), P=0.026] was the protective factor.ConclusionsLong-term agranulocytosis, skin and mucosal lesions, and hypoalbuminemia are independent risk factors for nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy. Laminar flow bed is its protective factor.
ObjectiveTo explore the expressions of nerve growth factor (NGF) and leukemia inhibitory factor (LIF) in both asthmatic mice and respiratory syncytial virus(RSV)-infected mice,explore if there is a same neurogenic mechanism between ashtma and RSV infection,in order to find a new treatment target for asthma. MethodsOne hundred healthy Balb/c inbred mice were randomly divided into a control group,a RSV group,an asthma group,an asthma with RSV group,and a dexamethasone group. The lung tissue pathology was observed by hematoxylin-eosin staining(HE). The quantitative analysis of NGF mRNA and LIF mRNA of lung tissue was detected by RT-PCR. The expression of NGF protein and LIF protein was detected by immunohistochemical method. ResultsUnder light mocroscope,there were alveolar septum widening,alveolar epithelium swelling,and interstitial edema in the RSV group. There were widen alveolar septum,narrowed bronchial lumen,thicken bronchial wall and a large number of inflammatory cells infiltration around the small blood vessels,alveolar and bronchioles both in the asthma group and the asthma with RSV group,with the latter being more serious. Compared with the RSV group,the inflammation was relieved significantly in the dexamethason group. There were mRNA and protein expressions of NGF and LIF in all groups, which were highest in the asthma with RSV group,then the RSV group and the asthma group,and lowest in the dexamethasone group. ConclusionsThe expressions of LIF and NGF in the lung of mice after RSV infection and futher increase when combined with asthma. Dexamethason can inhibit the expression of NGF and LIF to some extent.
目的 探討冬凌草甲素（Ori）對白血病Molt-4細胞致凋亡作用及其可能的機制。 方法 將不同濃度的Ori（2.5、5、10、20、40 μmol/L）作用于Molt-4細胞。采用甲基噻唑基四唑（MTT）法檢測細胞增殖，流式細胞術檢測細胞凋亡，電子顯微鏡觀察細胞凋亡超微結構的變化，Western blot方法分析凋亡相關蛋白及Caspase-3表達的變化。 結果 Ori可抑制Molt-4細胞的生長及誘導凋亡，并有時間-劑量依賴性；Ori可時間依賴性的下調抗凋亡蛋白Bcl-2的表達，上調促凋亡蛋白Bax和Bim表達以及活化Caspase-3。 結論 Ori可誘導Molt-4細胞凋亡，其機制可能與調節Bcl-2家族蛋白及活化Caspase-3有關。
Interferon regulatory factor 4 (IRF4) is one of the transcription factors in the interferon regulatory factor family. In the normal physiological process, IRF4 protein is a key factor regulating B cell development, such as early B cell development, pre-B cell switch recombination, mature B cell somatic hypermutation, and also a key factor regulating plasma cell differentiation. In addition, in recent years, it has been reported that Irf4 gene abnormalities or abnormal protein expression is closely involved in the occurrence and development of a variety of B cell or plasma cell tumors. This article reviews the physiological role of IRF4 in the differentiation and maturation of B cell or plasma cells, how IRF4 participates in the occurrence and development of B cell or plasma cell tumors, and its potential therapeutic target for B cell or plasma cell tumors.
Objective We intended to get good understanding of the current role of imatinib （or glivec） in the treatment of a patient with chronic-phase chronic myeloid leukemia. Methods We attempted to find the current best evidence of imatinib for treating chronic myeloid leukemia in chronic phase by searching ACP Journal Club （1991 -Jun, 2005 ）, The Cochrane Library（Issue 2, 2005 ）and MEDLINE（1990 -Jun, 2005 ） and further critically appraised the available evidence. Results Imatinib appeared to be more effective than current standard drag treatments in terms of hematologic and cytogenetic response with better quality of life and fewer side effects. However, there was uncertainty concerning long term outcomes. Given the current evidence together with our clinical experience and considering the patient and his family members＇ values and preference, imatinib （400 mg qd） was administered to him. No obvious adverse effects occurred with 3 months follow-up. Conclusions Imatinib is effective and well tolerated in the treatment of chronic myeloid leukemia in chronic phase. Further researches on long-term follow-up data from imatinib trials are definitely needed.
Objective?To assess the clinical effectiveness and safety of granulocyte colony stimulating factor (G-CSF) for patients with acute lymphoblastic leukemia (ALL). Methods?We searched the Cochrane Library, PubMed, EMbase, CNKI, and VIP databases from January 2000 to October 2009. Randomized controlled trials (RCTs) about G-CSF for patients with ALL were retrieved. The methodological quality of the included studies was assessed and the data was extracted according the Cochrane Reviewer’s Handbook. Meta-analyses for overall survival, complete remission, quality of life, infections, relapse rate, and adverse events were performed using RevMan 5.0 software. Results?Six RCTs involving 620 patients with ALL were included. The results of meta-analyses showed that the G-CFS group was superior to the control group in the overall survival of adult ALL patients (RR=2.24, 95%CI 1.28 to 3.90, P=0.004). Conclusion?G-CSF can improve the overall survival of adult ALL patients. However, it is not demonstrated that G-CSF could improve complete remission rate and quality of life, and reduce infections and relapse rate. More high-quality and large scale RCTs are required.
【摘要】 目的 觀察急性淋巴細胞白血病（ALL）患兒血清鐵蛋白（SF）及β2-微球蛋白（β2-MG）水平變化，探討SF和β2-MG水平變化對ALL患兒臨床治療效果的應用價值。 方法 對2008年7月-2010年4月期間血液病區住院確診為ALL的患兒53例，病情得到控制緩解后的ALL患兒28例，分別抽取空腹靜脈血進行SF和β2-MG測定，并選取正常健康兒童30例作為對照組。 結果 ALL患兒治療前血清SF和β2-MG水平均高于正常對照組（Plt;0.01），經治療緩解后ALL患兒的SF和β2-MG水平顯著降低，并隨著病情的轉歸而逐漸恢復至正常水平；與治療前比較，差異有統計學意義（Plt;0.01）。 結論 SF和β2-MG可作為ALL臨床治療效果的有效監測指標。【Abstract】 Objective To observe the dynamic changes of Serum Ferritin(SF) and β2-MG levels in children with acute lymphoblastic leukemia(ALL) and to investigate its clinical significance on clinical curative effect. Methods Fifty-three in-patients with ALL, 28 relieved patients from July 2008 to April 2010 in our Hematology and 30 normal as control were selected in our study. The venousblood of patients and controls were extract in order to detect SF and β2-MG. Results Before the treatment, the level of SF and β2-MG in ALL group were significantly higher than those in the control group (Plt;0.01). After the treatment, the level of SF and β2-MG in ALL group decreased significantly (Plt;0.01), and they return to normal level gradually with the outcome; compared with before the treatment, the differences were statistically significant(Plt;0.01). Conclusion SF and β2-MG can be used as a helpful indicator to evaluate the therapeutic effect of ALL.
ObjectiveTo report and analyze one case of Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) initially presented with skeletal destruction treated with imatinib-based personal therapy. MethodsWe described the therapeutic advancements for ALL cases initially presented as skeletal destruction and Ph+ ALL through case report and literature review. ResultsDefinite diagnosis of Ph+ ALL was made for the patient who subsequently obtained inductive remission and 17-month molecular remission with the aid of imatinib-based regimen. ConclusionWe should take potential diagnosis of ALL into consideration for patients with skeletal destruction. Imatinib-based standard chemotherapeutic regimen may improve therapeutic model and prognosis of Ph+ ALL.