目的探讨含地西他滨化疗方案对初治老年急性髓系白血病(AML)患者的疗效及预后影响因素。方法回顾分析2013年2月至2017年11月在吉林大学第一医院接受含地西他滨化疗方案治疗的47例初治老年AML(M3除外)患者的临床资料,其中单药地西他滨组1...目的探讨含地西他滨化疗方案对初治老年急性髓系白血病(AML)患者的疗效及预后影响因素。方法回顾分析2013年2月至2017年11月在吉林大学第一医院接受含地西他滨化疗方案治疗的47例初治老年AML(M3除外)患者的临床资料,其中单药地西他滨组11例,地西他滨联合减量化疗组36例。分析治疗效果及不同因素对预后的影响。结果47例患者中,男性15例,女性32例,中位年龄65岁(60~83岁)。地西他滨联合减量化疗组1个疗程总反应率高于单药地西他滨组[80.6%(29/36)比27.3%(3/11),χ^2=8.693,P=0.003],起效疗程数少于单药地西他滨组(u=3.133,P=0.002);两组患者的中位总生存(OS)时间差异无统计学意义(14个月比12个月,P=0.950)。单因素分析显示达完全缓解(CR)组患者的中位OS时间长于未达CR组(17个月比5个月,P<0.01);原发老年AML患者中位OS时间长于继发AML患者(16个月比6个月,P=0.01)。Cox多因素分析结果显示未达CR是OS的独立不良影响因素(HR=0.180,95% CI 0.085~0.382,P<0.01)。地西他滨联合减量化疗组粒细胞缺乏伴发热发生率高于单药地西他滨组[69.4%(25/36)比36.4%(4/11),χ^2=3.902,P=0.048]。结论对于初治老年AML患者,含地西他滨化疗方案是安全有效的治疗手段。展开更多
OBJECTIVE: To investigate the effect of low frequency electro-pulse acupuncture(EA) on blood glucose in rats with streptozotocin-induced type 2diabetes, and the possible mechanism underlying the action.METHODS: Rat mo...OBJECTIVE: To investigate the effect of low frequency electro-pulse acupuncture(EA) on blood glucose in rats with streptozotocin-induced type 2diabetes, and the possible mechanism underlying the action.METHODS: Rat models were established with high fat feeding and intraperitoneal injection of streptozotocin(STZ)(30 mg/kg). Rats with a random blood glucose > 16.7 mmol/L and blood glucose at 2 h-point of oral glucose tolerance test(OGTT) > 11.1 mmol/L were included as diabetic rats, and randomly divided into model group, EA Weiwanxiashu(EX-B 3) group, EA Zusanli(ST 36)group, glimepiride group, and EA non-acupoint group(n = 12). EA(2 Hz continuous wave, 2 m A,20 min/day, 6 days/week, 4 weeks) and intra-gastric administration of glimepiride were applied as interventions. With fasting blood glucose and OGTT tested at the end of the intervention, thestudy observed the patterns of hypoglycemic effects. For mechanism study, it observes hematoxylin and eosin staining and Masson staining of pancreas paraffin sections, protein expression of glucagon-like peptide 1 receptor(GLP-1R) in the pancreas and skeletal muscle, glucose transporter 4(GLUT4) protein expression in skeletal muscle membrane, to detect whether EA controls blood glucose via regulation of GLP-1R.RESULTS: EA Weiwanxiashu(EX-B 3) significantly increased model rats' pancreas GLP-1R, and GLUT4 of skeletal muscle membrane; the therapy significantly decreased model rats' skeletal muscle GLP-1R, restored pancreas morphology, and reduced fasting blood glucose and insulin resistance indices.CONCLUSION: EA Weiwanxiashu(EX-B 3) alone has significant effect on glycemia. EA Weiwanxiashu(EX-B 3) plus glimepiride further strengthen the effect. The regulation of the GLP-1R in pancreas and skeletal muscle might be mechanism underpinning the effect.展开更多
文摘目的探讨含地西他滨化疗方案对初治老年急性髓系白血病(AML)患者的疗效及预后影响因素。方法回顾分析2013年2月至2017年11月在吉林大学第一医院接受含地西他滨化疗方案治疗的47例初治老年AML(M3除外)患者的临床资料,其中单药地西他滨组11例,地西他滨联合减量化疗组36例。分析治疗效果及不同因素对预后的影响。结果47例患者中,男性15例,女性32例,中位年龄65岁(60~83岁)。地西他滨联合减量化疗组1个疗程总反应率高于单药地西他滨组[80.6%(29/36)比27.3%(3/11),χ^2=8.693,P=0.003],起效疗程数少于单药地西他滨组(u=3.133,P=0.002);两组患者的中位总生存(OS)时间差异无统计学意义(14个月比12个月,P=0.950)。单因素分析显示达完全缓解(CR)组患者的中位OS时间长于未达CR组(17个月比5个月,P<0.01);原发老年AML患者中位OS时间长于继发AML患者(16个月比6个月,P=0.01)。Cox多因素分析结果显示未达CR是OS的独立不良影响因素(HR=0.180,95% CI 0.085~0.382,P<0.01)。地西他滨联合减量化疗组粒细胞缺乏伴发热发生率高于单药地西他滨组[69.4%(25/36)比36.4%(4/11),χ^2=3.902,P=0.048]。结论对于初治老年AML患者,含地西他滨化疗方案是安全有效的治疗手段。
基金Supported by Ministry of Education of the People's Republic of China:a Mechanism Study of Electro-Acupuncture EX-B3's Effect on Pancreas PDX-1 of Goto-Kakizaki Rats(No.313010)
文摘OBJECTIVE: To investigate the effect of low frequency electro-pulse acupuncture(EA) on blood glucose in rats with streptozotocin-induced type 2diabetes, and the possible mechanism underlying the action.METHODS: Rat models were established with high fat feeding and intraperitoneal injection of streptozotocin(STZ)(30 mg/kg). Rats with a random blood glucose > 16.7 mmol/L and blood glucose at 2 h-point of oral glucose tolerance test(OGTT) > 11.1 mmol/L were included as diabetic rats, and randomly divided into model group, EA Weiwanxiashu(EX-B 3) group, EA Zusanli(ST 36)group, glimepiride group, and EA non-acupoint group(n = 12). EA(2 Hz continuous wave, 2 m A,20 min/day, 6 days/week, 4 weeks) and intra-gastric administration of glimepiride were applied as interventions. With fasting blood glucose and OGTT tested at the end of the intervention, thestudy observed the patterns of hypoglycemic effects. For mechanism study, it observes hematoxylin and eosin staining and Masson staining of pancreas paraffin sections, protein expression of glucagon-like peptide 1 receptor(GLP-1R) in the pancreas and skeletal muscle, glucose transporter 4(GLUT4) protein expression in skeletal muscle membrane, to detect whether EA controls blood glucose via regulation of GLP-1R.RESULTS: EA Weiwanxiashu(EX-B 3) significantly increased model rats' pancreas GLP-1R, and GLUT4 of skeletal muscle membrane; the therapy significantly decreased model rats' skeletal muscle GLP-1R, restored pancreas morphology, and reduced fasting blood glucose and insulin resistance indices.CONCLUSION: EA Weiwanxiashu(EX-B 3) alone has significant effect on glycemia. EA Weiwanxiashu(EX-B 3) plus glimepiride further strengthen the effect. The regulation of the GLP-1R in pancreas and skeletal muscle might be mechanism underpinning the effect.
