简介:AbstractAlthough the first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone regimen (R-CHOP) substantially improved outcomes for patients with diffuse large B-cell lymphoma (DLBCL), 40% of the patients suffered from relapsed/refractory disease and had poor survival outcomes. The detailed mechanism underlying R-CHOP resistance has not been well defined. For this review, we conducted a thorough search for literature and clinical trials involving DLBCL resistance. We discussed DLBCL biology, epigenetics, and aberrant signaling of the B-cell receptor (BCR), phosphatidylinositol 3-kinase (PI3K)/Akt, nuclear factor kappa light chain enhancer of activated B-cells (NF-κB), and the Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathways as defining mechanisms of DLBCL heterogeneity and R-CHOP resistance. The cell of origin, double- or triple-hit lymphoma and double-protein-expression, clonal evolution, tumor microenvironment, and multi-drug resistance help to contextualize DLBCL resistance in an (epi)genetically and biologically comparative manner. With better understanding of the biological and molecular landscape of DLBCL, a more detailed classification system and tailored treatments will ideally become available to further improve the prognosis of DLBCL patients.
简介:AbstractBackground:Secondary central nervous system lymphoma (SCNSL) is defined as lymphoma involvement within the central nervous system (CNS) that originated elsewhere, or a CNS relapse of systemic lymphoma. Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined.Methods:We conducted a retrospective study to assess the feasibility of an R-MIADD (rituximab, high-dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, and dexamethasone) regimen for SCNSL patients.Results:Nineteen patients with newly diagnosed CNS lesions were selected, with a median age of 58 (range 20 to 72) years. Out of 19 patients, 11 (57.9%) achieved complete remission (CR) and 2 (10.5%) achieved partial remission (PR); the overall response rate was 68.4%. The median progression-free survival after CNS involvement was 28.0 months (95% confidence interval 11.0-44.9), and the median overall survival after CNS involvement was 34.5 months. Treatment-related death occurred in one patient (5.3%).Conclusions:These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL, further investigation is warranted.
简介:摘要目的探讨R2-CHOP(来那度胺+利妥昔单抗+环磷酰胺+长春地辛+表柔比星+地塞米松)方案治疗肠切除弥漫大B细胞淋巴瘤(DLBCL)的效果及安全性。方法回顾性分析江苏省泰兴市人民医院2020年11月收治的1例小肠DLBCL患者治疗经过,并复习相关文献。结果该患者为原发性小肠DLBCL,接受R2-CHOP方案和R2-ECHOP(R2-CHOP+依托泊苷)方案化疗各1个疗程后,疗效良好,颈部、肺门及纵隔淋巴结缩小,其余淋巴结未见增大,且未出现严重不良反应。结论R2-CHOP方案是非生发中心型c-myc阳性DLBCL的有效治疗方案,可提高缓解率、总生存率,延长无进展生存期,且无明显不良反应。
简介:摘要目的探讨R-CHOP方案(利妥昔单抗+环磷酰胺+阿霉素+长春新碱+泼尼松)或类R-CHOP方案治疗的弥漫大B细胞淋巴瘤(DLBCL)患者治疗前血浆补体水平与临床病理特征和预后的关系。方法收集2010—2016年于中国医学科学院肿瘤医院就诊的105例DLBCL患者的临床病理资料。采用抗体芯片检测R-CHOP或类R-CHOP治疗的105例DLBCL患者治疗前和80例健康对照者血浆中34种补体的水平,分析DLBCL患者治疗前血浆补体水平与临床病理特征和预后的关系。结果国际预后指数(IPI)评分为3~5分患者血浆中补体C1QA的信号值为1 261.43±138.96,与IPI评分为0~2分患者(950.79±80.19)比较,差异有统计学意义(P=0.037)。IPI评分为3~5分患者的CR1L信号值为2 214.69±98.58,与IPI评分0~2分患者(1 984.67±121.79)比较,差异有统计学意义(P=0.017)。非完全缓解(non-CR)组患者的C1QA信号值为1 165.43±98.56,与完全缓解(CR)组(914.70±100.77)比较,差异有统计学意义(P=0.045);non-CR组患者的CR1L信号值为2 263.13±145.63,与CR组(1 821.34±84.68)比较,差异有统计学意义(P=0.008)。Cox回归分析显示,血浆中C1QA信号值升高与DLBCL患者的无进展生存时间(HR=2.063,95% CI为1.220~3.489,P=0.007)和总生存时间(HR=2.23,95% CI为1.036~4.798,P=0.040)有关。采用多因素Cox回归进行IPI评分校正后,血浆C1QA信号值升高仍与无进展生存时间有关(HR=1.765,95% CI为1.034~3.013,P=0.037)。结论采用R-CHOP或类R-CHOP方案治疗的DLBCL患者基线血浆中C1QA和CR1L水平与患者的IPI评分和疗效有关,C1QA血浆基线水平对DLBCL患者的预后具有一定的预测价值。
简介:摘要目的探讨R-CHOP方案(利妥昔单抗+环磷酰胺+阿霉素+长春新碱+泼尼松)或类R-CHOP方案治疗的弥漫大B细胞淋巴瘤(DLBCL)患者治疗前血浆补体水平与临床病理特征和预后的关系。方法收集2010—2016年于中国医学科学院肿瘤医院就诊的105例DLBCL患者的临床病理资料。采用抗体芯片检测R-CHOP或类R-CHOP治疗的105例DLBCL患者治疗前和80例健康对照者血浆中34种补体的水平,分析DLBCL患者治疗前血浆补体水平与临床病理特征和预后的关系。结果国际预后指数(IPI)评分为3~5分患者血浆中补体C1QA的信号值为1 261.43±138.96,与IPI评分为0~2分患者(950.79±80.19)比较,差异有统计学意义(P=0.037)。IPI评分为3~5分患者的CR1L信号值为2 214.69±98.58,与IPI评分0~2分患者(1 984.67±121.79)比较,差异有统计学意义(P=0.017)。非完全缓解(non-CR)组患者的C1QA信号值为1 165.43±98.56,与完全缓解(CR)组(914.70±100.77)比较,差异有统计学意义(P=0.045);non-CR组患者的CR1L信号值为2 263.13±145.63,与CR组(1 821.34±84.68)比较,差异有统计学意义(P=0.008)。Cox回归分析显示,血浆中C1QA信号值升高与DLBCL患者的无进展生存时间(HR=2.063,95% CI为1.220~3.489,P=0.007)和总生存时间(HR=2.23,95% CI为1.036~4.798,P=0.040)有关。采用多因素Cox回归进行IPI评分校正后,血浆C1QA信号值升高仍与无进展生存时间有关(HR=1.765,95% CI为1.034~3.013,P=0.037)。结论采用R-CHOP或类R-CHOP方案治疗的DLBCL患者基线血浆中C1QA和CR1L水平与患者的IPI评分和疗效有关,C1QA血浆基线水平对DLBCL患者的预后具有一定的预测价值。
简介:摘要:粗轧R1轧机的工作辊更换,是基于2250热轧产线品种结构调整、板形质量控制提出的正常工艺需求,更换频率在正常生产情况下为轧辊达到累计轧制吨位为(12万吨±3万吨)约1W/次,但单次换辊需人工手动分步操作,耗时较长(40min)且容易操作失误。整个粗轧R1轧机的换辊系统,共包含21个感应限位、11个压力传感器、7个位置传感器、2个编码器及1个流量计。在制定的软件程序及机械设备导位下按步骤进行,单次更换过程共涉及45步衔接步骤,为提高R1换辊效率,过程需要保证电气及机械设备稳定、步骤衔接紧密、设备动作响应迅速及时,本文主要通过系列优化技术,从单体设备的动作速度及衔接紧密性上,优化R1工作辊的更换效率,以达到高效稳定更换R1轧机换辊的目的。
简介:【摘要】目的:对异位妊娠患者应用阴道B超与腹部B超诊断的效果进行对比。方法:样本选取在我科住院治疗的,符合纳入和排除标准的异位妊娠患者132例,并分为参照组(采纳腹部B超检查)和观察组(采纳阴道B超检查)各66例,对比两组的效果。结果:就胚芽、附件包块、心血管搏动、宫内假孕囊等相关指标检出率而言,观察组分别为30.30%、93.94%、33.33%以及18.18%,均明显高于参照组的6.06%、63.64%、6.06%、3.03%,有统计学意义(χ2=13.338
简介:摘要:停车换乘模式(P&R)通过在轨道站点周边设置停车设施,从而鼓励转乘公共交通出行,是现阶段缓解城市拥堵的重要手段。文章创新性的从停车换乘设施的经济可行性的角度分析了制约P&R模式发展的因素,提出适合的设施类型和支持政策。分析了停车场类型、设施利用率、配建比例、收费价格、土地价格、差异化的政策支持这6个因素对停车换乘设施的经济运行指标的影响。研究显示,在没有政策支持下,地下两层停车场的内部收益率高和回收期短。减低土地成本和对单次停车予以补贴的政策能够提高设施的内部收益率和降低回收期。
简介:【摘要】目的:观察对妇产科急腹症患者实施腹部B超与阴道B超联用的诊断价值。方法:从2019年10月至2021年6月择取50例妇产科急腹症患者,所选患者均实施腹部B超检查、阴道B超检查、腹部B超与阴道B超联合检查,对照病理检查结果,分析三种检查方式的诊断结果。结果:经过病理检查,50例患者均确诊,其中30例异位妊娠、12例卵巢囊肿蒂扭转、6例黄体囊肿破裂、2例急性盆腔炎;在腹部B超检查中,38例患者确诊,其中23例异位妊娠、10例卵巢囊肿蒂扭转、4例黄体囊肿破裂、1例急性盆腔炎;在阴道B超检查中,42例患者确诊,其中26例异位妊娠、12例卵巢囊肿蒂扭转、2例黄体囊肿破裂、2例急性盆腔炎;在腹部B超与阴道B超联合检查中,49例患者确诊,其中30例异位妊娠、12例卵巢囊肿蒂扭转、5例黄体囊肿破裂、2例急性盆腔炎;腹部B超与阴道B超联合检查的诊断符合率高于单独腹部B超检查、阴道B超检查,误诊及漏诊率低于单独腹部B超检查、阴道B超检查,P
简介:摘要目的评价脊髓P2Y1嘌呤受体(P2Y1R)在瑞芬太尼诱发切口痛大鼠痛觉过敏形成中的作用及其与脊髓NMDA受体(NR)1和NR2B功能的关系。方法鞘内置管成功的健康成年雄性SD大鼠48只,10~12周龄,体重250~280 g,采用随机数字表法分为6组(n=8):对照组(C组)、P2Y1R拮抗剂MRS2179组(M组)、瑞芬太尼组(R组)、瑞芬太尼+MRS2179组(R+M组)、切口痛+瑞芬太尼组(I+R组)和切口痛+瑞芬太尼+MRS2179组(I+R+M组)。C组鞘内注射生理盐水10 μl,10 min后经尾静脉输注生理盐水0.1 ml·kg-1·min-1 60 min;M组鞘内注射MRS2179 0.6 nmol/kg,10 min后经尾静脉输注生理盐水0.1 ml·kg-1·min-1 60 min;R组鞘内注射生理盐水10 μl,10 min后经尾静脉输注瑞芬太尼1 μg·kg-1·min-1 60 min;R+M组鞘内注射MRS2179 0.6 nmol/kg,10 min后经尾静脉输注瑞芬太尼1 μg·kg-1·min-1 60 min;I+R组鞘内注射生理盐水10 μl,10 min后经尾静脉输注瑞芬太尼1 μg·kg-1·min-1 60 min,瑞芬太尼输注开始后10 min制备切口痛模型;I+R+M组鞘内注射MRS2179 0.6 nmol/kg,10 min后经尾静脉输注瑞芬太尼1 μg·kg-1·min-1 60 min,瑞芬太尼输注开始后10 min制备切口痛模型。分别于输注瑞芬太尼或生理盐水前24 h、输注停止后2、6、24和48 h时测定机械缩足反应阈(MWT)、热缩足潜伏期(TWL)和冷板抬足次数。最后一次痛阈测定结束后处死大鼠,取脊髓L4-6节段,采用Western blot法检测脊髓P2Y1R、磷酸化NR1(p-NR1)、NR1、磷酸化NR2B(p-NR2B)和NR2B表达,并计算p-NR1/NR1比值及p-NR2B/NR2B比值,采用RT-PCR法检测P2Y1R、NR1和NR2B的mRNA表达。结果与C组比较,R组MWT降低,TWL缩短,冷板抬足次数增加,脊髓P2Y1R及其mRNA、NR1及其mRNA、p-NR1、NR2B及其mRNA、p-NR2B表达上调,p-NR1/NR1比值和p-NR2B/NR2B比值升高(P<0.01)。与R组比较,R+M组MWT增加,TWL延长,冷板抬足次数减少,脊髓P2Y1R、p-NR1、NR1及其mRNA、p-NR2B、NR2B及其mRNA表达下调,p-NR1/NR1比值和p-NR2B/NR2B比值降低(P<0.05或0.01);与I+R组比较,I+R+M组MWT增加,TWL延长,冷板抬足次数减少,脊髓P2Y1R、p-NR1、NR1及其mRNA、p-NR2B、NR2B及其mRNA表达下调,p-NR1/NR1比值和p-NR2B/NR2B比值降低(P<0.01)。结论脊髓P2Y1R可增强NR1和NR2B功能,该作用可能参与了瑞芬太尼诱发切口痛大鼠痛觉过敏的形成。
简介:AbstractBackground:Hepatitis B core-related antigen (HBcrAg) is a promising disease-monitoring marker for chronic hepatitis B (CHB). We investigated correlations between HBcrAg with antiviral efficacy and virological and histological variables.Methods:One hundred and forty-five CHB patients from the mainland of China between August 2013 and September 2016 who underwent liver biopsy received entecavir therapy and had paired liver biopsy at 78 weeks. We analyzed correlations between HBcrAg and virological and histological variables in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients. We also explored the predictors of HBeAg loss after 78 weeks of antiviral therapy. Pearson correlation analysis and logistic forward stepwise regression were the main statistic methods.Results:HBeAg-positive patients (n = 93) had higher baseline HBcrAg (median 7.4 vs. 5.3 log10 U/mL P < 0.001) and greater HBcrAg declines (median 1.6 vs. 0.9 log10 U/mL P= 0.007) than HBeAg-negative patients after 78 weeks of therapy. At baseline, HBcrAg correlated with hepatitis B virus (HBV) DNA in both HBeAg-positive (r = 0.641, P < 0.001) and -negative patients (r = 0.616, P < 0.001), with hepatitis B surface antigen (HBsAg) in HBeAg-positive patients (r = 0.495, P < 0.001), but not with anti-hepatitis B virus core antibody (anti-HBc). Weak correlations existed between HBcrAg, histology activity index (HAI; r = 0.232, P= 0.025), and Ishak fibrosis score (r= -0.292, P= 0.005) in HBeAg-positive patients. At 78 weeks, significant correlations existed only between HBcrAg and anti-HBc in HBeAg-positive (r = -0.263, P = 0.014) and HBeAg-negative patients (r= -0.291, P= 0.045). Decreased HBcrAg significantly correlated with reduced HBV DNA (r= 0.366, P= 0.001; r= 0.626, P < 0.001) and HBsAg (r = 0.526, P = 0.001; r = 0.289, P = 0.044) in HBeAg-positive and -negative patients, respectively, and with reduced HAI in HBeAg-positive patients (r = 0.329, P = 0.001). Patients with HBeAg loss (n = 29) showed a larger reduction in HBcrAg than those without (median 2.3 vs. 1.3 log10 U/mL, P = 0.001). In multivariate analysis, decreased HBcrAg was an independent predictor of HBeAg loss (P = 0.005).Conclusions:HBcrAg reflects viral replication and protein production. Decreased HBcrAg could predict HBeAg loss after antiviral therapy.Trial registration:Clinical Trials.gov: NCT01962155; https://www.clinicaltrials.gov/ct2/show/NCT01962155?term=NCT01962155&draw=2&rank=1