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Risk factors for induction failure of standard chemotherapy with anthracycline and cytarabine in Acute Myeloid Leukemia Patients 急性髓系白血病患者蒽环类和阿糖胞苷标准化疗诱导失败的危险因素
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000365
C. Jehn, M. Pannenbeckers, A. Klapproth, Farouk Dahmash, H. Salwender, Anju Singh, Yana Shikova, J. Schlichting, S. Meyer, C. Niggemann, M. Vierbuchen, A. Elmaagacli
Induction therapy (IT) with anthracycline and cytarabine (DA) is, despite a new era with targeted therapies such as FLT-3- or IDH-1/2- inhibitors, still the backbone of treatment for acute myeloid leukemia (AML). In this retrospective study we investigated possible risk factors for induction failure (IF) in 109 AML-patients, who were consecutively treated between 2013 and 2018 at our institution. We evaluated all patients at diagnosis for CMV IgG-status, LDH-value, platelet count, blast count in bone marrow (BM), Sorror comorbidity score (range 0-6), age (>70 years), cytogenetic risk factors according to the ELN classification (favourable [n=15], intermediate [n=56], or high risk [n=38]), occurrence of biclonal AML detected by flow cytometry and extramedullary AML-manifestation. In 43 (39%) patients an IF was observed. 38 of these patients went on to received a salvage therapy with idarubicin and fludarabine (n=30) or directly to allotransplant (n=8), whereas 5 patients received only best supportive care. Only age >70-years (p=0.020, odds ratio [OR] 2.5), cytogenetic adverse risk classification (p=0.014; OR 3.21), Sorror comorbidity score of >2, (p=0.019, OR 2.72), and > 40% blasts in BM (p=0.004; OR 3.64), had influence on the occurrence of IF after DA. Patients with IF or adverse cytogenetics and without subsequent transplant had a worse prognosis (2-year OS for IF 19.4% + 16.8% versus 86.9% + 7.6%, p=0.0001). In multivariate analyses for OS only transplantation (HR 0.37; [95% CI 0.19-0.76], p=0.007) and blasts >40% in BM (HR 2.24, [95% CI 1.07 – 4.68], p= 0.032), but not IF were identified as independent risk factors.
尽管FLT-3-或IDH-1/2-抑制剂等靶向治疗进入了一个新时代,但蒽环类药物和阿糖胞苷(DA)诱导治疗(IT)仍然是急性髓性白血病(AML)治疗的主要方法。在这项回顾性研究中,我们调查了2013年至2018年在我院连续治疗的109例aml患者诱导失败(IF)的可能危险因素。在诊断时,我们对所有患者进行CMV igg状态、ldl值、血小板计数、骨髓细胞计数(BM)、Sorror合并症评分(范围0-6)、年龄(0- 70岁)、细胞遗传学危险因素(有利[n=15]、中等[n=56]、高风险[n=38])、流式细胞术检测的双克隆AML的发生情况和髓外AML表现进行评估。43例(39%)患者出现IF。其中38例患者继续接受伊达柔比星和氟达拉滨的补救性治疗(n=30)或直接进行同种异体移植(n=8),而5例患者仅接受最佳支持治疗。仅年龄为0 ~ 70岁(p=0.020,优势比[OR] 2.5),细胞遗传学不良风险分型(p=0.014;OR 3.21), Sorror合并症评分>2,(p=0.019, OR 2.72), > 40% BM (p=0.004;OR 3.64),对DA后IF的发生有影响。IF或不良细胞遗传学且未进行移植的患者预后较差(IF的2年OS为19.4% + 16.8%对86.9% + 7.6%,p=0.0001)。在多变量分析中,单纯OS移植(HR 0.37;[95% CI 0.19-0.76], p=0.007)和BM中原细胞>40% (HR 2.24, [95% CI 1.07 - 4.68], p= 0.032),但IF未被确定为独立危险因素。
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引用次数: 0
A rare but life-threatening pneumopathy induced by Olaparib: From a clinical case to a review of literature 奥拉帕尼引起的罕见但危及生命的肺病:从一个临床病例到文献回顾
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000366
G. Grisay, C. Percy, J. Pierrard, E. Seront
The diagnosis of drug-induced pneumopathy remains a challenge for clinicians, particularly in oncology field in which many new drugs are more and more used and induce uncommon adverse events by targeting specific pathways. We report the case of a patient with ovarian cancer who developed a rapidly progressive and life-threatening pneumopathy after initiation of olaparib. High dose of corticosteroids rapidly (in 3 days) improved the symptoms, decreased the oxygen supply and led to normalization of lung imaging. Olaparib-induced pneumopathy is rarely reported in literature. We discuss about the role of Poly (ADP-Ribose) polymerase (PARP) enzyme in the lung homeostasis and highlight the importance of consider high-doses steroids when suspecting this specific drug-induced pneumopathy.
药物性肺病的诊断对临床医生来说仍然是一个挑战,特别是在肿瘤领域,许多新药越来越多地使用,并通过靶向特定途径诱发罕见的不良事件。我们报告的情况下,患者卵巢癌谁发展迅速进展和危及生命的肺炎奥拉帕尼开始后。高剂量皮质类固醇可迅速(3天内)改善症状,减少供氧,使肺部影像学恢复正常。奥拉帕尼引起的肺炎在文献中很少报道。我们讨论了聚(adp -核糖)聚合酶(PARP)酶在肺内稳态中的作用,并强调在怀疑这种特异性药物引起的肺病时考虑大剂量类固醇的重要性。
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引用次数: 1
Cellular origin of miR-21 and miR-145 in prostate cancer. A reappraisal of their putative function in carcinogenesis 前列腺癌中miR-21和miR-145的细胞起源重新评估它们在致癌作用中的假定功能
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000381
Erik Nesje Wiik, J. Halgunset
Since their discovery, micro-RNAs (miRNA) have raised wide interest as potential biomarkers for a host of diseases. These short strands of RNA, which do not code for protein, play an important role in the regulation of protein expression, by their ability to bind to complementary sequences on specific mRNA and thus suppress its translation. Several miRNAs, which have been detected in blood or tissue homogenates, have been shown to correlate significantly with the presence of prostate cancer, or with the risk of developing a tumor at a later stage, or with the subsequent course of the disease in patients with an established cancer diagnosis [1]. However, published reports are often contradictory. Putative biomarkers that are based on a statistical correlation without an understanding of their biological origin may not necessarily reflect a direct connection with the underlying pathological process. RNA is produced inside cells, and in a solid tissue consisting of several cell types, individual miRNA sequences may be produced in certain cells and not in others, perhaps under particular conditions of cellular physiology. This aspect of miRNA-biology cannot be addressed by analysis of biological fluids or tissue homogenates, a simple fact which is all too often overlooked in current literature.
自发现以来,微rna (miRNA)作为许多疾病的潜在生物标志物引起了广泛的兴趣。这些不编码蛋白质的短链RNA,通过与特定mRNA上的互补序列结合从而抑制其翻译,在蛋白质表达调控中发挥重要作用。在血液或组织匀浆中检测到的几种mirna已被证明与前列腺癌的存在,或与晚期肿瘤发展的风险,或与确定癌症诊断bbb的患者的后续病程显著相关。然而,发表的报告往往是相互矛盾的。基于统计相关性而不了解其生物学起源的推定生物标志物可能不一定反映与潜在病理过程的直接联系。RNA是在细胞内产生的,在由几种细胞类型组成的实体组织中,可能在细胞生理的特定条件下,某些细胞会产生个别的miRNA序列,而其他细胞则不会产生。mirna生物学的这一方面不能通过分析生物流体或组织匀浆来解决,这是一个在当前文献中经常被忽视的简单事实。
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引用次数: 0
Sedeprovid, a novel vitamin D based substance, plus AlphaH℗ lead to complete recovery from COVID-19 within 48 hours after application in a 7-months old baby, a 1.5-year-old toddler and three further adults Sedeprovid是一种基于维生素D的新型物质,加上AlphaH®可使一名7个月大的婴儿、一名1.5岁的幼儿和另外三名成年人在使用后48小时内完全从COVID-19中恢复
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000385
Herwig R, Panhofer Tp, Greilberger M, Greilberger J
Aim: Coronavirus Disease (COVID-19) is caused by the newly emerged coronavirus SARS-CoV-2. To prevent further spread of SARS-CoV-2 and to provide a possible prophylaxis and treatment option we report about our experience on the application of two preparations with a clinical complete recovery of five patients, including two breastfed babies, from a Coronavirus disease with severe symptoms. Material and methods: Sedeprovid (ImmunoD ® CLS ℗ ) were applied twice a day and AlphaH ℗ 20 ml concentrate was consumed once a day in the morning. The course of disease and symptoms before, during and after treatment were recorded. Results: Prior to treatment, the patients suffered from severe symptoms of confirmed COVID-19 infections, including cough, inappetence, tiredness, bone and body pain, loss of taste and smell and body temperature of ≥39ºC for several days. Within 24 hours after application of ImmunoD ® CLS ℗ and AlphaH ℗ a significant reduction of symptoms and a drop down of maximal body temperature was recorded. A complete recovery with normal body temperature and normal or close to normal activity was documented after 48 hours. No side effects were reported from the patients or the parents. Conclusion: The combination of ImmunoD ® CLS ℗ and AlphaH ℗ might offer a good treatment regimen for COVID-19 infected patients with moderate and severe disease progression before entering or after leaving the ICU ward. In addition, this protocol might be used as a prophylactic therapy option for healthcare providers. We strongly recommend the instant confirmation of these results in a controlled randomized trial for a possible rapid benefit of COVID-19 infected patients.
目的:冠状病毒病(COVID-19)是由新出现的冠状病毒SARS-CoV-2引起的。为了防止SARS-CoV-2的进一步传播,并提供一种可能的预防和治疗方案,我们报告了我们应用两种制剂的经验,这些制剂使五名患有严重症状的冠状病毒疾病的患者(包括两名母乳喂养的婴儿)临床完全康复。材料和方法:Sedeprovid (ImmunoD®CLS®)每天2次,AlphaH®20 ml浓缩物每天1次,早晨服用。记录治疗前、治疗中、治疗后的病程及症状。结果:治疗前,患者出现咳嗽、食欲不振、疲倦、骨骼和身体疼痛、味觉和嗅觉丧失、体温≥39ºC数天的COVID-19确诊感染的严重症状。应用ImmunoD®CLS®和AlphaH®后24小时内,症状明显减轻,最高体温下降。48小时后完全恢复,体温正常,活动正常或接近正常。没有来自患者或家长的副作用报告。结论:ImmunoD®CLS©与AlphaH©联合应用可能是一种较好的治疗方案,适用于进入ICU病房前或出院后病情进展为中重度的COVID-19感染患者。此外,该方案可作为医疗保健提供者的预防性治疗方案。我们强烈建议立即在一项对照随机试验中确认这些结果,以便可能迅速使COVID-19感染患者受益。
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引用次数: 1
The half-life of truth in medicine regarding the Covid-19 disease 关于新冠肺炎的医学真理的半衰期
Pub Date : 2020-01-01 DOI: 10.15761/jts.1000428
C. Bastid, J. Frossard
Received: October 25, 2020; Accepted: October 29, 2020; Published: November 02, 2020 After successfully controlling the first surge of infection and death brought on by the Sars-Cov 2 virus, there is currently no doubt about the worldwide occurrence of a second wave of COVID-19 disease. In Europe, several countries are reporting more daily Covid-19 cases than they did during the first wave in March, although the higher numbers may be due to more people being tested [1]; hospitals are currently overwhelmed.
收稿日期:2020年10月25日;录用日期:2020年10月29日;在成功控制了Sars-Cov病毒带来的第一次感染和死亡激增之后,目前毫无疑问,全球将出现第二波COVID-19疾病。在欧洲,一些国家每天报告的Covid-19病例比3月份第一波期间更多,尽管更高的数字可能是由于更多的人接受了检测;医院目前不堪重负。
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引用次数: 0
mTOR in inflammatory skin diseases: Review of the literature and our experience 炎症性皮肤病的mTOR:文献综述和我们的经验
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000317
S. Cacciapuoti, C. Marasca, M. Luciano, A. Masarà, M. Donnarumma, A. Balato, G. Fabbrocini
The mTORC1 protein complex consists of multiple components such as the serine/threonine kinase mTOR and the regulatoryassociated protein of mTOR (Raptor). Three highly researched upstream modulators of mTOR are the phosphatidylinositol 3-kinases (PI3Ks), protein kinase B (Akt). PI3K, and tumor necrosis factor alpha (TNFa) regulates Akt. Increased expression of PI3K, Akt, and TNFa amplifies mTORC1 activity as well (Figure 1) [3,4].
mTORC1蛋白复合物由多种组分组成,如丝氨酸/苏氨酸激酶mTOR和mTOR的调节相关蛋白(Raptor)。目前研究较多的mTOR上游调节剂有磷脂酰肌醇3-激酶(pi3k)、蛋白激酶B (Akt)。PI3K和肿瘤坏死因子α (TNFa)调节Akt。PI3K、Akt和TNFa的表达增加也会增加mTORC1的活性(图1)[3,4]。
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引用次数: 0
Evaluating the effect of intrahepatic lesion status on the prognosis of advanced hepatocellular carcinoma patients with extrahepatic metastasis: A prospective multicenter cohort study 评估肝内病变状态对晚期肝癌肝外转移患者预后的影响:一项前瞻性多中心队列研究
Pub Date : 2020-01-01 DOI: 10.15761/jts.1000368
N. M, Kuromatsu R, Niizeki T, Okamura S, Iwamoto H, Shimose S, Shirono T, Noda Y, Kamachi N, Koga H, Torimura T
Sorafenib is an oral multikinase inhibitor that has been approved to treat advanced hepatocellular carcinoma (HCC), although it is unclear whether the intrahepatic lesion is associated with prognosis of advanced HCC patients with extrahepatic metastasis treated with sorafenib. This study aimed to assess survival risk factors and evaluate therapeutic strategies for advanced HCC patients with extrahepatic metastasis treated with sorafenib. We analyzed the clinical data and treatment outcomes for 524 consecutive advanced HCC patients treated with sorafenib. Among them, 288 (55%) patients had extrahepatic metastasis. Among the patients with extrahepatic metastasis, 212 (74%) also had intrahepatic lesion. Multivariate analyses of overall survival identified intrahepatic lesion as an independent risk factor in patients with extrahepatic metastasis. Of those, 106 (50%) were treated with sorafenib monotherapy and 106 (50%) with alternatives to sorafenib treatment. The median survival time was 6.1 months for patients with sorafenib monotherapy and 11.6 months for those administered alternative treatments (p=0.0015). Our results indicated that sorafenib treatment may have negative long-term therapeutic effects in advanced HCC patients with extrahepatic metastasis and intrahepatic lesion, and that alternative treatments should be considered for these patients after sorafenib treatment.
索拉非尼是一种口服多激酶抑制剂,已被批准用于治疗晚期肝细胞癌(HCC),尽管尚不清楚索拉非尼治疗的肝内病变是否与肝外转移的晚期HCC患者的预后相关。本研究旨在评估索拉非尼治疗晚期HCC肝外转移患者的生存危险因素和治疗策略。我们分析了524例连续接受索拉非尼治疗的晚期HCC患者的临床数据和治疗结果。其中肝外转移288例(55%)。在肝外转移患者中,有212例(74%)合并肝内病变。总生存率的多变量分析表明肝内病变是肝外转移患者的独立危险因素。其中,106例(50%)接受索拉非尼单药治疗,106例(50%)接受索拉非尼替代治疗。索拉非尼单药治疗患者的中位生存时间为6.1个月,替代治疗患者的中位生存时间为11.6个月(p=0.0015)。我们的研究结果表明,索拉非尼治疗对晚期HCC肝外转移和肝内病变患者可能有负面的长期治疗效果,应考虑在索拉非尼治疗后对这些患者进行替代治疗。
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引用次数: 0
Angiogenesis as a prognostic factor of pathological stage IA lung adenocarcinoma: developing an angiogenic score 血管生成作为病理期肺腺癌的预后因素:建立血管生成评分
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000382
Karol De Aguiar-Quevedo, A. R. Sauri, J. Navarro, C. J. Aragón, J. C. Mojarrieta, N. Franch, M. Martínez, Encarnación Martínez Pérez, F. V. Sempere, J. C. P. Cuesta
Purpose: This work was designed to correlate the expression of markers of tumoral angiogenesis in lung adenocarcinoma as a prognostic factor and create a predictive model with these factors. Patients and methods: A clinical, observational and analytical research study was undertaken. This work sought to describe and compare prognosis value of angiogenic markers of 119 resected patients, classified as pathological stage IA. The tumour angiogenesis analysis was performed, the survival and predictive value of microvascular density (MVD) expression with tumoral relapse and survival were evaluated. Finally, an accurate score, “Angioscore”, was calculated by combining different markers. Results: Low MVD-CD34 is associated with a worse disease-free survival (DFS) and cancer specific survival (CSS). High MVD-CD31 is significantly related to reduce DFS and CSS. High MVC-CD105 is associated with worse clinical outcomes. The predictive capacity of these angiogenic markers independently it is not exact. The “Angioscore” is able to provide better information about patient prognosis (74.8% and 73.7%). Two groups were obtained with the risk value obtained by “Angioscore”. A significant difference in the prognosis of both groups was accomplished (p < 0.001). Being in the multivariate analysis the only independent prognostic factor in patients with lung ADC in stage IA of this series. Conclusion: Tumour angiogenesis is a prognostic factor in early stage lung adenocarcinoma, the analysis of this factor being more accurate using a score, with great predictive value
目的:本研究旨在将肺腺癌中肿瘤血管生成标志物的表达与预后因素联系起来,并利用这些因素建立预测模型。患者和方法:进行了临床、观察和分析性研究。本研究旨在描述和比较119例病理分期为IA的切除患者的血管生成标志物的预后价值。进行肿瘤血管生成分析,评估肿瘤复发和生存的生存率及微血管密度(MVD)表达的预测价值。最后,结合不同的标记物计算出一个准确的评分“Angioscore”。结果:低MVD-CD34与较差的无病生存期(DFS)和癌症特异性生存期(CSS)相关。高MVD-CD31与降低DFS和CSS显著相关。高MVC-CD105与较差的临床结果相关。这些血管生成标志物的独立预测能力并不准确。“Angioscore”能够提供更好的患者预后信息(74.8%和73.7%)。两组采用“Angioscore”评分获得风险值。两组患者预后差异有统计学意义(p < 0.001)。在多变量分析中,是本系列中唯一独立影响肺ADC患者IA期预后的因素。结论:肿瘤血管生成是影响早期肺腺癌预后的因素之一,采用评分法分析该因素更为准确,具有较高的预测价值
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引用次数: 0
The power of surfaceome analysis in cancer to design novel targeted therapies 表面体分析在癌症中设计新型靶向治疗的力量
Pub Date : 2020-01-01 DOI: 10.15761/JTS.1000383
E. Marinari, D. Migliorini
The spectrum of cell surface proteins (the surfaceome) is one of the key focus of the drug industry, as 66% of approved human drugs registered in the Drug Bank database target a protein on the cell-surface, which makes the surfaceome of great therapeutical significance [1]. However, the comprehensive evaluation of the human surface protein repertoire remains a major challenge and several methods are needed to interrogate cell-surface proteins, in particular where low numbers of cells are available. The combination of gene expression analysis by next generation deep sequencing of bulk RNA-sequencing and single cell RNA-sequencing, integrated with cell-surface protein expression by proteomics, could potentially overcome inaccurate predictions of human cell-surface genes. This approach could avoid relying on an assumed correlation between mRNA levels and effective protein expression and define the cell proteome, including those proteins that are located on the cell surface. The for characterization in could constitute a for to in could be in and
细胞表面蛋白(表面体)的光谱是制药行业的重点之一,因为在药物库数据库中注册的66%的已批准的人用药物靶向细胞表面的蛋白质,这使得表面体具有很大的治疗意义[1]。然而,对人类表面蛋白库的全面评估仍然是一个主要的挑战,需要几种方法来询问细胞表面蛋白,特别是在细胞数量少的情况下。结合下一代大体积rna深度测序和单细胞rna测序的基因表达分析,结合蛋白质组学的细胞表面蛋白表达,有可能克服对人类细胞表面基因的不准确预测。这种方法可以避免依赖于mRNA水平和有效蛋白质表达之间的假设相关性,并定义细胞蛋白质组,包括那些位于细胞表面的蛋白质。表征中的for可以构成一个for,而in可以是和
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引用次数: 1
Cinematic rendering in vascular imaging: Abdominal aortic aneurysm (AAA) treated with fenestrated endovascular aortic repair (FEVAR) 血管成像中的电影渲染:开窗血管内主动脉修复术(FEVAR)治疗腹主动脉瘤(AAA)
Pub Date : 2020-01-01 DOI: 10.15761/jts.1000427
G. Hagleitner, P. Pichler, P. Kiblböck, F. Fellner
present Abstract Cinematic rendering (CR) of cross-sectional imaging data is a novel technique of post-processing cross-sectional imaing data. Through photorealistic CR images it is now possible to deliver a better understanding anatomy and pathoanatomy for medical professionals, students and the general public alike. Computed tomography (CT) plays an essential role in diagnosis of abdominal aortic aneurysms (AAA), planning and follow-up in fenestrated endovascular aortic repair (FEVAR). In the last few years FEVAR has emerged as a standard procedure for the treatment of AAAs involving the visceral and renal arteries. In this article, we want to discuss the possible applications for CR images in a case with AAA treated with FEVAR.
横断面成像数据的电影渲染(CR)是横断面成像数据后处理的一种新技术。通过逼真的CR图像,现在可以为医学专业人员、学生和公众提供更好的解剖学和病理学理解。计算机断层扫描(CT)在腹主动脉瘤(AAA)的诊断、开窗血管内主动脉修复(FEVAR)的计划和随访中发挥着重要作用。在过去的几年中,FEVAR已成为治疗累及内脏和肾动脉的AAAs的标准程序。在这篇文章中,我们想讨论用FEVAR治疗AAA的病例中CR图像的可能应用。
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引用次数: 0
期刊
Journal of translational science
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