To compare pregnancy outcomes between patients with gestational diabetes mellitus (GDM) with and without their own blood glucose meter. We conducted a retrospective-cohort study of 835 women with GDM at the Second Hospital of Tianjin Medical University, Tianjin, China from 1 January 2016 to 31 December 2018. Perinatal outcomes of these patients were monitored and collected in the Tianjin Maternal and Child Health System. Each patient was advised by a certified clinical nutritionist regarding dietary analysis and lifestyle recommendations. All pregnant women with GDM were divided into the following 2 groups according to whether they had their own blood glucose meter: women with self-measured blood glucose levels with a routine obstetric examination in the study group (n = 424); and those with non-self-measured blood glucose levels with a double obstetric examination in the control group (n = 411). Maternal and fetal pregnancy outcomes were compared between these 2 groups. According to different self-management modes, the women were also divided into eight subgroups to compare blood sugar control and compliance with recommended insulin therapy. The cesarean section rate was significantly lower in the study group than in the control group (P < .05). The prevalence of large-for-gestational age (P < .05) and macrosomia was significantly lower in the study group than in the control group (both P < .05). The prevalence of appropriate-for-gestational age was significantly higher in the study group than in the control group (P < .05). Birth weight was significantly lower in the study group than in the control group (P < .05). The mean times for blood sugar control and from the doctor recommendation for insulin treatment to the patient compliance in the study group were significantly shorter than those in the control group (both P < .05). The proportion of insulin required in the study group was significantly lower than that in the control group (P < .05). There were no significant differences in the time of controlling blood sugar and compliance among the 4 subgroups of the study group. However, subgroups with a dietary diary in the control group were better. Self-monitoring blood sugar plus a routine obstetric examination can help patients with GDM control blood sugar, even without dietary diaries and treadmills. In addition to increasing the number of obstetric examinations, recording dietary diaries is helpful for controlling blood sugar in patients with GDM who are unwilling to measure blood sugar by themselves.
Chidamide (CS055) is a new and highly selective histone deacetylase inhibitor displaying significant single-agent activity in peripheral T-cell lymphoma (PTCL). But there is little known the synergistic effect between CS055 and chemotherapy. The purpose of this study is to explore the synergistic effect and molecular mechanisms of CS055 combination with Doxorubicin in PTCL cells. We found that CS055 showed dose- and time-dependent inhibition effects on PTCL cell. Meanwhile, the synergistic effect was significantly observed after combination treatment with lower drug-concentration of CS055 and Doxorubicin. Lower drug-concentration of CS055 induced weak apoptosis in PTCL cells, but combination treatment with CS055 and Doxorubicin promoted more significant apoptosis. Combination treatment with CS055 and Doxorubicin significantly changed mitochondrial membrane potential and H3 acetylated level, resulting in up-regulating DNA damage protein p-γH2AX and apoptosis proteins including cleaved-caspase-3, cleaved-caspase-9 and cleaved-PARP, and down-regulating anti-apoptosis protein Bcl-2. In a word, Doxorubicin could increase the CS055-induced inhibition effects on PTCL cells, suggesting that CS055 combination with Doxorubicin or Doxorubicin-based chemotherapy drugs might be a new therapy approach for PTCL patients.
Double-hit lymphoma (DHL) refers to a group of mature B-cell lymphoma with Myc and Bcl-2 or Bcl-6 genomic rearrange-ments. DHL mainly occurs in patients with diffused large B-cell lymphoma (DLBCL) and B-cell lymphoma unclassifiable (BCLU). Fluores-cence in situ hybridization (FISH) is the gold standard for diagnosis and is used as the basis for changing regimen. Double-expression lymphoma (DEL) is more common than cytogenetically defined double-hit cases. Unlike true DHL, which are mostly of GCB type,~2/3 DEL cases are non-GCB type. The cut-off value for immunohistochemistry of C-myc and Bcl-2 should be defined to detect the presence of concurrent gene rearrangements by FISH. DHL is characterized by relatively special clinical characteristics and unfavorable progno-sis. A number of studies have shown that Bcl-6 DHL are more aggressive than Bcl-2 DHL. Other studies indicated that Bcl-6 DHL is simi-lar to Bcl-2 DHL in terms of poor prognosis. Compared with CHOP-like regiment, R-EPOCH/HyperCVAD regimen has good performance on progression free survival (PFS) and even on overall survival (OS). Despite this development, current chemotherapy regimens often have poor efficacy. Novel and specific molecular targeted agents, rather than chemotherapy drugs, may overcome poor prognosis and provide insights into future treatment strategies. On the basis of the above characteristics, DHL is defined as"high grade B-cell lympho-ma with Bcl-2/Myc or Bcl-6/Myc double-hit"in the 2016 WHO classification. In this review, we will issue the definition, pathogenesis, and key points of their argument to examine the diagnosis/treatment of the progress of DHL.
Objective:To identify whether the use of rituximab predisposed to interstitial pneumonia (IP) after treatment of B cell non-Hodgkin's lymphoma (B-NHL) with the chemotherapy and immunochemothrapy and to assess the clinical features and treatment of IP. Methods:A clinical study was conducted on 266 cases of CD20+B-NHL patients with CHOP-like or RCHOP-like therapeutic regimen from January 2010 to May 2015. The cases were divided into rituximab-containing chemotherapy group and chemotherapy group. We analyzed the relationship between the development of IP and the use of rituximab. The IP related clinical features were also reviewed. Results:The incidence of IP in the rituximab-containing chemotherapy group was significantly higher compared with the incidence in the chemotherapy group. The IP-related factors include age>60, male, elevated absolute lymphocyte count (ALC), diabetes, and dif-fuse larpe B-cell lymphoma (DLBCL) subtype. By multivariate analysis, elevated ALC, diabetes, DLBCL subtype, and addition of ritux-imab were revealed as significant factors for an elevated risk of IP. Conclusion:The incidence of IP was higher in patients with CD20+B-NHL receiving rituximab-containing chemotherapy;this result may be related to immune disorders. Corticosteroids and antifungal ther-apy can effectively relieve the patients' symptoms.
Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is a rare and distinct variant of DLBCL. It is classified as a unique subtype of DLBCL in the 2008 WHO classification of lymphomas. No standard and effective therapeutic regi-men is available for ALK+DLBCL because it shows a more aggressive clinical course and frequent relapse. Therefore, a standardized and individualized treatment is needed to benefit more patients diagnosed with ALK+DLBCL through a multiple disciplinary team. This arti-cle presents a case of an ALK+DLBCL patient who relapsed after transplantation and was successfully treated with the ALK kinase inhibi-tor Crizotinib.
随着靶向药物的不断上市,恶性淋巴瘤的治疗已经取得了长足进展,但仍有40%的患者出现原发耐药或复发而最终死亡[1] ,针对这部分的患者我们还迫切需要寻找新的治疗方法. 近年来,免疫治疗作为一种新的有效治疗手段备受关注,也为复发/难治恶性淋巴瘤患者的治疗提供了新的思路.