Objective To investigate the association between MDM2 gene promoter SNP 309 polymorphism and leukemia susceptibility. Methods Such databases as Ovid, EBSCO, PubMed, CNKI, CBM, VIP and WanFang Data were searched to collect the case-control studies published from January 1990 to June 2012. According to the inclusion and exclusion criteria, the studies were screened, the data were extracted, and the methodological quality of the included studies was evaluated. Then meta-analysis was conducted using RevMan 5.0 and Stata 10.0 software, the pooled odds ratio (ORs) with 95% confidence interval (CI) were calculated, and the sensitivity and publication bias were evaluated at the same time. Results A total of 9 studies within 8 articles were included, which involved 1 821 cases and 5 642 controls. The results of meta-analysis showed that, the susceptibility of leukemia was increased in the G allele carriers compared with the T allele carriers (OR=1.26, 95%CI 1.08 to 1.46, P=0.003), and the leukemia risk was higher in the GG genotype populations compared with the TT genotype populations (OR=1.46, 95%CI 1.02 to 2.10, P=0.04). Among Asians with recessive models, the leukemia risk was higher in the homozygous GG genotype compared with both the heterozygous GT genotype and the homozygous TT genotype (OR=2.00, 95%CI 1.37 to 2.92, P=0.000 3). There was no obvious publication bias. Conclusion MDM2 gene promoter SNP 309 polymorphism is associated with the susceptibility of leukemia, and the G allele is likely to be the risk factor for leukemia.
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.
ObjectiveTo study the effects of leukemia inhibitory factor (LIF) and basic fibroblast growth factor (bFGF) on the proliferation and differentiation of human bone marrow mesenchymal stem cells (hBMSCs). MethodshBMSCs at passage 4 were divided into 4 groups according to different culture conditions:cells were treated with complete medium (α-MEM containing 10%FBS, group A), with complete medium containing 10 ng/mL LIF (group B), with complete medium containing 10 ng/mL bFGF (group C), and with complete medium containing 10 ng/mL LIF and 10 ng/mL bFGF (group D). The growth curves of hBMSCs at passage 4 in different groups were assayed by cell counting kit 8; cellular morphologic changes were observed under inverted phase contrast microscope; the surface markers of hBMSCs at passage 8 including CD44, CD90, CD19, and CD34 were detected by flow cytometry. ResultsThe cell growth curves of each group were similar to the S-shape; the cell proliferation rates in 4 groups were in sequence of group D > group C > group B > group A. Obvious senescence and differentiation were observed very early in group A, cells in group B maintained good cellular morphology at the early stage, with slow proliferation and late senescence; a few cells in group C differentiated into nerve-like cells, with quick proliferation; and the cells in group D grew quickly and maintained cellular morphology of hBMSCs. The expressions of CD44 and CD90 in groups A and C at passage 8 cells were lower than those of groups B and D; the expressions of CD19 and CD34 were negative in 4 groups, exhibiting no obvious difference between groups. ConclusionLIF combined with bFGF can not only maintain multiple differentiation potential of hBMSCs, but also promote proliferation of hBMSCs.
Objective To observe the clinical characteristics and treatment of cytomegalovirus retinitis (CMVR) in leukemia patients. Methods This is a retrospective analysis. Seven leukemia patients (13 eyes) with CMVR were studied. All patients underwent examinations of visual acuity, slit lamp microscope, ophthalmoscope, color fundus photography, peripheral blood CD4+T cell count and serum/aqueous CMV-DNA test. All patients were treated with ganciclovir or zoledronic acid combined with intravitreal injection of ganciclovir. The follow-up period was 3-14 months. Results Six patients were treated with hematopoietic stem cell transplantation and 1 patient was with chronic leukemia. All patients were CMV-DNA positive for serum, and 18.5% (2/7) for aqueous humor. CMVR in leukemia patients showed mild anterior segment inflammation, ocular fundus with irregular yellowish-white retinal necrosis and radial hemorrhage (7 eyes). Some (2 eyes) also shoed gray and white granular retinal infiltrates. Intravenous ganciclovir/zoledronic acid combined with intravitreal injection of high concentration ganciclovir was an effective treatment, while systemic corticosteroids were effective in reducing vitreous opacity. Conclusions CMVR is characterized by progressive necrotic retinitis with hemorrhage and vasculitis. Intravenous ganciclovir/zoledronic acid combined with intravitreal injection of ganciclovir is effective in the treatment of CMVR with leukemia.
ObjectiveTo observe and analyze the clinical features and prognosis of proliferative diabetic retinopathy (PDR) with chronic myeloid leukemia.MethodsA retrospective case series study. From May 2011 to December 2020, 5 patients (10 eyes) were included in this study in Eye-ENT Hospital of Fudan University. Basic information about the patient's age, gender, diabetes history and CML history were collected. The endocrine and hematological indexes of all patients were evaluated. All the patients were undertaken visual acuity, intraocular pressure, slit lamp and fundus examination and other examinations to observe the eye conditions. Ophthalmic treatments included panretinal laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, vitrectomy. During the follow up period from 5 months to 6 years, prognosis was observed at each office visit. During the follow up period, patients' vision, intraocular pressure, anterior segment and retinal status were observed.ResultsThere were 4 males and a female in 5 patients. The ages were from 27 to 49 years, with the mean age of 39 years. All patients were bilateral. All patients suffered type 2 diabetes for 3 months to 13 years. Four of them were diagnosed as chronic myeloid leukemia before visiting to ophthalmologists, while the other visited to ophthalmology first due to poor vision. The initial visual acuity ranged from light perception to 0.4 and 6 eyes were less than 0.1. In addition to the typical manifestations of diabetic retinopathy, such as venous tortuous dilation, exudation, microaneurysm and neovascularization, patients also presented with Roth spot as leukemic fundus manifestations. All eyes developed to PDR stage. Abnormal thickening of the neovascular membranes may occur in the lower part of the retina, with secondary traction retinal detachment. All the eyes were treated with pan retinal photocoagulation and 9 eyes underwent pars plana vitrectomy. After treatment, retina of 8 eyes kept flat. The best corrected visual acuity ranged from no light perception to 1.0, and only 4 eyes reached more than 0.2. Unfortunately, one eye lost vision because of secondary neovascular glaucoma.ConclusionsPDR patients with CMLof fundus not only have venous tortuous dilation, exudation, microaneurysm and neovascularization, also present with Roth spot as leukemic fundus manifestations. Diabetic retinopathy combined with CML could progress rapidly, and its aggravating complications such as hyperplastic membrane, vitreous hemorrhage and traction retinal detachment may result in poor visual prognosis. Early screening and treatment can help improve the prognosis of patients.
Combined with leukemia is a risk factor for aggravating diabetic retinopathy. A combination of diabetic retinopathy and leukemia can be expected to have a rapid progression and patients often visit the department of ophthalmology first. In addition to the typical manifestations of diabetic retinopathy such as retinal venous tortuous dilation, microaneurysm, retinal hemorrhage and exudation, patients may also be associated with leukemic retinopathy. Areas of extensive capillary non-perfusion and neovascularization may appear in the early stage of mild microangiopathy. Moreover, severe complications such as vitreous hemorrhage, neovascular membranes and traction retinal detachment appear earlier, which may be a prognostic indicator for poor vision. The causes of leukemia aggravating diabetic retinopathy include retinal ischemia due to hyperviscosity, anemia and thrombocytopenia, direct infiltration of tumor cells, chemotherapy and radiotherapy, high level of vascular endothelial growth factor. In clinic, rapidly progressing diabetic retinopathy should alert the ophthalmologist to the underlying hematological disorder. Patients with both diabetes and leukemia need to be screened much earlier and followed up at shorter intervals. Early detection and aggressive management may help preserve visual acuity in such cases.
Leukemia is a common, multiple and dangerous blood disease, whose early diagnosis and treatment are very important. At present, the diagnosis of leukemia heavily relies on morphological examination of blood cell images by pathologists, which is tedious and time-consuming. Meanwhile, the diagnostic results are highly subjective, which may lead to misdiagnosis and missed diagnosis. To address the gap above, we proposed an improved Vision Transformer model for blood cell recognition. First, a faster R-CNN network was used to locate and extract individual blood cell slices from original images. Then, we split the single-cell image into multiple image patches and put them into the encoder layer for feature extraction. Based on the self-attention mechanism of the Transformer, we proposed a sparse attention module which could focus on the discriminative parts of blood cell images and improve the fine-grained feature representation ability of the model. Finally, a contrastive loss function was adopted to further increase the inter-class difference and intra-class consistency of the extracted features. Experimental results showed that the proposed module outperformed the other approaches and significantly improved the accuracy to 91.96% on the Munich single-cell morphological dataset of leukocytes, which is expected to provide a reference for physicians’ clinical diagnosis.
Objective To analyze the prevalence of leukemia in China from 1990 to 2019, predict the incidence, morbidity and mortality of leukemia in China from 2020 to 2040, and provides reference for the formulation of leukemia-related prevention and treatment strategies in China. Methods Based on the 2019 Global Burden of Disease database, the incidence, morbidity and mortality data of leukemia in China from 1990 to 2019 were collected, and the rate of change and annual estimated percentage of change (EAPC) were used to describe the epidemic trend of the disease. The Autoregressive Moving Average (ARIMA) model was used to predict the prevalence of leukemia in China from 2020 to 2040. Results In 2019, the age-standardized incidence, age-standardized prevalence and age-standardized mortality rate of leukemia in China decreased by 17.62%, 10.97%, and 41.56%, respectively, compared with 1990, and an average annual decrease of 1.06%, 0.89%, and 2.05%, respectively (P<0.05). From 1990 to 2019, the reduction age-standardized incidence rate, age-standardized prevalence rate and age-standardized mortality rate in Chinese women (EAPC was 1.56%, 1.38%, and 2.62%, respectively) was higher than that of men (EAPC was 0.61%, 0.43%, and 1.59%, respectively). In 2019, the incidence and prevalence were highest in the age group under 5 years of age, and the mortality rate was the highest in the age group over 80 years old. The prediction results of ARIMA model showed that the age-standardized incidence rate and prevalence of leukemia in China showed an increasing trend from 2020 to 2040, while the age-standardized mortality rate showed a decreasing trend. It is estimated that by 2040, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized mortality rate of leukemia will be 14.06/100 000, 108.23/100 000, and 2.83/100 000. Conclusions From 1990 to 2019, the age-standardized incidence rate, age-standardized prevalence rate and age-standardized mortality rate of leukemia in China decreased year by year, but they were still at a high level. The prediction results show that the age-standardized incidence rate and age-standardized prevalence rate of leukemia in China will continue to increase from 2020 to 2040, and it is necessary to continue to strengthen the surveillance, prevention and control of leukemia in the future.