[Impact of intensified maintenance therapy on the prognosis of children and adolescents with advanced lymphoblastic lymphoma]

目的

探讨增加维持治疗强度对Ⅲ期和Ⅳ期儿童青少年淋巴母细胞淋巴瘤（Lymphoblastic lymphoma, LBL）患者预后的影响。

方法

回顾性分析接受BFM-NHL-90/-95方案治疗且未做纵隔和中枢预防性放疗的Ⅲ期和Ⅳ期儿童青少年LBL患者的治疗结果。研究分组：1998年至2005年收治的患者于维持治疗阶段，在口服巯基嘌呤和甲氨蝶呤的基础上，定期采用“足叶乙甙+阿糖胞苷”和大剂量甲氨蝶呤交替进行化疗，为强化维持治疗组；其余为非强化维持治疗组。

结果

187例LBL患者纳入研究，其中强化维持治疗组52例，非强化维持治疗组135例，两组患者的性别、年龄、免疫分型、临床分期、危险度分层、受累部位的差异均无统计学意义（P值均>0.05）；中位随访48（0.5～221）个月，两组患者的5年无事件生存（EFS）率分别为（76.9±5.8）%和（77.9±4.3）%（χ²＝0.249，P＝0.617），5年总生存（OS）率分别为（78.8±5.7）%和（79.8±4.1）%（χ²＝0.353，P＝0.552），差异均无统计学意义；亚组分析结果显示，两组患者在不同临床分期（Ⅲ/Ⅳ期）、免疫分型（T/B-LBL）和危险分层（中/高危）中的EFS、OS率差异均无统计学意义（P值均>0.05）。维持治疗期间，强化维持治疗组和非强化维持治疗组患者Ⅲ、Ⅳ级骨髓抑制发生率分别为55.8%和18.5%（χ²＝25.363，P<0.05）。

结论

提高维持治疗强度并未提高Ⅲ期和Ⅳ期儿童青少年LBL患者的长期生存且可增加骨髓抑制等治疗相关不良反应。

Impaired glucose tolerance in first-episode drug-naïve patients with schizophrenia: relationships with clinical phenotypes and cognitive deficits

BACKGROUND

Schizophrenia patients have a higher prevalence of type 2 diabetes mellitus with impaired glucose tolerance (IGT) than normals. We examined the relationship between IGT and clinical phenotypes or cognitive deficits in first-episode, drug-naïve (FEDN) Han Chinese patients with schizophrenia.

METHOD

A total of 175 in-patients were compared with 31 healthy controls on anthropometric measures and fasting plasma levels of glucose, insulin and lipids. They were also compared using a 75 g oral glucose tolerance test and the homeostasis model assessment of insulin resistance (HOMA-IR). Neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).

RESULTS

Of the patients, 24.5% had IGT compared with none of the controls, and they also had significantly higher levels of fasting blood glucose and 2-h glucose after an oral glucose load, and were more insulin resistant. Compared with those patients with normal glucose tolerance, the IGT patients were older, had a later age of onset, higher waist or hip circumference and body mass index, higher levels of low-density lipoprotein and triglycerides and higher insulin resistance. Furthermore, IGT patients had higher PANSS total and negative symptom subscale scores, but no greater cognitive impairment except on the emotional intelligence index of the MCCB.

CONCLUSIONS

IGT occurs with greater frequency in FEDN schizophrenia, and shows association with demographic and anthropometric parameters, as well as with clinical symptoms but minimally with cognitive impairment during the early course of the disorder.

Tetraethylammonium inhibits glioma cells via increasing production of intracellular reactive oxygen species

BACKGROUND

Potassium channel blockers have been shown to possess antitumor properties, but the role of apoptosis remains to be clarified. In this study, we investigated the antiproliferative effect of tetraethylammonium (TEA), a nonspecific potassium channel blocker, in rat C6 and 9L glioma cells.

METHODS

Cytotoxicity was evaluated by MTT assay. Apoptosis was detected by TUNEL and annexin V-FITC/propidium iodide assays. Protein levels were determined by Western blot analysis. Intracellular reactive oxygen species (ROS) levels were assessed flow cytometrically.

RESULTS

TEA (2-60 mM) significantly inhibited the proliferation of C6 and 9L glioma cells. In addition, increased cell apoptosis was confirmed after treatment with 40 mM TEA. Apoptosis was associated with a dramatic increase in ROS levels and altered Bcl-2/Bax protein balance.

CONCLUSION

TEA can inhibit proliferation and induce apoptosis in both cell lines; therefore, it might be associated with the increase in intracellular ROS production.