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Yang S.-W.,Capital Medical University | Zhou Y.-J.,Capital Medical University | Liu Y.-Y.,Capital Medical University | Hu D.-Y.,Peking University | And 10 more authors.

We assessed whether the admission fasting plasma glucose (FPG) levels were associated with all-cause mortality and left ventricular (LV) function in older patients with acute myocardial infarction (AMI). A total of 1854 consecutive patients were categorized into 4 groups: hypoglycemia, euglycemia, mild hyperglycemia, and severe hyperglycemia. The primary outcomes were in-hospital/3-year mortality and LV function. There was a near-linear relationship between FPG and Killip class. However, no significant correlation was found between FPG levels and LV ejection fraction. Both FPG levels and Killip classes were all independent significant predictors of mortality. Compared with the euglycemia group, both the hypo- and hyperglycemia groups were associated with higher in-hospital and 3-year mortality. In older patients with AMI, the FPG values had differential influences on LV function and mortality. There was a U-shaped relationship between FPG and in-hospital/3-year mortality, and a near-linear relationship between increased admission glucose levels and higher Killip classification. © The Author(s) 2012. Source

Yang S.-W.,Capital Medical University | Zhou Y.-J.,Capital Medical University | Nie X.-M.,Capital Medical University | Liu Y.-Y.,Capital Medical University | And 14 more authors.
Mayo Clinic Proceedings

OBJECTIVE: To assess whether the relationship between abnormal fasting plasma glucose (FPG) levels and patient outcomes holds for both older men and older women with acute myocardial infarction (AMI). PATIENTS AND METHODS: From April 1, 2004, to October 31, 2006, a total of 2016 consecutive older patients (age ≥65 years) presenting with AMI were screened. Of these patients, 1854 were consecutively enrolled in the study. Patients were categorized into 4 groups: the hypoglycemic group (FPG, ≤90.0 mg/dL [to convert to mmol/L, multiply by 0.0555]; n=443, 23.9%), the euglycemic group (FPG, 90.1-126.0 mg/dL; n=812, 43.8%), the mildly hyperglycemic group (FPG, 126.1-162.0 mg/dL; n=308, 16.6%), and the severely hyperglycemic group (FPG, ≥162.1 mg/dL; n=291, 15.7%). The primary outcomes were rates of in-hospital and 3-year mortality. RESULTS: Female patients were older and had a higher incidence of diabetes mellitus but lower rates of smoking and use of invasive therapy. Men tended to have a higher frequency of hypoglycemia, whereas women tended to have a higher frequency of hyperglycemia. No significant difference was found in in-hospital (10.9% vs 9.1%; P=.36) or 3-year (24.5% vs 24.5%; P=.99) mortality between male and female patients, and FPG-associated mortality did not vary significantly by sex. CONCLUSION: An increased FPG level was associated with a relatively higher risk of in-hospital mortality in men but not in women. Nonetheless, increased and decreased FPG levels at admission could predict higher mortality rates regardless of sex. There was a striking U-shaped relationship between FPG levels and in-hospital and 3-year mortality. The effect of abnormal FPG level on outcomes among older patients with AMI did not vary significantly by sex. © 2011 Mayo Foundation for Medical Education and Research. Source

Guo Z.,General Hospital of Beijing Military | Chen H.-R.,General Hospital of Beijing Military | Liu X.-D.,General Hospital of Beijing Military | Lou J.-X.,General Hospital of Beijing Military | And 3 more authors.
Journal of Leukemia and Lymphoma

Objective To explore the efficacy and safety in the treatment of relapsed or refractory lymphoma after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The method of allo-HSCT was adopted to treat 7 patients with relapsed or refractory lymphoma from January 2007 to January 2012 in the General Hospital of Beijing Military. The primary disease included 6 cases of NHL and 1 case of HL. 4 cases had one recurrence, 2 cases had two or more relapses, and 1 case was primary refractory. The patients had an average age of 33.7 years old (ranging from18 to 48-year-old) and included 4 males and 3 females. The patients included 2 cases of diffuse large B-cell (DLBCL) and 1 for each case of T lymphoblastoid cell type (T-LL), skin extranodal NK/T cell type (ENKTCL-N), hepatosplenic T-cell type (HSTCL), Burkitt' s type (BL), and HL mixed cell type. 3 patients were in remission while 4 patients did not achieve remission at the time of transplantation. 3 cases had donor and recipient HLA matching while the remaining 4 mismatched. Bone marrow and peripheral blood stem cell transplantation were used in this study. Patients were pretreated with fludarabine, melphalan, anti-human thymocyte globulin cyclosporin A (CsA) and methotrexate (MTX) to prevent graft-versus-host disease (GVHD). Toxicity, GVHD and disease-free survival were monitored in patients after transplantation. Results 6 patients tolerated conditioned regimen and achieved hematopoietic reconstitution. Implantation evidence testing confirmed 100 % hematopoietic from donors. Follow-up was up to January 2011 with a median of 29.6 months (1-70 months). The overall survival rate was 71.4 %. 5 patients had acute GVHD and 4 experienced chronic GVHD. 1 patient died of infection and 1 died of relapse, and the rest patients were alive. The longest disease-free interval was up to 70 months. Conclusion allo-HSCT is effective and safe for relapsed or refractory lymphoma. It can be a key technology of extensive clinical use for treating relapsed or refractory lymphoma. Source

Lou J.-X.,General Hospital of Beijing Military | Chen H.-R.,General Hospital of Beijing Military | Liu X.-D.,General Hospital of Beijing Military | Guo Z.,General Hospital of Beijing Military | And 6 more authors.
Journal of Leukemia and Lymphoma

Objective To investigate the feasibility of HLA-mismatched allogeneic hematopoietic stem cell transplantation for refractory severe aplastic anemia (SAA). Methods From May 2008 to September 2009, a total of 7 patients with SAA were transplanted for 8 times, including 3 females, 4 males, the median age was 14.5 years old (1.4-29.0 years old), and median duration from diagnosis to transplantation was 13 months (5.5-87.0 months). All patients received more than one immunosuppressive therapy before transplantation for 3 months or more, depending on the blood transfusion survival. Only 2 had no pre-transplantation infectious complications, the remaining 5 patients had more than one locus of infection. The conditioning regimen, one patient with unmatched transplantation received CTX+TBI, 2 used CTX+ATG, and the remaining 5 cases were treated with CTX+Flu+ATG. Source of hematopoietic stem cells, 3 unrelated cases were from the China Marrow Donor Program, 5 HLA haploidentical cases were respectively from mother (3), father (1), and siblings (1), and were identical in 3/6 loci. All cases received CsA+MMF+MTX as acute GVHD prophylaxis. Results The 3 cases of non-blood transplantation patients, 1 was stable for 18 months, the other 2 had graft rejections with one of which was re-transplanted with her mother's graft (HLA haploidentical) 50 days from the first transplantation, and had been successfully followed up for more than 18 months. Chimerism check showed 100 % of donor type blood. The remaining 4 haploidentical transplantation cases, 1 stable implant died of intracranial fungal infection at +52 day, 2 died of pulmonary infection (+3 day) or septicemia (+11 day), the last one had graft rejection +30 day. Conclusion For patients with refractory SAA and failed immunosuppressive treatment, or having no ideal donors, treatment with CTX+Flu+ATG and conditioned HLA incompatible allogeneic hematopoietic stem cell transplantation may be a feasible choice, which is worthy of further exploration. Source

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