Ligustilide delays senescence of auditory cortex in mice by inhibiting ferritinophagy / 中国药理学通报

Aim To investigate the mechanism of ligu aged 2 months of the same strain were used as the constilide (LIG) in delaying the senescence of auditory trol (Ctrl) group. Auditory brainstem response test was cortex and treating central presbycusis. Methods used to detect the auditory threshold of mice before and Forty C57BL/6J mice aged 13 months were randomly di after treatment. Levels of serum MDA and activity of vided into ligustilide low-dose(L-LIG) group, ligustil serum SOD were detected to display the level of oxidative ide medium-dose (M-LIG) group, ligustilide high-dose stress. The pathological changes of auditory cortex were (H-LIG) group and aging (Age) group, and 10 mice observed by HE staining. Ferroptosis was observed by

Robustness assessment of cardiovascular meta-analysis / 中国胸心血管外科临床杂志

@#Objective     To evaluate the robustness of cardiovascular meta-analysis with use of fragility index. Methods     By searching PubMed, EMbase, and Web of Science databases from 2018 to 2022, relevant literature on cardiovascular meta-analysis was systematically collected and the fragility indexes were calculated; Spearman correlation analysis was used to explore the relationship between fragility index and sample size, total number of events, effect size and its confidence interval width. Results     A total of 212 meta-analyses from 29 articles were included, with a median fragility index of 11 (5, 25), a median sample size of 10 301 (3 384, 48 330), and a median total number of events of 360 (129, 1 309). Most meta-analyses chose relative risk as the effect measure (179/212), and chose Mantel-Haenszel method (102/212) and random effects model (153/212). The fragility index was positively correlated with the sample size (rs=0.56, P<0.05) and the total number of events (rs=0.61, P<0.05), and negatively correlated with confidence interval width of the effect size (rs=−0.52, P<0.05). No statistically significant results were obtained in the correlation between the fragility index and effect size. Conclusion     The fragility indexes of cardiovascular meta-analyses published in comprehensive journals of high impact factors and professional cardiovascular journals are generally low, and therefore lack robustness. Fragility index is suggested to be reported in medical researches, assisting in explaining the P-value.

In vitro efficacy and combined drug sensitivity of lycosin-I against methicillin-resistant Staphylococcus aureus / 中华检验医学杂志

Objective:The aim of this study was to evaluate the in vitro activity of lysosin-Ⅰ against Methicillin-resistant Staphylococcus aureus (MRSA) and its synergistic effect with eight common antibacterial drugs against MRSA. Methods:This study was conducted following the design principles of a randomized controlled trials. Ten MRSA isolates, clinically isolated from the Second Xiangya Hospital of Central South University between September and November 2021, were determined the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and bactericidal kinetic test of lycosin-Ⅰ in vitro anti-MRSA by micro-broth dilution method. Additionally, the micro-broth chessboard dilution method was utilized to evaluate the in vitro efficacy of lycosin-Ⅰ in combination with eight common antimicrobial agants, including penicillin, erythromycin, levofloxacin, gentamicin, rifampicin, minocycline, vancomycin, and linezolid. Results:The MIC range of lycosin-Ⅰ against MRSA was found to be between 4-8 mg/L with the MIC 50 and MIC 90 were 4 mg/L and 8 mg/L, respectively. The range of MBC was also between 4-8 mg/L, and the ratio of MBC/MIC was 1-2. The bactericidal kinetics test revealed that the number of surviving MRSA clinical isolates and standard strains initially decreased rapidly but then showed a resurgence when the concentration of lycosin-Ⅰ was 1/2 MIC or MIC. While, the bacterial load gradually reduced until complete elimination when the concentration was at 2 MIC or 4 MIC. The combination of lycosin-Ⅰ and gentamicin exhibited mainly synergistic effects, while the combination with other antibiotics showed mainly additive effects. Moreover, the combination of lycosin-Ⅰ and antibacterial drugs can significantly reduce the MIC 50 and MIC 90 of antibiotics. Conclusion:lycosin-Ⅰ has great antibacterial and bactericidal activity against MRSA in vitro with rapid and thorough sterilization effect and it can play a synergistic or additive role when combined with other antibacterial drugs against MRSA in vitro.

Three-dimensional printing technology in reverse shoulder arthroplasty after resection of proximal humeral tumors / 中华骨科杂志

Objective:To analyze the efficacy of the reconstruction of the proximal humerus by reverse shoulder arthroplasty with three-dimensional (3D) printing technology after tumor rescetion.Methods:A retrospective analysis was conducted on the data of eight patients undergoing semi-constrained reverse shoulder arthroplasty with 3D printing technology after the resection of bone tumors in proximal humeri at the Affiliated Wuxi People's Hospital of Nanjing Medical University from December 2017 to January 2021. There were four males and four females with an average age of 55.1 (range, 31-73) years, all of whom had unilateral onset, 2 on the left and 6 on the right. There was one case of leiomyosarcoma (Enneking IIB), two cases of chondrosarcomas (one Enneking IA and one Enneking IB), four cases of Campanacci grade 3 giant cell tumor of bone, and one case of bone metastasis of lung adenocarcinoma. Individualized prosthesis and implantation protocol were completed preoperatively in all patients. The glenoid baseplate was manufactured using 3D printing technology. During the surgery, Malawer type I tumor resection and semi-constrained reverse shoulder arthroplasty were performed, with 6 cases simultaneously using allograft-prosthetic composite reconstruction. The follow-up was scheduled, and the patient received X-ray examination of the shoulder. The range of motion of the shoulder was measured, the Constant-Murley score and musculoskeletal tumor society (MSTS) score were recorded.Results:All 8 patients successfully completed the surgery, with a surgical time of 173.8±46.7 min (range, 130-260 min), intraoperative blood loss of 487.5±334.6 ml (range 200-1,200 ml), and proximal humeral resection of 9.9±4.6 cm (range, 4.5-19.0 cm). All patients were followed up for a period of 45.6±12.5 months (range, 24-60 months). At the last follow-up, the abduction ranges of motion of the affected shoulders increased from 27.5°±14.4° pre-operatively to 106.3°±21.8° post-operatively, with a statistically significant difference ( t=11.37, P<0.001). The forward flexion ranges increased from 28.1°±12.8° pre-operatively to 115.6°±24.0° post-operatively, with a statistically significant difference ( t=11.49, P<0.001). The Constant-Murley score was improved from 40.5±14.3 pre-operatively to 79.3±11.2 post-operatively, with a statistically significant difference ( t=9.58, P<0.001). The MSTS score was 25.6±2.2 (range, 23-28), including 6 excellent cases and 2 good cases. At 2 weeks after surgery, one patient experienced joint dislocation that was successfully reduced manually. Up to the final follow-up, all patients had survived without local tumor recurrence, metastasis, prosthesis infection and loosening. Conclusion:3D printing technology assisted shoulder arthroplasty is helpful for effective reconstruction and shoulder joint function recovery after resection of proximal humeral tumors, with satisfactory outcomes in the early and middle stages.

Digital design and 3D-printed customized flanged cups in hip revision with severe acetabular bone defects / 中华骨科杂志

Objective:To investigate the effect of 3D-printed customized flanged cup in hip revision with severe acetabular bone defects.Methods:Since February 2017, 10 cases of 3D-printed customized flanged cups were used in hip revision with severe acetabular bone defects, including 2 cases of Paprosky type IIIA and 8 cases of Paprosky type IIIB. There were 5 males and 5 females, mean age 73.6±8.1 yrs (range, 62-87 yrs), 5 left and 5 right cases. The preoperative thin-layer CT scan was preformed to reverse reconstruct digital pelvis. Five cases of one-piece flanged cups and 5 cases of decomposed flanged cups, including 3 cases of composite one-piece cups were designed by computer. The surgery was performed strictly according to the plan.Postoperative follow-up was performed to evaluate the Harris score. Operation time,intraoperative bleeding and other complications such as vascular and nerve injury, postoperative infection, and dislocation were counted. Pelvic X-ray was used to assess the height and horizontal position of the center of rotation and the stability of the prosthesis.Results:The surgical procedure was successful, with an average operative time of 147.9±48.3 min (range, 96-212 min) and an average intraoperative bleeding of 730.4±262.6 ml (range, 500-1 300 ml). The mean time of final follow-up was 40.8±18.7 months (range, 16-70 months) after surgery. At the last follow-up, the average Harris score was 83.80±6.73, with 4 cases excellent, 5 cases good, and 1 case fair. The excellent and good rate was 90%. The last Harris score was significantly higher than that before operation 28.60±8.40 ( t=16.84, P<0.001). The height of affected hip joint rotation center decreased from 46.24±7.74 mm before operation to 15.54±2.54 mm after operation with significant difference ( t=14.61, P<0.001). It was slightly higher than the opposite side (13.81±1.48 mm), which had no significant difference ( t=1.83, P=0.100). The horizontal distance of affected hip joint rotation center increased from 33.79±5.27 mm before operation to 40.53±4.50 mm after operation with significant difference ( t=3.62, P=0.006). It had no significant difference ( t=1.28, P=0.232) compared with the opposite side (38.54±3.46 mm). All incisions were healed in one stage without infection, vascular or nerve injury. During the following-up, all prostheses were in satisfied position without loosening, dislocation or screw breaks. Conclusion:Digitally assisted 3D-printed flanged cups can be used in hip revision with severe acetabular bone defect. It can not only improve hip joint function, but also restore the acetabular rotation center and the prosthesis stability, which can achieve good early and mid-term effect.

Interventional treatment of chylous leakage in 60 cases: a preliminary study / 中华放射学杂志

Objective:To evaluate the feasibility, safety, treatment outcome, and the individualized surgical procedure selection of the interventional treatments of chylous leakage.Methods:From July 2019 to January 2022, the clinical data of 60 consecutive patients with chylous leakage underwent interventional treatment were respectively analyzed. The cases included chylothorax ( n=37), chylous ascites ( n=10), chyluria ( n=4), chylothorax combined with chylous ascites ( n=5), chylothorax combined with chylopericardium ( n=2), and pelvic chylous effusion ( n=2). Conservative treatment was considered to have failed for all patients. The lymphangiography was firstly performed to detect chylous leakage, then an individualized procedure was selected according to the lymphangiography results. The treatment outcomes and complications were recorded, and follow-up was performed. Results:Lymphangiography was technically successful in 55 of 60 patients (91.7%), and no cisterna chyli and thoracic duct opacification was observed in 5 patients. The procedures for the patients included lymphangiography alone ( n=23), thoracic duct embolization ( n=23), thoracic duct disruption ( n=5), lymphatic embolization for pelvic chylous effusion ( n=4), and balloon plasty for thoracic duct ( n=5). Clinical success was achieved in 53 of 60 cases (88.3%). The complication rate was 8.3% (5/60), and all complications were minor. The median follow-up time was 11 months (range 0.5-30 months) for 56 patients, and 4 patients were lost to follow-up. There was one patient presenting the reoccurrence of symptom, and 8 patients died. Conclusions:The interventional treatment of chylous leakage is safe with good outcomes and low complication rate. Individualized treatment procedures based on the lymphangiography findings is feasible and with good curative effect.

A survey on self-management level and physical activity in patients with type 2 diabetes mellitus of Zang and Han nationalities in Tibetan of China / 中国基层医药

Objective:To investigate the level of self-management and daily physical activity in patients with type 2 diabetes mellitus (T2DM) of Zang and Han nationalities in Tibetan, China, and to compare the difference in daily management between T2DM patients of Zang and Han nationalities, to develop reasonable and effective chronic disease management strategies for long-term out-of-hospital management of T2DM patients of Zang nationalities.Methods:A total of 265 T2DM patients with glycosylated hemoglobin (HbA1c) ≥ 7% who were admitted to the Endocrinology Ward of the Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from November 2020 to April 2021 and who were from different regions of Tibet were included in this study according to inclusion and exclusion criteria. The general data of all included patients were collected. Glucose and lipid metabolism-related indicators were determined. The Generalized Diabetes Self-Management Efficacy Scale and International Physical Activity Questionnaires (IPAQ) were used to evaluate patients' levels of self-management and daily physical activity.Results:The hemoglobin level in T2DM patients of Zang nationality was (154.09 ± 24.11) g/L, which was significantly higher than that in T2DM patients of Han nationality ( P < 0.05). The total cholesterol, fasting blood glucose, and low-density lipoprotein in T2DM patients of Zang nationality were (4.63 ± 1.41) mmol/L, (7.94 ± 2.19) mmol/L, and (2.75 ± 1.11) mmol/L, respectively, which significantly higher compared with T2DM patients of Han nationality (all P < 0.05). Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality had lower self-management scores (81.40 ± 15.44) points, diet control scores (17.26 ± 4.97) points, physical exercise scores (11.67 ± 4.42) points, prevention and treatment of high and low blood sugar score (12.21 ± 5.72) points. The differences were statistically significant (all P < 0.05). Moderate-intensity physical activity was a significant difference between T2DM patients of Zang and Han nationalities ( P < 0.05). Conclusion:Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality have lower overall self-management levels, including diet control, physical exercise, prevention and management of high and low blood glucose, and moderate-intensity physical activity. Targeted individualized education should be carried out according to the Tibetan cultural characteristics, to further develop an intervention method and an out-of-hospital management strategy for chronic disease, which are suitable for T2DM patients of Zang nationality.

Comparison of changes in functional optical zone and corneal morphology between SMILE and FS-LASIK in myopes / 中华实验眼科杂志

Objective:To compare the changes in functional optical zone (FOZ) and corneal morphology in myopes between femtosecond small incision laser lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK).Methods:A cohort study was performed.A total of 94 patients (94 eyes) who underwent FS-LASIK or SMILE at Eye Hospital, Wenzhou Medical University from March to December 2021 were enrolled.The selected patients were divided into a SMILE group (46 cases, 46 eyes) and an FS-LASIK group (48 cases, 48 eyes) according to the surgical procedure, and the follow-up period was 6 months.The primary outcome measures were postoperative changes in corneal FOZ and Q-value, and the secondary outcome measures were changes in central corneal thickness (CCT) and mean corneal curvature (Km). Corneal Q-value, horizontal and vertical FOZ diameters, CCT, and Km were recorded before surgery and at 1 day, 1 week, 1 month, and 6 months after surgery using the Pentacam anterior segment analysis system, and the differences in each parameter and the trends of changes between the two groups were compared.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Eye Hospital, Wenzhou Medical University (No.2021-034-k-27). Written informed consent was obtained from each subject.Results:There were statistically significant overall differences in the postoperative horizontal and vertical FOZ diameters between the two groups (horizontal diameter: Fgroup=7.06, P<0.001; Ftime=64.18, P=0.001; vertical diameter: Fgroup=11.08, P<0.001; Ftime=77.14, P<0.001). The horizontal and vertical FOZ diameters were significantly larger in SMILE group than in FS-LASIK group at various postoperative time points, and the differences were statistically significant (all at P<0.001). In the two groups, the postoperative 1-week, 1-month and 6-month horizontal FOZ diameters and the postoperative 1-week and 1-month vertical FOZ diameters were smaller than the postoperative 1-day ones, and the differences were statistically significant (all at P<0.05). There were significant overall differences in Q-values at different postoperative time points between the two groups ( Fgrouup=53.11, P=0.019; Ftime=29.18, P<0.001). The postoperative 1-day, 1-week, and 1-month Q-values of FS-LASIK group were significantly higher than those of SMILE group (all at P<0.05). The postoperative 1-week Q-value was significantly larger than the postoperative 1-day value in SMILE group ( P<0.001). The postoperative Q-values gradually decreased with time in FS-LASIK group, with significant pairwise differences at all adjacent time points (all at P<0.001). There were significant differences in CCT at various postoperative time points between the two groups ( Ftime=21.43, P<0.01). In FS-LASIK group, the CCT was decreased at 1 week than 1 day after surgery and was increased at 6 months than 1 week after surgery, and the differences were statistically significant (all at P<0.05). In SMILE group, the postoperative 1-week, 1-month and 6-month CCT was increased in comparison with the postoperative 1-day value, and the differences were statistically significant (all at P<0.05). There was no significant overall difference in the Km between the two groups ( Fgroup=27.29, P=0.41). There were significant pairwise differences in the Km at different postoperative time points between the two groups (all at P<0.001). The postoperative 6-month Km was smaller than the postoperative 1-day value in SMILE group, and the postoperative 6-month Km was greater than the postoperative 1-day value in FS-LASIK group (both at P<0.05). Conclusions:The FOZ shows a trend of gradual reduction within a month after SMILE and FS-LASIK.The FOZ is larger after SMILE than after FS-LASIK.The morphologic stability of corneal FOZ is better after SMILE than after FS-LASIK.

Application value of short-term prehabilitation in elderly patients undergoing gastrointestinal tumor surgery / 中国实用护理杂志

Objective:To explore the effectiveness of short-term prehabilitation in elderly patients undergoing gastrointestinal tumor surgery.Methods:Elderly patients(139 cases) with gastrointestinal tumors who were admitted to Nanfang Hospital, Southern Medical University for surgery from December 2020 to January 2022 were included through the purposive sampling method, and were divided into the intervention group (69 cases) and the control group (70 cases) according to the patient's wishes using a quasi-experimental research design of non randomized grouped. Routine perioperative nursing was used in the control group, while the short-term prehabilitation was used in the intervention group in addition. The incidence of postoperative complications, the performance indicators, and postoperative functional recovery indicators were analyzed in the two groups.Results:The 6MWD in the intervention group of 1 day and 7 days after the surgery were (460.93 ± 76.36) m and (391.72 ± 72.93) m, which were significant higher than those in the control group, (423.69 ± 72.88) m and (351.13 ± 65.04) m ( t = 8.65, 12.01, both P<0.05). The first exhaust time, first postoperative ambulatory time, the first full fluid intake time and the duration of drainage tube indwelling in the intervention group were (51.28 ± 21.74) h, (33.93 ± 12.50) h, (69.39 ± 29.36) h and (4.30 ± 1.44) d, which were significant lower than those in the control group, (71.51 ± 23.68) h, (47.37 ± 14.58) h, (96.29 ± 38.36) h and (5.35 ± 2.09) d ( t values were -5.83 - -3.44, all P<0.05). Besides, the best critical value of preoperative 6MWD to predict postoperative rehabilitation effect was 477.5 m, with a sensitivity of 68% and specificity of 71%. Conclusions:Short-term prehabilitation improves the perioperative functional reserve and promotes overall functional recovery after surgery to a certain extent, and the postoperative functional recovery effect may be better when the patient′s preoperative 6MWD reaches 477.5 m.

Efficacy and safety of Omalizumab for the treatment of pediatric allergic asthma: a retrospective multicenter real-world study in China / 中华实用儿科临床杂志

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Progress of ibrutinib combined with CD19 chimeric antigen receptor T-cell in treatment of chronic lymphocytic leukemia / 白血病·淋巴瘤

Chronic lymphocytic leukemia (CLL) is a clonal malignant disease of B lymphocytes (T lymphocytes are rare) and usually occurs in elderly people. CLL has a highly variable clinical course, with a median survival of 35 to 63 months. In the era of immunochemotherapy, the survival of CLL patients has improved significantly, but most patients still have primary drug resistance and relapse after the treatment. The emergence of Bruton tyrosine kinase inhibitor has completely changed the treatment mode of CLL, making the treatment of CLL into the era of targeted therapy. Ibrutinib combined with CD19 chimeric antigen receptor T-cell has good efficacy and can improve the prognosis of patients.

Effect of apigenin in combination with oxymatrine on non-small cell lung cancer and mechanism / 中国中药杂志

This study explores the effect of apigenin(APG), oxymatrine(OMT), and APG+OMT on the proliferation of non-small cell lung cancer cell lines and the underlying mechanisms. Cell counting kit-8(CCK-8) assay was used to detect the vitality of A549 and NCI-H1975 cells, and colony formation assay to evaluate the colony formation ability of the cells. EdU assay was employed to examine the proliferation of NCI-H1975 cells. RT-qPCR and Western blot were performed to detect the mRNA and protein expression of PLOD2. Molecular docking was carried out to explore the direct action ability and action sites between APG/OMT and PLOD2/EGFR. Western blot was used to study the expression of related proteins in EGFR pathway. The viability of A549 and NCI-H1975 cells was inhibited by APG and APG+OMT at 20, 40, and 80 μmol·L~(-1) in a dose-dependent manner. The colony formation ability of NCI-H1975 cells was significantly suppressed by APG and APG+OMT. The mRNA and protein expression of PLOD2 was significantly inhibited by APG and APG+OMT. In addition, APG and OMT had strong binding activity with PLOD2 and EGFR. In APG and APG+OMT groups, the expression of EGFR and proteins in its downstream signaling pathways was significantly down-regulated. It is concluded that APG in combination with OMT could inhibit non-small lung cancer, and the mechanism may be related to EGFR and its downstream signaling pathways. This study lays a new theoretical basis for the clinical treatment of non-small cell lung cancer with APG in combination with OMT and provides a reference for further research on the anti-tumor mechanism of APG in combination with OMT.

Three-dimensional multi-component analysis of Aurantii Fructus quality and research on influencing factors / 中国中药杂志

The present study explored the consistency of the content proportions of active components of Aurantii Fructus and analyzed the influencing factors based on three-dimensional multi-component analysis. A total of 839 Aurantii Fructus samples in 65 research articles were analyzed using the three-dimensional multi-component analysis mode. The content data of flavonoid components(naringin, hesperidin, neohesperidin, narirutin, and nobiletin), coumarin components(meranzin and gluconolactone), and alkaloid(synephrine) in 386 samples which met the criteria of 2020 edition of the Chinese Pharmacopoeia were extracted and adjusted to percentages, and the content ratios between components were calculated. The influencing factors of Aurantii Fructus quality were analyzed. The results showed content ratios of components as follows: neohesperidin∶naringin in the range of 0.4-1.2; narirutin∶naringin in the range of 0.02-0.16; hesperidin∶naringin in the range of 0.01-0.3; nobiletin∶naringin in the range of 0.000 588 3-0.069 68; synephrine∶naringin in the range of 0.02-0.042; gluconolactone∶naringin in the range of 0.001-0.01; meranzin∶naringin in the range of 0.000 4-0.035. The quality of Aurantii Fructus was closely related to the origin, variety, harvesting time, and processing method of medicinal materials. Harvesting time had a greater impact on the quality of Aurantii Fructus, and the origin and variety had a certain impact on the quality of Aurantii Fructus. The findings of this study indicated that the ratios between flavonoid components, flavonoids and coumarin components, and flavonoids and alkaloids fluctuated. The production base should optimize the varieties, harvesting period, and processing methods of Aurantii Fructus to provide a scientific basis for the production of high-quality Aurantii Fructus.

Expression and Clinical Significance of Serum sFas/sFasL in Patients with Secondary Hemophagocytic Lymphohistiocytosis / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression and clinical significance of soluble Fas (sFas) and sFasL in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).@*METHODS@#From September 2015 to December 2020, 86 sHLH patients who met the HLH2004 diagnostic criteria were collected. They were divided into 55 cases in the MAHLH group and 31 cases in the NonMAHLH group according to the etiology. Thirty healthy persons were chosen as the normal control group, and 20 patients with systemic lupus erythematosus (SLE) were chosen as the disease control group. The expression levels of sFas and sFasL in the serum of patients with each group were detected by ELISA, and the clinical data were collected for statistical analysis. The significance of sFas and sFasL in sHLH was analyzed by ROC curve.@*RESULTS@#Serum levels of sFas and sFasL in patients with newly diagnosed sHLH were significantly higher than those in disease control group and normal control group (P<0.01). The levels of sFas and sFasL in MAHLH group were significantly higher than those in nonMAHLH (infection related HLH and autoimmune disease related HLH) group (P<0.01). The serum levels of sFas and sFasL in 17 newly treated patients with sHLH (17/86) after treatment were significantly lower than those before treatment (P<0.01). The serum sFas level in newly diagnosed sHLH patients was positively correlated with SF(r=0.35), sCD25(r=0.79) and sFasL(r=0.73). The serum sFasL level was positively correlated with SF(r=0.39), sCD25(r=0.64) and sFas(r=0.73). Compared with the NonMAHLH group, the area under the ROC curve was 0.707 (95% CI: 0.593-0.821) (P=0.0015). The optimal critical value for diagnosing MAHLH by sFas level was 12 743 pg/ml, and the sensitivity and specificity were 70.9% and 71% respectively. Compared with the NonMAHLH group, the area under the ROC curve was 0.765(95% CI: 0.659-0.87)(P<0.01). The median OS time of sFas high expression group (≥16798.5 pg/ml) and sFasL high expression group (≥4 785 pg/ml) was significantly shorter than that of the low expression group (P<0.001).@*CONCLUSION@#Serum levels of sFas and sFasL can be used for the early diagnosis and differential diagnosis of sHLH disease, and are the factor related to the poor prognosis of sHLH.

Efficacy of CLAE Chemotherapy Regimen Followed by Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Relapsed/Refractory Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To observe the efficacy and safety of CLAE intensive chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with relapsed/refractory acute leukemia (R/R AL).@*METHODS@#CLAE regimen [cladribine 5 mg/(m2·d), d 1-5; cytarabine 1.5 g/(m2·d), d 1-5; etoposide 100 mg/(m2·d), d 3-5] followed by allo-HSCT was used to treat 3 R/R AL patients. The patients received CLAE chemotherapy in relapsed or refractory status and underwent bone marrow puncture to judge myelodysplastic state. After an interval of 3 to 5 days, followed by preconditioning regimen for allo-HSCT [fludarabine 30 mg/(m2·d), d -7 to d -3; busulfan 0.8 mg/kg q6h, d -6 to d -3 or d -5 to d -2. If the bone marrow hyperplasia was not active and the blasts were less than 10%, busulfan should be used for 3 days. If the bone marrow hyperplasia was active and the blasts were more than 10%, busulfan should be used for 4 days]. Cyclosporin A, mycophenolate mofetil and short-term methotrexate were used for graft-versus-host disease (GVHD) prevention. After transplantation, the status of minimal residual disease (MRD) and bone marrow chimerism were regularly monitored in all 3 patients, and demethylation drugs or dasatinib were used to prevent recurrence 3 months after transplantation.@*RESULTS@#2 patients with t(11;19) translocation and relapse/refractory acute myeloid leukemia recurred within 6 months after induction of remission, and received intensive chemotherapy with CLAE regimen followed by haploidentical allo-HSCT and unrelated donor allo-HSCT, respectively. The two patients both relapsed 6 months after transplantation, then achieved complete remission by donor lymphocyte infusion, interferon, interleukin-2 and other methods, and disease-free survival was 2 years after transplantation. The other patient was chronic myelogenous leukemia who developed acute lymphoblastic leukemia during oral administration of tyrosine kinase inhibitor, accompanied by T315I and E255K mutations in ABL1 kinase region and additional chromosomal abnormalities. After morphological remission by induction chemotherapy, central nervous system leukemia was complicated. Intensive chemotherapy with CLAE regimen followed by sibling allo-HSCT was performed in the positive state of MRD. The patient relapsed 3 months after transplantation, and achieved remission after chimeric antigen receptor T-cell (CAR-T) therapy, however, he died 5 months after transplantation because of severe cytokine release syndrome (CRS) and GVHD.@*CONCLUSION@#CLAE regimen followed by allo-HSCT may be an effective salvage treatment option for R/R AL patients to prolong the overall survival.

Expression and Clinical Significance of Exosome Derived MiR-181b-5p in Children with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the expression level of exosome derived miR-181b-5p in different disease stages of children with acute lymphoblastic leukemia and its relationship with clinical characteristics.@*METHODS@#Bone marrow plasma samples of 86 children with ALL were collected. Exosomes were extracted by exosome extraction kit, and RNA in exosomes was extracted by TRIzol method. The levels of miR-181b-5p in the blood plasma exosomes of the patients in the newly diagnosed group, relapse group, remission group and control group were detected by qRT- PCR. The difference of miR-181b-5p expression level in each group was compared and analyzed, and the relationship between miR-181b-5p expression level and clinical characteristics was analyzed.@*RESULTS@#The expression level of exosomal miR-181b-5p in the newly diagnosed group and the relapsed group was significantly lower than that in the remission group and the control group (P< 0.05). The expression level of exosomal miR-181b-5p in T-ALL children was higher than that in B-ALL children (P<0.05). The expression level of plasma exosomal miR-181b-5p in male children was higher than that in female children (P<0.01).@*CONCLUSION@#Exosome derived miR-181b-5p changes dynamically in the course of ALL children, and can be used as a marker miRNA to monitor disease status. Exosomes can transmit information in the tumor microenvironment and serve as a potential carrier for biomolecular targeted therapy.

Correlation between PAFAH1B3 Expression Level and Risk of Disease Progression After Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the association between the expression level of platelet-activating factor acetylhydrolase 1B3 (PAFAH1B3 ) gene in bone marrow CD138+ cells of patients with multiple myeloma (MM) treated with autologous hematopoietic stem cell transplantation (AHSCT) and the prognosis within 2 years.@*METHODS@#147 MM patients treated with AHSCT in The First and The Second Affiliated Hospital of Nantong University from May 2014 to May 2019 were included in the study. Expression level of PAFAH1B3 mRNA in bone marrow CD138+ cells of the patients was detected. Patients with disease progression or death during 2 years of follow-up were included in progression group, and the rest were included in good prognosis group. After comparing the clinical data and PAFAH1B3 mRNA expression levels of the two groups, the patients were divided into high PAFAH1B3 expression group and low PAFAH1B3 expression group based on the median PAFAH1B3 mRNA expression level of the enrolled patients. Progression-free survival rate (PFSR) between the two groups was compared by the Kaplan-Meier method. The related factors of prognosis within 2 years were analyzed by univariate analysis and multivariate COX regression analysis.@*RESULTS@#At the end of follow-up, there were 13 patients lost to follow-up. Finally, 44 patients were included in the progression group and 90 patients were included in the good prognosis group. Age in the progression group was higher than that in the good prognosis group, the proportion of patients with CR+VGPR after transplantation in the progression group was lower than that in the good prognosis group, and there was a statistical difference between two groups in the cases distribution of ISS stage (all P<0.05). PAFAH1B3 mRNA expression level and the proportion of patients with LDH>250U/L in the progression group were higher than those in the good prognosis group, and platelet count in the progression group was lower than that in the good prognosis group (all P<0.05). Compared with the low PAFAH1B3 expression group, the 2-year PFSR of the high PAFAH1B3 expression group was significantly lower (log-rank χ2=8.167, P=0.004). LDH>250U/L (HR=3.389, P=0.010), PAFAH1B3 mRNA expression (HR=50.561, P=0.001) and ISS stage Ⅲ(HR=1.000, P=0.003) were independent risk factors for prognosis in MM patients, and ISS stage Ⅰ (HR=0.133, P=0.001) was independent protective factor.@*CONCLUSION@#The expression level of PAFAH1B3 mRNA in bone marrow CD138+ cells is related to the prognosis of MM patients treated with AHSCT, and detecting PAFAH1B3 mRNA expression can bring some information for predicting PFSR and prognostic stratification of patients.

N-methyl-D-aspartic acid receptor/MAPK/cAMP-response element binding protein pathway mediating pain-related aversion in anterior cingulate cortex / 解剖学报

Objective To explore the mechanism of N-methyl-D-aspartic acid ( NMDA) receptor/MAPK/cAMPresponse element binding protein ( CREB) pathway involved in pain-related aversion mediated by anterior cingulate cortex. Methods A total of 42 healtlry SD rats were randomly divided into control group (Ctrl) , normal saline(NS) injection group (NS) , complete freund adjuvant (CFA) model group ( CFA ) , injected CFA into the soles of the foot and injected NS into rostral part of anterior cingulate cortex (rACC)group (CFA+NS) , injected NS into the soles of the foot and injected NS into rACC group (NS+NS) , injected CFA into the soles of the foot and injected NMDA receptor antagonist ( APV ) into rACC group (CFA+APV) , injected NS into the soles of the foot and injected APV into rACC group ( NS + APV ) with 6 rats in each group. Rats avoidance score was analysised and rat thermal foot contraction latency ( PWL) ws alserved, the expression of NMDA receptor in rACC region was detected by immunohistochemical staining, the expression of NMDA receptor, phosphorylated ERK( p-ERK) and phosphorylated CREB ( p - CREB ) in rACC region was detected by immunofluorescent staining, the number of Nissl bodies in rACC region was observed by Nissl staining, and the expression of NMDA receptor, MAPK, CREB, ERK, p-ERK, p-CREB, synaptosomal-associated protein 25 interaction protein 30 (SIP30) protein in rACCregion was detected by Western blotting, and Real-time PCR was used to detect the mRNA expression of NMDA receptor, MAPK, CREB and ERK in the rACC region. Results Compared with the Ctrl group, the avoidance score and PWL decreased significantly and the expression of NMDA receptor, MAPK and CREB increased significantly in the CFA group (P<0. 05). Compared with the CFA+NS group, the number of Nissl bodies in CFA+APV and NS+APV groups increased significantly, while the expression of NMDA receptor, MAPK, CREB, p-ERK and p-CREB decreased significantly in NS+NS and NS+APV groups (P<0. 05). Conclusion NMDA receptor-MAPK-CREB signal pathway in rACC is involved in painrelated aversion, and inhibition of NMDA can reduce pain-related negative aversion.

Angelica sinensis polysaccharide promotes stress erythropoiesis in mice caused by 5-FU / 中国药理学通报

Aim To investigate the effects of angelica sinensis polysaccharide (ASP) antagonizing 5-fluorou-raeil (5-FU) on spleen stress erythropoiesis in mice and its related mechanism. Methods C57BL/6J mice aged 6-8 weeks were randomly divided into control group, ASP group, 5-FU group and ASP + 5-FU group. The mouse body weight during the modeling pe-riod was recorded, and peripheral blood routine and the number of mononuclear cells in the bone marrow of femur were measured. Histopathology of spleen was de-tected, also the index and cellularity of spleen were analyzed. BFU-E of spleen mononuclear cells was counted. The number of F4/80

Analysis of prognostic factors of extranodal NK/T-cell lymphoma treated with pegaspargase/L-asparaginase: a multicenter retrospective study / 中华血液学杂志

Objective: To explore the prognostic factors of extracellular NK/T cell lymphoma (ENKTL) treated with pegaspargase/L-asparaginase. Methods: The clinical data of 656 ENKTL patients diagnosed at 11 medical centers in the Huaihai Lymphoma Working Group from March 2014 to April 2021 were retrospectively analyzed. The patients were randomly divided into two groups: a training set (460 cases) and a validation set (196 cases) at 7∶3, and the prognostic factors of the patients were analyzed. A prognostic scoring system was established, and the predictive performance of different models was compared. Results: Patients' median age was 46 (34, 57) years, with 456 males (69.5% ) and 561 nasal involvement (85.5% ). 203 patients (30.9% ) received a chemotherapy regimen based on L-asparaginase combined with anthracyclines, and the 5-year overall survival rate of patients treated with P-GEMOX regimen (pegaspargase+gemcitabine+oxaliplatin) was better than those treated with SMILE regimen (methotrexate+dexamethasone+cyclophosphamide+L-asparaginase+etoposide) (85.9% vs 63.8% ; P=0.004). The results of multivariate analysis showed that gender, CA stage, the Eastern Cooperative Oncology Group performance status (ECOG PS) score, HGB, and EB virus DNA were independent influencing factors for the prognosis of ENKTL patients (P<0.05). In this study, the predictive performance of the prognostic factors is superior to the international prognostic index, Korean prognostic index, and prognostic index of natural killer lymphoma. Conclusion: Gender, CA stage, ECOG PS score, HGB, and EB virus DNA are prognostic factors for ENKTL patients treated with pegaspargase/L-asparaginase.