Application of understanding teaching mode combined with hierarchical training in standardized training of gastrointestinal surgical nurses / 中华医学教育探索杂志

Objective:To explore the application of understanding teaching mode combined with hierarchical training in the standardized training of nurses in gastrointestinal surgery department.Methods:Sixty-three nurses who had standardized training in gastrointestinal surgery department in West China Hospital, Sichuan University from January 2018 to January 2022 were selected as the study objects, among which, 32 nurses from January 2018 to July 2020 were set as the control group, taking regular training method, and 31 nurses from August 2020 to January 2022 were set as the observation group, taking the understanding teaching mode combined with hierarchical training method. The core competence scores of the two groups after training were compared, the scores of basic theory and practical skills of the two groups were compared, and the satisfaction degree of nurses during training was compared between the two groups. SPSS 22.0 was used to perform t-test. Results:After the training, the scores of core competence in the observation group were higher than that in the control group, and the difference was statistically significant ( P < 0.05). The scores of theoretical assessment (96.59±3.22) and practical skills (97.09±2.88) in the observation group were significantly higher than those in the control group (91.52±2.45)(91.14±2.85) ( P < 0.05). The total satisfaction scores of the observation group (93.48 ± 2.52) was higher than that of the control group (86.80 ± 2.22), and the difference was statistically significant ( P < 0.05). Conclusion:It is suggested that understanding teaching mode and joint hierarchical training can improve the core ability and assessment score of nurses in gastrointestinal surgery department, and improve the satisfaction of nurses.

Application of "4C" teaching method combined with two-way evaluation method in nursing teaching of gastrointestinal surgery / 中华医学教育探索杂志

Objective:To explore the application effect of "connections, concepts, concrete practice and conclusions (4C)" teaching method combined with two-way evaluation method in nursing teaching of gastrointestinal surgery, so as to provide reference for personnel training and quality control of practice.Methods:A historical controlled study was conducted to prospectively include the nursing interns received by the Department of Gastrointestinal Surgery of the hospital from May 2020 to May 2022 as the subjects of this study. The interns were divided into the control group (64 interns from May 2020 to May 2021) and the research group (93 interns from June 2021 to May 2022) according to the order of admission of nursing interns. The control group was taught by traditional nursing teaching method, while the research group was taught by "4C" teaching method combined with two-way evaluation method. The scores of theoretical knowledge and operation of nursing students in the two groups were compared after 6 weeks of practice. The self-directed learning ability of nursing students in the two groups was compared before and after 6 weeks of practice [Chinese version of self-rating scale of self-directed learning (SRSSDL)]. The evaluation of teaching quality between two groups of nursing students were compared. SPSS 25.0 was used for t-test and Chi-square test. Results:One person in the control group voluntarily quit the internship, and two in the observation group voluntarily quit the internship. Finally, 63 people in the control group and 91 people in the research group entered the study. There was no statistical significant difference between the two groups in baseline data ( P>0.05). At 6 weeks of practice, the scores of theoretical knowledge (87.96±4.62) and operation (92.60±4.25) in the study group were higher than those in the control group [(86.02±4.53) and (88.27±4.31)] ( P<0.05). At 6 weeks of practice, the total scores of learning awareness, learning behavior, learning strategies, learning evaluation, interpersonal skills and self-directed learning ability of the two groups were higher than those before practice, and the study group was higher than the control group ( P<0.05). After 2 weeks, 4 weeks and 6 weeks of practice, the scores of the two groups of nursing students in evaluating the teaching quality of the teachers increased gradually compared with that of the first week of practice ( P<0.05). Conclusion:The "4C" teaching method combined with the two-way evaluation method in the nursing teaching of gastrointestinal surgery can improve the nursing students' theoretical knowledge, practical operation ability and self-directed learning ability, and is conducive to the improvement of teaching quality.

Analysis of 9 cases of pediatric-type follicular lymphoma / 中华儿科杂志

Objective: To summarize the pathological diagnosis, clinical features, treatment methods and outcomes of pediatric-type follicular lymphoma (PTFL). Methods: Clinical data including the pathology, clinical features, treatment methods, and follow-up results of 9 PTFL patients admitted to Henan Cancer Hospital from February 2017 to February 2023 were analyzed retrospectively. Results: The age of onset in 9 children was 6 to 18 years, all the patients were males. The clinical manifestation was local painless lymph node enlargement in the head and neck, with a stage of Ⅰ-Ⅱ. The histomorphological characteristics of PTFL were similar to those of classic follicular lymphoma (FL). The germinal center of most follicles were enlarged, the mantle zone disappeared, centroblasts were easily visible, and the histological grade were mostly grade Ⅲ, which may be accompanied by the "starry sky" phenomenon. Monoclonal peaks can be seen in B cell clonal rearrangements (BCR). Immunohistochemistry (IHC) showed CD20 positive, CD10 positive, Bcl-6 positive, Bcl-2 negative, C-myc negative, and Ki-67 was 70%-95%. Fluorescence in situ hybridization (FISH) test was negative for t (14, 18), Bcl-2 translocation, and C-myc translocation. Six cases underwent surgical resection, and 3 cases underwent surgical resection combined with chemotherapy. Up to February 2023, with a follow-up time of 45 to 72 months, all children survived without any recurrence and were in a complete remission state. Conclusions: PTFL is mainly characterized by adolescent male onset, with early clinical manifestations and pathological manifestations of high-level histological status, high proliferation index, and lack of t (14; 18)/Bcl-2 translocation and Bcl-2 expression. It is mainly treated by localized surgical excision and has a good prognosis.

Acupuncture for lumbar myofascial pain syndrome: systematic review and Meta-analysis / 中国针灸

This study systematically reviewed the clinical efficacy of acupuncture for lumbar myofascial pain syndrome. The randomized controlled trials (RCTs) regarding acupuncture for lumbar myofascial pain syndrome were searched in PubMed, Cochrane Library, Web of Science, EMbase, Scopus, China national knowledge infrastructure (CNKI), Wanfang database, VIP database, and China biomedical literature service system (SinoMed) from database inception until August 1st, 2022. The Cochrane's risk of bias assessment tool was used to assess the risk of bias in all included studies, and Review Manager 5.3 software was used for statistical analysis of the extracted data. As a result, 12 RCTs, involving 1 087 patients with lumbar myofascial pain syndrome, were ultimately included. The Meta-analysis results showed that the visual analog scale (VAS) score of pain in the observation group was lower than those in the oral non-steroidal anti-inflammatory medication control [SMD=-1.67, 95%CI (-2.44, -0.90), Z=4.26, P<0.000 1] and other treatment control [low-frequency electrical stimulation, tuina, electromagnetic wave irradiation combined with piroxicam gel, SMD=-1.98, 95%CI (-2.48, -1.48), Z=7.74, P<0.000 01]. The pain rating index (PRI) score in the observation group was lower than those in the lidocaine injection control [MD=-2.17, 95%CI (-3.41, -0.93), Z=3.44, P=0.000 6] and other treatment control [low-frequency electrical stimulation, tuina, MD=-5.75, 95%CI (-9.97, -1.53), Z=2.67, P=0.008]. The present pain intensity (PPI) score in the observation group was lower than that in other treatment control [low-frequency electrical stimulation, tuina, MD=-1.04, 95%CI (-1.55, -0.53), Z=4.01, P<0.000 1]. In conclusion, compared with oral non-steroidal anti-inflammatory medication, low-frequency electrical stimulation, tuina, and electromagnetic wave irradiation combined with piroxicam gel, acupuncture is more effective in reducing pain in patients with lumbar myofascial pain syndrome; acupuncture also exhibites advantage over lidocaine injection in improving PRI score and showed better outcomes over tuina and low-frequency electrical stimulation in improving PRI and PPI scores.

Research progress of artificial intelligence in ultrasound diagnosis of breast cancer / 中国医师杂志

Breast cancer is the cancer with the largest number of new cases in the world, and ranks first in the incidence spectrum and cause of death among women in most countries. In recent years, artificial intelligence (AI), especially deep learning and computer-aided diagnosis, has shown remarkable performance in image analysis and processing, computer vision and other aspects, and has great development potential in the field of medical and health lesions identification, disease diagnosis and other aspects. This paper mainly discusses the application and progress of AI in ultrasound diagnosis of breast cancers.

Research progress on anti-hyperuricemia effects and mechanisms of Chinese medicines based on regulation of intestinal flora and metabolites / 中国中药杂志

Chronical hyperuricemia, a severe metabolic disease characterized by increased serum uric acid, urea nitrogen, and creatinine, has a positive correlation with the risks of gouty arthritis, diabetes, hypertension, and kidney damage. Abnormal purine metabolism and reduced uric acid excretion are the major causes of hyperuricemia, which, thus, points to a potential strategy of preventing from or delaying the progress of hyperuricemia-related diseases and its complications by effectively controlling the serum uric acid level. Increasing evidence has revealed that Chinese medicines alleviate hyperuricemia through regulating intestinal flora, which plays a pivotal role in regulating metabolites, including uric acid level. The disease treatment with traditional Chinese medicine is based on syndrome differentiation, and Chinese medicines often have multiple effects and a wide range of targets. In this review, we summarized the anti-hyperuricemia effects and mechanisms of active compounds in Chinese medicines, single Chinese medicinal herbs, and Chinese medicinal prescriptions in regulating the uric acid level via intestinal flora and metabolites, which will be helpful for further study and application of Chinese medicines in hyperuricemia treatment.

Research Progress of Xinglou Chengqi Decoction in Treatment of Stroke with Heat-phlegm and Sthenic-Fu Syndrome / 中国实验方剂学杂志

Stroke is a destructive cerebrovascular event caused by the interruption of cerebral blood flow caused by the blockage or rupture of cerebral vessels， which is easy to cause physical disability and multiple functional injuries. The mortality rate of stroke patients in China occupies the first place in the world. How to effectively treat stroke is one of the urgent health problems to be solved. In the clinic， academician WANG Yong-yan observed that 60% of stroke patients with heat-phlegm and sthenic-Fu syndrome. Most of the patients with heat-phlegm and sthenic-Fu syndrome are characterized by stagnation of stool， bad breath and dry pharynx， and so on， After clinical practice， Xinglou Chengqi decoction （XLCQD） was established to treat stroke patients with heat-phlegm and sthenic-Fu syndrome. XLCQD is one of the representative prescriptions for removing phlegm to relax bowels， which is composed of Rhei Radix et Rhizoma， Natrii Sulfas， Trichosanthis Fructus and Arisaema Cum Bile by the ratio of 5∶5∶15∶3. At present， the research on XLCQD is mainly focused on clinical observation and pharmacological mechanism， while the basic research of its pharmacodynamic substance is relatively weak. This paper intends to sort out the chemical composition and pharmacological mechanism of XLCQD， in order to provide the basis for the chemical component identification， drug target prediction and material basis screening of this compound in the later stage. In addition， through the case analysis of XLCQD and modified XLCQD in the treatment of stroke， its rules of clinical application were summarized， in order to provide reference for the clinical application of this compound.

Effects of skin-resident regulatory T cells on wound healing after burn injury / 解放军医学杂志

Objective: To investigate the effect of skin-resident regulatory T cells (Tregs) on wound healing after burn injury. Methods: 60 Foxp3DTR mice and 60 wild-type C57BL/6 mice were included in the present study. The Foxp3DTRdiphtheria toxin (DT) injection group (F-DT group) and the wild-type DT injection group (C-DT group) were further divided into early (n=9) and late (n=9) groups according to the random number table method. In the early group, mice were injected intraperitoneally with DT during the early stage (-1, 0 and 3rd days ofter injury) after burns, while in the late group, mice were injected at the late stage (5th, 7th and 9th days after injury). We took photos of mouse wounds at different time points, and measured the wound area to assess wound healing rate. After HE staining, re-epithelialization of the wound was observed under light microscope. In addition, flow cytometry was used to analyze changes in local infiltration and functional expression of Tregs in skin of wild-type mice at different time points after burns. Results: Compared with the C-DT group, the rate of burn wound healing in the F-DT early group was significantly reduced (P0.05). In comparison to the C-DT group, HE staining in the F-DT early group revealed slower wound closure process and slower scar formation and crusting process, together with faster granulation tissue formation and obvious slower angiogenesis and re-epithelialization. Using flow cytometry to analyzing the infiltration of skin Tregs, CD4+Foxp3+T cells were significantly increased after burns, and gradually returned to basal level after reaching peak on day 5 (P<0.05). While CD25+Treg cells were markedly decreased to baselines after peaking on day 3 (P<0.05). In addition, CTLA- 4 expressions of skin Tregs was significantly enhanced after burns, and peaked on day 3 after burns, then gradually decreased to baseline values (P<0.05), while ICOS reached peak on day 5 postburn, and gradually decreased to normal range on day 11 (P<0.05). Conclusion: The skin Tregs appear to be infiltrated into the wounds during the early stage after injury, which might contributes to promoting wound healing following burns.

Research on PCI Damage Based on Oxidative Stress and Progress in Prevention and Treatment of Traditional Chinese Medicine / 中国实验方剂学杂志

The prevalence and mortality of cardiovascular diseases are still on the rise in China. Percutaneous coronary intervention(PCI)is the most effective strategy to reduce coronary artery stenosis and occlusion, it can also improve clinical symptoms on patients with coronary heart disease. Clinically, a large number of patients still have heartache symptoms after recanalization of the great vessel. During the perioperative period, PCI is often accompanied with adverse events such as oxidative stress, inflammation, calcium overload, endothelial function damage, and thrombus obstruction. More specifically, during the process of PCI, oxidative stress is more severe than other damages. For example, during the reperfusion period of PCI, the outbreak of reactive oxygen species (ROS) can lead to abnormal mitochondrial energy transfer and cell ion homeostasis, resulting in endothelial cell injury, it can also increase the level of vascular permeability, albumin leakage, the adhesion of leukocyte and platelet, and the level of vascular stenosis. After PCI, traditional Chinese medicine(TCM) brings vasucular restenosis into the category of " palpitation" . The movement of Qi and bloods is tightly related to the five Zang-orans. When the movement of Qi and blood is stagnant, the function of the heart's blood production and circulation is blocked, resulting in Qi of deficiency and blood stasis, thus causing a state of physical weakness. Moreover, at present, Probucol and Ticagrelor and other first-line clinical drugs have certain limitations, and ignore the body' s current status of " essential illusory and real" , unable to coordinate the relationship between the body' s Qi and blood, Yin, Yang and five zang-organs. The purpose of this research is to perform the negative effects of oxidative stress on coronary artery based on the molecular research of modern medicine accompanied with acknowledgement of TCM and to conclude the process of researching prevention and treatment of TCM, and to provide reference for the treatment of coronary artery and coronary artery experimental study.

Research progress and correlation analysis on “phytochemistry-pharmacological effects-CMM efficacy-diseases” of Portulaca oleracea / 中草药

Portulaca oleracea has the functions of clearing heat and removing toxin, cooling blood to stop bleeding and treating dysentery. It is a medicine and food homologous drug with no toxic effect, which is common to people. As a drug, it has high safety. P. oleracea has a variety of active ingredients and pharmacological effects. In order to fully exploit the purslane and accelerate the modernization of purslane research, this paper summarizes the research progress of purslane. On this basis, the correlation analysis of “composition-activity-CMM efficacy-disease” was carried out, in order to provide ideas for the modern research of P. oleracea.

Advance in Roles of Notch and Wnt Pathways for Neural Stem Cells after Cerebral Ischemia (review) / 中国康复理论与实践

Neural stem cells (NSCs) play a key role in repair of neurological dysfunction after cerebral ischemia. Notch pathway widely exists in animal cells and is a classical signaling pathway regulating the proliferation and differentiation of NSCs. Wnt pathway is involved in cell proliferation, differentiation and apoptosis, and plays an important role in proliferation of NSCs in brain tissue after injury. The recent studies found that the two pathways form a signaling network to regulate proliferation and differentiation of NSCs.

Safety and efficacy of patients with refractory B-lymphoblastic leukemia treated with anti-CD19 CAR-T cell bridging to allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

Objective: To investigate the efficacy and side effects of anti-CD19 CAR-T cell bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) regimen for refractory B-lymphoblastic leukemia. Methods: 10 patients with refractory B-lymphoblastic leukemia with minimal residual disease (MRD) negative after anti-CD19 CAR-T cell treatment, then bridging to allo-HSCT from November 2017 to March 2019 in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. Results: ①Among 10 patients, 5 were males and 5 females, with a median age of 23.6 (10-31) years. 9 patients were diagnosed refractory acute lymphoblastic leukemia and the other one was chronic lymphoblastic leukemia. 10 patients reached MRD negative 30 days after anti-CD19 CAR-T cell. ②The donors were identical sibling (2 cases) and haploidentical family member (8 cases) . The median time from MRD negative after CAR-T treatment to transplantation were 32.5 (20-60) days. ③10 patients obtained complete haploidentical engraftment. The median time of neutrophil implantation was 15 (15-21) days, and 19 (17-30) days of platelet implantation. ④ After conditioning, no hepatic venoocclusive disease and hemorrhagic cystitis occurred. One patient had leakage syndrome and got improved after intervention such as limited water entry, albumin supplementation and diuresis. 8 (80%) patients had fever, 2 cases experienced acute graft-versus-host disease (GVHD) grade Ⅱ, 1 case with aGVHD grade Ⅲ. Among 9 survivals, localized chronic GVHD occurred in 8 patients. ⑤The median follow-up was 262 (150-540) days and the estimated 1-years overall survivaln (OS) and disease free survival (DFS) were (90.0±1.0) % and (85.7±1.3) %, respectively. Conclusion: Anti-CD19 CAR-T cell bridging to allo-HSCT regimen is a feasible choice with favorable outcome for refractory B-lymphoblastic leukemia.

Effect of Dahuang Mudan Tang in Triggering Receptor Expressed on Myeloid Cells-1 in Intestinal Tract in Rats with Septic Acute Intestinal Dysfunction / 中国实验方剂学杂志

Objective:To investigate whether the therapeutic effect of Dahuang Mudan Tang on septic acute intestinal dysfunction in sepsis ratsis related to the regulation of expression of triggering receptor expressed on myeloid cells-1(TREM-1). Method:Totally 100 male SD rats were injected intraperitoneally with lipopolysaccharide (LPS) at a dose of 4.5 mg·kg-1 to build sepsis model. The sepsis model rats were randomly divided into five groups:model group, glutamine group (3.75 g·kg-1),low,medium, high-dose Dahuang Mudan Tang group(7.5,15,30 g·kg-1),and another 10 normal rats were selected as normal group. Seven days later,2 mL suspension (100 mg lactulose and 50 mg mannitol) was orally administrated by gavage, and 24 h urinewas collected. The ratio of lactulose to mannitol in urine (L/M) was detected by HPLC with pulsed electrochemical detection (HPLC-PED).Serum citrulline concentrationsin blood and ileum were determined by HPLC.Enzyme linked immunesorbent assay (ELISA) was used to detect the concentrations of triggering receptor expressed on myeloid cells-1(TREM-1),tumor necrosis factor-α(TNF-α),intestinal fatty acid binding protein(iFABP) and D-lactic acid.Real-time PCR was used to detect the mRNA expressions of TREM-1,Toll-like receptors2(TLR2),Toll-like receptors 4(TLR4),myeloid cell differentiation protein(MyD88),nuclear transcription factor-κB(NF-κB).Electron microscopy was used to observe the pathological changes of intestinal mucosa injury. Result:Compared with normal group, the serum concentrations of TREM-1,TNF-α,iFABP, D-lactate; the ratio of lactulose to mannitol in urine (L/M)and the expressions of TREM-1,TLR2,TLR4,MyD88,NF-κB mRNA in model group were increased obviously(PPPPPκB mRNA,and the serum concentrations of TREM-1 and TNF-α in all medication administration groups were decreased obviously(PD-lactate, L/M, the Chiu scorein glutamine group, medium-dose Dahuang Mudan Tang group and high-dose Dahuang Mudan Tang group were decreased obviously(PPPConclusion:Dahuang Mudan Tang can effectively treat SAID in rats, and its mechanism may be realized by regulating the expression of TREM-1 and relieving intestinal inflammation of intestinal tract.

The exploration of aerobic power and energy expenditure of Chinese rugby players / 中国应用生理学杂志

OBJECTIVE@#To explore aerobic power and energy expenditure of high level rugby players in China, which provide experimental basis for accurate training and nutritional strategy in match-play.@*METHODS@#Eighteen master rugby players were selected as research subjects. The parameters such as VOmax, lactic aicd threshold (LT) and modify conconi test were measured respectively. The differences of energy were compared between the forward and the defender. The data were analyzed by independent sample t test.@*RESULTS@#The VOmax(42.05±3.69 ml/min ·kg) of rugby players was poorer. The VOmax of the forward was 38.83±3.52 (ml/min ·kg), and that of the defender was 47.31±3.17 (ml/min ·kg),and there was significant difference between the forwards and the defenders (P＜0.05). The LT of the defenders was obviously higher than that of the forwards. Modifier conconi test had a high correlation (r = 0.772) with VOmax. The average energy consumption in the first half of the game was about(276.94±18.08)kcals, the second half was(225.58±22.86)kcals, and the second half was less than the first half (P＜0.05).@*CONCLUSION@#The aerobic power is different between the forwards and the defenders. The power of aerobic of Chinese players is weaker than that of the foreign rugby players.

Effect of Chiropractic on Nonspecific Low Back Pain / 中国康复理论与实践

Objective:To observe the clinical effect of chiropractic on nonspecific low back pain (NLBP). Methods:From July, 2016 to January, 2018, 90 patients with NLBP were randomly divided into control group (n = 45) and observation group (n = 45). Both groups accepted core stabilization exercises (CSE) and routine physical therapy, and the observation group received chiropractic additionally. They were treated for four weeks and followed up for six months. Before, and two and four weeks after treatment, and at six-month follow-up, they were evaluated with Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), abdominal and dorsal muscle endurance test (AMET) and waist active range of motion (AROM). Results:Two and four weeks after treatment, the result of VAS, ODI, AMET, and waist AROM improved significantly in both groups (P < 0.05), and they were better in the observation group than in the control group (t > 0.263, P < 0.001). At six-month follow-up, the scores of VAS and ODI improved significantly (P < 0.05), and were better in the observation group than in the control group (t > 5.911, P < 0.001). Conclusion:CSE and routine physical therapy combined with chiropractic could better reduce the pain, improve the dysfunction, and increase the spinal stability for patients with NLBP.

Fecal microbiota transplantation for patients with refractory diarrhea after allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

Objective: To explore the availability and safety of fecal microbiota transplantation for patients with refractory diarrhea after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: Four acute leukemia patients suffered from refractory diarrhea after allo-HSCT. One of them was refractory intestinal infection, the others were intestinal graft versus host disease. One or two doses of fecal microbiota, 3.4-6.0 U for one dose, were infused via nasal-jejunal tube. The curative effect and side effects were reviewed. Results: Three cases achieved complete remission while 1 was stable disease. The side effects included fever, abdominal pain and diarrhea, which all were Ⅰ grade. Conclusion: Fecal microbiota transplantation was effective and safe for refractory diarrhea after allo-HSCT.

Comparison of clinical efficacy between first-generation and second-generation tyrosine kinase inhibitors based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia / 中华血液学杂志

Objective: To explore the clinical efficacy and prognostic factors of first-generation and second-generation tyrosine kinase inhibitors (TKI) based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia (ALL) . Methods: Retrospectively analyze the clinical characteristics and prognostic factors of 89 patients with BCR-ABL positive ALL from April 2012 to June 2018 in our hospital, the clinical efficacy of first-generation and second-generation TKI was compared. Results: 60 patients were classified into the first-generation TKI (imatinib) group, and 29 patients were in the second-generation TKI (dasatinib) group. There were no significant differences in gender, age, WBC, hemoglobin concentration, PLT, chromosomal karyotype, the types of fusion genes, allogeneic hematopoietic stem cell transplantation (allo-HSCT) and TKI initiation time between the two groups. The first-generation and second-generation TKI groups, for which the complete remission (CR) rate at the fourth week of induction therapy was 83.3% and 89.7% (P=0.637) , respectively, and the complete molecular remission (CMR) was 48.3%and 58.6% (P=0.363) , respectively, the difference was not statistically significant. The 2-year overall survival (OS) rate of first-generation and second-generation TKI group was 34.9% and 64.0% (χ(2)=4.743, P=0.029) , the 2-year relapse free survival (RFS) rate was 17.2% and 55.0% (χ(2)=8.801, P=0.003) , respectively. Multivariate analysis showed that complete molecular remission (HR=0.281, 95%CI 0.151-0.523, P<0.001) was independent favorable prognostic factor for overall survival (OS) , complete molecular remission (HR=0.209, 95%CI 0.112-0.390, P<0.001) and second-generation TKI (HR=0.318, 95%CI 0.158-0.641, P=0.001) were independent favorable prognostic factors for RFS. Conclusion: For TKI-based regimen of BCR-ABL positive ALL, second-generation TKI is superior to first-generation TKI in OS and RFS time.

The role of mesenchymal stem cells in allogeneic hematopoietic stem cell transplantation for patients with refractory severe aplastic anemia / 中华血液学杂志

Objective: To evaluate the efficacy and safety of mesenchymal stem cells in allogeneic hematopoietic stem cell transplantation for patients with refractory severe aplastic anemia (R-SAA) . Method: The clinical data of 25 R-SAA patients receiving co-transplantation of mesenchymal stem cells combined with peripheral blood stem cells from sibling donors (10 cases) and unrelated donors (15 cases) from March 2010 to July 2018 in Zhengzhou University Affiliated Tumor Hospital were retrospectively analyzed. Antithymocyte globulin (ATG) treatment was ineffective/relapsed in 11 cases, and cyclosporine (CsA) treatment ineffective/relapsed in 14 cases. Results: There were 13 male and 12 female among these patients. One patient had a primary graft failure, one patient had a poorly engraftment of platelets, and the remaining 23 patients achieved hematopoietic engraftment. The median time of granulocyte engraftment was 12.5 (10-23) days and 15 (11-25) days for megakaryocyte. Incidences of grade Ⅰ/Ⅱ acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) were 37.5% (9/24) and 21.7% (5/23) , respectively. There was no severe GVHD and no severe complications that related to transplantation. 21 of 25 (84%) patients were alive with a median follow-up of 22.9 (1.6-107.8) months. The 5-year overall survival rate after transplantation was (83.6±7.5) %. Conclusion: The combination of mesenchymal stem cells is reliable and safe in the treatment of R-SAA in peripheral blood stem cell transplantation of unrelated donors and sibling donors, which could significantly reduce the incidence of GVHD and severe transplantation-related complications.

Isolation and Identification of Components in the Dihydroquercetin-Rich Extract from Larch Wood (Larix olgensis Henry)

Background: The finding that antioxidant dihydroquercetin (DHQ) present in high content in the wood of Dahurian larch (Larix gmelinii Rupr.) which distributes mainly in Khingan Mountains led to the development and manufacture of a DHQ-rich extract, Lavitol (a trade name). Whether the composition of DHQ-rich extract from L. olgensis Henry, a great resource of Larch species distributed in Changbai Mountain in China, is same or similar with trade DHQ product becomes an interesting question. Aims: To isolate and identify the components in the DHQ-rich extract from larch wood (L. olgensis). Methodology: Compounds were isolated from a DHQ-rich extract (91% purity) of L. olgensis through polyamide and Sephadex LH-20 column chromatography, and their structures were elucidated based on 1H-NMR, 13C-NMR, MS and CD data analysis. Thin layer chromatography (TLC) was applied to quickly identify the components in the extract. Results: Five compounds were isolated from the extract, the main one was (2R,3R)-dihydroquercetin (1), four minor components were identified as (2R,3R)-aromadendrin (2), quercetin (3), 3,5,7-trihydroxychromone (4) and (2R,3R)-3'-O-methyl-taxifolin (5). Polyamide and silica gel TLC were developed to identify these components in the extract, and the results indicated that three batches of DHQ-rich extracts contained the same components. Conclusion: Except for the presence of trace impurities 4 and 5, DHQ-rich extracts from L. olgensis contained (2R,3R)-DHQ (1) and two minor impurities 2 and 3, which were similar with the composition of trade DHQ-rich extract from Dahurian larch (L. gmelinii). Further quantification of these impurities in DHQ-rich extract from L. olgensis by HPLC analysis need to be done in the future.

Saponins isolated from Schizocapsa plantaginea inhibit human hepatocellular carcinoma cell growth in vivo and in vitro via mitogen-activated protein kinase signaling / 中国天然药物

The underground cane of Schizocapsa plantaginea (Hance) has long been used by Chinese ethnic minority as a constituent of anti-cancer formulae. Saponins are abundant secondary metabolic products located in the underground cane of this plant. The potential therapeutic effects of total saponins isolated from Schizocapsa plantaginea (Hance) (SSPH) on human hepatocellular carcinoma (HCC) were tested in vitro in human liver cancer cell lines, SMMC-7721 and Bel-7404. Apoptosis and cell cycle arrest were determined using flow cytometry, caspase activation was determined by ELISA, and PARP, cleaved PARP, mitogen-activated protein kinase (MAPK) expression and phosphorylation were measured using Western blotting analysis. In vivo anti-HCC effects of SSPH were verified in nude mouse xenograft model. SSPH exerted markedly inhibitory effect on HCC cell proliferation in time- and concentration-dependent manner. Moreover, SSPH significantly induced apoptosis through caspase-dependent signaling and arrested cell cycle at G/M phase. These anti-proliferation effects of SSPH were associated with up-regulated phosphorylation of extracellular signal-regulated kinase-1/2 (Erk1/2) and c-jun-NH2-kinase-1/2 (JNK1/2) and reduced phosphorylation of p38MAPK. Furthermore, inhibitors of ERK, UO126, and JNK, SP600125 inhibited the anti-proliferation effects by SSPH, suggesting that Erk and JNK were the effector molecules in SSPH induced anti-proliferative action. During in vivo experiments, SSPH was found to inhibit xenograft tumor growth in nude mice, with a similar mechanism in vitro. Our study confirmed that SSPH exerted antagonistic effects on human liver cancer cells both in vitro and in vivo. Molecular mechanisms underlying SSPH action might be closely associated with MAPK signaling pathways. These results indicated that SSPH has potential therapeutic effects on HCC.