Expression of PD-L1 and PD-1 in Pathological Tissue of Patients Newly Diagnosed with Diffuse Large B-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression of PD-L1 and PD-1 in pathological tissue of patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#Data of DLBCL patients who visited the Department of Hematology, Peking University Third Hospital from May 2014 to March 2017 were collected, and a total of 21 patients with pathological tissue sections which were still available at the initial treatment were selected. The patients were divided into complete remission (CR) group and refractory relapse (RR) group according to clinical outcome. The expression and proportion of PD-1 and PD-L1 in pathological tissue sections were detected by multiplex fluorescence immunohistochemical staining, and the differences in the expression of different molecular markers in different clinical characteristics and different prognosis were compared using non-parametric test.@*RESULTS@#The ratio of PD-L1+ cells to PD-1+ cells (PD-L1+ : PD-1+) was 5.14±3.825 in increased lactate dehydrogenase (LDH) group, which was significantly higher than 0.76±0.563 in non-increased LDH group (P=0.001). The ratio of PD-L1+ : PD-1+ in increased Treg cells group was 1.41±1.454, which was lower than 6.42±4.426 in decreased Treg cells group (P=0.023).@*CONCLUSION@#The increased expression ratio of PD-L1 to PD-1 in pathological tissue sections of newly diagnosed DLBCL patients is associated with poor prognostic clinical characteristics.

The Relationship between Reducing of Peripheral Blood Treg in Primary Diffuse Large B-Cell Lymphoma Patients and Poor Prognosis / 中国实验血液学杂志

OBJECTIVE@#To explore the relationship between Treg cells level in peripheral blood and prognosis of patients with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#The percentage and absolute value of Treg cells in peripheral blood of DLBCL patients were detected by flow lytometry, and their correlation to prognosis was analyzed by survival analysis. The absolute count of Treg cells was detected by using maximally selected Log-rank statistic, and it was used as cutoff point to distinguish difference survival. The new group of Treg based on cutoff point was combined with age, sex, pathological subtype, risk stratification, treatment plan, and other indicators to include in the single factor survival analysis of Kaplan-Meier. Finally, the COX proportional risk model was used to verify the effect of the above indicators on progression-free survival.@*RESULTS@#The absolute count of Treg cells in DLBCL patients was significantly lower in the disease progressed group than those in the remission group. The cutoff point of absolute value of the Treg cell was 19 cells /μl. The absolute count of Treg cells was an independent prognostic factor of the risk stratification.@*CONCLUSION@#At the beginning of diagnosis, the reduction of the absolute count of Treg cells in peripheral blood of DLBCL patients show a poor prognosis.

Analysis of the correlation between lymphocyte subsets and severity of corona virus disease 19 / 北京大学学报(医学版)

OBJECTIVE@#To understand the differences in lymphocyte subsets in patients with different clinical classifications of corona virus disease 19 (COVID-19).@*METHODS@#Eighty-one patients with COVID-19 who were admitted to the isolation ward under the responsibility of three medical aid teams in the Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, from February 8, 2020 to March 28, 2020, were selected to collect clinical data. According to the relevant diagnostic criteria, the disease status of the patients was classified into moderate cases (n=35), severe cases (n=39) and critical cases (n=7) when lymphocyte subset testing was performed. Their blood routine tests, lymphocyte subsets and other indicators were tested to compare whether there were differences in each indicator between the patients of different clinical classification groups.@*RESULTS@#The differences in the absolute count of total lymphocytes, T-lymphocytes, CD4+T-lymphocytes, CD8+T-lymphocytes and natural killer (NK) cells among the three groups of patients were all statistically significant (P < 0.05), and the critical cases were significantly lower than the moderate and severe cases in the above indicators, and the indicators showed a decreasing trend with the severity of the disease. In 22 patients, the six indicators of the absolute count of T-lymphocytes, B-lymphocytes, CD4+T-lymphocytes, CD8+T-lymphocytes and NK cells, CD4+/CD8+ ratio were all within the normal reference range in the first test, and 59 patients had abnormalities of the above indicators, with the absolute count of NK cells and CD8+ T lymphocytes decreasing most frequently (61%, 56%). The patients with the absolute count of NK cells and CD8+ T lymphocytes below the normal reference range were one group, and the remaining abnormal patients were the other group. There were more critical cases in the former group (moderate : severe : critical cases were 4 : 8 : 7 vs. 19 : 21 : 0, respectively, P=0.001), and all the deaths were in this group (6 cases vs. 0 case, P=0.001). The absolute B lymphocyte count was below the normal reference range in 15 patients, and the remaining 64 cases were within the normal range. The ratio of moderate, severe and critical cases in the reduced group was 4 : 7 : 4, and the ratio of critical cases was more in normal group which was 30 : 31 : 3, and the difference between the two groups was statistically significant (P=0.043).@*CONCLUSION@#The more critical the clinical subtype of patients with COVID-19, the lower the absolute count of each subset of lymphocytes.

Relationship of group B colonization in late pregnancy with perinatal outcomes / 浙江大学学报·医学版

OBJECTIVE@#To investigate the relationship of group B (GBS) colonization in late pregnancy with perinatal outcome.@*METHODS@#Pregnant women who underwent antenatal check-up at General Hospital of PLA Eastern Theater Command and the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were enrolled in the study. The vaginal and rectal swab samples were collected for GBS culture at 35-37 weeks of pregnancy. The perinatal outcomes of positive and negative GBS groups were compared. The GBS-positive group samples were tested for antibiotic susceptibility. In GBS positive group the maternal and child perinatal outcomes were compared between pregnant women with antibiotics treatment and those without antibiotics.@*RESULTS@#A total of 13 000 pregnant women were enrolled, and the overall colonization rate of GBS was 3.65%(475/13 000). The colonization rate of GBS in the vagina was 2.33%(303/13 000), and the colonization rate in the rectum was 1.75%(227/13 000). Through the collection and detection of rectal specimens, the positive rate of GBS increased by 56.77%(172/303). The monthly colonization rate of GBS showed significant fluctuations with the highest in March and October (all < 0.05). The sensitivity of 475 GBS-positive specimens to ceftriaxone, vancomycin and linezolid were 100%, and the sensitivity to ampicillin and penicillin were 97.26%and 93.47%, respectively. The resistance rates of the strains to levofloxacin, clindamycin, erythromycin and tetracycline were 30.11%, 48.00%, 52.21%and 88.63%. The incidence of premature rupture of membranes, postpartum hemorrhage, puerperal infection, neonatal pneumonia and sepsis in GBS positive group were significantly higher than those in GBS negative group (all < 0.01). In pregnant women with positive GBS, the incidence of puerperal infection, neonatal infection and admission to the NICU in the antibiotic group were significantly lower than those in the non-antibiotic group ( < 0.05 or < 0.01).@*CONCLUSIONS@#The total colonization rate of GBS is low. The detection of GBS can be significantly improved by supplementing rectal examination. Ceftriaxone, ampicillin and penicillin are currently the drugs of choice for the prevention and treatment of GBS-related diseases. GBS infection can increase the incidence of maternal and child complications. The use of antibiotics during labor can improve the outcome of mothers and infants.

Clinical Characteristics and Prognosis of 84 Elderly Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the prognostic factors of elderly AML patients, as well as the application and prognostic value of comprehensive geriatric assessment（CGA） in elderly AML patients in China, so as to determine a suitable comprehensive assessment method that can predict survival and guide treatment of patients in Chinese people.@*METHODS@#Retrospective analysis was performed on the medical records of 84 AML patients aged over 60 years old, and diagnosed in our department from October 2007 to December 2017, and the clinical, pathological and comprehensive evaluation of related prognostic factors was analyzed.@*RESULTS@#The median age of all patients was 70 (60-91) years old, ratio of male to female was 1.9∶1 (55∶29) , the median OS time was 9 (1-125) months, 1 year OS rate was 35.3%, and 5 year OS rate was 12.6%. The age grouping, remission of induction chemotherapy, whether refractory/relapse, WBC count grouping at initial diagnosis, levels of lactate dehydrogenase and creatinine were risk factors for OS. Remission of induction chemotherapy, whether refractory/relapse, WBC count grouping and co-infections at initial diagnosis, levels of lactate dehydrogenase, and ECOG score were the risk factors for DFS. In the assessment of comorbidities, the two score classifications of charlson comorbidity index(CCI) were the risk factor of OS, however,whose effects for DFS were not statistically different. The effects of 3 score classifications of hemaotopoietic cell transplantation comorbidity index (HCT-CI), 4 score classifications of comulative illness kating scale for geriatrics (CIRS-G) and 3 score classifications of CIRS-G on OS and DFS were not statistically different. The impact of the ACA index on OS and DFS was statistically significant in elderly patients. All indexes related with patients self factors and disease-related factors were no independent prognostic factors for OS and DFS, so the judgment of prognosis needs to be comprehensively evaluated.@*CONCLUSION@#The prognosis and treatment selection of elderly AML patients should be combined with traditional clinical and pathological prognostic factors as well as comprehensive assessment of the elderly patients.

Advances in metabolomics research of Glycyrrhizae Radix et Rhizoma / 中草药

As a famous medicinal material, Glycyrrhizae Radix et Rhizoma not only has good medicinal value, but also has been widely used in food and cosmetic industries. Therefore, a lot of research on Glycyrrhizae Radix et Rhizoma have been conducted. In recent years, metabolomics has been used more widely in traditional Chinese medicine research. This paper summarizes the identification of origin, processing, pharmacological effects, and ecological factors of Glycyrrhizae Radix et Rhizoma by the metabolomics. This review will benefit the further systematic study of licorice and reveal the mechanism of it’s pharmacological action.

Efficacy of anti-CD19 CAR-T cell therapy in 10 refractory recurrent B cell malignancies / 中华血液学杂志

Objective@#To investigate the outcomes of anti-CD19 CAR-T cell for relapsed and refractory B cell malignancies. @*Method@#Ten patients with relapsed and refractory B cell acute lymphocytic leukemia (B-ALL) and non-Hodgkin’s lymphoma (NHL), diagnosed in the Department of Hematology of Peking University third Hospital from December 2015 to July 2017, were treated with anti-CD19 CAR-T cell therapy, and the efficacy and safety were analyzed. @*Results@#Efficacy was assessed on the 28th day after cell infusion, including 66.7% (4/6) of complete remission (CR) for patients with ALL, 16.7% (1/6) of partial remission (PR), and 83.3% (5/6) of overall response rate (ORR). For NHL patients, CR was 33.3% (1/3) and most of the lesions disappeared in a patient with mantle cell lymphoma, but residual lesion presented persistent state. After infusion of anti-CD19 CAR-T cells, the main side effect was cytokine release syndrome (CRS) and fever. One patient presented with aphasia and the other one had multiple organ failure, which were improved after treatment. No patients died of CRS. @*Conclusion@#anti-CD19 CAR-T cell for relapsed and refractory B cells hematological malignancies is safe, and the most problematic side effect is CRS, which can be controlled by therapy.

The correlation between STAT3 phosphorylation and the activity of Behcet's disease / 复旦学报（医学版）

Objective To explore the role of signal transducer and activator of transcription 3 (STAT3) phosphorylation in the pathogenesis of Behcet's disease (BD),and to investigate the association between STAT3 phosphorylation and disease activity in BD patients.Methods Peripheral blood mononuclear cell (PBMC) was isolated from 15 mL peripheral boood of 10 active BD patients (BD-A),10 BD patients in remission (BD-R) and 10 healthy controls (HC) respectively.The blockade of STAT3 phosphorylation was performed by Stattic.The PBMC was divided into Stattic subgroup (treated with 2.5 μmol/L stattic and 1 640 medium,5 mL) and blank control subgroup (treated with 5 mL 1 640 medium),respectively.The protein levels of phosphorylated STAT3 (pSTAT3) and STAT3 were examined by flow cytometry and Western blot.The protein and mRNA levels of TNF-α,IFN-γ and IL-17 were tested by RT-PCR and ELISA.Two-way ANOVA and Bonferroni post hoc test were used to analyze the results.Results Compared with HC,the BD patients showed higher protein levels of pSTAT3 and STAT3,and higher protein and mRNA levels of TNF-α,IFN-γ and IL-17;compared with blank control subgroup,the protein levels of pSTAT3 and STAT3,and protein and mRNA levels of TNF-α,IFN-γ and IL-17 decreased in Stattic subgroup.In the BD-A group,the protein level of pSTAT3,and protein and mRNA levels of TNF-α,IFN-γ and IL-17 were significantly higher than those in the BD-R group.Conclusions An increased activation of the STAT3 pathway may contribute to the pathogenesis of BD and relate to disease activity in BD patients by inducing TH1 and Th17 cells activation.

Expression of PD1/PD-L1 in gastric carcinoma and its correlation with clinicopathological characteristics and prognosis / 临床与实验病理学杂志

Purpose To investigate the expression of pro-grammed death1 (PD-1), programmed death-ligand1 ( PD-L1) in gastric carcinoma and its correlation with clinicopathological characteristics and prognosis. Method Immunohistochemistry was used to dectect the expression of PD-1/PD-L1 in 75 cases of gastric cancer and adjacent tissues of cancer, without chemother-apy and radiotherapy from 2011 to 2016 in The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University. To analyzed the relationship between expression of PD-1/PD-L1 in gastric carci-noma and clinicopathologic characteristics, and analyzed rela-tionship of overall survival time in all patients. Result The tumor cells expressed 37. 3% (28/75) PD-L1 positive rate in 75 cases, which associated with age, tumor diameter and differ-entiation. PD-1 positive rate in the tumor infiltrating lympho-cytes was 46. 7% (35/75), which associated with pTNM stag-ing. The positively rate of PD-L1 expression in tumor cells and PD-1 expression in the tumor infiltrating lymphocytes were sig-nificantly higher than that in the adjacent tissues of carcinoma (P＜0. 001). Kaplan-Meier and Long-rank results showed the overall survival time was significantly related with tumor diame-ter, differentiation, invasion depth, metastasis and pTNM stag-ing ( P ＜0. 05), but unrelated with PD-1 and PD-L1 expres-sion. But if the follow-up time was 14 months, the prognosis of PD-L1 positive patients were significantly lower than that of the negative ones. Conclusion Expression of PD-1/PD-L1 in cancer cells are significantly higher than that in para-carcinoma tissue. Positive expression of PD-L1 in tumor cells may contrib-ute to evaluation of short-term prognosis, and has nothing to do with the overall survival rate.

Application of CD19-CAR T Cells in Refractory Relapsed Acute B Lymphocyte Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy of CD19-targeted chimeric antigen receptor T-cell (CD19-CAR T) in the treatment of patients with refractory relapsed B cell acute lymphocyte leukemia（B-ALL）.@*METHODS@#The efficacy and safety of CD19-CAR T cells in treatment of patients with refractory relapsed B-ALL from January 2015 to July 2017 in the Department of Hematology of Peking University Third Hospital were analyzed retrospectively.@*RESULTS@#A total of 10 patients were included in this analysis, all of which were consistent with the diagnosis of refractory relapsed B-ALL, and the immunophenotype of leukemia cells was CD19 positive. After treatment with CD19-CAR T cells, the overall response rate（ORR） on day 28 was 70%. Among them, 6 cases reached complete remission（CR）, 1 case reached partial remission（PR）. The rate of CR on day 90 was 30%.@*CONCLUSION@#CD19-CAR T cells are effective in the treatment of refractory relapsed B-ALL, and the adverse reactions are controllable.

Relationship of the Changes of Peripheral Blood Immuno-Cell Subsets with the Prognosis of B Cell Lymphoma Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the relationship of T lymphocyte subsets, B lymphocytes and NK cells with the genesis, progression and prognosis of B cell lymphoma.@*METHODS@#The levels of T lymphocyte subsets, B lymphocytes and NK cells in peripheral blood of healthy control group and B cell lymphoma group were detected by flow cytometry (FCM). The clinical data were collected, and the relationship of these immune indexes with the general conditions, laboratory indexes, curative effect and prognosis were analyzed.@*RESULTS@#Forty-four patients entolled in this study including 24 male and 20 females with the median age of 57 years old (17-82 years), all the patients were the first visit to our hospital and diagnosed. The total counts of lymphocytes, T, B and NK cells in the peripheral blood of patients with the first treatment of B-cell lymphoma were significantly lower than those in healthy controls, and the ratio of CD3HLA-DR activated T cells was significantly higher than that of healthy controls ( 61.5 /μl was higher than that in patients with low level of NK cells.@*CONCLUSION@#The level of total lymphocytes, total T cells, total B cells, NK cells and advanced activated T cells in the patients with B cell lymphoma were significantly different from those in normal subjects. Total count of lymphocytes, T cells, B cells, CD4 cells and NK cells in peripheral blood are important prognostic indicators for BCL. The ECOG score and β2-microglobulin level are independent risk factors for prognosis. The NK cell level and FAC-1 are independent protective factors for the prognosis of B cell lymphoma.

Changes and influence factors of body fluid volume and distribution after abdominal surgery / 肠外与肠内营养

Objective:TThe aim of this study was to observe the changes of the volume and distribution of body fluid after abdominal surgery,and further to explore its characteristics and influence factors.Methods:Sixtyone patients were included between March and June in 2016.The volume of intracellular water (ICW),extracellular water (ECW) and total body water (TBW) was estimated by InbodyS 10 on preoperative day 1 (PreD 1) and postoperative day (POD) 1,3,5 and 7.Furthermore,the patients were grouped according to the age,sex,type of operation,operation time and the daily liquid input,and the influence factors of postoperative fluid volume were analyzed in each subgroup.Results:Comparing to that of PreD1,the ICW,ECW,and TBW,mainly ECW,were increased significantly on POD1 (P＜ 0.05),and the level of postoperative fluid volume was decreased to that of PreD1 between POD3 and POD7.It showed that there was difference in the net increasing of body fluid on POD1 between different type of the patients.Obviously,the net increasing of fluid volume in woman on POD 1 was more than that in man.The net increasing of fluid volume on POD1 was correlated with the operation time and net liquid input.Conclusion:The fluid retention was found in the early stage of postoperative patients,and mainly exists in ECW.The main influence factors resulting postoperative fluid retention were prolonged operation time and increased net fluid input.

Knowledge and attitude towards free pneumonia vaccination among eldly people aged over 60 years old in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigate the cognition and attitude towards free pneumonia vaccination among elderly people aged over 60 years old in Minhang District of Shanghai.Methods Target population was based on registered citizen over 60 years old in Minhang District.According to their willingness of pneumonia vaccineinjection,participants were divided into two groups,willing group and refused group.We randomly selected 910 people for each group.And before vaccination,a self-made "pneumonia vaccination behavior cognition and attitude questionnaire" was completed by each participant.Whether there were significant differences in the cognitive and attitude towards pneumonia vaccination between the two groups was analyzed by t test.x2 test and Logistic regression model was used to analyze main risk factors affecting the elderly attitude and behavior towards pneumonia vaccination.Results Statistical significant relations were found among following five cognition dimensions,which were benefits of vaccination (t =21.691,P＜0.01),values of vaccination (t =6.105,P＜0.01),the severity of affecting pneumonia (t =9.882,P＜0.01),vulnerable of getting pneumonia (t =5.670,P＜0.01) and obstacle towards vaccination (t =-7.114,P＜0.01).x2 test and Logistic regression analysis results suggested that among these five dimensions,cognition of vaccination benefits (B =0.610,P＜0.01) played the most important role in the attitude of elderly people between the two groups.The severity of affecting pneumonia (B =-0.452,P＜0.01) and obstacle towards vaccination (B =0.311,P＜0.01) played less important role regards elderly making decision of taking pneumonia vaccination.There was no statistically significant relations in sensitivity of getting pneumonia.In addition to the five dimensions discussed above,people who are engaged in commercial and service industry before retirement,with an annual income of between ten thousand to one hundred thousand and having chronic diseases are more likely to have a higher degree of acceptance of taking pneumonia vaccine than those without these properties.Conclusions There were significantly differences in cognitive behavior between willing to injection group and refused group among elderly.The results suggest that the benefits of pneumonia vaccination in older people with chronic diseases may have a positive effect on further increasing the rate of free pneumonia vaccination in the elderly population in Minhang District of Shanghai.

Knowledge and attitude towards free pneumonia vaccination among eldly people aged over 60 years old in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigate the cognition and attitude towards free pneumonia vaccination among elderly people aged over 60 years old in Minhang District of Shanghai.Methods Target population was based on registered citizen over 60 years old in Minhang District.According to their willingness of pneumonia vaccineinjection,participants were divided into two groups,willing group and refused group.We randomly selected 910 people for each group.And before vaccination,a self-made "pneumonia vaccination behavior cognition and attitude questionnaire" was completed by each participant.Whether there were significant differences in the cognitive and attitude towards pneumonia vaccination between the two groups was analyzed by t test.x2 test and Logistic regression model was used to analyze main risk factors affecting the elderly attitude and behavior towards pneumonia vaccination.Results Statistical significant relations were found among following five cognition dimensions,which were benefits of vaccination (t =21.691,P＜0.01),values of vaccination (t =6.105,P＜0.01),the severity of affecting pneumonia (t =9.882,P＜0.01),vulnerable of getting pneumonia (t =5.670,P＜0.01) and obstacle towards vaccination (t =-7.114,P＜0.01).x2 test and Logistic regression analysis results suggested that among these five dimensions,cognition of vaccination benefits (B =0.610,P＜0.01) played the most important role in the attitude of elderly people between the two groups.The severity of affecting pneumonia (B =-0.452,P＜0.01) and obstacle towards vaccination (B =0.311,P＜0.01) played less important role regards elderly making decision of taking pneumonia vaccination.There was no statistically significant relations in sensitivity of getting pneumonia.In addition to the five dimensions discussed above,people who are engaged in commercial and service industry before retirement,with an annual income of between ten thousand to one hundred thousand and having chronic diseases are more likely to have a higher degree of acceptance of taking pneumonia vaccine than those without these properties.Conclusions There were significantly differences in cognitive behavior between willing to injection group and refused group among elderly.The results suggest that the benefits of pneumonia vaccination in older people with chronic diseases may have a positive effect on further increasing the rate of free pneumonia vaccination in the elderly population in Minhang District of Shanghai.

Comparison of the Outcomes of Modified Artificial Chordae Technique for Mitral Regurgitation through Right Minithoracotomy or Median Sternotomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Right minithoracotomy (RM) has been proven to be a safe and effective approach for mitral valve surgery, but the differences of artificial chordae technique between RM and median sternotomy (MS) were seldom reported. Here, we compared the outcomes of modified artificial chordae technique for mitral regurgitation (MR) through RM or MS approaches.</p><p><b>METHODS</b>One hundred and eighteen consecutive adult patients who received mitral valve repair with artificial chordae and annuloplasty for MR through RM (n = 58) or MS (n = 60) from January 2006 to January 2015 were analyzed.</p><p><b>RESULTS</b>All of the selected patients underwent mitral valve repair successfully without any complication during the surgery. There was no significant difference between RM group and MS group in cardiopulmonary bypass time, aortic cross-clamp time, and early postoperative complications. However, compared with the MS group, the RM group had shorter hospital stay and faster surgical recovery. At a mean follow-up of 44.8 ± 25.0 months, the freedom from more than moderate MR was 93.9% ± 3.5% in RM group and 94.8% ± 2.9% in MS group at 3 years postoperatively. Log-rank test showed that there was no significant difference in the freedom from recurrent significant MR between the two groups (χ2 = 0.247, P = 0.619). Multivariate analysis revealed that the presence of mild MR at discharge was the independent risk factor for the recurrent significant MR.</p><p><b>CONCLUSION</b>Right minithoracotomy can achieve the similar therapeutic effects with MS for the patients who received modified artificial chordae technique for treating MR.</p>

Antioxidant activities of cold-nature Tibetan herbs are signifcantly greater than hot-nature ones and are associated with their levels of total phenolic components / 中国天然药物

Tibetan medicinal plants have been used for more than 2 000 years. In order to find their differences in antioxidant activity, total phenolics and total flavonoids between "hot-nature" and "cold-nature" herbs, we investigated the antioxidant activities of 40 Tibetan herbs from Qinghai plateau, with 20 herbs in cold-nature and 20 herbs in hot-nature. Antioxidant capacities were evaluated by the following methods: scavenging ABTS•(+) (2, 2'azinobis-(3-ethylbenz-thiazoline-6-sulfonic acid), scavenging O2•(-), and Ferric-reducing antioxidant power (FRAP). The effects on inhibition of mitochondrion lipid peroxidation were determined by measuring the formation of TBARS (Thiobarbituric acid reactive substrates). Total phenolics and flavonoids were estimated by Folin-Ciocalteu and NaNO2-Al(NO3)3-NaOH colorimetric methods. Interestingly, the cold-nature herbs displayed higher antioxidant activities than the hot-nature ones, corresponding to nearly three-fold higher total phenolic contents in the cold-nature herbs. Moreover, the antioxidant activities correlated linearly with the levels of total phenolics for both cold-nature and hot-nature herbs, but only with the levels of total flavonoids for the hot-nature herbs. The results suggested that the phenolic compounds, but not the flavonoids, play the major role in antioxidant capacities of the cold-nature herbs. These findings could shed new lights on the study the theory of Tibetan medicine.

The study of the expression and the prognostic value of Survivin and Ki67 in pancreatic endocrine tumors / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To explore the relationship between the expression of Survivin and Ki67 with prognosis of pancreatic endocrine tumors (PETs).</p><p><b>METHODS</b>Immunohistochemistry for Survivin and Ki67 was performed in 25 cases of normal pancreatic tissues and 81 cases of PETs by tissue microarrays and to observe the expression and evaluate the relationship with prognosis.</p><p><b>RESULTS</b>(1)The expression of Survivin and Ki67 in PETs was significantly higher than that in normal pancreatic tissues (P <0.01); (2)The expression of Survivin and Ki67 in PETs was correlated with tissue grading and the TNM-staging (P < 0.05), but not related with tumor size, location and functional status. In addition, the expression of nuclear Survivin was association with lymph node metastasis (P < 0.05). (3)The high expression of Ki67 was related with the expression of nuclear Survivin, but not related with the expression of cytoplasmic Survivin.</p><p><b>CONCLUSION</b>Survivin and Ki67 were both expressed in PETs, which were closely related to the clinical pathological characteristics. They could be used as new indicators in the evaluation of prognosis of PETs. The expression of Survivin in nucleus had more diagnostic significance than that in cytoplasm, and that could be highly correlated with lymph node metastasis, which would be used as a new marker of poor prognosis.</p>

Effect of autologous stem cell transplantation on multiple myeloma in the era of targeted novel agents / 白血病·淋巴瘤

Multiple myeloma (MM) is malignant plasma cell clonal disease.Autologous stem cell transplantation (ASCT) strengthen the advantages of the high-dose chemotherapy in treatment of MM,which achieves long-term survival in some patients.Even in the era of targeted novel agents,ASCT can still obviously increase the response rate of treatment.To improve the therapeutic efficacy,targeted novel agents were administrated before and after ASCT.However,targeted novel agents still cannot replace ASCT therapy in the treatment of MM.The direction of future research is to find more reasonable,effective and low toxic treatment.

Population pharmacokinetics of remifentanil in adult patients undergoing elective major abdominal sur-gery / 临床麻醉学杂志

Objective The aim of this study was to explore possible pharmacokinetic factors and develop a population pharmacokinetic model for remifentanil in adult patients.Methods Eleven healthy patients,undergoing elective major abdominal surgery,aged 25 to 86 years,received random-ly remifentanil 0.3μg·kg-1 ·min-1 (group R3),or 0.6μg·kg-1 ·min-1 (group R6).Frequent ar-terial blood samples were drawn according to predetermined time and assayed for remifentanil concen-tration.Nonlinear mixed-effects modeling (NONMEM)was used to evaluate the time courses of the measured concentrations.The covariates include age,bodyweight (WT),gender,lean body mass (LBM),body mass index (BMI)and body surface area (BSA).Results The pharmacokinetic data of remifentanil were well described using a three-compartment linear model with first-order elimination from the central compartment.Forward analysis showed that age,height and body mass index (BMI) does not affect the pharmacokinetic parameters,which are contrast with body weight,lean body mass (LBM),body surface area (BSA)and gender;further analysis demonstrated only a significant effect of body weight on remifentanil systemic clearance (CL)and volume of the central compartment (V). For typical 60 years patients,PK parameters were:V1 =7.64 L,V2 =4.81 L,V3 =4.34 L,CL1 =2.74 L/min,CL2 = 0.738 L/min,CL3 = 0.0905 L/min.Conclusion The pharmacokinetics of remifentanil is consistent with its rapid elimination by blood and tissue esterase in Chinese patients. The systemic clearance and volume of distribution of central compartment increases with body weight in the population and the range of covariates studied,which suggests that a patient with greater body weight needs a greater initial dose and maintenance infusion rate higher to obtain a stable plasma con-centrations and clinical effects.

Feasibility of multi models targeting home pain alleviation service used on 220 cases with advanced cancer / 中华流行病学杂志

Objective To investigate the feasibility and effectiveness of multiple modes on home pain alleviation service used for advanced cancer patients to in prove clinical therapy services.Methods The study was involved with 220 patients with advanced cancers to provide them with multimodal analgesia services at home,from February 2010 to February 2013.Patients in this study had been taking both opioid treatments.They were randomly devided into two groups with the number as 112 and 10g and were given different doses of morphine or other drugs.During the period of observation,data was collected under the M.D.Anderson symptom Inventory (MDASI) score and classification of score on pain.Results Differences of pain scores in the two groups and the MDASI score were significant and presented as skewed distribution.Scores on pain score were between groups were significantly different (Z=-9.735,P＜0.001).The average rankings of A group and B group were 76.68 and 162.79 respectively.Under the application of 0.4 mg alprazolam,the degree of pain alleviation seemed to be better.The differences on comprehensive scores between different drug groups were statistically significant(Z=-13.334,P＜0.001).The average rankings of groups A and B were respectively 59.87 and 179.08.Under the use of 0.4 mg of alprazolam,the results could be considered to show better improvements in symptomatic patients.Application of 0.4 mg alprazolam on patients with advanced-cancer-induced-pain showed a better symptomatic improvement than using morphine.Conclusion Patients with advanced cancers receiving multimodal analgesia short-term sedation therapies at home,showed both ideal feasibility and good effectiveness.When morphine was combined used with midazolam at home,a better outcome could be seen in pain-releasing on patients with cancer,than single morphine analgesia was used.