The prognostic relationship between CD56 expression and newly diagnosed multiple myeloma / 中华内科杂志

Objective:To evaluate the prognostic value of CD56 expression in newly diagnosed MM (NDMM).Methods:A total of 332 NDMM patients were enrolled in Beijing Chaoyang Hospital, Capital Medical University from January 1, 2011 to January 1, 2021, with a median age of 60 years and a male to female ratio of 1.2∶1. CD56 expression on myeloma cells was detected by flow cytometry before induction therapy. Overall survival (OS) and progression-free survival (PFS) data were collected. In order to reduce the confounding factors, the propensity score matching technique was used to match CD56 positive versus negative patients at a ratio of 1∶1.Results:Among 332 patients, CD56 positivity rate was 65.1% (216/332). Patients with CD56 expression had significantly longer median OS (58.4 vs. 43.1 months, P=0.024) and PFS (28.7 vs. 24.1 months, P=0.013) than those with negative CD56. Univariate Cox proportional hazards regression analyses showed that CD56 expression was positively correlated with OS ( HR=0.644, 95 %CI 0.438-0.947, P=0.025) and a favorable prognostic factor for PFS ( HR=0.646, 95 %CI 0.457-0.913, P=0.013). The favorable effect of CD56 expression on PFS was confirmed in multivariate analysis ( HR=0.705, 95 %CI 0.497-0.998, P=0.049), but OS was not affected ( P>0.05).In the propensity score matching analysis, 194 patients with 97 in each group were identified. CD56 positivity consistently predicted longer PFS (34.2 vs.25.1 months, P=0.047), but not OS (63.4 vs.43.1 months, P=0.056). Conclusion:These results demonstrate that CD56 expression is a favorable prognostic factor for PFS of newly diagnosed MM patients.

Risk stratification and treatment progress of smoldering multiple myeloma / 白血病·淋巴瘤

Smoldering multiple myeloma is a kind of heterogeneous asymptomatic plasma cell disease. Some patients have a high risk of developing symptomatic multiple myeloma. However, the starting point and options of treatment for smoldering multiple myeloma patients are still unclear. This article reviews the risk stratification and treatment progress of smoldering multiple myeloma.

Effect of remnant preservation on recovery of knee proprioception in arthroscopic anterior cruciate ligament reconstruction:a meta-analysis / 中国组织工程研究

BACKGROUND:Arthroscopic anterior cruciate ligament (ACL) reconstruction is the conventional surgical treatment at present for patients with severe anterior cruciate ligament injury or fracture. However, the opinions varies about whether the ACL remnant should be preserved, and its impact on the knee proprioception gets more and more attention. OBJECTIVE:To compare the influence of arthroscopic ACL reconstruction with remnant preservation or not on the proprioception of the knee joint using a meta-analysis. METHODS:We retrieved randomized control ed studies on arthroscopic ACL reconstruction with remnant preservation or not from 2001 to 2016. Meta-analysis was used to compare postoperative threshold to detection of passive motion (TTDPM), passive angle regeneration test, joint position sense and KT-1000/2000, IKDC, and Lysholm scores between remnant preservation or not. RESULTS AND CONCLUSION:(1) A total of 11 randomized control ed trials were included. (2) The meta-analysis results showed that postoperative TTDPM [OR=-0.50,95%CI(-0.74,-0.26), P<0.0001], passive angle reproduction [OR=-0.13, 95%CI(-0.26,-0.01), P=0.03<0.05] and Lysholm scores [OR=1.25, 95%CI(0.63, 2.06), P=0.0002], IKDC scores (OR=1.28, 95%CI([0.27, 2.28], P=0.01] in preserving-remnant were superior to removing-remnant for arthroscopic ACL reconstruction. However, there were no statistical y significant differences in KT1000/2000 scores [OR=-0.05, 95%CI(-0.13, 0.03), P=0.24] and joint position sense [OR=-0.30, 95%CI(-0.79, 0.18), P=0.22]. (3) In the arthroscopic ACL reconstruction, retained stump postoperative proprioception recovered wel and can obtain satisfactory clinical effect. However, prospective large-sample long-term randomized control ed trials are needed for verification.

A prospective multi-center trial of non-interventional and observational study of lenalidomide in Chinese patients with multiple myeloma / 中华内科杂志

Objective To evaluate the efficacy and safety of lenalidomide in a real-world clinical practice in Chinese patients with multiple myeloma (MM).Methods It was a prospective,multi-center,observational study.A total of 165 consecutive patients with MM treated with lenalidomide-based regimens were enrolled in 12 hospitals from June 2013 to November 2015.Relevant information was recorded,such as baseline clinical data,cytogenetic abnormalities,treatment regimens,and duration of treatment,safety,and survival.Results (1)There were 126 relapsed and refractory MM (RRMM) patients,25 newly diagnosed patients and 19 maintenance patients.The evaluable RRMM patients accounted for 120 cases,among which 74 cases(61.7％) reached the partial response (PR) or above,and a very good partial response (VGPR) in 16 patients (13.3％),a complete response (CR) in 14 cases (11.7％),a strictly complete response (sCR) in 4 cases (3.3％).Thus,a VGPR or above in 34 patients accounted for 28.3％.(2)The median follow-up was 13 months,the median time to progression 12 months.The median survival after receiving lenalidomide was 19 months,and the median overall survival (OS) was 62 months.(3) The univariate analysis in 120 RRMM patients suggested that prognostic factors for significant improvement in PFS included normal karyotype,international staging system (ISS) Ⅰ-Ⅱ,t(4;14) negative (detected by fluorescence in situ hybridization),non-bortezomib resistance and response to previous regimens.As to OS,nonbortezomib resistance,response to previous regimens and non-primary refractoriness were positive factors.Multivariate analysis showed that the response to previous regimens (PR or better) was an independent good prognostic factor for progress-free survival (PFS),non-bortezomib resistance and non-primary refractoriness for OS.(4) Grade 3 or 4 adverse events that occurred in more than 10％ of all enrolled patients were neutropenia (12.7％),leukocytosis (11.5％) and thrombocytopenia (12.7％).Owing to intolerance of toxic side effects,7 cases withdrew lenalidomide.Conclusions No matter what combination,regimens containing lenalidomide are effective to RRMM patients with overall response rate 61.7％,a time to progression 12 months and an overall survival 62 months.The toxicity is quite tolerable and manageable.In addition,the response to previous treatment (reached PR or above) is the independent good prognostic factor for PFS,non-bortezomib resistance and non-primary refractoriness for OS.Clinical trail registration Clinicaltrials.gov,NCT01947309

Bridging external fixation combined with Kirschner-wire fixation versus volar locked plate fixation for unstable fractures of the distal radius / 中国组织工程研究

BACKGROUND:The unstable distal radius fractures are clinical y treated with external fixation, open reduction and internal fixation at present. These two methods have their advantages and disadvantages. OBJECTIVE:To compare the radiological, clinical and functional outcomes of two groups of patients treated by bridging external fixation combined with Kirschner wire fixation versus volar locked plate for a displaced fracture of the distal radius. METHODS:We col ected 68 cases of unstable distal radius fractures in the Department of Reparative and Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University, China from October 2014 to April 2016. They were randomly assigned to two groups, with 34 in each group. Patients in the external fixation group received external fixator and Kirschner wire. Patients in the internal fixation group received volar locked plate. In the fol ow-up, outcomes were assessed by radiographic parameters, function parameters, and Cooney functional score between both groups. RESULTS AND CONCLUSION:(1) Al patients were fol owed up. External fixation group was fol owed up for 12-16 months. Internal fixation group was fol owed up for 13-15 months. X-rays showed al fractures healed. (2) At 3 months postoperatively, significant differences in pronation, supination, extension and radial deviation were detected between the two groups (P0.05). The range of motion of the wrist was better in the internal fixation group, but no significant difference in the grip strength was determined between the two groups at any time points in 1-year fol ow-up. (3) These results demonstrated that compared with the external fixation, volar locked plate fixation showed better early recovery postoperatively. With time prolonged, clinical outcomes of both repair methods tended to be consistent.

A retrospective analysis of autologous peripheral blood hematopoietic stem cell mobilizations and collections in 149 multiple myeloma patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the results and influential factors of mobilization and harvesting of autologous peripheral blood stem cell in patients with multiple myeloma (MM).</p><p><b>METHODS</b>Retrospective analysis of peripheral blood stem cell collection data [CD34⁺ cells collected, successful mobilization rate (CD34⁺ cells≥2×10⁶/kg body weight), good mobilization rate (CD34⁺ cells≥5×10⁶/kg body weight)] of 149 multiple myeloma patients who were treated with cyclophosphamide (CTX) or E-CHOP (etoposide+ CTX+epirubicin+vindesine+prednisone) chemotherapy combined with G-CSF mobilization from January 1998 to March 2014. The relevance between gender, age, subtype, DS staging, ISS staging, treatment before mobilization, disease status at mobilization, regiment of mobilizationand the collection results was analyzed.</p><p><b>RESULTS</b>A total of 177 stem cell mobilizations were performed in 149 MM patients, the median CD34⁺ cells harvested were 3.20 (0.13-22.34)×10⁶/kg body weight (BW), successful mobilization rate and good mobilization rate were 74.5% and 27.5%, respectively. The single logistic regression analysis showed that gender, age （>60 ys vs ≤60 ys）, subtype, DS staging (III vs II+I), ISS staging (III vs II+I) and regiment of mobilization (E-CHOP+G-CSF vs ID-CTX+G-CSF) were not correlated with the cell collection or successful mobilization rate (P>0.05). However, successful collection rate of single harvest in old patients (age>60 ys) was lower (P<0.05), andthe good mobilization rate in patients at ISS stage III was lower (P<0.05). The collection results of patients with fewer cycles of treatment (treatment before mobilization ≤6 cycles) and optimal disease status (disease status at mobilization ≥partial remission) were much better. Analysis of logistic factors revealed that treatment efficacy before mobilization affected success rate of collection (P=0.006). Risk of collection failure in patients who received more than 6 cycles of treatment before mobilization was high (OR 3.57, 95% CI 1.45-8.78).</p><p><b>CONCLUSION</b>Gender, age, subtype, DS staging, ISS staging and mobilization regimen did not influence MM patients peripheral blood stem cell collection; but old patients may need twice mobilizations to collect sufficiently. Few cycles of treatment and stable disease status before mobilization is favorable to the mobilization and collection of peripheral blood stem cells.</p>

Design, synthesis and pharmacological investigation of isoindoline derivatives as 5-HT/NE double reuptake inhibitors / 药学学报

A series of isoindoline derivatives were designed, synthesized, and evaluated for their double inhibitory activities. All of them were new compounds, and their structures were confirmed by 1H NMR and HR-MS. Preliminary in vitro pharmacological tests showed that all compounds exhibited 5-HT or NE reuptake inhibition activity. Among the tested compounds, compound I-3 exhibited potent inhibitory activity against 5-HT and NE reuptake in vitro, and exhibited potent antidepressant activity in vivo. These compounds designed can be further optimized for finding more potent 5-HT/NE dual reuptake inhibitors and antidepressant candidates as well.

Effect of oleanolic acid derivatives on improving insulin resistance and its molecular mechanism / 中国药理学通报

Aim To detect the effect of Bio on impro-ving insulin resistance and explore its molecular mech-anism. Methods The HepG2 liver cells were derivat-ed by high concentration insulin to establish the insulin resistance cell model, and the cells were intervened by Bio. The glucose consumption was measured by glu-cose oxidase and peroxidase ( GOD-POD) assay. The expression of PPARγmRNA was detected by RT-PCR. The expression of PPARγ protein was detected by Western blot method. Results The glucose consump-tion was significantly decreased in the insulin resist-ance cells after incubated with 1 . 72 × 10 -5 mol · L-1 insulin ( P<0. 05 ) . 10 -5 ,10 -6 ,10 -7 mol · L-1 Bio increased the glucose consumption 135%,62%,39%separately in the insulin resistance cells. RT-PCR a-nalysis of PPARγ showed that Bio raised the PPARγmRNA. Western blot analysis displayed that the pro-tein of PPARγ with Bio was increased. Conclusion Bio can improve the insulin resistance of the HepG2 cells, and the molecular mechanism may be relevant with raising PPARγ expression.

Locking plate combined with anti-osteoporosis drugs for osteoporotic proximal humerus fractures in elderly patients / 医学研究生学报

Objective Proximal humerus fracture is the most common upper-arm osteoporotic fracture in elderly patients and the result of treatment directly affects the physiological function of the shoulder .This article discusses the clinical effect of the locking proximal humeral plate ( LPHP) combined with anti-osteoporosis drugs in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients . Methods This study included of 47 elderly osteoporotic patients with comminuted proximal humerus fractures treated from April 2009 to March 2012 and with complete follow-up data.According to the Neer classification , the patients were divided into groups A (LPHP treatment, n=23, including 13 cases of three-part fractures and 10 cases of four-part fractures) and B (LPHP+anti-osteoporosis drugs, n=24, including 13 cases of three-part fractures and 11 cases of four-part fractures). Results All the patients were followed up for 14 to 38 (mean 23.6) months.The postoperative healing time was significantly shorter in group B than in group A ([96.57 ±2.59]d vs [115.91 ±2.73]d, P<0.05), and the excellence rate was remarkably higher in B than in A (91.7%vs 78.3%,P<0.05). Conclusion With the advantages of short healing time and high excellence rate , LPHP+anti-os-teoporosis drugs is superior to simple LPHP in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.

Novel agents for multiple myeloma bone disease / 白血病·淋巴瘤

Bone disease is a major morbidity factor in patients with multiple myeloma and significantly affects their overall survival.A complex interplay between malignant plasma cells and other marrow cells results in the generation of a microenvironment to enhance both tumor growth and bone destruction.Bisphosphonates have consistently reduced the incidence of skeletal-related events in patients with multiple myeloma.However,their use is burdened with side-effects,including the risks of osteonecrosis of the jaw and kidney failure,suggesting that they should be discontinued after prolonged administration.New molecular targets of cell cross-talk in myeloma bone marrow are therefore under intensive investigation and new drugs are exploring in preclinical and clinical studies of myeloma bone disease.This review would focus on novel agents in myeloma bone disease.

Comparison of vacuum sealing drainage and shoelace technique for leg fasciotomy wounds / 中国组织工程研究

BACKGROUND:Vacuum sealing drainage is currently considered as a safe and effective for fasciotomy wounds in the treatment of compartment syndrome. But the wounds after treatment are often not self-closed, which needs skin grafts that can cause secondary injury. Studies have shown that shoelaces technology is useful for leg fasciotomy wounds in the surgical treatment of lower leg compartment syndrome, but so far there are few domestic reports. OBJECTIVE:To compare the vacuum sealing drainage and shoelace technique for treatment of leg fasciotomy wounds. METHODS:A total of 36 patients, with 46 leg fasciotomy wounds, were randomized into vacuum sealing drainage and shoelace technique groups, 23 wounds in each group. In the vacuum sealing drainage group, patients were subjected to vacuum sealing drainage after fasciotomy based on fracture reduction and external fixation;in the shoelace technique group, the fasciotomy wounds were covered with polyethylene/ethanol hydrated seaweed salt foam fol owed by shoelace technique. After 1 month, wound size, wound closure time, infection, further intervention and daily treatment cost were compared between the two groups. RESULTS AND CONCLUSION: Wound closure time was significantly higher in the vacuum sealing drainage group compared to the shoelace technique group (P < 0.05). Eight wounds in the vacuum sealing drainage group required skin grafts; while, no skin graft was necessary in the shoelace technique group. In the shoelace technique group, the vessel loops had to be replaced in five wounds. There was no wound infection, increased compartment pressure and skin flap necrosis postoperatively in both two groups. Both vacuum sealing drainage and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. Vacuum sealing drainage requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.

Comparison of the stability of three internal fixators for distal femoral fracture / 中国组织工程研究

BACKGROUND:There are various internal fixators in treatment of distal femoral fracture. The commonly used fixators are locking compression plate, anterograde intramedul ary nails and retrograde intramedul ary nails. However, the efficacy of three common fixation is controversial. OBJECTIVE:To compare the effect of locking compression plate, anterograde intramedul ary nails and retrograde intramedul ary nails for treatment of distal femoral fracture, and to select the appropriate internal fixation method. METHODS:From May 2007 to November 2007, 118 patients with distal femoral fractures were treated with internal fixation in the hospital and their clinical data were analyzed retrospectively. Among them, 38 cases received locking compression plate, 21 cases received anterograde intramedul ary nails, and 59 cases received retrograde intramedul ary nails. The intraoperative blood loss, operative time, fracture healing time and rate of good postoperative recovery of knee joint in three groups were compared. RESULTS AND CONCLUSION:Al the involved 118 patients were fol owed up for 14-26 months, average 20 months. No patients developed infection. Except one case delayed bone defect healing due to the fractures and was completely healed after bone fil ing at 19 weeks, the other cases healed within 4.5 months. There was no significant difference in fracture healing time among three groups (P>0.05). Intraoperative blood loss and operation time in anterograde intramedul ary nail group and retrograde intramedul ary nail group were superior to locking compression plate group. In addition, anterograde intramedul ary nail group was superior to retrograde intramedul ary nail group, with significant difference (P<0.05). Kolment grading fine rate in locking compression plate, anterograde intramedul ary nail and retrograde intramedul ary nail groups was 76.3%, 52.4%and 76.3%respectively. Retrograde intramedul ary nail fixation is firm, stable and reliable, with less intraoperative blood loss, shorter operation time, smal trauma, and easy fracture reset, especial y in the recovery of knee joint function. Compared with locking compression plate and anterograde intramedul ary nail, retrograde intramedul ary nailing treatment of distal femoral fractures has more advantages.

Parameter selection for steel ring of Ilizarov external fixation in the treatment of tibial bone defects / 中国组织工程研究

BACKGROUND:There was no effective method to thoroughly treat tibial bone defect and soft tissue defect. The application of Ilizarov technique solved shortening deformity, soft tissue injury and joint contracture to some degrees. OBJECTIVE:To discuss the effects of Ilizarov external fixation on treatment of tibial bone defect and the parameter selection of Ilizarov steel ring. METHODS:We retrospectively analyzed the clinical data of 67 patients with tibial bone defects, who were treated and fol owed up from March 2007 to January 2012. Al patients had fracture of tibia and received one-stage operation. After treatment, postoperative limb suffered from tibia osteomyelitis and soft tissue injury. Ilizarov external fixation was placed in the limb. The length of defected tibia and area of defected soft tissues were compared at 1, 3 and 6 months after external fixation and final fol ow-up. The ankle joint Kofoed score and knee joint ROM score were observed before and after external fixation. In final fol ow-up, functional recovery was evaluated in accordance with diagnosis and treatment criteria of Johner-Wruhs fracture of shaft of tibia. RESULTS AND CONCLUSION:A total of 67 patients were fol owed up for 6 to 35 months. Bone defects in 67 cases were rebuilt and the fracture was healed, but five cases had poor healing. Among 44 cases of soft tissue injury, wound had healed in 40 cases, and wound had not healed in 4 cases. The length of tibia defect and the area of soft tissue defects were improved at 1, 3, and 6 months after the operation (P<0.05). After operation, the ankle joint Kofoed score and knee joint ROM were significantly better than those before operation (P<0.05). During final fol ow-up, the excellent and good rate of each therapeutic plan was 85%. For the tibial osteomyelitis bone defect with the merged skin defect, the trauma was smal using Ilizarov technique, which can avoid several complicated operations, shorten the time and reduce the expenses of treatment, but there were some weaknesses and limitations. The size and material of Ilizarov external fixation affect the efficiency of the fixation and postfixation adjustment.

Plate internal fixation versus external fixator for the treatment of unstable distal radius fractures:A Meta-analysis / 中国组织工程研究

BACKGROUND:The surgical method for the treatment of unstable distal radius fracture mainly includes plate internal fixation and external fixator, but both of these two methods have the advantages and disadvantages. Which treatment is more conducive to the rehabilitation of patients, there is stil controversy. OBJECTIVE:To evaluate the clinical effectiveness of internal fixation and external fixator for the treatment of unstable distal radius fractures. METHODS:The relative databases and literatures were searched with the computer and hand to col ect the randomized control ed trials of internal fixation versus external fixator for the treatment of unstable distal radius fractures. After extraction literature data and quality evaluation, RevMan 5.2 software was used for system evaluation. The grip strength, disabilities of arm, shoulder&hand score, complications rates, infection rates, deformity rates and ulnar variance rates were compared between two groups. RESULTS AND CONCLUSION:A total of 9 literatures, involving total y 524 patients were included, 286 patients in the internal fixation group and 238 patients in the external fixator group. There was no significant difference in grip strength between internal fixation group and the external fixator group. The results of Meta-analysis showed that the internal fixation group was better than the external fixator group in the aspects of disabilities of arm, shoulder&hand score, complications rate, infection rate, deformity rate and ulnar variance rate at 3 months and 1 year after treatment. The results indicate that the plate internal fixation is better than external fixator in the treatment of unstable distal radius fractures, but the large sample, double-blind, and high quality randomized control ed trials are stil needed to identify the results.

Bruton tyrosine kinase inhibitor in B cell malignancies / 白血病·淋巴瘤

Bruton tyrosine kinase (BTK) is a non-receptor tyrosine kinase which belongs to the Tec kinase family and plays an important role in B cell receptor signaling.Nowadays,BTK has been a nove] target for treating some B cell malignancies.Recently,some studies have confirmed that BTK inhibitor,PCI-32765 (ibrutinib),can effectively treat chronic lymphocytic leukemia,mantle cell lymphoma and so on.This review will discuss the preclinical and clinical development of this BTK inhibitor in B cell malignancies.

Two kinds of locking plate for treatment of proximal humerus fractures in the elderly / 中国组织工程研究

BACKGROUND:Proximal humeral internal locking system (PHILOS) and locking proximal humerus plate (LPHP) are both new types of internal fixation plates, and have satisfactory effects in the treatment of proximal humerus fractures. However, which is better? OBJECTIVE:To compare the short-term efficacy of PHILOS and LPHP in the treatment of elderly patients with proximal humeral fractures. METHODS:The fol ow-up data of 61 elderly patients with proximal humeral fractures were retrospectively analyzed. The patients were divided into PHILOS group (n=34) and LPHP group (n=27). According to the Neer system, there were two parts of fractures in seven cases, three parts of fractures in 11 cases, four parts of fractures in nine cases in LPHP group;there were two parts of fractures in nine cases, three parts of fractures in 14 cases, four parts of fractures in 11 cases in PHILOS group. The operation time, blood loss, and drainage volume were recorded. The time of fracture healing, functional recovery, and complications were observed. Statistical analysis was performed. RESULTS AND CONCLUSION:Al 61 patients were fol owed up for 12-36 months (mean 20.6 months). There was no statistical difference in operation time, blood loss, drainage volume, time of fracture healing, functional recovery and complications between the two groups (P>0.05). Both LPHP and PHILOS groups could obtain good effects in treatment of senile proximal humeral fractures. The excellent and good rate was respectively 81.5%and 82.4%in two groups. They have advantages of reliable fixation, few complications, and high satisfaction rate. Currently these locking plates have a high clinical value and can be considered as useful implants for ORIF of displaced and unstable proximal humeral fractures.

Photo-activated DNA binding and antimicrobial activities of alkaloids from Glycosmis pentaphylla / 药学学报

In our screening for photosensitizers from natural resources, four alkaloids were isolated from Glycosmis pentaphylla by various chromatography techniques. Their structures were identified as glycoborinine (1), glybomine B (2), carbalexin A (3) and N-p-coumaroyltyramine (4) by spectral analysis. Their photoactivated antimicrobial activities were evaluated by thin-layer chromatography (TLC) agar overlay assay against Staphylococcus aureus and Bacillus subtilis. It was found that compounds 1 and 4 showed photo-activated antimicrobial activities. Meantime, photo-activated DNA binding activities of these compounds were also assessed by using a specially prepared 1.8 kb DNA fragment and restriction enzymes. Under UVA irradiation, compound 1 showed moderate inhibition on Nde I, Xba I, Nco I and Bcl I which have either 5'-TpA or 5'-ApT and trace or no inhibition on other restriction enzymes. It showed a similar inhibition pattern with the reference 8-methoxypsoralen. However, compounds 2-4 showed no inhibition against any of the restriction enzymes.

Sequential therapy of BTD and MPT regimen for the newly-diagnosed multiple myeloma patients no eligible for bone marrow transplantation / 白血病·淋巴瘤

Objective To retrospectively analyze the outcomes and adverse effects of sequential therapy of BTD and MPT regimen for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation. Methods Thirty-six patients were involved in this study and the patients were treated with tandem therapy of BTD and MPT regimen. The patients were treated with BTD regimen as induced therapy no less than 2 cycles. When the patients got PR or above PR,they were treated with MPT regimen as consolidation therapy which was no less than 2 cycles. Then,the patients who achieved PR or partial PR were received MPT chemotherapy regimen as consequent treatment. After that,low dose thalidomide was used as maintenance therapy. The outcomes and adverse effects were retrospectively evaluated. Results Thirty-six patients were treated with BTD regimen as induced therapy. The results were that 7 patients (19.4 %) achieved CR,8 (22.2 %) VGPR,14 (38.9 %) PR and the OR rate was 80.6 %. The patients (n=29) who achieved no less than PR was treated with MPT regimen as consequent therapy. The results were that four patients were in progression and the others were stable. Twenty-five patients were treated with low dose thalidomide as maintenance therapy. The median progression-free survival (PFS) did not reached yet until last follow-up (median follow-up time was 16.5 months). One-year overall survival rate was expected 86.0 % and 3-year expected overall survival rate was 77.0 %. The main regimen-associated toxicities included thrombocytopenia,peripheral neuropathy (PN),Herpes Zoster,gastrointestinal symptoms,anemia,neutropenia,constipation,fatigue,rash and so on. The incidence of grade 3 and 4 adverse events was low. Conclusion Sequential therapy of BTD and MPT regimen can be used as the front-line therapy for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation.

A new chromone derivative from Berchemia lineata / 药学学报

To study the chemical constituents from the root of Berchemia lineata (L.) DC., nine compounds were isolated from the EtOAc extract by using silica gel, RP-C18 silica gel column chromatography and preparative HPLC. Based on the spectroscopic analysis, their structures were identified as 5-hydroxy-7-(2'-hydroxypropyl)-2-methyl-chromone (1), (-)-(1'R, 2'S)-erythro-5-hydroxy-7-(1', 2'-dihydroxypropyl)-2-methyl-chromone (2), naringenin (3), eriodictyol (4), (+)-aromadendrin (5), (+)-taxifolin (6), (+)-catechin (7), (+)-epigallocatechin (8) and quercetin (9). Among them, compound 2 is a new chromone derivative. Compound 1 is a known chromone derivative and isolated from this genus for the first time. Compounds 3-9 are known flavonoids and isolated from this plant for the first time.

Sulfur-containing amides from Entada phaseoloides / 药学学报

To study the chemical constituents of the Entada phaseoloides (L.) Merr., seeds of Entada phaseoloides were extracted with 70% ethanol at room temperature. Isolation and purification were performed by silica gel, reversed-phase silica gel column chromatography and semi-preparative HPLC. Structures of the pure compounds were established on the basis of spectral analysis. Four sulfur-containing amide compounds were isolated from the n-BuOH-soluble fraction and identified as entadamide A-beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranoside (1), entadamide A (2), entadamide A-beta-D-glucopyranoside (3) and clinacoside C (4). Compound 1 is a new compound. Compound 4 is isolated from the genus Entada for the first time.