Clinical features and prognosis of children with acute leukemias of ambiguous lineage under different diagnostic criteria / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features and prognosis of children with acute leukemias of ambiguous lineage (ALAL) under different diagnostic criteria.@*METHODS@#A retrospective analysis was performed on the medical data of 39 children with ALAL who were diagnosed and treated from December 2015 to December 2019. Among the 39 children, 34 received treatment. According to the diagnostic criteria for ALAL by World Health Organization and European Group for the Immunological Characterization of Leukemias, the 39 children were divided into two groups: ALAL group (@*RESULTS@#The 34 children receiving treatment had a 3-year event-free survival (EFS) rate of 75%±9% and an overall survival rate of 88%±6%. The children treated with acute myeloid leukemia (AML) protocol had a 3-year EFS rate of 33%±27%, those treated with acute lymphoblastic leukemia (ALL) protocol had a 3-year EFS rate of 78%±10%, and those who had no remission after induction with AML protocol and then received ALL protocol had a 3-year EFS rate of 100%±0% (@*CONCLUSIONS@#ALL protocol has a better clinical effect than AML protocol in children with ALAL, and positive MRD after induction therapy suggests poor prognosis. Hyperleukocytosis and adverse genetic changes are not observed in children with myeloid expression, and such children tend to have a good prognosis, suggesting that we should be cautious to take it as ALAL in diagnosis and treatment.

Effect of swertiamarin, gentiopicrin and sweroside on cell apoptosis and expression of Bcl-2 in rheumatoid arthritis fibroblast-like synoviocytes / 中国中药杂志

The aim of this paper was to discuss the effect of swertiamarin, gentiopicrin and sweroside on rheumatoid arthritis fibroblast-like synoviocytes(RA-FLSs) and B-cell lymphoma-2(Bcl-2) and their mechanisms. ZINC database and RCSB PDB database were retrieved for 3 D chemical structures of swertiamarin, gentiopicrin and sweroside and 3 D target protein structures. AutoDock Mgltools 1.5.6, AutoDockVina 1.1.2 and pyMOL 2.2.0 were applied for molecular docking to analyze the relationship between Bcl-2(1 GJH) target protein and important ingredients. The cell apoptosis of RA-FLSs was tested by Annexin V-FITC. The Bcl-2 protein expression of RA-FLSs treated with different ingredients was tested by Western blot. The Bcl-2 mRNA expression of RA-FLSs treated with different ingredients was tested by RT-PCR. Swertiamarin, gentiopicrin and sweroside were docked well with Bcl-2(1 GJH). The binding energy of swertiamarin was-6.9 kcal·mol~(-1), the binding energy of gentiopicrin was-6.7 kcal·mol~(-1) and the binding energy of sweroside was-6.4 kcal·mol~(-1). Compared with the blank group, the Bcl-2 protein expression of each group were reduced, while that of the gentiopicrin group was the highest(P<0.01). Compared with the blank group, the Bcl-2 mRNA expression of each groups were reduced. Gentiopicrin can reduce the Bcl-2 protein expression and the Bcl-2 mRNA expression, so as to promote the RA-FLSs apoptosis.

Effect of Different Combinations of Gentianae Macrophyllae Radix on MMP-3 and TIMP-1 in Rheumatoid Arthritis Rats with Wind-cold-dampness Arthralgia / 中国实验方剂学杂志

Objective: To observe the effects of different combinations of Gentianae Macrophyllae Radix (Qinjiao) on the ankle joint matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) of rheumatoid arthritis (RA) model rats with wind-cold-dampness arthralgia.Method: Eighty healthy SD rats were randomly divided into 8 groups, namely blank control group, collage Ⅱ model group, wind-cold-dampness syndrome model group, positive control group, single-taste Gentianae Macrophyllae Radix group, Gentianae Macrophyllae Radix-Clematidis Radix et Rhizoma group (GC group), Gentianae Macrophyllae Radix-Taxilli Herba group (GT group), Gentianae Macrophyllae Radix-Stephanlae Tetrandrae Radix group (GS group), with 10 rats in each group. Rat model of wind-cold-dampness RA was induced through the injection with type Ⅱ collagen emulsion and wind-cold-dampness stimulation. After the establishment of the model, the blank control group, collage Ⅱ model group and wind-cold-dampness syndrome model group were given normal saline, and the corresponding liquid medicine was given to each administration group. In the experiment, the thickness of the left posterior metatarsal of rats was measured every 3 days, and the swelling degree of metatarsal was calculated. The arthritis index (AI) was evaluated on the 38th day of the experiment. The serum rheamatoid factor(RF) content of rats was detected by enzyme linked immunosorbent assay (ELISA). The expressions of MMP-3 and TIMP-1 in ankle joint were detected by Western blot. The expressions of MMP-3 and TIMP-1 mRNA in ankle joint were detected by real-time fluorescence quantitative PCR (Real-time PCR).Result: Compared with the blank group, the swelling degree, AI score, serum RF content, MMP-3 protein expression and MMP-3 mRNA expression in ankle joints of coll age Ⅱ model group and model wind-cold-dampness syndrome group were significantly increased (PPPPPPConclusion: For rheumatoid arthritis with wind-cold-dampness arthralgia, mild and warm traditional Chinese medicine (TCM) has a better effect than the combination of mild and cold TCM or mild TCM drugs. The experimental results are basically consistent with the principle of "treating cold diseases with hot medicine". The mechanism of the compatibility in treating rheumatoid arthritis due to wind-cold-dampness arthralgia may be related to the reduction of MMP-3, the increase of TIMP-1 expression and the reduction of articular cartilage damage.

Anatomical study on finger of extensor tendon in zone Ⅰ / 局解手术学杂志

Objective To discuss the effect of proximal interphalangeal joint(PIPJ) motion on the tension of the zone Ⅰ extensor tendon through measuring the extensor tendon and find the fixed position of PIPJ when the zone Ⅰ extensor tendon at minimum tension,and to provide reference for best fixed position in clinical treatment.Methods The maximal passive flexion angles of the distal interphalangeal joint (DIP J) of the index,distal,ring and little fingers were measured in 20 cadaver hands when the PIPJ flexed at 0 °,20 °,40 °,60 °,80 ° and 100 °.Making an incision over the back of the DIPJ to expose the zone Ⅰ extensor tendon.Incising the extensor tendon laterally at the level of the DIPJ with the DIPJ fixed in extension position to make a mallet finger.Pierced a Kirschner wire through and perpendicular to the distal phalangeal basement as a sign.Parallel to this sign,marked the zone Ⅰ extensor tendon and measured its relative distance to the sign as the sliding distance of the extensor.Recording the widest gap between the tendon edges and the tendon sliding distance while the PIPJ was in extension and 20°,40°,60°,80° and 100°flexion position,severally.Results The maximal passive flexion angle of the DIPJ increased with the PIPJ flexed from 0°to 100°in 80 fingers.The gap between the extensor tendon edges in zone Ⅰ was (1.322 8 ± 1.078 9) mm when the PIPJ was in extension position.The proximal extensor tendon glide distally while the PIPJ flexed to 100° with an average sliding distance of(1.540 5 ± 0.690 7) mm.Conclusion The zone Ⅰ extensor tendon has the maximal tension while the PIPJ is in extension position.Flexing PIPJ can make the tension decrease.

Research progress on pharmacological action and clinical application of Stephania Tetrandrae Radix / 中国中药杂志

Stephania Tetrandrae Radix is one of the common traditional Chinese medicines, which has bitter and pungent taste as well as cold properties. It can subside edema, get rid of rheumatism and relieve pain. Therefore, it is mainly used for the treatment of rheumatism arthralgia, edema, dysuria, athlete's foot, swollen wet sores and other diseases in traditional Chinese medicine(TCM). Stephania Tetrandrae Radix is mainly composed of dual-benzyl isoquinoline alkaloids, including tetrandrine, fangchinoline and so on. Modern pharmacology research shows that Stephania Tetrandrae Radix and its main components have a wide range of pharmacological activities in the anti-inflammatory, anti-pathogenic microorganisms, anti-tumor, anti-hypertensive, anti-arrhythmic, anti-myocardial ischemia, anti-fibrosis, anti-silicosis, inhibiting scar and other aspects, with broad application prospect. Stephania Tetrandrae Radix is often applied with compatibility of other Chinese medicines in clinically, and has achieved obvious effects in the treatment of rheumatoid arthritis, cardiovascular disease, cancer, hypertension, liver ascites and other diseases. There are some representative prescriptions, such as Fangji Fuling decoction, Fangji huangqi decoction, Jijiao Lizhuang pill, Xuanbi decoction, and compound Hanfangji granule. In this paper, the pharmacological effects and clinical applications of Stephania Tetrandrae Radix in the past ten years were reviewed, providing reference for its further development and application.