Early Efficacy Predictors of Bushen Shengxue Prescription Combined with Western Medicine in Treatment of Aplastic Anemia / 中国实验方剂学杂志

ObjectiveTo investigate the predictive indicators of early efficacy of Bushen Shengxue prescription combined with western medicine in the treatment of aplastic anemia， and provide prognosis indicators for the treatment of aplastic anemia （AA） with kidney-tonifying therapy in traditional Chinese medicine （TCM） combined with western medicine. MethodA total of 126 patients treated by Bushen Shengxue prescription combined with western medicine in 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected for a retrospective study. The therapy was proven to be effective after six months of treatment. According to the efficacy after 4 months of treatment， the patients were assigned into a 4-month effective group and a 4-month ineffective group. The age， sex， disease severity （including severe aplastic anemia and non-severe aplastic anemia）， course of disease， degree of bone marrow nucleated cell proliferation， baseline hemogram levels ［including white blood cell count （WBC）， absolute neutrophil count （ANC）， hemoglobin （HGB）， platelets （PLT）， and reticulocytes （RET）］， T lymphocytes subsets， and the expression levels of T-box transcription factor （T-bet） and GATA-binding protein-3 （GATA-3） were compared between the two groups before treatment. ResultThe proportions of patients within the age ranges of ［20， 40） and ［60， 80） were higher in the 4-month effective group （P<0.05）. The sex， disease severity， course of disease， and comorbidities had no significant differences between the two groups. The 4-month effective group had higher baseline levels of HGB， WBC， ANC， and PLT than the 4-month ineffective group （P<0.05）， and there was no significant difference in the RET level between the two groups before treatment. Binary Logistic regression analysis showed that the PLT level before treatment was an independent factor affecting the onset time， while other indicators did not affect the onset time. The receiver operating characteristic （ROC） curve was established to analyze the value of PLT level before treatment for predicting the onset time， and the area under the curve was 0.691. With the critical value of 40.5×109/L， the sensitivity and specificity of the prediction that the therapy will take effect within 4 months were 0.569 and 0.893， respectively. The two groups of patients were graded according to age ｛（14， 20）， ［20， 40）， ［40， 60）， and ［60， 80）｝ and PLT level before treatment （PLT<40×109/L， PLT≥40×109/L）. The proportion of the patients with PLT≥40×109/L before treatment in the 4-month effective group was significantly higher than that in the 4-month ineffective group （P<0.05）. The degree of bone marrow nucleated cell proliferation before treatment had no significant difference between the two groups. The level of total T lymphocytes in the 4-month effective patients was lower than that in the 4-month ineffective patients before treatment （P<0.05）. The levels of Th1 cells， Th2 cells， CD4+ T cells， and CD8+ T cells showed no significant differences between the two groups before treatment. The T-bet expression level in the 4-month effective group was higher than that in the 4-month ineffective group before treatment （P<0.05）， while the expression level of GATA-3 showed no significant difference between the two groups before treatment. ConclusionBushen Shengxue prescription combined with western medicine will achieve faster effect for the patients within the age ranges of ［20， 40） or ［40， 60）， with higher levels of HGB， WBC， ANC， and PLT （especially those with PLT≥40×109/L）， lower level of total T lymphocytes， or higher T-bet expression level before treatment.

Analysis of Predictive Factors for Efficacy of Yiqi Yangxue Prescription Combined with Western Medicine in Treatment of Aplastic Anemia in Non-elderly Adults / 中国实验方剂学杂志

ObjectiveTo explore the predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating aplastic anemia （AA） in non-elderly adults， so as to provide a reference for predicting the prognosis of this therapy. MethodA retrospective study was conducted with the clinical data of non-elderly adult AA patients who visited 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 and were treated with Yiqi Yangxue Prescription combined with western medicine. According to the efficacy evaluation results at the 6th month of treatment， the patients were assigned into effective and ineffective groups. The two groups were compared in terms of the gender， age， disease classification ［non-severe aplastic anemia （NSAA）/severe aplastic anemia （SAA）］， course of disease， family history， complications， history of drug allergy， baseline blood routine examination ［hemoglobin （HGB）， white blood cell （WBC）， neutrophil （ANC）， platelet （PLT）， and reticulocyte （Ret）］， T lymphocyte subsets， degree of proliferation of nucleated cells in bone marrow， and expression of T-bet and GATA-3. ResultA total of 101 non-elderly adult AA patients were enrolled in this study， including 81 in the effective group and 20 in the ineffective group. The effective group had a higher proportion of the patients without a history of drug allergy than the ineffective group （P<0.05）. The body height， body weight， gender， age， disease classification， course of disease， family history， and complications showed no significant differences between two groups. The effective group had higher levels of ANC and PLT before treatment （P<0.05） and higher proportion of patients with ANC≥1.6×109/L and PLT≥25×109/L （P<0.05， P<0.01） than the ineffective group. The baseline levels of WBC， HGB， and Ret showed no significant statistical differences between two groups. The levels of CD3+HLA-DR+T cells in the effective group before treatment was higher than that in the ineffective group （P<0.05）. The levels of CD3+CD19-T cells， CD4+T cells， CD8+T cells， Th1 cells， Th2 cells， and CD3+CD25+T cells showed no significant statistical differences between two groups before treatment. The proportion of patients with active bone marrow nucleated cells proliferation in the effective group before treatment were significantly higher than that in the ineffective group, while the proportion of patients with reduced or extremely reduced proliferation were significantly lower than that in the ineffective group （P<0.05）. The expression levels of T-bet and GATA-3 genes had no significant differences between two groups before treatment. The multivariate binary logistic regression analysis showed that the ANC level before treatment and history of drug allergy were independent influencing factors for efficacy （P<0.05， P<0.01）， while other indicators were not influencing factors for efficacy. The receiver operating characteristic （ROC） curve was applied to analyze the predictive value of the ANC level before treatment in the treatment of AA in non-elderly adults with Yiqi Yangxue prescription combined with western medicine. The area under the curve was 0.679 （P<0.05）， with the critical value of 1.595×109/L， the sensitivity of 0.42， and the specificity of 0.95. ConclusionThe history of drug allergy， pre-treatment ANC， PLT， CD3+HLA-DR+ T cell levels， and proliferation of nucleated cells in bone marrow before treatment are predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating AA in non-elderly adults. This therapy tends to be more effective for the patients with no history of drug allergy， higher ANC and PLT levels before treatment， especially those with ANC≥1.6×109/L， PLT≥25×109/L， and higher CD3+ HLA-DR+T cell levels and the more active proliferation of nucleated cells in bone marrow before treatment.

Professor SUN Weizheng's Experience in Diagnosing and Treating Multiple Myeloma with the Clearing-Releasing Therapy / 中医杂志

The article summarized professor SUN Weizheng's clinical experience in treating multiple myeloma using the clearing-releasing therapy. It is believed that the mechanism of multiple myeloma is kidney essence insufficiency， pathogenic toxin erosion， and blinding of phlegm and stasis. The treatment should consider both the deficiency and the excess， and the root and branch. Thus， the clearing-releasing therapy is proposed. “Clearing” refers to the approach of supplementing deficiency and reinforcing health while advocating the use of clearing and supplementing products to replenish without generating additional pathogenic factors. Additionally， products that clear heat， resolve toxins， dispel stasis， dissolve phlegm， and eliminate masses is suggested to benefit for clearing away pathogenic toxins. “Releasing” means to replenish the normal yang qi with sweet-warm and acrid-warm products on the basis of “clearing” method， and to release the cold pathogen constraint in the muscles and bones. Based on the principle of clearing and releasing， the selfmade Jishi Beverage （济世饮） is formulated to supplement the kidney and secure essence， dispel phlegm and dissolve stasis， resolve toxins and dissipate masses. The prescription can be modified according to syndrome differentiation. It is also advocated to use multiple methods and pay attention to external therapies such as enema for relieving constipation and draining heat， and to combine acupuncture and medicine to relieve pain.

Clinical Effect of Bushen Shengxue Prescription on Chronic Aplastic Anemia and Its Effect on T Cell Subsets and Expression of T-bet and GATA3 / 中国实验方剂学杂志

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ2=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ2=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ2=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4+， and CD4+/CD8+ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19-， HLA/DR+， and CD25+ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4+， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

Clinical efficacy of apatinib for metastatic castration-resistant prostate cancer / 中国肿瘤临床

Objective: To evaluate the therapeutic effects and adverse events related to apatinib use among conventional, treatment-failed, advanced, metastatic castration-resistant prostate cancer (mCRPC). Methods: A total of 25 patients were treated with apatinib at The Second Hospital of Tianjin Medical University from June 2016 to December 2017. Clinical data were classified according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Pain relief evaluation, changes in serum prostate specific antigen (PSA), and adverse effects, were recorded. The evaluation period included 4 cycles (approximately 112 days). Results: The 25 patients were aged between 53 and 81 years (median: 72 years). All tumors were classified as adenocarcinomas in terms of histopathology. Classification of the therapeutic effect was as follows: 0 patients (0) had complete remission; 11 patients (44%) had partial remission;8 patients (32%) had stable disease; and 3 patients (12%) had progressive disease. The objective remission rate (ORR) was 44%, and the disease control rate (DCR) was 76%. Treatment-related adverse events were recorded for all patients: fatigue (n=22, 88%), gastroin-testinal symptoms (n=15, 60%), hypertension (n=7, 28%), hand-foot syndrome (n=6, 24%), dizziness, proteinuria, and others. Conclu-sions: Based on the demonstrated short-term therapeutic effects, apatinib could be a promising agent for conventional treatment-failed advanced CRPC. Adverse events are mild to moderate, and patients should be kept under observation and active management. To improve the effectiveness of apatinib treatment in the future, the mechanism of action of apatinib against mCRPC showld be ex-plored.

Tet2 Regulates Osteoclast Differentiation by Interacting with Runx1 and Maintaining Genomic 5-Hydroxymethylcytosine (5hmC) / 基因组蛋白质组与生物信息学报·英文版

As a dioxygenase, Ten-Eleven Translocation 2 (TET2) catalyzes subsequent steps of 5-methylcytosine (5mC) oxidation. TET2 plays a critical role in the self-renewal, proliferation, and differentiation of hematopoietic stem cells, but its impact on mature hematopoietic cells is not well-characterized. Here we show that Tet2 plays an essential role in osteoclastogenesis. Deletion of Tet2 impairs the differentiation of osteoclast precursor cells (macrophages) and their maturation into bone-resorbing osteoclasts in vitro. Furthermore, Tet2 mice exhibit mild osteopetrosis, accompanied by decreased number of osteoclasts in vivo. Tet2 loss in macrophages results in the altered expression of a set of genes implicated in osteoclast differentiation, such as Cebpa, Mafb, and Nfkbiz. Tet2 deletion also leads to a genome-wide alteration in the level of 5-hydroxymethylcytosine (5hmC) and altered expression of a specific subset of macrophage genes associated with osteoclast differentiation. Furthermore, Tet2 interacts with Runx1 and negatively modulates its transcriptional activity. Our studies demonstrate a novel molecular mechanism controlling osteoclast differentiation and function by Tet2, that is, through interactions with Runx1 and the maintenance of genomic 5hmC. Targeting Tet2 and its pathway could be a potential therapeutic strategy for the prevention and treatment of abnormal bone mass caused by the deregulation of osteoclast activities.

Study on the relationship between viral load of severe fever with thrombocytopenia syndrome bunyavirus and patient's condition / 中华传染病杂志

Objective To explore the severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) existence time in the body,and the correlation between viral load and the severity and prognosis of disease.Methods The clinical data of 125 SFTS patients from May 2015 to October 2016 in Weihai Central Hospital in Shandong province were analyzed retrospectively.Patients were divided into low viral load group and high viral load group according to the SFTSV RNA levels.Neurological symptoms,bleeding tendency,the incidence of myocardial damage and severe pneumonia,laboratory biochemical index and prognosis of two groups were compared.SFTSV RNA of 46 cases were detected dynamically.Data with homogeneity of variance were tested by t test,and data with heterogeneity of variance was tested by rank sum test.Results Among the 125 cases,64 were male and 61 were female.The mean age was (59.0±3.6) years old.One hundred and one cases were cured,and 24 died.SFTSV RNA loads in low viral load group(81 cases) were (3.08± 1.01) copies/mL,and those in high viral load group (44 cases) were (5.69 ± 0.99) copies/mL,with statically significant difference (t =11.78,P＜0.05).By the dynamic detection of SFTSV RNA load in 46 patients,viral loads in most patients were gradually declined after 1 week of onset,and cleared after 23 days.The incidence of neurological symptoms,bleeding tendency,severe myocardial damage and pneumonia of two groups showed significant difference (x2 =92.987,38.711,75.889 and 54.680,respectively,all P＜0.05).The viral loads of patients who died varied from 1.06× 104 copies/mL to 5.78 × 107 copies/mL.White blood counts of two groups showed no significant difference (t =0.181,P＞ 0.05).The platelet counts of two groups had significant difference (t =2.869,P＜0.05).AST and γ-GT of two groups also had significant difference (P＜0.01 and 0.05,respectively).creatine kinase,creatine kinase isoenzyme,lactic dehydrogenase and hydroxybutyrate dehydrogenase of two groups all had significant difference (P＜0.01 or 0.05).Serum sodium,blood calcium and glucose of the two groups had significant difference (P＜0.01 or 0.05).activated partial thromboplastin time of the two groups showed significant difference as well (t=5.623,P＜0.01).Conclusions After the onset of SFTSV infection,the virus existence in the body may less than 4 weeks.Viral loads are closely associated with disease severity and prognosis.The higher the viral loads are,the heavier organ dysfunction could be and the higher mortality is.

An analysis of the effect of midazolam conscious sedation therapy in patients with 125I seed implantation / 中华放射医学与防护杂志

Objective To investigate thc clinical effect of midazolam in CT-guided 125I seed implantation.Methods Totally 86 patients who underwent CT-guided radioactive 125I seed implantation were collected from December 2015 to February 2017 in the Second Hospital of Tianjin Medical University and randomly divided into two groups:the test group and the control group.The test group was given intravenous infusion of midazolam and local anesthesia of lidocaine while the control group were given the same amount of saline and lidocaine.The changes of heart rate (HR),mean arterial pressure (MAP),respiration (RR) and oxygen saturation (SpO2) were observed and compared between the two groups at 15 min before the midazolam(T0),15 min after the midazolam (T1),15 min after lidocaine local anesthesia (T2),the moments the lesion was punctured (T3),and after implantation of the seeds (T4) and the end of the operation (T5),respectively.In addition,the body reaction,operation time,the amount of lidocaine,the effect of analgesic and adverse reactions were also observed.Results The levels of HR,MAP,RR and SpO2 in test group were significantly lower than those in control group (t =38.9,31.0,14.1,2.4,P ＜0.05),but there was no significant difference at T1,T2,T3,T4 and T5(P ＞0.05).In control group,HR,MAP and RR were significantly higher than those before operation (t =-23.6,-18.0,-9.5,P＜0.05).The difference ofHR,MAP,RR and SpO2 among T1,T2,T3,T4 and T5 was statistically significant (F =997.3,833.7,120.1,77.5,P ＜ 0.05).In addition,the incidence of adverse reactions was both less in the two groups,and the incidence of response of patients,operation time,the amount of lidocaine and other indicators and analgesic effect in the test group were superior to the control group (-15.4,9.2,-56.3,P ＜ 0.05).Conclusions Midazolam in CT-guided 125I particle implantation can improve the patient's tolerance and shorten the operation time,guarantec security.

Dosimetric study of 3D-printing coplanar template combined with CT-guided 125I seed implantation for treating non-small cell lung cancer / 中华放射医学与防护杂志

Objective To explore the safety,effectivity and dosimetric continence of 3D-printing coplanar template(3D-PCT)combined with CT-guided 125I seed implantation in the treatment of non-small cell lung cancer(NSCLC).Methods From May 2014 to November 2016,a total of 20 NSCLC patients who were suitable for 125I seed implantation were recruited in this study.Of all the patients,10 received 125I seed implantation treatment by CT-guided combined with 3D-PCT (3D group),and the rest,by freehand puncture combined with CT-guided 125I seed implantation (free-hand group).During two days before the surgery,the patients received the CT scan.Then the digital imaging and communications in medicine (DICOM) was collected to input to the Brachytherapy Treatment Planning System (BTPS).The dose parameters including D90,D100,V100,V150,conformal index(CI),external index(EI),and homogneneity index(HI) were compared between pre-operation and post-operation.Pair t-test and single sample t-test were performed.Results V150 in 3D group between preoperation and postoperation showed statistically significant difference (t =-2.916,P ＜ 0.05),and there was no significant difference in the rest parameters(P ＞ 0.05).However,the number of seeds,V100,EI,HI in free-hand group between preoperation and postoperation showed statistically significant difference (t =-2.516,2.492,4.725,7.258,P ＜0.05),and there was no significant difference in the rest parameters(P ＞0.05).Comparison of indicuted that there was significant difference in V100,V150,CI,EI,HI and dose error rate between the 3D group and the free-hand group with single sample t test,the result showed V100,CI,EI,HI between two groups(t =2.598,2.278,4.637,4.616,-4.785,P ＜0.05),and there was no significant difference in V150 (P ＞ 0.05).Conclusions CT-guided 125I seed implantation brachytherapy combined with 3D-PCT for treatment of NSCLC safe is feasible,and dose controllable,and there is a certain advantage in the spatial distribution of seed compared with free-hand puncture.

Efficacy and safety of stents loaded with 125I seeds for patients with advanced esophageal cancer: a meta-analysis / 中华放射医学与防护杂志

Objective To evaluate the clinical effectiveness and safety of stents loaded with 125I seeds compared to conventional stents.Methods Literatures were searched in PubMed,EMbase,Cochrane Library,CBM,CNKI,Wanfang Data and other electronic databases from inception to November 2016.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and assessed quality of the included studies independently.Meta-analyses were performed using RevMan 5.3.Results A total of five RCTs and 14 CCTs involving 1 211 patients were included.The mean survival time of the 125I stent group was significantly higher than that of the control group [mean difference =4.11,95％ CI (2.16-6.07)P ＜0.001].The incidence of restenosis after 3:The available data showed that the incidence of re-staging of 125I stent in the treatment group was lower than that of the normal stent group [RR =0.23,95％ CI(0.12-0.62),P =0.002].Postoperative bleeding [RR =0.80,95％CI (0.52-1.23),P=0.30];Postoperative pain[RR=1.06,95％CI(90.88-1.27),P=0.55];postoperative stent shift [RR =0.53,95％ CI(0.27-1.05),P =0.07].The difference of incidence of complications was not statistically significant.There was no difference in the incidence of complications between the two groups.Conclusions The available data suggest that 125I stent is superior to common stent in the treatment of advanced esophageal cancer.There are no differences found in the incidence of complications between 125I stent and conventional stent.However,due to the limited quality of the included studies,more high-quality and multicenter-based studies are needed to verify the above conclusion.

CT and template-guided radioactive seed implantation for inoperable early stage non-small cell lung cancer / 中华放射医学与防护杂志

Objective To investigate the efficacy and side effects of radioactive seed implantation in the treatment of non-surgical early stage non-small cell lung cancer (NSCLC) based on CT guidance combined with template.Methods Twenty-one patients with inoperable T1 2N0M0 NSCLC who underwent CT-guided radioactive seed implantation therapy were retrospectively analyzed from December 2010 to October 2016 in the Second Hospital of Tianjin Medical University.All patients were diagnosed by histopathology.All seeds,with the activity of 18.5-29.6 MBq and prescription dose of 120-160 Gy,were completed in an operation of the radioactive seed implantation.The preoperative and postoperative TPS treatment plans and quality verification were corducted.In addition,the local control rate of tumors,overall survival (OS),progression free survival time (PFS),satisfaction rate of dose validation and adverse reactions were evaluated.Results The median follow-up was 25.1 months (range 4.4-72.7months).The local control rate of primary tumor in 1-,2-and 3-year was 100％,95.2％ and 95.2％,respectively.Of all patients,the median OS was 48 months with the median PFS 43.4 months.In particular,the 1-,2-and 3-year survival rate was 100％,91.7％ and 72.9％,respectively.Moreover,the rate of 3-year PFS was 70.2％ and the satisfactory rate of postoperative quahty verification was 100％.The treatment-related adverse events included pneumothorax,bronchial hemorrhage,pleural effusion,cough,pulmonary fibrosis and seed shifts.In all,7 (33.3％) patients had grade 1 adverse events and 4 (19％) patients with grade 2,but no grade 3 adverse event.Conclusions CT and template-guided radioactive seed implantation in NSCLC with T1 2 N0 M0 has a high tumor local control rate and low treatment-related adverse reactions,suggesting that it might provide an alternative way for the treatment of inoperable early stage NSCLC.

Efficacy and safety of CT-guided 125I seed implantation for treatment of advanced pancreatic cancer: a Meta-analysis / 中华放射医学与防护杂志

Objective To systematically evaluate the efficacy and safety of 125I seed implantation for treatment of advanced pancreatic cancer.Methods An electronic literatuire search was performed about randomized controlled trials(RCTs) of 125I implantation for treamtent of advanced pancreatic cancer in CNKI,Wanfang Data,CBM,Cochrane Library,PubMed and Embase (from the date of building the database to November 2016).Two investigators independently screened literature,extracted data and assessed the risk bias of included studies,and the Meta-analysis was performed by using Revman 5.3software.Results There were 12 RCTs (n =689) included.Meta-analysis showed that the objective respond rate(ORR) (OR =3.24,95％CI2.33-4.52,P＜0.001),the 6-month survival rate(OR =3.61,95％ CI 1.53-8.52,P =0.003),the 12-month survival rate(OR =4.80,95％ CI 2.40-9.57,P ＜ 0.001) and the relief rate of pain were higher than those in the control group.However,there were no significant differences between both groups in the 2-year survival rate and the adverse reaction rate,which were (OR=2.36,95％ CI 0.47-11.74,P =0.29) and (OR =4.94,95％ CI 1.05-23.23,P =0.04),respectively.Conclusions The limited current evidence showed that 125I implantation for treatment of advanced pancreatic cancer is effective and safety.125I implantation can improve the ORR,short-time survival rate and pain relief rate.In addition,there was no significant increase in the incidence of related adverse events except for seed malposition.Although the quality and quantity of evidences is limited,it merits further study to provide high quality evidences.

The efficacy and safety of pemetrexed and nedaplatin in salvage chemotherapy of advanced urinary carcinoma / 中华泌尿外科杂志

Objective To evaluate the efficacy and toxicity of pemetrexed and nedaplatin in the treatment of patients with locally advanced or metastatic urothelial cell carcinoma who failed a first-line GC regimen.Methods A total of 11 patients with locally advanced or metastatic urothelial carcinoma failed with first-line treatment of GC regimen were included in the present study.There were 6 males and 5 females,aged 56-80 years old,median age was 65 years old.Six patients' primary tumors were in bladder,4 in the renal pelvis,1 ureter.There were 7 cases with ECOG score 0 point,3 cases 1 point,1 case 2 points.Patients received pemetrexed 500 mg/m2 intravenously on the 1st day,and nedaplatin 25mg/m2 from the 1st to 3th day every 21 days.The evaluation of efficacy and adverse reactions were carried out after 2 to 3 cycles.Results Eleven patients received 1 to 6 cycles (mean 3.3 cycles) treatments.There were 2 cases (18.2％) complete remission,5 cases (45.5％) partial remission,2 cases (18.2％) no change and 2 cases (18.2％) progressed.The total effective rate was 63.6％.The main adverse events were anemia (6 cases),leukopenia (5 cases),nausea and vomiting (6 cases) and rash (5 cases),all of which were mild to moderate.No treatment-related death occurred.Conclusions Pemetrexed and nedaplatin regimen could be effective in the treatment of advanced urothelial carcinoma after first-line chemotherapy failed.The side effect is mild.

Anti-gamma-aminobutyric acid B receptor encephalitis:2 cases report and literatures review / 中华老年医学杂志

Objective To discuss the characteristics of clinical features,diagnosis and therapy procedure of Anti-gamma-aminobutyric acid B (anti-GABAB)receptor encephalitis.Methods Procedure of clinical diagnosis and treatment in two patients with anti-GABAB receptor encephalitis were retrospected in Neurological Department of Tianjin Huanhu Hospital and the characteristics of anti-GABAB receptor encephalitis were analyzed with literature review.Results In both patients,the clinical manifestations were epileptic seizure,which was a focal seizure at first,seconded by generalized tonic clonic seizure,with frequent attacks or epilepticus state.Significant cognitive and memory impairments and psychological and behavioral abnormalities were observed during the course of the disease.Abnormal MRI signals were found in mesial temporal lobe,with normal electroencephalography.Antibody against anti-GABABreceptor was positive in both cerebrospinal fluid and blood,and immune regulation therapy was effective.Conclusions The patients present with epileptic seizures,seconded by cognitive and memory impairment,often accompanied by MR imagingrevealed mesial temporal lobe lesion.And positive anti-GABAB receptor antibody is major characteristics of anti-GABAB receptor encephalitis.The patients often combine small cell lung cancer,and Immune regulation therapy is effective.

Xiaoqinglong decoction combined with standard treatment for acute exacerbation of chronic obstructive pulmonary disease / 国际中医中药杂志

Objective To evaluate the therapeutic effect of Xiaoqinglong decoction combined with standard treatment for acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods A total of 60 patients with acute exacerbation of COPD were enrolled and randomly divided into a standard treatment group and a combined treatment group, 30 in each group. The standard treatment group received standard therapy and the combined treatment group receivedXiao Qing Long decoction combined with standard treatment. The forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC were detected using a pulmonary function tester. The partial pressure of arterial oxygen (PaO2), carbon dioxide (PaCO2) were evaluated.Results After the treatment, the FVC (1.94 ± 0.26 Lvs. 1.55 ± 0.33 L;t=-2.201, P<0.05), FEV1 (1.34 ± 0.24 Lvs. 0.99 ± 0.25 L;t=-6.004,P<0.05), and PaO2 (86.12 ± 13.26 mmHgvs. 80.02 ± 12.75 mmHg;t=-14.158,P<0.05) in the combined treatment group were significantly higher than those in the standard treatment group. The total effective rate in the combined treatment group was significantly higher than that in the standard treatment group (86.7%vs.70.0%;χ2=2.095,P=0.036).Conclusions Xiaoqinglong decoction combined with standard treatment can improve symptom, sign, arterial blood gas and the pulmonary function in patients with acute exacerbation of COPD, and its efficiency is superior to standard therapy alone.

Correlation studies between real-time shear wave elastography measuring liver stiffness and the degree of esophageal varices / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Application of real-time shear wave elastography (SWE) measurement of patients with Chronic severe hepatitis B and liver cirrhosis of the liver stiffness, aimed to explore SWE can evaluate the existence of liver cirrhosis patients with esophageal varices (EV) and its severity.</p><p><b>METHODS</b>According to the results of gastroscope, 256 cases of patients with chronic liver disease and cirrhosis of the liver can be divided into no EV group,mild EV group,moderate to severe EV group,analysis between groups in patients with liver stiffness, portal vein,spleen vein diameter, the correlation of liver fibrosis indexes and the degree of esophageal varices.Using receives operating characteristic curve (ROC) and area under curve of ROC to evaluate each index prediction ability.</p><p><b>RESULTS</b>Compare the liver stiffiness, portal vein,spleen vein diameter had statistically significant difference in the no EV group, mild EV group,moderate to severe EV group, (F values are respectively 137.86,44.77,73.88, P < 0.05), Patients age, type IV collagen, larninin, hyaluronic acid had no statistically significant difference in the no EV group and mild EV group (P > 0.05) and had statistically significant difference in the other two groups (P < 0.05). Patients with gender, pro-collagen type III N-terminal peptide (PC III NP) had no statistically significant difference in the three groups (P > 0.05). Correlation analysis showed that portal vein, spleen vein diameter, type IV collagen, laminin, hyaluronic acid showed significant positive correlation (P < 0.05),highest correlation was liver stiffness and the degree of esophageal varices, correlation coefficient of 0.689 (P < 0.01). PC III NP and the degree of esophageal varices, liver stiffness showed no correlation (P > 0.05). Liver stiffness area under the ROC curve is 0.923, with a strong ability to predict than the portal vein and splenic vein diameter, LN, IV-C, HA, PCIII NP. Liver stiffness more than 7.55 kPa, diagnose mild EV sensitivity 90.5%, specificity 60%.Liver stiffness more than 18.85 kPa,the sensitivity of the diagnosis of severe EV 82.4%, specificity of 90.5%.</p><p><b>CONCLUSIONS</b>SWE liver stiffness measurement was predicted the existence of the EV and the severity of liver disease patients and effective inspection method, can be used as evaluation of liver disease patients with esophageal varices non-invasive indicator of the initial screening.</p>

Multi-channel Synchronization Analysis of Mild Cognitive Impairment in Type 2 Diabetes Patients / 生物医学工程学杂志

The cognitive impairment of type 2 diabetes patients caused by long-term metabolic disorders has been the current focus of attention. In order to find the related electroencephalogram (EEG) characteristics to the mild cognitive impairment (MCI) of diabetes patients, this study analyses the EEG synchronization with the method of multichannel synchronization analysis--S estimator based on phase synchronization. The results showed that the S estimator values in each frequency band of diabetes patients with MCI were almost lower than that of control group. Especially, the S estimator values decreased significantly in the delta and alpha band, which indicated the EEG synchronization decrease. The MoCA scores and S value had a significant positive correlation in alpha band.

Biological characteristics of endothelial progenitor cells derived from granulocyte colony-stimulating factor mobilized peripheral blood / 中国组织工程研究

BACKGROUND:Endothelial progenitor cells have good prospects for clinical application;especial y as seed cells, they are involved in construction of tissue engineered blood vessels and disease treatment. OBJECTIVE:To investigate the biological characteristics of endothelial progenitor cells derived from granulocyte colony-stimulating factor (G-CSF) mobilized peripheral blood. METHODS:Mononuclear cells from G-CSF mobilized peripheral blood (n=9) and normal adult peripheral blood (n=8) were obtained and cultured in expanded medium. The immunophenotype of endothelial progenitor cells was investigated by FACS and immunohistochemistry. Real-time PCR was used to detect the expression of different cytokines. Proliferation and adhesion ability of endothelial progenitor cells were detected by MTT assay and adhesion assay. Moreover, the abilities of vasculogenesis in vitro and Dil-labeled acetylated low density lipoprotein uptake were detected. The acquired cells were seeded onto the basilar membrane gel containing vascular endothelial growth factor and basic fibroblast growth factor to induce angiogenesis. RESULTS AND CONCLUSION:Endothelial progenitor cells derived from G-CSF mobilized peripheral blood were similar to those from normal adult peripheral blood in phenotype and morphology. FACSs and immunohistochemistry showed that endothelial progenitor cells were positive for endothelial cellmarkers, such as CD31, vWF, CD34, FLK-1, VE-Cadherin and CD133. In addition, the expression of vascular endothelial growth factor and stromal cel-derived factor 1 were significantly increased in G-CSF mobilized endothelial progenitor cells. Moreover, endothelial progenitor cells derived from two sources possessed the abilities of angiogenesis in vitro and Dil-labeled acetylated low density lipoprotein uptake. But, the number and the proliferation ability of endothelial progenitor cells derived from G-CSF mobilized peripheral blood were better than that of endothelial progenitor cells derived from normal adult peripheral blood. These findings indicate that there is a population of cells with characteristics of endothelial progenitor cells in G-CSF mobilized peripheral blood. They possess the abilities of vasculogenesis in vitro. Moreover, compared to endothelial progenitor cells derived from normal adult peripheral blood, we could obtain more endothelial progenitor cells in G-CSF mobilized peripheral blood and those cells show better proliferation ability.

A preliminary study about the interaction between basic fibroblast growth factor and signal transducer and activator of transcription 3 in glioma apoptosis / 中华外科杂志

<p><b>OBJECTIVE</b>To study the relationship of basic fibroblast growth factor (bFGF) and signal transducer and activator of transcription 3(STAT3) in glioma apoptosis and possible mechanisms of its interaction.</p><p><b>METHODS</b>Two glioblastomamultiforme (GBM) cell lines: U87 (wild-type p53) and U251 (mutant p53) were used in this study and divided into normal control group, mock group and experiment group.Small interfering RNA-carried recombinant lentivirus, LV-bFGFsiRNA and LV-STAT3siRNA, targeting bFGF and STAT3 were constructed respectively. After 48 hours of lentivirus transfection, small molecular inhibitors were used to block specific signaling pathways, AG490 20 µmol/L blocking JAK, LY294002 20 µmol/L blocking PI3K/Akt pathways for 24 hours, 48 hours and 72 hours, respectively. Then, apoptosis, changes in apoptosis-related proteins and mitochondrial membrane potential were detected through the methods of flow cytometry, protein chip and confocal microscopy, respectively.Groups were compared using single factor analysis of variance (One-way ANOVA).</p><p><b>RESULTS</b>Western blot results revealed the levels of Tyr705 and Ser727 phosphorylationin reduced in a time dependent manner by blocking JAK and PI3K/Akt pathway respectively. The results of flow cytometry showed that the apoptosis rate in normal control group, mock group, experiment group were 17.97% ± 0.24%, 18.26% ± 0.88%, 46.57% ± 1.63% in U87 cells and 15.94% ± 1.18%, 16.88% ± 0.17%, 39.34% ± 0.87% in U251 cells, respectively. There was no statistically significant change between the normal control group and the mock group (P > 0.05) , while when compared with the experiment group, both group showed statistically significant difference (F = 697.41, 729.58, both P < 0.05). The results of protein chip demonstrated that protein expression of Bad, Caspase3, Cytochrome C, p27 were higher and XIAP was lower in the experiment group compared with the normal control group and mock group. Also, confocal microscopy could detect apoptosis and mitochondrial membrane potential reduced significantly in the experimental group compared with the normal control group and the mock group.</p><p><b>CONCLUSIONS</b>bFGF mainly interacts with STAT3 tyrosine site-pSTAT3(Tyr705) to influence the level of STAT3 phosphorylation;blocking bFGF/STAT3 signaling pathway can induce glioma cell apoptosis through mitochondrial pathway.</p>

Biological characteristics of bone marrow mesenchymal stem cells from multiple myeloma patients before and after cryopreservation / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cells derived from multiple myeloma patients are characterized by pluripotential differentiation, immunoregulation and supporting hematopoiesis, but whether these features are affected after cryopreservation is unclear. OBJECTIVE:To study the biological characteristics of cryopreserved bone marrow mesenthymal stem cellderived from multiple myeloma patients. METHODS:Bone marrow mesenchymal stem cells derived from multiple myeloma patients were cryopreserved in-196 ℃ liquid nitrogen for 1 month (short term) and 12 months (long term) with Iscove’s modified Dulbecco’s medium containing 10%dimethyl sulfoxide and 40%fetal bovine serum as cryoprotectant. The viability and proliferation ability of thawed bone marrow mesenchymal stem cells were investigated. Hematopoiesis support of thawed bone marrow mesenchymal stem cells in vitro was detected by long-term bone marrow culture and the methylcellulose progenitor assay. The immunoregulatory ability of thawed mesenchymal stem cells was detected by mixed lymphocyte culture assay. RESULTS AND CONCLUSION:The cellviability was (92.9±7.5)%and (86.7±9.2)%for mesenchymal stem cells cryopreserved as long as 1 month or 12 months, respectively. Furthermore, thawed bone marrow mesenchymal stem cells possessed the ability of supporting colony forming and could significantly suppress proliferation of T lymphocytes. At last, there were no changes detected as compared with pre-cryopreserved mesenchymal stem cells in the abilities of proliferation, hematopoiesis support and immunoregulation. Cryopreservation can decrease the cellviability of bone marrow mesenchymal stem cells derived from the patients with multiple myeloma, but cannot affect the abilities of proliferation, hematopoiesis support and immunoregulation.