Effect of transcutaneous acupoint electrical stimulation at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy / 中国针灸

OBJECTIVE@#To evaluate the effect of transcutaneous acupoint electrical stimulation (TEAS) at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy.@*METHODS@#A total of 66 patients of primary lung cancer undergoing thoracoscopic lobectomy were divided to an observation group (33 cases, 1 case discontinued) and a control group (33 cases). In the observation group, TEAS at Neiguan (PC 6) was used 30 min before anesthesia induction till the end of surgery. The surgery time, maximum value of partial pressure of end-tidal carbon dioxide (PETCO2) and minimum value of oxygen saturation (SpO2) of the two groups were recorded. The dosage of propofol, sufentanil, remifentanil and dexmedetomidine were analyzed. Separately, before induction (T0), at the start of surgery (T1), thoracic exploration (T2) and lobectomy (T3), as well as 30 min (T4) and 60 min (T5) after lobectomy, the mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), serum cortisol (Cor) and norepinephrine (NE) were measured. The time of post anesthesia care unit (PACU) stay, ambulation, flatus, chest drainage and the incidence of nausea and vomiting were compared between the two groups.@*RESULTS@#The maximum value of PETCO2, the dosage of propofol and remifentanil in the observation group were lower than those in the control group (P < 0.05, P < 0.01), the minimum value of SpO2 in the observation group was higher than that of the control group (P < 0.01). At T1-T5, the MAP, HR, serum Cor and NE levels in the observation group were all lower than those in the control group (P < 0.05). The ambulation time, the time for the flatus, chest drainage time, and the incidence of nausea and vomiting in the observation group were all lower than those in the control group (P<0.001, P < 0.01).@*CONCLUSION@#For the general anesthesia under preserving spontaneous breathing in thoracoscopic surgery, TEAS at Neiguan (PC 6) relieves stress response, reduces opioids dosage and promotes postoperative recovery.

Detection of RAS gene mutation and its clinical significance in children with acute lymphoblastic leukemia / 中国当代儿科杂志

OBJECTIVES@#To investigate the mutation rate of the RAS gene and its clinical significance in children with acute lymphoblastic leukemia.@*METHODS@#A retrospective analysis was performed on the medical data of 120 children with newly diagnosed acute lymphoblastic leukemia, who were admitted to the Third Affiliated Hospital of Zhengzhou University from January 2015 to January 2020 and underwent next-generation sequencing. The clinical and molecular features were analyzed. The impact of RAS gene mutation on the overall survival rate was evaluated in these children.@*RESULTS@#Among the 120 children, 35 (29.2%) had RAS gene mutation, 30 (25.0%) had KRAS gene mutation, and 5 (4.2%) had both NRAS and KRAS gene mutations. All NRAS mutations and 71% (25/35) of KRAS mutations were located at the 12th and 13th codons. RAS gene mutation was detected in 35 (33.3%) out of 105 children with B-lineage acute lymphoblastic leukemia, but it was not detected in those with acute T lymphocyte leukemia. Of all the children, 11 (9.2%) were lost to follow-up, and among the 109 children followed up, 16 (14.7%) died. The children with RAS gene mutation had a significantly lower 2-year overall survival rate than those without RAS gene mutation (P<0.05). The prognosis of children with RAS gene mutation combined with WT1 overexpression and WBC>50×109/L at diagnosis was worse (P<0.05).@*CONCLUSIONS@#RAS gene mutation is commonly observed in children with B-lineage acute lymphoblastic leukemia and may have an adverse effect on prognosis.

Effect of electroacupuncture at Neiguan (PC 6) on pulmonary function during one-lung ventilation in patients with lobectomy / 中国针灸

OBJECTIVE@#To observe the protective effect of electroacupuncture (EA) at Neiguan (PC 6) on pulmonary function during one-lung ventilation (OLV) in patients with lobectomy, and explore its action mechanism.@*METHODS@#Sixty patients with lobectomy were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with general anesthesia, and OLV was given when surgery began; when the surgery finished, air was removed from the thoracic cavity and two-lung ventilation was performed. On the basis of the treatment in the control group, the patients in the observation group were treated with EA (disperse-dense wave, 2 Hz/100 Hz of frequency) at Neiguan (PC 6) 30 min before anesthesia induction until the end of the surgery. The pulmonary function indexes [arterial partial pressure of oxygen (PaO@*RESULTS@#Compared with T@*CONCLUSION@#EA at Neiguan (PC 6) has protective effects on lung injury induced by OLV after lobectomy, and its mechanism may be related to the improvement of oxidative stress and inflammatory response.

Clinical Analysis of B-Cell Non-Hodgkin Lymphoma Treated with Modified Conditioning Regimen / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy, safety and prognosis of auto-HSCT between classical and modified conditioning regimen in patients with B-cell non-Hodgkin lymphoma.@*METHODS@#36 patients diagnosed as B-cell non-Hodgkin lymphoma treated with autologous hematopoietic stem cell transplantation from January 2015 to June 2018 in Tianjin Cancer Hospital were retrospectively analyzed. The patients were divided into two groups: Idarubicin group and non-Idarubicin group. The overall survival (OS), progression-free survival (PFS), adverse reactions and hematopoietic reconstitution time between the two groups were compared. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox regression was used for multivariate analysis.@*RESULTS@#The median follow-up time was 29 months. Among these 36 patients with B-cell non-Hodgkin lymphoma before transplantation, 21 patients achieved CR and 15 patients achieved PR. The reconstitution time of neutrophil (P>0.05) and platelet (P>0.05) was not significantly different between Idarubicin and non-Idarubicin group. Also, the adverse reactions were not significantly different between two groups. The addition of idarubicin showed not aggravate the adverse reactions of patients. The OS and PFS of patients with idarubicin was longer than that of patients without idarubicin. The multivariate analysis showed that, the modified conditioning regimen and the remission state before transplantation were closely associated with prognosis.@*CONCLUSION@#The above-mentioned results indicated that the combination of modified conditioning regimen with idarubicin can lengthen the OS and PFS of the patients significantly, and show not aggravate of bone marrow inhibition, moreover, the hematopoietic reconsititution time show not lengthen, which means that it can be a safe and effective choice for autologous HSCT in the patients with B cell non-Hodgkin lymphoma.

Effect of Exercise on Expression of NeuN and SynapsinI in Cortex and Cognitive Function in Rats after Cerebral Ischemia-reperfusion / 中国康复理论与实践

Objective:To observe the effect of exercise on cognitive function and the expression of NeuN and SynapsinI in prefrontal cortex of rats after cerebral ischemia-reperfusion. Methods:Forty health male Sprague-Dawley rats were randomly divided into sham group (S group, n = 10), model group (M group, n = 10), sham & exercise group (SE group, n = 10) and model & exercise group (ME group, n = 10). The left middle cerebral artery was occluded for one hour and reperfused. SE and ME groups accepted treadmill training, for 14 days. The cognitive function of rats was evaluated with open field experiment and new object recognition experiment. The number and distribution of nerve cells in rat brain were observed with Nissl staining and immunofluorescence staining. The SynapsinI expression in serum was detected with ELISA. Results:Compared with S group, the activity, times of crossing, length and activity time in central area of open field experiment decreased in M group, as well as the cognitive index and length of new object recognition experiment (P < 0.05). Compared with M group, all the indexes increased in ME group (P < 0.05). The number of Nissl bodies decreased in M group (P < 0.05) and the arrangement was disordered, while the number of Nissl bodies increased in ME group (P < 0.05) compared with M group. The NeuN positive cells was more in S group than in M group (P < 0.05), and it was more in ME group than in M group (P < 0.05); as well as that of SynapsinI. The expression of SynapsinI decreased in M group (P < 0.05), and increased in ME group (P < 0.05). Most results of behavioral experiments positively correlated with the expression of Nissl, NeuN and SynapsinI (r > 0.221, P < 0.05). Conclusion:Cerebral ischemia-reperfusion can cause cognitive impairment in rats. Exercise can alleviate nerve injury and improve cognitive function, which may relate to promoting the expression of NeuN and SynapsinI in prefrontal cortex, to increase the number of neurons and synapses.

Preparation and in vitro release study of ligustrazine pamoate sustained-release nanosuspension / 中草药

Objective: To prepare ligustrazine pamoate (Lig-PAM) sustained-release nanosuspension (Lig-PAM-NSps) and determine its in vitro release characteristics. Methods: Lig-PAM was prepared by hydrophobic salt formation method and its physicochemical properties were characterized. Then, Lig-PAM-NSps was prepared by miniaturized medium grinding method. The prescription and preparation process of Lig-PAM-NSps were optimized by the single factor and orthogonal experiment with average particle size, polydispersity index (PDI) and stability coefficient (SI) as indicators. Lig-PAM-NSps was characterized, and its stability and in vitro release was also investigated. Results: The compound ratio of Lig-PAM prepared by Lig and PAM in the amount of 1:1 was (97.48 ± 0.04)%. Compared with Lig, the solubilities of Lig-PAM in water and simulated body fluids were decreased by 95.50% and 77.39%, respectively. Fourier transform infrared spectroscopy (FT-IR) and X-ray powder diffraction (XRD) showed that the Lig and PAM formed Lig-PAM. The optimum prescription size of Lig-PAM-NSps was (585 ± 5) nm, PDI was (0.328 ± 0.015) and SI was (0.928 ± 0.012). The scanning electron microscopy (SEM) showed that Lig-PAM-NSps was spherical with uniform size distribution, and the particle size was about 600 nm and its physical stability was good within 60 d. The results of in vitro release showed that Lig-PAM-NSps had obvious sustained-release effect compared with Lig solution within 48 h, and showed the first-order release characteristics [ln(1-Q) = 0.153 67 t + 80.458 14, r = 0.998 26]. Conclusion: The preparation progress of Lig-PAM-NSps is stable and can release Lig slowly in vitro.

Clinical Characteristics of 219 Patients with Primary Gastrointestinal Non-Hodgkin's Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical and pathological characteristics of primary gastrointestinal non-Hodgkin's lymphoma (PGI-NHL) patients, and to explore the factors affecting the patients' survival and prognosis.@*METHODS@#The clinical data of 219 patients with PGI-NHL diagnosed in our hospital from March 2009 to April 2016 was collected and retrospectively analyzed. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison among the groups, and Cox regression was used for multivariate analysis.@*RESULTS@#Among the 219 patients with PGI-NHL, 126 patients were males and 93 patients were females. 182 patients were IPI 0 to 2 and 37 patients were IPI 3 to 5. There were 205 cases (93.6%) of B cell phenotype and 14 cases (6.4%) of T cell phenotype. 140 patients (63.9%) were patients with primary gastric NHL, including 85 DLBCL and 19 MALT. 79 cases (36.1%) were patients with primary intestinal NHL, including 46 DLBCL, 4 MALT, 7 FL, 3 MCL and 4 Burkitt lymphoma. 23 cases were HP positive and received anti-HP therapy. 57 cases and 32 cases received surgery and chemotherapy respectively. 84 cases received combination treatment of surgery and chemotherapy and 11 cases received combination treatment of radiotherapy and chemotherapy. Overall survival (OS) of indolent B-cell non-Hodgkin's lymphoma was longer than that of invasive B-cell non-Hodgkin's lymphoma, which shows better prognose. Kaplan-Meier analysis showed that there was no difference between progression-free survival (PFS) and OS in the patients with different origin sites, age and sex. There was no significant difference in PFS between B-cell and T-cell-derived patients, whereas OS of B-cell-derived PGI-NHL patients was longer than that of T-cell-derived PGI-NHL patients. The OS and PFS of patients with IPI 0-2 were longer than those of patients with IPI 3-5. According to Lugano and Ann Arbor staging systems, there was no difference in prognosis of patients between phase I/II and III/IV. The prognosis of patients treated with surgery alone was worse than that of patients treated with combination therapy, and the prognosis of patients with surgery combined with chemotherapy was not significantly different from that of patients with chemotherapy alone.@*CONCLUSION@#B-cell phenotype, indolent and low IPI score lymphoma indicate better prognosis, while that of different origin site, sex and age shows no different in prognosis. Surgery is used only for emergency case or pathological materials, and these patients should be treated with chemotherapy-based combined treatment.

Research Advance of Exosomes in the Immune Microenvironment of Hematological Malignancies--Review / 中国实验血液学杂志

Exosomes are microvesicles that can be secreting in many kinds of cells, under the condition of normal and pathology. Exosomes contain abundant proteins, miRNAs and RNA fragments, which play an important role in communicating between cells, especially non-contact cells. The interaction between blood tumor cells and immune microenvironment is inseparable from the involvement of exosomes. Exosomes are involved in the interaction among tumor cells, NK cells, T cells, stromal cells and endothelial cells, such as promoting the proliferation of blood tumor cells, helping blood tumor cells to achieve immune evasion, promoting angiogenesis and migration of tumor cells. Therefore, exosomes are closely related to the diagnosis, treatment and prognosis of hematological tumors. In this review, the basic characteristics of exosomes, the important role of exosomes in the immune microenvironment of hematological tumors, and the research progress of exosomes in clinical applications was sammrized briefly.

Study on puerarin dispersible tablet based on solubilization effect of glycyrrhizic acid / 中国中药杂志

Based on the fact that glycyrrhizic acid can form micelles in aqueous solution and play a role in solubilization, the optimal compatibility ratio between puerarin and glycyrrhizic acid was screened to prepare puerarin-glycyrrhizic acid dispersible tablets and investigate the dissolution of puerarin. The particle size, Zate potential and puerarin dissolution were compared among the micellar solutions with mass ratio of 7∶1, 6∶1, 5∶1, 4∶1, 3∶1 and 2∶1(puerarin to glycyrrhizic acid), and it was found that when the mass ratio of puerarin and glycyrrhizic acid was 5∶1, the micelle showed smallest particle size, uniform distribution, and largest puerarin dissolution, so mass ratio of 5∶1 was determined as the optimal condition. The formulation of puerarin-glycyrrhizic acid dispersible tablets was optimized by single factor and orthogonal test: puerarin 100.0 mg, glycyrrhizin 20.0 mg, polyvinylpolypyrrolidone 24.0 mg as disintegrating agent, microcrystalline cellulose 135.0 mg as stuffing bulking agent, hydroxypropyl methyl cellulose 18.0 mg as adhesive agent, magnesium stearate 2.7 mg as lubricant, and tablet weight of 300.0 mg. High-performance liquid chromatography(HPLC) method was used to determine the content of puerarin in dispersible tablets. Puerarin showed a good linear relationship(r=0.999 8) in the range of 15.5-248 g·L~(-1), with high precision(RSD<2.0%) and good repeatability(RSD<2.0%), and the recovery rate was 101.1%, RSD 0.89%. There was no significant difference in the quantity of puerarin in different batches of puerarin-glycyrrhizic acid dispersible tablets. When the artificial gastric juice was used as the dissolution medium, the dissolution of puerarin in puerarin-glycyrrhizic acid dispersible tablets could reach over 85% within 15 min. When phosphate buffer(pH 6.8) was used as the dissolution medium, the dissolution of puerarin in the puerarin-glycyrrhizic acid dispersible tablets had a faster dissolution rate in vitro, 99.8% in 30 min. Therefore, puerarin-glycyrrhizic acid dispersible tablets could improve the dissolution of puerarin in vitro due to the solubilization effect of glycyrrhizic acid.

Comparison of Different Staging Systems and Prognostic Analysis in 68 Cases of Primary Intestinal Diffuse Large B Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To compare the prognostic value of different staging systems in primary intestinal diffuse large B cell lymphoma（PI-DLPCL）, and their correlation with clinicopathological characteristics，treatment and prognosis of PI-DLBCL.@*METHODS@#A total of 68 patients with PI-DLBCL were recruited from January 2009 to July 2017. All the patients underwent staging by using TNM, Lugano, Blackledge and Musshoff system, survival curves for the PI-DLBCL patients were plotted using the Kaplan-Meier method and were judged by the log-rank test. The accuracy of each staging system for predicting survival of PI-DLBCL patients was evaluated by calculating the area under curve(AUC) of the receiver operating characteristic(ROC). The correlation of the 4 staging systems, clinical features patients and treatment regimes with PFS and OS were analysed.@*RESULTS@#The median follow-up time was 52 (1-105) months, the median PFS time was 41(1-86) months, patients did not reached the median OS time. The most frequently involved site was ileocecal (30.9%), followed by small intestine (29.4%) and colon (29.4%), multiple sites involvement (7.4%) and rectum (2.94%)．The PFS and OS rates at 5-year were 44.9% and 51.1%, respectively. Kaplan-Meier survival curves and log-rank test results showed that using different staging systems to describe the cumulative retention rates of PFS and OS in PI-DLBCL patients, none of the 4 staging systems can distinguish the survival curves of each stage significantly. The results of ROC curve showed that the prediction ability of the Lugano staging system was better than other staging system for 1 year PFS （AUC=0.826；P=0.015）and 1 year OS（AUC=0-792；P=0.001） in PI-DLBCL patients. The 3 year PFS rate in the operation+chemo or radio-therapy group (62 cases) and the single operation group (6 cases) were 53.9% and 16. 7%,respectively（P=0.116），The 3 year OS rate were 66.7% and 16.7%（P=0.015）,respectively. Patients who received chemotherapy combined with rituximab had a higher 3-year PFS(66.0％ vs 44.0％，P=0.139) and 3.year OS(70.2% vs.39.2%，P=0.148).The patients with ileocecal lesion had higher PFS rate and OS rate than other sites(P<0.05). Multivariate Cox regression analysis indicated that only bone marrow invasion was an independent prognostic factor in patients with PFS.@*CONCLUSION@#Bone marrow invasion is an independent risk factor for PFS in patients with PI-DLBCL , according to this limited preliminary data，Lugano staging system for stratifying and predicting the prognosis of PI-DLBCL patients is better than other staging system.

Life Quality and Its Related Factors of Patients with Multiple Myeloma during Maintenance Therapy / 中国实验血液学杂志

OBJECTIVE@#To evaluate the quality of life (QOL) on patients with multiple myeloma(MM) during maintenance therapy and to explore the related factors important for QOL.@*METHODS@#The demography, clinical and laboratorial data of 66 MM patients during maintenance therapy were collected and explored by using a cross-sectional question naire(EORTC QLQ C30 V 3.0). The statistical analysis was performed using Nowegram normal mode(NM) and reference values(RV) of MM patients which were used as control.@*RESULTS@#In comparison with Nowegran normal mode, the scores of general health status, physical function, role function and social function of patients during maintenance therapy were lower than those of normal mode (61.3, 73.9, 65.4 and 65.2 vs 75.3, 89.9, 83.3 and 85.8 respectively), while the scores of constipation and financial difficulty were higher than those of normal mode(16.7 and 44.4 vs 10.7 and 9.7 respectively) (P<0.05). In comparison with reference values, the scores of general health status, emotional and coguitive functions of patients during maintenance therapy were significantly higher than those of reference values(61.3, 81.7 and 84.3 vs 55.7, 71.3 and 78.1 respectively) (P<0.05). In addition, the maintenance therapy yet decreasd the scores of fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss and constipation of patients, but increased the score of financial difficulty of patients (P<0.05). The age of initial diagnosis, serum LDH level, peripheral neuropathy, high ratio of own expense and underlying diseases were main factors affecting the general health status of patients (P<0.05), while the decrease of Hb level, increase of blood Ca level and accompanied genetic changes negatively influence the QOL (P<0.05), while the high culture level showed positive effect on QOL (P<0.05). The choise of drugs for maintenace (therapy thalidomide and bortezomib) not had significant effect on QOL of patients.@*CONCLUSION@#The maintenance therapy can improve the QOL of MM patients, the age at initial diagnses, serum LDH level, peripheral neuropathy and high ratio of own expence are the main factors affecting the QOL of MM patients.

Identification of New Designer Benzodiazepine Diclazepam in Drug Facilitated Sexual Assault / 法医学杂志

OBJECTIVES@#To identify the new designer drugs which are totally unknown and not in the routine testing list by the technologies such as high-resolution mass spectrometry in drug facilitated sexual assault, in order to solve the problem in actual cases.@*METHODS@#The milky fluid from an actual case was extracted and analyzed using LC-QE, ¹H-NMR and GC-MS, respectively. The accurate masses and cluster ions isotope patterns of unknown compound were obtained by LC-QE. The molecular formula was confirmed as C₁₆H₁₂C₂N₂O based on the protons number of ¹H-NMR. The isomers diclazepam and 4-chlorodiazepam were separated and detected with GC-MS.@*RESULTS@#The new designer benzodiazepine as diclazepam in the milky fluid was identified. The results provided direct evidence for the investigation and qualitative analysis of such cases.@*CONCLUSIONS@#The combined application of various methods, including LC-QE, ¹H-NMR and GC-MS, can be used to detect unknown new psychoactive substances.

Clinical Analysis on the Therapeutic Efficacy of Autologous Hematopoietic Stem Cell Transplantation in 56 Multiple Myeloma Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic efficacy and prognosis of autologous stem Hematopoietic cell transplantation (auto-HSCT) in multiple myeloma (MM) patients.</p><p><b>METHODS</b>A retrospective study was conducted for 56 patients diagnosed with MM and then received auto-HSCT in our hospital from December 2008 to September 2016.</p><p><b>RESULTS</b>All the patients successfully underwent hematopoietic reconstruction without transplantation-related mortality (TRM). The complete response (CR) rate of all the patients after induction chemotherapy was 23.2% (13/56), while the CR rate of these patients with auto-HSCT increased to 78.6% (44/56) (P<0.01). The CR plus VGPR (very good partial response) rates of these 56 patients after induction chemotherapy and auto-HSCT were 53.6%（30/56）and 94.6%（53/56） respectively (P<0.01). The median progression-free survival (PFS) time and median overall survival (OS) time were 37 and 71 months, respectively. The median PFS time in the patients with induction therapy containing bortezomib was 37 months, however, the median OS time did not reach to 71 months; the median PFS (P<0.01) and the median OS (P<0.01) in the patients with the induction chemotherapy without bortezomib was 27 and 51 months, respectively. Univariate analysis demonstrated that the patients maintained CR or VGPR after auto-HSCT or with less than 6 cycles of induction chemotherapy significantly correlated with PFS (P<0.01).</p><p><b>CONCLUSION</b>auto-HSCT can further increase the CR rate, prolong PFS and OS time. Sequential auto-HSCT after bortezomib-based therapy is the first line therapy for the transplant-eligible MM patients. Maintenance treatment is beneficial to the sustained CR+VGPR patients after auto-HSCT.</p>

Progress of Auto-HSCT for Treatment of DLBCL--Review / 中国实验血液学杂志

Diffuse large B cell lymphoma（DLBCL）is the most common non-Hodgkin's lymphoma in adults，accounting for 30%-40% of non-Hodgkin's lymphoma in adults. The treatments of this lymphoma mainly include chemotherapy，radiotherapy and autologous hematopoietic stem cell transplantation. A large amount of studies show that autologous hematopoietic stem cell transplantation considered as the main treatmant approach can be used for primary high-risk young and relapsed or refractory DLBCL patients. Many scholars have evaluated the effectiveness of autologous hematopoietic stem cell transplantation for primarily high-risk young and relapsed or refractory DLBCL patients，and tried to improve the effectiveness of transplantation that showed some advantagcs for DLBCL patients.

Clinical Analysis of Maintenance Therapy with Thalidomine and Bortezomib for Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To evaluate the therapeutic effect and adverse reactions of the maintenance therapies with Thalidomine or Bortezomib in the patients with newly diagnosed multiple myeloma (MM), so as to provide a reference for clinical treatment.@*METHODS@#A retrospective analysis was conducted to compare the progression-free survival (PFS), overall survival (OS) and adverse reaction rate of 23 MM patients received the maintenance therapies of Bortezomib and of 68 MM patients received maintenance therapy of Thalidomine.@*RESULTS@#The maintenance therapy with Bortezomib could extend the PFS of MM patients as compared with Thalidomine (PFS rate of patients on the maintenance therapy of Bortezomib in 12th, and 24th month was 100%, 88.89%, and that of Thalidomine-treated group was 72.31%, 47.54%). What's more, some specific patients could get better 2-year PFS rate in Bortezomib group than that in Thalidomine group, such as older than 65 years old, after autologous hematopoietic stem cell transplantation(ASCT), having genetic changes, extramedullary lesions, poor renal function, low serum free light chain ratio, high β2-MG, anemia, high LDH, VGPR of induction and consolidation therapy. The OS rate of Bortezomib on 18th, 24th and 30th month was 100%, 88.89%, 80% verus 91.52%,83.63%,72.90% of the group with thalidemide at the same time. As for 2-year OS rate, the Bortezomib group was higher than Thalidomine without statistical differences. However, the patients such as older than 65 years old, poor renal function and with extramedullary lesions, would also get higher 2-year OS rate from Bortezomi. Bortezomib and thalidomide could cause bone marrow suppression, peripheral neuritis and other adverse reactions.@*CONCLUSION@#The efficacy of maintenance therapy with Bortezomib is superior to thalidomide. As a conclusion, bortezomib is a better option for maintenance therapy of MM patient.

Advances in the Molecular Diagnosis and Therapy of Relapsed/Refractory Diffuse Large B-cell Lymphoma -Review / 中国实验血液学杂志

Diffuse large B-cell lymphoma (DLBCL) is biologically aggressive and most common pathological type of non-Hodgkin's lymphoma (NHL), and about one-third of these patients are refractory or relapsed ultimately. Based on the molecular heterogeneity, DLBCL can be divided into 3 main molecular subtypes: germinal center B-cell like (GCB), activated B-cell like (ABC) and primary mediastinal B-cell lymphoma (PMBL). Arising from B cells at distinct stages of differentiation, these subtypes are also diverse in mechanisms of oncogenic activation. So targeting specific oncogene addictions within the DLBCL subtypes offers a more-precise approach to therapy in comparison with the traditional chemotherapies, undoubtedly bringing a bright hope for the treatment of relapsed/refractory DLBCL. In this article, the advances in diagnosis and therapy of GCB-DLBCL, ABC-DLBCL and PMBL relapsed/refractory diffuse large B-cell lymphoma are summarized.

Evaluation of Brodifacoum-induced Toxicity by Metabonomics Approach Based on HPLC-TOF-MS / 法医学杂志

OBJECTIVES@#To analyse the metabolic changes in urine of rats with brodifacoum intoxication, and to reveal the molecular mechanism of brodifacoum-induced toxicity on rats.@*METHODS@#By establishing a brodifacoum poisoning rats model, the urine metabolic profiling data of rats were acquired using high performance liquid chromatography-time of flight mass spectrometry （HPLC-TOF-MS）. The orthogonal partial least squares analysis-discrimination analysis （OPLS-DA） was applied for the multivariate statistics and the discovery of differential metabolites closely related to toxicity of brodifacoum.@*RESULTS@#OPLS-DA score plot showed that the urinary metabolic at different time points before and after drug administration had good similarity within time period and presented clustering phenomenon. Comparing the urine samples of rats before drug administration with which after drug administration, twenty-two metabolites related to brodifacoum-induced toxicity were selected.@*CONCLUSIONS@#The toxic effect of brodifacoum worked by disturbing the metabolic pathways in rats such as tricarboxylic cycle, glycolysis, sphingolipid metabolism and tryptophan metabolism, and the toxicity of brodifacoum is characterized of accumulation effect. The metabonomic method based on urine HPLC-TOF-MS can provide a novel insight into the study on molecular mechanism of brodifacoum-induced toxicity.

Biological characteristics and clinical observation of autologous nasal mucosa mesenchymal stem cells in the treatment of spinal cord injury / 中国组织工程研究

BACKGROUND:Stem cells have been widely used in the treatment of spinal cord injury,but the clinical application is limited by immune rejection,difficulty in cell harvesting and purification.However,human nasal mucosa mesenchymal stem cells (hNM-MSCs) have no such problems,and its clinical application in the treatment of spinal cord injury has been not reported yet.OBJECTIVE:To observe the biological characteristics of autologous hNM-MSCs and its clinical efficacy in the treatment of advanced incomplete spinal cord injury.METHODS:NM-MSCs were isolated from the human nasal mucosa,cultured and identified in vitro.The ultrastructure of NM-MSCs was observed by transmission electron microscope and scanning electron microscope.Then the NM-MSCs were induced to differentiate into osteocytes,adipocytes,stem cell spheres,or neurons in vitro.Totally eight patients with incomplete spinal cord injury were enrolled and subjected to hNM-MSCs transplantation via lumbar puncture for 1-3 sessions of about 5× 107 cells each,with an interval of 5-7 days,after the approval of the medical ethics committee.All the patients were followed up for 6 months.Preoperative and postoperative therapeutic effect evaluations were performed on the basis of American Spinal Injury Association (ASIA) scores.RESULTS AND CONCLUSION:Under light microscope,the NM-MSCs were mainly spindle-shaped,positive for STRO-1 and exhibited a radial arrangement.NM-MSCs highly expressed CD73,CD90 and CD105,but did not express CD34 and CD45,with the purity of over 97％.And lots of podgy microvilli were seen on the surface of NM-MSCs under the scanning electron microscope,and two kinds of cell morphologies were seen under the transmission electron microscope.Moreover,hNM-MSCs had the ability to differentiate into osteocytes,adipocytes,stem cell spheres and neurons.During the 6-month follow-up,seven patients achieved neurological function recovery to different extents except for one patient,and no side effects were found.It is concluded that hNM-MSCs can become the ideal seed cells for tissue-engineered cell repair.Autologous NM-MSCs transplantation for the treatment of spinal cord injury can achieve the ideal effect,with the value of clinical application.

Identification of Methamphetamine Abuse and Selegiline Use: Chiral Analysis of Methamphetamine and Amphetamine in Urine / 法医学杂志

Objective To study the content variation of selegiline and its metabolites in urine, and based on actual cases, to explore the feasibility for the identification of methamphetamine abuse and selegiline use by chiral analysis. Methods The urine samples were tested by chiral separation and LC-MS/MS method using CHIROBIOTICTM V2 chiral liquid chromatography column. The chiral analysis of metham-phetamine and amphetamine were performed on the urine samples from volunteers of selegiline use and drug addicts whom suspected taking selegiline. Results After 5 mg oral administration, the positive test time of selegiline in urine was less than 7 h. The mass concentrations of R(-)-methamphetamine and R(-)-amphetamine in urine peaked at 7 h which were 0.86μg/mL and 0.18μg/mL and couldn't be de-tected after 80 h and 168 h, respectively. The sources of methamphetamine and amphetamine in the urine from the drug addicts whom suspected taking selegiline were analysed successfully by present method. Conclusion The chiral analysis of methamphetamine and amphetamine, and the determination of selegi-line's metabolites can be used to distinguish methamphetamine abuse from selegiline use.

Progress on Treatment of Splenic Marginal Zone Lymphoma-Review / 中国实验血液学杂志

Splenic marginal zone lymphoma (SMZL) is an uncommon indolent B-cell non-Hodgkin's lymphoma. The clinical features of SMZL are splenomegaly, lymphocytosis and cytopenia in peripheral blood. Immunopheno-typically, the neoplastic cells are typically positive for CD45, CD20, CD79a, PAX5, IgD, BCL-2. The previous common used treatment is splenectomy and chemotherapy. Nowadays, rituximab-based chemotherapy regimens has improved the curative effect dramaticlly. IFN-α with or without ribavirin can be used to treat the patients with HCV infection. Some new target agents such as Bruton tyrosine kinase, NOTCH inhibitor, CAL-101 are under clinical research. This review mainly discuss the progress in the treatment of SMZL.