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1.
Article in Chinese | WPRIM | ID: wpr-984594

ABSTRACT

ObjectiveTo carry out the clinical comprehensive evaluation of Biantong capsules and Biantong tablets in the treatment of constipation guided by the clinical value of drugs, and to provide a scientific basis for the rational pricing, rational use, and cataloging of Biantong capsules/tablets. MethodThe available evidence and survey data were used for the clinical comprehensive evaluation of Biantong capsules/tablets and three control drugs in the treatment of constipation in terms of the six dimensions including effectiveness, safety, economics, innovation, suitability, and accessibility. ResultIn terms of effectiveness, Biantong capsules/tablets can improve the response rate, with clear pharmacological mechanism. In terms of safety, the absence of toxic reaction, the mild adverse reactions, and the favorable prognosis indicate high safety. In terms of economics, the average daily cost of Biantong capsules/tablets is the lowest among the tested drugs, which indicates a cost-effectiveness advantage. In terms of innovation, Biantong capsules/tablets have been authorized patents in China and listed as members in the third category of new drugs of traditional Chinese medicine/ninth new drugs of traditional Chinese medicine. In terms of suitability, Biantong capsules/tablets are convenient to store and take and have good suitability in terms of drug technical characteristics and drug usage. In terms of accessibility, Biantong capsules/tablets have a wide coverage in hospitals, sufficient capacity, low patient burden, extensive drug catalogue coverage, and no major environmental risk for long-term application. The comprehensive values of the tested drugs follow a descending order of control drug B (84.27 score), Biantong capsules/tablets (82.47 score), control drug A (70.47 score), and control drug C (59.46 score). The recommendations of the expert panel are Class A (18/18), which can be directly converted into decision-making. ConclusionBiantong capsules/tablets demonstrate a high clinical comprehensive value in the treatment of constipation, providing a reference for the rational pricing, rational use, and cataloging of drugs.

2.
Article in Chinese | WPRIM | ID: wpr-988184

ABSTRACT

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.

3.
Article in Chinese | WPRIM | ID: wpr-975159

ABSTRACT

ObjectiveTo explore the effects of Bushen Jianpi prescription on the autophagy and phosphatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway in the patients with aplastic anemia (AA). MethodA total of 30 AA patients admitted to Xiyuan Hospital and 6 healthy donors who were prepared to undergo peripheral blood hematopoietic stem cell transplantation in 304 Hospital from September 2020 to August 2021 were enrolled and assigned into an AA group and a control group. The AA group was treated with Bushen Jianpi prescription combined with cyclosporin A (CsA) and androgen for 3 months. The mononuclear cells from bone marrow in the AA group before and after treatment and the peripheral blood of the control group were collected. Transmission electron microscopy was then employed to detect autophagosomes. Western blotting was employed to determine the protein levels of microtuble-associated protein 1 light chain 3 (LC3)Ⅰ, LC3Ⅱ, mTOR, phosphorylated (p)-mTOR, Akt, p-Akt, PI3K, and p-PI3K, and real-time polymerase chain reaction (PCR) to determine the mRNA levels of LC3, mTOR, Akt, and PI3K. ResultIn the AA group, the treatment was completed in 29 patients, and the total response rate was 51.72% (15/29). ① The AA group showed lower levels of white blood cell (WBC), hemoglobin (HGB), platelet (PLT), and absolute neutrophil count (ANC) in the peripheral blood (P<0.01) and lower number of intracellular autophagosomes than the control group before treatment. Moreover, the AA group showed lower mRNA level of LC3 (P<0.01) and protein levels of LC3Ⅰ and LC3Ⅱ (P<0.01) and higher mRNA levels of mTOR, Akt, and PI3Kα (P<0.01) and protein levels of Akt, p-Akt, PI3K, p-PI3K, mTOR, and p-mTOR (P<0.01) than the control group. ② In AA group, the levels of HGB and PLT elevated (P<0.05) and the number of intracellular autophagosomes increased after treatment compared with those before treatment. Moreover, the mRNA level of LC3 and the protein levels of LC3Ⅰ and LC3Ⅱ were up-regulated (P<0.01), the mRNA levels of mTOR, Akt, and PI3Kα (P<0.01) and the protein levels of Akt, p-PI3K (P<0.01), p-Akt, PI3K, mTOR, p-mTOR (P<0.05) were down-regulated after treatment. ConclusionAA patients show lower autophagy levels, while Bushen Jianpi prescription can effectively improve the autophagy level and down-regulated the expression of PI3K/Akt/mTOR signaling pathway in AA patients.

4.
Article in Chinese | WPRIM | ID: wpr-975158

ABSTRACT

ObjectiveTo explore the clinical effect of kidney-tonifying and blood-generating method and qi-promoting and blood-nourishing method combined with western medicine on the treatment of aplastic anemia and the characteristics of blood routine recovery, and to explore a new phased treatment model for aplastic anemia. MethodThis study was based on a prospective, multicenter, double-blind, and randomized controlled clinical trial. Patients with aplastic anemia from 19 centers were analyzed and divided into a kidney-tonifying and blood-generating group and a Qi-promoting and blood-nourishing group, which were treated with traditional Chinese medicine (TCM) combined with western medicine. The clinical effect and the changes in blood routine in each group during treatment were evaluated. ResultDuring the observation period, 375 cases of aplastic anemia were included in two groups, and TCM syndrome differentiation conformed these cases as Qi-deficiency type and both Qi and blood-deficiency type. These cases were randomly divided into two groups, including 184 in the kidney-tonifying and blood-generating group and 191 in the Qi-promoting and blood-nourishing group, being treated by kidney-tonifying and blood-generating granules and Qi-promoting and blood-nourishing granules, respectively, and combined oral androgen and ciclosporin soft capsules. The treatment lasted for six months and was divided into three stages. Visits were conducted from the beginning of the treatment to the end of the first, fourth, and sixth months. The curative effect was evaluated six months later. The total effective rate of the kidney-tonifying and blood-generating group was 86.4% (159/184), which was significantly better than that of the Qi-promoting and blood-nourishing group [68.6% (131/191), P<0.01)]. The results of the percentage quartile of blood cell growth in each stage of the 2 groups were analyzed. The hemoglobin concentration and platelet count of the patients in the kidney-invigorating blood group continued to increase after treatment, and significantly increased in the second and third stages compared with the first stage (P<0.05). The increase of reticulocyte count was most significant in the first stage of treatment (P<0.05). The reticulocyte count in supplementing Qi and nourishing blood group increased significantly in the first and second stages of treatment (P<0.05). The other observation indicators increased at each stage, but there was no statistical difference in the growth rate. The effects of the two groups were compared by stages. In the second stage of treatment, the increase of hemoglobin concentration in the kidney-invigorating blood group was better than that in the supplementing Qi-nourishing blood group (P<0.05). The increase of platelet count and red blood cell count in supplementing Qi and nourishing blood group was greater (P<0.05). In the third stage of treatment, the increase of hemoglobin concentration in the bushen Shengxue group was more significant (P<0.05). ConclusionThe overall effective rate of the kidney-tonifying and blood-generating method in the treatment of aplastic anemia is better than that of the Qi-promoting and blood-nourishing method, with significant effects and safety. This study has proposed a three-stage early treatment mode for aplastic anemia. The first and third stages (0-1, 5-6 months) were mainly treated by invigorating kidney and generating blood. In the second stage of treatment (2-4 months), invigorating kidney and generating blood combined with invigorating Qi and nourishing blood were adopted. It may be closer to the actual clinical treatment response and objective rule changes of aplastic anemia.

5.
Article in Chinese | WPRIM | ID: wpr-975157

ABSTRACT

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.

6.
Article in Chinese | WPRIM | ID: wpr-973150

ABSTRACT

Gastroesophageal reflux disease (GERD) is a frequently and commonly occurring disease in clinic. In recent decades, with the development in pathophysiology and drug researches, modern medicine has achieved remarkable progress and results in diagnosis and treatment. However, the treatments for non-erosive reflux disease, refractory gastroesophageal reflux disease, proton pump inhibitor resistance, overlap of disease symptoms, and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine (TCM) was widely used in clinical practice, which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine (CACM) and undertaken by the Spleen and Stomach Disease Branch of CACM, "the 12th Youth Salon of Clinical Predominance Disease Series (GERD)" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions, improvement and maintenance of symptoms, response to overlapping disease symptoms, reduction and withdrawal of acid suppressors, and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths, combing the difficulties of modern medical diagnosis and treatment, which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.

7.
Article in Chinese | WPRIM | ID: wpr-970669

ABSTRACT

At present, the incidence of Parkinson's disease (PD) is gradually increasing. This seriously affects the quality of life of patients, and the burden of diagnosis and treatment is increasing. However, the disease is difficult to intervene in early stage as early monitoring means are limited. Aiming to find an effective biomarker of PD, this work extracted correlation between each pair of electroencephalogram (EEG) channels for each frequency band using weighted symbolic mutual information and k-means clustering. The results showed that State1 of Beta frequency band ( P = 0.034) and State5 of Gamma frequency band ( P = 0.010) could be used to differentiate health controls and off-medication Parkinson's disease patients. These findings indicated that there were significant differences in the resting channel-wise correlation states between PD patients and healthy subjects. However, no significant differences were found between PD-on and PD-off patients, and between PD-on patients and healthy controls. This may provide a clinical diagnosis reference for Parkinson's disease.


Subject(s)
Humans , Parkinson Disease/diagnosis , Quality of Life , Cluster Analysis , Electroencephalography , Healthy Volunteers
8.
Article in Chinese | WPRIM | ID: wpr-942342

ABSTRACT

ObjectiveTo evaluate the safety, efficacy, and economy of the four Chinese patent medicines (CPMs), including Simotang oral liquid, Liuwei Anxiao capsule, Baohe pill, and Jianwei Xiaoshi oral liquid in the treatment of functional dyspepsia (FD) by a rapid health technology assessment (RHTA), thus providing evidence support for clinical decision making. MethodChina National Knowledge Infrastructure (CNKI), WanFang Database, VIP Chinese Technology Periodical Database (VIP), China Biology Medicine disc (CBMdisc), PubMed, EMBASE, Cochrane Library, and Web of Science were searched by computer from inception to March 2022. After literature screening, data extraction, and quality evaluation, the descriptive analysis of the results combined with visual charts was performed. Nineteen studies were included, involving 18 randomized controlled trials (RCTs) and 1 Meta-analysis. Neither economic studies nor health technology assessment (HTA) reports were retrieved. ResultThe four CPMs were safe and effective in the treatment of FD, but economic research was lacking. Among them, Simotang oral liquid could be used for children with FD and FD caused by qi and food stagnation, liver and spleen disharmony, and liver and spleen stagnation. Liuwei Anxiao capsule could be used for adult patients with FD caused by food stagnation. Baohe pill could be used for the elderly with FD. Jianwei Xiaoshi oral liquid could be used for children with FD caused by spleen and stomach weakness. ConclusionThe four CPMs have their advantages in the treatment of FD. Among them, the clinical universality of Simotang oral liquid is higher. However, the quality of clinical evidence is generally low, and comparative analysis among drug dosage forms is lacking. In the future, it is necessary to improve, apply, and promote RHTA for rapid evidence production while carrying out a more standardized and scientific evidence-based demonstration of the comprehensive clinical efficacy of CPMs.

9.
Article in Chinese | WPRIM | ID: wpr-942340

ABSTRACT

This study systematically and comprehensively sorted out the application status of Chinese patent medicines for the treatment of constipation in the clinic, to provide scientific evidence for future research directions and clinical drug use in this field. Based on the method of scoping review, the Chinese patent medicines for the treatment of constipation were retrieved from three drug lists to obtain the medicines that needed to be evaluated. A comprehensive and systematic search was carried out on the included studies on the treatment of constipation by Chinese patent medicines through eight Chinese and English databases, and the included studies were integrated and analyzed. The results were displayed in combination with charts. Thirty-four Chinese patent medicines and 118 studies were included in this study. According to the efficacies, Chinese patent medicines were divided into 4 categories, namely eliminating accumulation, purging fire, promoting Qi, and moistening bowels, involving 125 Chinese medicines. The overall attention of constipation research is on the rise. Marenwan (granules or soft capsules) gained the highest attention, with 42 studies, followed by Qirong Runchang oral liquid, with 21 studies, and Biantong tablets (capsules), with 19 studies. There are 10 studies on Congrong Tongbian oral liquid. Seventeen Chinese patent medicines had no corresponding clinical research. There were 8 study design types, and all drugs were mainly randomized controlled trials except Danggui Longhui pill. Among the intervention types, the comparison between Chinese patent medicines and western medicines was the most. The highest outcome indicators were efficacy, safety evaluation, and main symptoms or scores, and there was a lack of a unified core outcome indicator set. There were few studies on adverse reactions and the economy. Only 11.86% of the studies were funded. Clinically, Chinese patent medicines are widely used in the treatment of constipation, and the amount of related research shows an increasing trend. However, some Chinese patent medicines lack corresponding clinical evidence, and the published research has problems such as unrigorous design, ununified criteria for efficacy evaluation, lack of comprehensive evidence studies, and insufficient funds. It is hoped that more investment will be made in this field in the future, and more attention will be paid to drugs with relatively blank research and constipation syndromes with few treatments. Comprehensive evidence studies such as systematic reviews should be carried out actively. And the study design should be standardized to provide reliable evidence for the treatment of constipation with Chinese patent medicines.

10.
Article in Chinese | WPRIM | ID: wpr-940801

ABSTRACT

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.

11.
Acta Pharmaceutica Sinica B ; (6): 2798-2818, 2021.
Article in English | WPRIM | ID: wpr-888888

ABSTRACT

Inflammatory bowel disease (IBD) is a chronic intestinal disease with painful clinical manifestations and high risks of cancerization. With no curative therapy for IBD at present, the development of effective therapeutics is highly advocated. Drug delivery systems have been extensively studied to transmit therapeutics to inflamed colon sites through the enhanced permeability and retention (EPR) effect caused by the inflammation. However, the drug still could not achieve effective concentration value that merely utilized on EPR effect and display better therapeutic efficacy in the inflamed region because of nontargeted drug release. Substantial researches have shown that some specific receptors and cell adhesion molecules highly expresses on the surface of colonic endothelial and/or immune cells when IBD occurs, ligand-modified drug delivery systems targeting such receptors and cell adhesion molecules can specifically deliver drug into inflamed sites and obtain great curative effects. This review introduces the overexpressed receptors and cell adhesion molecules in inflamed colon sites and retrospects the drug delivery systems functionalized by related ligands. Finally, challenges and future directions in this field are presented to advance the development of the receptor-mediated targeted drug delivery systems for the therapy of IBD.

12.
Journal of Chinese Physician ; (12): 1529-1532, 2020.
Article in Chinese | WPRIM | ID: wpr-867435

ABSTRACT

Objective:To investigate the expression changes of serum C-reactive protein (CRP) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in patients with acute viral infection and the value of clinical diagnosis and treatment.Methods:83 patients with acute viral infection in Hunan Provincial Brain Hospital from March 2018 to June 2019 were selected as the observation group, 81 patients with acute bacterial infection in the same period were selected as the control group A, and 81 healthy people as the control group B for prospective study. On the day of admission or physical examination, peripheral venous blood was drawn; the serum CRP and TRAIL levels were detected. The serum CRP and TRAIL levels of the three groups were compared, and the serum levels of CRP and TRAIL in different treatment groups were analyzed, and the application value of serum CRP and TRAIL in the diagnosis of acute viral infection was analyzed.Results:The serum CRP level of the observation group was lower than that of the control group A, which was higher than that of the control group B ( P<0.05); the serum TRAIL level of the observation group was higher than that of the control group A and B ( P<0.05); the area under the receiver operating characteristic (ROC) curve of the combined diagnosis of serum CRP and TRAIL was 0.921, which was higher than that of the two alone; When the cut-off value of CRP and TRAIL were 5.664 mg/L and 146.82 pg/ml, the combined diagnostic sensitivity was 95.00%, and the specificity was 80.00%; after treatment, the serum CRP and TRAIL levels of the observation group were significantly lower than those before treatment ( P<0.05), and the serum CRP and TRAIL levels of the effective group were lower than those of the ineffective group ( P<0.05). Conclusions:Serum CRP and TRAIL levels have certain value in the identification and efficacy evaluation of patients with acute viral infection. Combined detection can significantly improve the diagnostic value and provide a reliable reference for clinical treatment and prognosis evaluation.

13.
Journal of Leukemia & Lymphoma ; (12): 523-526, 2019.
Article in Chinese | WPRIM | ID: wpr-798242

ABSTRACT

Objective@#To investigate the clinical effects of Qinghuang powder, low-intensity chemotherapy and Qinghuang powder alternated with low-intensity chemotherapy in the treatment of elderly acute myeloid leukemia patients progressed from myelodysplastic syndromes (MDS-AML).@*Methods@#A total of 32 elderly patients with MDS-AML treated in Xiyuan Hospital, China Academy of Chinese Medical Sciences from January 2014 to December 2017 were retrospectively analyzed. Of them, 12 patients received Qinghuang powder (Qinghuang powder group), 6 patients received Qinghuang powder alternated with low-intensity chemotherapy (alternating group), and 14 patients received low-intensity chemotherapy (low-intensity chemotherapy group), based on the real world of patient's voluntary choice of treatment. The efficacy and adverse reactions in the 3 groups were observed.@*Results@#The overall response number of Qinghuang powder, alternating, and low-intensity chemotherapy groups were 2, 2 and 4 cases, respectively, there was no significant difference among the 3 groups (P > 0.05). The median overall survival time of 3 groups were 14, 12 and 8 months, respectively, there was no significant difference among the 3 groups (P > 0.05). Two cases in Qinghuang powder group presented with gastrointestinal reactions; 3 cases in alternating group with myelosuppression, 2 cases with liver function damage, and 2 cases with gastrointestinal reaction; 11 cases in low-intensity chemotherapy group presented with bone marrow suppression, 3 cases with liver function damage, 7 cases with gastrointestinal reactions, and 2 cases with myocardial enzyme changes. The incidences of myelosuppression, liver function damage and myocardial enzyme changes in Qinghuang powder group were lower than those in the alternating group and low-intensity chemotherapy group.@*Conclusion@#The efficacy of Qinghuang powder or Qinghuang powder alternated with low-intensity chemotherapy for the treatment of elderly MDS-AML is not worse than the low-intensity chemotherapy, furthermore Qinghuang powder or Qinghuang powder alternated with low-intensity chemotherapy has fewer adverse reactions and better tolerance.

14.
Article in Chinese | WPRIM | ID: wpr-754789

ABSTRACT

Objective To compare the efficacy between intramedullary nail and plate in the internal fixation for distal tibial shaft fractures in adults.Methods A retrospective analysis was conducted of the 49 patients with distal tibial shaft fracture who had been treated by internal fixation with intramedullary nail or plate at Department of Orthopaedics,The First People's Hospital of Neijiang from September 2014 to September 2018.They were 26 males and 23 females,aged from 19 to 71 years (average,42.3 years).According to the AO/ ASIF classification,there were 34 cases of type 43A1 and 15 cases of type 43A2.There were 7 open and 42 closed fractures.Of them,23 received intramedullary nailing and 26 steel plating.The 2 groups were compared in terms of intraoperative blood loss,operation time,hospitalization time,fracture healing time,The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score,infection and fracturemalunion.Results The 2 groups were comparable because there were no significant differences in the preoperative general data between them(P > 0.05).The intraoperative blood loss in the intramedullary nail group (160.3 mL ± 15.2 mL) was significantly greater than that in the plate group (110.5 mL ± 13.4 mL) (P < 0.05).There were no significant differences between the 2 groups in operation time,hospitalization time,fracture healing time or AOFAS ankle-hindfoot scores at the final follow-up (P > 0.05).There were no significant differences between the 2 groups either in the rates of malunion,infection or internal fixation failure (P > 0.05).Five cases in the intramedullary nail group reported painful discomfort in the front of the knee joint while 7 cases in the plate group postoperative discomfort due to plate protrusion.Conclusions Both intramedullary nail and plate are effective treatments of adult distal tibial fracture.However,in order to minimize the risk of infection,intraoperative maneuvers should be as careful and gentle as possible,repeated violence be avoided and soft tissues be carefully protected.

15.
Journal of Leukemia & Lymphoma ; (12): 523-526, 2019.
Article in Chinese | WPRIM | ID: wpr-751436

ABSTRACT

Objective To investigate the clinical effects of Qinghuang powder, low-intensity chemotherapy and Qinghuang powder alternated with low-intensity chemotherapy in the treatment of elderly acute myeloid leukemia patients progressed from myelodysplastic syndromes (MDS-AML). Methods A total of 32 elderly patients with MDS-AML treated in Xiyuan Hospital, China Academy of Chinese Medical Sciences from January 2014 to December 2017 were retrospectively analyzed. Of them, 12 patients received Qinghuang powder (Qinghuang powder group), 6 patients received Qinghuang powder alternated with low-intensity chemotherapy (alternating group), and 14 patients received low-intensity chemotherapy (low-intensity chemotherapy group), based on the real world of patient's voluntary choice of treatment. The efficacy and adverse reactions in the 3 groups were observed. Results The overall response number of Qinghuang powder, alternating, and low-intensity chemotherapy groups were 2, 2 and 4 cases, respectively, there was no significant difference among the 3 groups (P> 0.05). The median overall survival time of 3 groups were 14, 12 and 8 months, respectively, there was no significant difference among the 3 groups (P> 0.05). Two cases in Qinghuang powder group presented with gastrointestinal reactions; 3 cases in alternating group with myelosuppression, 2 cases with liver function damage, and 2 cases with gastrointestinal reaction; 11 cases in low-intensity chemotherapy group presented with bone marrow suppression, 3 cases with liver function damage, 7 cases with gastrointestinal reactions, and 2 cases with myocardial enzyme changes. The incidences of myelosuppression, liver function damage and myocardial enzyme changes in Qinghuang powder group were lower than those in the alternating group and low-intensity chemotherapy group. Conclusion The efficacy of Qinghuang powder or Qinghuang powder alternated with low-intensity chemotherapy for the treatment of elderly MDS-AML is not worse than the low-intensity chemotherapy, furthermore Qinghuang powder or Qinghuang powder alternated with low-intensity chemotherapy has fewer adverse reactions and better tolerance.

16.
Journal of Leukemia & Lymphoma ; (12): 245-247, 2019.
Article in Chinese | WPRIM | ID: wpr-751388

ABSTRACT

Clonal hematopoiesis is a common aging_associated biological state. The incidence of malignant neoplasms for the patients with clonal hematopoiesis of indeterminate potential (CHIP) is 0.5%-1% every year. Potential factors of clonal progression in hematopoietic cells have been summarized, including disordered endogenous immunity caused by the augmentation of proliferative pressure, chromosomal instability caused by telomeres short; the amplification of clonal stem cells, acquisition of new mutations, and aging_associated changes in hematopoietic stem cells, including altered DNA damage response, an altered transcriptional program and epigenetic alterations while failing to support healthy hematopoiesis. CHIP is a vascular risk factor driven by interactions between clonal monocytes_macrophages and the endothelium, as well as a neoplastic progression risk factor driven by the acquisition of additional somatic mutations in the context of many other influences on hematopoiesis and clonal balance. Strategies to reduce the clonal burden associated with CHIP and to inhibit the key inflammatory pathways leading to atherosclerosis could improve the prognosis of the patients.

17.
Journal of Leukemia & Lymphoma ; (12): 137-141, 2019.
Article in Chinese | WPRIM | ID: wpr-742769

ABSTRACT

Myelodysplastic syndromes (MDS) are clonal disorders characterized by the accumulation of complex genomic abnormalities that defined disease phenotype,prognosis,and the risk of transformation to acute myeloid leukemia.The clinical manifestations and prognosis of patients with different phenotypes arevary different,and the overall survival varies from several months to several years.Prognostic scoring systems are important staging tools that aided physicians in their treatment recommendations and decision-making and could help patients understand their disease trajectory and expectations.These models and others use mainly clinical variables that are obtained from bone marrow biopsy and peripheral blood measurements.Adding gene mutation data into current models might improve the total predictive power.The search for an optimal way to merge the clinical and genomic data in a sophisticated and highly accurate model remains a work in progress.A comprehensive geno-clinical model that could translate the use of genomic data into clinical practice would finally be established.This paper mainly introduces the progress of the gene mutations and prognosis models of MDS in the 60th American Society of Hematology (ASH) Annual Meetings were reviewed.

18.
Journal of Leukemia & Lymphoma ; (12): 132-136, 2019.
Article in Chinese | WPRIM | ID: wpr-742768

ABSTRACT

The myelodysplastic syndromes (MDS) are collectively the most common myeloid neoplasms,and the clonal hematopoiesis presented in MDS results in bone marrow failure.An understanding of the MDS gene mutation profile can help to understand the biological significance of MDS and can be used for early diagnosis of disease,precise risk stratification,interpretation of pathogenesis,and improvement of treatment options.As the pathological features of MDS are gradually elucidated,individualized and effective treatment options are improved,and the targeted drug therapy may improve the prognosis of MDS patients.This article introduces the progress of MDS gene mutations and targeted therapy in the 60th American Society of Hematology (ASH) Annual Meeting.

19.
Chongqing Medicine ; (36): 871-874, 2018.
Article in Chinese | WPRIM | ID: wpr-691874

ABSTRACT

Objective To investigate the expression of HERV-HLTR-associating protein 2(HHLA2).in hepatocellular carcinoma(HCC) tissue and its relationship with different pathological grades,clinical stages,liver function and serum AFP level.Methods The positive rate of HHLA2 expression in 150 cases of paraffin-embedded HCC tissues was detected by immunohistochemistry.Ten cases of normal liver tissue specimens from health donors served as the normal control.The differences of HHLA2 expression in HCC tissues were compared among different pathological grades,clinical stage,liver function grades and serum AFP levels.Results The positive expression rate of HHLA2 in HCC tissue was significantly higher than that in normal control (P<0.05).The positive rate of HHLA2 expression in low differentiated HCC tissue was highest.The positive rate of HHLA2 expression in the low differentiation and moderate differentiation HCC groups was significantly higher than that in the high differentiation group (P<0.05).The positive expression rate in the patients with Barcelona stage C and D was significantly higher than that in the patients with the stage A and B(P<0.05).The positive expression rate in the patients with Child-Pugh stage A was significantly higher than that in the patients with stage B and C(P<0.01).While the HHLA2 expression rate had no statistically significant difference among different ages and different serum AFP levels(P>0.05).Conclusion The positive expression rate of HHLA2 in cancer tissues of HCC patients is significantly increased.HHLA2 might play a certain role in the occurrence,development and metastasis of HCC.

20.
Journal of Leukemia & Lymphoma ; (12): 396-399, 2018.
Article in Chinese | WPRIM | ID: wpr-691644

ABSTRACT

Objective To investigate the survival of oral arsenic-containing Qinghuang Powder (QHP) and low intensive chemotherapy (LIC) in the treatment of elderly patients with acute myeloid leukemia (AML).Methods Forty-two AML patients older than 60 years in Xiyuan Hospital from January 2015 to December 2017 were retrospectively analyzed.Of them,20 cases were treated with QHP (QHP group),22 cases were treated with LIC (LIC group).The survivals of the two groups were compared.Results There was no significant difference of median survival time (13 months vs.13.5 months,x2 =0.096,P =0.757),1-year survival rates (59.1% vs.70.0 %,x2 =0.543,P =0.461),2-year survival rates (13.6 % vs.15.0 %,x2 =0.016,P > 0.05),and 3-year survival rates (4.6 % vs.5.0 %,x2 =0.005,P > 0.05) between LIC and QHP groups.There was no significant difference of median survival time in age ≥75 year (12 months vs.12.5 months,x2 =1.317,P =0.251),performance status scores > 2 (12 months vs.12 months,x2 =0.834,P =0.361),hematopoietic stem cell transplantation with combined disease index > 2 (12 months vs.13 months,x2 =1.726,P =0.189),secondary AML (10 months vs.14 months,x2 =1.552,P =0.213),and poor cytogenetics (12 months vs.8 months,x2 =0.479,P =0.489) between LIC and QHP group.Conclusion The survival of elderly AML patients is considerable in patients treated with oral QHP and LIC,which suggests that oral QHP may be an equivalent alternative treatment since elderly AML (especially more than 75 years) patients refused to LIC therapy.

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