Efficacy and safety of deferasirox in aplastic anemia patients with iron overload: a single arm, multi-center,prospective study in China / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the efficacy and safety of deferasirox in aplastic anemia (AA)patients with iron overload.</p><p><b>METHODS</b>A single arm, multi- center, prospective, open- label study was conducted to evaluate absolute change in serum ferritin (SF)from baseline to 12 months of deferasirox administration, initially at a dose of 20 mg·kg(-1)·d(-1), and the safety in 64 AA patients with iron overload.</p><p><b>RESULTS</b>All patients started their deferasirox treatment with a daily dose of 20 mg · kg(-1) ·d(-1). The mean actual dose was (18.6±3.60) mg · kg(-1)·d(-1). The median SF decreased from 4 924 (2 718- 6 765)μg/L at baseline (n=64) to 3 036 (1 474- 5 551)μg/L at 12 months (n=23) with the percentage change from baseline as 38%. A median SF decrease of 651 (126-2 125)μg/L was observed at the end of study in 23 patients who completed 12 months' treatment, the median SF level decreased by 1 167(580-4 806)μg/L [5 271(3 420-8 278)μg/L at baseline; 3 036(1 474-5 551)μg/L after 12 months' treatment; the percentage change from baseline as 42% ] after 12 months of deferasirox treatment. The most common adverse events (AEs) were increased serum creatinine levels (40.98%), gastrointestinal discomfort (40.98%), elevated liver transaminase (ALT: 21.31%; AST: 13.11%)and proteinuria (24.59%). The increased serum creatinine levels were reversible and non-progressive. Of 38 patients with concomitant cyclosporine use, 12(31.8%)patients had two consecutive values >ULN, 10(26.3%)patients had two consecutive values >1.33 baseline values, but only 1(2.6%)patient's serum creatinine increased more than 1.33 baseline values and exceeded ULN. For both AST and ALT, no patients experienced two post- baseline values >5 ×ULN or >10 × ULN during the whole study. In AA patients with low baseline PLT count (less than 50 × 10(9)/L), there was no decrease for median PLT level during 12 months' treatment period.</p><p><b>CONCLUSIONS</b>AA patients with iron overload could achieve satisfactory efficacy of iron chelation by deferasirox treatment. The drug was well tolerated with a clinically manageable safety profile and no major adverse events.</p>

Dysfunction of T lymphocytes and clonal haematogenesis in patients with myelodysplastic syndrome / 白血病·淋巴瘤

Objective To investigate the effect of dysfunction of T lymphocytes on clonal haematogenesis in patients with myelodysplastic syndrome (MDS). Methods The cytogentics, the subsets of lymphocytes and their activation in 76 patients with MDS were analyzed. Results There were 36 patients with normal karyotype and 40 patients with abnormal karyotype. The incidence of abnormal karyotype were 52.6 %. There were 24 cases (60.0 %) with trisomy 8 (+8) in 40 cases of abnormal karyotype. The expression rates of CD+3 CD-19 cells, CD+3 CD-4 CD+8 cells and CD+3 HLA-DR+ cells in MDS were significantly increased, and CD-3 (CD16CD56)+ cells were significantly lower than that in control group. The expression rates of CD+3 (CD16CD56)+ cells in MDS with abnormal karyotype were significantly higher than that in control group. The expression rates of CD+3 CD+4 CD-8 cells in +8 MDS were significantly lower than that in MDS patients with normal karyotype and with other abnormal karyotype. The ratio of CD4/CD8 in +8 MDS were significantly lower than that in control group. Conclusion The abnormalities of T cell subsets and functions in patients with MDS were observed and the proliferation of malignant clone was prevalent which indicated a poor prognosis in MDS with abnormal karyotype. Dysfunction of immunosurveillance was more aggravated in +8 MDS, which led to excess proliferation of malignant clone and over inhibition of remaining haematogenesis.

Effect of Integrated Traditional Chinese and Western Medicine on Primary Trigeminal Neuralgia / 中国康复理论与实践

@#ObjectiveTo observe the effect of Integrated Traditional Chinese and Western Medicine on primary trigeminal neuralgia. Methods126 cases with primary trigeminal neuralgia were divided into treatment group (63 cases) and control group (63 cases), who accepted Integrated Traditional Chinese and Western Medicine and western medicine only. They were assessed with Chinese version McGill Pain Questionnaire before and after treatment, and followed up for 1 year. ResultsThe incidence of cure in treatment group was higher than that of control group (P<0.05), and the relapse was reduced (P<0.05). ConclusionThe Integrated Traditional and Western Medicine is more effective on primary trigeminal neuralgia, and reduce the relapse.

Effect of Electro-Acupuncture Combined with Rehabilitation Training to Shorten Period of Flaccid Paralysis after Cerebral Infarction / 中国康复理论与实践

@#Objective To observe the curative effect of electro-acupuncture combined with rehabilitation training to shorten the period of flaccid paralysis after cerebral infarction.Methods 78 victims were divided into treatment group and control group at random. The treatment group received electro-acupuncture combined with rehabilitation training, and the control group received rehabilitation training only. Muscular tension was evaluated on the 15th day and 30th day after admission according to the modified Ashworth spasm rating scale.Results The number of flaccid paralysis victims in the treatment group is significantly less than that in the control group (P＜0.05) on the 15th day and 30th day after treatment.Conclusion Electro-acupuncture combined with rehabilitation training can shorten the period of flaccid paralysis after cerebral infarction significantly.

Primary study of the phenotype and biological characteristics of chronic myelogenous leukemia derived mesenchymal stem cells / 白血病·淋巴瘤

Objective To isolate and study the phenotype and biological characteristics of chronic myelogenous leukemia-derived mesenchymal stem cells. Methods Cultivate the mesenchymal stem cells from chronic myelogenous leukemia in vitro, identify the immunophenotype by fluorescence-activated cell sorter (FACS), and detect the bcr-abl fusion gene by RT-PCR and FISH. Results The mesenchymal stem cells from chronic myelogenous leukemia can express the bcr-abl fusion gene. Conclusion These findings provide the evidence that the rearrangement of bcr-abl gene might happen at least more primitive than CD+34 CD-38 cells.

The character of glial line-cell derived neurotrophic factor mRNA expression in a facial nerve-striking model / 华西口腔医学杂志

<p><b>OBJECTIVE</b>It has been known that glial line-cell derived neurotrophic factor (GDNF) has the nutritional and protective effect in motor neurons. In this experiment, we investigated the character of GDNF mRNA expression in a facial nerve-striking model; combined with other scholars' experimental results; and analyzed what role GDNF plays in the regeneration process of injured motor nerves.</p><p><b>METHODS</b>We established a striking model in rabbit facial nerves with a striking gun with the striking velocity of 10 m/s and the total striking energy of 7.5 J. Then we detected the GDNF mRNA expression in facial neurons and axons with in situ hybridization on days 3, 7, 14 and 21 after striking. We counted the expression numbers of facial neurons and, compared with normal facial neurons and peripheral facial nerves.</p><p><b>RESULTS</b>We detected GDNF mRNA expression in the facial neurons from day 3 to day 21 after the facial nerve injured by striking. The peak of GDNF mRNA expression appeared on the 7th day, and then the expression number of facial neurons decreased gradually. A high level expression was also detected on day 21. GDNF mRNA expression was not detected neither in Schwann cells nor in normal facial neurons from the 3rd day to the 21st day.</p><p><b>CONCLUSION</b>GDNF is a kind of neurotrophic growing factor (NGF) that could be activated by injury. The character of GDNF mRNA expression was accordant to the process of nerve regeneration. These results showed that GDNF plays a very important role in the regeneration of injured motor nerves.</p>