Sjögren's syndrome combined with cold agglutinin disease: A case report / 北京大学学报(医学版)

Sjögren's syndrome(SS)is a chronic autoimmune disease that affects exocrine glands, especially salivary and lacrimal glands. The main clinical manifestations are dry mouth and dry eyes, but also multi-organ and multi-system can be involved. Cold agglutinin disease(CAD)is an autoimmune disease characterized by red blood cell agglutination in the blood vessels of extremities caused by cold agglutinin at low temperature, resulting in skin microcirculation disturbance, or hemolytic anemia. Cold agglutinin disease is divided into two categories, primary cold agglutinin disease and secondary cold agglutinin disease. Primary cold agglutinin disease is characterized with cold agglutinin titer of 1 ∶4 000 or more and positive Coomb's test. However, the Coomb's test is not necessarily positive and the cold agglutinin titer is between 1 ∶32 and 1 ∶4 000 in secondary cold agglutinin disease. Here, we reported an elderly patient admitted to hospital due to fever. He was diagnosed with respiratory infection, but he showed incompletely response to the anti-infection treatment. Further laboratory tests showed the patient with positive ANA and anti-SSA antibodies. Additionally, the patient complained that he had dry mouth and dry eyes for 1 year. Schirmer test and salivate gland imaging finally confirmed the diagnosis Sjogren's syndrome. During the hospital stay, the blood clots were found in the anticoagulant tubes. Hemolytic anemia was considered as the patient had anemia with elevated reticulocytes and indirect bilirubin. In addition, further examination showed positive cold agglutination test with a titer of 1 ∶1 024, and cold agglutinin disease was an important type of cold-resistant autoimmune hemolytic anemia. Furthermore, the patient developed cyanosis after ice incubating at the tip of the nose. Hence, the patient was diagnosed as CAD and he was successfully treated with glucocorticoids instead of anti-infection treatments. Hence, the patient was diagnosed with SS combined with secondary CAD. SS combined CAD are rarely reported, and they are both autoimmune diseases. The abnormal function of B lymphocytes and the production of autoantibodies might be the common pathogenesis of them. Cold agglutinin disease can lead to severe hemolytic anemia, even life-threatening. In clinical practice, timely recognizing and dealing with CAD might promote the prognosis of the patient.

Study on mechanism of Qinbaohong Oral Liquid in anti-inflammation, stopping cough, eliminating phlegm and relieving asthma based on network pharmacology / 中国中药杂志

This study aimed to investigate the anti-inflammatory, antitussive, expectorant, and anti-asthmatic effects of Qinbaohong Oral Liquid in mouse experiments and explore its action mechanism based on network pharmacology. The mouse auricle swelling was induced by xylene for detecting the anti-inflammatory effect of Qinbaohong Oral Liquid, whose antitussive effect was then examined in mice with cough after exposure to ammonium hydroxide. The expectorant effect was determined based on the excretion of phenol red into the mouse trachea. The mouse model of asthma induced by histamine phosphate and acetylcholine chloride was used to observe the anti-asthmatic effect. The chemical components of Qinbaohong Oral Liquid were retrieved from TCMSP and literature, followed by target prediction based on BATMAN-TCM. The targets of inflammation, cough, expectoration, and asthma collected from GeneCards were intersected with drug targets for GO and KEGG enrichment analysis using Metascape. The results were imported into STRING for exploring protein-protein interactions and screening the key targets. As demonstrated by our findings, Qinbaohong Oral Liquid at 4.5 and 9.0 mL·kg~(-1) obviously decreased the weight(P<0.05) and thickness(P<0.01) of the right swelling ear and also the weight diffe-rence(swelling degree) between the two ears(P<0.05), prolonged the incubation period of cough(P<0.05), reduced the frequency of cough within 3 min(P<0.05), and increased the excretion of phenol red into the mouse trachea(P<0.01). Qinbaohong Oral Li-quid at 2.3, 4.5, and 9.0 mL·kg~(-1) dramatically prolonged the incubation period of asthma(P<0.05). A total of 324 chemical components and 1 245 targets were harvested for the Qinbaohong Oral Liquid, together with 10 272 inflammation targets, 4 400 cough targets, 192 expectoration targets, and 7 533 asthma targets. Their intersection revealed that the anti-inflammatory, antitussive, expectorant and anti-asthmatic effects of Qinbaohong Oral Liquid were correlated with such GO biological processes as the regulation of ion transport and blood circulation and such KEGG pathways as cancer-related signaling pathways and neuroactive ligand-receptor interaction. Qinbaohong Oral Liquid has been confirmed by both experiments and network pharmacology analysis to be efficient in anti-inflammation, stopping cough, eliminating phlegm, and relieving asthma.

Assessment of schistosomiasis transmission risk in Nanjian County of Yunnan Province in 2019 / 中国血吸虫病防治杂志

Objective To assess the schistosomiasis transmission risk in Nanjing County, so as to provide the scientific evidence for the development of the schistosomiasis control strategy and consolidation of the control achievements. Methods On May 2019, the Deqiu Village in Deqiu Town and Baiyun Village in Nanjing Town of Yunnan Province, where schistosomiasis were historically relatively highly endemic, were selected to assess the risk of transmission of schistosomiasis by means of a retrospective review of the data pertaining to the historical endemic situation and schistosomiasis control, combined with a cross-sectional survey of snail and wild feces distribution. Results During the period between 2017 and 2018, the mean sero-prevalence rates of Schistosoma japonicum infections were 6.76% (202/2 990) and 2.86% (142/4 971) in humans and 0 (0/1 160) and 10.65% (31/291) in bovines in Deqiu and Baiyun villages of Nanjian County, respectively; however, no egg-positives were identified; in addition, there were 21.06 hm2 snail habitats found, but no S. japonicum infections were detected in snails. In 2019, there was 6.17 hm2 snail habitats detected, with 2.17% (245/11 298) occurrence of frames with snails and a 0.06 snails/0.1 m2 density of living snails; however, no positives for nucleic acid detection were seen in snails; among the 136 wild fecal samples captures from 23 settings, no S. japonicum infections were identified. Conclusions The risk of schistosomiasis transmission remains at a low level in Nanjian County; however, the factors affecting the transmission of schistosomiasis have not been completed eliminated. The integrated schistosomiasis control strategy with an emphasis on the control of the source of S. japonicum infections requires to be reinforced to consolidate the control achievements.

Spatial - temporal clustering analysis of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015 / 中国血吸虫病防治杂志

Objective To explore the spatial-temporal clustering distribution of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015, so as to provide scientific evidence for the future schistosomiasis control and consolidation of the control achievements. Methods All data pertaining to endemic situation of human and bovine schistosomiasis and snail survey at a township level in Yunnan Province from 2004 to 2015 were collected. A descriptive epidemiological method and Joinpoint model were used to describe the changing trends of Schistosoma japonicum infections in humans, bovine and snails, and the hotspots and clusters of schistosomiasis transmission risk were identified using spatial autocorrelation analysis, hotspots analysis and retrospective space-time scan statistic in Yunnan Province from 2004 to 2015. Results The prevalence of S. japonicum infections appeared a continuous decline in humans, bovine and snails in Yunnan Province from 2004 to 2015, and the estimated number of schistosomiasis cases reduced from 43 056 in 2004 to 756 in 2015, with a decline rate of 98.24%. There were no acute cases since 2008 and no infected snails since 2014 in Yunnan Province. There were significant differences in the changing trends of human and bovine S. japonicum infections in Yunnan Province between 2012 and 2015 and between 2013 and 2015, respectively using the Joinpoint model (P < 0.05). In addition, there was a spatial autocorrelation in human S. japonicum infections in Yunnan Province from 2004 to 2013 (P < 0.01), and the hotspots areas for human S. japonicum infections were mainly distributed in some townships from Dali City, Weishan County and Eryuan County. Retrospective spatial-temporal scanning revealed that S. japonicum human, bovine and snail infections were clustered in 23, 15, 4 townships from Dali City, Weishan County, Eryuan County, Nanjian County and Heqing County, respectively, with relative risks of 6.25 to 28.75 (P < 0.01), which was almost consistent with the cluster areas detected by hotspots analysis. Conclusions The endemic situation of schistosomiasis significantly reduced in Yunnan Province from 2004 to 2015; however, there is still a risk of schistosomiasis transmission. The monitoring and control of schistosomiasis should be intensified in the future in Yunnan Province.

Capability building and professional staff of schistosomiasis control institutions in Yunnan Province: a cross-sectional survey / 中国血吸虫病防治杂志

To understand the current status of professional staff and capacity building among schistosomiasis control institutions in Yunnan Province, the data pertaining to the current status of professional staff and capacity building were captured from the schistosomiasis control institutions at all levels in Yunnan Province. There were 20 schistosomiasis control institutions at a level of above county in Yunnan Province, with 411 employees, and there were 11 institutions with an independent legal personality, with a mean building area of 69.83 m2 per capita. Among all institutions, the number of posts was 382, and the actual number of employees was 360, with 22 job vacancies. The mean age of professional staff was 41.6 years at a province level, 44.1 years at a city level and 42.4 years at a county level, and there were no professionals at ages of < 30 years in city-level institutions. Of all professionals, there were 45.76% with a college degree or below, and 54.26% with a bachelor degree or higher, and 16.55%, 24.57% and 39.90% had senior, moderate and primary professional titles, with mean ages of 49.10, 44.37 years and 38.36 years, respectively. The results of the cross-sectional study demonstrate that there are problems of job vacancy, population aging and low education levels in schistosomiasis control institutions in Yunnan Province. Therefore, the capability building and professional quality should be further improved in schistosomiasis control institutions to meet the requirements of schistosomiasis control activities in Yunnan Province.

Construction and operation of schistosomiasis diagnosis reference (network) laboratory in Yunnan Province / 中国血吸虫病防治杂志

A three-level (provincial, municipal and county levels) schistosomiasis diagnosis network platform had been created in Yunnan Province, and assessment of laboratory quality-control samples and field evaluation of nucleic acid diagnostic techniques and immunodiagnostic reagents had been performed. This paper described the review process of the schistosomiasis diagnosis network laboratory and the operation of schistosomiasis diagnosis network laboratory and analyzed the problems of the schistosomiasis diagnosis network laboratory in Yunnan Province. The establishment of the schistosomiasis diagnosis reference (network) laboratory will provide a strong support for schistosomiasis control in Yunnan Province in the new era.

Risk assessment of schistosomiasis transmission in Chuxiong City of Yunnan Province / 中国血吸虫病防治杂志

Objective To evaluate the potential risk of schistosomiasis transmission so as to provide the evidence for formulating the control strategy. Methods Two villages were selected as the investigated sites in Chuxiong City and the risk of schistosomiasis transmission was evaluated by reviewing the data of schistosomiasis epidemic situation and prevention and control work, and carrying out the field survey for Oncomelania hupensis snail status, wild faeces, and schistosome infection of the population from 2015 to 2017. Results There was 1.49 hm2 area of snail habitats, with an average density of 0.54 snails/0.1 m2. The occurrence rate of frames with snails was 5.41%. No schistosome-infected snails were found. The positive rate of schistosomiasis serological tests of the residents was 3.36%, but the stool examination positive cases were not found. A total of 58 wild faeces samples were collected but no schistosome infested cases were found. The risk levels of schistosomiasis transmission in both villages were Grade III. Conclusions Although Chuxiong City has been in a low risk state of schistosomiasis transmission, the density of snails is still high, and there is a risk of infection source importation. In the future, the infection source control and snail control should be strengthened.

Spatial - temporal clustering analysis of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015 / 中国血吸虫病防治杂志

Objective To explore the spatial-temporal clustering distribution of schistosomiasis transmission risk in Yunnan Province from 2004 to 2015, so as to provide scientific evidence for the future schistosomiasis control and consolidation of the control achievements. Methods All data pertaining to endemic situation of human and bovine schistosomiasis and snail survey at a township level in Yunnan Province from 2004 to 2015 were collected. A descriptive epidemiological method and Joinpoint model were used to describe the changing trends of Schistosoma japonicum infections in humans, bovine and snails, and the hotspots and clusters of schistosomiasis transmission risk were identified using spatial autocorrelation analysis, hotspots analysis and retrospective space-time scan statistic in Yunnan Province from 2004 to 2015. Results The prevalence of S. japonicum infections appeared a continuous decline in humans, bovine and snails in Yunnan Province from 2004 to 2015, and the estimated number of schistosomiasis cases reduced from 43 056 in 2004 to 756 in 2015, with a decline rate of 98.24%. There were no acute cases since 2008 and no infected snails since 2014 in Yunnan Province. There were significant differences in the changing trends of human and bovine S. japonicum infections in Yunnan Province between 2012 and 2015 and between 2013 and 2015, respectively using the Joinpoint model (P < 0.05). In addition, there was a spatial autocorrelation in human S. japonicum infections in Yunnan Province from 2004 to 2013 (P < 0.01), and the hotspots areas for human S. japonicum infections were mainly distributed in some townships from Dali City, Weishan County and Eryuan County. Retrospective spatial-temporal scanning revealed that S. japonicum human, bovine and snail infections were clustered in 23, 15, 4 townships from Dali City, Weishan County, Eryuan County, Nanjian County and Heqing County, respectively, with relative risks of 6.25 to 28.75 (P < 0.01), which was almost consistent with the cluster areas detected by hotspots analysis. Conclusions The endemic situation of schistosomiasis significantly reduced in Yunnan Province from 2004 to 2015; however, there is still a risk of schistosomiasis transmission. The monitoring and control of schistosomiasis should be intensified in the future in Yunnan Province.

Capability building and professional staff of schistosomiasis control institutions in Yunnan Province: a cross-sectional survey / 中国血吸虫病防治杂志

To understand the current status of professional staff and capacity building among schistosomiasis control institutions in Yunnan Province, the data pertaining to the current status of professional staff and capacity building were captured from the schistosomiasis control institutions at all levels in Yunnan Province. There were 20 schistosomiasis control institutions at a level of above county in Yunnan Province, with 411 employees, and there were 11 institutions with an independent legal personality, with a mean building area of 69.83 m2 per capita. Among all institutions, the number of posts was 382, and the actual number of employees was 360, with 22 job vacancies. The mean age of professional staff was 41.6 years at a province level, 44.1 years at a city level and 42.4 years at a county level, and there were no professionals at ages of < 30 years in city-level institutions. Of all professionals, there were 45.76% with a college degree or below, and 54.26% with a bachelor degree or higher, and 16.55%, 24.57% and 39.90% had senior, moderate and primary professional titles, with mean ages of 49.10, 44.37 years and 38.36 years, respectively. The results of the cross-sectional study demonstrate that there are problems of job vacancy, population aging and low education levels in schistosomiasis control institutions in Yunnan Province. Therefore, the capability building and professional quality should be further improved in schistosomiasis control institutions to meet the requirements of schistosomiasis control activities in Yunnan Province.

Construction and operation of schistosomiasis diagnosis reference (network) laboratory in Yunnan Province / 中国血吸虫病防治杂志

A three-level (provincial, municipal and county levels) schistosomiasis diagnosis network platform had been created in Yunnan Province, and assessment of laboratory quality-control samples and field evaluation of nucleic acid diagnostic techniques and immunodiagnostic reagents had been performed. This paper described the review process of the schistosomiasis diagnosis network laboratory and the operation of schistosomiasis diagnosis network laboratory and analyzed the problems of the schistosomiasis diagnosis network laboratory in Yunnan Province. The establishment of the schistosomiasis diagnosis reference (network) laboratory will provide a strong support for schistosomiasis control in Yunnan Province in the new era.

Risk assessment of schistosomiasis transmission in Chuxiong City of Yunnan Province / 中国血吸虫病防治杂志

Objective To evaluate the potential risk of schistosomiasis transmission so as to provide the evidence for formulating the control strategy. Methods Two villages were selected as the investigated sites in Chuxiong City and the risk of schistosomiasis transmission was evaluated by reviewing the data of schistosomiasis epidemic situation and prevention and control work, and carrying out the field survey for Oncomelania hupensis snail status, wild faeces, and schistosome infection of the population from 2015 to 2017. Results There was 1.49 hm2 area of snail habitats, with an average density of 0.54 snails/0.1 m2. The occurrence rate of frames with snails was 5.41%. No schistosome-infected snails were found. The positive rate of schistosomiasis serological tests of the residents was 3.36%, but the stool examination positive cases were not found. A total of 58 wild faeces samples were collected but no schistosome infested cases were found. The risk levels of schistosomiasis transmission in both villages were Grade III. Conclusions Although Chuxiong City has been in a low risk state of schistosomiasis transmission, the density of snails is still high, and there is a risk of infection source importation. In the future, the infection source control and snail control should be strengthened.

Preparation, characterization and dissolution characteristics of dragon's blood extract nanosuspensions / 中国中药杂志

The single-factor test was used to optimize the high-pressure homogenization method to prepare the phenolic extract nanosuspensions(DBNs). The physicochemical properties of the obtained nanosuspensions were characterized and the cumulative release in vitro was evaluated. The results showed that the drug concentration was 0.5 g·L~(-1), the mass concentrations of PVPK30 and SDS were 0.5 and 0.25 g·L~(-1), respectively, the probe ultrasonic time was 5 min, the homogenization pressure was 900 bar, and the number of homogenization was 2 times. The prepared DBNs had an average particle size of(168.80±0.36) nm, polydispersity index(PDI) of 0.09±0.04, stability index(SI) of 0.85, and DBNs were stable for storage within 30 days. Scanning electron microscopy showed that the particle size of the dragon's blood extract was reduced and the uniformity was improved in the obtained nanosuspensions. X-ray diffraction pattern and differential scanning calorimetry showed that the phenolic extract of dragon's blood was still in an amorphous state after being prepared into nanosuspensions. The results of saturated solubility measurement showed that the solubility of DBNs lyophilized powder reached 6.25 g·L~(-1), while the solubility of DB raw powder was only 28.67 mg·L~(-1). The in vitro dissolution experiments showed that DBNs lyophilized powder accumulated in gastrointestinal fluid for 8 h. The release amount was 90%,the cumulative release of the raw powder in the gastrointestinal fluid for 24 h was less than 1%, and the solubility and dissolution rate of the DBNs lyophilized powder were significantly higher than the DB raw powder. The method is simple in process and convenient in operation, and can successfully prepare uniform and stable nanosuspensions to improve its solubility, and provides a research basis for solving the application limitation of dragon's blood extract.

Oncomelania hupensis status in national schistosomiasis surveillance sites of Yunnan Province from 2015 to 2017 / 中国血吸虫病防治杂志

Objective To master the Oncomelania hupensis distribution and infection status in the national schistosomiasis surveillance sites of Yunnan Province, so as to provide the evidence for making the control and prevention measures. Methods The data of O. hupensis surveillance in the 18 national surveillance sites of Yunnan Province from 2015 to 2017 were collected and analyzed with the descriptive analysis method according to the national schistosomiasis surveillance programme. Results The total surveillance area was 5 710.94 hm2, the area with O. hupensis snails was 205.69 hm2. The number of surveillance frames was 2 094 553, the occurrence rate of frames with snails was 0.62%, and the density of living snails was 0.025 4 snails/0.1 m2. In the schistosomiasis epidemic controlled areas, the area with snails, the occurrence rate of frames with snails and the density of living snails were all the highest. The snail concentrated distribution areas were the small reservoir, bottomland, paddy field, ditch, and dry land, and the snails mainly distributed in the rice, dry crop, weed and wood vegetation. The number of frames with snails, occurrence rate of frames with snails, total number of snails, number of living snails, and repetition areas with snails presented increasing trends, and however, no schistosome-infected snails were found during the three years. Conclusions The O. hupensis snail status is obviously serious in the national schistosomiasis surveillance sites of Yunnan Province. The comprehensive snail control measures should continue to be strengthened, so as to effectively control the spread of the snails and reduce the risk of schistosomiasis outbreaks.

Oncomelania hupensis status in national schistosomiasis surveillance sites of Yunnan Province from 2015 to 2017 / 中国血吸虫病防治杂志

Objective To master the Oncomelania hupensis distribution and infection status in the national schistosomiasis surveillance sites of Yunnan Province, so as to provide the evidence for making the control and prevention measures. Methods The data of O. hupensis surveillance in the 18 national surveillance sites of Yunnan Province from 2015 to 2017 were collected and analyzed with the descriptive analysis method according to the national schistosomiasis surveillance programme. Results The total surveillance area was 5 710.94 hm2, the area with O. hupensis snails was 205.69 hm2. The number of surveillance frames was 2 094 553, the occurrence rate of frames with snails was 0.62%, and the density of living snails was 0.025 4 snails/0.1 m2. In the schistosomiasis epidemic controlled areas, the area with snails, the occurrence rate of frames with snails and the density of living snails were all the highest. The snail concentrated distribution areas were the small reservoir, bottomland, paddy field, ditch, and dry land, and the snails mainly distributed in the rice, dry crop, weed and wood vegetation. The number of frames with snails, occurrence rate of frames with snails, total number of snails, number of living snails, and repetition areas with snails presented increasing trends, and however, no schistosome-infected snails were found during the three years. Conclusions The O. hupensis snail status is obviously serious in the national schistosomiasis surveillance sites of Yunnan Province. The comprehensive snail control measures should continue to be strengthened, so as to effectively control the spread of the snails and reduce the risk of schistosomiasis outbreaks.

Total Arterial Off-Pump Coronary Artery Bypass Grafting: A 10-Year Experience / 中华医学杂志(英文版)

<p><b>Background</b>Arterial grafts had better mid-term and long-term patency than saphenous vein grafts in coronary artery bypass grafting (CABG). We summarized our experience with total arterial off-pump coronary artery bypass grafting (OPCAB) and assessed the early clinical results, surgical complications, and follow-up.</p><p><b>Methods</b>From January 2007 to May 2017, 508 coronary artery disease patients undergoing total arterial OPCAB were enrolled. Clinical features, approaches, outcomes of surgical treatments, and follow-up data of these patients were studied retrospectively. A total of 122 patients underwent single left internal mammary artery (IMA)-left anterior descending artery grafts, whereas the other 386 patients underwent multiple vessel grafts.</p><p><b>Results</b>The average distal anastomosis was 2.34 ± 0.97 (range: 1-4). All the patients were discharged from hospital except one died. A total of 457 (90.32%) patients were followed up. In the 4-, 7-, and 10-year follow-up groups, the rate of death from any cause was 1.19%, 6.47%, and 10.67%; rate of cardiac death was 0.60%, 2.88%, and 3.33%; rate of repeat revascularization was 0.00%, 3.60%, and 8.67%; rate of ischemic symptoms was 1.79%, 7.91%, and 11.33%; and incidence of stroke was 2.38%, 4.32%, and 6.67%, respectively. Poor medication adherence was observed in 9.38% of the follow-up population.</p><p><b>Conclusions</b>Total arterial OPCAB with bilateral IMA, radial artery, and right gastroepiploic artery grafting yielded satisfactory early and midterm outcomes in this patient group, without a significant increase in early mortality or morbidity. Moreover, the long-term outcomes are also positive.</p>

Molecular Characterization and Correlation with β-lactam Resistance of Streptococcus pneumonia Isolates in Hangzhou, China / 生物医学与环境科学（英文）

Penicillin-binding proteins (PBPs) are the target of β-lactam antibiotics (the major treatment for Streptococcus pneumoniae infections), and mutations in PBPs are considered as a primary mechanism for the development of β-lactam resistance in S. pneumoniae. This study was conducted to investigate the mutations in the PBPs of clinical S. pneumoniae isolates in Hangzhou, China, in correlation with β-lactam resistance. Results showed that 19F was the predominant serotype (7/27) and 14 of the S. pneumoniae isolates were resistant to both penicillin G and cephalosporin. Genotyping results suggested that β-lactam-resistant isolates primarily exhibited single-site mutations in both the STMK and SRNVP motifs of pbp1a in combination with double-site mutations in the STMK motif of pbp2x, which might be the primary mechanisms underlying the β-lactam resistance of the isolates in this study.

Research on preparation process of andrographolide-glycyrrhizic acid polymeric micelles / 中国中药杂志

This study aimed to prepare andrographolide (AP)-loaded glycyrrhizic acid (GA) micelles (AP-GA)-PMs to enhance the solubility and anti-tumor effect of andrographolide. Firstly, andrographolide (AP) was used as the model drug and glycyrrhizic acid (GA) as carriers to prepare (AP-GA)-PMs. Then the preparation methods and the ratios of drug and carrier were screened and optimized based on particle size, encapsulation efficiency (EE) and loading capacity of micelles. Finally, the pharmaceutical characters and the inhibition rate on HepG2 cells were evaluated on the (AP-GA)-PMs prepared by optimal process. The results showed that the prepared micelles under the optimal process had a nanosize of (127.11±1.38) nm, zeta potential of (-24.01±0.55) mV, the entrapment efficiency rate of (92.01±4.02)% , the drug loading rate of (51.44±1.24)% and high storage stability at 4 °C in 30 d, with slow but highly stable release. Moreover, (AP-GA)-PMs with the IC₅₀ value of 19.25 mg·L⁻¹ had a more synergistic and better anti-tumor effect in comparison with AP (IC₅₀=122.40 mg·L⁻¹) on HepG2 cells (P<0.01). In conclusion, the (AP-GA)-PMs prepared with glycyrrhizic acid as a carrier had a small particle size, large drug loading capacity, and high stability, and could significantly improve the anti-tumor effects of AP.

Clinical observation of Shuanghuang Shengbai Granule () on prevention and treatment of myelosuppression caused by chemotherapy in cancer patients / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the efficacy and safety of Shuanghuang Shengbai Granule (, SSG), a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy.</p><p><b>METHODS</b>A total of 330 patients were randomly assigned to the treatment group (220 cases, analysed 209 cases) and the control group (110 cases, analysed 102 cases) with a 2:1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation.</p><p><b>RESULTS</b>At the 7th day of chemotherapy, the white blood cells (WBCs) level in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade I, while 8.1% and 5.7% of patients emerged grade III and grade IV myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group (P<0.05). The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group (84.2% vs. 72.5%, P<0.05). The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3and CD4cells were significantly increased in the treatment group after treatment (P<0.05). The discrepancy of CD3and CD4cell activity before and after treatment in both groups were significantly different (P<0.05). No obvious adverse event occurred in both groups.</p><p><b>CONCLUSION</b>SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.</p>

Clinical Value of Serum Fructosamine Measurement in IgA Type Multiple Myeloma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the value of serum fructosamine (FMN) measurement in clinical typing and staging of multiple myeloma(MM) as well as evaluation of curative efficacy and prognosis of IgA type MM.</p><p><b>METHODS</b>The levels of FMN were detected by nitro-blue-tetrazolium colorimetric method in 62 IgA type MM patients, 65 IgG type MM patients, 24 IgM type MM patients. The difference between the serum FMN levels and different MM types and its relationship with IgA type MM, patients' stages, efficacy and as well as, the effect of FMN level on overall survival (OS) time of IgA type MM patients were analyzed.</p><p><b>RESULTS</b>FMN level of IgA type patients was obviously higher than that of IgG type and IgM type patients. Patients of DS stage III had higher FMN level than that of stage II, and patients of DS stage II had higher FMN level than that of stage I, the differences were statistical significant(P<0.05). Patients of ISS stage III also had higher FMN level than that of stage II, and patients of ISS stage II also had higher FMN level than that of stage I, the differences were statistical significant(P<0.05). After treatment, FMN level of patients obtained complete remission (CR) or very good partial remission(VGPR) obviously decreased, FMN level of patients obtained partial remission(PR) decreased, FMN level of patients obtained less than PR increased. Patients with normal FMN level had longer OS time, while patients with high FMN level had obviously short OS time.</p><p><b>CONCLUSIONS</b>Serum FMN is obviously elevated in the IgA type MM, there is a certain association between staging and serum FMN level, the IgA type MM patients with FMN normalization after treatment have better prognosis.</p>

Treatment of cerebral palsy children by integrative medical sequential method: a clinical efficacy observation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the efficacy of integrative medical sequential method in treating cerebral palsy (CP) children's intelligence development, muscular tension, serum interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-alpha).</p><p><b>METHODS</b>Totally 111 CP children were randomly assigned to the control group (50 cases) and the treatment group (61 cases). All patients received comprehensive rehabilitation training and intravenous dripping of Monosialotetrahexosylganglioside Sodium Injection for 10 days. But those in the treatment group additionally received Chinese medical enema for brain resuscitation, relieving rigidity of muscles and activating collaterals for 14 days. Then they started another medication cycle and lasted for a total of 6 cycles. Serum IL-6 levels and TNF-alpha contents were determined before treatment. Scoring for muscular tension, Gesell score for intelligence development, contents of serum IL-6 and TNF-alpha were assessed before and after treatment in the two groups.</p><p><b>RESULTS</b>Compared with before treatment in this group, muscular tension, Gesell scores for intelligence development all decreased in the two groups (P < 0.05). As for inter-group comparison, the decrement was more obvious in the treatment group than in the control group (P < 0.05). The total effective rate was 86.9% in the treatment group and 76.0% in the control group (P < 0.05). The contents of IL-6 and TNF-alpha were obviously reduced in the treatment group and the control group after treatment (P < 0.01). The decrement was more obvious in the treatment group (P < 0.05).</p><p><b>CONCLUSION</b>The two treatment methods were effective for CP children, but the efficacy was superior in the treatment group than in the control group, indicating integrative medical methods could play a synergistic effect and optimize the treatment program for CP.</p>