Clinical Efficacy and Mechanism of Quyu Qingjintang on Stroke Complicated with Lung Infection with Phlegm-heat Accumulation Lung Syndrome and Blood Stasis Syndrome / 中国实验方剂学杂志

Objective:To explore the clinical efficacy and mechanism of Quyu Qingjintang in the treatment of stroke complicated with lung infection （SCLI） with phlegm-heat accumulation lung syndrome and blood stasis syndrome. Method:The 60 patients with SCLI with phlegm-heat accumulation lung syndrome and blood stasis syndrome were selected and divided into control group （30 cases） and observation group （30 cases）. The patients in both groups received basic treatments such as thrombolysis and anticoagulation， and were injected with imipenem cilastatin sodium and ambroxol hydrochloride. The patients in control group additionally received Tanreqing capsule on the basis of the conventional treatment while those in observation group were additionally treated with Quyu Qingjintang on the basis of the conventional treatment. The clinical efficacy， lung function， inflammatory factor levels， time to symptoms disappearance， haptoglobin （HPT） and amyloid A （SAA） levels， T lymphocyte subset level and safety index were compared between two groups. Result:The total effective rate was 93.33% （28/30） in observation group， significantly higher than 70.00% （21/30） in control group （<italic>χ²=</italic>5.450， <italic>P</italic><0.05）. After treatment， the symptoms of both groups were improved （<italic>P</italic><0.05）. The scores of fever， cough， wheezing， and expectoration in observation group were lower than those in control group （<italic>P</italic><0.05）. The levels of interleukin-6（IL-6）， white blood cell（WBC）， procalcitonin（PCT）， C-reactive protein（CRP）， HPT， and SAA in observation group were significantly lower than those in control group （<italic>P</italic><0.05）. The forced expiratory volume in one second （FEV₁）， forced vital capacity （FVC） and peak expiratory flow rate （PEF） in observation group were better than those in control group （<italic>P</italic><0.05）. The levels of CD3⁺， CD4⁺， CD4⁺/CD8⁺ in observation group were significantly higher than those in control group （<italic>P</italic><0.05）. The recovery time of WBC count， hospitalization time， lung rales， the time to fever and cough disappearance in observation group were lower than those in control group （<italic>P</italic><0.05）， no serious adverse reactions occurred in two groups. Conclusion:Quyu Qingjintang in the treatment of stroke complicated with lung infection with phlegm-heat accumulation lung syndrome and blood stasis syndrome can significantly improve the treatment efficiency， improve the symptoms of pulmonary infection， reduce the level of inflammatory factors， and improve lung function， with less adverse reactions and high safety， so it is worthy of clinical application.

Clinical Efficacy of Modified Qingjin Huatan Tang on Bronchiectasis with Syndrome of Phlegm-heat Accumulating Lung at Acute Exacerbation / 中国实验方剂学杂志

<b>Objective::To observe the clinical efficacy of modified Qingjin Huatan Tang on bronchiectasis with syndrome of phlegm-heat accumulating lung at acute exacerbation and its inhibitory effect on pro-inflammatory factors and proteolytic activity. <b>Method::One hundred and thirty patients were randomly divided into control group and observation group by random number table. Patients in control group got tazobactam sodium and piperacillin sodium for injection, 3.375 g/time, 1 time/6 hours, and the types of antibiotics were regulated according to the bacterial culture results. And patients in control group also got Ambroxol Hydrochloride injection, 30 mg/time, 2 time/days, and postural drainage. In addition to the therapy of control group, patients in observation group were also given modified Qingjin Huatan Tang, 1 dose/day. Before and after treatment, symptoms and signs were scored. And levels of white blood cell count (WBC), neutrophile granulocyte (GRAN), C-reactive protein (CRP), procalcitonin (PCT) were detected. And scores of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and BODE were graded. And levels of tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-4 (IL-4), IL-6 and IL-8 in sputum, peripheral neutrophil elastase (NE) and cathepsin G were detected. <b>Result::By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.086, <italic>P</italic><0.05), while scores of symptoms and signs in observation group were lower than those in control group (<italic>P</italic><0.01). WBC, GRAN, CRP, PCT, airflow limitation (O), dyspnea (D), motor ability (E) score, BODE index, TNF-<italic>α</italic>, IL-4, IL-6, IL-8, plasma NE and cathepsin G were all lower than those in control group (<italic>P</italic><0.01). And levels of FEV₁, FVC, PEF and FEV₁/FVC were higher than those in control group (<italic>P</italic><0.01). <b>Conclusion::In addition to routine anti-infection and expectoration western medicine therapy, modified Qingjin Huatan Tang can be added to control symptoms and signs, alleviate the degree of illness, improve pulmonary function and the quality of life of patients, and inhibit expression of airway pro-inflammatory factor and proteolysis, with a better clinical efficacy than pure western medicine.

CD7 expression and its prognostic significance in acute myeloid leukemia patients with wild-type or mutant CEBPA / 中华血液学杂志

Objective: To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7(+) in AML patients with wild-type (WT) or mutant-type (MT) CEBPA. Methods: The clinical data of 298 newly diagnosed non-M(3) AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7(+) and CD7(-) patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7(+) group by Kaplan-Meier method. Results: In CD7(+) group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7(-) group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7(+) group comparing to those of CD7(-) group in AML patients with wild type CEBPA. There were no statistical difference between CD7(+) group and CD7(-) group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7(+) group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7(+)-CEBPA MT group, CD7(-) and CD7(+)-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) . Conclusion: The CEBPA mutation rate was higher in CD7(+) AML patients then that of CD7(-) patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.