Clinical observation of venetoclax-based treatment regimens for acute myeloid leukemia / 白血病·淋巴瘤

Objective:To investigate clinical efficacy and safety of venetoclax (VEN)-based regimens in the treatment of acute myeloid leukemia (AML).Methods:The clinical data of 41 AML patients treated with venetoclax-based regimens from January 2021 to December 2021 in Ruijin Hospital North of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The treatment regimens included VEN+demethylating drugs ± gene mutation inhibitors or VEN+chemotherapy with a median number of 2 courses (1- 5 courses).Results:The median age of all patients was 60 years (18-73 years), and there were 24 males and 17 females. After 1 course of VEN-based therapy, 22 (53.7%) patients achieved complete remission (CR) or morphological complete remission without complete blood count recovery (CRi), including 5 patients achieving minimal residual disease (MRD) negative. After 2 courses of treatment, of 17 patients available for efficacy evaluation, 7 patients achieved MRD negative. Among 20 relapsed/refractory AML patients, 9 cases achieved CR/CRi after 1 course of treatment, of which 1 patient had MRD negative. Among 21 patients initially treated and re-treated, 13 cases achieved CR/CRi and 1 case achieved partial remission after 1 course of treatment, of which 4 cases had MRD negative.Conclusions:VEN-based treatment regimens for AML have a high remission rate and tolerable adverse effects.

Fingerprint establishment ，chemical pattern recognition analysis and content determination of Kangfuyan capsules / 中国药房

OBJECTIVE To establish the fingerprints of Kangfuyan capsules and carry out chemical pattern recognition analysis，and simultaneously determine the contents of five components so as to promote the quality standard of the drug. METHODS High performance liquid chromatography （HPLC）fingerprints of 11 batches of Kangfuyan capsules （S1-S11）were established by Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）；identification and attribution analysis of chromatographic peaks were carried out by comparison with the chromatograms of the reference substance and the decoction pieces of single ingredient. SPSS 26.0 and SIMCA 14.1 software were used for cluster analysis and principal component analysis. HPLC method was used to determine the contents of matrine ，phellodendrine chloride ，rutin，forsythoside A and berberine hydrochloride. RESULTS There were 29 common peaks in the fingerprints for 11 batches of samples ，and the similarity was higher than 0.99. A total of 5 chromatographic peaks were identified ，which are matrine （peak 3），phellodendron chloride （peak 14），rutin （peak 20），forsythiaside A （peak 22） and berberine hydrochloride （peak 28）. The results of cluster analysis and principal component analysis showed that S 1-S9 were clustered into one category ，and S 10 and S 11 were clustered into another category. The contents of above 5 components were 29.320 5-60.144 3，0.621 6-1.076 6，1.025 9-2.830 5，2.899 3-6.212 7 and 4.425 1-8.581 6 mg/g， respectively. CONCLUSIONS The established fingerprint and content determination method are stable and reliable ，and can provide reference for the quality control of the preparation in combination with chemical pattern recognition analysis.

The clinical significance of plasma PTX3 in patients with secondary hemophagocytic lymphohistiocytosis / 中华内科杂志

Objective:To investigate the significance of plasma pentraxin 3 (PTX3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods:Plasma PTX3 levels were tested by ELISA in 48 newly diagnosed sHLH patients, 18 healthy volunteers and 9 lymphoma controls in the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2019. Clinical parameters were collected, and the correlations with PTX3 levels were analyzed.Results:PTX3 level in newly diagnosed group was significantly higher than that of healthy control group [16.29(1.17-66.00) vs. 0.76(0.01-7.86) μg/L, P<0.01]. Patients with lymphoma-associated HLH(LHLH) had higher plasma level of PTX3 than Fhose with infection-associated HLH (IHLH) [24.29(3.36-66.00) vs. 9.56(1.17-36.50)μg/L, P<0.05]. Plasma PTX3 levels in 48 sHLH patients were positively correlated with serum ferritin ( P<0.05). Receiver operating characteristic (ROC) curve for plasma PTX3 levels of sHLH and healthy controls produced a cutoff value at 3.9 μg/L, with its 86.7% sensitivity and 94.4% specificity. And ROC analysis showed that PTX3 17.5 μg/L was the critical value for diagnosis of LHLH from non-LHLH group, that the sensitivity and specificity were 63.0% and 76.2% respectively. The 1-year overall survival (OS) rate in patients with PTX3≥17.5 μg/L was significantly lower in those with PTX3<17.5 μg/L (18.5% vs. 75.8%, P<0.01). Conclusion:These results indicate the potential of PTX3 as a biomarker for diagnosis and prognosis in patients with sHLH.

Analysis of intestinal flora in patients with chronic rhinosinusitis based on highthroughput sequencing / 南方医科大学学报

OBJECTIVE@#To investigate the changes in diversity, relative abundance and distribution of intestinal flora in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) using high-throughput sequencing technology identify the intestinal flora significantly related to pathogenesis and progression of CRSwNP.@*METHODS@#Ten patients with CRSwNP hospitalized in the Department of Otolaryngology-Head and Neck Surgery of Guangdong Provincial People's Hospital were selected as the case group with 10 healthy volunteers recruited in the same period as the control group. Fecal genomic DNA extraction kit was used to extract the DNA in the fecal samples, and the DNA fragment length was measured and quantified. The V3 and V4 highly variable regions of the 16S rDNA gene of prokaryotes were amplified followed by library construction, Illumina MiSeq sequencing, sequence alignment and species identification analysis. The relative abundance, diversity and distribution characteristics of the intestinal flora were analyzed, and the relevant metabolic pathways were predicted.@*RESULTS@#Compared with the control group, the patients with CRSwNP had significant changes in the overall structure of the intestinal flora, highlighted by increased abundance of Saccharopolyspora and decreased contents of , , and . Among the metabolic pathways predicted to be associated with CRSwNP, 9 showed significant changes in patients with CRSwNP as compared with the control group ( < 0.05).@*CONCLUSIONS@#Patients with CRSwNP have significant changes in the structural characteristics of intestinal flora related with multiple metabolic pathways, and these changes may play an important role in the development of chronic rhinosinusitis.

Association of glycosylated hemoglobin level at admission with outcomes of intracerebral hemorrhage patients / 中华流行病学杂志

Objective@#To explore the association of the glycosylated hemoglobin (HbA1c) level at admission with 90 days functional outcome in patients with spontaneous intracerebral hemorrhage (ICH).@*Methods@#Patients admitted to the Department of Neurology, Tongji Hospital from January to December 2017 were prospectively and continuously enrolled in this study. Clinical data were collected at admission and functional outcomes 90 days after ICH were assessed by using the modified RANKIN scale. Univariate and multivariate conditional logistic regression models were constructed. Patients were divided into four groups according to the quartile of HbA1c values. The median value of HbA1c in each group was taken as the substitute value and P for trend was calculated. The logistic regression model was fitted by restricted cubic splines to investigate the association between HbA1c level and outcome of ICH.@*Results@#A total of 345 patients with ICH were enrolled, including 214 with favorable outcomes and 131 with poor outcomes (99 severe disability cases and 32 deaths). The risk of poor 90 days outcomes was significantly associated with HbA1c level at admission indicated by multivariate logistic regression analysis, and the P for trend test was <0.001 (middle-level group vs. low-level group: OR=2.33, 95%CI: 1.07-5.07; high-level group vs. low-level group: OR=2.52, 95%CI: 1.12-5.64; extremely high-level group vs. low-level group: OR=6.80, 95%CI: 3.01-15.34). Results from the restricted cubic spline showed that there was a linear correlation between HbA1c level at admission and poor 90 days outcomes of ICH (χ2=14.81, P<0.001; non- linear test: P=0.118). Compared with patients with HbA1c level of 6.5%, the risk of poor outcomes in patients with HbA1c level of <6.5% decreased linearly with the decrease in HbA1c level at admission, and the risk in patients with HbA1c level >6.5% was higher but not significantly.@*Conclusion@#There was correlation between high HbA1c level at admission and 90 days poor outcome of ICH. High HbA1c level is an independent prediction indicator for ICH.

Study on in vitro Bacteriostatic Activity of the Extracts from Miao Medicine Polygonum runcinatum / 中国药房

OBJECTIVE:To study in vitro bacteriostatic activity of the extracts from Miao medicine Polygonum runcinatum. METHODS:Using chloramphenicol and fluconazole as positive control,the inhibitory effects of water extract,95％ ethanol extract and its ethyl acetate and n-butanol fraction on 9 kinds of strains were determined by cup plate method, such as Staphylococcus aureus,Escherichia coli,Shigella flexneri,Salmonella typhi,Bacillus subtilis,Pseudomonas aeruginosa,type B Hemolytic streptococcus,Candida albicans and Cryptococcus neoformans. The parts with bacteriostatic activity and trial strains sensitive to drug were screened. Micro-broth dilution method and agar culture medium plate method were used to determine MIC and MBC of 95％ ethanol extract and its fractions of P. runcinatum to sensitive strains. RESULTS:The water extract of P. runcinatum almost had no inhibitory effect. 95％ ethanol extract showed different degrees of bacteriostatic activity to strains;bacteriostatic effects of it to 6 kinds of bacteria as S. typhi was better than that of type B H. streptococcus and 2 kinds of fungus. The ethyl acetate and n-butanol fraction of 95％ ethanol extracts showed good bacteriostatic effect and the ethyl acetate fraction had stronger effect,while all the fractions of 95％ ethanol extracts showed no inhibitory effect on fungus. MIC and MBC of 95％ethanol extract to above 6 kinds of bacteria were 6.25-12.5 and 12.5-25 mg/mL,respectively;MIC and MBC of ethyl acetate fraction were 3.13-6.25, 6.25-12.5 mg/mL; MIC and MBC of n-butanol fraction were 6.25-12.5, 12.5-25 mg/mL. CONCLUSIONS:95％ ethanol extract,ethyl acetate and n-butanol fractions of Miao medicine P. runcinatum have obvious in vitro bacteriostatic activity to 6 common bacterias as S. typhi.

Relationship between recurrence fear and medical coping modes in cancer patients / 中国实用护理杂志

Objective To explore the relationship between recurrence fear and coping styles of cancer patients. Methods This study was a cross-sectional study, using the convenience sampling to select 126 inpatient cancer patients as the research object. The Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and Medical Coping Modes Questionnaire (MCMQ) were used. Results The Fear of Progression score was (29.97 ± 9.24) points,the mean score of items was (2.50 ± 0.77) points, and the face dimensions of coping styles was (2.55±0.35) points, the avoidance dimension was (2.54±0.35) points, and the yield dimension was (2.38±0.54) points. Different gender (F=4.36,P<0.05) and marital status (F=3.22, P<0.05) of cancer patients in social family dimension of recurrence fear was statistically significant, different gender of cancer patients in avoid disease dimension was statistically significant (F=6.59,P<0.05). The yield dimension in coping style was positively correlated with the recurrence of cancer (r=0.481, P<0.05). Conclusions The recurrent fear of cancer patients with women, divorce and surrender coping strategy is prominent, women tend to take avoid coping strategy in response to disease. Therefore, it′s important to focus on women and divorced people in the psychological intervention of tumor patients, and guide patients to adopt the positive coping style to reduce the recurrence fear.

Efficacy observation of standard-dose IA regimen in treatment of ≥ 55 years old newly diagnosed patients with acute myeloid leukemia / 白血病·淋巴瘤

Objective To explore the clinical efficacy and toxicity of standard-dose IA regimen as induction chemotherapy in treating initially diagnosed acute myeloid leukemia (AML) patients ≥55 years old. Methods A total of 32 patients were enrolled in this study. The remission, survival time and adverse effects after IA regimen were retrospectively analyzed. Results The complete remission (CR) rate, partial remission (PR) rate and overall response (OR) rate were 71.9%(23/32), 9.4%(3/32), 81.3%(26/32) after IA regimen. In favorable, intermediate and poor prognosis groups (grouped by cytogenetic or molecular factors), 6, 14 and 3 cases achieved CR (χ2= 5.571, P= 0.067), 1, 2 and 0 cases achieved PR, while OR rates were 100.0 %(7/7), 84.2 % (16/19), 50.0 % (3/6) (χ2= 2.114, P= 0.359). The median overall survival (OS) time of three groups were 28.07 months (6.57-46.33 months), 16.93 months (0.40-87.57 months) and 3.03 months (2.00-6.00 months) (Z=9.630, P=0.008) and the 2-year OS rates were 83.33%, 46.80%and 0, respectively (χ2=12.206, P< 0.001). Myelosuppression and infections due to neutropenia were the main adverse effects and severe non-hemotologic toxicities were not observed. Conclusion The standard-dose IA regimen can increase CR/OR rate and prolong the median OS time of patients with favorable and intermediate prognosis and it can be used as the first induction chemotherapy regimen for elderly AML patients of ≥55 years old.