Expanded activated autologous lymphocyte infusions improve outcomes of low- and intermediate-risk childhood acute myeloid leukemia with low level of minimal residual disease.

The presence of minimal residual disease (MRD) is a risk factor for relapse among children with acute myeloid leukemia (AML), and eliminating MRD can usually improve survival rates. To investigate the effect of expanded activated autologous lymphocytes (EAALs) combined with chemotherapy on eliminating MRD and improving survival rates of children with AML, we retrospectively analyzed the results of 115 children with low- or intermediate-risk AML with MRD treated at the Pediatric Hematological Center, Peking University People's Hospital, between January 2010 and January 2016. The patients were assigned to the chemotherapy plus EAAL (combined therapy) group (n = 61) and chemotherapy group (n = 54). The MRD-negativity rates were 95.1% (58/61) in the combined therapy group and 63.0% (34/54) in the chemotherapy group (P < 0.0001) during consolidation treatment. The 5-year event-free survival rate was higher in the combined therapy group than in the chemotherapy group (86.3 ± 4.6% vs. 72.1 ± 6.1%, P = 0.025). No severe adverse event was observed after EAAL infusion. The present study showed that EAAL combined with chemotherapy could improve the MRD-negativity rate and event-free survival rate among children with AML with low level MRD-positive status.

Identification of autotoxic compounds in fibrous roots of Rehmannia (Rehmannia glutinosa Libosch.).

Rehmannia is a medicinal plant in China. Autotoxicity has been reported to be one of the major problems hindering the consecutive monoculture of Rehmannia. However, potential autotoxins produced by the fibrous roots are less known. In this study, the autotoxicity of these fibrous roots was investigated. Four groups of autotoxic compounds from the aqueous extracts of the fibrous roots were isolated and characterized. The ethyl acetate extracts of these water-soluble compounds were further analyzed and separated into five fractions. Among them, the most autotoxic fraction (Fr 3) was subjected to GC/MS analysis, resulting in 32 identified compounds. Based on literature, nine compounds were selected for testing their autotoxic effects on radicle growth. Seven out of the nine compounds were phenolic, which significantly reduced radicle growth in a concentration-dependent manner. The other two were aliphatic compounds that showed a moderate inhibition effect at three concentrations. Concentration of these compounds in soil samples was determined by HPLC. Furthermore, the autotoxic compounds were also found in the top soil of the commercially cultivated Rehmannia fields. It appears that a close link exists between the autotoxic effects on the seedlings and the compounds extracted from fibrous roots of Rehmannia.

[Study of lower extremity muscle function in stroke patients by velocity-encoded phase-contrast magnetic resonance imaging].

OBJECTIVE: To compare the difference of muscle dynamic characteristics for the ankle dorsiflexors and plantarflexors between stroke patients at the chronic stage and healthy controls so as to provide a new method of assessing the in vivo muscle function in patients with hemiplegia. METHODS: From May 2008 to May 2009, 26 stroke patients and 21 age-and gender-matched normal controls were recruited. All subjects were positioned on a scanner table and requested to perform the voluntary movement of ankle flexion-extension. The velocity encoded phase contrast magnetic resonance imaging (VE-PC MRI) provided the images of tibialis anterior muscle (TA), medial head of gastrocnemius muscle (MG) and soleus muscle (SOL) during a movement cycle. By measuring the calf muscle contraction velocity, the balance function was assessed by Berg balance scale (BBS). The correlation between scores of BBS and the mean maximum velocity were compared and analyzed. RESULTS: The peak velocity of TA (1 - 8 phase, 8.900 - 21.120 mm/s vs 12.99 - 34.50 mm/s), MG (12-19phase, 13.60 - 13.28 mm/s vs 25.85 - 18.38 mm/s) and SOL (12 - 16 phase, 18.63 - 33.62 mm/s vs 27.68 - 47.22 mm/s) was lower in the affected side than that in the controls during ankle extension (P < 0.05); During ankle dorsiflexion, the co-contraction index of SOL/TA (2 - 9 phase, 0.81 - 0.82 vs 0.27 - 0.44) and the co-contraction index of GM/TA (2 - 9 phase, 0.73 - 0.58 vs 0.10 - 0.11) was markedly higher in the affected side than the controls. The patient score of BBS was negatively correlated with the mean velocity of TA (r = -0.69, P = 0.001) and GM (r = -0.47, P = 0.01) in the affected side. There was correlation between TA (r = -0.60, P = 0.001) and GM (r = -0.49, P = 0.01) in the unaffected side. CONCLUSION: During the movement of active ankle flexion-extension, the velocities of TA, SOL and MG are lower in the affected side. The co-contraction index is markedly higher in the affected side during ankle dorsiflexion. This in turn leads to a decline of balance function in patients. VE-PC MRI can provide quantitative in vivo measurements of lower extremity muscle function in stroke patients.

[Relationship between the changes of surface electromyographic signal of thigh muscle and balance function in stroke patients].

OBJECTIVE: To explore the relationship between the changes of surface electromyography (sEMG) signal of thigh muscles and balance function in stroke patients during maximum isometric voluntary contraction (MIVC) of knee extension and flexion so as to provide rationales for rehabilitation. METHODS: Twenty-one stroke patients and 18 age- and sex-matched normal controls were recruited for this study. The surface electromyographic signals of of vastus medialis (VM), rectus femoris (RF), vastus lateralis (RL) and biceps femoris (BF) were recorded during MIVC of knee extension and flexion. Root mean square (RMS) and co-contraction ratio (CR) of both groups were compared and analyzed. The balance function was assessed by Berg balance scale (BBS). RESULTS: There were significant differences in RMS of VM, RF, VL and BF of ipsilateral [(136 +/- 63) microV, (107 +/- 24) microV, (154 +/- 19) microV, (91 +/- 63) microV], thigh during knee extension and flexion (P < 0.05). There were significant differences in CR on ipsilateral thigh muscles than the unaffected (43% +/- 13% vs 37% +/- 20%) and controls (43% +/- 13% vs 32% +/- 10%) during knee flexion (P < 0.05). The RMS of RF and BF on ipsilateral thigh was significantly positively correlated with the score of BBS (rRF = 0.53, P = 0.01 vs rBF = 0.51, P = 0.02); The CR of knee extension and flexion on ipsilateral thigh had a significantly negative correlation (CRE = -0.59, P = 0.005 vs. CRF = -0.41, P = 0.046). CONCLUSION: The strength of bilateral thigh muscles decreases in stroke patients. The spasticity of thigh extensor still exists. Besides reducing the spasticity of hemiplegic limb extensor, rehabilitation should also focus upon bilateral thigh muscles, particularly ipsilateral RF and BF strength training to improve the knee joint stability and improve the balance function.