[Breakthrough of invasive fungal disease with posaconazole as primary prophylaxis after induction chemotherapy for acute myeloid leukemia].

Objective: To investigate the breakthrough incidence of invasive fungal disease(IFD) and side effects of posaconazole as primary prophylaxis during induction chemotherapy for acute myeloid leukemia(AML). Methods: A total of 206 newly diagnosed AML patients admitted to our department during January 2016 and December 2018 were enrolled in the study. Exclusive criteria were as followings including patients diagnosed as acute promyelocytic leukemia; those who received intravenous antifungal therapy after admission or had history of IFD one month before induction chemotherapy, or those with functional insufficiency of vital organs and those older than 65. Forty-seven patients received posaconazole (posaconazole group), 61 cases received voriconazole (voriconazole group) and 98 cases did not receive any prophylaxis (control group) during induction chemotherapy. Prophylactic efficacy and safety between posaconazole and voriconazole were compared. Results: During induction chemotherapy, five possible cases of IFD occurred in posaconazole group (10.6%); while 11 cases (18.0%) were in voriconazole group including 7 possible, 3 probable and 1 proven. Thirty-five cases (35.7%) in control group were diagnosed as IFD including 19 possible, 11 probable and 5 proven ones. The incidences of IFD in posaconazole and voriconazole group were significantly lower than that in control group (P<0.05). The difference of posaconazole group and voriconazole group was not significant (P>0.05). The reported adverse events in posaconazole group were significantly lower than those in voriconazole group [12.8%(6/47) vs. 32.8%(20/61), P<0.05]. Conclusions: Posaconazole and voriconazole decrease IFD as primary prophylaxis during induction chemotherapy in patients with AML. The prophylactic effect of IFD with posaconazole is similar as voriconazole, but posaconazole shows better safety.

[Effect of FLT3-ITD with DNMT3A R882 double-mutation on the prognosis of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation].

Objective: To investigate the impact of FLT3-ITD and DNMT3A R882 double mutations to the prognosis of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: FLT3-ITD, DNMT3A, C-kit, CEBPA, FLT3-TKD and NPM1 mutations were detected in 206 newly diagnosed AML patients by Sanger sequencing (M(3) and those received FLT3 inhibitor were excluded). Clinical data of AML patients were retrospectively analyzed to compare the prognosis of each gene mutation group. Results: ①Of 206 patients, 104 were male and 102 female with a median age of 38 (3-63) years, including 6 cases of M(0), 24 cases of M(1), 56 cases of M(2), 39 cases of M(4), 63 cases of M(5), 6 cases of M(6) and 12 unclassified cases. ②All 206 patients were divided into four groups according to the mutation gene at the time of diagnosis: FLT3-ITD(+) DNMT3A R882(+) group (group A), FLT3-ITD(+) DNMT3A R882(-) group (group B), FLT3-ITD(-) DNMT3A R882(+) group (group C) and FLT3-ITD(-) DNMT3A R882(-) groups (group D). Gender, leukocyte count at diagnosis, chromosome karyotype, the median age, FAB classification, disease status prior to transplantation, type of donor, conditioning regimen and GVHD were not significantly different between four groups (P>0.05). ③The 2-year cumulative recurrence rate (CIR) of group A was significantly higher than that of other groups [group A (72.2±2.6)%, group B (38.6±0.6)%, group C (36.8±1.6)%, group D (27.8±0.1)%, respectively, P<0.05], while the 2-year overall survival (OS) rate and 2-year leukocyte-free survival (LFS) rate were lower than those of other groups [group A (30.9±13.3)%, (11.3±10.2)%; group B (67.5±7.8)%, (47.9±8.4)%; group C (61.4±12.4)%, (56.8±12.5)%; group D (80.1±3.7)%, (79.7±3.6)%, respectively, P<0.05]. Conclusion: AML patients with FLT3-ITD and DNMT3A R882 double mutations had a very high CIR and low OS, LFS after transplantation.

[Expression characteristics and prognosis significance of miRNA-181a in acute myeloid leukemia with normal karyotype].

Objective: To study the expression of miRNA-181a in acute myeloid leukemia (AML) patients with normal karyotype to probe its prognosis significance. Methods: The expression level of miRNA-181a in bone marrow mononuclear cells of 120 de novo AML patients with normal karyotype was detected by real time fluorescence quantitative PCR. The direct sequencing method was used to detect IDH1, IDH2, NPM1, FLT3-ITD, DNMT3A and CEBPα mutations in CN-AML patients after PCR. The relationship between miRNA-181a expression and gene mutation, the clinical parameters and prognosis were analyzed. Results: The rates of overall surviva1 (OS) in high expression and low expression groups were 25.0 months and 15.0 months, respectively (P<0.05) . Relapse free survival (RFS) in high expression and low expression groups were 21.4 months and 11.2 months, respectively (P<0.05) . Significantly higher level hemoglobin, complete remission rate and proportion of wild type NPM1 expression in the high expression of miRNA-181a group were observed when compared with the lower expression of miRNA-181a group (P<0.05) . Multivariate Cox regression analysis showed miRNA-181a overexpression was an independent prognostic factor for CN-AML (HR=2.219, 95%CI 1.601~2.432, P=0.018) . Conclusion: Higher expression of miRNA-181a was a good prognostic factor independent of clinical parameters and high frequency gene mutations, which implicated that the miRNA-181a expression level could be used as an important prognostic indicator of AML patients with normal karyotype.

[RAPD markers for wheat chromosomes in Langdon disomic substitution lines].

Optimal conditions were developed for a random amplified polymorphio DNA (RAPD) assay of hexaploid bread wheat and tetraploid durum wheat. AmpliTaq Stoffcl fragment was found to be better than Taq DNA polymerase in generating RAPDs. Studies on chromosome specific RAPD markers of the A- and B- and D-genome were performed using the complete set of Langdon disomic substitution lines and the parental lines (Langdon and Chinese Spring) as templete. Seven out of twelve arbitrary primers (all Operon 10-mer sequences) yielded 13 products that could be assigned to 1.0 chromosomes of A- and B- and D-genome, five of 13 markers for A-genome (2A: J6a and J11b; 3A: D11b; 6A: J17; 7A: J15a), seven for B-genome (1B: J11c; 2B: D5, D11c and J18) and one for D-genome (1D: J11a). Using Chinese Spring ditelosomic lines, four RAPD markers were further mapped to a specific chromosome arm (i.e., J11b-2AL, J17-6AL, D11c-2BL, and J11a-1DL). This study demonstrates that reproduoible RAPID markers can be generated and assigned to wheat chromosomes except 4AL, using Langdon disomic substitution lines and Chinese Spring euploid and aneuploids as malerids.

[Protective effects of Angelica sinensis injection on myocardial ischemia/reperfusion injury in rabbits].

The injection of aqueous extract of Angelica sinensis (AS), 50 mg/kg, 30 ml, were administered intravenously at a rate of 0.4 ml/min by an infusion pump 10 min before the left anterior descending coronary artery of rabbit was ligated, the LVP and +/- dp/dtmax of the rabbit heart injured by ischemia/reperfusion in vivo, were significantly higher than those in the control group (N.S. group, P < 0.05-0.01), and the level of malon-dialdehyde (MDA) and the activity of creatine phosphokinase (CPK) in the blood plasma were lower than those in the control group remarkably (P < 0.05-0.01). These results showed that AS exerted obvious protective effects on myocardial dysfunction and myocardial injury induced by ischemia/reperfusion.

Release and depletion of substance P by capsaicin in substantia gelatinosa studied with the antibody microprobe technique and immunohistochemistry.

Using an antibody microprobe technique, we have detected substance P release from the region of the substantia gelatinosa of the cat during the first, but not the second, 30 min of topical application of capsaicin (1-3%) to the tibial nerve. Immunohistochemical analysis also showed that substance P-like immunoreactivity was markedly reduced in the superficial layer of the dorsal horn 30 min after application of capsaicin. These results indicate that substance P is released and then depleted from primary afferent central terminals following acute application of capsaicin to the peripheral sensory nerve.

[Protective effect of Angelica injection on arrhythmia during myocardial ischemia reperfusion in rat].

The protective effects of Angelica injection on arrhythmia were studied through the model of ischemic myocardial reperfusion in rats. The results showed that the incidence of ventricular premature beat and the total incidence of arrhythmia (IA) were greatly reduced by peritoneal injection of Angelica (0.6 gm crude drug/kg) in rats. The difference between the Angelica group (n = 12, IA = 41.7%) and the saline control group (n = 12, IA = 91.7%) was significant (P less than 0.05), while that between Angelica group and verapamil group (n = 10, IA = 40%) was insignificant (P greater than 0.05). The data suggested that Angelica injection is effective on the protection of arrhythmia during the myocardial ischemia reperfusion in rats.