The Relationship between Body Mass Index and Adult Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analysis the relationship between different BMI (body mass index) and the clinical characteristics, laboratory examination indexes of newly diagnosed adult patients with acute myeloid leukemia (AML), so as to investigate the effects of BMI to the efficacy of first induction chemotherapy.@*METHODS@#The clinical data of 145 newly diagnosed adult AML patients treated in the First Hospital of Lanzhou University from August 2015 to August 2019 were retrospective analyzed. According to the guidelines for prevention and control of overweight and obesity in Chinese adults, the BMI (kg/m@*RESULTS@#Among the 145 newly diagnosed adult AML patients, there were 71 males and 74 females. The median age was 50 years old(range 18 to 82 years old). There were 21 patients in underweight group (14.5%), 79 patients in normal weight group (54.5%), and 45 patients in overweight and obese group (31.0%). The patients with higher BMI level showed the older in age（P=0.018）. There were significant differences in sex between the patients in each group(P=0.035). In overweight and obese patients, the number of male was significantly higher than female. There were no statistical differences in AML classification, comorbidities(Diabetes, hypertension, coronary heart disease), hospital days, whether secondary AML and FLT3 gene mutation among the patients in different BMI groups. There were significant differences in TG of the patients in the different groups, the overweight and obese patients were higher (P=0.007). There were no significant differences in WBC and Hb counts, ALB, TC, HDL, LDL, or LDH between the patients in each BMI group at newly diagnosed. The complete remission rate of the patients in the low body mass group or overweight and obese group were lower than that in the normal body weight group (P=0.035). The rate of documented infection during the first induction chemotherapy were significantly higher for the patients in low body mass group than those in normal weight group or overweight and obese group (P=0.038). There was no statistical difference in chemotherapy regimens, the number of chemotherapy until CR, febrile neutropenia, bleeding, and the time of neutropenia, liver and kidney toxicity among each BMI group. Multivariate analysis showed that overweight and obese (P=0.012) , FLT3 mutation (P=0.015) were the risk factors affecting the CR rate of the patients. And the patients with secondary AML, high-risk type, and newly diagnosed WBC ≥50×10@*CONCLUSION@#In newly diagnosed adult patients with AML, low body mass, overweight and obesity, and FLT3 mutations were the factors reducing the early efficacy of AML patients. There were more adverse reactions induced by chemotherapy in the low body mass group. Therefore, inappropriate BMI level can be a risk factor for assessing the prognosis of adults with newly diagnosed AML.

Efficacy of Modified Bushen Huoxuetang on Kidney Deficiency and Blood Stasis Type Early Unexplained Recurrent Abortion and Its Effect on Intestinal Flora / 中国实验方剂学杂志

Objective::To explore the clinical efficacy of modified Bushen Huoxuetang on kidney deficiency and blood stasis type early unexplained recurrent abortion and its effect on intestinal flora. Method::Totally 90 patients with kidney deficiency and blood stasis type early unexplained recurrent abortion were selected from March 2017 to October 2018.According to the random number table, they were divided into control group and observation group, with 45 cases in each group. The control group was given Bushen Huoxue capsule, while the observation group was given modified Bushen Huoxuetang. After treatment, the clinical efficacy, traditional Chinese medicine (TCM) syndrome scores and adverse reactions of two groups were compared, and the changes of serum inflammatory factors, coagulation function and intestinal flora were detected before and after treatment. Result::After treatment, the total effective rate of the observation group was 91.11%, which was higher than 77.78%of the control group (P<0.05). The scores of TCM syndromes in observation group were significantly lower than that in control group (P<0.05). The levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) in the observation group were significantly lower than those in control group (P<0.05). The thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT) in observation group were significantly higher than those in control group, while fibrinogen (FIB) was significantly lower than that in control group (P<0.05). The numbers of enterococcus, yeast and Enterobacter in observation group were significantly lower than those of control group, while the numbers of bifidobacteria and Lactobacillus in observation group were significantly higher than those of control group (P<0.05). The incidence of adverse reactions in observation group was 11.11%, which was lower than 28.89%of the control group (P<0.05). Conclusion::Modified Bushen Huoxuetang has a good clinical efficacy in treating kidney deficiency and blood stasis type early unexplained recurrent abortion, and can reduce the TCM syndrome score. Its mechanism may be related to the reduction of inflammation, and improvement of coagulation function and intestinal flora, with a good safety.

Expression and prognostic value of M2 macrophages and regulatory T cells in gastric carcinoma tissue / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the prognostic value of M2 macrophages and regulatory T cells(Tregs) in gastric carcinoma.</p><p><b>METHODS</b>Clinicopathological characteristics and follow up data of 135 patients with gastric carcinoma were collected. Patients included were those who underwent D2 radical resection(R0) at Zhongshan Hospital of Fudan University from February 1999 to December 2005. Tissue chips of gastric carcinoma specimen were stained using immunohistochemistry to determine the cells density and number of M2(CD163 positive) and Tregs(Foxp3 positive).</p><p><b>RESULTS</b>The median positive cells density of M2 macrophages and Tregs in tumor tissue were 7.48/HP and 6.33/HP, respectively, higher than that in adjacent tissues(1.37/HP and 2.92/HP, P<0.001). The density of M2 macrophages was positively correlated with that of Treg cells(r=0.415, P<0.001) in tumor tissue. The median survival of patients with low expression of M2 and Tregs(n=43) was significantly longer than those with high expression of the 2 cells(n=45) (99.0 vs. 72.3 months, P<0.05).</p><p><b>CONCLUSION</b>Combined detection of M2 macrophages and Tregs may predict the prognosis of gastric carcinoma.</p>