Computational omics biology model predicts therapy response of refractory acute myeloid leukemia:report of 1 case and review of literature / 白血病·淋巴瘤

Objective:To investigate the value of computational omics biology model (CBM) in treatment of refractory acute myeloid leukemia (AML) patients.Methods:The clinical data of a refractory AML patient who received personalized therapy regimen predicted by Cellworks tumor response index (TRI) test in November 2018 were retrospectively analyzed. The diagnosis, treatment and the therapeutic efficacy were summarized. The literature related to CBM in AML was reviewed.Results:The patient, a 43-year-old female, was diagnosed as AML accompanied with t(6;11)(q27;q23). She failed to respond after 2 courses of induction therapy, and had poor tolerance of chemotherapy. And then the Cellworks TRI test recommended the 3-drug combination regimen of cladribine, trametinib and cytarabine as the optimal chemotherapy regimen. After 1 course of treatment, the patient achieved complete remission and minimal residual disease negative. After remission, the patient successfully underwent haplo-hematopoietic stem cell transplantation. She experienced a prolonged disease-free survival of 19 months and relapsed in November 2020, and passed away in April 2021. The overall survival time was 28.5 months.Conclusions:Cellworks TRI test based on CBM provides a new therapeutic approach for refractory AML patients, and its personalized treatment regimen based on genomics may improve the survival of patients.

Study of betulinic acid to improve non-alcoholic fatty liver disease / 中华内分泌代谢杂志

Objective To explore the effect of betulinic acid on NAFLD and its mechanism. Methods We used the high-fat diet animal models, with or without feeding the standard chow diet containing betulinic acid for 2 months. During this period, the body weight was monitored regularly and metabolism cage was used to monitor the energy metabolism of the animals. After killing the mice, molecular biological analysis was performed on serum and tissue related to liver. Results In diet induced obese mice animal experiments, the mice body weight had been reduced and NAFLD had been improved significantly by betulinic acid. The various indexs of serum and liver tissue had also been significantly improved. The metabolic rate increased significantly. Fatty acid synthase gene and protein levels were significantly lower. Furthermore, FAS activity was significantly lower than the control mice. Liver FAS activity of the high fat mice and the high fat mice treated with betulinic acid were (1873.6 ± 85.7) and (1181.6 ± 85.7) pmol NADPH/ min/ mg protein, respectively. Conclusion Betulinic acid inhibited FAS at expression and activity level, and improved lipid deposition in liver.

Clinical Effectiveness Comparison of Xuebijing or Ulinastain Combined with Conventional Treatment for Chronic Obstructive Pulmonary Disease with Acute Exacerbation Complicated with Systemic Inflammatory Response Syndrome / 中国药师

Objective: To compare the clinical effect of Xuebijing or ulinastain combined with the conventional treatment for chronic obstructive pulmonary disease with acute exacerbation (AECOPD) complicated with systemic inflammatory response syndrome(SIRS).Methods: Totally 82 AECOPD patients with SIRS were randomly divided into group A and group B with 41 ones in each and both groups were treated with the conventional therapy.Group A was treated with ulinastatin (dissolved in 100 ml 0.9% sodium chloride injection, intravenous infusion, once daily), group B was given 50ml Xuebijing injection (mixed with 100 ml saline, intravenous infusion, twice a day).The lung function test, blood gas analysis and inflammatory factors were carried out in both groups.Results: After treatment, the lung function indices of FEV, FEV1 and FEV1/FVC in group A and B were significantly higher than those of before treatment (P0.05).Conclusion: The clinical effect of Xuebijing or ulinastain combined with the conventional treatment is promising for AECOPD complicated with SIRS.Xuebijing injection combined with the conventional treatment shows better effect on the improvement of lung function and blood gas, and the levels of inflammatory cytokines can be reduced more significantly, which is also safe in the clinical application.

Efficacy and prognostic factors of induction therapy combined with autologous stem cell transplantation in 201 patients with multiple myeloma / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the efficacy and prognostic factors of induction therapy combined with autogenetic peripheral blood stem cells transplantation (APBSCT)in patients with multiple myeloma (MM).</p><p><b>METHODS</b>From January 1998 to May 2015, 201 patients with MM were enrolled. All patients received APBSCT after induction therapy. With the follow up to 20 June 2015, the overall survival (OS), progression free survival (PFS)and prognostic factor were analyzed.</p><p><b>RESULTS</b>① With a media follow up of 36.67 months, the median PFS and OS were 22.87 (17.48- 28.26)and 69.63 (63.57- 75.69)months, 5-year PFS and OS were 17% and 49%, respectively. ②After APBSCT, when the subgroup (n= 112) achieved complete response (CR)compared with the subgroup (n=89) not achieved CR, the median PFS were 32.93 (21.03-44.83) and 18.13 (14.46-21.80) months (P<0.001), respectively; And the media OS were 96.77 (71.79- 121.75)and 54.70 (49.53- 59.87) months (P=0.004), respectively. The risks for disease progression and death declined in CR subgroup. ③ Two subgroups included or not included bortezomib/thalidomide at induction therapy (123 patientsvs 21 patients), the media PFS were 31.67 (24.36- 38.98)and 15.20 (10.11- 20.29) months (P=0.013), respectively; And the media OS were 76.30 (55.44- 97.15)and 52.03 (33.76- 70.30) months (P=0.014), respectively. ④According to the ISS stage, the media OS of stageⅠ, Ⅱ, Ⅲ were 99.47 (59.58-139.36), 66.77 (52.17-81.37), 53.97 (28.71-79.23) (P< 0.001), respectively. The risk for death of stage Ⅱ, Ⅲ were 2.16 and 3.04 times higher than stage Ⅰ, with no difference in terms of PFS. ⑤ The media PFS in IgD (n=22) and IgG (n=101) type MM were 11.17 (10.27- 13.13)and 35.43 (22.69- 48.17)months (P=0.007) , respectively; The media OS were 30.83 (0.24-61.42)and 70.70 (53.52-87.88) months (P=0.039), respectively. The risk for disease progression of IgD type was 2.47 times higher than IgG type. ⑥ Patients received 1 line induction therapy (n=132) compared with more than 1 line (n=69), the media PFS were 25.43 (16.09- 34.77)and 20.27 (15.04- 25.50) months (P=0.042). ⑦Cox analysis showed that CR after APBSCT and ISS stage were independent prognostic factors for OS. IgD type MM and CR after APBSCT were independent prognosis factor for PFS.</p><p><b>CONCLUSION</b>CR after APBSCT and ISS stage were independent prognostic factors for OS in MM. CR after APBSCT was independent prognostic factor for PFS in MM. However, disease progression more likely occurred in IgD type MM, which was independent negative prognostic factor for PFS in MM.</p>

Research Progress in Chemical Constituents and Pharmacological Effects of Chaenomeles Speciosa Nakai and Chaenomeles / 中国药师

The studies on the chemical compositions and pharmacological actions of Chaenomeles speciosa Nakai were systemized and compared with those of the other plants of Chaenomeles in this paper. The pharmacological effects of the fruit of Chaenomeles inclu-ding anti-tumor, anti-oxidation, anti-inflammation and analgesia, antibacterial, hypoglycemic and hypolipidemic action and so on were reviewed to provide scientific basis for the further studies and utilization of Chaenomeles.

Influence of Harvest Time on the Characters of Chaenomeles Spciosa (Sweet) Nakai / 中国药师

Objective:To study the influence of harvest time on the characters of Chaenomeles Spciosa ( Sweet) Nakai to determine the optimal harvest time with traditional characters of the Chinese medicine. Methods: In order to explore the optimal harvest time of Chaenomeles Spciosa ( Sweet) Nakai, the content of alcohol-soluble extract, weight and acidity of Chaenomeles Spciosa ( Sweet) Nakai with different harvest time were determined, the weather conditions in recent 3 years was summarized, and the drying process was also studied. Results:The average weight of Chaenomeles Spciosa(Sweet)Nakai was the lowest in June and highest in August, and the den-sity reached maximum in mid-July. During the whole harvest time, the content of alcohol-soluble extract was stable. The weather con-ditions from mid-July to late-July were with high temperature, dry and little rain, which was suitable for drying of Chaenomeles Spciosa ( Sweet) Nakai. Conclusion:The optimal harvest time of Chaenomeles Spciosa( Sweet) Nakai is confirmed in mid-July according to the traditional customs, drying conditions and characters of the Chinese medicine.

Effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients / 中国医师进修杂志

Objective To investigate the effect of three blood purification techniques on minerals disorder in maintenance hemodialysis patients,and provide clinical guidance for patients to choice the blood purification techniques.Methods Eighty-eight maintenance hemodialysis patients were divided into three groups according to the blood purification techniques:hemodialysis (HD) group (30 cases),hemodiafiltration (HDF) group (30 cases),and hemoperfusion (HP) group (28 cases).Serum urea nitrogen,creatinine,calcium,phosphorus,intact parathyroid hormone (iPTH),ftbroblast growth factor (FGF)-23 and so on before and after treatment were measured and compared among the groups.Results The serum phosphorus in HD group,HDF group and HP group before treatment were (1.93 ±0.44),(2.11 ±0.54) and (2.17 ±0.59)mmol/L,and after treatment were (1.01 ±0.23),(0.84 ±0.19),(0.99 ±0.27) mmol/L.There were significant differences in serum phosphorus level after treatment compared with that before treatment in the three groups (P ＜0.05).There were no significant differences in the descend rate of serum phosphorus among the three groups (P ＞0.05).There were no significant differences in clearance index of serum phosphorus among the three groups (P ＞ 0.05).The serum iPTH in HD group before treatment was (48.8 ± 42.9) pmol/L,and after treatment was (49.9 ± 42.9) pmol/L.The serum iPTH in HDF group and HP group before treatment were (64.7 ± 45.4) and (50.4 ± 45.9) pmol/L,after treatment was (46.2 ± 37.8) and (35.8 ± 36.5) pmol/L.There were significant differences in serum iPTH level after treatment compared with that before treatment (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum iPTH in HDF group and HP group (P ＞ 0.05).There was no significant difference in serum FGF-23 in HD group before and after treatment (P＞ 0.05).The serum FGF-23 in HDF group and HP group before treatment were (782.5 ± 105.8) and (879.5 ±97.2) ng/L,after treatment were (712.0 ±98.1),(823.5 ± 89.1) ng/L.There were significant differences in serum iPTH level after treatment compared with that before treatment in HDF group and HP group (P ＜ 0.05).The descend rate of serum FGF-23 in HD group,HDF group and HP group were (5.7 ±2.8)％,(12.3 ±6.2)％ and (9.1 ±4.6)％,and there was significant difference among the three groups (P ＜0.05).The clearance index of serum FGF-23 in HD group,HD F group and HP group were 0.06 ± 0.05,0.19 ± 0.11 and 0.12 ± 0.08,and there were significant differences among the three groups (P ＜ 0.05).There were no significant differences in the descend rate and clearance index of serum urea among the three groups (P ＞ 0.05).Conclusions HD can only clear serum phosphorus.HDF and HP can clear serum phosphorus,iPTH and FGF-23 effectively,while HDF has better clearance effect on FGF-23.The HDF and HP blood purification can reduce minerals disorder in maintenance hemodialysis patients and has important clinical significance in improving the long-term prognosis of the patients.

Effects of adsorption combined with continuous venovenous hemofiltration on the serum inflammatory mediators levels in systemic inflammatory response syndrome patients / 中国医师进修杂志

ObjectiveTo discuss the effects of adsorption(AP) combined with continuous venovenous hemofiltration(CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.ResultsThere was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).ConclusionAP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH.

Evaluation of Pulmonary Venous Flow Pattern in Atrial Septal Defect and Mitral Stenosis by Transesophageal Echocardiography / 中国医师杂志

Objective To investigate the pulmonary venous flow pattern (PVFP) in atrial septal defect (ASD) and mitral stenosis (MS),to analyze the differences of PVFP in each group and evaluate their clinical value. Methods The characteristics of PVFP and mitral valve flow pattern in 42 patients of ASD and 17 patients of MS were prospectively compared by transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), and also compared with the normal subject. Result The PVFP was significantly different between MS and ASD, including S、D、Ar、S-T (P