Outcomes of different types of pulmonary atresia in neonates treated by ductus arteriosus stenting / 中华儿科杂志

Objective: To summarize the outcomes of different types of pulmonary atresia in neonates treated by ductus arteriosus stenting. Methods: This study was a retrospective cohort study. A total of 19 neonates who had pulmonary atresia treated by ductus arteriosus stenting in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from April 2014 to June 2021 were included. They were divided into the intact ventricular septum (PA-IVS) group and the ventricular septal defect (PA-VSD) group. Ductus arteriosus stents were implanted by different approaches. These children were followed up regularly at the 1, 3, 6, and 12 months after the surgery and annually since then to evaluate the outcome. Independent sample t-test was used for the statistical analysis. Results: There were 12 children in PA-IVS group and 7 in PA-VSD group. All of them were full term in fants. The gestational age of the PA-IVS group and the PA-VSD group was (38.8±1.1) and (37.7±1.8) weeks, the birth weights were (3.2±0.4) and (3.4±1.1) kg, and the age at operation was (10±9) and (12±7) days, respectively, without significant difference (all P>0.05). Among the 12 children with PA-IVS, 9 had stents successfully implanted through the femoral artery and 3 through the femoral vein. Of the 7 children with PA-VSD, 2 had the stents successfully implanted via the femoral artery and 2 failed, and the remaining 3 had stents successfully implanted via the left carotid artery. There was no postoperative thromboembolism, arteriovenous fistula, pseudoaneurysm or other vascular complications. Five children with PA-VSD who had successful operations were followed up at 6 months of age. They all had the operation for pulmonary atresia, repair of the ventricular septal defect, removal of arterial duct stents, and ligation of the arterial duct. All children survived without any stent displacement or stenosis and biventricular circulation was achieved during the follow-up. Conclusions: Ductus arteriosous stenting can be the first-stage treatment for children with PA-IVS and PA-VSD. In addition to the traditional femoral vein and femoral artery approach, the carotid artery can be used as a route for stent placement.

Establishment of a Patient-Derived T-Cell Acute Lymphoblastic Leukemia Xenograft Model in Novel Immunodeficient NCG Mice / 中国实验血液学杂志

OBJECTIVE@#The leukemia cells from patients with T-cell acute lymphoblastic leukemia (T-ALL) were inoculated into NCG mice to establish a stable human T-ALL leukemia animal model.@*METHODS@#Leukemia cells from bone marrow of newly diagnosed T-ALL patients were isolated, and the leukemia cells were inoculated into NCG mice via tail vein. The proportion of hCD45 positive cells in peripheral blood of the mice was detected regularly by flow cytometry, and the infiltration of leukemia cells in bone marrow, liver, spleen and other organs of the mice was detected by pathology and immunohistochemistry. After the first generation mice model was successfully established, the spleen cells from the first generation mice were inoculated into the second generation mice, and after the second generation mice model was successfully established, the spleen cells from the second generation mice were further inoculated into the third generation mice, and the growth of leukemia cells in peripheral blood of the mice in each group was monitored by regular flow cytometry to evaluate the stability of this T-ALL leukemia animal model.@*RESULTS@#On the 10th day after inoculation, hCD45+ leukemia cells could be successfully detected in the peripheral blood of the first generation mice, and the proportion of these cells was gradually increased. On average, the mice appeared listless 6 or 7 weeks after inoculation, and a large number of T lymphocyte leukemia cells were found in the peripheral blood and bone marrow smear of the mice. The spleen of the mice was obviously enlarged, and immunohistochemical examination showed that hCD3+ leukemia cells infiltrated into bone marrow, liver and spleen extensively. The second and third generation mice could stably develop leukemia, and the average survival time was 4-5 weeks.@*CONCLUSION@#Inoculating leukemia cells from bone marrow of patients with T-ALL into NCG mice via tail vein can successfully construct a patient-derived tumor xenografts (PDTX) model.

Effect of Celastrol Based on IRAK4/ERK/p38 Signaling Pathway on Proliferation and Apoptosis of Multiple Myeloma Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of celastrol on the proliferation and apoptosis of human multiple myeloma (MM) cell lines, reveal the relationship between IRAK4/ERK/p38 signaling pathway and celastrol regulating the proliferation and apoptosis of H929 and ARP-1 cells, and explore whether celastrol combined with bortezomib has synergistic effect. @*METHODS@#CCK-8 method was used to detect the viability of MM cell lines H929 and ARP-1 treated by different concentrations of celastrol, bortezomib, and their combination, and the synergistic effect was determined by Kim's formula. The apoptosis rate of H929 cells and necrosis rate of ARP-1 were detected by Annexin V/PI method. The expression of key proteins and apoptosis proteins in IRAK4/ERK/p38 signaling pathway were detected by Western blot. @*RESULTS@#Celastrol could significantly inhibit the proliferation of H929 and ARP-1 cells (r=0.9018, r=0.9244) and induce apoptosis in a time-dependent manner. Compared with the control group, celastrol could significantly up-regulate the expression of PARP and cleaved caspase-3 while down-regulate the expression of p-IRAK4, p-ERK, and p-p38 in H929 and ARP-1 cells. Celastrol and bortezomib alone inhibited the proliferation of H929 and ARP-1 cells. Compared with celastrol and bortezomib alone, their combination had lower cell survival rate and higher apoptosis rate (P<0.05). @*CONCLUSION@#Celastrol can inhibit the proliferation and promote the apoptosis of H929 and ARP-1 cells, which may be related to inhibiting the phosphorylation of IRAK4 and blocking the activation of IRAK4/ERK/p38 signaling pathway. Celastrol combined with bortezomib has synergistic effect, which can more effectively inhibit the proliferation and induce apoptosis of H929 and ARP-1 cells.

Effects of Qingguang’an Granules on mitochondrial autophagy of retinal ganglion cells in rats with chronic ocular hypertension / 数字中医药（英文）

@#Objective To investigate the effect and underlying mechanism of Qingguang’an Granules (青光安颗粒剂, QGAG) on mitochondrial autophagy (mitophagy) of retinal ganglion cells (RGCs) in rats with chronic ocular hypertension (COH). Methods Sixty Sprague Dawley (SD) rats, half males and half females, were randomly assigned to three groups: the control, model, and QGAG (2.5 g/kg) groups, with 20 rats in each group. Rats’ model of COH was established by cauterizing episcleral veins in the model group and QGAG group. Three weeks after successful modeling, rats in the QGAG group were intragastrically administered with QGAG, while rats in the control group and the model group received an equal dose of normal saline. After three months of intragastric administration, intraocular pressure (IOP) of all rats was measured. The mitophagy was monitored by the immunofluorescence method, the mitochondrial membrane potential was measured using the JC-1 method, and the morphological changes of mitophagy in RGCs were observed by transmission electron microscopy. Meanwhile, rat RGCs were labeled using the fluorescent gold method, and RGCs density in each group was calculated. Moreover, RGCs apoptosis was observed by TdT-mediated dUTP Nick-End Labeling (TUNEL) assay. Finally, the expression levels of Parkin, optineurin, microtubule-associated protein 1 light chain 3-II/microtubule-associated protein 1 light chain 3-I (LC3-II/LC3-I), recombinant lysosomal associated membrane protein 1 (LAMP1), and B-cell lymphoma-2 (Bcl-2) in RGCs were determined by Western blot assay. The corresponding mRNAs were detected through quantitative real-time polymerase chain reaction (qRT-PCR). Results The QGAG reduced IOP in COH rats, and inhibited mitophagy and apoptosis of RGCs (P < 0.05). Besides, the QGAG significantly increased the expression levels of Parkin and Bcl-2 (P < 0.05), and inhibited the expression levels of optineurin, LAMP1, and LC3-II/LC3-I (P < 0.05) in RGCs of COH rats. Conclusion The QGAG can inhibit mitophagy in RGCs of COH rats and show a protective effect against optic nerve damage caused by glaucoma, which may be mediated through the mitophagy ubiquitination via the Parkin/PINK1-related pathway.

Progress in the study of antiviral activity of cepharanthine against SARS-CoV-2 / 南方医科大学学报

As a member of the dibenzyl isoquinoline alkaloid family, cepharathine is an alkaloid from the traditional Chinese medicine cepharathine, which is mainly used for treatment of leukopenia and other diseases. Recent studies of the inhibitory effect of cepharathine against SARS-CoV-2 have attracted widespread attention and aroused heated discussion. As the original discoverer of the anti-SARS-CoV-2 activity of cepharanthine, here we briefly summarize the discovery of cepharanthine and review important progress in relevant studies concerning the discovery and validation of anti-SARS-CoV-2 activity of cepharathine, its antiviral mechanisms and clinical trials of its applications in COVID-19 therapy.

Performance test and evaluation on Halcyon medical linear accelerator / 中国职业医学

@#Abstract: Objective To evaluate the key quality control and protective performance test of Halcyon medical linear accelerator. Methods WS 674-2020Specification for Testing of Quality Control in Medical Linear Accelerator（ According to the hereinafter WS 674-2020） ， referred to and the manufacturer´s manual the performance of the first Halcyon medical linear accelerator in Results ， ， Hunan Province was tested. The results showed that all ten indicators of the accelerator including dose deviation ， ， （ ， ， ， - repeatability linearity daily stability and symmetry the results were 0.10% 0.03% 0.04% 0.50% and 100.50% 100.80% ）， - - respectively met the requirements of WS 674 2020. The results of manufacturer quality control indicators such as dose rate ， ， stability in beam gantry rotation isocenter and mechanical position accuracy megavolt image parameters and cone beam computer tomography image parameters met the requirements of the manufacturer´s regulations. Due to the special structure and ， - ： function of the accelerator it is difficult to detect the parameter required by WS 674 2020 as below the radiation leakage - ， ， ， ， outside the M zone the uniformity the indicators related to the light field the offset of the radiation beam axis the zero scale Conclusion - position of the rotating motion scale and others. It is difficult to carry out complete testing according to WS 6742020 for Halcyon medical linear accelerator and it is urgent for the state to issue relevant testing standards to standardize and strengthen the quality control testing of various accelerators.

Analysis of Serum Metabonomics in Patients with Multiple Myeloma Based on Liquid Chromatography-Mass Spectrometry / 中国实验血液学杂志

OBJECTIVE@#To observe the changes of serum metabolites in patients with multiple myeloma (MM) by metabonomics, and explore the potential biomarkers for diagnosis, prognosis, and progression of MM.@*METHODS@#Serum samples were collected from 26 patients with MM and 50 healthy controls. The data detected by liquid chromatography-mass spectrometry (LC-MS) was input into SIMCA-14.0 software for multivariate statistical analysis. Principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), and orthogonal partial least squares discriminant analysis (OPLS-DA) were used to analyze the changes of metabolites.@*RESULTS@#The metabolic change of uric acid and trans-vaccenic acid in serum samples of MM patients was 9.39 times and 2.77 times of these in healthy people, respectively, which were significantly higher than those of healthy people, and the difference was statistically significant(P<0.01).@*CONCLUSION@#Uric acid and trans-vaccenic acid are expected to be important metabolic indicators for the diagnosis, prognosis, and efficacy evaluation of MM, thus providing some clues for the pathogenesis of MM.

Moisture sorption and diffusion determination of Chinese herbal granules: Moisture-resistant effects of fluidized bed granulation with dextrin / 中草药·英文版

Objective: To investigate the effects of fluidized bed granulation with dextrin on moisture sorption and diffusion of Zexie Decoction granules. Methods: The particle characterization was studied by the particle size, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and Fourier transform infrared (FTIR). The moisture sorption isotherm, equilibrium moisture content (EMC), and moisture diffusion coefficients were determined by using the saturated salt solution method. Results: The particle size increased from 6.04 µm (powder) to 1201.47 µm (granule). The glass transition temperature of dextrin, Zexie Decoction powder, and granule was 107.13 °C, 94.82 °C, and 126.25 °C. As the increase of temperature, the initial rate of moisture sorption become higher. Furthermore, the initial rate of moisture sorption of Zexie Decoction granules was lower than those of powders and dextrin. The EMC and moisture diffusion coefficients were reduced significantly after granulation (P < 0.01). Critical relative humidity and diffusion activation energy of granules were higher than powders. Conclusion: Results suggested that fluidized bed granulation with dextrin could reduce the hygroscopicity of the Zexie Decoction extract powders and inhibited moisture diffusion, which is mainly related to the microstructure reorganization by fluidized bed granulation and anti-plasticizing effects of dextrin.

Application of optical coherence tomography angiography in donor selection in xenocorneal transplantation / 眼科新进展

Objeetive To compare the thickness of corneal epithelium and full-thickness of the cornea among New Zealand rabbits,cats and the human using optical coherence tomography angiography (OCTA) technology as to explore the morphological basis for different animals as experimental models of xenocorneal transplantation.Methods Totally selected 12 New Zealand male rabbits and 12 male cats were included in this study and divided into group A and B.Then the thickness of corneal epithelium and full-thickness of the cornea of both eyes in the two groups were measured with OCTA technology,and according to the distance from the center of the cornea,the cornea was divided into 17 areas by System software.The center of the cornea was a diameter of 2 mm around the center of the cornea,with the inner ring and outer ring of 5 mm and 6 mm in diameter,respectively;and the inner and outer ring region was again divided into 8 areas,including superior side (S),superior nose side (SN),nasal side (N),inferior nose side (IN),inferior side (I),inferior temporal side (IT),temporal side (T),superior temporal side (ST).Then the thickness of corneal epithelium and full-thickness of the cornea in each region were measured for comparing the difference of New Zealand rabbits' and cats' corneal thickness with the human's.Results The thickness of corneal epithelium and full-thickness of the cornea of cats were both thicker than those of rabbits.The full-thickness of the cats' cornea became thinner from the central to the peripheral side,and the difference of thickness between the T5,ST5,S5,SN5,N5 areas and the central of the cornea was statistically significant (all P ＜0.05);the thickness of corneal epithelium in the ST5,S5,SN5 areas was significantly thicker than the central area (all P ＜0.05);And this was true of the rabbits' full-thickness of the cornea,and the difference in the full-thickness of the cornea between the T5,IT5,IN5,N5,T6,N6 area and the central region was statistically significant (all P ＜ 0.05);meanwhile there were also significant difference in the thickness of corneal epithelium between the ST5,S5,SN5,ST6,S6,SN6 areas and the central area (all P ＜ 0.05).Additionally,there were significant differences in the thickness of corneal epithelium and full-thickness of the cornea between the two experimental animals and humans (all P ＜ 0.05).Conclusion The cornea of cats possesses similar regions in corneal full-thickness and epithelial thickness as well as the distribution to human cornea,so cats have superiority to the rabbits for the potential donor of xenocorneal transplantation in human beings.

Discussion on battery management of ECG monitor in grade A tertiary hospital / 医疗卫生装备

Objective To discuss the battery management of ECG monitor to enhance its benefits.Methods The application of ECG monitor battery in all the departments was analyzed,and a management scheme was proposed that executed proper supplying in the nurse station and centralized allocation in leasing center.Results The proposed scheme decreased the failure risks of the battery and saved the cost of the departments.Conclusion Battery management concept can be applied to other types of medical equipment so as to further optimize medical equipment management mechanism in the medical facility.

Design of data acquisition and monitoring system for ventilator / 医疗卫生装备

Objective To design a data acquisition and monitoring system to facilitate the maintenance of the ventilator.Methods The system was composed of two modules of data acquisition and monitoring.The data acquisition module used MSP430F149 SCM as the master control chip to realize real-time acquisition and storage of operation data,and the monitoring module adopted STM32 SCM as the master control chip to implement equipment monitoring,server serial port conversion and data communication.Wireless data transmission between the two modules was executed with wireless NRF24L01 module.Results The system realized real-time acquisition and storage of the ventilator log,and transmitted acquired data to the server.Conclusion The system eliminates the deficiencies of manual operation and implements basic risk analysis,and facilitates the engineer to monitor and maintain the ventilator.

Discussion on battery management of ECG monitor in grade A tertiary hospital / 医疗卫生装备

Objective To discuss the battery management of ECG monitor to enhance its benefits.Methods The application of ECG monitor battery in all the departments was analyzed,and a management scheme was proposed that executed proper supplying in the nurse station and centralized allocation in leasing center.Results The proposed scheme decreased the failure risks of the battery and saved the cost of the departments.Conclusion Battery management concept can be applied to other types of medical equipment so as to further optimize medical equipment management mechanism in the medical facility.

Design of data acquisition and monitoring system for ventilator / 医疗卫生装备

Objective To design a data acquisition and monitoring system to facilitate the maintenance of the ventilator.Methods The system was composed of two modules of data acquisition and monitoring.The data acquisition module used MSP430F149 SCM as the master control chip to realize real-time acquisition and storage of operation data,and the monitoring module adopted STM32 SCM as the master control chip to implement equipment monitoring,server serial port conversion and data communication.Wireless data transmission between the two modules was executed with wireless NRF24L01 module.Results The system realized real-time acquisition and storage of the ventilator log,and transmitted acquired data to the server.Conclusion The system eliminates the deficiencies of manual operation and implements basic risk analysis,and facilitates the engineer to monitor and maintain the ventilator.

Study of therapeutic effects of Alprostadil Injection and Composite Salvia Injection on diabetic foot / 药物评价研究

Objective To study the therapeutic effects of Alprostadil Injection and Composite Salvia Injection on diabetic foot.Methods Selected 210 cases of patients with diabetic foot who were treated in our hospital from January 2012 to December 2016,divided into three groups randomly.The group A was treated with Alprostadil Injection,group B was treated with Composite Salvia Injection,the group C was treated with Alprostadil Injection and Composite Salvia Injection.The clinical therapeutic effects of the three groups were compared,and the levels of blood lipid,urea nitrogen,creatinine,beta-globulin and urinary microalbumin before and after treatment were compared.Results After treatment,the effective rate of the group C was 92.86％ (65/70),significantly higher than that of the group A and B (P ＜ 0.05).After treatment,the levels of TG,TC and LDL-C in the three groups were significantly lower than before treatment (P ＜ 0.05),HDL-C levels were significantly higher than before treatment (P ＜ 0.05),and the group C was more significant (P ＜ 0.05).After treatment,the levels of urea nitrogen,creatinine,beta 2 and urinary microalbumin were significantly decreased in the three groups than before (P ＜ 0.05),and the group C was more significant (P ＜ 0.05).Conclusion The effect of Alprostadil Injection and Composite Salvia Injection on diabetic foot is better,which is safe and effective.

A preliminary study of emergency blood collection during a long-distance voyage / 军事医学

Objective To study the method of emergency blood collection during a long-distance voyage to ensure blood transfusion treatment.Methods Ten voluntary blood donors were recruited, a base unit of blood was collected and preserved.Reactions of the blood donors were observed, and the blood quality was tested.Results The success rate of blood collection was 90% and the qualification rate was 100%.Conclusion Emergency blood collection during a long-distance voyage is feasible,which can help ensure blood supply in peace time or war time.

Development of rain gear for stretcher cart / 医疗卫生装备

Objective To develop a rain gear for the stretcher cart to facilitate casualty transport during rainy days. Methods The rain gear was designed with emphases on rain proof, portability, compactness and etc, which was composed of multi fixing and guiding slots and multi metal racks at the cart as well as the rain-proof raincloth and hanger. Results The rain gear behaved well in rain proof, deployment and withdrawal, and enhanced the patient satisfaction and medical staff's efficiency greatly. Conclusion The rain gear gains advantages in design, structure and safety, and thus is worthy promoting practically.

Modified Shengma Biejia Decoction Combined with CAG Program for Elderly Acute Myeloid Leuke- mia Patients with Yin Deficiency Toxin Stasis Syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety of modified Shengma Biejia Decoction (MSBD) combined with CAG program in treating elderly acute myeloid leukemia (AML) patients with yin deficiency toxin stasis syndrome (YDTSS).</p><p><b>METHODS</b>Totally 46 elderly AML patients were assigned to the treatment group (24 cases; treated with MSBD + CAG) and the control group (22 cases; treated with CAG + placebos of Chinese medicine) according to random digit table. The therapeutic course of CM placebo or MSBD was 21 days. The clinical efficacy and adverse reactions were observed. Meanwhile, physical state (ECOG Score), transfusion dependency, and TCM syndrome score were compared before and after treatment.</p><p><b>RESULTS</b>(1) The complete remission rate was 54% (13/24) and the objective response rate (ORR) was 71% (17/24) in the treatment group, obviously higher than those of the control group [36% (8/22); 54% (13/24)], with statistical difference (P = 0.036, 0.042). When comparing the efficacy based on risk level, the moderate and poor ORR was 71% (10/14) and 67% (6/9) in the treatment group, and 57% (8/14) and 33% (2/6) in the control group, with statistical difference between the two groups (P = 0.048; P = 0.010). (2) Compared with before treatment in the same group, the ECOG score significantly decreased, the average infusion time of red cells and platelets were markedly prolonged in the treatment group after treatment (P < 0.05). ECOG score, the average infusion time of red cells and platelets were significantly better in the treatment group than in the control group after treatment (P < 0.05). (3) Compared with before treatment in the same group, scores of fever, hemorrhage, and bone pain were markedly reduced in the control group (P < 0.05); scores of fever, fatigue, hemorrhage, dry mouth, and bone pain were markedly reduced in the treatment group (P < 0.05). Better effect in relief of fever, fatigue, hemorrhage, dry mouth, and so on was obtained in the treatment group than in the control group (P < 0.05). (4) In aspect of hematotoxicity, the incidence of neutropenia, anemia, thrombocytopenia was obviously lower in the treatment group than in the control group [29.2% (7/24) vs 54.5% (12/22); 16.7% (4/ 24) vs 45.5% (10/22); 33.3% (8/24) vs 63.6% (14/22); P < 0.05]. The incidence of fatigue and anorexia was obviously lower in the treatment group than in the control group [37.5% (9/24) vs 63.6% (14/22), 37.5% (9/24) vs 81.8% (18/22); P < 0.05].</p><p><b>CONCLUSION</b>MSBD combined with CAG program in treating elderly AML patients with YDTSS, with efficacy enhancing toxicity reducing effect, had distinct advantages in improving physical condition and clinical symptoms, and reducing transfusion dependency.</p>

Distribution and antimicrobial resistance of pathogens in blood cultures in a tertiary hospital from 2012 to 2015 / 中国感染控制杂志

Objective To investigate the distribution and antimicrobial resistance of major pathogens causing bloodstream infection in a tertiary hospital,so as to guide the clinical rational use of antimicrobial agents.Methods Blood specimens from patients with suspected bloodstream infection in this hospital between January 2012 and January 2015 were cultured,identified and performed antimicrobial susceptibility testing,the major pathogens and antimi-crobial susceptibility testing results were analyzed statistically.Results A total of 1 658 strains of pathogens were isolated from 19 326 blood culture specimens,isolation rate was 8.58%,in which gram-negative bacilli,gram-posi-tive cocci,and fungi accounted for 58.57% (n=971 ),39.38% (n=653),and 2.05% (n=34)respectively,the major gram-negative bacillus,gram-positive coccus,and fungus were Escherichia coli ,coagulase-negative staphylo-cocci (CNS),and Candida albicans respectively.The isolated pathogens mainly distributed in departments of hema-tology,gastroenterology,and cardiovascular surgery.Detection rates of extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli and Klebsiella pneumoniae were 56.35% and 36.14% respectively,but were highly sen-sitive to cefoperazone/sulbactam and carbapenems (resistance rates <3%).The percentage of methicillin-resistant coagulase-negative staphylococcus (MRCNS ) and methicillin-resistant Staphylococcus aureus (MRSA ) were 78.60% and 32.28%respectively,but were highly sensitive to vancomycin and linezolid(resistance rates < 1 %). Conclusion Escherichia coli and CNS are predominant pathogens causing bloodstream infection in this hospital,antimicro-bial resistance rates are high;regular analysis on distribution and antimicrobial resistance of pathogens causing bloodstream infection is helpful for the prevention and control of infection caused by multidrug-resistant organisms.

Effectiveness of CLAT Protocol for Treating Patients with Refractory Acute Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical efficacy and toxicity of CLAT protocol (cladribine, cytarabine and topotecan) for treating patients with refractory acute myeloid leukemia (R-AML).</p><p><b>METHODS</b>A total of 18 patients with R-AML (median age 37 years, range 18 to 58 years; male n = 16, female n = 2) were treated with CLAT protocol, which consisted of cladribine 5 mg/m(2)/d, i.v. on days 1-5, cytarabine 1.5 g/m(2)/d, i.v. on days 1-5, topotecan 1.25 mg/m(2)/d, i.v. on days 1-5 and G-CSF 300 µg/d subcutaneous injection on day 6 until neutrophile granulocyte recovery.</p><p><b>RESULTS</b>Out of 18 patients 2 died of severe infection before the assessment. Among 16 evaluated patients, 10 (55.6%) achieved complete remission (CR), and 2 (11.1%) achieved partial remission (PR), the overall response rate was 66.7%, the rest 4 patients did not respond (NR). The median overall survival time and DFS for the CR patients was 9.5 months (95%CI: 6.7-16.64) and 9.5 months (95%CI: 6.1-16.7) respectively. The 1 year OS and DFS rates were 45% and 46.9%, respectively. All patients developed grade 4 of granulocytopenia and thrombocytopenia, the median duration was 13 (range 2 to 21) days and 12 days (range 2 to 21), respectively, all patients developed infection, 2 patients died of severe infection. The most common non-hematological side effects included nausea, vomiting, diarrhoea, rash, aminotransferase or bilirubin elevation and were grade 1 to 2.</p><p><b>CONCLUSION</b>The CLAT protocol seems to have promising for the treatment of refractory AML patients, and patients well tolerated. This CLAT protocol offers an alternative treatment for R-AML patients who received severe intensive treatment, especially with anthracycline-containing chemotherapy.</p>

The diagnostic value of circulating microRNAs for middle-aged (40–60-year-old) coronary artery disease patients

OBJECTIVE: Circulating microRNAs have been recognized as promising biomarkers for various diseases. The present study aimed to explore the potential roles of circulating miR-149, miR-424 and miR-765 as non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged (40–60-year-old) patients. METHODS: Sixty-five stable coronary artery disease patients (49–57 years old), 30 unstable coronary artery disease patients (49–58 years old), and 32 non-coronary artery disease patients (49–-57 years old) who were matched for age, sex, smoking habits, hypertension and diabetes were enrolled in this study. Total RNA was isolated from plasma with TRIzol reagent. Circulating miRNA levels were measured by quantitative real-time polymerase chain reaction. RESULTS: Circulating miR-149 levels were decreased 4.49-fold in stable coronary artery disease patients (1.18 ± 0.84) and 5.09-fold in unstable coronary artery disease patients (1.04 ± 0.65) compared with non-coronary artery disease patients (5.30 ± 2.57) (p<0.001). Circulating miR-424 levels were reduced 3.6-fold in stable coronary artery disease patients (1.18 ± 0.60) and 5-fold in unstable coronary artery disease patients (0.86 ± 0.54) compared with non-coronary artery disease patients (4.35 ± 2.20) (p<0.001). In contrast, circulating miR-765 levels were elevated 3.98-fold in stable coronary artery disease patients (6.09 ± 2.27) and 5.33-fold in unstable coronary artery disease patients (8.17 ± 2.77) compared with non-coronary artery disease patients (1.53 ± 0.99) (p<0.001). Receiver operating characteristic curve analysis revealed that the respective areas under the curve for circulating miR-149, miR-424 and miR-765 were 0.938, 0.919 and 0.968 in stable CAD patients and 0.951, 0.960 and 0.977 in unstable coronary artery disease patients compared with non-coronary artery disease patients. CONCLUSION: Our results suggest that circulating miR-149, ...