Short-term efficacy of venetoclax combined with azacitidine in acute myeloid leukemia: a single-institution experience / 中华血液学杂志

Objective: To explore the safety and short-term efficacy of venetoclax combined with azacitidine (Ven+AZA) in previously untreated patients unfit for standard chemotherapy and patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) in China. Methods: A retrospective study was conducted in 60 previously untreated patients unfit for standard chemotherapy and patients with R/R AML who received Ven+ AZA (venetoclax, 100 mg D1, 200 mg D2, 400 mg D3-28; azacitidine, 75 mg/m(2) D1- 7) at the Peking University Institute of Hematology from June 1, 2019 to May 31, 2021. The incidence of adverse events, complete remission (CR) /CR with incomplete hematological recovery (CRi) rate, objective remission rate (ORR) , and minimal residual disease (MRD) status in patients with different risk stratification and gene subtypes were analyzed. Results: The median age of the patients was 54 (18-77) years, 33 (55.0%) were males, and the median follow-up time was 4.8 (1.4-26.3) months. Among the 60 patients, 24 (40.0%) were previously untreated patients unfit for standard chemotherapy, and 36 (60.0%) were R/R patients. The median mumber cycles of Ven+AZA in the two groups were both 1 (1-5) . According to the prognostic risk stratification of the National Comprehensive Cancer Network, it was divided into 8 cases of favorable-risk, 2 cases of intermediate risk, and 14 cases of poor-risk. In previously untreated patients unfit for standard chemotherapy, after the first cycle of Ven+AZA, 17/24 (70.8%) cases achieved CR/CRi, 3/24 (12.5%) achieved partial remission (PR) , and the ORR was 83.3%. Among them, nine patients received a second cycle chemotherapy and two received a third cycle. Among CR/CRi patients, 8/17 (47.1%) achieved MRD negativity after two cycles of therapy. In the R/R group, after the first cycle of Ven+AZA, 21/36 (58.3%) cases achieved CR/CRi (7/21 achieved MRD negativity) , 3 achieved PR, and the ORR was 66.7%. Among R/R patients, 12 were treated for more than two cycles. There were no new CR/CRi patients after the second treatment cycle, and 14 cases (66.7%) achieved MRD negativity. According to the time from CR to hematological recurrence, the R/R group was divided into 12 cases in the favorable-risk group (CR to hematological recurrence ≥18 months) and 24 in the poor-risk group (CR to hematological recurrence<18 months, no remission after one cycle of therapy, and no remission after two or more cycles of therapy) . Eleven of 24 (45.8%) cases achieved CR/CRi after one cycle of Ven+AZA in the poor-risk R/R group, and 10 of 12 (83.3%) achieved CR/CRi in the favorable-risk R/R group, which was significantly superior to the poor-risk group (P=0.031) . After one cycle of treatment, 13 patients with IDH1/2 mutations and 4 that were TP53-positive all achieved CR/CRi. The CR/CRi rate of 18 patients with NPM1 mutations was 77.8%. Five patients with RUNX1-RUNX1T1 combined with KIT D816 mutation (two initial diagnoses and three recurrences) had no remission. Ven+ AZA was tolerable for AML patients. Conclusion: Ven+AZA has acceptable safety in previously untreated patients unfit for standard chemotherapy, patients with R/R AML can achieve a high response rate, and some patients can achieve MRD negativity. It is also effective in NPM1-, IDH1/IDH2-, and TP53-positive patients. The long-term efficacy remains to be observed.

Two new pyranonaphthoquinones from Mansoa alliacea / 中国中药杂志

Mansoa alliacea,commonly known as garlic vine,is native to the tropical rain forests of South America and widely cultivated in South China. As a popular folk medicine with various biological activities,however,this plant remains to be fully elucidated in terms of its phytochemical constituents. In this study,two new pyranonaphthoquinones were isolated from the 95% ethanol extract of the leaves and twigs of M. alliacea by various chromatographic approaches including silica gel,octadecyl silica( ODS),Sephadex LH-20,and preparative high-performance liquid chromatography( PHPLC). Their structures were determined to be 8,9-dimethoxy-α-lapachone( 1) and 7-hydroxy-8,9-dimethoxy-α-lapachone( 2) by comprehensive spectroscopic analyses and therefore respectively named as mansonin A( 1) and mansonin B( 2).

Triterpenoids from leaves of Ilex guayusa / 中国中药杂志

The chemical constituents from the leaves of Ilex guayusa were investigated. Sixteen triterpenoids were isolated from the 95% ethanol extract of dried leaves of I. guayusa by silica gel, Sephadex LH-20, and ODS column chromatographies and semi-prepa-rative HPLC. Those triterpenoids were identified by NMR, HR-MS, and literature analysis: 3β-hydroxy-11α,12α-epoxy-24-nor-urs-4(23)-ene-28,13β-olide(1), 3β-hydroxy-24-nor-4(23),12-oleanadien-28-methyl ester(2), oleanolic acid(3), 3β,28-dihydroxy-12-oleanene(4), 2α,3β-dihydroxy-11α,12α-epoxy-24-'nor-olean-4(23)-ene-28,13β-olide(5), ursolic acid(6), 3β,23-dihydroxy ursolic acid(7), 3β,28-dihydroxy-12-ursene(8), 3β-28-nor-urs-12-ene-3,17-diol(9), 3β-hydroxyurs-11-ene-28,13β-olide(10), 13β,28-epoxy-3β-hydroxy-11-ursene(11), 3β-hydroxy-28,28-dimethoxy-12-ursene(12), 3β-hydroxy-24-nor-urs-4(23),12-dien-28-oic acid(13), 3β-hydroxy-24-nor-urs-4(23),12-dien-28-methyl ester(14), 2α,3β-dihydroxy-11α,12α-epoxy-24-nor-urs-4(23)-ene-28,13β-olide(15) and 2α,3β-dihydroxy-11α,12α-epoxy-24-nor-urs-4(23),20(30)-dien-28,13β-olide(16). Compounds 1-2 were new compounds, and compounds 4-5, 7 and 9-16 were isolated from I. guayusa for the first time.

UPLC characteristic fingerprint of leaves of Moringa oleifera / 中国中药杂志

This study aims to establish the characteristic fingerprint of the leaves of Moringa oleifera by Ultra High Performance Liquid Chromatography (UPLC) for its quality control. The method was developed on a column of Agilent Eclipse XDB-C₁₈ with acetonitrile-0.01% TFA solution as the mobile phase by gradient elution at a flow rate of 0.5 mL·min⁻¹. The detective wavelength was 210 nm, and the column temperature was 35 °C. The 14 batches of the leaves of M. oleifera were compared for the similarity by using Traditional Chinese Medicine Chromatographic Fingerprint Similarity Evaluation System (2004A). The UPLC characteristic fingerprint was established, and twelve common peaks were identified by comparison with the references and UPLC-MS. The relative retention times were 0.08 (No. 1, adenosine), 0.14 (No. 2, L-phenylalanine), 0.22 (No. 3, 5-caffeoylquinic acid), 0.28 (No. 4, L-tryptophane), 0.42 (No. 5, 4-caffeoylquinic acid), 0.65 (No. 6, vicenin-2), 0.94 (No. 7, vitexin), 0.96 (No. 8, isovitexin), 1.00 (No. 9, isoquercitrin), 1.11 [No. 10, quercetin 3-O-β-D-(6"-malonyl)-glucopyranoside], 1.21 (No. 11, astragalin) and 1.37 [No. 12, kaempferol 3-O-β-D-(6"-malonyl)-glucopyranoside]. It is the first time to establish the UPLC characteristic fingerprint of the leaves of M. oleifera. The method is simple, quick and reproducible with high precision, which can provide a scientific basis for the quality control of the leaves of M. oleifera.

Low-dose tadalafil combined with Shuganyiyang capsules for mild-to-moderate erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of low-dose once-daily tadalafil combined with Shuganyiyang Capsules in the treatment of mild-to-moderate erectile dysfunction (ED).</p><p><b>METHODS</b>Ninety patients with mild-to-moderate ED were equally randomized to groups A, B and C to receive Shuganyiyang Capsules, tadalafil, and tadalafil + Shuganyiyang Capsules, respectively. The scores of the patients on IIEF-5 and SF-PAIRS (15-Item Short Form of Psychological Interpersonal Relationship Scales) were recorded before and at 1 and 3 months after treatment.</p><p><b>RESULTS</b>The IIEF-5 scores of groups A, B and C were 10.13 +/- 1.55, 11.00 + 1.60 and 10.73 +/- 1.91 before treatment, and 13.77 +/- 2.11, 17.77 +/- 2.13 and 17.17 +/- 3.84 at 1 month after treatment, significantly higher in B and C than in A (P <0. 001) , but with no remarkable difference between B and C (P =0. 411). At 3 months after treatment, the IIEF-5 scores were 15.77 +/- 2.05, 18.07 +/- 2.24 and 19.37 +/- 3.76 in the three groups, dramatically higher in B and C than in A (P <0.001) as well as in C than in B (P<0.05). The scores on sexual self-confidence, sexual spontaneity and time concerns in SF-PAIRS were 3.90 +/-0.80, 8.67 +/- 1.94 and 14.43 +/- 1.92 before medication, 5.83 +/- 1.02, 9.90 +/- 1.75 and 11.17 +/- 1.68 at 1 month and 6.73 +/- 0.98, 11.07 +/- 2.08 and 10.67 +/-1.60 at 3 months after medication in group A; 4.17 +/- 0.87, 9.37 +/-1.43 and 14.47 +/-1.57 before medication, 6.47 +/-0.78, 10.83 +/- 2.18 and 10.20 +/-1.56 at 1 month and 6.83 +/-0.91, 11.30 +/- 1.88 and 9.47 +/- 1.57 at 3 months in group B; and 4.23 +/-0. 94, 9.50 +/- 1.89 and 14.67 +/- 2.91 before medication, 8.03 +/- 1.67, 13.43 +/-1.10 and 9.70 +/-1.21 at 1 month and 8.93 +/- 1.78, 14.70 +/- 1.26 and 8. 87 +/- 0. 97 at 3 months in group C. Compared with the baseline, the SF-PAIRS scores of the three groups were all significantly improved after treatment (P <0. 05) , and markedly higher in C than in the other two groups (P <0.05).</p><p><b>CONCLUSION</b>Low-dose once-daily tadalafil combined with Shuganyiyang Capsules is obviously effective in the treatment of mild-to-moderate ED, which not only improves the patients'erectile function, sexual self-confidence and sexual spontaneity, but also reduces their time concerns.</p>

Chemical constituents from leaves of Ilex latifolia / 中国中药杂志

Nine compounds were isolated from the leaves of Ilex latifolia. Their structures were respectively identified as 5-hydroxy-6, 7, 8, 4'-tetramethoxyflavone (1), tangeretin (2), nobiletin (3), 5-hydroxy-6, 7, 8, 3', 4'-pentamethoxyflavone (4), 5, 6, 7, 8, 4'-pentamethoxyflavonol (5), 5, 6, 7, 8, 3', 4'-hexamethoxy-flavonol (6), 5-hydroxy-3', 4', 7-trimethoxyflavanone (7), soyacerebroside I (8), and soyacerebroside II (9) by their physicochemical properties and spectroscopic data Compounds 1-9 were isolated from this plant for the first time.

Simultaneous determination of nine antiviral agents illegally adulterated into traditional Chinese medicines by HPLC-MS/MS / 中国药学杂志

OBJECTIVE: To develop an HPLC-MS method for qualitative and quantitative analysis of nine antiviral agents illegally adulterated in traditional Chinese medicines. METHODS: The samples were separated on a CAPCELL PAK CR 1:4 column (2.0 mm × 150 mm, 5 μm) by gradient elution with 0.1% formic acid solution(adjusted to pH 3.5 with ammonium hydroxide) as the mobile phase A and acetonitrile as the mobile phase B. The gradient elution program was as follows: 0-12 min (90% A→48% A), 12-15 min (48% A→20% A), 15-19 min (20% A→15% A), 19-20 min (90% A). The flow rate was 0.2 mL·min-1 and the injection volume was 5 μL. After being separated by HPLC, the test solution was analyzed by mass spectrometer operated in positive ion mode and in product mode and SRM mode. RESULTS: The calibration curves of the nine antiviral agents showed good linearity and the correlation coefficients were more than 0.998. The recoveries at 3 spiked levels were in the range of 80.6%-117.7%. The limits of quantification were in the range of 0.1-1 μg·g-1. The fragmentation pattern of the nine antiviral agents was summarized. CONCLUSION: The method is sensitive, specific, accurate and applicable to detect the nine antiviral agents in traditional Chinese medicines.

Chemical constituents of leaves of Psidium guajava / 中国中药杂志

To study the chemical constituents of the 95% ethanol extract of Psidium guajava. Compounds were separated by using a combination of various chromatographic methods including silica gel, D101 macroporous resin, ODS, Sephadex LH-20 and preparative HPLC. Their structures were elucidated by physicochemical properties and spectral data Eighteen compounds were isolated and identified as (+) -globulol (1), clovane-2beta, 9alpha-diol (2), 2beta-acetoxyclovan-9alpha-ol (3), (+) -caryolane-1 ,9beta-diol (4), ent-T-muurolol (5), clov-2-ene-9alpha-ol (6), isophytol (7), tamarixetin (8), gossypetin (9), quercetin (10), kaempferol (11), guajaverin (12), avicularin (13), chrysin 6-C-glucoside (14), 3'-O-methyl-3, 4-methylenedioxyellagic acid 4'-O-beta-D-glucopyranoside (15), p-hydroxy-benzoic acid (16), guavinoside A (17) and guavinoside B (18). Compounds 2-9 and 14-16 were isolated from this plant for the first time. The ethanol extract showed 61.3% inhibition against the proliferation of colon cancer cell line SW480.

A new chromone glycoside from roots of Polygonum multiflorum / 中国中药杂志

Several kinds of column chromatography methods were used to investigate the chemical constituents of roots of Polygonum multiflorum. The structures of the isolated compounds were identified based on their physicochemical properties, spectral data and chemical methods. A new chromone glycoside was isolated and its structure was identified as (S)-2-(2'-hydroxypropyl)-5-methyl7-hydroxychromone-7-0-alpha-L-fucopyranosyl (1-->2)-beta-D-glucopyranoside (1).

Effect of modified tianxiong powder in treating oligospermia and asthenospermia / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy and safety of modified Tianxiong Powder (MTP) in treating oligospermia and asthenospermia.</p><p><b>METHODS</b>Eighty patients were equally randomized into two groups, the treated group administered with MTP, and the controlled group administered with Wuzi Yanzong Pill (WYP), all for 3 months. The comprehensive efficacy was observed; and parameters of patients' semen and figure of sperm were analyzed before and after treatment.</p><p><b>RESULTS</b>The observation was completed in 70 patients. The total effective rate and markedly effective rate were 91.43% and 65.71%, respectively in the treated group, 85.71% and 54.29%, respectively in the control group, the pregnancy rate in their wives was 8.57% and 5.71%, respectively. Comparisons showed no statistical significance between groups (P > 0.05). Significant elevated perm count in semen and more active sperms with significantly better spermic figure, were found in both groups. However, the improvements in the treatment group were superior to those in the control group (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>MTP shows good efficacy and high safety in treating oligospermia and asthenospermia, and it could improve the spermic count, motility and figure, and reduce the head deformity rate.</p>

Prevention of urethral stricture after transurethral vaporesection of prostate by adjustable urethral tractor / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To reduce the complication by transurethral vaporesection of prostate (TUVP) using adjustable urethral tractor.</p><p><b>METHODS</b>One hundred and six cases with benign prostate hypertrophy underwent TUVP and catheter traction after operation by an adjustable tractor. The results by catheter traction were compared with those by rubberized cloth paste and carbasus compression.</p><p><b>RESULT</b>The urethral stricture occurred in 2.7%, 6.7%, 30.4% of cases by the catheter traction, rubberized cloth paste and carbasus compression respectively, which had statistical significance (P <0.01).</p><p><b>CONCLUSION</b>The incidence of urethral stricture can be reduced by catheter traction after TUVP.</p>

Combined use of TUVP and TURP for treating BPH (report of 179 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate a new operation method for the treatment of benign prostate hyperplasia(BPH).</p><p><b>METHODS</b>One hundred and seventy-nine patients with BPH were treated by the combined use of transurethral electrovaporization ablation of the prostate(TUVP) and transurethral resection of the prostate(TURP).</p><p><b>RESULTS</b>The procedure was successful and the results were satisfactory, with little bleeding and no serious complication. IPSS decreased from 29.0 preoperatively to 7.6 postoperatively (P < 0.05) and Qmax increased from 5.8 ml/s preoperatively to 14.8 ml/s postoperatively(P < 0.05).</p><p><b>CONCLUSIONS</b>The combined use of TUVP and TURP is a safe, effective and ideal method for the treatment of BPH.</p>