[Efficacy of Shengxue Mixture Combined with Intraosseous Infusion for Treatment of Aplastic Anemia].

OBJECTIVE: To evaluate the efficacy and safety of Shengxue mixture combined with intraosseous blood infusion for treatment of aplastic anemia patients. METHODS: From 2011 to 2015, Institute of blood diseases of Shaanxi Medical University admitted 53 patients with aplastic anemia. The patients were treated with shengxue mixture 200 ml, orally, twice a day. Stanozolol tablets, Adult 2 mg, three times a day, mycophenolate mofetil 1.0 g, twice a day. Intraosseous infusion of the following medicine were administered in patients: recombinant human EPO 10000 U, recombinant human G-CSF 450 µg, recombinant human IL-11 4.5 mg, dexmethasone 20 mg, once a week, a total of four times. One month later, the blood cell counts and bone marrow biopsy were performed. Consolidation treatment continued for 3 to 6 months after discharge, and therapeutic effect was observed and followed-up for more than a year. RESULTS: After one month of treatment, 40 patients were basically cured (75.47%), 8 patients were remitted(15.09%), Hemoglobin level, white blood cell count and platelet count were significantly improved after treatment (P<0.01). The overall response rate was 90.57%(48 patients). Patients with bone marrow hyperplasia was 46 (86.79%), versus 9(16.98%) before treatment. There was a difference (P<0.05). After 3 to 6 months of treatment, 40 patients were cured (75.47%); 8 patients were remitted(15.09%); 3 patients were obviously improved(5.66%); 2 patients were ineffective(3.77%). The overall response rate was 96.23%(51 cases). No obvious side effects were observed. No patients were relapsed after one year. CONCLUSION: Shengxue mixture combined with Intraosseous infusion is a fast, efficient, safe method for the treatment of aplastic anemia.

[Clinical study of combination of Chinese medicine and western medicine in treatment of 500 patients with hemophilia hemorrhage].

OBJECTIVE: To study the effect and safety of haemostatic apozem combined with haemostatic mixture on hemophilia hemorrhage. METHODS: Five hundred hemophilia patients were randomly recruited from Shaanxi Yida Hematology Institute from February 2005 to July 2010. Under the condition of using no blood products such as platelet cofactors VIII and IX, oral administration of haemostatic apozem combined with intravenous dripping of haemostatic mixture were given to 332 hemorrhagic patients and 451 patients in need of surgery for hemorrhagic prevention. The treatment was lasted for three successive weeks. The hemostatic time, hemorrhage absorption (recovery) time, and their safety were observed. RESULTS: The hemostatic time for open bleeding and closed bleeding was (0.85 +/- 0.83) h and (2.69 +/- 0.65) h respectively. The average hemostatic time was (2.00 +/- 0.69) h. The recovery time for different portions was as follows respectively: intra-cranial hemorrhage (14.13 +/- 6.01) days; muscular hemorrhage (18.18 +/- 7.34) days; hematuria (8.25 +/- 4.69) days; arthrorrhagia(3.27 +/- 1.31) days; ecchymoma (7.16 +/- 2.32) days; bleeding of oral and nasal cavities (4.26 +/- 1.35) days; intramedullary hemorrhage (19.15 +/- 1.36) days; hematoma ulceration (50.01 +/- 20.91) days. The hemorrhage recovery ratio was 99.10% (329/332). The success rate of preventing from surgery hemorrhage was 100% (451/451). No severe adverse reaction occurred during the therapeutic course. CONCLUSIONS: Haemostatic apozem combined with haemostatic mixture was effective and fast in preventing and treating hemophilia hemorrhage, with no complications or adverse reactions. It could be taken as the first choice for prevention and treatment of hemophilia hemorrhage.

Study on the efficacy and safety of Xueyou Mixture in treating hemophilia.

OBJECTIVE: To observe the effect of Xueyou Mixture (, XYM) on blood coagulation factors and its safety in treating hemophilia. METHODS: To the randomly selected 65 inpatients of hemophilia, XYM was administered accompanied with intravenous dripping of liver cell growth factor 60-100 mg once a day to protect the liver, with no blood products like concentrated VIII and FIX factors or blood plasma given. The treatment lasted for 3 weeks. The short-term efficacy and adverse reactions were observed. The long-term efficacy in patients was observed in a follow-up study of 6-12 months after they were discharged from the hospital but continuously took XYM orally. RESULTS: The short-term markedly effective rate in the patients was 95.38% (62/65). After they were treated for 3 weeks, the level of FVIII factor activity increased in 56 patients of type A from (3.32+/-2.21) % to (4.18+/-2.23) %, and in 9 of type B from (4.92+/-1.81) % to (5.64+/-1.96) %. Compared with that before treatment, the difference was significant in both of them (P<0.01). No obvious adverse reaction was found in the treatment period. The follow-up study showed that in 22 patients of type A, the FVIII factor activity ratio increased from (3.25+/-2.11) % to (6.31+/-2.16) %, (8.36+/-1.05) %, and (16.38+/-2.71) % in the 2nd, 3rd and 6th month after discharge respectively, all showing significant difference to that before treatment (P<0.01); and in 4 patients of type B, it increased from (4.15+/-2.26) % to 7.8% and 11.6% (mean value) in the 2nd and 6th month respectively. CONCLUSION: XYM could raise the activity of factors VIII and IX in patients with hemophilia, and the degree of the rise is related with the duration of the therapy, with no obvious adverse reaction, which strikes out a new path and new train of thinking for the treatment of the disease by nonblood preparation.

Study on graded therapy of hemophilic arthritis by integrative traditional Chinese and Western medicine.

OBJECTIVE: To study the effect and safety of graded therapy featuring integrative traditional Chinese and Western medicine for the treatment of hemophilic arthritis. METHODS: Forty patients with hemophilic arthritis were hospitalized randomly, with their blood coagulation factor activity determined by one-stage method and their arthritis classified into 4 stages. The treatment was applied according to the stage of arthritis and finding of intra-articular cavity puncture. For stage I, based on the principle of RICE (rest, ice, compression and elevation), 1.8 g of Xuefuda was medicated orally once per day, intravenous dripping of 250 mL of hemostasis mixture twice a day and 1.2 g of clindamycin per day were also given for hemostasis and anti-inflammation. For stage II-III, Kangyanling was additionally administered via intra-articular cavity injection twice a week, 2 mL every time, for 5-6 times in total. For stage IV, the drug for intra-articular cavity injection was replaced with 25 mg of sodium hyaluronate and the frequency of injection reduced to every two weeks, for 5-6 times in total. Coagulation factors III and IV as well as blood plasma were not given in the whole treatment course. Short-term therapeutic effects and adverse reaction in patients were evaluated, and the long-term effects were followed-up after patients left the hospital with 6-month consolidation therapy by Xuefuda. RESULTS: After a 3-week treatment, 33 patients (82.5%) were completely remitted; 5 (12.5%) were partially remitted and 2 (5.0%) un-remitted, setting the short-term effective rate at 95.0% (38 cases). The 6-month follow-up showed that except for a relapse in 2 and 4 patients of stage III and IV respectively, long-term remission displayed in all the other 34 patients, with the remission sustaining rate being 85.0%. No complication such as an infection, bleeding or aggravating pain occurred in the 215 times intra-articular puncturing conducted in the 40 patients. Normal figures were shown in liver and kidney function, electrolytes, ECG, blood glucose and routine test of blood and urine throughout the course. CONCLUSION: The graded treatment of integrative medicine for hemophilia with non-blood preparation has a favorable effect and is safe or without any adverse reaction, which opens a high efficacy and new safe path and thinking for the treatment of and deformity prevention in the hemophilic patients.

[Changes of gene expression profile of multiple myeloma cell line RPMI 8226 treated by arsenic trioxide].

OBJECTIVE: To compare the changes of gene expression profiles of multiple myeloma cell line RPMI 8226 before and after 24-hour intervention of arsenic trioxide. METHODS: The responses of the RPMI 8226 cells to arsenic trioxide were determined with cDNA microarray which included 4,096 different human genes. RESULTS: Of these 4,096 genes, the expressions of 273 genes were altered significantly at mRNA level. The expressions of 121 genes were up-regulated while the expressions of 152 genes were down-regulated. CONCLUSION: The effect of arsenic trioxide on RPMI 8226 cells is related to changing the expression levels of a number of genes. ZFYVE16, ALK1 and TXNIP genes may play important roles in apoptosis and differentiation of RPMI 8226 cells.

[Effects of realgar on tissue factor expression of NB4 and MR2 cells].

OBJECTIVE: To investigate the effects of Realgar on procoagulant activity (PCA), tissue factor expression and tissue factor mRNA transcription in acute promyelocytic leukemia (APL) cell lines NB4 and MR2 cells. METHOD: NB4 and MR2 cells were treated with 300 micrograms.L-1 Realgar PCA of the treated cells was detected using one-stage clotting assay. TF antigen was detected by ELISA and TFmRNA by semi-quantitive RT-PCR. RESULT: The PCA and TF antigen level in NB4 and MR2 cells were significantly higher than that in HL-60 and K562 cells. Realgar could down-regulate the membrane PCA, TF antigen and TF mRNA transcription of NB4 and MR2 cells in a time-dependent manner. CONCLUSION: Down-regulating TF expression and PCA of NB4 and MR2 cells by Realgar may be one of the mechanism of its improvement effect on DIC-related hemorrhage of APL patients.

[In vitro study on realgar induced apoptosis of all-trans acid resistant acute promeylocytic leukemia cell line (MR2)].

OBJECTIVE: To acquire a deep understanding of the possible mechanisms of realgar in the treatment of acute promyelocytic leukemia (APL). METHOD: All-trans retinoic acid (ATRA) resistant APL cell line MR2 was used as in vitro model. The effect of realgar on MR2 cell was observed by watching cell viability, cell growth, and by using Methy thiazolyl tetrazolium (MTT) assay, cell morphology, DNA gel electrophoresis and flow cytometry assay. RESULT: The viability and growth of MR2 cell were inhibited after the treatment, to some extent, in a dose and time dependent manner. After being treated with realgar, MR2 cell presented morphologically some features of apoptotic cells such as intact cell membrane, chromatin condensation and nuclear fragmentation, and apoptotic body could be found by electron microscopy as well. Sub-G1 cells were observed by flow cytometry, as well as Annexin V FITC+/PI-cells. DNA ladder could be found by DNA gel electrophoresis. CONCLUSION: Realgar can induce apoptosis of ATRA resistant APL cell line MR2, Which shows the therapeutic effect of realgar on APL may be different from that of ATRA.

[Investigation on NB4 cell responses to realgar by cDNA microarray].

OBJECTIVE: To elucidate the molecular mechanism of realgar-induced apoptosis and differentiation of acute promyelocytic leukemia(APL) cell line NB4. METHOD: The response of NB4 cells to realgar was explored with a cDNA microarray representing 1003 different human genes. RESULT: The analysis of gene expression profiles indicated that 9 genes were up-regulated and 37 genes were down-regulated. Among the 9 up-regulated genes, 2 genes were involved in proteasome degradation pathway. CONCLUSION: PSMC2, PSMD1 and ITGB1 genes may play a role in the apoptosis and differentiation of NB4 cells.