[A real-world study of 176 cases with aplastic anemia treated in outpatient].

Objective: To explore the diagnostic process and outcomes of patients with aplastic anemia (AA) who received outpatient treatment in a real-world setting. Methods: The diagnostic processes, treatment regimens, and outcomes of 176 patients with AA treated in outpatient centers from January 2018 to December 2019 were reviewed. Results: The median interval from the onset of symptoms to the first visit was 7 (5-120) months. Complaints during the first visit included bleeding (52.3% ) , anemia (51.7% ) , and infection (6.8% ) . For diagnosis, 168 patients (95.5% ) underwent bone marrow aspiration; however, only 22 of them (17.1% ) consented aspiration in multiple sites (sternum) . The completion rate of bone marrow biopsy was 85.1% (143/168) ; flow immunophenotype and karyotype analyses were performed on 59.5% (100/168) and 58.9% (99/168) of AA patients, respectively, and the culture of clonal forming units by bone marrow mononuclear cells was performed on 26.8% (45/168) of AA patients. The most preferred regimen was cyclosporine combined with androgen and levamisole (43.8% , 77 patients) , followed by cyclosporine combined with androgen (25.6% , 45 patients) . Cyclosporine alone was administered in 24 patients (13.6% ) and androgen alone in 16 patients (9.1% ) . Furthermore, 14 patients (7.9% ) did not consent to any drugs or only chose traditional Chinese medicine. The patients were divided according to the frequencies of follow-up: regular follow-up group (≥4 times/year, n=130) and irregular group (<4 times/year, n=46) . The former had a higher 6-month remission rate (52.5% vs 28.0% , P=0.005) , a greater high-quality remission rate in 12 months (40.7% vs 16.7% , P=0.027) , and a lower relapse rate in 24 months (4.4% vs 36.4% , P=0.001) . Conclusion: In real-world settings, bone marrow aspiration in multiple sites should be addressed in outpatient treatment for AA diagnostic work-up, including PNH clone screening, flow immunophenotype, chromosome karyotype analysis, and culture of clonal forming units. Patients with AA who follow regular visits were more likely to achieve high-quality remission and a lower relapse rate. Visits at least four times per year are recommended for AA patients undergoing outpatient treatment.

An integrated method of therapeutic lifestyle change for older adults with dyslipidaemia.

OBJECTIVES: To evaluate the effect of therapeutic lifestyle change with a non-pharmacological intervention method in older adults with dyslipidaemia. STUDY DESIGN: Stratified randomized trial. METHODS: Participants with dyslipidaemia (n = 214) aged ≥60 years were randomized to the conventional guide group, the educational course (EC) group, the telephone call (PC) group or the PC + EC group for 24 weeks. Total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and the knowledge, attitude and practice score for serum lipids were measured at baseline (T1), mid-intervention (week 12, T2) and post-intervention (week 24, T3). RESULTS: Except the conventional guide group (n = 62), the PC group (n = 56), the EC group (n = 49) and the PC + EC group (n = 47) showed significant intra-group differences in serum total cholesterol, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol and knowledge, attitude and practice score after the intervention. The improvements were most prominent and sustained over time in the PC + EC group at post-intervention. CONCLUSIONS: The PC + EC method is more efficient for improving serum lipids and enhancing health awareness than any single programme in older adults with dyslipidaemia. This overlapped therapeutic lifestyle change method may serve as a cost-effective adjunct and ensure the continuity of high-quality health services for patients with dyslipidaemia.

[Relationship between lipid peroxidase and superoxide dismutase in bronchoalveolar lavage fluid and pulmonary qi deficiency syndrome].

Investigating the levels of lipid peroxidase (LPO) and superoxide dismutase (SOD) in serum, bronchoalveolar lavage fluid (BALF) and alveolar macrophage (AM) were determined in 40 chronic bronchitis patients with Pulmonary Qi Deficiency (PQD) Syndrome and 36 normal subjects. Results showed: (1) No significant differences were found between PQD syndrome and normal subjects on serum SOD or LPO levels. (2) Patients with PQD Syndrome. LPO level in BALF was significantly higher, and SOD significantly lower, when compared with normal subjects. (3) Through correlation analysis, it was found in BALF that SOD level was markedly correlated with AM, while LPO was significantly correlated with neutrophil. In short, SOD and LPO in BALF play an important role in the development of the PQD Syndrome, and are good indications in evaluating the PQD Syndrome.

[Relationship between local effect of cortisol used by chronic bronchitis patients and syndrome differentiation in TCM].

Serum cortisol levels and bronchoalveolar lavage fluid (BALF) from 105 patients with chronic obstructive pulmonary disease (COPD) and 36 normal subjects were examined and the relationship between cortisol inhibiting the TXB2 secreted by alveolar macrophage (AM) and the theory of Syndrome Differentiation in TCM was explored. Results showed: (1) No significant differences were found between chronic bronchitis and normal subjects on cortisol levels in serum, but in BALF, cortisol levels was significantly lower in Lung Qi Deficiency when compared with that in normal subjects. (2) the levels of cortisol inhibiting the TXB2 secreted by AM which were significantly lower in chronic bronchitis when compared with that in control. In short, the amount and function of cortisol in BALF were significantly different in various syndromes in TCM of chronic bronchitis.

Effects of selenium deficiency on Ca transport function of sarcoplasmic reticulum and lipid peroxidation in rat myocardium.

Two groups of weanling Sprague-Dawley rats were fed a low-selenium basal diet (Se 0.009 mg/kg) and the same diet supplemented with sodium selenite (Se 0.25 mg/kg), respectively, for 1, 2, and 3 months. At each feeding time, the Ca(2+)-ATPase activity, Ca2+ uptake rate and the capacity of Ca2+ uptake in isolated cardiac sacroplasmic reticulum from the Se-deficient rats were decreased significantly compared to those from the Se-supplemented rats, the contents of lipid peroxide in postmitochondrial supernatant and isolated sarcoplasmic reticulum from the Se-deficient rats were significantly higher than that from Se-supplemented rats. Compared to the Se-supplemented rats, the cytosolic glutathione peroxidase activity in Se-deficient rats decreased significantly. In addition, significant linear negative correlations of lipid peroxide in postmitochondrial supernatant to sarcoplasmic reticular Ca(2+)-ATPase activity, Ca2+ uptake rate and to whole blood selenium concentration were observed. The results suggest that the enhancement of lipid peroxidation via the depressed glutathione peroxidase activity might be responsible for the decrease of Ca(2+)-ATPase and Ca2+ uptake activities in sarcoplasmic reticulum in Se-deficient animals.

Effects of selenium on ribonucleic acid synthesis and degradation in rat liver.

Six groups of weanling rats were fed a low-selenium based diet containing less than 0.01 mg/kg of Se in the diet or the basal diet supplemented with five levels of selenium as selenite (0.1, 0.2, 0.3, 0.4 and 0.5 mg/kg) for at least 16 to 18 weeks. For determination of the effect of selenium on ribonucleic acid (RNA) synthesis in rat liver, rats of each dietary group were injected with a single dose of (5-3H)-uridine, and 3 hours later their livers were removed and subjected to cell fractionation. The radioactivities in the nuclear and cytoplasmic RNA were taken as a measure of the RNA synthesis rate. With selenium supplementation between 0.2 and 0.5 mg/kg diet, the radioactivities, amounts of RNA, as well as RNA/DNA ratios in both nuclear and cytoplasmic fractions of rat liver all increased significantly. In addition, at similar levels of selenium supplementation, statistically significant increments of glutathione peroxidase (GSH-Px) activity and reductions in lipid peroxide in liver were also observed. For assessment of RNA degradation, activities of ribonucleases (RNase) and RNase inhibitor in rats fed the low-selenium diet or a selenium-supplemented diet were determined. The activities of acid RNase and both free and latent alkaline RNase in liver homogenate were not affected by selenium deficiency; however, the level of RNase inhibitor present in the supernatant fraction increased significantly with selenium supplementation at 0.2 mg/kg diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of selenium on RNA synthesis and content in rat pancreas.

In order to investigate the effect of selenium supplementation on RNA in the rat pancreas, the rate of in vitro incorporation of [3H]uridine into RNA by pancreas slices derived from two groups of rats fed either a low-selenium diet or a diet supplemented with 0.25 mg/kg selenium as selenite was examined. The RNA and lipid peroxide contents and glutathione peroxidase activity in homogenates from the pancreas were also determined. After feeding for 12-14 weeks, the rates of [3H]uridine incorporation were significantly higher in the pancreatic tissue from the selenium-supplemented diet group. Concomitantly, an increase in glutathione peroxidase activities and RNA content, and a reduction of lipid peroxides, were also found in the pancreatic tissue of the selenium-supplemented group. The results suggest that selenium supplementation at a level of 0.25 mg/kg selenium could promote RNA synthesis with an increase in glutathione peroxidase activity and a decrease of lipid peroxides.