Short-term efficacy observation of venetoclax combined with azacitidine in treatment of patients with acute myeloid leukemia / 白血病·淋巴瘤

Objective:To explore the clinical short-term efficacy of venetoclax (Ven) combined with azacitidine (AZA) in treatment of newly treated and relapsed/refractory patients with acute myeloid leukemia (AML).Methods:The data of 18 newly treated and relapsed/refractory patients with AML who received Ven+AZA treatment in Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from April 2020 to June 2022 were retrospectively analyzed. The complete remission or complete remission with incomplete recovery of blood cell count (CR/CRi) and objective remission rate (ORR) [calculated as CR/CRi+partial remission (PR)] were analyzed in newly treated and relapsed/refractory patients or patients with different gene mutations. The patients were followed up until June 30, 2022, and the overall survival (OS) of relapsed/refractory patients was analyzed. The occurrence of adverse reactions was summarized.Results:The median age of the 18 patients was 58 years old (23-81 years old), 8 were males and 10 were females; 6 were newly treated and 12 were relapsed/refractory; the median follow-up time was 3 months (1-15 months). In 6 newly treated patients, after the first cycle of Ven+AZA, 5 cases achieved CR/CRi, and the ORR was 83.3% (5/6). In 12 relapsed/refractory patients, after the first cycle of Ven+AZA, 5 cases achieved CR/CRi, 3 achieved PR, and the ORR was 66.7% (8/12). Among the 18 patients, 7 cases had FLT3-ITD/TKD mutation, after the first cycle of Ven+AZA, 1 case achieved CR/CRi, 1 case achieved PR, and the ORR was 28.6% (2/7); 3 cases had NPM1 mutation combined with FLT3-ITD/TKD mutation, 1 case achieved CR/CRi, and the ORR was 33.3% (1/3); 4 cases had IDH1/2 mutation, and 3 cases of them combined with FLT3-ITD/TKD mutation, all of which were non-remission, and the other 1 relapsed/refractory patient combined with K/NRAS mutation achieved CR/CRi; among the 4 cases with K/NRAS mutation, 2 cases combined with FLT3-ITD/TKD mutation, including 1 case of NR and 1 case of PR, and the other 2 cases achieved CR/CRi, the ORR was 75.0% (3/4). Of the 12 relapsed/refractory patients, 6 died by the end of follow-up, with a median OS time of 2.6 months (1- 8 months), including 4 cases of disease progression and 2 cases of disease relapse; the 6 surviving patients had stable disease. All the 18 patients had ≥grade 3 hematologic adverse reactions, and non-hematologic adverse reactions included lung infection, nausea, vomiting and diarrhea.Conclusions:Ven+AZA treatment for newly treated and relapsed/refractory AML patients results in a high response rate with tolerable adverse reactions, but it is not effective in AML patients with FLT3-ITD/TKD mutation.

Research on the application and effects of adjustable pressure drainage device in the total hip arthroplasty / 中国实用护理杂志

Objective To compare the effects of adjustable pressure drainage device, negative pressure ball drainage and drainage bag drainage on patients with the total hip arthroplasty. Methods The silicone drainage ball with negative pressure, the urine collection bag, the infusion set′s regulator were used to make adjustable pressure drainage device. 120 cases of total hip arthroplasties from January to December in 2015 were chosed and divided randomly into 3 groups based on the sequence of operation notifications. In 40 cases, drainage bag were used (control group 1), 40 cases with negative pressure ball drainage (control group 2) and 40 cases with adjustable pressure drainage device (experimental group). Total postoperative bleeding, the blood transfusion amount, swelling (the thickness of hematoma) and the nursing workload of the three groups were compared. Results The total postoperative bleeding, the blood transfusion amount, the thickness of hematoma and the nursing workload in the experimental group were (775.1±130.5) ml, (3.5±1.3) mm, (180.2±29.9) ml, (34.5±5.2) min. The total postoperative bleeding, the blood transfusion amount, the thickness of hematoma and the nursing workload in the control group 1 were (889.4 ± 160.8) ml, (5.2 ± 1.1) mm, (285.9 ± 30.4) ml, (40.6 ± 7.4) min and in the control group 2 were (876.2±156.7) ml, (4.3±1.2) mm,(208.3±33.3) ml, (50.3±8.5) min. Compared the data of the experimental group and the control group 1, the difference was of statistically significance (t=3.49-15.68, P < 0.01). Compared the data of the experimental group and the control group 2, the difference was of statistically significance (t=2.86-10.03, P<0.01). Conclusions The effects of adjustable pressure drainage device are better than the drainage bag and negative pressure drainage ball. It can effectively reduce the postoperative bleeding and the swelling degree, and bring a lot of relief to the patients and lots of convenience to the nursing work. The method is affordable, reliable and safe which should be promoted in the primary hospital.

Evaluation on lnsulin Combined HCG Improved Method in Establishment of Obese PCOS Rat Models / 世界科学技术-中医药现代化

This study was aimed to establish and evaluate obese polycystic ovary syndrome (PCOS) rat model. Rats were randomly divided into the blank control group, high-fat model group, insulin (INS) combined human chorionic gonadotropin (HCG) model group, and INS combined HCG plus high fat emulsion model group. The obese PCOS rat model was induced by subcutaneous injection of INS and HCG on the nape, respectively. The intragastric administration of high fat emulsion was also used in the PCOS rat model establishment. The estrous cycle of rat was monitored. The detection was also made the weight increasing rate of rats, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), testosterone (T), high-density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), cholesterol (TC), fasting plasma glucose (FPG), fasting insulin (FINS), 2 h blood glucose and 2 h INS. Calculation was made on the HOMA index, related viscera index and bilateral ovaries HE staining. The results showed that when INS combined HCG improved method (INS combined HCG plus high fat emulsion model group) rats were sacrificed, the body weight, weight increasing rate, ovary viscera index, T, LH, and HOMA index were significantly higher than that of the blank control group, high-fat model group and INS combined HCG model group (P < 0.05,P < 0.01); HDL was significantly decreased (P < 0.05,P < 0.01). FPG, FINS, and 2 h INS of the INS combined HCG improved method group were significantly higher than that of the high-fat model group (P <0.01). It was concluded that INS combined HCG improved method was one of the ideal animal model establishment methods in the pathogenesis study of PCOS.

Progress Review on Transduction Mechanism of Obese PCOS and IR through Kidney-tonifying, Spleen-invigorating and Phlegm-resolving / 世界科学技术-中医药现代化

This paper elaborated the research progress on transduction mechanisms of obese polycystic ovary syndrome (PCOS) and insulin resistance (IR). The action mechanisms of kidney-tonifying, spleen-invigorating and phlegm-resolving in the treatment of obese PCOS and IR were explored. It provided new ideas for the treatment of obese PCOS patients in the clinical practice of traditional Chinese medicine (TCM) gynecology. Literatures on TCM theories and modern signal pathways were used in the analysis of spleen-kidney deficiency and phlegm-dampness retention, which were the key pathogenesis of obese PCOS and IR. The scientific nature of treating obese PCOS and IR from the method of kidney-tonifying, spleen-invigorating and phlegm-resolving was demonstrated. The results showed that the scientific nature of treating obese PCOS and IR from the method of kidney-tonifying, spleen-invigorating and phlegm-resolving was initially demonstrated by the organic combination of TCM and modern medicine theories. It innovatively proposed that the treatment study strategy of transduction molecular mechanism took the interactive dialogue between PI-3K/Akt signal pathway and TNF-α signal pathway as its target. The regulatory role and action mechanism of this method in the treatment of obese PCOS and IR were discussed.

Evaluation and Screening on Animal Models of Polycystic Ovary Syndrome of Etiology and Pathogenesis in Traditional Chinese Medicine / 世界科学技术-中医药现代化

By combing differe nt modelin g factors and evaluation indicators of experimental animals of polycystic o-vary syndrome (PCOS), application scope, advantages and disadvantages were analyzed among various kinds of animal models, in order to screen models of etiology and pathogenesis in traditional Chinese medicine (TCM). Through the collection of 77 Chinese literatures published since 1979, the database on PCOS of modeling factors (i.e., animal species, age, modeling reagent and dose, etc.) and evaluation indicators (i.e., ovarian morphology and hormone levels) were established, analyzed and summarized. The results showed that the experimental PCOS models established by researchers both at home and abroad included androgen method, combination method of androgen with HCG, combi-nation method of progestrone with HCG, estrogen method, aromatic cyclase inhibitor method, combination method of HCG with insulin, combination method of androgen with insulin, insulin method, and etc. The SD and Wistar rats at the age of 3-50 days were commonly used. Chemicals, such as dehydroepiandrosterone (DHEA), testosterone propi-onate, sodium prasterone sulfate, dihydrotestosterone (DHT), levonorgestrel, estradiol valerate, letrozole, insulin and HCG were chosen to build the animal models. The evaluation indicators included ovarian morphology, the total num-ber of follicles at different levels, sex hormones (E2, P, T, FSH, LH) and insulin resistance (IR) index (FINS, FPG, HOMA). It was concluded that each modeling method described above had its own advantages and disadvantages, which cannot completely simulate clinical onset process of PCOS patients. Researchers should choose appropriate reagent and evaluation index according to different purpose. DHEA, DHT slow-release, progesterone combined with HCG modeling methods are more suitable for the study of the role of IR in the pathogenesis of PCOS. Kidney-defi-ciency and dampness-phlegm is fundamental etiology and pathogenesis of obese type of PCOS. DHEA method, com-bination method of levonorgestrel with HCG, aromatic cyclase inhibitor method conformed obese type of PCOS. The evaluation indicators included body weight, sex hormones, IR index and ovarian morphology. The method of kidney-tonifying and phlegm-reducing was often used in the treatment of obese type of PCOS in the clinical practice.

Study of the clinical characteristics and resistance of Stenotrophomona maltophila in intensive care unit / 国际检验医学杂志

Objective To investigate the clinical characteristics and resistance of Stenotrophomona maltophila in intensive care unit.Methods 47 cases with nosocomial pneumonia by Stenotrophomona maltophila in intensive care unit from Jan 2003 to Nov 2007 were studied retrospectively.Results All patients had clinical symptoms,treatment with broad spectrum of antibiotics,the length of stay in ICU,artificial airways,mechanical ventilation,central venous catheter and usage of immunosuppressor,all the factor were obviously related with Stenotrophomona maltophila;SMITMP,ticarcillin/clavulanate,cefoperazone/sulbactam,levo-floxacin,ciprofloxacin were higher susceptive to S: maltophila,in range of 80.85%～61.7%.Conclusion The drug resistance in this kind of bacterium is extremely severe,and it mainly cause the infection of respiratory tract.Decreasing days being in hospital and ICU,using antibiotic reasonably,reducing invasive operation may decrease the infection of S.maltophila.

The analytical method of three phenoxyalkanoic acid herbicides in grape leaf by dichloropropyl esterification and gas chromatography / 中国法医学杂志

ObjectiveTo develop a analytical method of three phenoxyalkanoic acid herbicides,MCPA,2,4-D and dichlorprop,in grape leaf using dichloropropyl esterification and gas chromatography with electron-capture detection.MethodsSamples were pounded to pieces,added into internal standard 2,4-dichlorophenylacetic acid,acidified and extracted with ethyl ether.The extracts were cleaned up by liquid-liquid partition.The cleaned organic solutions were evaporated and the residues were dichloropropylated using sulfuric acid and 1,3-dichloropropan-2-ol.The formed esters were analysed by gas chromatography.ResultsThe detection limits of MCPA,2,4-D and dichlorprop in grape leaf were 20ng/g,20ng/g,and 30ng/g,respectively.The concentritions of herbicides in grape leaf were linear over the ranger 100~1000ng/ml.The average recoveries of MCPA,2,4-D and dichlorprop in spiked grape leaf at concentrition of 200ng/g were 98.8%,101.3% and 103.1% with the coefficients of variation 11.4%,11.0% and 9.3% respectively.ConclusionThis method is sensitive and accurate for determination of these three herbicides in poisoned grape leaf.

Determination of α-Hydroxytriazolam and α-Hydroxyalprazolam in Human Urine by Gas Chromatogrphy/Electron-Capture Detector / 分析化学

A method was developed to assay α-Hydroxyltriazolam and α-Hydroxyalprazolam,　which are the major metabolites of triazolam and alprazolam respectively,in human urine.　After addition of 2-hydroxyflurazepam　(interal standard) and hydrolysis with β-glucuronidase, the hydroxy-metabolites were extracted with hexane-dichloromethane (1∶1) at pH　10.8, then were derivated with (BSTFA). The analysis was performed on a HP-5 capillary column with electron-capture detector.The detection limits of analysis in urine were about 1μg/L.The method was successfully applied to urine specimens collected from healthy human volunteers who ingested 0.5 mg of triazolam or 0.8 mg alprazolam. The method was enough sensitive to assay urine specimen excreted at 24 h by volunteers after taking the medicine.