Pyridoxine Is Effective for Preventing Hand-Foot Syndrome Induced by Pegylated Liposomal Doxorubicin for Multiple Myeloma: The Results of a Randomized Study.

PURPOSE: Pegylated liposomal doxorubicin (PLD) is highly effective for treating multiple myeloma (MM). Hand-foot syndrome (HFS) is a dose-limiting adverse event of PLD that may reduce a patient's quality of life or prevent certain patients from receiving PLD. Several researchers have discovered that pyridoxine, an activated form of vitamin B6, may prevent PLD-associated HFS. We designed a prospective randomized trial to examine whether prophylactic pyridoxine might prevent the incidence or delay the occurrence of PLD-induced HFS in patients with MM. METHODS: Patients who met the trial's eligibility requirements were randomized and then administered either pyridoxine 100 mg twice daily or no pyridoxine, in both cases accompanied by their PLD-containing chemotherapeutic agent. Follow-up of patients was performed until the completion of induction therapy, the development of HFS or disease progression. RESULTS: Between January 1, 2017, and January 1, 2019, 105 patients were randomly assigned to the pyridoxine group (n = 52) or the no pyridoxine group (n = 53). In the pyridoxine and no pyridoxine groups, HFS developed after a median of 4 (range, 1-8 cycles) and 3 (range, 1-7 cycles) chemotherapeutic cycles, respectively. There were no grade 3 incidents recorded. Overall, 13.3% of patients experienced HFS. A 11 of 53 (20.8%) patients in the no pyridoxine group experienced HFS, compared to 3 of 52 (5.8%) patients in the pyridoxine group (P = .042); there was no difference in HFS grades (P = .725). CONCLUSIONS: The findings of benefit from prophylactic pyridoxine in this open-label trial have suggested its promise as a treatment for reducing HFS in MM patients. Further research with a placebo-controlled design is recommended. CLINICAL TRIAL REGISTRATION: ChiCTR2100050294.

Investigation of the immune profile of multiple myeloma patients achieving long-term survival after autologous stem cell transplantation / 中华内科杂志

Objective:To identify the characteristics of the bone marrow immune microenvironment associated with long-term survival in multiple myeloma (MM) patients.Methods:In the follow-up cohort of patients with newly diagnosed MM and who received “novel agent induction therapy and subsequent autologous stem cell transplantation and immunomodulator maintenance therapy” in the First Affiliated Hospital of Sun Yat-sen University, a cross-sectional study was carried out between August 2019 and May 2020. Using NanoString technology, the RNA expression of 770 bone marrow immune-related markers was compared between 16 patients who had progression-free survival ≥5 years and 5 patients with progressive disease. Among the 16 patients who achieved long-term survival, 9 achieved persistent minimal residual disease (MRD) negative while the other 7 had persistent positive MRD. The functional scores of each kind of immune cells were calculated based on the expression level of characteristic genes, so as to indirectly obtained the proportion of each immune cell subset. The Mann-Whitney U test and the Kruskal Wallis test were used for statistical analysis. Results:The proportion of neutrophils was significantly higher in long-surviving MM patients than in patients with progressive disease [functional scores, 13.61 (13.33, 14.25) vs. 12.93 (12.58, 13.38); Z=2.31, P=0.021]. Among long-surviving patients, those who were MRD-positive had a significantly greater number of mast cells compared with those who were MRD-negative [functional scores, 7.09 (6.49, 8.57) vs. 6.03 (5.18, 6.69); H=2.18, P=0.029]. Compared with patients with progressive disease, four genes (CTSG, IFIT2, S100B, and CHIT1) were significantly downregulated and six (C4B, TNFRSF17, CD70, IRF4, C2, and GAGE1) were upregulated in long-surviving patients. Among long-surviving patients, only gene CMA1 was significantly upgraded, 10 genes (ISG15, OAS3, MX1, IFIT2, DDX58, SIGLEC1, CXCL10, IL1RN, SERPING and TNFSF10) were significantly downregulated in the MRD-positive group compared with that in the MRD-negative group, the first 5 of which are related to the interferon response pathway. Conclusions:The increased neutrophil and mast cell numbers may be related to long-term survival in MM. Interferon signaling activation may be a key bone marrow immune profiling feature for MRD-negative, long-surviving patients with MM.

Comparison of Wild and Cultivated Codonopsis pilosula Based onTraditional Quality Evaluation / 中国实验方剂学杂志

ObjectiveTo conduct a systematic comparative study on wild and cultivated Codonopsis pilosula（CP） from three aspects， including characters， microscopy， and contents of primary and secondary metabolites. MethodWild and cultivated CP samples were collected， their characters were measured using vernier caliper， tape measure and balance， the paraffin sections were stained with safranin-fixed green dyeing， and their microstructure were observed under the optical microscope. The content of alcohol-soluble extracts in wild and cultivated CP was determined according to the method for determination of extract under CP in the 2020 edition of Chinese Pharmacopoeia， the starch content was determined by anthrone colorimetry， the content of total polysaccharides was determined by kit method， Fiber analyzer was used to determine the content of fiber components， and ultra performance liquid chromatography（UPLC） was used to determine the content of monosaccharides， disaccharides and some secondary metabolites. Multivariate statistical analysis methods such as principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were employed to screen key differential components between wild and cultivated CP on the basis of variable importance in the projection（VIP） value>1 and P<0.05. ResultIn terms of morphological characteristics， the "lion's head-like" shape， longitudinal wrinkles， and circumferential wrinkles below the root cap of wild CP were more pronounced in wild CP compared to the cultivated ones. Regarding transverse sectional features， wild CP had more fissures on the outer side of the cortex and a larger duramen. Under microscopic examination， wild CP had more stone cells， a larger proportion of xylem， and the presence of cork cells arranged in rings in the xylem， while cultivated CP has a larger proportion of phloem， smaller vessel diameters， and a more loosely arranged vascular system. In terms of primary metabolites， the contents of 45% ethanol-soluble extract and total polysaccharides in cultivated CP were significantly higher than those in the wild ones（P<0.05）， the contents of lignin， hemicellulose， cellulose， fructose and glucose in wild CP were significantly higher than those in the cultivated ones（P<0.05）， while sucrose content in the cultivated CP was significantly higher than that in the wild ones（P<0.05）. Concerning secondary metabolites， the contents of tryptophan and tangshenoside Ⅰ in cultivated CP were significantly higher than those in the wild ones（P<0.05）， whereas the contents of lobetyolinin， lobetyol and atractylenolide Ⅲ in wild CP were significantly higher than those in the cultivated ones（P<0.05）. ConclusionThere are significant differences between wild and cultivated CP in terms of morphological characteristics， microscopic features and chemical composition. Glucose， fructose， sucrose， tangshenoside Ⅰ， tryptophan and cellulose components are the key differential components between wild and cultivated CP. Wild CP contains more polyacetylenes and fructose， whereas cultivated CP has higher levels of tangshenoside Ⅰ and sucrose， with noticeably lower cellulose content. These distinctions may be related to their growth conditions， growth years and cultivation techniques. Based on the results of this study， it is recommended to increase polyacetylenes and the content ratio of fructose to sucrose as an indicators to characterize different production methods of CP， in order to guide the high-quality production of CP.

Regionalization of Chinese Material Medical Quality Based on Maximum Entropy Model: A case study of Atractylodes lancea.

Atractylodes is an East-Asiatic endemic genera that distributed in China, Japan and Russian Far Eastern. As an important resource of medicinal plant, atractylodes has long been used as herbal medicine. To example the significant features in its trueborn quality and geographical distribution, we explored the relationships between medicine quality and habitat suitability in two classifications-lower atractylodin content than the standard of Chinese Pharmacopoeia (2010) and the other has higher content. We found that the atractylodin content is negatively related to the habitat suitability for atractylodes with lower atractylodin, while the atractylodin content is positively related to the habitat suitability for those with higher atractylodin. By analyzing the distribution of atractylodeswith lower atractylodin content than the standard of Pharmacopeia, we discovered that the main ecological factors that could inhibit the accumulation of atractylodin were soil type (39.7%), soil clay content (26.7%), mean temperature in December (22.3%), Cation-exchange capacity (6%), etc. And these ecological factors promoted the accumulation of atractylodin for the atractylodes with higher atractylodin. By integrating the two classifications, we finally predicted the distribution of atractylodin content in China.Our results realized the query of atractylodes quality in arbitrary coordinates, and satisfied the actually cultivation demands of "Planting area based on atractylodin quality".

Three patients with multiple myeloma developing secondary lymphoblastic leukemia: case reports and review of the literature.

INTRODUCTION: Secondary lymphoblastic leukemia has been rarely reported in patients with multiple myeloma. CASE REPORTS: We report 3 cases of secondary lymphoblastic leukemia in multiple myeloma patients. They shared a similar phenotype of myeloma cells and secondary lymphoblasts. The chemotherapy treatments in the 3 patients were complex due to various factors. CONCLUSIONS: Multiple immune defects caused by exposure to a variety of agents can play an important role in the development of secondary lymphoblastic leukemia. Microscopic morphology and flow cytometry are important means to detect secondary malignancies in multiple myeloma. Further clinical, experimental and genetic studies of secondary malignancies in multiple myeloma will be necessary in the future.

Bortezomib-based induction chemotherapy followed by autologous hematopoietic stem cell transplantation and maintenance in 200 patients with multiple myeloma: long-term follow-up results from single center / 中华血液学杂志

Objective@#To study the efficacy, safety and long-term outcomes of integrated strategy of bortezomib-based induction regimens followed by autologous hematopoietic stem cell (ASCT) and maintenance therapy in Chinese multiple myeloma (MM) patients.@*Methods@#200 MM patients receiving integrated strategy of bortezomib--based induction regimens followed by ASCT and maintenance therapy were retrospectively and prospectively analyzed from December 1. 2006 to April 30. 2018.@*Results@#The complete remission rates (CR) and better than very good partial remission rates (VGPR) after induction therapy, transplantation and maintenance therapy were respectively 31% and 75.5%, 51.8% and 87.7%,73.6% and 93.4%. There was no difference between 4 cycles and more than 5 cycles induction chemotherapy. The negative rate of MRD detection by flow cytometry was 17.6% and 38.2% respectively after induction and 3 months after transplantation. The negative rate of MRD gradually increased during the maintenance therapy. The success rate of high dose CTX combined with G-CSF mobilization was 95.5% and transplantation related mortality (TRM) was zero. The median time to progress (TTP) was 75.3 months and the median overall survival (OS) was 99.5 months. TTP of patients obtaining CR and negative MRD after induction were longer that those of no CR and positive MRD. TTP and OS of patients receiving triple-drug induction and ASCT in early stage were longer than those of double-drug induction and ASCT in late stage. LDH≥240 U/L, high risk cytogenetics, ISS II+III stage and HBsAg positive were prognostic factors at diagnosis. However, only MRD and high risk cytogenetics were independent prognostic factors after transplantation and maintenance therapy. The clinical characteristics of patients of TTP ≥6 years were listed below: light-chain type M protein, ISS I stage, normal level of hemoglobin and platelet, normal LDH, HBsAg negative, chromosome 17p-negative, good response and sustained good response.@*Conclusions@#Integrated strategy of bortezomib-based induction regimens followed by ASCT and maintenance therapy can significantly improve the short-term and long-term efficacy. The prognostic factors of TTP in different disease stages were different. Response to treatment, especially MRD, played a more important role in prognostic factors.

Practice and experience of classified management of the teaching hospital staff / 中华医院管理杂志

In the reform of human resource system at public institutions,public hospitals are challenged with changing employment mechanism and effective mobilization of all-staff's incentives.This paper introduced the classified staff management by Sir Run Run Shaw Hospital,College of Medicine,Zhejiang University,which covered the background,specific methods,purposes,initial results,as well as the key links and problems encountered.The study proved that classified management of the hospital staff helps create a fair and impartial workplace,conducive for sustainable development of the hospital.

Locality identification of Chinese medicinal plant Scutellaria baicalensis (Lamiaceae) population-level DNA barcoding / 中国中药杂志

Scutellaria baicalensis is an important traditional Chinese medicine and Scutellaria flavonoids have received worldwide attention in recent years. It is the basis of controlling quality of S. baicalensis to develop a reliable genetic marker system used to identify locality of origin. Because of the characteristics of maternal inherited and high-rate of evolution, the cpDNA intergenic spacer can effectively elucidate the degree of genetic variation in different areas of the same species (populations), which can be used as the population-level DNA barcoding to locality identify. In this study, we have used the molecular phylogeography analysis for the three cpDNA intergenic spacers atpB-rbcL, trnL-trnF and psbA-trnH of 17 wild populations from different localities, which reveals the 20 haplotypes, including 13 polymorphic sites and constitutes a shallow gene tree. The authers have divided the haplotypes of S. baicalensis into three grades of population-level DNA barcoding according to the frequence and geographic distribution: 3 highest-frequency haplotypes as area-population-level DNA barcoding, 3 haplotypes were mainly shared by 2-3 adjacent populations as region-population-level DNA barcoding, and there are also 8 unique-population haplotypes as unique-population-level DNA barcoding. The result of this study reveals that population-level DNA barcoding is a reliable genetic marker used to locality identify of S. baicalensis.

AM and its application in plant disease prevention of Chinese medicinal herbs cultivation / 中国中药杂志

To study the beneficial effect of AMF from the utilization achievement in the agroforestry research, we discuss the application of AM in medicinal plant disease prevention and control. This paper summarized the type of medicinal plant disease, the influence of plant disease and the commonly used prevention method in production. As for the adverse consequences caused by plant's non-infectious and infectious diseases, AM has some improvement function. Something will affect the function of AM in the prevention of medicinal plant disease, for example, the relationship between AMF and the plants, the quantity, the time and the environmental factors about AMF inoculation and so on. In order to achieve the useful effect of AM in the prevention of medicinal plant disease, we should choose the suitable condition during production in practice to carry on the vaccination.

Researches on relationship between genetic differentiation and chemical variation of Cinnamomum migao / 中国中药杂志

<p><b>OBJECTIVE</b>To study the relationship between the genetic diversity and chemical variation of Cinnamomum migao.</p><p><b>METHOD</b>ISSR marker technique was used to research the genetic structure of 9 population, GC-MS was used to analyze the main ingredients of the volatile oil in C. migao.</p><p><b>RESULT</b>The analysis on the main ingredients of the volatile oil showed that there were significant or extremely significant differences in 9 populations. The minimum variation index of population was Yunnan Funing and the maximum variation index of population was Guangxi Yueye. ISSR marker analysis showed that the average of polymorphic loci percentage (P) was 42.41%, expected heterozygosity (H) was 0.181 0, Shannon's information index (I) was 0.293 8, the Nei's genetic diversity (H(s)) in the group was 0.188 9, genetic differentiation index (G(st)) was 2.269 1. The relationship between the genetic diversity and chemical variation showed that there was no significant correlation between the main ingredients of the volatile oil and 4 indexes of genetic structure of C. migao.</p><p><b>CONCLUSION</b>The genetic diversity of C. migao was relatively high at the population levels, while it is low within the population levels, the relationship between chemical variation and genetic diversity was not obvious, that may indicate that other factors causes the chemical variation of C. migao.</p>

Study on modules biomass structure of Epimedium acuminatum in different habitats / 中国中药杂志

<p><b>OBJECTIVE</b>To study the biomass structure of Epimedium acuminatum Franch in the different ecological environments for the development and protection.</p><p><b>METHOD</b>Through the scientific investigation in four typical habitats, the sampling spots were set up, the functional modules' biomass structure and relationship of E. acuminatum were researched.</p><p><b>RESULT</b>The average of rhizome, as the largest biomass, and the average total biomass had the same pattern: the open areas of forest edge > shrub lumber > shrub-weed > stream drains. The ratio of the functional modules' biomass had different rates under different habitat conditions. By analyzing and combining investigation, the aerial part of E. acuminatum in the shrub-weed were comparative advantage, and the roots of nutrient accumulation of E. acuminatum in the open areas of forest edge were the highest efficient. Under different ecological condition, the distribution of water metabolism was different strategies.</p><p><b>CONCLUSION</b>In the open areas of forest edge, E. acuminatum growing well, followed by shrub-weed. These two habitats are the ideal ecological environments while the rhizome or the whole plant used as medicine, but also the protection of E. acuminatum.</p>

Volatile metabolites analysis and molecular identification of endophytic fungi bn12 from Cinnamomum camphora chvar. borneol / 中国中药杂志

<p><b>OBJECTIVE</b>To identify endophytic fungi bn12 from Cinnamomum camphora chvar, borneol and analysis its volatile metabolites.</p><p><b>METHOD</b>The endophytic fungi bn12 was identified by morphological observation. volatile metabolites of endophytic fungi bn12 was analyzed by gas chromatography/mass spectrography (GC-MS).</p><p><b>RESULT</b>Volatile metabolites of endophytic fungi bn12 contain borneol and much indoles. The ITS sequence of endophytic fungi bnl2 is most similar to the ITS sequence of pleosporaceae fungus, particularly C. nisikadoi.</p><p><b>CONCLUSION</b>Endophytic fungi bn12 is belong to pleosporaceae fungus. It has the ability of producing broneol.</p>

Discussion on appraisal methods and key technologies of arbuscular mycorrhizal fungi and medicinal plant symbiosis system / 中国中药杂志

Applications of arbuscular mycorrhizal fungi in research of medicinal plant cultivation are increased in recent years. Medicinal plants habitat is complicated and many inclusions are in root, however crop habitat is simple and few inclusions in root. So appraisal methods and key technologies about the symbiotic system of crop and arbuscular mycorrhizal fungi can't completely suitable for the symbiotic system of medicinal plants and arbuscular mycorrhizal fungi. This article discuss the appraisal methods and key technologies about the symbiotic system of medicinal plant and arbuscular mycorrhizal fungi from the isolation and identification of arbuscular mycorrhiza, and the appraisal of colonization intensity. This article provides guidance for application research of arbuscular mycorrhizal fungi in cultivation of medicinal plants.

Genetic diversity analysis of Vitex trifolia var. simplicifolia populations with inter-simple sequence repeats (ISSR) technique / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate 4 populations of 80 samples of Vitex trifolia var. simplicifolia collected from Shandong and Jiangxi province and analyze their intraspecies genetic variance.</p><p><b>METHOD</b>Inter-simple sequence repeat (ISSR) technique was applied for the study.</p><p><b>RESULT</b>Fifteen specific and stable primers were selected from 100 primers. A total of 129 sites were generated, and 115 of them (89.15%) were polymorphic. The data analyzed by PopGene demonstrated that the average polymorphic site percentage among the four populations was 71.89%. The average Shannon's information index was 0. 220 4. According to cluster analysis and the law of geographic variation, the populations were classified into two large groups: the Shandong group and the Jiangxi group.</p><p><b>CONCLUSION</b>These results will provide the information for protection and utilization of V. trifolia var. simplicifolia and also further data for the study of genetic variation and species differentiation of V. trifolia var. simplicifolia.</p>

Callus induction of Cinnamonum camphora and formation of borneol / 中国中药杂志

<p><b>OBJECTIVE</b>To optimize the condition of callus of Cinnamonum camphora induced.</p><p><b>METHOD</b>GC and plant tissue culture method were applied in the study.</p><p><b>RESULT</b>The effect of callus induced and the growth of callus were different in MS medium with different proportion of hormone. The ration of callus induced was the highest and the growth of callus was the most prosperous in the MS medium with 4 mg x L(-1) 2,4-D and 0.2 mg x L(-1) 6-BA. It is found that callus induced by young leaf contained borneol, but callus induced by young stem not.</p><p><b>CONCLUSION</b>The optimization of callus of C. camphora induced is using the MS medium with 4 mg x L(-1) 2,4-D + 0.2 mg x L(-1) 6-BA. Callus induced by young leaf can generate borneol.</p>

Discussing on significance, position and classification standard of chemotype of medicinal plants / 中国中药杂志

The authors propose suggestions for definition of classification position, classification standard, nomenclature and naming methods of chemotype on discussing the significance of chemotype of medicinal plants. This classification of chemotype should be established in infraspecific categories of "forma". Chemotype identification mainly has two aspects. One is that the main constituents are distinct or one or two components are half or more than half of the total chemical content. The main constituents come from the same biosynthetic pathway and have some genetic stability. The other is the chemical variation is genetic. The chemotype of medicinal plants study on the classification has important theoretical and practical value for quality assessment, resource development and the genuine medicinal research. It also can ensure the safe and effective of clinical medicine.

Theory and practice of bionic cultivation of traditional Chinese medicine / 中国中药杂志

The bionic cultivation of medicinal plant is an ecological cultivation pattern, which is adopting ecological engineering and modern agricultural techniques to simulate the natural ecosystem of wild medicinal plant community, and has been given greater attention on the agriculture of traditional Chinese medicine (TCM). It is also the cross subject that combines Chinese traditional medicine, agronomy, horticulture, ecology, agricultural engineering and management. Moreover, it has significant technology advantages of promoting the sustainable utilization of medicinal plant resources, improving the ecological environment and harmonizing man and nature. So it's important to develop the bionic cultivation of TCM.

An experimental study on destruction of K562 and HL60 induced by 5-aminolaevulinic acid-based photodynamic therapy / 生物医学工程学杂志

This experiment was designed to explore the pattern of K562 and HL60 leukemia cells death, the effects on their cell cycle and the cytoplasmic free calcium concentration ([Ca2+]i) induced by 5-aminolaevulinic acid-based photodynamic therapy (ALA-PDT). Under the transmission electron microscope (TEM), two kinds of leukemia cells' ultrastructure were observed. Flow cytometry combined with Annexin V-FITC/PI labeling was used to detect the pattern of K562 and HL60 cells' death induced by ALA-PDT. Flow cytometry combined with PI labeling was used to analyze the change in the cell cycle induced by ALA-PDT, and confocal laser scanning microscopy (CLSM) combining with calcium fluorescence probe was used to detect the change in the cytoplasmic free calcium concentration ([Ca2+]i). Immediately after irradiation, many typical apoptotic bodies were seen in the cells treated. Most of the cells treated were necrotic at 24 hours following irradiation. Flow cytometry analysis suggested that the main patterns of the cells' death were apoptosis immediately after irradiation and necrosis post-apoptosis at 24 hours post irradiation. Immediately and 24 hours after irradiation, the proportion of S phase of K562 was 57. 67% +/- 1.13% and 84.77% +/- 6.20% respectively, and the proportion of S phase of HL60 was 74.60% +/- 7.27% and 84.60% 1.74% respectively. Both [Ca+]i of the treated K562 and HL60 were increased obviously. In the best experiment condition, the initial pattern of the K562 and HL60 leukemia cells' death induced by PDT was apoptosis and the main pattern was necrosis post apoptosis. The two kinds of cells were arrested at S phase by ALA-PDT. During the death of the leukemia cells, the increase in intracellular free calcium concentration could be responsible for the ALA photodynamically induced damage to K562 and HL60 cells.

Laser photodynamic therapy with hematoporphyrin derivative in tumor diagnosis / 西安交通大学学报(医学版)

Objective To investigate the efficacy of photodynamic therapy(PDT) for tumor diagnosis.Methods A total of 1 400 patients with the cervix of uterus disease,56 patients with gullet disease,133 patients with stomach diseases,37 patients with urinary bladder tumor and 14 patients with brain tumor underwent diagnosis with PDT,combination of He-cd laser,Ar+ laser,and KTP laser.Results All of the patients could be explicitly diagnosed by this method,which indicated that PDT helped greatly in early tumor diagnosis. Conclusion PDT can be an effective diagnostic method for tumors of early stage,and should be widely applied clinically.

Mycoflora in Natural Mineral Water Sources for Drinking / 环境与健康杂志

Objective To understand the pollution of fungi in natural mineral water sources for drinking. Methods Sampling was carried out in 73 natural mineral water sources supplying water for 69 manufactories of bottled mineral water for drinking. Results 982 strains of fungi were found in 45 water samples (61.64%) of the total 73 water samples. Fungi imperfect! revealed the highest detected rates. Phycomycetea, Ascomycetes, Basidiomycetes were all detected, but less frequently. Among 18 detected fungal genera, Aspergillus and Cladosporium were all the dominant genera, as well as Penicilliurn, Trichoderma and Fusarium were commonly detectable genera. No correlations were observed between the detected rates of fungus and total count of bacteria, total coliform, the concentrations of nitrite in source water. Conclusion The extragenous fungal contamination in the process of post-extraction might be the main factor resulting in the pollution of fungi in natural mineral water source.