Objective To evaluate the efficacy and toxicity for the protocol of low-dose harringtonine and cytarabine(HA regimen)in combination with granulocyte colony-stimulating factor(G-CSF)in elderly patients with acute myelogenous leukemia(AML).Methods Thirty-five AML patients were treated with HAG including low-dose chieved PR.The overall response rate was 83%.5 of 35(14%)was non-remiasion.Two patients died in the duration of treatment.The main complication of chemotherapy is myelosuppresion.Conclusion Low-dose HA regimen in combination with G-CSF is effective and safe in elderly patients with AML.

OBJECTIVETo evaluate the usage of Mayo staging system in Chinese patients with primary light chain (LC) amyloidosis.

METHODClinical data, treatment and outcome of 162 primary LC amyloidosis patients with Mayo Clinic staging in Peking Union Medical College Hospital from January 2009 to June 2015 were retrospectively analyzed.

RESULTSThe median age of 162 patients with Mayo Clinic 2004 stage was 57 (20-81) y, of them 62.3% were male. The number of patients with stage I to III were 44 (27.2%), 69 (42.6%), and 49 (30.2%), respectively. The median overall survival was not reached, 23 months and 12 months in patients with Mayo Clinic 2004 stage I, II, and III, respectively (P<0.001). Among 128 patients with Mayo Clinic 2012 stage, 48 patients (37.5%), 32 patients (25.0%), 32 patients (25.0%) and 16 patients (12.5%) were staged as Mayo Clinic 2012 stage 1 to 4, and the median OS was not reached, not reached, 13 months and 3 months, respectively (P<0.001).

CONCLUSIONMayo Clinic staging systems had important prognostic value in patients with primary LC amyloidosis.

Adult ; Aged ; Aged, 80 and over ; Amyloidosis ; diagnosis ; Female ; Humans ; Immunoglobulin Light-chain Amyloidosis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

Objective To investigate the influence of intensive heart rate control on inflammatory factor and cardiac function in patients with chronic heart failure. Methods From January 2015 to December 2015 ,a total of 120 CHF patients in New York Heart Association(NYHA)functional classes Ⅱ to Ⅳ were enrolled and randomized into treatment group(n=60)and control group(n=60). All the patients were in stable situation af-ter conventional drug treatment. The patients in treatment group underwent intensive heart rate control for target HR (55~60 beats/min)through adjusting the dose of metoprolol sustained-release tablets. The concentration of C-reac-tion protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)were de-tected before and after 6-month treatment. The resting heart rate and the concentration of brain natriuretic peptide (BNP),left ventricular ejection fracetion(LVEF),left ventricular end diastolic diameter(LVEDD)and left ven-tricular end systolic dimension(LVEDD)were measured at the start and 6-months after treatment. Results After 6-month treatment,the resting heart rate of the patients in the treatment group decreased significantly compared with that of the control group(P<0.001). Inflammatory factors(CRP,IL-1β,IL-6 and TNF-α)levels decreased significantly compared with that of control group (P < 0.05). The echocardiography parameters (LVEDD and LVESD)and the concentration of BNP of the patients in the treatment group decreased significantly(P < 0.05), LVEF of treatment group increased significantly(P < 0.05). Conclusion Intensive heart rate control in patients with chronic heart failure can significantly reduce Inflammatory factor levels and improve the cardiac function.

Objective: To evaluate the clinical characteristics and outcomes of very high risk patients with primary immunoglobulin light-chain amyloidosis (pAL) at a single center in China. Method: Clinical data, treatment and outcome of 205 pAL patients in Peking Union Medical College Hospital from January 2009 to February 2016 were retrospectively analyzed. A 'very high risk’ group includes patients with Mayo 2004 stage Ⅲb and Mayo 2012 stage 4. Results: Of 205 patients, 34 (16.6%) were defined as very high risk pAL patients. The median age at diagnosis was 57 (20-84) years, and 22 patients (64.7%) were male. All 34 patients were diagnosed with cardiac involvement, multi-organ involvement was observed in 15 patients (44.1%) , and 27 (81.8%) had New York Heart Association Class Ⅲ or Ⅳ. Median values of serum cTnI, NT-proBNP, and free light chains difference were 0.25 μg/L, 11 733 ng/L, and 403 mg/L, respectively. Eight (24.2%) had more than 10% plasma cell on the bone marrow aspirate. Sixteen (47.1%) patients received bortezomib based chemotherapy and overall hematologic response rate was 58.3%. Median overall survival (OS) was 4 months. The estimated OS at 3, 6, 12, and 24 months was 51.3%, 44.0%, 35.2%, and 29.6%, respectively. Fourteen (41.2%) patients died within 3 months after the diagnosis. The estimated 1-year survival rate for the patients who got hematologic response, without hematologic response, and palliative treatment was 90.9%, 11.1%, and 0, respectively (P<0.001) . Conclusion Patients with very high risk pAL had very poor prognosis and the early death rate remained high. Those patients who obtained hematologic remission would have significantly better outcomes.

Vaccination, one of the greatest inventions of mankind, prevents millions of people from infectious diseases and death each year. With the continuous improvement in immunization coverage, the safety of vaccines has attracted widespread attention. Common adverse reactions to vaccinations are mainly caused by inflammation, but the immune responses and biological damages following immunization are so complicated that the possible mechanisms have not been completely unveiled. Exploring the relationship between inflammation and immunogenicity after vaccination is of great significance for the monitoring and management of vaccines after marketing. This article reviewed the mechanism of inflammatory responses after vaccination and its potential impact on immunogenicity.

SARS-CoV-2 vaccines are effective in preventing COVID-19, but their efficacy in blocking virus transmission is controversial. Although SARS-CoV-2 vaccines can reduce the sources of infection and the possibility of secondary transmission from breakthrough infection cases, their effectiveness wanes over time. Moreover, the emergence of variants with stronger transmissibility and immune escape ability also poses huge challenges to the effectiveness of SARS-CoV-2 vaccines in blocking virus transmission. Therefore, ending the COVID-19 pandemic still requires the continuous research and development of new vaccines as well as the adoption of effective prevention and control measures.

The routes of immunization largely determine the features of vaccine-induced immune responses. This paper mainly reviewed the immune responses and protective efficacy induced by mucosal immunization and intramuscular injection of vaccines against poliovirus, Salmonella typhi, influenza virus and SARS-CoV-2 and compared the differences between different immunization routes, with the goal of providing some fundamental theoretical data for the development of vaccines and vaccination strategies against infectious diseases.