Objective:To study on the mechanism of Chinese medicine in treatment of systematic lupus erythematosus(SLE)and to observe long-term therapeutic effect of Chinese medicine on damage of organs in SLE.Methods:51 cases in-patients and out-patients of SLE from 1999 to 2003 were randomly divided into a treatment group treated with integrated Chinese medicine and western medicine and a control group treated with simple western medicine.Serum intracellular adhesion molecule-1(ICAM-1),adhesion molecule-3(ICAM-3),P-selectin and SLE injury index(SLICC/ACRDI)before and after treatment were observed.Results: ICAM-1,ICAM-3 and P-selectin in the patient of SLE were significantly increased as compared with those in normal persons. After treatment,ICAM-1 and P-seleetin in the treatment group decreased significantly as compared with those control group.The cumulative score of SLE injury index in treatment group was more stable and increased significantly in control group compared with that before treatment.Conclusion:The integrated treatment of Chinese medicine and western medicine with Yangyin Qingre Decoction has significant inhibiting action on the high expression of serum adhension molecule and has significant protective and repairing actions on the injury of organs in the patient of SLE.

Objective:To study the clinical efficacy of chimeric antigen receptor T-cell (CART) treatment followed by a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with B-cell acute lymphoblastic leukemia (ALL) who relapsed following the first HSCT.Methods:Retrospective analysis of the clinical characteristics and prognosis of 41 patients with B-cell ALL who received a second allo-HSCT from October 2015 to June 2020 in Hebei Yanda Lu Daopei Hospital. After the first HSCT, all patients received CD19-CART, or CD22-CART treatment following a relapse of bone marrow morphology or extramedullary leukemia.Results:A total of 41 patients (male, 21; female, 20) were included in this study. The median age at the second HSCT was 16 (3-46) years. There were 31 cases of bone marrow recurrence (75.6%) , 5 cases of extramedullary recurrence (12.2%) , and 5 cases of bone marrow and extramedullary recurrences (12.2%) . After relapse, 35 patients (85.4%) received CD19-CART treatment, 2 patients received CD22-CART treatment (4.9%) , and 4 patients received CD19-CART and CD22-CART treatments (9.8%) . The expected 3-year overall survival (OS) , leukemia-free survival, cumulative relapse incidence, and non-relapse mortality (NRM) of patients after the second HSCT were 48.9% (95% CI 23.0%-70.6%) , 41.8% (95% CI 17.3%-64.9%) , 8.8% (95% CI 2.9%-26.4%) , and 51.1% (95% CI 31.2%-83.6%) , respectively. The 1-year OS of patients who relapsed ≤6 months and >6 months after the first HSCT were 45.0% (95% CI 12.7%-73.5%) and 75.0% (95% CI 51.4% -88.8%) ( P=0.017) , respectively. Conclusion:CART bridging in the second HSCT enables some B-cell ALL patients who relapsed after the first HSCT to achieve long-term survival. However, because of the high NRM, further modifications could help improve the outcome.