OBJECTIVE:To establish the quality standard for Mongolian medicine Yishen powder. METHODS:TLC was used for the qualitative identification of Rheum palmatum and Terminalia chebula in the preparation;HPLC was used for the contents de-termination of aloe emodin,rhein,emodin,chrysophanol and physcion:the column was Inertsil C18 with mobile phase of metha-nol-0.1% phosphoric acid(gradient elution)at a flow rate of 1.0 mL/min,detection wavelength was 254 nm,column temperature was 35 ℃ and the injection volume was 10 μL. RESULTS:The TLC pots of R. palmatum and T. chebula were clear and well-sepa-rated,negative control without interference. The linear range was 23.55-117.75 ng for aloe emodin(r=0.9999),44.72-223.62 ng for rhein(r=0.9998),43.18-215.90 ng for emodin(r=0.9997),77.41-387.12 ng for chrysophanol(r=0.9999)and 46.02-230.10 ng for physcion (r=0.9997);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 95.80%-99.66%(RSD=1.21%,n=6),95.01%-98.07%(RSD=0.92%,n=6),95.06%-97.84%(RSD=0.5%,n=6),95.19%-97.66%(RSD=1.07%,n=6)and 95.07%-98.20%(RSD=0.95%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Mongolian medicine Yishen powder.

Objective To study clinical efficacy on cesarean scar pregnancy (CSP) treated by transvaginal surgery.Methods From Jan.2008 to Mar.2011,31 cases with CSP were managed by transvaginal surgery in Anshan Women and Children Hospital.Based on ultrasonograpy examination and intraoperative exposure of lesion,variable surgical options were executed.Fifteen cases in group A were treated by debridement resection and vaginal repair of uterine wall,7 cases in group B were treated by transvaginal uterine artery ligation and curettage,9 cases were treated by cutting the anterior wall in the lower uterine segment and repairing uterine.The intraoperative blood loss,operation time,hospital stay,hCG fluctuation at postoperative period and complications were analyzed among those groups.Results Allcases in 3 groups were cured well in one time.( 1 ) The intraoperative blood loss were (41 ±21 ) ml in group A,(27 ±7) ml in group B and ( 148 ± 132) ml in group C.There was no statistically different blood loss between group A and group B ( P ＞ 0.05 ),however,the amount blood loss in group C was significantly more than those in group A and group B ( P ＜ 0.05 ).( 2 ) The average surgical time,the mean hospital stay,postoperative recovery time of blood hCG were (40 ± 11 ) minutes,(4.7 ± 0.8 ) days and ( 2.7 ± 1.0) weeks in group A,(44 ± 5 ) minutes,(4.0 ± 0.8) days and (2.9 ± 1.0) weeks in group B,(40 ± 12) minutes,(4.9 ± 1.0) days and (2.8 ±0.9) weeks in group C.Those clinical index were no statistically different among those 3 groups(P ＞0.05).(3) No bladder injury and other complications were observed in those groups.Conclusions Transvaginal surgery is efficacy,easy to operate,to keep the uterus,safe and economy in treatment of CSP.Surgery in group A is suitable to treat early and exogenous lesions; surgery in group B is suitable to treat endogenous lesions; surgery in group C is suitable to treat failure cases in group A and B,however,the injury is greater than those in group A and B.

Objective:To investigate the clinical characteristics, diagnosis, treatment and prognosis of acute leukemia (AL) with NUP98-DDX10 fusion gene-positive.Methods:The clinical data of 2 AL patients with NUP98-DDX10 fusion gene-positive who admitted to Blood Diseases Hospital, Chinese Academy of Medical Sciences in April 2020 and February 2021, respectively were retrospectively analyzed. Transcriptome gene sequencing was used to detect fusion gene, and the fusion gene fragment was amplified by using reverse transcription polymerase chain reaction (RT-PCR), and Sanger sequencing was used to clarify sequences. The clinical and experimental indicators characteristics were analyzed and the relevant literatures were reviewed.Results:According to the clinical diagnosis, 1 patient was diagnosed as acute myeloid leukemia M 5 (AML-M 5) and 1 patient was diagnosed as acute leukemia of ambiguous lineage, not otherwise specified (ALAL-NOS). The AML-M 5 patient presented with severe coagulation abnormalities, and fulfilled the diagnostic criteria for diffuse intravascular coagulation (DIC) at the initial visit. Transcriptome sequencing of 2 patients showed NUP98-DDX10 fusion gene- positive. RT-PCR confirmed that sequencing results identified 2 different splice fusion modes: one was NUP98 exon 14 fused with DDX10 exon 7(usually called "type Ⅱ"), the other was NUP98 exon 14 fused with DDX10 exon 13, which was never reported and named as "type Ⅳ". From 1997 to 2018, a total of 16 cases with NUP98-DDX10 related hematologic neoplasms were reported in the literature. A summary analysis of 16 cases added with 2 patients in our center included 13 males and 5 females with median age 31.5 years (0.08-61 years). The median overall survival was 12 months (1-46 months). Conclusions:A novel fusion gene NUP98-DDX10 transcriptome is identified in ALAL-NOS patient. Hematological malignancies with NUP98-DDX10 are very rare. They respond poorly to conventional treatment and require allogeneic hematopoietic stem cell transplantation (allo-HSCT) to improve the prognosis.