Objective To investigate the therapeutic efficacy and side effects of arsenic trioxide (As2O3) with ATRA on newly-diagnosed patients with acute promyelocytic leukemia (APL). Methods 35 patients of newly-diagnosed APL received As2O3 with ATRA treatment. The therapeutic effects were compared with As2O3 treatment on 33 patients. The dose were adjusted according with As2O3 0.16 mg·kg-2·d-1 and ATRA 25 mg·m-2·d-1 until complete remission (CR). The CR rate, period to CR, the incidence of early death and side effects were observed in two groups. Results There was no significant difference in CR rate, in which 94.3 % for As2O3 with ATRA group and 90.9 % for As2O3 group (P >0.05). Significant difference was observed in the period to CR, in which the medium time to CR was 26.1 days for As2O3 with ATRA group and 30.5 days for As2O3 group (P <0.05). No significant differences was detected in APL associated syndrome, the occurrence of cytoxic responses and the incidence of early death. The death rate was higher in high WBC group than that in middle and low WBC group, with statistical difference (P <0.05), but there was no obvious difference between lower WBC and middle WBC group (P >0.05). Conclusion The treatment combined with As2O3 and ATRA could lessen the time of reaching CR. The WBC count > 10×l09/L was one of the main causes of therapy associated death and the APL differentiation syndrome should be detected and given attention immediately.

ObjectiveTo explore the effects of the conjugate prepared from the cholera toxin B subunit(CB) and nerve growth factor(NGF) on the spatial learning and memory abilities and cholinergic function.MethodsThe conjugate of CB-NGF was prepared by the improved sodium metaperiodate method and nasally administrated to the β-amyloid protein(Aβ25-35) induced amnesic mice for 7 days with 2 dosage (7-5 μg/d、15 μg/d). Spatial learning and memory abilities were evaluated by Morris water maze and cholinergic function was assessed with the choline acetyl transferase (ChAT) immunohistochemical methods.ResultsMorris water maze test showed that the escape latency in Aβ25-35-treated mice prolonged and the staying time reduced in the crossed first quadrant where the platform had been located, compared with the control mice (P<0-01). In addition, the number of ChAT positive neuron declined in the model mice(P<0-001). CB-NGF nasal administration significantly shortened the escape latency and elevated the staying time and number of ChAT positive neuron(P<0-01).ConclusionCB-NGF treatment can improve the spatial and memory performance which may involve the neuroprotection to cholinergic system.

OBJECTIVETo establish the fingerprint of Vernonia anthelmintica extracts of different ethanol concentrations to study the effect of common peak components on the proliferation of A375 human melanoma cells and the correlation between fingerprint and pharmacodynamics of V. anthelmintica extracts, in order to provide both theoretical basis and data support for establishing a traditional Chinese medicine quality control mode with the combination of fingerprint and pharmacology.

METHODHPLC was applied to establish fingerprint of V. anthelmintica extracts of different ethanol concentrations and the similarity evaluation was made. MTT was used to study the proliferation of A375 human melanoma cells. Grey relation analysis was adopted to analyze the correlation between fingerprint and pharmacology of V. anthelmintica.

RESULTThe HPLC fingerprint of different V. anthelmintica ethanol extracts showed 13 common peaks with the proliferation effect on A375 human melanoma cells. The 4th peak had the largest contribution and highest correlation to cell proliferation.

CONCLUSIONDifferent V. anthelmintica ethanol extracts have different fingerprints, which show a certain correlation between their common peaks and effect on cell proliferation.

Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Melanoma ; drug therapy ; pathology ; Plant Extracts ; analysis ; pharmacology ; Vernonia ; chemistry

Objective:To investigate the incidence of social isolationin community elderly patients with knee osteoarthritis and analyze its influencing factors.Methods:From January to April 2021, 240 community elderly with knee osteoarthritis in three community health service centers in Taiyuan (Yingbin community, Dawang community and Pingyang second community) were selected as research objects by convenient sampling method. They were investigated by general data questionnaire, Lubben Social Network Scale-6(Lubben-6), Geriatric Depression Scale-15, Perceived Social Support Scale, Numerical Rating Scale. Single factor analysis and binary Logistic regression analysis were used to explore the influencing factors of social isolation in elderly patients with knee osteoarthritis.Results:The prevalence of social isolation among community elderly patients with knee osteoarthritis was 43.33% (104/240) . The results of binary logistic regression analysis showed that age ( OR = 2.228, 95% CI 1.436-3.457), complicated diseases ( OR = 1.733, 95% CI 1.028-2.919), exercise ( OR = 0.560, 95% CI 0.360-0.869), depression ( OR = 3.603, 95% CI 1.768-7.339), comprehension of social support ( OR = 0.424, 95% CI 0.253-0.710) and pain ( OR = 1.792, 95% CI 1.147-2.799) were the influencing factors of social isolation in elderly patients with knee osteoarthritis ( P<0.05). Conclusions:The degree of social isolation in community elderly patients with knee osteoarthritis is relatively high, and is affected by many factors. Community medical staff should formulate targeted nursing intervention plans based on their influencing factors to reduce the occurrence of social isolation.

Objective To evaluate the effect of Otago exercise program on the elderly′s falls. Methods The relevant randomized controlled trials were searched from PubMed, Web of science, Scopus,CINAHL,Chinese Biomedical Literature Database,China National Knowledge Infrastructure and Wanfang database. According to the inclusion and exclusion criteria two reviewers screened literature, extracted data and assessed the quality of included studies, using Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 independently. Meta-analysis was conducted using RevMan5.3. Results Totally 16 randomized controlled trials were included. Meta-analysis showed that Otago exercise program can reduce the incidence of falls(ratio ratio was 0.85,P=0.000 6),improve falls efficacy (standardized mean number difference was 0.67, 0.43, all P<0.05), enhance elderly′ s balance (standardized mean number difference was 0.65,P<0.01)and mobility(mean number difference was-5.46, P=0.000 1),but can′t effectively reduce the incidence of falls related injury(ratio ratio was 0.98,P=0.78). Conclusions Otago exercise program is effective to improve falls efficacy, enhance balance and mobility,reduce the incidence of falls.It is suggested to promote clinical use.

Objective To analyze the prognosis ofⅠb2 andⅡa2 cervical squamous cancer without high risk factors treated with neo-adjuvant chemotherapy(NACT)and radical hysterectomy. Methods This retrospective study included patients with International Federation of Gynecology and Obstetrics (FIGO)stageⅠb2 andⅡa2 cervical squamous cancer without high risk factors who underwent platinum-based NACT followed by radical surgery from January 2008 to January 2015.The responses of NACT were observed and compared in their effect on postoperative pathologic risk factors. Kaplan-Meier method and Cox regression analysis were performed to analyze survival status. Results This study was recruited 282 patients with the average age of(44.4±6.7)years old.After NACT,42 patients achieved complete response [CR,14.9%(42/282)],while 138 patients achieved partial response[PR,48.9%(138/282)]and 102 stable disease [SD, 36.2%(102/282)]. The rate of pathologic diameter ≥4 cm, deep stromal invasion(DSI) positive and lymph-vascular space invasion(LVSI)positive rate decreased significantly in CR and PR group compared with SD group(P<0.05). The number of postoperative risk factors in CR, PR and SD groups varied significantly(χ 2=64.869, P=0.000). Besides,the rate of multiple intermediate risk factors was respectively 0 vs 13.8% vs 45.1%(χ2=7.107, P=0.008). The disease relapsed in 23 patients, and 12 died. On the whole series, 5-year overall survival rate was 91.7%, and 5-year recurrence-free survival rate was 88.9%. The rate of recurrence(P=0.002)and mortality(P=0.036)were higher in LVSI positive patients compared with LVSI negative. And the rate of recurrence was higher in patients with multiple intermediate risk factors,compared with no or one intermediate risk factors(P=0.002).Univariate analysis revealed that LVSI positive and multiple intermediate risk factors were the factors predicted recurrence and mortality(P<0.05), and no significance in age, stage, tumor grade, tumor diameter before or after NACT, response to NACT,or DSI positive factors(all P>0.05).The multivariate analysis showed that,the factor of primary tumor diameter≥6 cm(P=0.022)and multiple intermediate risk factors(P=0.001)were independent prognostic variables for recurrent-free survival.Besides,multiple intermediate risk factors was independent prognostic variable for overall survival(P=0.034). After surgery, 107 patients did not receive adjuvant therapy,while 175 patients received adjuvant therapy with 26 radiotherapy,46 chemotherapy and 103 concurrent radiochemotherapy.On survival analysis of postoperative adjuvant treatment,5-year recurrence-free survival rate of radiotherapy group was significantly lower in patients with the factor of SD response to NACT(P=0.011)and multiple intermediate risk factors(P=0.008), while overall no significance in overall survival rate(P>0.05).Conclusions NACT may be play beneficial role in relieving the status of intermediate risk factors for stage Ⅰb2 andⅡa2 cervical squamous cancer without high risk factors. The status of multiple intermediate risk factors is independent prognostic factors for recurrence and mortality. For patients with multiple intermediate risk factors, postoperative adjuvant chemotherapy or concurrent radiochemotherapy might be the better choice to prevent relapse.

Objective: To assess the significance of DDAVP use in the diagnosis and treatment of VWD. Methods: An analysis of 15 VWD cases who referred to Hematology Division of First affiliated Hospital of Soochow University and treated with DDAVP from March 2016 to August 2018 was conducted. Efficacy and treatment response of DDAVP were monitored by observations of changes in factor Ⅷ procoagulant (FⅧ∶C) and von Willebrand Factor (VWF) related indicators before and 2 h after DDAVP injection. Results: Of 15 cases with VWD, 7 males and 8 females with a median age of 23 (6-46) years, 7 of 9 type I VWD patients achieved complete response (CR) , 1 type 2A VWD case CR, 5 type 3 VWD ones no response (NR) . The VWF multimer analysis in 5 patients combined with other plasma VWF values were in accordance with the known diagnosis. Conclusions DDAVP was effective in most type 1 patients, and ineffective in some type 2 and almost all type 3 cases. It was helpful for diagnosis and subsequent treatment planning.

Objective: To explore the normal range of plasma VWF levels of healthy Chinese and to analyze the influencing factors to VWF level. Methods: To detect the levels of von Willebrand factor antigen (VWF∶Ag) , von Willebrand factor ristocetin cofactor activity (VWF∶Rco) , von Willebrand factor collagen binding activity (VWF∶CB) , and the factor Ⅷ coagulation activity (FⅧ∶C) by using fully automatic and standardized testing instruments and matching reagent in 70 healthy Chinese. The effects of age, ABO blood type, gender and region were also analyzed. Meanwhile, 8 standard plasma samples (2 normal subjects, 6 cases of type 2 VWD) confirmed by NIBSC were tested for VWF values. Results: ① In 70 cases of healthy Chinese, the mean value of plasma VWF∶Ag, VWF∶Rco and VWF∶CB were (95.4±44.9) %, (105.9±35.4) % and (89.8±28.4) %, respectively; the ratio of VWF∶Rco/VWF∶Ag and VWF∶CB/VWF∶Ag was 1.18±0.25 and 1.03±0.29, respectively. ②There was no statistical significance in plasma VWF values between the age ≥30 years and <30 years group (P>0.05) . ③The VWF∶Rco, VWF∶CB of type O blood group were lower than that of non-O group (t=2.074, P=0.042; t=3.949, P=0.001) , but there was no statistical significance in VWF∶Ag, VWF∶Rco/VWF∶Ag, VWF∶CB/VWF∶Ag between the two groups (P>0.05) . ④There was no significant difference in VWF values between male and female groups (P>0.05) . ⑤The VWF∶Ag, VWF∶CB of the northern population (North area of Huaihe River) group were higher than that of southern population (Suzhou area) group (t=4.525, P=0.001; t=3.214, P=0.002) , but VWF∶Rco/VWF∶Ag, VWF∶CB/VWF∶Ag were lower than that of southern population group (t=6.373, P=0.001; t=2.902, P=0.005) , and there was no significant difference in VWF∶Rco between the two groups (t=1.598, P=0.115) . ⑥The VWF values of 8 standard plasma samples were in accordance with the known diagnosis. Conclusions A more integrate plasma VWF levels of healthy Chinese people were obtained for the first time by using fully automatic and standardized testing instruments. It was also found that ABO blood group and region had a significant impact on the level of VWF, while the age and gender had no significant effect.

OBJECTIVETo investigate the feature of underlying disorders, clinical symptoms, diagnosis and treatment strategies of patients with acquired hemophilia(AH).

METHODSThe clinical data and laboratory tests results of 22 patients with AH from March 2010 to June 2014 were retrospectively analyzed.

RESULTSA total of 22 patients with AH were enrolled in our study, including 20 patients diagnosed as acquired hemophilia A (AHA) and 2 as acquired hemophilia B (AHB). Among the AHA patients, there were 10 males and 10 females with the median age of 37.5 (range, 2-95) years old. The median activity of FVIII (FVIII:C) of the 20 AHA patients was 1.9% (0.5%-39.0%). Soft tissue hematoma (80.0%) and subcutaneous bleeding (75.0%) were the most common clinical symptoms. Two male children were diagnosed as AHB (age 1 and 3 years old, respectively) with mild bleeding symptoms, and the activities of FIX (FIX:C) were 5.0% and 16.0%, respectively. In addition, an underlying disorder was found in 7 patients (31.8%). In laboratory testing, all patients had prolonged APTT, normal PT, decreased FVIII:C or FIX:C, positive antibody screening test or antibody titer (2-32 BU), and negative for lupus anticoagulant and anticardiolipin antibody. Nineteen out of 20 patients were treated with blood products to stop acute bleeding episodes. Corticosteroid alone was applied to 7 patients, corticosteroid combined with other immunosuppressive agents to 11 patients, rituximab to 3 patients. Nineteen patients responded well to hemostatic treatment, except 1 patient who died of fatal bleeding. The FVIII:C of 8 patients increased to a normal level with the median time of 42.5(21-145) days. After treatment, the activity of FIX:C of the 2 AHB patients achieved 35% and 24% in 48 and 60 days, respectively.

CONCLUSIONAcquired hemophilia is not an uncommon disease in clinical practices, which can occur in people of all ages. AH is a bleeding disorder with heterogeneous characteristics. Compared with adult, the clinical symptoms of children patients were mild, which lead to underdiagnosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; Child ; Child, Preschool ; Female ; Hematoma ; Hemophilia A ; Hemorrhage ; Hemostatics ; Humans ; Immunosuppressive Agents ; Male ; Middle Aged ; Retrospective Studies ; Rituximab ; Young Adult