AIM To establish the quality standard for Cyclocarya paliurus (Batal.) ljinsk..METHODS The contents of water,ash and extract in twelve batches of samples were determined.TLC and HPLC were adopted in the qualitative identification and quantitative determination of quercetin and kaempferol,respectively,and phenol-sulfuric acid method was used for the polysaccharide content assessment.RESULTS The average contents of water,total ash,acid-insoluble ash,water-soluble extract and alcohol-soluble extract were 11.05％,5.81％,1.70％,11.25％ and 10.16％,respectively.The clear TLC spots demonstrated their strong specificity.Quercetin and kaempferol showed good linear relationships within the ranges of 0.004 953-0.022 29 mg/mL and 0.005 748-0.028 74 mg/mL (r =0.999 9),whose average recoveries were 97.1％ (RSD =2.59％) and 97.9％ (RSD =2.86％),respectively.Polysaccharide showed a good linear relationship within the range of 0.021 22-0.095 58 mg/mL,whose average recovery was 97.2％ (RSD =2.42％).The contents of three constituents in various batches of samples showed obvious differences.CONCLUSION In C.paliurus,the contents of water,total ash,acid-insoluble ash,water-soluble extract and ethanol-soluble extract should not be more than 13.0％,7.0％,2.0％,13.5％ and 12.0％,while those of quercetin,kaempferol and polysaccharide (calculated by dry product) should not be less than 0.040％,0.070％ and 0.60％,respectively.

Objective: To establish the determination method of gallic acid in Ninbitai Capsules.Methods: HPLC with Shimadzu Shim-pack VP-ODS(250mm?4.6mm,5??m) column was used. Methanol-water-dimethylformamide-acetic acid glacial (1∶81∶15∶3) was used as mobile phase. The flow rate was 0.5mL/min. The detection wavelength was at 272nm.Results: The linearity of this method was well. The recovery of the added sample was 98.16%. RSD was 1.18%.Conclusion: This method is convient with a good separating degree and can be used for the quality control of Ninbitai Capsules.

Objective To investigate the effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with intensified conditioning regimen followed by rapidly tapering immunosuppressants and sequential minimal residual disease (MRD)-guided donor lymphocyte infusion (DLI) post-transplantation on outcome of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods Two cases of BPDCN from January 2009 to May 2011 in Nanfang hospital were diagnosed according to 2008 WHO classification of tumours of haematopoietic and lymphoid tissues.Case 1 initially presented with typical cutaneous involvement and was promptly diagnosed with CD+4CD+56LCA+TdT+CD+43 BPDCN by skin biopsy.Case 2 was recognized as acute lymphocyte leukemia and acute non-lymphocytic leukemia,which was diagnosed to BPDCN at recurrence through flow cytometry analysis.Total-body-irradiation plus cyclophosphamide based intensified conditioning regimen were followed by allo-HSCT from sibling donor.Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate.Anti-thymocyteglobulin was included additionally for haploid donor allo-HSCT.Multi-color labeling flow cytometry was performed to monitor MRD.Rapidly tapering of prophylactic immunosuppressants and sequential MRD-guided donor lymphocyte infusion (DLI) were performed to control relapse of primary malignancy.Results Two cases of BPDCN received allo-HSCT from sibling donor after intensified conditioning regimen.Both patients achieved complete remission and complete donor engraftment.Case 1 survived refractory acyclovir-resistant Epstein-Barr virus viremia benefiting from preemptive treatment with rituximab and DLI-induced grade Ⅳ acute GVHD,but died of thrombotic microangiopathy mixed with diffuse alveolar hemorrhage and sepsis on +243 days.Case 2 relapsed just 2 months after allo-HSCT despite DLI and rapidly tapering of CsA,died of sepsis followed by diffuse intravascular coagulation on +101 days.Conclusion BPDCN is characterized with typical cutaneous and/or bone marrow involvement with CD4+CD+56CD+123CD+43 blastic plasmacytoid dendritic cell and highly aggressive clinical course.Allo-HSCT seems to be a promising treatment for early phase of aggressive BPDCN aided with MRD monitoring and DLI,but it deserves more intensive researches to promote outcome of advanced staged BPDCN.

Objective To investigate the characteristics and the risk factors of pulmonary function in patients with chronic obstructive pulmonary disease (COPD) for a 3 year follow-up.Methods Subjects diagnosed as COPD were followed up for 3 years in the Management Center of Chronic Respiratory Disease at XINQIAO Hospital from September 2009 to June 2012.This was a retrospective study.Parameters related to respiratory function mainly first second forced expiratory volume (FEV1),COPD assessment test (CAT),6 minutes walking distance (6MWD) and acute exacerbation were recorded during follow-up.Results Although the majority of patients were treated with drugs such as inhaled corticosteroid combined with longterm bronchial dilatation during the three years,FEV1 decreased progressively.The average annual decline of FEV1 was(31.80 ± 61.99) ml,translating into a mean annual decline of(3.74 ± 6.18) ％.However,there were significant differences in changes of FEV1.Approximately,FEV1 in 78.3％ (47/60) patients decreased,only 21.7％ (13/60) patients kept stable FEV1.There was a correlation between decrease of FEV1,FEV1 ％ predicted and the exacerbation (r =0.298,0.361,0.273;P ＜ 0.05).Logistic regression showed that the positive bronchodilator reversibility and the initial FEV1 were the independent factors associated with significant changes in FEV1 (respectively,OR =5.54,95％ CI 1.55-19.73;OR =8.28,95％ CI 1.42-48.32).Conclusion The changes of pulmonary function in patients with COPD are heterogeneous,although most patients are treated in a standard way.Nearly 80％ patients still represent deterioration of pulmonary function.Decline of FEV1 is closely related to the initial pulmonary function and bronchodilator reversibility.

OBJECTIVETo analyze the effect of sorafenib as salvage therapy used before and/or after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in refractory relapsed FLT3-positive acute myeloid leukemia (AML).

METHODSA total of 16 patients with refractory relapsed FLT3-positive AML, including 10 refractory relapsed pre-transplantation and 6 relapsed after allo-HSCT, were enrolled in this retrospective study. Sorafenib treatment protocols included sorafenib in combination with chemotherapy inducing remission, and sorafenib monotherapy as mauntenance treatment after complete remission (CR).

RESULTSThirteen of the 16 patients achieved CR after one or two courses of induction therapy, including 7 refractory relapsed pre-transplantation and 6 relapsed after allo-HSCT. With a median follow up of 472 (range, 59-1569) days post-transplantation, 12 patients survived and 4 died. Causes of death included leukemia relapse (n=3) and acute graft-versus-host disease (n=1). The 2-year overall and disease-free survival post-transplantation of the 16 patients were (75.0±10.8) % and (50.5±13.7) % respectively. The main side effect of sorafenib was the skin rash. The incidence of rash was lower in the patients used sorafenib pre-transplantation than those post-transplantation (30.0% vs 75.0%, P=0.043).

CONCLUSIONSorafenib used as salvage therapy befor and/or after transplantation for refractory relapsed FLT3-positive AML could reduce the relapse rate and improve the survival.

Antineoplastic Agents ; therapeutic use ; Disease-Free Survival ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; genetics ; therapy ; Mutation ; Niacinamide ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; therapeutic use ; Recurrence ; Remission Induction ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome ; fms-Like Tyrosine Kinase 3 ; genetics

ObjectiveTo investigate the therapeutic effects of the conditioning regimen with or without total body irradiation on allogeneic hematopoietic stem cell transplantation in acute leukemia.Methods We retrospectively evaluated clinical outcomes in 287 allo-HSCT recipients with acute leukemia (ALL- 105,AML-129,and AUL-53) who received myeloablative conditioning regimen with or without total body irradiation from January 2002 to August 2011.Two hundred and six patients obtained complete remission (CR) and 81 non-remission (NR) before transplantation.One hundred and ninety-nine patients received conditioning with total body irradiation (TBI+ Cy group,9 Gy given over 2 days),and 88 patients received busulfan (BuCy group,3.2 mg·kg-1 ·d-1 ),both followed by cyclophosphamide.ResultsThere were no statistically significant differences in hematopoietic reconstitution,regimen-related toxicity (RRT),graft-versus-host disease (GVHD) and relapse between two groups.For patients with AML and AUL,there was no significant difference in the 5-year survival between the two regimens (P＞ 0.05),while for ALL-CR patients,the TBI + Cy regimen had a higher over survival rate (52.0％ vs.31.3％,LogRank=4.249,P＜0.05) and DFS (50.4％ vs.27.8％,LogRank =4.445,P＜0.05) than BuCy.In TBI + Cy group and BuCy group,the proportion of CD19+ B cells at the first month after HSCT was (4.04 ± 1.86)％ and (1.47 ±0.99) ％ (P＜0.05),that of NK cells at 12th month after HSCT was (23.38 ± 12.19) ％ and (13.11± 7.99) ％ (P＜0.05),and that of CD4+ CD45RO+ cells at 9th month after HSCT was (14.63 ±6.17)％ and (9.07 ± 3.12)％ (P＜0.01),respectively.ConclusionUsing TBI-containing regimen was more effective for treating ALL-CR patients than busulphan-containing regimen,but no difference was found for long-term outcomes in patients with AML and AUL between the two regimens.The 9 Gy TBI-based regimens may not affect recipients' thymic function,T-cells reconstitution and immune tolerance,coming out a non-increase of GVHD.

By analysing the f(a) singularity spectra of the ST segments of the synchronous 12-lead ECG, we have found that the singularity spectrum is close to monofractality and its area is only half the area of the synchronous 12-lead ECG f(alpha) singularity spectrum. The ST segments of the synchronous 12-lead ECG signal also has f(alpha) singularity spectra distribution and it also has a reasonable varying scope. We have also found that the lead number of the ST segment f (alpha) singularity spectra for adults having coronary heart disease overstep the reasonable scope tends to increase over that of the ECG f(alpha) singularity spectra. These findings show that using the ST segments f(alpha) singularity spectra distribution of the synchronous 12-lead ECG is more effective than using the synchronous 12-lead ECG on the clinical analysis.
Electrocardiography ; methods ; Humans ; Signal Processing, Computer-Assisted

Using the algorithm proposed by Costa M, et al., we studied the multiscale entropy (MSE) of electrocardiogram. The sample entropy (SampEn) of the healthy subjects was found to be higher than that of the subjects with coronary heart disease or myocardial infarction. The healthy subjects' complexity was found to be the highest. The SampEn of the subjects with coronary heart disease was noted to be only slightly higher than that of the subjects with myocardial infarction. These findings show that the complexity of the subjects with coronary heart disease or myocardial infarction is distinctly lower than the complexity of the healthy ones, and the subjects suffereing from coronary heart disease are liable to the onset of myocardial infarction.
Algorithms ; Coronary Disease ; physiopathology ; Electrocardiography ; methods ; Entropy ; Humans ; Myocardial Infarction ; physiopathology ; Signal Processing, Computer-Assisted

Objective To explore the changes of left ventricular torsion function in patients with latent obstructive hypertrophic cardiomyopathy ( HCM ) ,and provide quantitative informations for clinical evaluation of cardiac function . Methods A total of 49 consecutive patients with HCM without left ventricular outflow tract obstruction at rest were enrolled . All subjects underwent exercise stress echocardiography . After exercise left ventricular outflow tract pressure gradient ( LVO T‐PG ) ≥30 mm Hg was positive for exercise stress test ( latent obstruction) ,w hile LVO T‐PG＜ 30 mm Hg was negative for exercise stress test ( non‐obstruction) . An ultrasound system obtained two‐dimensional ultrasound images of resting and moving peaks . The global longitudinal strain ( GLS ) ,global circumferential strain ( GCS ) , global radial strain ( GRS) of the left ventricle 16 segments and left ventricular rotation ,twist were analysis using off‐line EchoPAC software . T he differences of the above parameters were compared between the two groups . Results T here were no significant differences in GLS ,GRS ,GCS and Rotation‐B between the two groups in resting and peak period of exercise ( all P ＞ 0 .05 ) ,GRS in both groups were significantly increased compared with that before exercise ( all P ＜ 0 .05 ) . Compared with the negative exercise stress group ,the left ventricular twist and Rotation‐A were significantly increased in resting and peak period of exercise in the positive exercise stress test group( all P ＜0 .05) . Compared with before exercise ,Rotation‐A and left ventricular twist were significantly decreased in the positive exercise stress test group ( all P ＜0 .05) ,while no significantly difference was found in the negative exercise stress group ( all P ＞ 0 .05 ) . Conclusions Left ventricular torsion function is significantly changed in rest and after exercise in latent obstructive HCM patients ,providing valuable quantitative information for clinical comprehensive evaluation of cardiac function .

Objective:To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF).Methods:A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared.Results:Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher ( P<0.05) and there were no significant differences of the other serological indexes between the two groups(all P>0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P<0.05). There were no significant differences of other conventional echocardiographic measurements between the two groups(all P>0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P<0.05); but there was no significant difference of GCS between the two groups( P>0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. Conclusions:3D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA.