OBJECTIVETo study the effect of Qinghuang Powder (QHP) combined Chinese herbs for Pi-strengthening and Shen-reinforcing (CHPSSR) on hypoxia-inducible factor 1alpha (HIF-1alpha) in bone marrow mononuclear cells of myelodysplastic syndrome (MDS) patients.

METHODSChanges of HIF-1alpha in bone marrow mononuclear cells of MDS patients were detected in 25 MDS patients treated by QHP combined CHPSSR using flow cytometry. Meanwhile, 13 healthy subjects were recruited as the control group. Changes HIF-1alpha levels in various serial bone marrow mononuclear cells were detected.

RESULTS(1) Among the 25 patients in the treatment group, there were 19 patients effective and 6 patients ineffective, with the total effective rate being 76%. (2) Compared with before treatment, levels of peripheral blood WBC, Hb, PLT, and ANC significantly increased in the treatment group after treatment, showing statistical difference (P < 0.05, P < 0.01). (3) Compared with before treatment, the HIF-1alpha mean fluorescence intensity was enhanced in bone marrow lymphocytes, monocytes, granulocytes, and nucleated red blood cells of the treatment group after treatment (P < 0.05, P < 0.01). Compared with the control group, the HIF-1alpha mean fluorescence intensity was weakened in bone marrow lymphocytes, monocytes, and nucleated red blood cells of the treatment group before treatment; while it was obviously enhanced in granulocytes (P < 0.01). But after treatment the HIF-1alpha mean fluorescence intensity increased more in the granulocytes of the treatment group than in those of the control group (P < 0.01), but there was no statistical difference in bone marrow lymphocytes, monocytes, or nucleated red blood cells.

CONCLUSIONQHP combined CHPSSR could improve HIF-1alpha levels in bone marrow lymphocytes, monocytes, granulocytes, and nucleated red blood cells of MDS patients, thus improving Hb levels of MDS patients, and improving their anemia and correlated symptoms.

Adolescent ; Adult ; Aged ; Arsenicals ; therapeutic use ; Bone Marrow ; Bone Marrow Cells ; drug effects ; metabolism ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Monocytes ; drug effects ; metabolism ; Myelodysplastic Syndromes ; drug therapy ; metabolism ; Phytotherapy ; Young Adult

Objective To expore the effects of FGF-2 and TGF-β1 on the differentiation of rat bone mar-row mesenchymal stem cells(BMSCs)towards cardiocytes. Methods BMSCs were isolated from bones of SD rats and cultured and identified by flow cytometry.The cells were divided into four groups:group A(FGF-2),group B (TGF-β1),group C(FGF-2+TGF-β1)and group D(blank control).The morphological changes were observed by the microscope. The expressions of Desmin,α-sarcomeric actin and cTnI were detected by immunocytochemical stainning.The expressions of GATA-4 and Nkx2.5was detected by RT-qPCR.Result The positive expression rate of CD90,CD29 and CD45 was 84.7%,86.5%,0.3% respectively. After induction,group C presence of myotube structures and the shape is fusiform.The positive rate of combined induction group was higher than the others (P < 0.05). The expression of GATA-4 and Nkx2.5 genes was higher than that in the other groups(P < 0.05). Conclution FGF-2 and TGF-β1 can be used to induce BMSCs into cardiocytes,and the combined group has the better effect.

Objective To investigate the clinical and biologic characteristics of acute myeloid leukemia (AML) with 6q deletions (6q-). Methods Two cases of with 6q deletions (6q-) were here described, and all the AML cases with 6q- found in the literature were reviewed. Results Two cases were diagnosed with AMLMt and AML-M2, respectively. Myloloid markers were positive on the leukemia cells in both cases, none of them expressing lymphocytic antigens. The karyotype of these patients were 46,XX,del(6)(q21q25),t(4; 7)(q10;q10)[3]/46,XX,del(6)(q21q25)[2]/46,XX[25], and 46,XX,del(6)(q23),t(7;11)(p15;p15)[5]/46,XX,t(7;11)' (p15;p15)[9]/46,XX [6]. Until now, 28 cases (including present 2 cases) of AML with 6q- have been documented in the world literature. Many of the AML patients with 6q -have additional chromosomal abnormalities. The breakpoints on 6q- were widely distributed from q12 to q27, mainly involved in the 6q21-23 region. Overall, the AML patients with 6q- were associated with an unfavorable clinical outcome, with a poor response to chemotherapy and a shorter duration. 6q-clone may itself confer a malignant clinical outcome. The 6q- found in some AML cases may associate with leukemogenesis via an activation of an oncogene other than myb or deletion of an antioncogene located in the long arm of chromosome 6. Conclusion Deletion of 6q is a very rare event in AML. AML with 6q- had distinct biologic features and a. poor clinical outcome.

Objective　To investigate the risk factors for cerebral microbleeds (CMBs) in patients with white matter hyperintensities (WMH),and to find out the correlation between the severity of cerebral microbleeds and the duration of taking aspirin in patients with white matter hyperintensities.Methods　We collected patients with white matter hyper-intensities confirmed by MRI，who were admitted to the neurology department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from June 2016 to September 2017.All enrolled patients were divided into non-CMBs group,mild CMBs group and moderate to severe CMBs group.All patients’ clinical data were collected for analyzing the risk factors of CMBs.Furthermore,the WMH patients who is taking aspirin were analyzed by subgroup analysis.Results　A total of 357 WMH patients were enrolled in this study,including 189 patients in the non-CMBs group,94 in the mild-CMBs group,and 74 in the moderate to severe CMBs group.There were significant differences among the three groups in gender,acute ischemic stroke,the history of hypertension,the history of ischemic stroke,diastolic blood pressure on admission,taking aspirin for more than two years,homocysteine level and the severity of WMH (P<0.05).Results　From subgroup analysis of 263 patients with WMH patients taking aspirin showed that with the increase of CMBS,the percentage of severe WMH patients increased gradually,and the percentage of patients taking aspirin for more than 2 years increased gradually as well.Conclusions　The severity of WMH is correlated with the severity of CMBs in WMH patients.Male,the history of hypertension and taking aspirin for more than two years are risk factors for CMBs in WMH patients,and the longer duration of taking aspirin in WMH patients,the more severe CMBs are.

Objective To evaluate the effect of correcting upper eyelid retraction in patients with iatrogenic ophthalmopathy by a new technique of modified transsection and longitudinal suture levator muscle prolongation treatment.Methods The traditional levator muscle flap trapezoidal incision was changed into horizontal incision,According to the amount of upper eyelid retraction we designed a transverse incision with 1 ∶ 2 in the central part of levator aponeurosis.Along the line of incision was designed transverse incision of Mulller's muscle combined with levator aponeurosis complex was designed,with longitudinal suture of incision.Results Five patients (6 eyes) with iatrogenic upper eyelid retraction were treated by this method.The follow up was performed for 3 to 12 months.All were satisfied with good cosmetic results,the degree of bilateral corneal exposure was symmetrical,with no recurrence and complications,except for 1 cases of unilateral upper eyelid retraction width slightly asymmetry.Conclusions The application of modified levator muscle prolongation treatment is not only quite simple,easy to adjust in operation,but also with reliable effect and less complication.It is effective for iatrogenic upper eyelid retraction range from mild to moderate degrees of correction.

OBJECTIVETo explore the effect of Yiqi Bushen Granule (YBG) on CD4+ CD8high T lymphocyte in patients with minimal residual leukemia (MRL) and to probe its prognosis after treatment.

METHODSThe changes of CD4+ CD8high T lymphocyte subgroup and natural killer (NK) cells in 36 patients (16 males and 20 females) received long-term (> 3 months) YBG therapy before and after treatment were analyzed using multi-parameter flow cytometry and controlled by those in 34 healthy persons (19 males and 15 females).

RESULTSThe 3-year and 5-year complete remission rates in MRL patients were 75.0% and 63.9%; their 3-year and 5-year survival rates were 80.5% and 72.2%, respectively; as compared with the baseline, the absolute value and percentage of CD4+ CD8high T lymphocyte and NK cells were all significantly raised after treatment (P < 0.05 or P < 0.01).

CONCLUSIONYBG could prolong the disease-free survival in MRL patients by way of regulating the immune function of organism, elevating the amount of CD4+ CD8high T lymphocyte and NK cells to kill or suppress the residual leukemic cell in body.

Adult ; Aged ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Disease-Free Survival ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Killer Cells, Natural ; immunology ; Leukemia ; drug therapy ; immunology ; Male ; Middle Aged ; Neoplasm, Residual ; Phytotherapy ; Survival Rate ; Young Adult

Objective To search for application ways for the safe and effective clinical methods of arsenic-containing Compound Qinghuang Powder (Compound QHP) for the treatment of myelodysplastic syndrome (MDS). Methods Totally 200 patients with MDS were included in the study and treated with Compound QHP. After one-month treatment, the 60 patients with the blood arsenic concentrations <20 μg/L were randomly divided into control group and treatment group, with 30 cases in each group. Control group was given stable treatment, while the treatment group was given increased dose of realgar; blood arsenic concentration was detected monthly; realgar 0.1 g was increased each time until blood arsenic concentrations ≥20 μg/L and realgar ≤0.3 g/d. The blood arsenic concentration, clinical efficacy and safety in the two groups were observed. Results Totally 24 cases in each group were included for evaluation finally. The average blood arsenic concentration of treatment group was significantly higher than those of control group (P<0.05). The rate of hematologic improvement was significantly higher in treatment group (54.2％, 13/24) than that in control group (29.2％, 7/24) , with significant difference (P<0.05). The Hb, ANC, and PLT significantly increased in treatment group after treatment (P<0.05). There was no significant difference of incidence rate of adverse reaction observed between treatment group and control group (P>0.05). Conclusion In application of Compound QHP, the blood arsenic concentration can be monitored to adjust the daily dose of realgar, thus to increase the effective blood arsenic concentration, and then improving efficacy without increasing the clinical toxicity.

ABSTRACT OBJECTIVETo explore the effects of Qinghuang Power (QHP) combined Chinese herbs for Shen reinforcing and Pi strengthening (CHSRPS) on activated T cells of myelodysplastic syndrome (MDS) patients.

METHODSThe percentage and the absolute value of CD3+ CD28+, CD3+ CD28+ CD4+ CD8-, CD3+ CD28+ CD8+ CD4-, CD3+ CD25+, CD3+ CD25+ CD4+ CD8-, CD3+ CD25+ CD8+ CD4-, CD3+ DR+, CD3+ DR+ CD4+ CD8-, and CD3+ DR+ CD8+ CD4- in the peripheral blood of 24 MDS patients were detected by flow cytometry before and after treatment by QHP combined CHSRPS for 9 months. The changes of the differences in the aforesaid indices were analyzed between the effective group and the in-, and CD3 + effective group.

RESULTSThe absolute values of CD3+ CD28+, CD3+ CD28+ CD4+ CD8-, and CD3+ CD28+ CD8+ CD4- obviously decreased in the effective group(13 cases)after treatment (P <0.05). The percentages of the three indices also obviously decreased in the ineffective group (11 cases, P <0.05). After treatment, both the percentage and the absolute value of CD3+ CD25+ and CD3+ CD25+ CD4+ CD8- obviously decreased in the effective group (P <0.05). There was no statistical difference in the two indices of the ineffective group between before and after treatment (P >0.05).

CONCLUSIONSQHP combined CHSRPS could induce second signal loss by decreasing the expressions of in vitro costimulatory molecules, resulting in deactivation of T cells. It also could suppress the hyperfunction of the immune state in MDS patients, thus preventing normal hematopoietic cells from immune attack induced apoptosis.

Adult ; Aged ; Arsenicals ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Flow Cytometry ; Humans ; Lymphocyte Activation ; Male ; Middle Aged ; Myelodysplastic Syndromes ; drug therapy ; immunology ; metabolism ; Phytotherapy ; T-Lymphocytes, Regulatory ; immunology ; metabolism ; Young Adult

Objective To isolate and study the phenotype and biological characteristics of chronic myelogenous leukemia-derived mesenchymal stem cells. Methods Cultivate the mesenchymal stem cells from chronic myelogenous leukemia in vitro, identify the immunophenotype by fluorescence-activated cell sorter (FACS), and detect the bcr-abl fusion gene by RT-PCR and FISH. Results The mesenchymal stem cells from chronic myelogenous leukemia can express the bcr-abl fusion gene. Conclusion These findings provide the evidence that the rearrangement of bcr-abl gene might happen at least more primitive than CD+34 CD-38 cells.

OBJECTIVETo observe the clinical efficacy of a low dose Qinghuang Powder (QP) combined with Chinese drugs for Shen supplementing and Pi invigorating (CDSSPI) in treatment of hypocellular myelodysplastic syndromes (hypo-MDS).

METHODSTotally 33 hypo-MDS patients enrolled in this study came from outpatient clinics between November 2011 and December 2012. A self-control method was used in this study. Patients took QP (0.4 g per day) combined with CDSSPI (one dose per day), and Stanozolol Tablet (2 mg each time, three times per day), 3 months as one therapeutic course, a total of 2 courses. The clinical efficacy was evaluated timely at the end of each therapeutic course. The venous blood was withdrawn before treatment, at month 3 and 6 after treatment. Changes of neutrophils (ANC), hemoglobin (Hb), and platelet (PLT) were mainly observed.

RESULTSTotally 31 patients in this study finished the treatment. Three months after treatment ANC, Hb, and PLT increased more than before treatment (P < 0.05). Six months after treatment Hb and PLT increased (P < 0.01, P < 0.05), but with no statistical difference in ANC (P > 0.05). Hb increased higher at month 6 after treatment than at month 3 after treatment (P < 0.01), but with no statistical difference in ANC or PLT (P > 0.05). After 3-month treatment the number of hematologic progress, stability, disease progression were: 13 cases (41.9%), 15 cases (48.4%), and 3 cases (9.7%), respectively; after 6-month treatment the number of hematologic improvement, stability, and disease progression were: 18 cases (58.1%), 7 cases (22.6%), 6 cases (19.3%), respectively. There was no significant difference between 3-month efficacy and 6-month efficacy (P > 0.05). There was no correlation between the efficacy and ages of hypo-MDS patients or the efficacy and courses of hypo-MDS patients (P > 0.05).

CONCLUSIONSA low dose QP combined with CDSSPI showed confirmative efficacy in treatment of hypo-MDS. But the efficacy had little correlation with ages and courses of hypo-MDS patients.

Arsenicals ; administration & dosage ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Hemoglobins ; Humans ; Medicine, Chinese Traditional ; methods ; Myelodysplastic Syndromes ; drug therapy ; Neutrophils ; Phytotherapy ; methods