1.Survival characteristics of myelodysplastic syndrome with U2AF1-mutation and the clinical efficacy of arsenic-containing traditional Chinese medicine compound prescription
Chaochang ZHANG ; Chi LIU ; Dexiu WANG ; Zhuo CHEN ; Yan LYU ; Haiyan XIAO ; Weiyi LIU ; Yonggang XU ; Xiupeng YANG ; Rou MA ; Xudong TANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(9):1211-1221
Objective To explore the clinical characteristics of myelodysplastic syndrome(MDS)with U2 small nuclear RNA cofactor 1(U2AF1)mutation in different age groups,as well as the efficacy and prognosis of an arsenic-containing traditional Chinese medicine(TCM)compound prescription(Qinghuang Capsules combined with Bushen Yijing Formula).Methods A retrospective analysis was conducted on the clinical data of patients with MDS who were hospitalized in the Hematology Department Ward of Xiyuan Hospital,China Academy of Chinese Medical Sciences,and received arsenic-containing TCM compound treatment from November 30,2020,to September 30,2023.Stratified by age,the U2AF1 mutation and wild-type groups aged<65 years and≥65 years were compared in terms of sex,TCM syndrome,World Health Organization classification,MDS Revised International Prognostic Score System(IPSS-R)score,blood routine indicators,serum lactate dehydrogenase content,nephroblastoma 1(WT1)expression level,bone marrow puncture and biopsy indicators,and chromosomal prognostic grades,et al.Furthermore,the efficacy of arsenic-containing TCM compound were compared in the U2AF1 mutation and wild-type groups among different age groups,as well as the influence of age on the survival prognosis of MDS patients with U2AF1 mutation.Results A total of 201 patients with MDS were included.104 patients were under 65 years old,among whom 20 had U2AF1 mutation,and 84 had wild-type.Ninety-seven patients were aged 65 years or older,among whom 19 patients had the U2AF1 mutation and 78 had the wild-type.Among patients aged<65 years,the U2AF1 mutation group had a higher proportion of male patients and very low-risk/low-risk patients with an IPSS-R score≤3(P<0.05),a lower mean corpuscular volume(MCV)(P<0.05),and a relatively higher proportion of peripheral blood cell line 1 reduction than the wild-type group(P<0.05).Among patients aged≥65 years,the MCV in the U2AF1 mutation group was lower(P<0.05),and the expression level of the bone marrow WT1 gene and the proportion of patients with reticular fiber grade 4 were relatively higher than in the wild-type group(P<0.05).The total effective rate of the arsenic-containing TCM compound for patients with U2AF1 mutation was 61.5%(24/39),and the total response rate was 30.8%(12/39).The total effective rate for the wild-type patients was 67.9%(110/162),and the total response rate was 29.6%(48/162).No significant difference was observed in the total effective and response rates.Kaplan-Meier survival analysis of 39 patients with U2AF1 mutation revealed that the median overall survival(mOS)of patients older than 65 years had not been reached.The 1-,2-,and 3-year survival rates were 93.8%,84.4%,and 84.4%,respectively.The mOS of the patients aged≥65 years was 35 months(95%confidence interval[CI]:7.559-62.441),and the 1-,2-,and 3-year survival rates were 66.2%,58.9%,and 29.4%,respectively.The mOS of patients in the aged≥65 years group was significantly lower than that in the aged<65 years group(P<0.05),and no significant difference was observed in median progression-free survival between the two groups.Conclusion The U2AF1 mutation is closely associated with the clinical characteristics of MDS.However,age and the presence of U2AF1 mutation have no significant effect on the total effective and response rates of arsenic-containing TCM compound.Age is a significant factor influencing the prognosis of patients with MDS with U2AF1 mutation.Patients aged 65 years or older have a shorter survival time than those younger than 65 years.
2.Investigation on influencing factors of TCM constitutions among female medical workers in a tertiary TCM Hospital
Xiaoqing CAI ; Yan LI ; Xiaochun CUI ; Xinyi LIU ; Xujie WANG ; Huidong ZHU ; Xiupeng YANG
International Journal of Traditional Chinese Medicine 2025;47(10):1384-1390
Objective:To explore the impact of lifestyle on TCM constitutions among female medical workers at Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine using questionnaires; To provide references for optimizing their health management.Methods:A cross-sectional study was conducted. A total of 500 female medical workers were randomly selected from Xiyuan Hospital from April to December 2022 to complete the questionnaires. The relationship between lifestyle and constitutions of female medical workers was analyzed.Results:A total of 457 cases completed the questionnaires. Among the 9 constitutions, 102 people (22.32%) had a peaceful constitution, while 355 people (77.68%) had a biased constitution; the top three biased constitutions were qi stagnation constitution 90 people (19.69%), yang deficiency constitution 83 people (18.16%), and phlegm-dampness constitution 56 people (12.25%). The factors that influenced physical constitutions according to the severity of lifestyle were: sleep, diet, mood, exercise, labor, environment, children, and education.Conclusions:Female medical workers have a high proportion of biased constitution, and the main types of biased constitution are qi stagnation constitution, yang deficiency constitution, and phlegm-dampness constitution. According to the existing biased constitution, targeted adjustments and interventions are carried out, and it is of great significance to protect and care for the health of female medical workers from the concept of preventive treatment of diseases with TCM.
3.Survival characteristics of myelodysplastic syndrome with U2AF1-mutation and the clinical efficacy of arsenic-containing traditional Chinese medicine compound prescription
Chaochang ZHANG ; Chi LIU ; Dexiu WANG ; Zhuo CHEN ; Yan LYU ; Haiyan XIAO ; Weiyi LIU ; Yonggang XU ; Xiupeng YANG ; Rou MA ; Xudong TANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(9):1211-1221
Objective To explore the clinical characteristics of myelodysplastic syndrome(MDS)with U2 small nuclear RNA cofactor 1(U2AF1)mutation in different age groups,as well as the efficacy and prognosis of an arsenic-containing traditional Chinese medicine(TCM)compound prescription(Qinghuang Capsules combined with Bushen Yijing Formula).Methods A retrospective analysis was conducted on the clinical data of patients with MDS who were hospitalized in the Hematology Department Ward of Xiyuan Hospital,China Academy of Chinese Medical Sciences,and received arsenic-containing TCM compound treatment from November 30,2020,to September 30,2023.Stratified by age,the U2AF1 mutation and wild-type groups aged<65 years and≥65 years were compared in terms of sex,TCM syndrome,World Health Organization classification,MDS Revised International Prognostic Score System(IPSS-R)score,blood routine indicators,serum lactate dehydrogenase content,nephroblastoma 1(WT1)expression level,bone marrow puncture and biopsy indicators,and chromosomal prognostic grades,et al.Furthermore,the efficacy of arsenic-containing TCM compound were compared in the U2AF1 mutation and wild-type groups among different age groups,as well as the influence of age on the survival prognosis of MDS patients with U2AF1 mutation.Results A total of 201 patients with MDS were included.104 patients were under 65 years old,among whom 20 had U2AF1 mutation,and 84 had wild-type.Ninety-seven patients were aged 65 years or older,among whom 19 patients had the U2AF1 mutation and 78 had the wild-type.Among patients aged<65 years,the U2AF1 mutation group had a higher proportion of male patients and very low-risk/low-risk patients with an IPSS-R score≤3(P<0.05),a lower mean corpuscular volume(MCV)(P<0.05),and a relatively higher proportion of peripheral blood cell line 1 reduction than the wild-type group(P<0.05).Among patients aged≥65 years,the MCV in the U2AF1 mutation group was lower(P<0.05),and the expression level of the bone marrow WT1 gene and the proportion of patients with reticular fiber grade 4 were relatively higher than in the wild-type group(P<0.05).The total effective rate of the arsenic-containing TCM compound for patients with U2AF1 mutation was 61.5%(24/39),and the total response rate was 30.8%(12/39).The total effective rate for the wild-type patients was 67.9%(110/162),and the total response rate was 29.6%(48/162).No significant difference was observed in the total effective and response rates.Kaplan-Meier survival analysis of 39 patients with U2AF1 mutation revealed that the median overall survival(mOS)of patients older than 65 years had not been reached.The 1-,2-,and 3-year survival rates were 93.8%,84.4%,and 84.4%,respectively.The mOS of the patients aged≥65 years was 35 months(95%confidence interval[CI]:7.559-62.441),and the 1-,2-,and 3-year survival rates were 66.2%,58.9%,and 29.4%,respectively.The mOS of patients in the aged≥65 years group was significantly lower than that in the aged<65 years group(P<0.05),and no significant difference was observed in median progression-free survival between the two groups.Conclusion The U2AF1 mutation is closely associated with the clinical characteristics of MDS.However,age and the presence of U2AF1 mutation have no significant effect on the total effective and response rates of arsenic-containing TCM compound.Age is a significant factor influencing the prognosis of patients with MDS with U2AF1 mutation.Patients aged 65 years or older have a shorter survival time than those younger than 65 years.
4.Correlation Between Expression of HIF-1α and Prognosis of Arsenic-containing Chinese Herbal Compound in Treatment of Myelodysplastic Syndrome
Peizhen JIANG ; Xiupeng YANG ; Dexiu WANG ; Wenru WANG ; Yan LYU ; Weiyi LIU ; Zhuo CHEN ; Hongzhi WANG ; Xiaoqing GUO ; Shanshan ZHANG ; Yonggang XU ; Xudong TANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):101-107
ObjectiveMyelodysplastic syndromes (MDS) is a group of clonal hematopoietic stem cell disorders,and this study aims to investigate the expression of hypoxia-inducible factor-1α(HIF-1α) in the bone marrow cells of patients with MDS and its correlation with the clinical features of MDS,the therapeutic efficacy of arsenic-containing Chineseherbal compound,and the survival prognosis. MethodAccording to the inclusion and exclusion criteria,27 MDS patients treated with arsenic-containing Chinese herbal compound in the Department of Hematology,Xiyuan Hospital,China Academy of Chinese Medical Sciences from January 2022 to September 2022 were included,and their bone marrow samples were collected by myelotomy. HIF-1α expression level in bone marrow cells was detected by real-time polymerase chain reaction (PCR) to analyze its correlation with clinical features,and logistic and Cox regression was used to analyze the risk factors affecting the efficacy and prognostic survival of MDS patients. ResultThe HIF-1α mRNA expression level was lower in bone marrow cells of MDS patients than in healthy subjects. HIF-1α was positively correlated with the degree of myelodysplasia(r=0.384,P<0.05) and bone marrow granulocytic system%(G%)(r=0.560,P<0.01). Logistic regression showed that HIF-1α was a risk factor for the prognosis in the follow-up of the efficacy of treatment(P<0.05)and Cox regression showed that HIF-1α was an independent factor affecting the survival prognosis of MDS patients [odds ratio(OR)=398.968,95% confidence interval(CI)(1.281,116 858.743),P<0.05]. ConclusionThe level of HIF-1α expression in bone marrow cells of MDS patients was closely related to the degree of clinical myelodysplasia and G%,and HIF-1α was a risk factor for the efficacy for and survival prognosis of MDS patients.
5.Association between polarization status of microglia/macrophage in brain tissue and edema around hematoma in patients with acute cerebral hemorrhage
Xueming SHEN ; Xiupeng HAN ; Chao HE ; Yanjun TANG ; Song HAN ; Changxiang YAN
Journal of Xinxiang Medical College 2023;40(12):1161-1166
Objective To explore the correlation between polarization status of microglia/macrophages(MG/MP)in brain tissue and edema around hematoma in patients with acute cerebral hemorrhage.Methods A total of 52 patients with acute intracerebral hemorrhage admitted to Anyang People's Hospital from December 2020 to November 2022 were selected as the research subjects.All patients underwent craniotomy to remove hematoma,and the normal brain tissue in the cortical area that was not invaded by the hematoma and the fragmented brain tissue around the hematoma(brain tissue around the hematoma)on the surgical pathway were obtained.The expression levels of inflammatory factors such as interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α),IL-10 and transforming growth factor-β(TGF-β)protein in brain tissue were detected by Western blot.The expression levels of IL-1 β,IL-6,TNF-α,IL-10 and TGF-β mRNA in brain tissue were detected by fluorescence quantitative polymerase chain reaction.The levels of M1-type and M2-type MG/MP in brain tissue was detected by immunofluorescence confocal technique.CT images data of patients before operation were collected and the relative-erihema-tomal edema(r-PHE)was calculated.The patients were divided into high r-PHE group(2.0≤ r-PHE<2.5)and low r-PHE group(1.5<r-PHE<2.0)according to r-PHE.The relative expression of IL-1 β,IL-6,TNF-α,IL-10 and TGF-β mRNA in brain tissue around the hematoma of patients between the high r-PHE group and the low r-PHE group was compared.Results The relative expressions of IL-1 β,IL-6,TNF-α protein and mRNA in brain tissue around the hematoma were significantly higher than those in the normal brain tissues(P<0.05),but there was no significant difference in the relative expressions of IL-10 and TGF-β protein and mRNA between the brain tissue around the hematoma and the normal brain tissue(P>0.05).The levels of M1 type and M2 type MG/MP in the brain tissue around the hematoma were significantly higher than those in normal brain tissue(P<0.05).The relative expressions of IL-1β,IL-6 and TNF-α mRNA in the brain tissue around the hematoma of patients in the high r-PHE group were significantly higher than those in the low r-PHE group(P<0.05),and there was no significant difference in the relative expressions of TGF-β and IL-10 mRNA in the brain tissue around the hematoma of patients between the two groups(P>0.05).Conclusion The levels of pro-inflammatory factors and M1-type MG/MP are increased in the brain tissue around the hematoma in patients with acute cerebral hemorrhage,and the degree of polarization of M1-type MG/MP is consistent with the degree of edema around hematoma after cerebral hemorrhage.
6.Role of epileptogenicity index in the epileptogenic zone and network localization
Haixiang WANG ; Xiupeng YAN ; Bingqing ZHANG ; Xiancheng SONG ; Jiuluan LIN ; Jing RUAN ; Jia LI ; Bo HONG ; Wenjing ZHOU
Chinese Journal of Neurology 2017;50(5):362-367
Objective To propose a novel stereo-electroencephalography(SEEG) quantitative measure analyzing ictal high frequency (60-90 Hz) and calculating high frequency epileptogenicity index (HFEI) to localize epileptogenic zone and evaluate epileptogenic network. Methods The clinical presurgical evaluation and SEEG data of 15 patients who were performed SEEG electrodes implantation from April 2015 to March 2016 were analyzed retrospectively. Post-implantation head CT images and 3D MRI data were fused for accurately identifying and locating each electrode contact. Ictal SEEG quantitative measure HFEI was calculated and threshold was set. The epileptogenic network was divided into focal, regional, multiple regional and bilateral ones and the results were compared with the pathological results.Results The epileptogenic network was focal for four patients, regional for four patients, multiple regional for six patients and bilateral for one patient (7/15). In terms of the pathology,two cases with hippocampal sclerosis both showed regional network. In four cases with cerebral malacia, two cases showed multiple regional network and the other two cases showed focal network. In six cases with cortical malformation, three cases showed multiple regional network, the other three cases showed focal, regional and bilateral networks respectively. Conclusions We explored a novel SEEG quantitative measure based on the high frequency power analysis,which is objective and could localize epileptogenic zone and evaluate the epileptic network.

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