1.Effect of Tuina at "Weizhong (BL 40)" on Spinal Microglial Activation-related Proteins and the IL-10/β-EP Pathway in a Rat Model of Chronic Sciatic Nerve Compression Injury
Tianwei ZHANG ; Xiangqian LYU ; Yani XING ; Liuchen ZHU ; Qingguang ZHU ; Lingjun KONG ; Yanbin CHENG ; Zhen YAN ; Wuquan SUN ; Min FANG ; Zhiwei WU
Journal of Traditional Chinese Medicine 2025;66(7):734-740
ObjectiveTo investigate the analgesic effect of Tuina at the "Weizhong (BL 40)" on neuropathic pain in a rat model of chronic constriction injury (CCI) of the sciatic nerve and its potential central spinal mechanisms. MethodsThirty-two Sprague-Dawley rats were randomly divided into four groups (8 rats in each group), sham-operated group, model group, Tuina group, and blockade group. The CCI model was established in the model group, Tuina group, and the blockade group by ligating the sciatic nerve with catgut, while the sham-operated group underwent only sciatic nerve exposure without ligation. From postoperative day 4 to day 14, rats in the Tuina group and the blockade group received Tuina manipulation at the "Weizhong (BL 40)" using a dynamic pressure distribution measurement system (5 N pressure, 2 Hz frequency, 10 min per session, once daily). The blockade group also received intraperitoneal injections of the microglial inhibitor minocycline (10 mg/kg) once daily. The sham-operated and the model group underwent the same handling and fixation as the Tuina group without actual Tuina. Mechanical withdrawal threshold (MWT) and paw withdrawal latency (PWL) were measured before surgery and on day 3, 7, 10, and 14 post-surgery. Transmission electron microscopy was used to evaluate sciatic nerve injury and repair, measuring axon diameter and total myelinated fiber diameter to calculate the g-ratio. Western Blotting was performed to detect the protein levels of ionized calcium-binding adapter molecule 1 (Iba-1), CD206, CD68, interleukin-10 (IL-10), and β-endorphin (β-EP) precursor pro-opiomelanocortin (POMC) in the ipsilateral spinal dorsal horn. ResultsCompared with the sham-operated group, the model group showed significantly reduced MWT and PWL on day 3, 7, 10, and 14 (P<0.01). Compared with the model group, the Tuina group and the blockade group showed increased MWT and PWL on day 10 and 14 (P<0.05). Compared with the Tuina group, the blockade group exhibited higher MWT on day 7, 10, and 14, and higher PWL on day 10 (P<0.05). Sciatic nerve pathological morphology revealed intact and well-structured myelin in the sham-operated group, while the model group exhibited myelin collapse, distortion, and myelin ovoid formation. The Tuina group displayed partially irregular myelin with occasional myelin collapse, whereas the blockade group exhibited partial myelin irregularities and phospholipid shedding. Compared with the sham-operated group, the model group showed a decreased g-ratio and increased levels of Iba-1 and CD68 in the spinal dorsal horn (P<0.05 or P<0.01). Compared with the model group, the Tuina group and the blockade group exhibited an increased g-ratio and reduced Iba-1 and CD68 levels. Additionally, the Tuina group showed elevated levels of CD206, IL-10, and POMC, whereas the blockade group had decreased CD206 levels (P<0.05). ConclusionTuina at "Weizhong (BL 40)" alleviates neuropathic pain in CCI rats, potentially by regulating microglial activation in the spinal cord, inhibiting M1 polarization while promoting M2 polarization, and activating the IL-10/β-EP pathway to exert analgesic effects.
2.Icariin pretreatment enhances effect of human periodontal stem cells on M1-type macrophages
Ting YU ; Dongmei LYU ; Hao DENG ; Tao SUN ; Qian CHENG
Chinese Journal of Tissue Engineering Research 2025;29(7):1328-1335
BACKGROUND:Human periodontal stem cells have a certain inhibitory effect on the pro-inflammatory function of M1-type macrophages,and it is not clear whether icariin,which has anti-inflammatory and other pharmacological activities,can enhance the inhibitory effect of human periodontal stem cells on M1-type macrophages. OBJECTIVE:To investigate the effect of icariin on M1 macrophages after pretreatment of human periodontal stem cells. METHODS:Primary human periodontal stem cells were isolated,cultured and characterized.THP-1 was induced and M1-type macrophages were identified by immunofluorescence staining and PCR.Human periodontal stem cells were cultured with α-MEM complete medium containing concentrations of 10-7,10-6,10-5,and 10-4 mol/L icariin,and the cytotoxicity of Icariin on human periodontal stem cells was detected by the CCK-8 assay at 1,3,5,and 7 days,respectively.α-MEM complete medium,untreated α-MEM conditioned medium for human periodontal stem cells and α-MEM conditioned medium for human periodontal stem cells pretreated with icariin for 24 hours were conditioned with RPMI-1640 complete medium in a 1:1 ratio for M1-type macrophages in the control,untreated,and pretreated groups,and 24 hours later,the mRNA expression of inflammatory factors in M1 macrophages was detected by RT-PCR.The protein expression of inflammatory factors in M1 macrophages was detected by ELISA.The expression of surface markers and nuclear factor-κB pathway-related proteins in M1/M2 macrophages was detected by western blot assay. RESULTS AND CONCLUSION:(1)CCK-8 assay results showed that 10-7,10-6,10-5,10-4 mol/L icariin was not cytotoxic to the human periodontal stem cells,and from day 5 onwards,all the concentrations increased the cell viability,and promoted the cell proliferation.10-4 mol/L icariin was selected for follow-up experiment.(2)RT-PCR and ELISA results showed that compared with the control group,the untreated group and the pretreated group both decreased the expression and secretion of interleukin-1β,interleukin-6,and tumor necrosis factor-α of M1-type macrophages(P<0.05),and the pretreated group was lower than the untreated group(P<0.05).(3)Western blot assay results showed that compared with the untreated group,the expression of CD86 was significantly lower in the pretreated group(P<0.05);compared with the control group,the expression of CD206,a surface marker of M2-type macrophages,was elevated in both the untreated and pretreated groups(P<0.01),and it was significantly higher in the pretreated group than in the untreated group(P<0.01).In M1-type macrophages after 24 hours of conditioned culture,compared with the control group,the expression of nuclear factor-κB/P65 was decreased in the untreated group and the pretreated group(P<0.01),and the expression of p-IκBα was decreased only in the pretreated group(P<0.01);the expression of both nuclear factor-κB/P65 and p-IκBα was significantly reduced in the pretreated group compared with the untreated group(P<0.05),while the difference of IκBα in the three groups was not statistically significant.(4)These results indicated that icariin enhanced the inhibitory effect of human periodontal stem cells on M1-type macrophages,and this effect may be related to the inhibition of the nuclear factor-κB signaling pathway of macrophages.
3.Control effect of defocus incorporated multiple segments on myopia in adolescents
Jing CHENG ; Aijiao QIN ; Simin CHEN ; Lu LYU
International Eye Science 2025;25(7):1067-1072
AIM: To investigate the effectiveness and safety of defocus incorporated multiple segments(DIMS)on myopia in adolescents, and provide a theoretical basis for clinical application.METHODS:Retrospective study. A total of 560 myopic children(560 eyes)aged 8-13 years who were admitted to our hospital from January 2019 to January 2022 were selected as research subjects, of whom 180 cases(180 eyes)were enrolled in the DIMS group. The orthokeratology(OK lens)group consisted of 182 patients(182 eyes), and the single vision(SV)group consisted of 198 patients(198 eyes). The changes of the spherical equivalent and axial length in the three groups were observed after 1 and 2 a respectively. The myopia degree(group A: spherical equivalent ≥-3.00 D and group B: -6.00 D≤ spherical equivalent <-3.00 D), and age(group Ⅰ: 8-10 years old and group Ⅱ: 11-13 years old)were grouped to further analyze the effect of myopia degree and age on treatment effect.RESULTS: At 1 and 2 a after wearing lenses, the spherical equivalent in the DIMS and SV groups was statistically significant(all P<0.05); there was statistical significance in the axial length among the DIMS, OK and SV groups(F=21.791, 3.576, all P<0.05). At 1 and 2 a after wearing lenses, there was statistical significance in the changes of spherical equivalent in both the DIMS and SV groups of the groups A and B(all P<0.05); and there was statistical significance in axial length growth of the DIMS, OK and SV groups(all P<0.05). At 1 and 2 a after wearing lenses, there was statistical significance in the changes of spherical equivalent in the DIMS and SV groups of the groups Ⅰ and Ⅱ(all P<0.01); in the group Ⅰ, there was statistical significance in the comparison of axial length growth in the DIMS, OK and SV groups(all P<0.05); in the group Ⅱ, there was no statistical significance in the changes of axial length in the DIMS and OK groups. The efficacy of DIMS and OK in the prevention and treatment of myopia was comparable, and the myopia progression was delayed, and the efficacy was enhanced in those older adolescents wearing DIMS.CONCLUSION: Compared with SV lens, DIMS and OK lenses effectively slow down the myopia progression in adolescents. The overall myopia control effect of DIMS is slightly inferior to that of OK lens. However, with the increase of age and the degree of refractive error, the delaying effect of DIMS on myopia progression is enhanced.
4.Development and validation of risk prediction model for carbapenem-resistant Klebsiella pneumoniae infection
Yinzhu MO ; Xianxiong CHENG ; Cangsang SONG ; Shijie LYU ; Baojun REN ; Zhiwei LI ; Jinying BAO ; Huanzhi YANG
China Pharmacy 2025;36(14):1786-1791
OBJECTIVE To investigate the independent risk factors for carbapenem-resistant Klebsiella pneumoniae (CRKP) infection, develop a nomogram prediction model and validate it. METHODS Clinical data of hospitalized patients infected with CRKP between April 2020 and May 2023 at Kunming First People’s Hospital were retrospectively collected and matched 1∶1 with patients infected with carbapenem-susceptible Klebsiella pneumoniae (CSKP) during the same period as the modeling group. Using the same criteria, data from patients hospitalized and infected with CRKP and matched CSKP between June 2023 and June 2024 were collected as the validation group. Univariate analysis, LASSO regression and multivariate Logistic regression were conducted to identify independent risk factors for CRKP infection and to develop a nomogram prediction model. Internal validation of the model was performed using Bootstrap resampling, and external validation was carried out using the data of validation group. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curves and calibration plots. RESULTS A total of 530 patients were enrolled, with 372 in the modeling group and 158 in the validation group. Cerebrovascular disease, indwelling gastric tube, mechanical ventilation, exposure to carbapenem antibiotics, and exposure to β-lactamase inhibitor compound agents were identified as independent risk factors for CRKP infection (P<0.05). The nomogram predicting CRKP infection risk achieved an area under ROC of 0.729 and 0.803 in internal and external validations, respectively. Calibration curves indicated a high degree of consistency between predicted and observed probabilities. CONCLUSIONS Cerebrovascular disease, indwelling gastric tube, mechanical ventilation, exposure to carbapenem antibiotics, and exposure to β-lactamase inhibitor compound agent are independent risk factors for CRKP infection. The developed nomogram model for predicting CRKP infection risk demonstrates good predictive performance and can aid in the early identification of patients at high risk for CRKP infection.
5.Mechanism of Liangfang Wenjing Decoction in Regulating Endoplasmic Reticulum Stress to Reduce Apoptosis and Alleviate Ovarian Microvascular Injury in Rats with Cold Coagulation and Blood Stasis Syndrome
Tianyuan LYU ; Xueyan MA ; Yue HU ; Liqun FENG ; Xiaodan SONG ; Lianmin MEI ; Xiumei CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):103-114
ObjectiveTo observe ovarian microvascular damage in rats with cold coagulation and blood stasis syndrome and to explore the mechanism by which Liangfang Wenjing decoction improves this condition in rats. MethodsFifty SPF female SD rats were randomly divided into a blank group, a model group, low-dose (8.1 g·kg-1) and high-dose groups (16.2 g·kg-1) of Liangfang Wenjing decoction, and a 4-phenylbutyric acid (0.1 g·kg-1) group, with 10 rats in each group. The ice-water bath method was employed to establish the rat model of cold coagulation and blood stasis syndrome. Concurrent with modeling, Liangfang Wenjing decoction was administered continuously for 21 days, once daily. The rats' syndrome manifestations and estrous cycles were recorded. The enzyme-linked immunosorbent assay (ELISA) was used to detect serum reproductive hormone levels and levels of endothelin-1 (ET-1), nitric oxide (NO), thrombomodulin (TM), and von Willebrand factor (vWF) in ovarian tissue. Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB) were measured. The ovarian microcirculatory blood perfusion was detected by laser speckle contrast imaging. Hematoxylin-eosin (HE) staining was performed to observe the ovarian histopathology, flow cytometry to detect ovarian apoptosis rate, and transmission electron microscopy to observe the ultrastructure of ovarian microvascular endothelial cells. Western blot was employed to detect the protein expression of endothelial nitric oxide synthase (eNOS), phosphorylated eNOS (p-eNOS), Caspase-3, B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), inositol-requiring enzyme1α (IRE1α), p-IRE1α, apoptosis signal-regulating kinase 1 (ASK1), p-ASK1, c-Jun N-terminal kinase (JNK), and p-JNK. Immunofluorescence was used to detect ovarian Bax and Bcl-2 expression in microvascular endothelial cells. ResultsCompared with the blank group, the model group showed signs of cold coagulation and blood stasis syndrome, prolonged estrus cycles, and reproductive hormone disorders. Histopathological results revealed a decrease in follicle counts at all stages and disorganized granulosa cell arrangement. Ovarian microcirculatory perfusion was significantly decreased (P<0.01). PT, APTT, and TT were reduced (P<0.05, P<0.01), while FIB levels were increased (P<0.05). In ovarian tissue, NO content was decreased, while ET-1, vWF, and TM levels were increased significantly (P<0.01). The apoptosis rate of ovarian cells was markedly increased (P<0.01). Furthermore, p-eNOS/eNOS and Bcl-2 were decreased (P<0.05), whereas Bax, cleaved-Caspase-3/Caspase-3, GRP78, CHOP, p-IRE1α/IRE1α, p-ASK1/ASK1, and p-JNK/JNK expression showed significant increases (P<0.05, P<0.01). Compared with the model group, Liangfang Wenjing decoction intervention alleviated the symptoms of cold coagulation and blood stasis, gradually restored the estrus cycle, and improved ovarian histopathology and endothelial cell ultrastructure. Microcirculatory blood perfusion was significantly elevated (P<0.05). NO content in ovarian tissue was elevated, while ET-1, vWF, and TM levels were significantly decreased (P<0.05, P<0.01). The p-eNOS/eNOS ratio and Bcl-2 expression were significantly elevated (P<0.05), while the expression of Bax, cleaved-Caspase-3/Caspase-3, GRP78, CHOP, p-IRE1α/IRE1α, p-ASK1/ASK1, and p-JNK/JNK was significantly decreased (P<0.05, P<0.01). ConclusionLiangfang Wenjing decoction may regulate the IRE1α/ASK1/JNK signaling pathway to inhibit endoplasmic reticulum stress, attenuate apoptosis, and improve microvascular endothelial injury in ovaries of rats with cold coagulation and blood stasis syndrome.
6.Mechanism of Xiangsha Liujunzi Decoction in improving autophagy in interstitial cells of Cajal of rats with functional dyspepsia by regulation of IRE1/ASK1/JNK pathway.
Ming-Kai LYU ; Yong-Qiang DUAN ; Jin JIN ; Wen-Chao SHAO ; Qi WU ; Yong TIAN ; Min BAI ; Ying-Xia CHENG
China Journal of Chinese Materia Medica 2025;50(8):2237-2244
This study explored the mechanism of Xiangsha Liujunzi Decoction(XSLJZD) in the treatment of functional dyspepsia(FD) based on inositol-requiring enzyme 1(IRE1)/apoptosis signal-regulating kinase 1(ASK1)/c-Jun N-terminal kinase(JNK) pathway-mediated autophagy in interstitial cells of Cajal(ICC). Forty-eight SPF-grade male SD suckling rats were randomly divided into a blank group and a modeling group, and the integrated modeling method(iodoacetamide gavage + disturbance of hunger and satiety + swimming exhaustion) was used to replicate the FD rat model. After the model replications were successfully completed, the rats were divided into a model group, high-dose, medium-dose, and low-dose groups of XSLJZD(12, 6, and 3 g·kg~(-1)·d~(-1)), and a positive drug group(mosapride of 1.35 mg·kg~(-1)·d~(-1)), and the intervention lasted for 14 days. The gastric emptying rate and intestinal propulsion rate of rats in each group were measured. The histopathological changes in the gastric sinus tissue of rats in each group were observed by hematoxylin-eosin(HE) staining. The ultrastructure of ICC was observed by transmission electron microscopy. The immunofluorescence double staining technique was used to detect the protein expression of phospho-IRE1(p-IRE1), TNF receptor associated factors 2(TRAF2), phospho-ASK1(p-ASK1), phospho-JNK(p-JNK), p62, and Beclin1 in ICC of gastric sinus tissue of rats in each group. Western blot was used to detect the related protein expression of gastric sinus tissue of rats in each group. Compared with those in the blank group, the rats in the model group showed decreased body weight, gastric emptying rate, and intestinal propulsion rate, and transmission electron microscopy revealed damage to the endoplasmic reticulum structure and increased autophagosomes in ICC. Immunofluorescence staining revealed that the ICC of gastric sinus tissue showed a significant elevation of p-IRE1, TRAF2, p-ASK1, p-JNK, and Beclin1 proteins and a significant reduction of p62 protein. Western blot revealed that the expression levels of relevant proteins in gastric sinus tissue were consistent with those of proteins in ICC. Compared with the model group, the body weight of rats in the high-dose and medium-dose groups of XSLJZD was increased, and the gastric emptying rate and intestinal propulsion rate were increased. Transmission electron microscopy observed amelioration of structural damage to the endoplasmic reticulum of ICC and reduction of autophagosomes, and the p-IRE1, TRAF2, p-ASK1, p-JNK, and Beclin1 proteins in the ICC of gastric sinus tissue were significantly decreased. The p62 protein was significantly increased. Western blot revealed that the expression levels of relevant proteins in gastric sinus tissue were consistent with those of proteins in ICC. XSLJZD can effectively treat FD, and its specific mechanism may be related to the inhibition of the expression of molecules related to the endoplasmic reticulum stress IRE1/ASK1/JNK pathway in ICC and the improvement of autophagy to promote gastric motility in ICC.
Animals
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Male
;
Drugs, Chinese Herbal/administration & dosage*
;
Autophagy/drug effects*
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Rats
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Rats, Sprague-Dawley
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Interstitial Cells of Cajal/metabolism*
;
Dyspepsia/physiopathology*
;
Protein Serine-Threonine Kinases/genetics*
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MAP Kinase Kinase Kinase 5/genetics*
;
MAP Kinase Signaling System/drug effects*
;
Humans
;
Endoribonucleases/genetics*
;
Multienzyme Complexes
7.Domestication progress of endangered Chinese medicinal material Fritillariae Cirrhosae Bulbus.
Ting XIAO ; Ming-Hao YANG ; Qiu-Ling WANG ; Qiang LYU ; Yu-Qing ZHENG ; Lian-Cheng XU ; Ma YU ; Jian-He WEI
China Journal of Chinese Materia Medica 2025;50(16):4483-4489
Fritillariae Cirrhosae Bulbus is the dried bulb of perennial herbaceous plants in the Fritillaria genus(Liliaceae family) and is a representative traditional Chinese medicinal material with distinctive regional characteristics. Clinically, it is widely used in the treatment of dry cough, bronchial asthma, and other respiratory diseases, possessing significant medicinal and economic value and being highly esteemed in TCM. Currently, Fritillariae Cirrhosae Bulbus primarily relies on wild harvesting. However, due to excessive collection, its wild resources have drastically declined, and all source species have been classified as category Ⅱ in the List of National Key Protected Wild Plants, exacerbating the supply-demand imbalance in the market. To mitigate this issue, large-scale cultivation through the domestication of wild Fritillariae Cirrhosae Bulbus has become an inevitable trend. However, its strict environmental requirements, low propagation efficiency, high seedling mortality, and immature cultivation techniques have severely hindered industrialization. This study investigates the domestication process of Fritillariae Cirrhosae Bulbus, focusing on seed propagation, seedling cultivation, and medicinal material production. It also reviews the species and distribution of wild resources, their endangered status, market supply-demand dynamics, and the historical and current development of domestication. The findings indicate that enhancing propagation efficiency, optimizing cultivation models, and distinguishing between seed propagation and medicinal material production are key measures to accelerate the industrialization of domesticated Fritillariae Cirrhosae Bulbus. This research aims to promote the industrialization of Fritillariae Cirrhosae Bulbus domestication and provide a reference model for the conservation and sustainable utilization of rare and endangered medicinal plant resources.
Fritillaria/chemistry*
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Endangered Species
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Plants, Medicinal/growth & development*
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Drugs, Chinese Herbal/economics*
;
China
8.Multi-source adversarial adaptation with calibration for electroencephalogram-based classification of meditation and resting states.
Mingyu GOU ; Haolong YIN ; Tianzhen CHEN ; Fei CHENG ; Jiang DU ; Baoliang LYU ; Weilong ZHENG
Journal of Biomedical Engineering 2025;42(4):668-677
Meditation aims to guide individuals into a state of deep calm and focused attention, and in recent years, it has shown promising potential in the field of medical treatment. Numerous studies have demonstrated that electroencephalogram (EEG) patterns change during meditation, suggesting the feasibility of using deep learning techniques to monitor meditation states. However, significant inter-subject differences in EEG signals poses challenges to the performance of such monitoring systems. To address this issue, this study proposed a novel model-calibrated multi-source adversarial adaptation network (CMAAN). The model first trained multiple domain-adversarial neural networks in a pairwise manner between various source-domain individuals and the target-domain individual. These networks were then integrated through a calibration process using a small amount of labeled data from the target domain to enhance performance. We evaluated the proposed model on an EEG dataset collected from 18 subjects undergoing methamphetamine rehabilitation. The model achieved a classification accuracy of 73.09%. Additionally, based on the learned model, we analyzed the key EEG frequency bands and brain regions involved in the meditation process. The proposed multi-source domain adaptation framework improves both the performance and robustness of EEG-based meditation monitoring and holds great promise for applications in biomedical informatics and clinical practice.
Humans
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Electroencephalography/methods*
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Meditation
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Calibration
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Neural Networks, Computer
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Brain/physiology*
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Rest/physiology*
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Deep Learning
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Signal Processing, Computer-Assisted
9.Research progress of spinal-pelvic characteristics in adolescent patients with idiopathic scoliosis.
Zi-Cheng WEI ; Zhi-Zhen LYU ; Zi-Han HUA ; Qiong XIA ; Tao LI ; Yuan-Shen HUANG ; Chao YANG ; Li-Jiang LYU
China Journal of Orthopaedics and Traumatology 2025;38(10):1076-1082
Adolescent idiopathic scoliosis (AIS) is a common spinal deformity in adolescents, with potential causes etiologies associated with mesenchymal stem cells, genetic factors, histological features, and biomechanical aspects. Biomechanically, the pelvis, serving as the central and majort load-bearing structure, exhibits morphological and alignment abnormalities highly correlated with the development of AIS. Recent studies have extensively explored three-dimensional pelvic parameters and kinematics, demonstrating that abnormal pelvic characteristics may contribute to AIS onset and progression and are increasingly incorporated into clinical interventions. This review summarizes sagittal and coronal features of the spine-pelvis, as well as the influence of three-dimensional kinematic features on the pathogenesis of AIS, providing insights for advancing the study of spine-pelvis features related to AIS.
Humans
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Scoliosis/pathology*
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Adolescent
;
Spine/pathology*
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Pelvis/pathology*
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Biomechanical Phenomena
10.Efficacy Analysis of Stanozolol Combined with Avatrombopag in the Treatment of Chemotherapy-Induced Thrombocytopenia in Relapsed/Refractory Tumors.
Yan HE ; Wei-Yi LIU ; Yan-Yu ZHANG ; Yan LYU ; Shan-Shan ZHANG ; Ri-Cheng QUAN
Journal of Experimental Hematology 2025;33(4):1127-1130
OBJECTIVE:
To investigate the efficacy and safety of stanozolol combined with avatrombopag in the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with relapsed/refractory tumors.
METHODS:
Twenty-five patients with relapsed/refractory CIT admitted to the Hematology Department of Xiyuan Hospital, China Academy of Chinese Medical Sciences between March 2023 to December 2023 were enrolled. These patients received a combined therapy of stanozolol and avatrombopag. The clinical efficacy, onset time, changes in platelet levels and blood cell counts before and after treatment, and adverse reactions of patients were evaluated.
RESULTS:
The combination therapy demonstrated remarkable efficacy with a total effective rate of 100%. Among the 25 patients, 19 achieved complete remission and 6 achieved partial remission. The median onset time was 42.5(range: 35-48)days. The average platelet count of the 25 patients increased from (25.73±17.75)×109/L before treatment to (146.4±49.59)×109/L after 3 months of treatment, with a statistically significant difference ( P < 0.05). 18 patients who previously required platelet transfusion were all weaned off platelet transfusion after 3 months of treatment, with a median time to be free from platelet transfusion was 26 (range: 18-51) days. During the treatment, both neutrophils and hemoglobin exhibited various degrees of elevation. Two patients experienced a slight increase in alanine aminotransferase(ALT) levels, which normalized after treatment with oral hepatoprotective drug. One patient had a PLT increase exceeding 350×109/L, and the treatment with avatrombopag was suspended, and aspirin and other drugs were given to prevent thrombosis. No thrombose events or CIT-related bleeding events were observed in all patients.
CONCLUSION
The combination therapy of stanozolol and avatrombopag is significantly effective for treating relapsed/refractory CIT patients, with a high response rate and good safety, making it a suitable clinical treatment option.
Humans
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Thrombocytopenia/chemically induced*
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Stanozolol/therapeutic use*
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Male
;
Female
;
Neoplasms/drug therapy*
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Middle Aged
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Thiophenes/therapeutic use*
;
Adult
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Platelet Count
;
Treatment Outcome
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Antineoplastic Agents/adverse effects*
;
Recurrence
;
Thiazoles

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