OBJECTIVE: To explore the safety and efficacy of high-dose etoposide (VP-16) combined with recombinant human granulocyte colony-stimulating factor (rhG-CSF) as salvage mobilization for peripheral blood stem cells (PBSC) in newly diagnosed multiple myeloma (NDMM) patients. METHODS: From April 2021 to May 2023, eight NDMM patients who had failed to yield sufficient PBSC during initial mobilization with high-dose cyclophosphamide (CTX) combined with rhG-CSF underwent salvage mobilization with 1.2 g/m2 etoposide combined with rhG-CSF 10 μg/(kg·d). The effects and adverse reactions of initial mobilization and salvage mobilization were analyzed. RESULTS: For salvage mobilization and initial mobilization, the numbers of PBSC collections were 16 and 18, respectively. The mean value of total collected CD34⁺ cells were (11.90±5.75)×10⁶/kg and (1.67±0.75)×10⁶/kg (P =0.0010) in salvage mobilization group and initial mobilization group, respectively. The proportion of patients with a total collection of CD34⁺ cell count≥2×10⁶/kg were 100% and 37.5% (P =0.0625), and the proportion of patients with a total collection of CD34⁺ cell count≥5×10⁶/kg were 87.5% and 0% (P =0.0156) in salvage mobilization group and initial mobilization group, respectively. For five patients who underwent high-dose CTX initial mobilization but had a total CD34⁺ cell count < 2×10⁶/kg, successful collection was achieved through salvage mobilization with high-dose VP-16. Salvage mobilization with high-dose VP-16 was scheduled 2-3 weeks after failure of CTX mobilization. Adverse reactions of high-dose VP-16 mobilization did not increase compared to the initial mobilization with high-dose CTX. CONCLUSION As a salvage mobilization regimen, VP-16 1.2 g/m² combined with rhG-CSF is safe and highly effective in NDMM patients who failed to initial mobilization with high-dose CTX combined with rhG-CSF.
Humans ; Multiple Myeloma/therapy* ; Etoposide/therapeutic use* ; Hematopoietic Stem Cell Mobilization/methods* ; Cyclophosphamide/therapeutic use* ; Granulocyte Colony-Stimulating Factor ; Salvage Therapy ; Peripheral Blood Stem Cells ; Male ; Middle Aged ; Female ; Peripheral Blood Stem Cell Transplantation

BACKGROUND: Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction (AAMI) is an important factor in occurrence of heart failure which additionally results in poor prognosis. Therefore, the treatment of ventricular remodeling needs to be further optimized. Compound Danshen Dripping Pills (CDDP), a traditional Chinese medicine, exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction. OBJECTIVE: This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale. METHODS: This study is a multi-center, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The total of 268 patients with AAMI after primary percutaneous coronary intervention (pPCI) will be randomly assigned 1:1 to the CDDP group (n=134) and control group (n=134) with a follow-up of 48 weeks. Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction (STEMI), with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI, and the control group treated with a placebo simultaneously. The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide (NT-proBNP) level, arrhythmias, and cardiovascular events (death, cardiac arrest, or cardiopulmonary resuscitation, rehospitalization due to heart failure or angina pectoris, deterioration of cardiac function, and stroke). Investigators and patients are both blinded to the allocated treatment. DISCUSSION This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI. Patients in the CDDP group will be compared with those in the control group. If certified to be effective, CDDP treatment in AAMI will probably be advised on a larger scale. (Trial registration No. NCT05000411).
Humans ; ST Elevation Myocardial Infarction/therapy* ; Stroke Volume ; Ventricular Remodeling ; Prospective Studies ; Microcirculation ; Ventricular Function, Left ; Myocardial Infarction/etiology* ; Treatment Outcome ; Percutaneous Coronary Intervention/adverse effects* ; Heart Failure/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic

Objective: To explore the clinical characterist ics and risk factors of hemorrhage complicated by hemoperfusion therapy in patients with acute poisoning. Methods: In January 2021, the clinical data of 196 patients with acute poisoning who received hemoperfusion therapy in the Second Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2020 were analyzed, and the patients were divided into bleeding group and non-bleeding group according to whether the patients were complicated with bleeding. Multivariate logistic regression was used to analyze the independent risk factors for hemorrhage in patients treated with hemoperfusion. Results: A total of 21 patients in the bleeding group and 175 patients in the non-bleeding group were included. There was no significant difference in general data such as gender, age, and body mass index between the two groups (P>0.05) . Organophosphorus pesticides (χ(2)= 4.56, P=0.030) , HA230 perfusion device (χ(2)=4.12, P=0.042) , platelet count (t=-2.33, P=0.009) and activated partial thromboplastin time (t=14.53, P<0.001) at 2 h of perfusion were the influencing factors of hemorrhage in patients with acute poisoning treated with hemoperfusion. Among them, organophosphorus pesticides, 2 h perfusion activated partial thromboplastin time ≥35 s and other factors were independent risk factors forcomplicated bleeding (P<0.05) . Conclusion: Patients with acute poisoning, especially organophosphorus pesticide poisoning, are at greater risk of bleeding during hemoperfusion therapy. Monitoring of changes in activated partial thromboplastin time should be strengthened and the dose of anticoagulants should be adjusted in time to reduce the risk of bleeding.
Hemoperfusion ; Hemorrhage/therapy* ; Humans ; Organophosphorus Compounds ; Pesticides ; Poisoning/therapy* ; Risk Factors

The poor stability of the ligustilide (LIG) makes its quantitation in Angelica sinensis (AS) difficult. This study establishes a chemical conversion method for the determination of ligustilide content in AS and proposes a national pharmacopoeia standard. Mechanical agitation and sonication of a powdered AS extract in a methanol/cyprolamine mixture facilitated the stabilization and transformation of ligustilide. Using an external reference HPLC-DAD method, the cyclopropyl-ligustilide (LIGc) content in the mixture could be determined. The content of ligustilide was greater than 1.0% based on 144 AS specimens including 68 obtained from the originally planted areas of Qinghai and Gansu Province; 55 specimens were obtained from Minxian and Weiyuan County medicine markets, and 21 specimens for which the storage period reached or exceeded 1.5 years. According to the Hong Kong Chinese materis medica standards, the content of ligustilide in AS should not be lower than 0.6%. The developed method could also be applied to the quality control of other Chinese medicinal materials (such as Ligusticum chuanxiong) or Chinese patent medicines in which ligustilide is the main component.

OBJECTIVE: To investigate the risk factors for brain injury in preterm infants by a multicenter epidemiological investigation of brain injury in hospitalized preterm infants in Anhui, China. METHODS: Preterm infants who were hospitalized in the department of neonatology in 9 hospitals of Anhui Neonatal Collaboration Network between January 2016 and January 2017 were enrolled as subjects. The data of maternal pregnancy and clinical data of preterm infants were collected, and the logistic regression model was used to analyze the risk factors for brain injury in preterm infants. RESULTS: A total of 3 378 preterm infants were enrolled. Of the 3 378 preterm infants, 798 (23.56%) had periventricular-intraventricular hemorrhage (PVH-IVH), and 88 (2.60%) had periventricular leukomalacia (PVL). Intrauterine distress, anemia, hypoglycemia and necrotizing enterocolitis (NEC) were risk factors for PVH-IVH (OR=1.310, 1.591, 1.835, and 3.310 respectively; P<0.05), while a higher gestational age was a protective factor against PVH-IVH (OR=0.671, P<0.05). PVH-IVH, NEC and mechanical ventilation were risk factors for PVL (OR=4.017, 3.018, and 2.166 respectively; P<0.05), and female sex and use of pulmonary surfactant were protective factors against PVL (OR=0.514 and 0.418 respectively; P<0.05). CONCLUSIONS Asphyxia/anoxia, infection/inflammation, mechanical ventilation, anemia and hypoglycemia may increase the risk of brain injury in preterm infants.
Brain Injuries ; Cerebral Hemorrhage ; China ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular

Proton pump inhibitors (PPIs) are commonly used to lessen symptoms in patients with gastroesophageal reflux disease (GERD). However, the effects of PPI therapy on the gastrointestinal microbiota in GERD patients remain unclear. We examined the association between the PPI usage and the microbiota present in gastric mucosal and fecal samples from GERD patients and healthy controls (HCs) using 16S rRNA gene sequencing. GERD patients taking PPIs were further divided into short-term and long-term PPI user groups. We showed that PPI administration lowered the relative bacterial diversity of the gastric microbiota in GERD patients. Compared to the non-PPI-user and HC groups, higher abundances of Planococcaceae, Oxalobacteraceae, and Sphingomonadaceae were found in the gastric microbiota from the PPI-user group. In addition, the Methylophilus genus was more highly abundant in the long-term PPI user group than in the short-term PPI-user group. Despite the absence of differences in alpha diversity, there were significant differences in the fecal bacterial composition of between GERD patients taking PPIs and those not taking PPIs. There was a higher abundance of Streptococcaceae, Veillonellaceae, Acidaminococcaceae, Micrococcaceae, and Flavobacteriaceae present in the fecal microbiota from the PPI-user group than those from the non-PPI-user and HC groups. Additionally, a significantly higher abundance of Ruminococcus was found in GERD patients on long-term PPI medication than that on short-term PPI medication. Our study indicates that PPI administration in patients with GERD has a significant effect on the abundance and structure of the gastric mucosal microbiota but only on the composition of the fecal microbiota.
Adult ; Aged ; Bacteria ; genetics ; isolation & purification ; Feces ; microbiology ; Female ; Gastric Mucosa ; microbiology ; Gastroesophageal Reflux ; drug therapy ; microbiology ; Gastrointestinal Microbiome ; drug effects ; Humans ; Male ; Microbiota ; Middle Aged ; Proton Pump Inhibitors ; therapeutic use ; RNA, Ribosomal, 16S ; genetics

Objective To evaluate the imaging study of two positron emission computed tomography (PET) tracers of 18 F-fluoroethyl (FEA)-Erlotinib and 11C-Erlotinib in HCC827 tumor-bearing nude mice.Methods The 18F-FEA-Erlotinib and 11C-Erlotinib were synthesized by nucleophile substitution reactions.The dynamic micro-PET/CT imaging of 18F-FEA-Erlotinib for 1 h was performed in HCC827 tumor -bearing mice to evaluate the in vivo biological distribution and determine the best imaging time.Static scan of 18 F-FEA-Erlotinib and 11C-Erlotinib were performed after 1 h injection.The regions of interest (ROIs) were sketched and the semi-quantitative analysis was conducted by the percentage activity of injection dose per gram of tissue (％ ID/g).Results Dynamic micro-PET/CT imaging analysis revealed that the best static imaging time was 1 h.The resolution and contrast were good and the tumor boundaries were clear in the 18F-FEA-Erlotinib static images.In the semi-quantitative analysis,the ratios of tumor/brain,tumor/lung,tumor/bone and tumor/muscle ratios were 5.87 ± 1.21,2.97 ± 0.58,3.33 ± 0.60 and 3.80 ± 0.72 respectively for 18F-FEA-Erlotinib.Meanwhile,the ratios of the same tissues were 5.48 ± 1.45,1.10 ± 0.34,2.63 ± 0.54 and 2.10 ± 0.63respectively for 11C-Erlotinib.The resolution of 18F-FEA-Erlotinib imaging was better than 11C-Erlotinib images.Conclusion The uptake of 18F-FEA-Erlotinib in HCC827 tumor was visual obviously.The image resolution and the target/non-target ratio of 18F-FEA-Erlotinib was higher than 11C-Erlotinib.

Objective To study the cytotoxicity of multiple gliomaassociated antigens sensitized dentritic cell activated cytotoxic T lymphocytes (GDC-CTL) on the human glioma cell line U87 in vitro and the anti-tumor effect of GDC-CTL on the BALB/c nude mouse model of malignant glioma in vivo.Methods Multiple glioma-associated antigens sensitized dentritic cell (GDC) and GDC-CTL were prepared and then analyzed with the phenotypes by flow cytometry.Cytotoxicity of GDC-CTL on U87 cells was determined by CCK8 assay and the level of interferon-γ (IFN-γ) secreted from GDC-CTL co-culturing with U87 cells for 48 h was detected by ELISA at different effect/target ratios (5∶ 1,10∶1,20∶1).The T lymphocytes without activation with GDC were evaluated as the control group.The BALB/c Nude mice tumor model established by the subcutaneous injection of U87 cells was adopted to assess the anti-tumor effect.The mice were randomly divided into four groups:the control group receiving subcutaneous injection with 0.9％ NaCl 0.2 mL,the model,intravenous treatment and local treatment groups receiving subcutaneous injection with 1 × 107 U87 cells in 0.2 mL Dulbecco's Modified Eagle Medium (DMEM).When the diameter of tumor tissue reached 3 mm,the model group was subcutaneously injected with 0.9％ NaC1 0.2 mL surrounding the tumor,while the intravenous treatment group and local treatment group were injected with 0.2 × 107 GDC-CTL in 0.2 mL phosphate buffer saline (PBS) through the tail vein and subcutaneous injection into the surrounding area of the tumor respectively,3 times a week for 2 weeks.The tumor volume was calculated and the pathological changes in the tumor tissues were observed for comparison.Results Matured GDC expressing the high levels of CD83,CD1a and HLA-DR successfully activated GDC-CTL in which 93.00％ of CD3 + T lymphocytes and 69.00％ of CD3 + CD8 + T lymphocytes were detected.In vitro experiments proved that the killing rates of GDC-CTL and T lymphocytes on U87 cells were (24.35 ±1.12)％ vs (15.21 ±0.91)％,(38.57±2.10)％ vs (23.35 ±1.30)％,(59.44±3.79)％ vs (35.23 ± 2.33) ％,and the IFN-γlevels secreted from GDC-CTL and T lymphocytes co-culturing with U87 cells were (405.36±27.65) vs (371.11 ±23.23) pg · mL-1,(1509.22 ±97.16) vs (913.54 ±48.35) pg · mL-1,(2429.57 ±183.18) vs (1814.97 ± 123.24) pg · mL-1,at the different effect/target ratios of 5∶1,10∶1 and 20∶1 respectively.There were significant differences between this two groups at the effect/target ratios of 10∶1 and 20∶1 (P ＜0.05).The results obtained from the in vivo experiments showed that the tumor volumes in the intravenous treatment group and local treatment group shrank 34.83％ and 45.37％ respectively,when comparing with the model group (100.00％,P ＜ 0.05).The pathological changes of tumor tissues showed that the tumor cells in the local treatment group and intravenous treatment group were significandy decreased.Conclusion The experimental results that GDC-CTL can significantly inhibit the growth of ghoma provide more evidences to further study the effective targeting therapy on glioma.

OBJECTIVETo investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.

METHODSThe registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).

RESULTSThe preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).

CONCLUSIONPROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.

Apgar Score ; Birth Weight ; Female ; Fetal Membranes, Premature Rupture ; pathology ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Infant, Premature ; Pregnancy ; Risk Factors

Objective The lentiviral vector was recombined with metal-lothionein ( MT) gene to identify the MT overexpression in human adi-pose-derived mesenchymal stem cells ( hADSCs) after transfection and then to study the lead tolerance of genetically modified hADSCs with MT (MT-hADSCs).Methods The recombinant plenti-CMV-MT2A-EYFP vector was constructed with pLenti -CMV -hChR 2 ( E123 T -H134R)-EYFP and MT2A gene for transfecting hADSCs to obtain the MT-hADSCs.The overexpression of MT in hADSCs was identified by immunofluorescence assay.The MTT method was used to assess the cell viability of hADSCs, hADSCs transfected with empty vector, and MT-hADSCs, all of which were treated with lead acetate.Results The re-combinant plenti -CMV -MT2A -EYFP was successfully constructed and transfected into hADSCs.The overexpression of MT was positively detected in the MT -hADSCs.The tolerance of MT-hADSCs to lead was significantly higher than the hADSCs and hADSCs transfected with empty vector.Conclusion MT can significantly increase the tolerance of hADSCs to lead, indicating that MT can reduce the cytotoxicity of lead.The experimental results from this study provide more evidences for further study of using MT-hADSCs to treat lead poisoning.