1.Differentiation and Treatment of Polycystic Ovary Syndrome from Perspective “Deficiency Cause,Cold Accumulation, and Qi Stagnation” in Essentials from the Golden Cabinet (《金匮要略》)
Yizhuo QIAO ; Yi LI ; Yini SUN ; Yajun LI ; Yating QI ; Heqiao LI ; Xinru CHEN ; Jinghong XIE
Journal of Traditional Chinese Medicine 2024;65(7):745-749
“Deficiency cause, cold accumulation, and qi stagnation” originates from Essentials from the Golden Cabinet (《金匮要略》), which is a guiding principle for the pathogenesis of women's diseases, pioneering the differentiation and treatment of women's diseases based on patterns, and having a profound influence on future generations. Following the classical principles and simplifying the complexities, this paper explored the pathogenesis and mechanism of polycystic ovary syndrome (PCOS) from the perspective of “deficiency cause, cold accumulation, and qi stagnation”, and believed that depletion of essence and blood, long-term accumulation of internal cold, and qi constraint and blood stasis are the causes of PCOS, with depletion of essence and blood, and lack of nourishment of zang-fu (脏腑) organs as the root, and cold pathogen invasion, qi constraint and blood stasis as the branch. The main treatment principle is “treating deficiency with supplementation”, and dispelling pathogen while reinforcing healthy qi, along with “treatment of cold by warming” and “treatment of stagnation by dispersing”. This is of great significance for the treatment of polycystic ovary syndrome. Clinically, these methods can be used flexibly to guide treatment and formula selection for PCOS, with the goal of harmonizing qi and blood and regulating menstruation.
2.Characteristics Evaluation and Application Analysis on Animal Models of Recurrent Spontaneous Abortion
Tiansong DING ; Jinghong XIE ; Bin YANG ; Heqiao LI ; Yizhuo QIAO ; Xinru CHEN ; Wenfan TIAN ; Jiapei LI ; Wanyi ZHANG ; Fanxuan LI
Laboratory Animal and Comparative Medicine 2024;44(4):393-404
Objective To summarize and evaluate the characteristics of current recurrent spontaneous abortion(RSA)animal models at home and abroad,and to provide reference and guidance for the standardized preparation of RSA models.Methods"Recurrent spontaneous abortion"and"animal model"were used as co-keywords in CNKI,Wanfang,VIP,PubMed and Web of Science databases to search the RSA animal experimental literature,covering the period up to January 20,2024,and a total of 1 411 articles were collected.The analysis focused on construction methods and essential elements of RSA animal models,the modeling process and result evaluation,as well as the application of these models in pharmacological and pharmacodynamic research.An Excel table was established for systematic analysis and discussion.Results A total of 138 experimental studies were obtained after screening.In constructing RSA animal models,immunological models were the most widely used in Western medicine(96.92%),with the Clark model being the main one(92.31%).In traditional Chinese medicine(TCM)models,70.00%were kidney deficiency-luteal inhibition-syndrome combination models,20.00%were kidney deficiency and blood stasis models,and 10.00%were deficiency-heat syndrome models.Most animals were selected at 6-8 weeks(33.86%)and 8 weeks(32.28%)of age.The majority of animals were paired for mating at 18:00 on the day of cage pairing.In 81.03%of literatures,vaginal plugs were checked once the following morning,with 8:00 being the most common time(17.02%).The most commonly used drug administration cycle was 14 days of continuous gavage after pregnancy.Among the tested drugs,Western drugs were mainly protein-based(29.17%),while TCM drugs were mainly TCM decoction(81.11%).The most frequently used methods for detecting indicators included visual observation of embryos(22.54%),western blot(15.96%),PCR(13.58%),ELISA(12.91%),HE staining(10.80%)and immunohistochemistry(9.39%).Conclusion The etiology of RSA is complex,and corresponding animal models should be established based on different etiologies.Clark model is commonly used in the construction of Western medicine model,while the kidney deficiency-luteal inhibition-syndrome combination model is predominant in TCM.RSA animal model is widely used in related research,but systematic evaluation needs to be strengthened.
3.A genetic variant in the immune-related gene ERAP1 affects colorectal cancer prognosis
Danyi ZOU ; Yimin CAI ; Meng JIN ; Ming ZHANG ; Yizhuo LIU ; Shuoni CHEN ; Shuhui YANG ; Heng ZHANG ; Xu ZHU ; Chaoqun HUANG ; Ying ZHU ; Xiaoping MIAO ; Yongchang WEI ; Xiaojun YANG ; Jianbo TIAN
Chinese Medical Journal 2024;137(4):431-440
Background::Findings on the association of genetic factors and colorectal cancer (CRC) survival are limited and inconsistent, and revealing the mechanism underlying their prognostic roles is of great importance. This study aimed to explore the relationship between functional genetic variations and the prognosis of CRC and further reveal the possible mechanism.Methods::We first systematically performed expression quantitative trait locus (eQTL) analysis using The Cancer Genome Atlas (TCGA) dataset. Then, the Kaplan-Meier analysis was used to filter out the survival-related eQTL target genes of CRC patients in two public datasets (TCGA and GSE39582 dataset from the Gene Expression Omnibus database). The seven most potentially functional eQTL single nucleotide polymorphisms (SNPs) associated with six survival-related eQTL target genes were genotyped in 907 Chinese CRC patients with clinical prognosis data. The regulatory mechanism of the survival-related SNP was further confirmed by functional experiments.Results::The rs71630754 regulating the expression of endoplasmic reticulum aminopeptidase 1 ( ERAP1) was significantly associated with the prognosis of CRC (additive model, hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.08-1.88, P = 0.012). The results of dual-luciferase reporter assay and electrophoretic mobility shift assay showed that the A allele of the rs71630754 could increase the binding of transcription factor 3 (TCF3) and subsequently reduce the expression of ERAP1. The results of bioinformatic analysis showed that lower expression of ERAP1 could affect the tumor immune microenvironment and was significantly associated with severe survival outcomes. Conclusion::The rs71630754 could influence the prognosis of CRC patients by regulating the expression of the immune-related gene ERAP1. Trial Registration::No. NCT00454519 (https://clinicaltrials.gov/)
4.Clinical characteristics and management strategies of lymphoma patients with COVID-19
Xueping DANG ; Shuling HOU ; Pan CHEN ; Guiqin WANG ; Yizhuo CHEN
Chinese Journal of Clinical Infectious Diseases 2023;16(4):315-320
Novel coronavirus has brought great threats to the people and challenges to the health systems around the world. Compared with general population, lymphoma patients are more vulnerable to novel coronavirus infection(COVID-19) and have poorer prognosis. So the clinical management of COVID-19 in lymphoma patients in more difficult and the great importance should be attached. This article reviews the clinical characteristics and current management strategies of lymphoma patients with COVID-19, to provide reference for the clinical treatment of lymphoma patients with COVID-19.
5. A comparative study of induction chemotherapy with or without autologous hematopoietic stem cell transplantation in the treatment of newly diagnosed young medium/high risk diffuse large B cell lymphoma patients
Xi WANG ; Bing XIA ; Chaoyu WANG ; Mengzhen LI ; Wen XU ; Tian YUAN ; Chen TIAN ; Haifeng ZHAO ; Hongliang YANG ; Zhigang ZHAO ; Xiaofang WANG ; Yafei WANG ; Yong YU ; Yizhuo ZHANG
Chinese Journal of Hematology 2019;40(2):117-124
Objective:
To compare the efficacy of induction chemotherapy with or without autologous hematopoietic stem cell transplantation (auto-HSCT) for newly diagnosed young diffuse large B cell lymphoma (DLBCL) patients.
Methods:
The retrospective study was performed in 90 cases of young patients (≤60 years) with newly diagnosed DLBCL and an age-adjusted International Prognostic Index (aa-IPI) score of 2 or 3. All of them were treated with R-CHOP (32 cases, rituximab combined with CHOP), dose-intensive regimens (DA-EPOCH, Hyper CVAD/MA or ESHAP) combined with or without rituximab (25 cases), and consolidated with up-front auto-HSCT (33 cases), respectively. The efficacy and the potential predictors were evaluated.
Results:
①The median age of 90 patients was 43 (18-60) years old. The median follow-up time was 42 (3-110) months. ②The 5-year progression-free survival (PFS) for R-CHOP group, dose-intensive chemotherapy group and auto-HSCT group were (33.5±10.7) %, (55.3±10.1) % and (65.8±13.6) % (
6.Clinical analysis of autologous peripheral blood hematopoietic stem cell mobilization regimen in 56 multiple myeloma patients
Xia BING ; Chaoyu WANG ; Wen XU ; Chen TIAN ; Haifeng ZHAO ; Zhigang ZHAO ; Xiaofang WANG ; Yafei WANG ; Yong YU ; Yizhuo ZHANG
Chinese Journal of Clinical Oncology 2018;45(11):557-561
Objective: To compare the efficacy between chemotherapy plus granulocyte colony-stimulating factor (G-CSF) and chemotherapy plus G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF) for the mobilization of peripheral blood stem cells (PBSC) and hematopoietic recovery after transplantation in patients with multiple myeloma (MM). Methods: A retrospective study of autologous PBSC (APBSC) mobilization data of 56 MM patients who were treated with chemotherapy plus G-CSF or chemotherapy plus G-CSF and GM-CSF from May 2008 to July 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. The mobilization efficacy and hematopoietic recovery were analyzed. Results: In the univariate analysis, the successful collection rate of a single harvest in women and in patients with ISS stage Ⅲ and R-ISS stage Ⅱ/Ⅲ and treated with chemotherapy plus G-CSF was lower (P<0.05). However, age (≤60 years vs.>60 years), subtype, D-S staging (Ⅰ+Ⅱvs.Ⅲ), number of cycles of chemotherapy before mobilization (≤6 cycles vs.>6 cycles), disease phase before mobilization (PR vs. CR), and interval between diagnosis and mobilization (≤18 months vs.>18 months) were not correlated with CD34+ cell collection and successful mobilization rates (P>0.05). In the multivariate model, the successful mobilization rate in patients who received the chemotherapy plus G-CSF and GM-CSF mobilization regimen was higher (OR=12.009, 95% CI=1.961-73.537). The effect of mobilization regimens remained significant (P=0.007). Hematopoietic recovery without transplantation-related mortality occurred successfully in all patients. Conclusions: Chemotherapy plus G-CSF and GM-CSF mobilization regimens can significantly increase the effect of APBSC mobilization and ensure the recovery of hematopoietic function after transplantation. Chemotherapy plus G-CSF and GM-CSF mobilization regimens are safe and effective for mobilizing APBSCs.
7. Expressions and prognostic significance of PTEN and PD-1 protein in patients with classical Hodgkin’s lymphoma
Bing XIA ; Dongwei WU ; Tengteng WANG ; Shanqi GUO ; Yi WANG ; Hongliang YANG ; Wen XU ; Chen TIAN ; Lianyu ZHANG ; Baochun SUN ; Yizhuo ZHANG
Chinese Journal of Hematology 2018;39(10):839-844
Objective:
To elucidate the expression levels of key immune biomarkers, phosphate and tension homology deleted on chromosome ten (PTEN) and programmed cell death protein1(PD-1),of different immune tolerance pathway in classic Hodgkin’s lymphoma (CHL) to further determine their clinical role and prognostic significance.
Methods:
The clinical features and prognostic factors of 56 CHL patients, who were admitted to the TianJin Medical University Cancer Institute from February 2003 to August 2013, were retrospectively analyzed. PTEN and PD-1 protein expression levels were analyzed by immunohistochemistry, Epstein-Barr virus encoded RNA (EBER) was performed by in situ hybridization assay. Correlations between the expression of biomarkers and clinicopathologic parameters were examined and survival analyses were performed.
Results:
This cohort of 56 CHL patients included 34 males and 22 females with a median age of 25 years (ranged from 7 to 71 years). In a univariate analysis, age≥45, IPS score >2, EBER positive, high expression of PTEN protein conferred inferior 5-year OS and 5-year PFS; In a multivariate model, age≥45, IPS score >2, EBER positive, high expression of PTEN protein were identified as the independent adverse prognostic factors for CHL.
Conclusions
This study suggested for the first time that PTEN was independent prognostic immune biomarkers in CHL, which provided the novel therapeutic strategy of immune therapy for CHL.
8.Clinical analysis of autologous peripheral blood hematopoietic stem cell mobilization regimen in 61 lymphoma patients
Chaoyu WANG ; Bing XIA ; Wen XU ; Chen TIAN ; Haifeng ZHAO ; Hongliang YANG ; Zhigang ZHAO ; Xiaofang WANG ; Yafei WANG ; Yong YU ; Yizhuo ZHANG
Chinese Journal of Clinical Oncology 2017;44(8):377-383
Objective:To compare the efficacy between chemotherapy with granulocyte colony-stimulating factor (G-CSF) and chemo-therapy with G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF) for the mobilization of peripheral blood hemato-poietic stem cells and hematological recovery post-transplantation in patients with malignant lymphoma. Methods:Autologous pe-ripheral blood hematopoietic stem cell mobilization data of 61 malignant lymphoma patients who were treated with chemotherapy plus G-CSF or chemotherapy plus G-CSF and GM-CSF from May 2008 to October 2016 were included in this study. The mobilization effi-cacy and hematopoietic recovery were analyzed. Results:During mobilization, White blood cells (WBC) of all patients decreased to 1.0×109/L and platelets (PLT) dropped to 40×109/L. The successful mobilization rates of CD34+cell are 52.5%in chemotherapy plus G-CSF group and 90.5%in chemotherapy plus G-CSF+GM-CSF group (P=0.003). All patients successfully underwent hematopoietic recon-struction without transplantation-related mortality. Conclusion: Although chemotherapy with G-CSF+GM-CSF can significantly in-crease the effect of autologous peripheral blood hematopoietic stem cell mobilization, the reconstruction of hematopoietic function after transplantation and side reaction between the two groups are the same. Thus, chemotherapy with G-CSF+GM-CSF is not superior to chemotherapy with G-CSF in mobilizing autologous peripheral blood hematopoietic stem cells.
9.Pancreatoblastoma in children:9 case reports and literature review
Jing LI ; Weiling ZHANG ; Dongsheng HUANG ; Huimin HU ; Yizhuo WANG ; Yuan WEN ; Tao HAN ; Fan LI ; Liping CHEN
Chinese Journal of Applied Clinical Pediatrics 2017;32(15):1162-1165
Objective To analyze the clinical features,treatment and prognosis of the pancreatoblastoma (PB).Methods A total of 9 patients including 4 boys and 5 girls diagnosed as pancreatoblastoma in Beijing Tongren Hospital Affiliated to Capital Medical University between July 2008 and February 2016 were enrolled.The clinical features,therapy and prognosis were analyzed.Results (1) Clinical manifestations:6 cases had abdominal mass,1 case had jaundice,2 cases had abdominal pain at the time of diagnosis;5 cases were found in caput pancreatis,2 cases were found in corpora pancreatis and 2 cases were found in cauda pancreatis;4 cases had local tumor,3 cases had local invasion,and 2 cases had liver metastasis at diagnosis.(2) Enzymology and tumor marks:elevated alpha-fetoprotein (AFP) was found in 5 cases (48.5-52 971.0 μg/L),elevated neuron-specific enolase(NSE) was found in 5 cases(22.4-53.4 pg/L),elevated carbohydrate antigen 125 (CA-125) was found in 5 cases [(40.3-122.8) × 103 U/ L],elevated carbohydrate antigen 19-9 (CA19-9) was found in 2 cases [(65.4-362.5) × 103 U/ L],elevated lactate dehydrogenase was found in 2 cases(380 ~ 838 U/L) and elevated hemodiastase was found in 2 cases (105.5-122.8 U/L).(3) Treatment and prognosis:in 9 patients,the tumors were resected at first in 6 patients,and 5 of them remitted until now,1 of them relapsed after the comprehensive treatment for 9 months.Two of the patients underwent operation after the chemotherapy,in which 1 case received complete resection but without chemotherapy after the surgery,whom relapsed 1 year later;and the other one was resected partly.But after stopping the comprehensive treatment for 6 months,the disease relapsed.One patient could not receive operate because of huge tumor size,and the chemotherapy failed to control tumor progression;the patient died without operation.Three relapsed children were still in chemotherapy.The median follow-up period was 21 months (8-98 months).Conclusions AFP may be used as monitoring indicator for PB.Complete tumor resection is an important factor affecting the outcome.Adjuvant chemotherapy may reduce recurrence and prolong survival.
10.Prognostic significance of peripheral absolute monocyte count, platelet-lymphocyte ratio in patients with primary nasal natural killer/T-cell lymphoma
Yafang CHEN ; Li ZANG ; Xiaoying ZHANG ; Pan ZHAO ; Ying YUAN ; Zhijie YUE ; Hongliang YANG ; Haifeng ZHAO ; Yong YU ; Yafei WANG ; Zhigang ZHAO ; Yizhuo ZHANG ; Xiaofang WANG
China Oncology 2017;27(5):376-382
Background and purpose: Natural killer/T-cell lymphoma (NKTCL) is a scarce subtype of malignant lymphoma, and it has heterogeneous clinical manifestation and treatment effect. Currently, no precise risk stratification is used to guide prognosis. This study aimed to evaluate the prognostic impact of pre-treatment peripheral blood absolute monocyte count (AMC) and platelet-lymphocyte ratio (PLR) in patients with primary nasal NKTCL, and provide more precise information for better risk stratification to select appropriate treatment and improve survival. Methods: Clinical data of 132 patients newly diagnosed with primary nasal NKTCL was collected in the Tianjin Medical University Cancer Institute and Hospital from Jan. 2008 to Dec. 2013. The relationship between AMC and PLR in pre-treatment peripheral blood and 5-year overall survival (OS) and progression-free survival (PFS) of patients was analyzed retrospectively. Independent prognostic factors of patients were determined by univariate analysis and Cox regression analysis. Results: Pre-treatment peripheral blood AMC and PLR play important roles in the prognosis stratification of patients with primary nasal NKTCL. The prognosis in patients of AMC<0.5×109/L were higher than those of AMC≥0.5×109/L, The prognosis in patients of PLR<150 were higher than those of PLR≥150 (P<0.05). Based on the four independent risk factors of staging, ECOG scoring, AMC and PLR, we tried to establish a new prognostic model, dividing all patients into three different risk groups and found that the 5-year OS and PFS of three groups had significant statistical differences. Conclusion: Peripheral blood AMC and PLR were significantly correlated with the prognosis of patients with primary nasal NKTCL. The new prognostic patterns based on the four independent risk factors, such as staging, ECOG scoring, AMC and PLR may be more convenient and more economical than IPI (International Prognostic Index, IPI) and KPI (Korean Prognostic Index, KPI).

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