ObjectiveTo explore the medication patterns of Professor Zhang Farong in treating type 2 diabetes mellitus （T2DM） and the clinical efficacy of his core prescription. MethodsClinical case records of T2DM treated by Professor Zhang Farong were collected to establish a prescription database. Frequency statistics， visual analysis， and factor analysis were employed to investigate the characteristics and principle of the prescriptions， and a core prescription was derived. A randomized controlled trial was conducted， enrolling 60 T2DM patients with the dampness-heat syndrome. The patients were allocated into an observation group （core prescription + metformin） and a control group （metformin alone）， with both groups undergoing a 12-week treatment course. Changes in TCM symptom scores， glucose metabolism indicators ［fasting plasma glucose （FPG）， 2-hour postprandial blood glucose （2 hPG）， and glycated hemoglobin （HbA1c）］， pancreatic function indicators ［fasting C-peptide （FCP）， 2-hour postprandial C-peptide （2 hCP）， and area under the C-peptide curve （AUCcp）］， and lipid profiles were measured before and after treatment. The adverse reactions were observed and recorded. ResultsA core prescription named modified Gegen Qinlian Decoction was formulated， comprising Puerariae Lobatae Radix， Coptidis Rhizoma， Scutellariae Radix， Astragali Radix， Lycii Cortex， Mori Cortex， Jineijin Endothelium Corneum Gigeriae Galli， Rehmanniae Radix Praeparata， Atractylodis Rhizoma， Polygonati Rhizoma， and Pogostemonis Herba. The clinical trial results showed that both groups had significantly decreased FPG， 2 hPG， and HbA1c （P0.05）， and the observation group outperformed the control group in recovering the level of HbA1c （P0.05）. After treatment， both groups had declined TCM symptoms scores （P0.05）， and the declines in the observation group were larger than those in the control group （P0.05）. After treatment， the TC and LDL-C levels declined in the observation group （P 0.05）， while the lipid levels showed a decreasing trend with no statistically significant difference in the control group. After treatment， both groups showed increases in FCP and AUCcp （P0.05）， and the 2 hCP in both groups presented a recovering trend with no statistically significant difference. There was no statistically significant difference in the incidence of adverse reactions between the two groups. ConclusionModified Gegen Qinlian Decoction embodies Professor Zhang Farong's academic philosophy of treating consumptive thirst by tonifying the spleen and kidney， replenishing Qi and Yin， clearing deficiency and heat， unblocking stasis in collaterals， and addressing both deficiency and stasis. The combination of the core prescription with metformin alleviates clinical symptoms in T2DM patients with the dampness-heat syndrome， demonstrating potential effects in restoring pancreatic islet function， regulating blood glucose， and improving lipid profiles. It serves as a therapeutic option for T2DM in the patients with the dampness-heat syndrome under syndrome differentiation， meriting broader clinical application.

Objectives:To explore the cardiac magnetic resonance(CMR)features of early ventricular aneurysm formation in patients with acute anterior myocardial infarction. Methods:One hundred and eight patients with acute anterior myocardial infarction who underwent primary percutaneous coronary intervention and completed CMR scans within two weeks were retrospectively analyzed and divided into non-ventricular aneurysm group(n=72)and ventricular aneurysm group(n=36)according to the absence or presence of early ventricular aneurysm after primary percutaneous coronary intervention.The obtained CMR images were imported into CVI42 software for image analysis,and a logistic regression analysis model was established to evaluate CMR features useful for the diagnosis of early ventricular aneurysm formation. Results:Aging and larger area of late gadolinium enhancement(LGE)and worse left ventricular systolic function and lower myocardial strain were features of patients in the ventricular aneurysm group as compared to the non-ventricular aneurysm group.LGE area(OR=1.32,95%CI:1.071-1.628,P=0.009),apical angle(OR=1.24,95%CI:1.041-1.475,P=0.016),septal mitral annular plane systolic excursion(septal MAPSE,OR=0.36,95%CI:0.169-0.757,P=0.007)and global longitudinal strain(GLS,OR=0.53,95%CI:0.154-0.953,P=0.046)were associated with early ventricular aneurysm formation.ROC curves were analyzed for the above four CMR parameters,and the AUC were 0.922,0.921,0.905,and 0.814,respectively.The optimal cutoff values were 28.5%,90°,8.245 mm,and 10.155%,respectively. Conclusions:Estimation of LGE area,apical angle,septal MAPSE and GLS using CMR technique can help diagnose early ventricular aneurysm in patients with acute anterior myocardial infarction.

Abivertinib, a third-generation tyrosine kinase inhibitor, is originally designed to target epidermal growth factor receptor (EGFR)-activating mutations. Previous studies have shown that abivertinib has promising antitumor activity and a well-tolerated safety profile in patients with non-small-cell lung cancer. However, abivertinib also exhibited high inhibitory activity against Bruton's tyrosine kinase and Janus kinase 3. Given that these kinases play some roles in the progression of megakaryopoiesis, we speculate that abivertinib can affect megakaryocyte (MK) differentiation and platelet biogenesis. We treated cord blood CD34⁺ hematopoietic stem cells, Meg-01 cells, and C57BL/6 mice with abivertinib and observed megakaryopoiesis to determine the biological effect of abivertinib on MK differentiation and platelet biogenesis. Our in vitro results showed that abivertinib impaired the CFU-MK formation, proliferation of CD34⁺ HSC-derived MK progenitor cells, and differentiation and functions of MKs and inhibited Meg-01-derived MK differentiation. These results suggested that megakaryopoiesis was inhibited by abivertinib. We also demonstrated in vivo that abivertinib decreased the number of MKs in bone marrow and platelet counts in mice, which suggested that thrombopoiesis was also inhibited. Thus, these preclinical data collectively suggested that abivertinib could inhibit MK differentiation and platelet biogenesis and might be an agent for thrombocythemia.
Acrylamides/pharmacology* ; Animals ; Blood Platelets/drug effects* ; Cell Differentiation ; Megakaryocytes/drug effects* ; Mice ; Mice, Inbred C57BL ; Piperazines/pharmacology* ; Pyrimidines/pharmacology*

Combined with the relevant policies promulgated by the state, the paper elaborates three basic modes of prescription refill management for chronic diseases: community model, pharmacy model, and distribution model. Then from multiple perspectives including the internal strengths and weaknesses of chronic disease management reform, as well as external opportunities and threats, the paper uses the SWOT analysis method to analyze the feasibility of establishing and popularizing the management of refilled prescriptions for chronic diseases during the COVID-19 epidemic and the advantages and disadvantages of carrying out this management mode. At the same time, medical institutions, doctors and patients are required to change the concept of chronic disease management mode in the context of COVID-19 prevention and control. On the premise of ensuring the safety of patients’ medication and the safety of national medical insurance funds during this period, we should promote the implementation of prescription refills for chronic diseases.

OBJECTIVE: To explore the genetic basis for a child with clinically suspected nephronophthisis (NPHP). METHODS: Peripheral blood samples of the patient and her parents were collected subjected to high-throughput sequencing. Sanger sequencing was used to verify the gene variants. RESULTS: The patient, a 7-year-old girl with congenital blindness, was admitted to a local hospital due to repeated vomiting for 7-8 days and then transferred to author's hospital due to renal failure. Her urine occult bloods (3+) and urine protein (1+) were abnormal. Her blood urea nitrogen and creatinine showed a significant progressive increase. Renal ultrasound showed a mild enlargement in bilateral renal, increased echogenicity, loss of corticomedullary differentiation, and the presence of cysts in both kidneys. No familial genetic history was found in the family of patient and the child was clinically diagnosed with nephronophthisis. The proband was found to harbor compound heterozygous variants of the CEP290 gene, namely c.2587-2A>T and c.2251C>T, which were inherited from her mother and father, respectively. Based on the ACMG guidelines, both variants were predicted to be pathogenic. CONCLUSION The patient was diagnosed with NPHP type 6 due to variants of the CEP290 gene. Above finding has provided new evidence for the genotype-phenotype correlation of this disease.

This study aimed to investigate the prevalence, clinical characteristics, and prognostic impact of 1p32.3 deletion in patients with newly diagnosed multiple myeloma (MM). A retrospective analysis was conducted on 411 patients with newly diagnosed MM; among which, 270 received bortezomib-based therapies, and 141 received thalidomide-based therapies. Fluorescence in situ hybridization (FISH) was performed to detect six cytogenetic abnormalities, namely, del(1p32.3), gain(1q21), del(17p13), del(13q14), t(4;14), and t(11;14). Results showed that 8.3% of patients with MM were detected with del(1p32.3) and had significantly more bone marrow plasma cells (P = 0.025), higher β2-microglobulin levels (P = 0.036), and higher lactate dehydrogenase levels (P = 0.042) than those without del(1p32.3). Univariate analysis showed that patients with del(1p32.3) under thalidomide-based therapies (median PFS 11.6 vs. 31.2 months, P = 0.002; median OS 16.8 vs. 45.9 months, P < 0.001) were strongly associated with short progression-free survival (PFS) (P = 0.002) and overall survival (OS) (P < 0.001). Multivariate analysis revealed that del(1p32.3) remained a powerful independent factor with worse PFS (P = 0.006) and OS (P = 0.016) for patients under thalidomide-based treatments. Patients with del(1p32.3) under bortezomib-based treatments tended to have short PFS and OS. In conclusion, del(1p32.3) is associated with short PFS and OS in patients with MM who received thalidomide- or bortezomib-based treatments.

Objective:To investigate the effect of pregnancy on endothelial progenitor cells (EPCs) in patients with rheumatoid arthritis (RA) and its mechanism.Methods:The newly treated RA patients in our hospital from January 2016 to June 2018, were included in this study. According to pregnancy or not, patients were divided into simple RA group and RA pregnancy group. They were all female patients, 30 in each group. Immunohistochemical staining was used to detect the number of lymphocyte common antigen (LCA) + lymphocytes and CD68 + macrophages in synovial tissue, flow cytometry was used to detect the proportion of EPC and endothelial cells, and enzyme-linked immunosorbent assay(ELISA) was used to detect the concentrations of vascular endothelial growth factor (VEGF), stromal cell derived factor (SDF-1), interleukin (IL)-6 and IL-10 in EPC supernatant. T-test was used for the comprarison between the two groups, and single factor analysis of variancewas used for the comparison between multiple groups. Results:Immunohistoche-mical results showed that the number of CD68 + macrophages and LCA + lymphocytes in synovium of RA with pregnancy group was significantly lower than that of non-pregnant RA group. The results of ELISA showed that the concentration of human leucocyte antigen-G (HLA-G) in peripheral blood was (8.9±1.7) pg/ml in non- pregnant RA group and (396.7±89.6) pg/ml in RA pregnancy group, the difference beween the two groups was statistically significant ( t=4.329, P<0.01). The results of flow cytometry showed that the proportion of EPC in lymphocytes was (0.13±0.03)% in non-pregnant RA group and (0.76±0.09)% in RA with pregnancy group, the difference beween the two groups was statisti-cally significant ( t=6.671, P<0.01). The results of correlation analysis showed that the proportion of EPC in peripheral blood was positively correlated with HLA-G concentration ( r=0.886 1, P<0.01). In vitro experiments showed that HLA-G could promote the recovery of EPC paracrine and differentiation function in RA patients. Conclusion:Pregnancy can improve the number and biological function of EPC in patients with RA. HLA-G may play an important role in this process.

Objective:To observe the expression level of histone demethyltransferase Jmjd3 in patients with pre-eclampsia (PE), and to investigate the possible mechanism of its epigenetic modification in regulating Th1/Th2 imbalance in PE patients.Methods:The mRNA levels of histone demethyltransferase Jmjd3 from peripheral blood mononuclear cells (PBMC) of PE patients and normal pregnant women were detected by RT-PCR. Peripheral serum IFN-γ and IL-4　　were detected by ELISA. RT-PCR was used to detect the mRNA levels of Jmjd3, Tbx21 and Cxcr3 in the spleen of PE and control mice. Immunomagnetic beads were used to sort out the initial CD4 + T cells in the spleen of control and PE mice. Western blot was used to detect H3K27me1 and H3K27me3 levels. ChIP analysis was used for H3K27me3 demethylation modification in spleens of PE mice. Results:Compared with normal pregnant women, the mRNA level of Jmjd3 in PBMC of PE patients was significantly increased, the level of IFN-γ in serum was significantly increased, and the level of IL-4 was significantly reduced ( P<0.01). Compared with normal control mice, the mRNA level of Jmjd3 in the spleen of PE mice was significantly increased, and the expression of Tbx21 and Cxcr3 was significantly increased in PE mice ( P<0.01); the H3K27me3 level of CD4 + T cells in PE mice was significantly reduced ( P<0.05), but H3K27me1 was not changed. ChIP analysis showed that CD4 + T cells H3K27me3 in PE group mice were in the Ifng promoter region, compared with control mice. Recruitment was significantly reduced, while recruitment in the promoter region of Il4 was significantly increased ( P<0.01). Conclusions:In both PE patients and mice with PE model, the relative expression level of histone demethyltransferase Jmjd3 is significantly up-regulated, which further induces the demethylation of H3K27me3 in the Ifng promoter region and promotes the initial CD4 + T cells to Th1 cell differentiation and development, leading to an imbalance of Th1/Th2, which may be one of the important reasons for the development of preeclampsia.

OBJECTIVE: To characterize cytogenetic changes and prognosis of patients with acute myeloid leukemia (AML) from different age groups. METHODS: The karyotypes of 515 AML patients were analyzed by using short-term culture of bone marrow cells and R-banding technique. Combined with FAB typing and genetic testing, cytogenetic changes and prognosis of different age groups were analyzed. RESULTS: The abnormal cloning rate was 54.6% among the 515 patients. The abnormal cloning rate and adverse risk karyotype proportion of those with myeloproliferative syndromes (MDS) and secondary AML were higher than those with de novo AML (P = 0.027; P<0.01). A significant difference was found in the number of structural abnormalities and proportion of favorable risk karyotypes among different age groups (P = 0.026; P = 0.004). And there was also a significant difference in the abnormal cloning rate between different FAB types (P<0.01). In those with non-acute promyelocytic leukemia (APL), the expression level of WT1 gene seemed to affect the prognosis. The survival rate of patients with karyotypes of adverse risk was lower than those with karyotypes of favorable risk (P = 0.015). The survival rate of the ≥60-year-old group was lower than the ≤30-year-old and 31 to 59-year-old groups (P<0.01, P<0.01). CONCLUSION The karyotypes of AML patients have different age distribution characteristics. The survival rate of ≥60-years-old group and karyotype of poor prognosis is low. Patients with MDS with secondary AML have a poor prognosis.
Adult ; Chromosome Aberrations ; Cytogenetic Analysis ; Cytogenetics ; Humans ; Karyotype ; Karyotyping ; Leukemia, Myeloid, Acute ; Middle Aged ; Myelodysplastic Syndromes ; Prognosis

Ovarian vein thrombosis (OVT) is a rare, insidious and dangerous disease mostly occurs in the postpartum period. Early diagnosis and timely treatment are very important and may avoid serious complications. Here we reported a woman who had a fever and left back pain three days after vaginal delivery. Enhanced CT suggested that thrombosis occurred in the left ovarian vein, and even the renal vein was involved. Thrombus susceptibility gene detection revealed that the plasminogen activator inhibitor-1 gene was 4G/5G heterozygous genotype and the 5,10- methylenetetra-hydrofolate reductase gene was C/T heterozygous genotype. Anticoagulant treatments with low-molecular-weight heparin and rivaroxaban were effective.