Objective: To monitor the WT1 mRNA level and its dynamic changes in patients with myelodysplastic syndromes (MDS) after hypomethylating agents (HMA) , as well as to assess the significance of WT1 mRNA levels and its dynamic changes in evaluating the efficacy of HMA and distinguishing the disease status of heterogeneous patients with stable disease (SD) . Methods: Bone marrow or peripheral blood samples of 56 patients with MDS who underwent hypomethylating agents (≥4 cycles) from November 2009 to March 2018 were tested by real-time quantitative polymerase chain reaction (PCR) to detect the expression of WT1 mRNA, and to observe the correlation between the dynamic changes of WT1 mRNA expression and clinical efficacy and prognosis of patients. Results: WT1 mRNA expression levels of MDS patients decreased significantly after 3 cycles of hypomethylating agent treatment. Besides, the WT1 mRNA expression levels of patients increased significantly after diseases progression. According to the dynamic changes of WT1 mRNA expression levels during SD, 45 cases could be further divided into increased group and non-increased group. In those SD patients with increased WT1 mRNA expression level, the ratio of suffering disease progression or transformation to AML was 95.65% (22/23) , whereas the ratio turned to be 9.09% (2/22) for the non-increased group (χ(2)=33.852, P<0.001) . Compared with those SD patients reporting no increase in WT1 mRNA expression level, the overall survival[17 (95%CI 11-23) months vs not reached, P<0.001] and progression-free survival [13 (95%CI 8-18) months vs not reached, P<0.001] of those SD patients reporting increase in WT1 mRNA expression level were significantly shorter. Conclusion: WT1 mRNA expression level is a useful indicator to assess the efficacy of hypomethylating agents in MDS patients. Especially in patients with SD, detection of the changes in WT1 mRNA expression level is able to predict disease progression and help to make clinical decision.
Bone Marrow ; Humans ; Myelodysplastic Syndromes/genetics* ; Prognosis ; RNA, Messenger ; WT1 Proteins/genetics*

3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics* ; Child, Preschool ; DNA Mutational Analysis ; Disorder of Sex Development, 46,XY/genetics* ; Female ; Humans ; Membrane Proteins/genetics* ; Mutation

OBJECTIVE To evaluate the clinical effects of TCM diagnosis and treatment project for patients with MODS gastrointestinal dysfunction of abdominal distension and fullness disease.METHODS TCM diagnosis and treatment project (draft protocol)for abdominal distention and fullness disease was decided according to MODS diagnosis criteria which was for-mulated in the 3rd CSCCM.Seventy-eight patients with abdominal distension and fullness disease included in ICU of the affilia-ted hospital of Nanjing University of Chinese Medicine from July,2012 to December,2016 were enrolled in this study,and were randomly divided into the control group(n=35)and the treatment group(n=43).Basic treatments such as active anti-infection,functional support of organs,immuno-nutrition supplement were performed for both groups.For the treatment group,patients who were diagnosed as the syndrome of middle-heat obstruction were treated with the modified Dahuang Huan-glian Xiexin decoction to eliminate stagnation,clear away heat and detoxify.patients who were diagnosed as the syndrome of qi stagnation and blood stasis were treated with the modified Xuefu Zhuyu decoction to regulate qi and dredge fu-organs,activate blood circulation and remove blood stasis,and patients who were diagnosed as the qi deficiency of lung and spleen were treated with the self-formulated Yiqi Tongfu decoction to supplement qi,invigorate spleen and purge fu-organs.In addition,all syn-dromes were also treated with acupuncture and moxibustion and acupoints application.gastrointestinal function related indexes such as abdominal symptoms,signs,intra-abdominal pressure,ICU stays and mortality during hospitalization in both groups were recoded and compared on the 7th and 14th day before and after the treatment.RESULTS TCM Symptom score,abdomi-nal signs score,intra-abdominal pressure level in both groups showed a downward trend after the treatment,but all indexes in the treatment group decreased more significantly on the 7th and 14th day compared with those of the control group,the differ-ences had statistical significance(P<0.05),and the TCM symptom score and abdominal signs score decreased more signifi-cantly on the 14th day(P<0.01).The mortality rate of two groups during 28 days showed no significant difference,but the mean ICU stays in treatment group was lower than that in the control group(P<0.05).Treatment group Analysis showed that the proportion of the middle-heat obstruction patients was the highest,and the recovery rate of whom was obviously higher than that of patients belong to syndromes of qi stagnation and blood stasis,qi deficiency of spleen and lung,while the ineffec-tive rate was lower than those of the other two syndromes(P<0.05).CONCLUSIONS For hospitalized patients with abdom-inal distention and fullness disease,the application of TCM diagnosis and treatment project can significantly improve the clinical effect and decrease ICU stays.

Vertical sleeve gastrectomy (VSG) is becoming more and more popular among the world. Despite its dramatic efficacy, however, the mechanism of VSG remains largely undetermined. This study aimed to test interferon (IFN)-γ secretion n of mesenteric lymph nodes in obese mice (ob/ob mice), a model of VSG, and its relationship with farnesoid X receptor (FXR) expression in the liver and small intestine, and to investigate the weight loss mechanism of VSG. The wild type (WT) mice and ob/ob mice were divided into four groups: A (WT+Sham), B (WT+VSG), C (ob/ob+Sham), and D (ob/ob+VSG). Body weight values were monitored. The IFN-γ expression in mesenteric lymph nodes of ob/ob mice pre- and post-operation was detected by flow cytometry (FCM). The FXR expression in the liver and small intestine was detected by Western blotting. The mouse AML-12 liver cells were stimulated with IFN-γ at different concentrations in vitro. The changes of FXR expression were also examined. The results showed that the body weight of ob/ob mice was significantly declined from (40.6±2.7) g to (27.5±3.8) g on the 30th day after VSG (P<0.05). At the same time, VSG induced a higher level secretion of IFN-γ in mesenteric lymph nodes of ob/ob mice than that pre-operation (P<0.05). The FXR expression levels in the liver and small intestine after VSG were respectively 0.97±0.07 and 0.84±0.07 fold of GAPDH, which were significantly higher than pre-operative levels of 0.50±0.06 and 0.48±0.06 respectively (P<0.05). After the stimulation of AML-12 liver cells in vitro by different concentrations of IFN-γ (0, 10, 25, 50, 100, and 200 ng/mL), the relative FXR expression levels were 0.22±0.04, 0.31±0.04, 0.39±0.05, 0.38±0.05, 0.56±0.06, and 0.35±0.05, respectively, suggesting IFN-γ could distinctly promote the FXR expression in a dose-dependent manner in comparison to those cells without IFN-γ stimulation (P<0.05). It was concluded that VSG induces a weight loss in ob/ob mice by increasing IFN-γ secretion of mesenteric lymph nodes, which then increases the FXR expression of the liver and small intestine.
Animals ; Body Weight ; Cell Line ; Gastrectomy ; methods ; Gene Expression ; Hepatocytes ; cytology ; drug effects ; metabolism ; Interferon-gamma ; biosynthesis ; pharmacology ; secretion ; Intestine, Small ; drug effects ; metabolism ; Liver ; drug effects ; metabolism ; Lymph Nodes ; drug effects ; metabolism ; Mesentery ; drug effects ; metabolism ; Mice ; Mice, Obese ; Obesity ; metabolism ; pathology ; surgery ; Receptors, Cytoplasmic and Nuclear ; agonists ; genetics ; metabolism ; Weight Loss