Objective:To optimize the preparation process of Qinggan Liangxue Granules.Methods:The L 9 (3 4) orthogonal experimental design was used to investigate the effects of water addition, extraction time and extraction times on the extraction process of Qinggan Liangxue Granules by taking the transfer rate of astilbin and paeoniflorin as the indexes, so as to screen the optimal extraction process. The evaluation indexes of granule molding rate, water content, solubility and fluidity were used to compare the effect of finished products under different ratios of excipients and granulation conditions. Results:The optimal extraction process was to add 10 times the amount of water reflux extraction twice, each time 1.5 h; using wet granulation, the ratio of dry paste powder to base material was 4:1 ( m/ m), and the wetting agent was 95% ethanol. Conclusion:The preparation process of Qinggan Liangxue Granules is stable and feasible, which lays a foundation for further research and development and quality control.

Post-amputation pain causes great suffering to amputees, but still no effective drugs are available due to its elusive mechanisms. Our previous clinical studies found that surgical removal or radiofrequency treatment of the neuroma at the axotomized nerve stump effectively relieves the phantom pain afflicting patients after amputation. This indicated an essential role of the residual nerve stump in the formation of chronic post-amputation pain (CPAP). However, the molecular mechanism by which the residual nerve stump or neuroma is involved and regulates CPAP is still a mystery. In this study, we found that nociceptors expressed the mechanosensitive ion channel TMEM63A and macrophages infiltrated into the dorsal root ganglion (DRG) neurons worked synergistically to promote CPAP. Histology and qRT-PCR showed that TMEM63A was mainly expressed in mechanical pain-producing non-peptidergic nociceptors in the DRG, and the expression of TMEM63A increased significantly both in the neuroma from amputated patients and the DRG in a mouse model of tibial nerve transfer (TNT). Behavioral tests showed that the mechanical, heat, and cold sensitivity were not affected in the Tmem63a^-/- mice in the naïve state, suggesting the basal pain was not affected. In the inflammatory and post-amputation state, the mechanical allodynia but not the heat hyperalgesia or cold allodynia was significantly decreased in Tmem63a^-/- mice. Further study showed that there was severe neuronal injury and macrophage infiltration in the DRG, tibial nerve, residual stump, and the neuroma-like structure of the TNT mouse model, Consistent with this, expression of the pro-inflammatory cytokines TNF-α, IL-6, and IL-1β all increased dramatically in the DRG. Interestingly, the deletion of Tmem63a significantly reduced the macrophage infiltration in the DRG but not in the tibial nerve stump. Furthermore, the ablation of macrophages significantly reduced both the expression of Tmem63a and the mechanical allodynia in the TNT mouse model, indicating an interaction between nociceptors and macrophages, and that these two factors gang up together to regulate the formation of CPAP. This provides a new insight into the mechanisms underlying CPAP and potential drug targets its treatment.
Animals ; Mice ; Amputation, Surgical ; Chronic Pain/pathology* ; Disease Models, Animal ; Ganglia, Spinal/pathology* ; Hyperalgesia/etiology* ; Ion Channels/metabolism* ; Macrophages ; Neuroma/pathology*

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective:To observe the pathological changes of levator palpebrae superiors muscle in patients with different severities of simple congenital ptosis (SCP).Methods:Levator palpebrae superiors muscle specimens from 102 eyes of 68 patients with SCP who received levator palpebrae superiors muscle shortening surgery at Wuhan Aier Hankou Eye Hospital from August 2018 to October 2019 were collected as the observation group.According to the severity of ptosis, the specimens were divided into three groups, coverage ≤4 mm group (n=35), coverage >4 mm to ≤6 mm group (n=30), and coverage >6 mm group (n=37). Fresh levator palpebrae superiors muscle tissues from 8 normal donors in Aier Eye Bank of Wuhan Red Cross were selected as the control group.All specimens were performed with Masson trichrome staining and immunohistochemical staining for α-smooth muscle actin (α-SMA), and ImageJ software was used to measure the collagen fiber area ratio, skeletal muscle fiber area ratio and the integrated absorbance (IA) value of α-SMA.Seventeen specimens (2 from the control group, 5 from coverage ≤4 mm group/coverage >4 mm to ≤6 mm group/coverage >6 mm group) were observed with a transmission electron microscope (TEM). This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Wuhan Aier Hankou Eye Hospital (No.HKAIER2018IRB-005-01). All patients and their legal guardians were well informed about the treatment method and the purpose of sampling and voluntarily signed informed consent.Results:Compared with the control group, the skeletal muscle fiber was reduced in number and was in disordered arrangement, and the striation of some muscle fibers disappeared, and hyperplastic fibrous connective tissue was found in intercellular substances in the observation group.The collagen fiber area ratio of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group were significantly higher than that of the control group, and the skeletal muscle fiber area ratio of the three groups was significantly lower than that of the control group (all at P<0.008 3). There were more smooth muscle fibers and positive expression of α-SMA found in the specimens of the observation group.The IA value of α-SMA of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group was 7 195.28(5 935.69, 14 058.29), 55 584.18(33 861.88, 80 419.32), 166 507.76(119 121.95, 187 890.86), respectively, which were all higher than 5 543.03(4 867.67, 8 312.02) of the control group, among which, there were statistically significant differences between the control group and the coverage >4 mm to ≤6 mm group, coverage >6 mm group (both at P<0.008 3). Abundant organelles and some damaged mitochondria were found in smooth muscle cytoplasm in the observation group with a TEM.But no characteristic structure of smooth muscle cells such as dense patch and dense body was detected.Conclusions:There are abnormal smooth muscle cells in the levator palpebrae superiors muscle of SCP patients, and the dysgenesis of the levator palpebrae superiors muscle may be related to this abnormal muscle cell.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were collected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1-2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm). The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts. The postoperative follow-up was performed to observe the morphology of the eyelid margin, the repair of the eyelid defect area, the degree of movement of the eyelid and the function of opening and closing, and lifting.Results:A total of 8 cases were included, 3 males and 5 females, aged 31-76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Aside from the absence of eyelashes in the reconstructed area, the eyelids were in good shape. The movement of eyelid was good, the functions of opening and closing and lifting were normal. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.

Objective:To explore the effect of sliding tarso-conjunctival flap combined with allogeneic scleral transplantation for one-stage reconstructing posterior eyelid defect.Methods:The clinical data of eyelid tumor patients who admitted to Hankou Aier Eye Hospital from January 2015 to March 2019 were selected. The lesions crossed the gray line and the tarsal plates were involved. The benign tumor was removed from the margin by 1—2 mm and the pathological examination was performed. Mohs method (intraoperative delivery of frozen sections to control the cut edge) resection was performed for malignant tumor. The residual tarsal plate in the vertical direction after tumor was removed (upper eyelid≥3 mm, lower eyelid ≥2 mm) . The posterior defect reconstruction was performed by sliding the residual tarsal conjunctival flap to the eyelid margin, and the posterior tarsal defect area was repaired with allogeneic sclera. The anterior defect was reconstructed with sliding flaps, rotating flaps and free skin grafts.Results:A total of 8 cases were selected, including 3 males and 5 females, aged 31—76 years, with an average of 42 years old. 2 cases of eyelid intradermal nevi, 1 case of eyelid basal cell carcinoma, 4 cases of eyelid adenocarcinoma, and 1 case of eyelid squamous cell carcinoma. All patients were followed up for 6 to 24 months. All of the 8 patients had no tumor recurrence. Except for the absence of eyelashes in the reconstructed area, the eyelids were in good shape. Patients did not complain about foreign body sensation. No allogeneic sclera dissolution or rejection.Conclusions:For the residual tarsal plate in the vertical direction after tumor resection (upper eyelid≥3 mm, lower eyelid≥2 mm). The use of the sliding tarso-conjunctival flap combined with allogeneic scleral transplantation to reconstruct the posterior layer of the eyelid defect can achieve satisfactory result in both appearance and function.