Objective:To investigate clinical efficacy and safety of venetoclax (VEN)-based regimens in the treatment of acute myeloid leukemia (AML).Methods:The clinical data of 41 AML patients treated with venetoclax-based regimens from January 2021 to December 2021 in Ruijin Hospital North of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The treatment regimens included VEN+demethylating drugs ± gene mutation inhibitors or VEN+chemotherapy with a median number of 2 courses (1- 5 courses).Results:The median age of all patients was 60 years (18-73 years), and there were 24 males and 17 females. After 1 course of VEN-based therapy, 22 (53.7%) patients achieved complete remission (CR) or morphological complete remission without complete blood count recovery (CRi), including 5 patients achieving minimal residual disease (MRD) negative. After 2 courses of treatment, of 17 patients available for efficacy evaluation, 7 patients achieved MRD negative. Among 20 relapsed/refractory AML patients, 9 cases achieved CR/CRi after 1 course of treatment, of which 1 patient had MRD negative. Among 21 patients initially treated and re-treated, 13 cases achieved CR/CRi and 1 case achieved partial remission after 1 course of treatment, of which 4 cases had MRD negative.Conclusions:VEN-based treatment regimens for AML have a high remission rate and tolerable adverse effects.

Humans ; Hypertension, Pulmonary/surgery* ; Learning Curve ; Angioplasty, Balloon ; Pulmonary Embolism/therapy* ; Chronic Disease ; Pulmonary Artery/surgery*

Exosomes are extracellular vesicles released from various cellular sources and are widely present in body fluids. Bioactive substances such as microRNAs, mRNAs, and proteins are encapsulated in exosomes, which can activate various signaling pathways and play important roles in early warning of stroke and neurovascular unit repair. This article reviews the signal transduction of exosomes in cerebral ischemia.

Mesenchymal stem cells are a kind of pluripotent stem cells that play a role in stroke treatment mainly through paracrine mechanisms. Recent studies have shown that mesenchymal stem cell-derived exosomes play an important role in reducing post-stroke injury, promoting neural repair and angiogenesis. This article describes the research progress of bone marrow mesenchymal stem cell-derived exosomes in the treatment of stroke, and investigates the therapeutic mechanism and application prospects of exosomes bioactive substances represented by microRNAs.

Micro RNAs are a kind of conserved short non-coding RNAs that regulate life activities at molecular level. Micro RNAs are active in various stages of autophagy after ischemic stroke; micro RNAs play protective or destructive roles in autophagy after stroke. Based on the autophagy process, we discuss the possible mechanism of autophagy regulated by micro RNAs through autophagy related genes or pathways, and analyze the application prospect of micro RNAs in stroke diagnosis and treatment.

Objective To analyze the therapeutic effect and tolerability of decitabine monotherapy or combined with arsenic trioxide for the treatment of patients with myelodysplastic syndromes (MDS). Methods Clinical characteristics of 32 patients with primary MDS in North Hospital of Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2014 to April 2017 were retrospectively analyzed. The clinical data of these patients were collected, and the patients were followed up. Decitabine combined with arsenic trioxide was used in 23 cases, decitabine (20 mg·m-·2d-1) and arsenic trioxide (0.16 mg/kg) were administrated from day 1 to day 5 and was repeated every 4-6 weeks. For the remaining 9 cases, only decitabine was applied, decitabine(20 mg·m-2·d-1) was administrated from day 1 to day 5 and was repeated every 4-6 weeks. The clinicopathological characteristics and the effect of genetic mutations on the efficacy of treatment were investigated. Results Of the 32 patients with primary MDS, 18 were male and 14 were female. The patients were 17-72 years old with a median age of 56 years old. Genetic analysis revealed 10 cases with TP53 mutations, 8 cases with TET2 mutations, 4 cases with U2AF1 mutations, 3 cases with RUNX1 mutations, 3 cases with ASXL1 mutations, 2 cases with NRAS mutations, 2 cases with DNMT3A mutations and 1 case with JAK2 V617 mutation. The follow﹣up time was 2-23 months with a median follow﹣up time of 8 months. A total of 21 cases (65.6%) attained treatment response. Among them, there were 10 cases (31.3%) with complete remission (CR), 5 cases (15.6%) with bone marrow complete remission (MCR), and 6 cases (18.7%) with hematological improvement. There was no significant difference in the efficiency and CR rate between the combination group and the monotherapy group (P＝0.441, P＝0.681). Ten cases were found to have TP53 mutations, of which 7 cases had CR. Multivariate analysis demonstrated that TP53 mutation was an independent risk factor for CR (P＝ 0.037). All patients developed myelosuppression after treatment, of which 16 cases developed pulmonary infection. Conclusions Decitabine combined with arsenic trioxide in the treatment of MDS is effective and well tolerated. The therapeutic effects of decitabine monotherapy or decitabine combined with arsenic trioxide for treatment of patients with TP53 mutations are better than the average levels.

Objective To investigate the mechanism of rapamycin inhibiting the differentiation and proliferation of newborn porcine pancreatic adult stem cells, and to explore the therapeutic methods that may effectively reduce the side effects of rapamycin. Method Porcine NPCCs were treated with rapamycin alone or in combination with IGF-Ⅱ, and the caspase-3 and [ 3 H ]-thymidine uptake assays were performed to detect apoptosis and proliferation. The expression of insulin, PDX-1, NeuroD/Beta2, and Foxo1, a downstream transcription factor of IGF-Ⅱ, were analyzed by RT-PCR and Western blot to evaluate the differentiation ability of pancreatic adult stem cells. Results The NPCCs treated with rapamycin inhibited the proliferation ofβ-cells, increased apoptosis, reduced insulin secretion, inhibited the expression of PDX-1 and NeuroD/Beta2, and decreased the expression of IGF-Ⅱ. Foxo1 expression and induction of Foxo1 from the cytoplasm to the nucleus of the ectopic. The combined treatment of rapamycin and IGF-Ⅱcan reduce the side effects of rapamycin, inhibit the decrease ofβ-cell number and insulin content, repair the expression of insulin, PDX-1, NeuroD/Beta2, inhibit Foxo1 expression and intracellular ectopic. Conclusion Aberrant expression of IGF-Ⅱ and Foxol genes is the key inducing factor of rapamycin inhibiting the proliferation and differentiation of NPCCs, and IGF-Ⅱtreatment can effectively reduce the side effects of rapamycin on NPCCs differentiation.

Ninety-one patients over 60 year old with type 2 diabetes mellitus(T2DM) were selected from our outpatient department. The patients of experimental group uploaded their blood glucose data detected with glucometers, and obtained integrated management called " Mobile Health(M-health)" management such as medicines,diet,exercise from medical groups. The patients of control group got medical care in a traditional way without receiving other interventions. Regular follow-up was conducted in 2 groups every 3 months. The results showed that 3 months later,postprandial 2h plasma glucose in the experimental group was significantly improved compared with that of control group (P<0.05). Six months later, postprandial 2h plasma glucose and HbA1Clevels in the experimental group showed a decline comparing to the baseline, showing a statistical significance compared with control group(P<0.05). These results suggest that smartphone-based telemedicine is helpful of blood glucose control in elderly T2DM patients.

Objective To investigate the secondary metabolites of the South China Sea spine body sponge Acanthella cavernosa.Methods The acetone extract of A.cavernosa was isolated and purified by repeated column chromatography on sili-ca gel,sephadex LH-20,and high-performance liquid chromatography (HPLC).Structures were determined by spectroscopic analysis and comparison with reported data.Results Nine compounds were isolated.Their structures were determined as kali-hinol E (1),kalihinol A (2),10-epi-kalihinol X (3),10-epi-kalihinol I (4),1 H-indole-3-carboxylic acid methyl ester (5), 1H-indole-3-carboxylic acid (6),3-buten-2-one,4-(2,3,6-trimethylphenyl)-(3E)(7),aristolone (8),and 5α,8α-epidioxy-(22E,24R)-erost-6,22-dien-3β-ol (9).Conclusion Compounds 5 to 8 were isolated from the sponge of genus Acanthalla for the first time.

Objective To observe any differences in motor cortex excitability between Parkinson's disease (PD)patients and patients with multiple system atrophy (MSA) and to explore whether motor evoked potentials (MEPs) can be used as an electrophysiological indicator for differentiating the 2 diseases.Methods Thirty-four PD patients, 22 MSA patients and 15 age- and sex-matched healthy control subjeets were included in this study. Relaxed motor thresholds (RMTs), central motor conduction time (CMCTs) and MEP amplitudes (AMPs) were recorded in all three groups. The relationships of RMT, CMCT and AMP with the severity of the disease were observed.Results Average RMT in the PD group was significantly lower than that in the MSA and control groups. Average RMT in the MSA group was also significantly lower than that in the control group. There was no significant difference among the three groups with regard to CMCT. AMP in the PD group was significantly higher on average than in the MSA and control groups, but there was no significant difference between the MSA and control groups. RMT decreased and CMCT shortened progressively with the severity of the disease in the PD group, but not in the MSA group.Conclusions There were differences in motor cortex excitability between PD patients and MSA patients. MEP RMTs and CMCTs may be valuable for identifying PD and MSAc but the clinical significance of the amplitude differences remains to be further explored.