Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
Adult ; Humans ; Adolescent ; Imatinib Mesylate/adverse effects* ; Incidence ; Antineoplastic Agents/adverse effects* ; Retrospective Studies ; Pyrimidines/adverse effects* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Treatment Outcome ; Benzamides/adverse effects* ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Aminopyridines/therapeutic use* ; Protein Kinase Inhibitors/therapeutic use*

ObjectiveTo explore the effect and mechanism of Lactobacillus paracasei （Lpa） on the prevention of atherosclerosis. MethodsEight-week-old male ApoE^-/- mice were used to establish the atherosclerotic model， and the mice were randomly divided into three groups： ① normal chow control group： ApoE^-/- + normal chow diet （n=10）； ② model group： ApoE^-/- + western diet + PBS （n=10）； ③ Lactobacillus paracasei intervention group： ApoE^-/- + western diet + Lactobacillus paracasei （n=10）. followed by histological evaluations of atherosclerotic lesion in aorta. Immunofluorescence analysis was used to measure the cholesterol accumulation and cholesterol uptake of peritoneal macrophages. Western blot was used to measure the protein expression level of class A scavenger receptor （SR-A） and class B scavenger receptor （CD36）. ResultIntervention of Lactobacillus paracasei can significantly suppress the formation of atherosclerotic plaque in ApoE^-/- mice， reduce the inflammatory reaction of arterial blood vessels， inhibit the lipid accumulation and cholesterol uptake of macrophages， and reduce the protein expression of SR-A. ConclusionsLactobacillus paracasei may protect against atherosclerosis by preventing the inflammation of arterial blood vessels and the formation of foam cells by reducing the protein expression of SR-A.

Consensus ; Critical Illness ; Humans ; Serum Albumin ; Serum Albumin, Human

This study aims to explore the mechanism of fresh Phragmitis Rhizoma against chronic bronchitis airway inflammation. The SD rats of SPF grade were divided into control group, model group, Guilongkechuanning group(GLKCN, 1.125 g·kg~(-1)), high-dose fresh Phragmitis Rhizoma group(LG-HD, 15 g·kg~(-1)), and low-dose fresh Phragmitis Rhizoma group(LG-LD, 7.5 g·kg~(-1)). The chronic bronchitis models of rats in other groups except the control group were induced by the modified smoking method. From the 15 th day of modeling, the rats were given corresponding agents by gavage for 20 consecutive days. After the last administration, the rats were sacrificed for sample collection. Enzyme-linked immunosorbent assay(ELISA) was employed to detect serum transforming growth factor-β(TGF-β) and interleukin-6(IL-6) levels. The protein expression of TGF-β, IL-1β and IL-6 in lung tissue was detected by immunohistochemical method. Masson staining was performed to detect collagen fibers and muscle fibers in lung tissue, and HE staining to detect the pathological changes of lung tissue. Human bronchial epithelial(16 HBE) cells were cultured in vitro, and CCK-8(cell counting kit-8) method was used to detect the cytotoxicity of cigarette smoke extract(CSE) and fresh Phragmitis Rhizoma. After the exposure of 16 HBE cells to 3.5% CSE and appropriate concentration(800, 400 μg·mL~(-1)) of fresh Phragmitis Rhizoma for 24 h, quantitative real-time PCR was conducted to determine the mRNA levels of TGF-β and IL-1β, and Western blot was employed to determine the protein levels of TGF-β and IL-6 in the cells. The rat model of chronic bronchitis induced by smoking was successfully established. Fresh Phragmitis Rhizoma reduced serum TGF-β and IL-6 levels, down-regulated the protein levels of TGF-β, IL-1β, and IL-6 in lung tissue, and alleviated pathological changes and fibrotic lesions in lung tissue. Moreover, it down-regulated the CSE-induced protein expression of TGF-β and IL-6 as well as the mRNA level of TGF-β in 16 HBE cells. These results indicated that fresh Phragmitis Rhizoma could prevent airway inflammation from chronic bronchitis and promote cell repair by inhibiting the TGF-β signaling pathway.
Animals ; Bronchitis, Chronic/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Inflammation ; Lung ; Poaceae/chemistry* ; Rats ; Rats, Sprague-Dawley ; Rhizome ; Signal Transduction ; Transforming Growth Factor beta/genetics*

Objective:To evaluate the effect of Kinesio taping on chronic nonspecific low back pain (CNLBP). Methods:The Cochrane Library, PubMed, Web of Science, CNKI, CBM, VIP, and Wanfang Data were searched for the randomized controlled trials (RCT) about the effect of Kinesio taping on CNLBP from establishment to January, 2019. The included studies were evaluated according to the method recommended by the Cochrane Collaboration. RevMan 5.3 software was used to analyze the extracted data. Results:Finally, nine RCTs involving 545 patients were included. Meta-analysis showed that the effect of Kinesio taping was significantly different in the improvement of pain compared with the non-stimulated group (MD = -0.76, 95%CI: -1.43 to -0.08, P = 0.03), the difference might be significant compared with the sham stimulation group (MD = -1.10, 95%CI: -2.22 to 0.02, P = 0.05); For improving dysfunction, the Oswestry Disability Index (ODI) scores were better in the Kinesio taping group than in the non-stimulation group (MD = -6.02, 95%CI: -8.63 to -3.41, P < 0.001) and the sham stimulation group (MD = -4.11, 95%CI: -5.82 to -2.41, P < 0.001), however, their was no significant difference in Roland Morris Disability Questionnaire (RMDQ) score between the Kinesio taping group and the non-stimulated group (MD = 0.69, 95%CI: -2.35 to 3.74, P = 0.66), and between the Kinesio taping group and the sham stimulation group (MD = -0.17, 95%CI: -1.43 to 1.08, P = 0.78). Conclusion:For the patients with CNLBP, the intervention of Kinesio taping could alleviate pain and improve function.

BackgroundPostmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.

MethodsThis was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.

ResultsA total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E'; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E' to the late diastolic mitral annular velocity (E'/A'; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E' (E/E'; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E' (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E'/A' (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E' (r = 0.472; P = 0.003) and E'/A' (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E' (r = -0.590; P < 0.001), E/E' (r = 0.454; P = 0.004), and E'/A' (r = -0.377; P = 0.018).

ConclusionsConventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.

Chinese Clinical Trial RegisterChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.

BackgroundPostmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.

MethodsThis was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.

ResultsA total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E'; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E' to the late diastolic mitral annular velocity (E'/A'; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E' (E/E'; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E' (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E'/A' (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E' (r = 0.472; P = 0.003) and E'/A' (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E' (r = -0.590; P < 0.001), E/E' (r = 0.454; P = 0.004), and E'/A' (r = -0.377; P = 0.018).

ConclusionsConventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.

Chinese Clinical Trial RegisterChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.

Astragalus propinquus ; chemistry ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; Metabolic Syndrome ; drug therapy ; Postmenopause ; drug effects ; Prospective Studies ; Risk Factors ; Ventricular Dysfunction, Left ; drug therapy

Aim To investigate the effects of Periplane-ta americana extract Ento-A on the immune function in immunosuppressed mice . Methods Immunosup-pressed mouse model was induced by intraperitoneal injection of cyclophosphamide in KM mice .To evalu-ate the effects of Ento-A on the immune function in im-munosuppressed mice , neutral red method and MTT assay were used respectively to detect the effects of En-to-A on the phagocytosis of peritoneal macrophages and T cell proliferation rate in mice; with sheep red blood cell as immunogen , the effects of Ento-A on the pro-duction of serum hemolysin were evaluated;peripheral blood was tested and immune organ index calculated . Results Compared with model control group , the high, medium and low doses of Ento-A could improve the expression of serum hemolysin in immunosup-pressed mice ( P<0.01 ) , and increase the spleen in-dex(P<0.01) and thymus index (P>0.05), signifi-cantly increased the content of WBC ( P<0.01 ) , PLT ( P<0.01 ) , HGB ( P<0.01 ) , while the contents of RBC was on the rise , with no significant difference ( P>0.05 ) in peripheral blood , significantly enhanced phagocytic function and T lymphocyte proliferative abil-ity in a dose-dependent manner ( P<0.01 ) .Conclu-sion Ento-A can enhance the immune function of im-munosuppressed mice .

Objective To investigate the clinical efficacy of contralateral acupuncture in treating motor dysfunction in patients with acute ischemic stroke.Methods Sixty patients with acute ischemic stroke were randomized to treatment and control groups, 30 cases each. Both group received electroacupuncture in addition to conventional rehabilitation training. Besides, the treatment group received electroacupuncture at points on the healthy side in the morning and on the affected side in the afternoon and the control group, electroacupuncture at points on the affected side in both the morning and afternoon. Motor function was assessed using the Fugl-Meyer Assessment (FMA), the modified Barthel Index (MBI), integrated electromyography (iEMG) and median frequency (MF) in the two groups of patients before and after treatment.Results There were statistically significant pre-/post-treatment differences in the FMA score, the MBI score, iEMG and MF in the two groups (P<0.01). There were statistically significant post-treatment differences in the FMA score, the MBI score and iEMG between the treatment and control groups (P<0.01,P<0.05).ConclusionContralateral and healthy side acupuncture can markedly improve motor function in acute stroke patients.

Objective · To explore the prognostic factors for postoperative radiotherapy for patients with locally advanced esophageal squamous cell carcinoma (ESCC) and the effects of lymph nodes metastasis status on the survival of patients and failure modes of treatment. Methods · Data of 121 patients with locally advanced ESCC who underwent radical resection and postoperative radiotherapy from 2006 to 2013 were collected. The overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier. Univariate analysis and multivariate analysis were performed to investigate prognostic factors with the log-rank test and the Cox regression model. The differences in OS and recurrence patterns between patients with different lymph node metastasis status were compared. Results · The median DFS of all patients was 22.57 months and median OS was 32.90 months.Multivariate analysis showed that KPS score, length of lesion, and positive lymph nodes ratio (pLNR) were independent prognostic factors for DFS and OS. For patients with positive lymph nodes, the median DFS of patients with pLNR ≤ 0.15 and pLNR>0.15 were 33.43 and 19.20 months (P=0.04).Patients without nodal skip metastasis (NSM) had better median OS than patients with NSM, but the difference was not statistically significant. OS was significantly worse in patients with pLNR>0.15 and NSM than in other patients with positive lymph nodes (median OS of 14.33 vs 32.50 months, P=0.02).pLNR had a better prognostic value for OS than the number of positive lymph nodes (AUC=0.673, P=0.04). Analysis of the failure patterns showed that more distant metastases were observed in patients with pLNR>0.15, while more local and regional recurrences were observed in patients with pLNR ≤ 0. 15. Conclusion · The status of lymph nodes metastasis is associated with the prognosis of postoperative radiotherapy for patients with locally advanced ESCC. pLNR has a better prognostic value for OS for patients with positive lymph nodes. The recurrence pattern varies in patients with different pLNR after postoperative radiotherapy. The patients with high pLNR and NSM have poor prognosis.