[Breakthrough of invasive fungal disease with posaconazole as primary prophylaxis after induction chemotherapy for acute myeloid leukemia]

Objective: To investigate the breakthrough incidence of invasive fungal disease(IFD) and side effects of posaconazole as primary prophylaxis during induction chemotherapy for acute myeloid leukemia(AML). Methods: A total of 206 newly diagnosed AML patients admitted to our department during January 2016 and December 2018 were enrolled in the study. Exclusive criteria were as followings including patients diagnosed as acute promyelocytic leukemia; those who received intravenous antifungal therapy after admission or had history of IFD one month before induction chemotherapy, or those with functional insufficiency of vital organs and those older than 65. Forty-seven patients received posaconazole (posaconazole group), 61 cases received voriconazole (voriconazole group) and 98 cases did not receive any prophylaxis (control group) during induction chemotherapy. Prophylactic efficacy and safety between posaconazole and voriconazole were compared. Results: During induction chemotherapy, five possible cases of IFD occurred in posaconazole group (10.6%); while 11 cases (18.0%) were in voriconazole group including 7 possible, 3 probable and 1 proven. Thirty-five cases (35.7%) in control group were diagnosed as IFD including 19 possible, 11 probable and 5 proven ones. The incidences of IFD in posaconazole and voriconazole group were significantly lower than that in control group (P<0.05). The difference of posaconazole group and voriconazole group was not significant (P>0.05). The reported adverse events in posaconazole group were significantly lower than those in voriconazole group [12.8%(6/47) vs. 32.8%(20/61), P<0.05]. Conclusions: Posaconazole and voriconazole decrease IFD as primary prophylaxis during induction chemotherapy in patients with AML. The prophylactic effect of IFD with posaconazole is similar as voriconazole, but posaconazole shows better safety.

[Expression characteristics and prognosis significance of miRNA-181a in acute myeloid leukemia with normal karyotype]

目的

探讨核型正常急性髓系白血病（CN-AML）患者微RNA（miRNA）-181a的表达水平及其与预后的关系。

方法

采用实时荧光定量PCR法检测120例初诊原发CN-AML患者骨髓单个核细胞miRNA-181a的表达水平，PCR后采用直接测序方法检测IDH1、IDH2、NPM1、FLT3-ITD、DNMT3A和CEBPα突变。分析miRNA-181a表达与基因突变、其他临床指标和预后的关系。

结果

miRNA-181a高表达组和低表达组患者中位总生存（OS）时间分别为25.0和15.0个月（P<0.05）；中位无复发生存（RFS）时间分别为21.4和11.2个月（P<0.001）。miRNA-181a高表达组患者HGB水平、完全缓解率、NPM1野生型比例均较低表达组高，差异有统计学意义（P值均<0.05）；用Cox回归模型多因素分析显示，miRNA-181a高表达是影响CN-AML患者预后的独立因素（HR=2.219，95%CI 1.601~2.432，P=0.018）。

结论

miRNA-181a高表达是独立于临床指标和高频基因突变的预后良好的标志物，miRNA-181a表达水平可作为CN-AML预后的重要指标。

[Effect of FLT3-ITD with DNMT3A R882 double-mutation on the prognosis of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation]

目的

探讨FLT3-ITD和DNMT3A R882双突变对急性髓系白血病（AML）患者allo-HSCT预后的影响。

方法

使用直接测序法检测206例接受allo-HSCT的AML患者（M₃和使用分子靶向药物索拉菲尼的病例除外）初诊时骨髓中常见的基因突变组套（包括FLT3-ITD、DNMT3A、c-kit、CEBPA、FLT3-TKD、NPM1），回顾性分析患者的临床资料，比较各基因突变组的移植预后。

结果

①206例AML患者中男104例，女102例，中位年龄38（3~63）岁。FAB分型：M₀ 6例，M₁ 24例，M₂ 56例，M₄ 39例，M₅ 63例，M₆ 6例，不能分类12例。②全部206例患者根据初诊时的突变基因情况分为4组：FLT3-ITD⁺ DNMT3A R882⁺组（A组）19例，FLT3-ITD⁺ DNMT3A R882⁻组（B组）38例，FLT3-ITD⁻DNMT3A R882⁺组（C组）21例，FLT3-ITD⁻DNMT3A R882⁻组（D组）128例。四组间性别、年龄、初诊时白细胞计数、FAB分型、移植前疾病状态、染色体核型、供者类型、预处理方案及GVHD发生率比较，差异无统计学意义（P>0.05）。③A组和B、C、D组比较，2年累积复发率较高[分别为（72.2±2.6）%、（38.6±0.6）%、（36.8±1.6）%、（27.8±0.1）%，P值均<0.05]，总生存率较低[分别为（30.9±13.3）%、（67.5±7.8）%、（61.4±12.4）%、（80.1±3.7）%，P值均<0.05]，无白血病生存率较低[分别为（11.3±10.2）%、（47.9±8.4）%、（56.8±12.5）%、（79.7±3.6）%，P值均<0.05]。

结论

伴有FLT3-ITD与DNMT3A R882双突变的AML患者移植后累积复发率较高，总生存率和无白血病生存率较差。

[RAPD markers for wheat chromosomes in Langdon disomic substitution lines]

Optimal conditions were developed for a random amplified polymorphio DNA (RAPD) assay of hexaploid bread wheat and tetraploid durum wheat. AmpliTaq Stoffcl fragment was found to be better than Taq DNA polymerase in generating RAPDs. Studies on chromosome specific RAPD markers of the A- and B- and D-genome were performed using the complete set of Langdon disomic substitution lines and the parental lines (Langdon and Chinese Spring) as templete. Seven out of twelve arbitrary primers (all Operon 10-mer sequences) yielded 13 products that could be assigned to 1.0 chromosomes of A- and B- and D-genome, five of 13 markers for A-genome (2A: J6a and J11b; 3A: D11b; 6A: J17; 7A: J15a), seven for B-genome (1B: J11c; 2B: D5, D11c and J18) and one for D-genome (1D: J11a). Using Chinese Spring ditelosomic lines, four RAPD markers were further mapped to a specific chromosome arm (i.e., J11b-2AL, J17-6AL, D11c-2BL, and J11a-1DL). This study demonstrates that reproduoible RAPID markers can be generated and assigned to wheat chromosomes except 4AL, using Langdon disomic substitution lines and Chinese Spring euploid and aneuploids as malerids.

[Protective effects of Angelica sinensis injection on myocardial ischemia/reperfusion injury in rabbits]

The injection of aqueous extract of Angelica sinensis (AS), 50 mg/kg, 30 ml, were administered intravenously at a rate of 0.4 ml/min by an infusion pump 10 min before the left anterior descending coronary artery of rabbit was ligated, the LVP and +/- dp/dtmax of the rabbit heart injured by ischemia/reperfusion in vivo, were significantly higher than those in the control group (N.S. group, P < 0.05-0.01), and the level of malon-dialdehyde (MDA) and the activity of creatine phosphokinase (CPK) in the blood plasma were lower than those in the control group remarkably (P < 0.05-0.01). These results showed that AS exerted obvious protective effects on myocardial dysfunction and myocardial injury induced by ischemia/reperfusion.

Release and depletion of substance P by capsaicin in substantia gelatinosa studied with the antibody microprobe technique and immunohistochemistry

Using an antibody microprobe technique, we have detected substance P release from the region of the substantia gelatinosa of the cat during the first, but not the second, 30 min of topical application of capsaicin (1-3%) to the tibial nerve. Immunohistochemical analysis also showed that substance P-like immunoreactivity was markedly reduced in the superficial layer of the dorsal horn 30 min after application of capsaicin. These results indicate that substance P is released and then depleted from primary afferent central terminals following acute application of capsaicin to the peripheral sensory nerve.

[Protective effect of Angelica injection on arrhythmia during myocardial ischemia reperfusion in rat]

The protective effects of Angelica injection on arrhythmia were studied through the model of ischemic myocardial reperfusion in rats. The results showed that the incidence of ventricular premature beat and the total incidence of arrhythmia (IA) were greatly reduced by peritoneal injection of Angelica (0.6 gm crude drug/kg) in rats. The difference between the Angelica group (n = 12, IA = 41.7%) and the saline control group (n = 12, IA = 91.7%) was significant (P less than 0.05), while that between Angelica group and verapamil group (n = 10, IA = 40%) was insignificant (P greater than 0.05). The data suggested that Angelica injection is effective on the protection of arrhythmia during the myocardial ischemia reperfusion in rats.