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Arsenic concentration in peripheral blood is correlated with efficacy of a Traditional Chinese Medicine regimen containing realgar for the treatment of myelodysplastic syndromes

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Journal of Traditional Chinese Medicine 2021年第4期41卷 630-635页

作者： WANG Dexiu XU Yonggang DU Yu WANG Hongzhi LI Liu HU Xiaomei YANG Xiupeng ma rou ZHOU Qingbing Department of Hematology Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing 100091China Institute of Geriatric Medicine Xiyuan HospitalChinese Academy of Chinese Medical SciencesBeijing 100091China

OBJECTIVE:To explore the relationship between the efficacy of realgar for the treatment of myelodysplastic syndromes with multilineage dysplasia(MDS-MLD)and arsenic concentration in the peripheral blood of patients.METHODS:In this prospective study,a total of 50 MDS-MLD patients were treated with traditional Chinese drugs containing realgar for 3 months in Xiyuan Hospital from march 2018 to January 2019.routine blood examination as well as liver and kidney function were monitored before and after treatment.The concentration of arsenic in the peripheral blood was measured using an atomic fluorescence spectrometer after treatment.The correlation between clinical effect and arsenic concentration was analyzed by Spearman’s method.RESULTS:The treatment response rate was 54%.Two patients(4%)achieved complete remission,50%(25 of 50)showed hematologic improvement,and 23 patients had stable disease(23%).No disease progression was observed.Arsenic concentration in the peripheral blood ranged from 14.60 to 85.96μg/L.Clinical efficacy was positively correlated with arsenic concentration(Pmay improve the clinical efficacy of realgar in MDS-MLD patients.

关键词： realgar arsenic myelodysplastic syndromes multiline dysplasia

Effect of Yiqi Tongyang Decoction(益气通阳方) on Blood T Cell Subsets in Patients with Chronic Immune Thrombocytopenia

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Chinese Journal of Integrative Medicine 2017年第9期23卷 709-713页

作者： YANG Xiu-peng ma rou YANG Xiao-hong ZHU Hui-lan XU Yong-gang Department of Hematology Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijing100091China

Objective： To measure the proportions of blood T cel subsets, Th1, Th2, Th17, Th22, and Treg cel s, and other parameters in patients with chronic immune thrombocytopenia（CITP） before and after treatment with Yiqi Tongyang Decoction（益气通阳方, YTD） to explore T cel status of patients with CITP, and to define the mechanism of action of YTD. Methods： The changes in peripheral blood T lymphocyte subsets, and those of Th1, Th2, Th17, Th22, and Treg cel s in 30 patients with CITP（22 females and 8 males） were analyzed using multiparametric flow cytometry before and after treatment with YTD for 6 months, and 26 healthy volunteers（14 males and 12 females） acted as a control. T-box expressed in T-cel s（T-bet） and GATA binding protein 3（GATA-3） m RNA levels in patients and controls were analyzed using real-time reverse transcription-polymerase chain reaction. Results： The proportions of Th1, Th17, Th22, Th1/Th2, and Th17/Treg cells increased in the peripheral blood of patients with CITP compared to those in controls before YTD therapy（P〈0.05）. Th1 cel numbers and the Th1/Th2 ratio fel in the treated patients with CITP to approximate the values of the control group（P〉0.05）. Th17 cel numbers and the Th17/Treg ratio also decreased in the treatment group（P〈0.05）, but not to the levels of the controls. The number of Treg cel s in the peripheral blood of patients with CITP before treatment was lower than that in the control group（P〈0.05）, but increased after YTD treatment（P〈0.05）, but not to the level of controls. T-bet and GATA-3 m RNA levels in peripheral blood were initially higher in patients before treatment than controls（P〈0.05）, but decreased after YTD therapy（P〈0.05）. Conclusions： Imbalances in T lymphocyte levels, particularly those of Th1/Th2 and Th17/Treg cel s, play important roles in the pathogenesis of CITP. YTD efficiently regulated the dynamics of Th1/Th2 and Th17/Treg equilibria.

关键词： immune thrombocytopenia Chinese medicine Yiqi Tongyang Decoction T-box expressed inT-cells GATA binding protein 3 Th cells Treg cells

Effect of Qinghuang Powder(青黄散) Combined with Bupi Yishen Decoction(补脾益肾方) in Treating Patients with Refractory Cytopenia with Multilineage Dysplasia through Regulating DNA Methylation

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Chinese Journal of Integrative Medicine 2019年第5期25卷 354-359页

作者： ZHOU Qing-bing YANG Xiao-hong WANG Hong-zhi WANG De-xiu XU Yong-gang HU Xiao-mei XU Feng-qin ma rou National Hematological Medical Center of Traditional Chinese Medicine Department of HematologyXiyuan HospitalChina Academy of Chinese Medical SciencesBeijing(100091)China

Objective: To explore the effect of Qinghuang Powder(QHP, 青黄散) combined with Bupi Yishen Decoction(BPYS, 补脾益肾方)on myelodysplastic syndromes(MDS) patients with refractory cytopenia with multilineage dysplasia(RCMD) and determine the change of DNA methylation in MDS-RCMD patients after the treatment of Chinese medicine formula. Methods: All 308 MDS-RCMD patients were treated with QHP combined with BPYS for 2 months at least, absolute neutrophil count(ANC), hemoglobin(Hb), platelets(PLT), primitive bone marrow cells and chromosome karyotype were chosen as the main evaluation indexes to analyze the treatment effect according to criteria from the MDS International Working Group. Then 43 bone marrow samples from 15 MDS-RCMD patients and 28 healthy donors were obtained for the examination of DNA methylation.Gene Ontology(GO) and Pathway analysis were applied to analyze the methylation data. Results: The overall MDS response rate to QHP was 61.68%(190/360) including hematologic improvement-neutrophil(HI-N) or hematologic improvement-erythroid(HI-E) or hematologic improvement-platelet(HI-P). Patients with anemia had a better response rate than patients with neutropenia or thrombocypenia(55.88% vs 31.54% or 55.88%vs. 36.9%). The DNA methylation microarray analysis disclosed that 4,257 hypermethylated genes were demethylated upon the treatment with QHP and BPYS. GO analysis and Pathway analysis showed that these demethylated genes were involved in a lot of tumor-related pathways and functions. Conclusions: QHP combined with BPYS could effectively treat MDS-RCMD patients through hematologic improvement(HI-N, HI-P or HI-E)and PLT and RBC transfusion independence due to the demethylation, thereby providing another choice for the treatment of patients with MDS-RCMD.

关键词： Qinghuang Powder Bupi Yishen Decoction myelodysplastic syndromes demethylation Chinese medicine

Relation of Blood Arsenic Concentration with Effect and Safety of Arsenic-Containing Qinghuang Powder (青黄散) in Patients with Myelodysplastic Syndrome

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Chinese Journal of Integrative Medicine 2019年第7期25卷 497-501页

作者： DENG Zhong-yang ZHU Shi-rong WANG Ming-jing FANG Su ZHAO Pan ZHU Qian-zhe WANG Hong-zhi GUO Xiao-qing XU Yong-gang YI Bo-wen SHANG Xiao-hong ma rou HU Xiao-mei Department of Hematology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing (100091) China Graduate School of China Academy of Chinese Medical Sciences Beijing (100700) China Graduate School of Beijing University of Chinese Medicine Beijing (100000) China Zhengyuan Clinic of Nantong Nantong (226000) Jiangsu Province China

Objective: To investigate the relation of blood arsenic concentration (BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder (青黄散,QHP) in patients with myelodysplastic syndrome (MDS). Methods: Totally 163 patients with MDS were orally treated with QHP for 2 courses of treatment, 3 months as 1 course. The BACs of patients were detected by atomic fluoresce nee spectrophotometry at 1, 3, and 6 months during the treatment, and the effective rate, hematological improvement and safety in patients after treatment with QHP were analyzed. Results: After 2 courses of treatment, the total effective rate was 89.6%(146/163), with 31.3%(51/163) of hematological improvement and 58.3%(95/163) of stable disease. The hemoglobin increased from 73.48 ± 19.30 g/L to 80.39 ± 26.56 g/L (P0.05). Among 46 patients previously depended on blood transfusion, 28.3%(13/46) completely got rid of blood transfusion and 21.7%(10/46) reduced the volume of blood transfusion by more than 50% after treatment. The BACs were significantly increased in patients treated for 1 month with 32.17 ± 18.04 jig/L (P0.05). The adverse reactions of digestive tract during the treatment were mild abdominal pain and diarrhea in 14 cases (8.6%), and no patients discontinued the treatment. The BACs of patients with gastrointestinal adverse reactions were significantly lower than those without gastrointestinal adverse reactions (22.39 ±10.38 vs. 37.89 ± 11.84,μg/L, P<0.05). The BACs of patients with clinical effect were significantly higher than those failed to treatment (40.41 ± 11.69 vs. 23.84 ± 12.03,μg/L, P<0.05). C

关键词： myelodysplastic syndrome realgar arsenic Qinghuang Powder Chinese medicine

Antithymocyte globulin/antilymphocyte globulin plus kidney-nourishing Chinese Medicinal:effect on severe aplastic anemia

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Journal of Traditional Chinese Medicine 2012年第4期32卷 604-608页

作者： Xudong Tang Feng Liu Liu Li Chi Liu Shanshan Zhang Haiyan Xiao Chunmei Zheng Shu Xu rou ma Departmentof Hematology Xi Yuan Hospital Affiliated to China Academy of Chinese Medical Sciences

OBJECTIVE:To explore the effect of antithymocyte globulin(ATG)/antilymphocyte globulin(ALG) plus kidney-nourishing Chinese medicinal(KNCM) on severe aplastic anemia(SAA).METHODS:Twenty-five subjects of severe aplastic anemia were treated with ATG/ALD plus KNCM between 1992 and 2009,and the clinical data before and after treatment were collected and analyzed.RESULTS:Of the 25 patients,9 were nearly cured,6 were improved,5 were in remission,and 5 failed.The overall effective rate was 80.0%.The 3-year,5-year,10-year,15-year survival rate were respectively 98.6%,97.3%,97.3%,67.5%,and median survival time was 180 months.Compared to the conditions before administering the medication of ATG/ALG plus KNCM,after 2 weeks,reticulocyte was first improved(P=0.001);one month later,followed by palette(P=0.037);two months later,by neutrophil cell in peripheral blood(P=0.001);three months later,then by the hemoglobin(P=0.012).By conducting 1-year follow-up,1 case of complication-paroxysmal nocturnal hemoglobinuria(PNH) was identified and the patient still alive today.CONCLUSION:ATG/ALG plus KNCM had better effect on SAA and could improve patients' survival rate.

关键词：再生障碍性贫血淋巴细胞胸腺细胞中国医药球蛋白重型养血补肾

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免疫介导的造血抑制与骨髓衰竭

中国中西医结合杂志 2010年第3期30卷 334-336页

作者：麻柔中国中医科学院西苑医院血液病中心北京100091

再生障碍性贫血(aplastic anemia,AA,以下简称再障)是一组以造血干/祖细胞损伤、外周血全血细胞减少,临床以贫血、出血、感染为主要表现的骨髓造血功能衰竭性疾病(骨髓衰竭).先天性或遗传性骨髓衰竭的发病机制研究近年来获得不少新进展... 详细信息

再生障碍性贫血(aplastic anemia,AA,以下简称再障)是一组以造血干/祖细胞损伤、外周血全血细胞减少,临床以贫血、出血、感染为主要表现的骨髓造血功能衰竭性疾病(骨髓衰竭).先天性或遗传性骨髓衰竭的发病机制研究近年来获得不少新进展.本文主要讨论获得性再生障碍性贫血.我国再障的年发病率为7.4/105,高于欧美国家,其中急性再障(AAA)的发病率为1.4/105,慢性再障(CAA)的发病率为6.0/105.再障的发病机制有造血干/祖细胞减少或缺陷、造血微环境缺陷和免疫异常.目前再障的临床治疗,国外主要用免疫抑制剂抗胸腺球蛋白(ATG)或/和环胞菌素A(CsA)及骨髓移植,雄激素已极少应用,仅作为"补救"或"替代"治疗措施;国内主要是免疫抑制剂、雄激素和补脾肾中药.

关键词：骨髓衰竭获得性再生障碍性贫血造血抑制免疫介导骨髓造血功能衰竭全血细胞减少细胞损伤主要表现

Simulation study on cuttings transport of the backreaming operation for long horizontal section wells

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Petroleum Science 2024年第2期21卷 1149-1170页

作者： Yu-Fei Chen Hui Zhang Wen-Xin Wu Jun Li Yong Ouyang Zong-Yu Lu De-Xin ma Yong-Chuan Wu Jun-Bo Liu Ke-rou Liu Zhuo-Xin Dong China University of Petroleum(Beijing) Beijing102249China Beijing Normal University at Zhuhai Experimental and Practical Education Innovation CenterZhuhai519087GuangdongChina Oil&Gas Technology Research Institute of PetroChina Changqing Oilfield Company Xi'an710016ShaanxiChina PetroChina Xinjiang Oilfield Company Karamay834002XinjiangChina China Oilfield Services Ltd. Tianjin300459China

The backreaming operation plays a significant role in safe drilling for horizontal wellbores, while it may cause severe stuck pipe accidents. To lower the risk of the stuck pipe in backreaming operations, the mechanism of cuttings transport needs to be carefully investigated. In this research, a transient cuttings transport with multiple flow patterns model is developed to predict the evolution of cuttings transported in the annulus while backreaming. The established model can provide predictions of the distribution of cuttings bed along the wellbore considering the bulldozer effect caused by large-size drilling tools(LSDTs). The sensitivity analyses of the size of LSDTs, and backreaming operating parameters are conducted in Section 4. And a new theory is proposed to explain the mechanism of cuttings transport in the backreaming operation, in which both the bit and LSDTs have the “cleaning effect” and “plugging effect”.The results demonstrate that the cuttings bed in annuli is in a state of dynamic equilibrium, but the overall trend and the distribution pattern are obvious. First, larger diameters and longer drilling tools could lead to a higher risk of the stuck pipe. Second, we find that it is not the case that the higher flow rate is always better for hole cleaning, so three flow-rate intervals are discussed separately under the given conditions. When the “dangerous flow rate”(maller flow rate instead facilitates borehole cleaning. If the flow rate is large enough to be in the “high flow rate” interval(>35 L/s in Case 4),the higher the flow rate, the better the cleaning effect of cuttings beds. Third, an interval of tripping velocity called “dangerous velocity” is proposed, in which the cuttings bed accumulation near the LSDTs is more serious than those of other tripping velocities. As long as

关键词： Backreaming Stuck pipe Hole cleaning Transient solid transport Multiple flow patterns

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麻柔教授应用含砷中药治疗血液病的临床实践

中国中西医结合杂志 2011年第8期31卷 1138-1140页

作者：李柳麻柔中国中医科学院西苑医院血液病中心北京100091

麻柔教授从事中西医结合血液病临床及实验研究40余年,擅用中医整体观念和辨证论治治疗血液系统疑难性疾病。在应用含砷中药治疗骨髓增生异常综合征(MDS)、原发性真性红细胞增多症(CMPDPV)、原发性血小板增多症(CMPD-ET)、部分不能分类... 详细信息

麻柔教授从事中西医结合血液病临床及实验研究40余年,擅用中医整体观念和辨证论治治疗血液系统疑难性疾病。在应用含砷中药治疗骨髓增生异常综合征(MDS)、原发性真性红细胞增多症(CMPDPV)、原发性血小板增多症(CMPD-ET)、部分不能分类骨髓增生异常综全征/骨髓增殖性疾病及除急性早幼粒细胞白血病以外的其他类型的急性非淋巴细胞白血病中进行了大胆创新与探索,对某些病种的治疗积累了较成熟的经验,部分虽处于探索阶段,但已初步显示出良好的效果。

关键词：麻柔含砷中药血液病治疗

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砷剂治疗骨髓增生异常综合征进展

中国中西医结合杂志 2009年第1期29卷 83-84页

作者：徐述麻柔中国中医科学院西苑医院北京100091

骨髓增生异常综合征(MDS)是一组源于造血干/祖细胞的恶性克隆性疾病,是长期积累的多重突变作用于造血干/祖细胞,造成以骨髓无效造血、难治性多系血细胞减少、高风险向急性白血病转化为特征的恶性血液病。MDS的发病率1976—1990年间从1/1... 详细信息

骨髓增生异常综合征(MDS)是一组源于造血干/祖细胞的恶性克隆性疾病,是长期积累的多重突变作用于造血干/祖细胞,造成以骨髓无效造血、难治性多系血细胞减少、高风险向急性白血病转化为特征的恶性血液病。MDS的发病率1976—1990年间从1/10万增加到4·1/10万,1991—2001年发病率约为4·9/10万,这种发病率的增高主要反映了诊断水平的提高。MDS呈异质性,在疾病的发生发展过程中异常克隆造血逐步替代正常造血,病变累及骨髓多个系列。鉴于MDS的难治性,2000年MDS国际工作组提出,MDS的治疗目标是提高血细胞数量和保持较好的生活质量。中药砷剂在恶性血液病的应用已多年,砷剂中的砒霜——亚砷酸治疗急性早幼粒细胞白血病取得良好疗效;砷剂中的雄黄-硫化砷在我科应用治疗恶性血液病已有50余年的历史。由其组成的方剂——青黄散最初治疗慢性粒细胞白血病取得了较好的疗效,后扩大应用范围用于治疗急性早幼粒细胞白血病及MDS,亦取得了不错的疗效。现就砷剂治疗MDS的概况做一简要综述。

关键词：骨髓增生异常综合征砷剂治疗造血干/祖细胞恶性克隆性疾病年发病率血细胞减少恶性血液病白血病转化