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Adding cyclosporin A to eltrombopag for aplastic anemia secondary to chemotherapy for solid cancers

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Chinese Medical Journal 2023年第9期136卷 1120-1122页

作者： Ziqi Wan Yang Chen Junling Zhuang Miao Chen Shuyang Zhang Bing Han Department of Hematology Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China eight-year program of clinical medicine M.D.ProgramDepartment of Clinical MedicinePeking Union Medical CollegeBeijing 100005China Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical ScienceBeijing 100730China

To the Editor:Myelosuppression is one of the most common side effects of chemotherapy.Some patients would develop long-lasting aplastic anemia(AA)even after stopping chemotherapy for over three months,due to persistent destruction of the bone marrow.As a thrombopoietin-receptor agonist,eltrombopag(EPAG)has been widely used in patients with thrombocytopenia from various origins,[1]including those with AA secondary to chemotherapy.However,both EPAG and cyclosporin A(CsA)have been reported to possibly induce the expansion of abnormal clones or controversially increase the risk of neoplasms.[2]Thus,the challenge was to treat severe cytopenia while preventing cancer relapse.Our study reported the efficacy and safety of EPAG with or without CsA for patients with AA secondary to chemotherapy,in an attempt to find solutions to these difficulties.

关键词： anemia chemotherapy cyclosporin

Humanity factors and more: A little heads up for medical students and future doctors

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Journal of Medical Colleges of PLA(China) 2013年第1期28卷 29-31页

作者： CHANG Yifan The eight-year program on clinical medicine Second Military Medical University

Exactly how can we become a successful doctor in the future? It has been widely accepted that chasing perfection in our field of expertise alone is not enough. Here in China, doctors have the liability to do more. Chinese doctors are relatively more prone to confronting difficult situations in a more complex manner. Therefore, the humanity factor in medical practice is discussed, and some essential communication skills are suggested for medical practitioners, with heartfelt anticipation for a better medical environment as well as a more pleasant Doctor-Patient relationship.

关键词：医疗环境医生人性因素学生小脑专业知识人文因素中国

Insight into Crosstalk Between Mitophagy and Apoptosis/Necroptosis:Mechanisms and clinical Applications in Ischemic Stroke

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Current Medical Science 2022年第2期42卷 237-248页

作者： Yan-di YANG Zi-xin LI Xi-min HU Hao WAN Qi ZHANG Rui XIAO Kun XIONG Department of Anatomy and Neurobiology School of Basic Medical ScienceCentral South UniversityChangsha 410013China Clinical Medicine Eight-Year Program 03 Class18 GradeXiangya School of MedicineCentral South UniversityChangsha 410013China Clinical Medicine Eight-Year Program 02 Class17 GradeXiangya School of MedicineCentral South UniversityChangsha 410013China Administrative Office the Third Xiangya HospitalCentral South UniversityChangsha 410013China Hunan Key Laboratory of Ophthalmology Changsha 410008China Key Laboratory of Emergency and Trauma Ministry of EducationCollege of Emergency and TraumaHainan Medical UniversityHaikou 571199China

Ischemic stroke is a serious cerebrovascular disease with high morbidity and mortality.As a result of ischemia-reperfusion,a cascade of pathophysiological responses is triggered by the imbalance in metabolic supply and demand,resulting in cell loss.These cellular injuries follow various molecular mechanisms solely or in combination with this disorder.Mitochondria play a driving role in the pathophysiological processes of ischemic stroke.Once ischemic stroke occurs,damaged cells would respond to such stress through mitophagy.Mitophagy is known as a conservatively selective autophagy,contributing to the removal of excessive protein aggregates and damaged intracellular components,as well as aging mitochondria.Moderate mitophagy may exert neuroprotection against stroke.Several pathways associated with the mitochondrial network collectively contribute to recovering the homeostasis of the neurovascular unit.However,excessive mitophagy would also promote ischemia-reperfusion injury.Therefore,mitophagy is a double-edged sword,which suggests that maximizing the benefits of mitophagy is one of the direction of future efforts.This review emphasized the role of mitophagy in ischemic stroke,and highlighted the crosstalk between mitophagy and apoptosis/necroptosis.

关键词： mitophagy ischemic stroke apoptosis necroptosis clinical application crosstalk

Investigations and thoughts of the ethics in genetic discrimination

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中国人民解放军军医大学学报：英文版 2013年第1期28卷 46-53页

作者： DUAN Guoli ZHAI Xiao HE Qianyun LI Junqiang LIU Jie ZHANG Yan The eight-year program on clinical medicine Second Military Medical University Department of Foreign Languages Second Military Medical University

A questionnaire research in ethics was conducted to get the view of students of medical universities in Shanghai on genomics and genetic discrimination. We find that 66% respondents indicated their willingness to understand the genetic information and 79% of respondents mind their own genetic information be aware of by other people. In contrast, 77% of the respondents believe that medical organization are not able to protect personal genetic information from disclose. Hence, it is significant to take some measures to preserve citizen's genetic information privacy. Depending on our results, we put forward our suggestion to this problem.

关键词：基因歧视道德遗传信息医学院校基因组学问卷调查信息披露医疗机构

Military Surgeon and Humanity

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校园英语 2015年第19期 254-255页

作者： LU Lu WANG Yiran Foreign Languages Department Second Military Medical University The eight-year program of clinical medicine Second Military Medical University

Military surgeons are a special group of doctors.They are both medical workers and soldiers.Their mission is to serve the wounded on the battlefield.And there is no doubt that military surgeons will save our comrades in the army.However,should a military surgeon save the wounded enemy?It is indeed a dilemma.Some may save the wounded enemy because military surgeons are doctors after all and they can’t possibly abandon anybody to his fate,but some refuse to do so because military surgeons are soldiers.Therefore,some situations on the battlefield are discussed and advice is suggested for military surgeons,with heartfelt anticipation for there being less casualties on the battlefield as well as alleviating human suffering caused by war.

关键词： Military surgeon Humanity Wounded enemy Geneva Conventions

HMGB1/RAGE axis mediate stress-induced RVLM neuroinflammation in mice via impairing mitophagy flux in microglia.

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HMGB1/RAGE axis mediate stress-induced RVLM neuroinflammatio...

Facing pressure: How should medical students or future doctors do?

2019中国生理学会学术年会暨张锡钧基金第十五届全国青...

作者：张书田 Chunmei Xia clinical medicine (eight-year program) Shanghai Medical CollegeFudan University Department of Physiology and Pathophysiology School of Basic Medical ScienceFudan University

Objective: Neuroinflammation-sympathetic overactivation coupling in rostral ventrolateral medulla（RVLM） is involved in the pathogenesis of stress-induced hypertension（SIH）.Highmobility group box-1（HMGB1） acts as a regulator of autophagy and initiates the production of proinflammatory cytokines（PICs）.Here, the potential mechanism of HMGB1/RAGE axis mediating inflammatory phenotype（M1 polarization） in microglia was explored.Methods: The stressed mice were subjected to intermittent electric foot-shocks plus noises administered for 2 h twice daily for15 consecutive day.Blood pressure（BP） and renal sympathetic nerve activity（RSNA） were monitored by microinjection siRNA-HMGB1（siHMGB1） into the RVLM of mice.mRFP-GFPtandem fluorescent LC3（tf-LC3） vectors were transfected into RVLM to evaluate the process of autophagic flux.Increased autophagosomes and/or reduced lysosomal degradation will result in autophagic flux impairment.Mitophagy was identified by transmission electron microscopic observation or by checking LC3 and Mito-Tracker co-localization under confocal microscopy.Results: The results showed chronic stress increased cytoplasmic translocations of HMGB1 and upregulation of its receptor RAGE expression in microglia.siHMGB1 in RVLM resulted in reduced M1 polarization and lowered BP in SIH mice.Stress induced mitochondria disruption, oxidative stress and M1 polarization, which were attenuated in microglia-specific deletion RAGE mice（CreCX3 CR1/RAGEfl/fl mice）.HMGB1/RAGE axis increased stress-related mitophagy initiation while impaired the late stages of mitophagy flux in microglia, as revealed by decreased GFP fluorescence quenching of GFP-RFP-LC3-II puncta and decreased co-localization of lysosomes with mitochondria.The expression of RAB7, the autophagosomes-lysosome fusion promoting protein,and lysosomal-associated membrane protein 1（LAMP1）, were decreased in the stressed-microglia,while knockout of RAGE-/-in microglia rescued this effect and increased acidation of lysosome.When facilitated the mitophagy flux by u

关键词： microglia stress hypertension mitochondria High mobility group box 1 RAGE autophagy neuroinflammation

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Journal of Medical Colleges of PLA(China) 2013年第4期28卷 252-256页

作者： HAO Lu ZHU Deyuan ZHU Weiye ZHANG Yan The eight-year program on clinical medicine Second Military Medical University Department of Foreign Languages Second Military Medical University

On April 1st2013,HUANG Yang,a medical master student in Fudan University,was poisoned by his roommate,LIN Senhao.Unfortunately,HUANG died 15 days later.It’s quite a shock to the whole society.We have to reconsider our education,and our expectancy to doctors.We have to ask ourselves"How to become a qualified doctor?"Learn to release the pressure from studies and lives;learn to defend ourselves from danger.Is it enough?No!Whatever happened,never do harm to others.Medical humanity is the most important thing we should always remember.

关键词：释放压力医学院医生学生硕士研究生复旦大学

Celastrol attenuates pulmonary ischemia reperfusion injury in cardiopulmonary bypass via mitigating ER stress and inducing autophagy depend on Sirt1 activation in rat model.

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Celastrol attenuates pulmonary ischemia reperfusion injury i...

Diagnostic accuracy and safety of Dermatophagoides pteronyssinus extracts used for skin prick test

2019中国生理学会学术年会暨张锡钧基金第十五届全国青...

Objective: Cardiopulmonary bypass（CPB） carries a risk of lung ischemia reperfusion, leading to acute lung injury（ALI）.It is well known that abundant ROS production, overloaded calcium,exhausted ATP and acidosis in pulmonary epithelial cells induced by ischemia and reperfusion（I/R）result in endoplasmic reticulum stress（ERS） associated autophagy, which eventually cause lung injury.Silent information regulator 1（Sirt1） is a sort of histone deacetylase, which has the function of dual-directional control of autophagy.Studies suggest that the overexpression of Sirt1 in lung I/R can inhibit the level of ERS.Celastrol, a major active constituent of Tripterygium wilfordii with antioxidant, anti-inflammatory and autophagy-modulatory effects, has been shown to protect against ischemia/reperfusion（I/R） injury.This study aimed to investigate the protective effects of celastrol on alveolar tissue injury during cardiopulmonary bypass and to further explore whether its mechanism of action was associated with Sirt1-regulated ERS and autophagic level.Materials and methods: SD adult male rats were used, weighing 200-300 g.The rats were randomly divided into three groups: sham group, cardiopulmonary bypass（CPB） group, CPB + celastrol group, CPB +celastrol+EX 527（Sirt 1 antagonist） group and CPB + celastrol+SRT1720（Sirt 1 agonist） group（n=10 in each group）.Rats were subjected to CPB under anesthesia for 60 min.Celastrol（5 mg/kg）was administered via arterial inflow.The indexes of dynamic pulmonary function, including expiratory resistance（Re）, inspiratory resistance（Ri） and dynamic compliance（Cdyn） were recorded by using the plethysmographic measurement system.The wet weight（W）, and post-4 hours drying wet（D） of the lung was weighed.The total lung weight（TLW） and the wet and dry ratio（W/D） were calculated.The lung injury and pathological morphology were observed by HE staining under light microscope.The expression and localization of Sirt1, ERS marker GRP78 and autophagic marker LC3 in lung tissue were detected by immunohistochemistry

关键词： Celastrol Pulmonary ischemia reperfusion injury Cardiopulmonary bypass ER stress Autophagy Sirt1

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Chinese Medical Journal 2022年第21期135卷 2563-2569页

作者： Rui Tang Xiaohong Lyu Yuxi Liu Ruiqi Wang Lianglu Wang Hong Li Jinlyu Sun Yuxiang Zhi Jianqing Gu Kai Guan Liping Wen Zixi Wang Lisha Li Le Cui Yingyang Xu Junxiong Zhou Tao Xu Jia Yin Department of Allergy Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic DiseasesNational Clinical Research Center for Dermatologic and Immunologic DiseasesPeking Union Medical College HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100730China eight-year program of clinical medicine Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100730China Department of Statistics Institute of Basic Medical SciencesChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100730China

Background:Dermatophagoides pteronyssinus is a common allergen causing allergic diseases in China.The aim of this study was to evaluate the efficacy and safety of D.pteronyssinus extracts produced by Peking Union Medical College Hospital(PUMCH)for the skin prick test(SPT)in the diagnosis of D.pteronyssinus allergy.Methods:A total of 910 subjects with allergic diseases were prescribed D.pteronyssinus SPT and specific sIgE(sIgE)test among the Outpatients of Department of Allergy,PUMCH from August 10,2015 to August 30,2017.Receiver operating characteristic curve(ROC)analysis was performed according to the results of D.pteronyssinus-sIgE detection.The accuracy of D.pteronyssinus extracts used for SPT in the diagnosis of D.pteronyssinus allergy was evaluated under different cutoff values.Adverse events after SPT were recorded to evaluate safety.Results:There were 796 and 618 subjects in the full analysis set(FAS)and the per protocol set(PPS),respectively.The areas under the curve of FAS and PPS were 0.871 and 0.873,respectively.According to the ROC of PPS,the optimal and 95%specificity diagnostic cutoff values of D.pteronyssinus SPT mean wheal diameter were 3.25 and 3.75 mm,respectively.No adverse events occurred.Conclusion:The extracts of D.pteronyssinus for SPT were simple,highly accurate,and safe and should be considered for recommendation in the clinical diagnosis of D.pteronyssinus allergy.

关键词： Dermatophagoides pteronyssinus Allergen extract allergy Skin prick test Immunoglobulin E Allergy