β-CTX、t-P1NP及N-MID-OT在绝经后女性骨质疏松性骨折风险评估中的应用

目的探讨β胶原特殊序列(β-crosslaps,β-CTX)、总1型胶原氨基端延长肽(t-P1NP)及N端中段骨钙素(N-MID-OT)在绝经后女性骨质疏松性骨折风险评估中的应用价值。方法回顾性分析2020年2月至2022年12月解放军总医院第六医学中心收治的102例绝经后骨质疏松(postmenopausal osteoporosis,PMOP)患者的临床资料,将其作为研究组,并根据是否发生骨折将其分为PMOP骨折组(39例)与PMOP未骨折组(63例),另选100名健康体检者作为对照组。记录所有研究对象的β-CTX、t-P1NP及N-MID-OT水平并进行比较,用ROC曲线评价β-CTX、t-P1NP及N-MID-OT在绝经后女性骨质疏松性骨折风险评估中的应用价值。结果研究组的平均体重、体质量指数、股骨颈骨密度(bone mineral density,BMD)、左髋总和BMD及L 1~4总和BMD均明显低于对照组(P<0.05);而两组研究对象的平均年龄、平均身高及绝经年龄等比较差异均无统计学意义(P>0.05)。研究组的β-CTX、t-P1NP及N-MID-OT均明显高于对照组(t值依次为12.688、37.430、26.599,P<0.05)。β-CTX+t-P1NP+N-MID-OT联合检测用于预测PMOP的AUC值为0.978,敏感度为98.04%,特异度为97.00%,表明β-CTX+t-P1NP+N-MID-OT三指标联合检测用于预测PMOP的效能更高。PMOP骨折组的β-CTX、t-P1NP及N-MID-OT均明显高于PMOP未骨折组(t值依次为6.078、16.363、12.227,P<0.05)。β-CTX+t-P1NP+N-MID-OT联合检测用于评估PMOP骨折风险的AUC值为0.939,敏感度为94.87%,特异度为95.24%,表明β-CTX+t-P1NP+N-MID-OT联合检测用于评估PMOP骨折风险的效能更高。结论PMOP患者β-CTX、t-P1NP及N-MID-OT水平均明显升高,而PMOP骨折患者β-CTX、t-P1NP及N-MID-OT水平升高更为明显,且β-CTX+t-P1NP+N-MID-OT联合检测可显著提高对PMOP预测及骨折风险评估效能,值得借鉴。

血液高RDW和高N-MID OC/β-CTX比值在老年女性椎体骨折中的诊断价值

目的 探讨血液红细胞分布宽度(RDW)及骨钙素N段中分子片段(N-MID OC)/Ⅰ型胶原羧基端肽β特殊序列(β-CTX)比值联合检测对老年女性骨质疏松椎体骨折(OPVF)的诊断价值。方法 纳入2021年1月—2021年12月我院≥60岁女性骨质疏松住院患者786例,分为无骨折组(A组,378例)和OPVF组(B组,388例)。N-MID OC、β-CTX、NMID-OC/β-CTX比值、红细胞计数(RBC)、红细胞压积(HCT)、血红蛋白(Hb)、红细胞平均体积(MCV)、平均血红蛋白浓度(MCHC)、平均血红蛋白量(MCH)、红细胞分布宽度(RDW-CV)、钙(Ca)、磷(P)及镁(Mg)。结果 与A组相比,B组Ca、P、Hb、HCT、MCV、MCH、MCHC含量降低,RDW-CV、N-MID OC/β-CTX含量增加,差异有统计学意义(均P<0.05)。OPVF与β-CTX、Ca、P呈负相关,与RDW-CV、N-MID OC/β-CTX呈正相关(均P<0.05)。骨折患者RDW与N-MID OC、β-CTX、Ca、P、Mg呈负相关(均P<0.05)。RDW、N-MID-OC/β-CTX为OPVF的风险因素(均P<0.05),OR分别为1.38、1.005。二者含量越高,椎体骨折风险越高,最高层是最低层的约3倍和2倍,OR为2.818,1.734。二者联合检测可提高对OPVF的诊断性能,其AUC敏感性、特异性、阳性预示值、阴性预示值分别为0.64、42.78%、82.01%、70.9%、58.3%。结论 血液高RDW和高N-MID OC/β-CTX比值与老年女性骨质疏松性椎体骨折明显相关,是其危险因素,可用于辅助诊断及预测其发生。

UPLC-Q-TOF/MS-based metabolomics reveals modulatory effects of Mesona chinensis Benth polysaccharide in liver injury mice induced by cyclophosphamide

The main purpose of this study was to investigate the improvement effect of Mesona chinensis Benth polysaccharide(MP)on cyclophosphamide(CTX)induced liver injury in mice.To explore metabolic profile of liver tissue and feces among normal group,CTX-induced group and MP management group based on metabolomics method by using UPLC-Q-TOF/MS.The results showed that MP could alleviate liver injury and promote the production of short chain fatty acids(SCFAs),with the best dose of 200 mg/kg·body weight(bw).The principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLSDA)scores plots of the liver and feces samples showed a clear separation among normal,model and highdose of MP(MPH).There were 18 endogenous metabolites in liver and 29 endogenous metabolites in feces,which were mainly involved in 8 metabolic pathways:taurine and hypotaurine metabolism,phenylalanine metabolism,α-linolenic acid metabolism,tricarboxylic acid(TCA)cycle,phenylalanine,tyrosine and tryptophan biosynthesis,arachidonic acid metabolism,sphingolipid metabolism as well as tryptophan metabolism.Moreover,a common metabolite arachidonic acid was observed in liver and feces samples.These endogenous metabolites may be considered to be MP’s response to liver protection.It will help to further understand the mechanism of MP and provide a basis for further research.

Treatment outcome analysis of bevacizumab combined with cyclophosphamide and oxaliplatin in advanced pseudomyxoma peritonei

BACKGROUND Pseudomyxoma peritonei(PMP)is a rare peritoneal malignant tumor syndrome.Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy is its standard treatment.However,there are few studies and insufficient evidence regarding systemic chemotherapy of advanced PMP.Regimens for colorectal cancer are often used clinically,but there is no uniform standard for late-stage treatment.AIM To determine if bevacizumab combined with cyclophosphamide and oxaliplatin(Bev+CTX+OXA)is effective for treatment of advanced PMP.The primary study endpoint was progression-free survival(PFS).METHODS Retrospective analysis was conducted on the clinical data of patients with advanced PMP who received Bev+CTX+OXA regimen(bevacizumab 7.5 mg/kg ivgtt d1,oxaliplatin 130 mg/m2 ivgtt d1 and cyclophosphamide 500 mg/m2 ivgtt d1,q3w)in our center from December 2015 to December 2020.Objective response rate(ORR),disease control rate(DCR)and incidence of adverse events were evaluated.PFS was followed up.Kaplan-Meier method was used to draw survival curve,and log-rank test was used for comparison between groups.Multivariate Cox proportional hazards regression model was used to analyze the independent influencing factors of PFS.RESULTS A total of 32 patients were enrolled.After 2 cycles,the ORR and DCR were 3.1%and 93.7%,respectively.The median follow-up time was 7.5 mo.During the follow-up period,14 patients(43.8%)had disease progression,and the median PFS was 8.9 mo.Stratified analysis showed that the PFS of patients with a preoperative increase in CA125(8.9 vs 2.1,P=0.022)and a completeness of cytoreduction score of 2-3(8.9 vs 5.0,P=0.043)was significantly longer than that of the control group.Multivariate analysis showed that a preoperative increase in CA125 was an independent prognostic factor for PFS(HR=0.245,95%CI:0.066-0.904,P=0.035).CONCLUSION Our retrospective assessment confirmed that the Bev+CTX+OXA regimen is effective in second-or posterior-line treatment of advanced PMP and that adverse reactions can be tolerated.A preoperative increase in CA125 is an independent prognostic factor of PFS.

广东省腹泻仔猪大肠杆菌blaCTX-M-65与mcr-1基因共传播特征

【目的】调查分析广东省某生猪养殖场腹泻仔猪的大肠杆菌耐药情况以及同时携带blaCTX-M-65与mcr-1两种耐药基因的阳性大肠杆菌的分子特征与其共同传播特征,为耐药性监测及风险防控提供科学依据。【方法】从广东省肇庆市某生猪养殖场采集腹泻仔猪直肠棉拭子样品90份,并进行大肠杆菌分离鉴定;采用PCR方法检测产超广谱β-内酰胺酶(ESBLs)与mcr-1基因,通过测序确定CTX-M亚型;采用琼脂二倍稀释法和微量肉汤稀释法测定分离菌对12种抗菌药物的最小抑菌浓度(MIC);使用脉冲场凝胶电泳(PFGE)及多位点序列分型(MLST)分析菌株间的遗传背景;通过接合转移方法确定质粒水平转移的能力;使用复制子分型、S1-PFGE、Southern blotting方法检测质粒类型、耐药基因的定位及定位质粒的大小;通过三代测序及序列分析确定质粒的重组过程。【结果】共分离鉴定86株大肠杆菌,检测到44株携带CTX-M型ESBLs基因,其中blaCTX-M-55基因最流行(n=16,36.4%),其次是blaCTX-M-65(n=10,22.7%)、blaCTX-M-27(n=8,18.2%)、blaCTX-M-15(n=5,11.4%),还检测出blaCTX-M-79(n=2,4.5%)、blaCTX-M-14(n=2,4.5%)和blaCTX-M-24(n=1,2.3%)。10株blaCTX-M-65基因阳性菌有8株同时携带mcr-1基因。这8株大肠杆菌均表现为多药耐药,包括氨苄西林、阿莫西林、头孢噻呋、头孢喹肟、黏菌素等多种抗生素。8株菌共分为6种ST型、7个PFGE谱型。接合转移试验发现,有6株菌的blaCTX-M-65和mcr-1基因发生了共转移,且blaCTX-M-65与mcr-1基因均位于IncHI2型(253 kb)质粒上。其中1株菌在接合转移的过程中,其所携带的一个253 kb IncHI2质粒与一个69 kb IncFⅡ质粒发生融合,形成一个大小323 kb的融合质粒。对融合质粒进行三代测序解析,结果表明,在接合转移的过程中IS26介导了两个不同大小质粒的重组。【结论】IncHI2质粒是介导blaCTX-M-65和mcr-1基因共同传播的主要媒介,IS26通过与靶位点GTTTCACT的整合导致IncHI2质粒与IncFⅡ质粒融合。质粒重组扩大了大肠杆菌的耐药谱,加速了耐药基因的传播,促使多药耐药现象更严重,对公共卫生安全构成威胁,本研究为阐明多重耐药大肠杆菌的传播机制提供了参考依据。

新疆维吾尔自治区塔额垦区牛源大肠杆菌耐药性、CTX-M基因携带情况与毒力基因检测

[目的]了解新疆维吾尔自治区塔额垦区牛源大肠杆菌耐药性及CTX-M基因和毒力基因携带情况。[方法]从塔额垦区某牛场采集16份牛腹泻粪样,通过选择性培养、革兰染色镜检、16S rDNA PCR扩增及测序进行大肠杆菌分离鉴定。利用PCR法对牛源大肠杆菌分离株进行分子分型(系统发育群和脂多糖核心型)以及耐药基因、CTX-M基因亚型、毒力基因检测;分别使用K-B纸片法、CTX与TCL双纸片法进行药物敏感性试验和产ESBLs大肠杆菌鉴定;采用结晶紫染色法半定量检测菌株的生物被膜形成能力。[结果]根据菌落生长特征、革兰染色特性及16S rDNA测序结果,从16份牛腹泻粪样中分离鉴定出16株大肠杆菌,分离率为100%;系统发育群主要为B1群(14/16,87.50%),脂多糖核心型多为R1型(15/16,93.75%)。分离菌株对青霉素、利福平、复方新诺明表现出较强耐药性,耐药率分别为100%、68.75%、68.75%;对多黏菌素、替加环素、美罗培南敏感,耐药率均为0;有12株(75.00%)具有多重耐药表型;有11株(68.75%)产ESBLs;有15株(93.75%)可形成生物被膜。16株大肠杆菌中共检出17种耐药基因,CTX-M、ant(6′)、sul1等8种耐药基因的检出率为100%;有14株(87.50%)为CTX-M-1G基因亚型;共检出12种毒力基因,iroN、ompA、yijP等5种毒力基因的检出率为100%。[结论]新疆维吾尔自治区塔额垦区牛源大肠杆菌CTX-M基因检出率较高,携带多种耐药基因和毒力基因,耐药性较强,对该地区牛健康养殖存在潜在威胁,应加强该地区CTX-M型大肠杆菌的流行情况监控。

Moxibustion at ST36 activates peritoneal macrophages in CTX-induced immunosuppression in mouse model via IFN-γ

Background:To explored whether moxa cone moxibustion can reduce peritoneal inflammation by increasing the content of peritoneal macrophages and B cells via interferon-gamma.Methods:The mice were randomly divided into three groups with six mice in each group:the control group,model group,and moxibustion group,and the model was established in mice using cyclophosphamide.In the moxibustion group,the mice received moxa cone moxibustion at Zusanli(ST36)for 7 days.Analysis of Peritoneal cell were detected by flow cytometry and immunofluorescence,the protein expression level in the peritoneal fluid were measured with mouse cytokine antibody arrays and verified by enzyme linked immuno sorbent assay test,and RNA-Sequencing was used for peritoneal cell RNA analysis.Results:Our results showed that moxa cone moxibustion could reduce the loss of large peritoneal macrophages and B1 cells(P<0.05).With the cytokine array analysis and enzyme linked immuno sorbent assay test of peritoneal fluid,we found that IFN‐γwas up-regulated in moxibustion group(P<0.05).There were 169 genes were down-regulated in the model group and up-regulated in the moxibustion group while 19 genes that were up-regulated in the model group and down-regulated in the moxibustion group via RNA-sequencing.Kyoto Encyclopedia of Genes and Genomes pathway analysis of 188 intersect differentially expressed genes were found that the top 3 pathways with the highest enrichment of up-regulated genes included Hematopoietic cell lineage,Inflammatory bowel disease and Malaria.The differentially expressed genes visualization protein-protein interaction network shows the top 10 genes including Ifng,Grb2,CCR7,CTLA4,CXCR5,Foxp3,kit,PRF1,CD5 and klrg1.Conclusion:These findings showed that moxa cone moxibustion can alleviate chemotherapy-induced diarrhea by reducing the loss of large peritoneal macrophages and B1 cells in the peritoneal cavity,possibly through up-regulating inflammatory bowel disease signaling pathway via interferon-gamma to regulate the survival and function of large peritoneal macrophages and B1 cells.

Effect of Rituximab Versus Mycophenolate Mofetil or Cyclophosphamide as Control in Lupus Nephritis:A Meta-Analysis

Objective:To evaluate the effects of rituximab versus mycophenolate mofetil or cyclophosphamide as control in lupus nephritis by meta-analysis.Methods:A systematic search was carried out up to January 2022,obtaining 7 studies involving 645 participants with lupus nephritis at the commencement of the investigation;198 of them were treated with rituximab,while 447 were treated with mycophenolate mofetil or cyclophosphamide.We determined the odds ratio(OR)and mean difference(MD)with 95%confidence index(CI)to compare rituximab’s efficacy to that of mycophenolate mofetil or cyclophosphamide as control in lupus nephritis using random-or fixed-effects model by dichotomous or continuous techniques.Results:The rituximab group showed significantly higher complete renal remission rate(OR=2.52;95%CI 1.30-4.91,P=0.006)and total renal remission rates(OR=2.22;95%CI 1.36-3.63,P=0.001)than the control group.However,there was no significant difference in terms of end Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score(MD-1.16;95%CI-2.88-0.57,P=0.19),proteinuria(MD-0.31;95%CI-0.70-0.09,P=0.013),and serum creatinine(MD 0.01;95%CI-0.04-0.07,P=0.64)between the rituximab group and the control.Conclusion:Rituximab exhibited significantly greater complete renal remission rate and total renal remission rates,with no significant difference in terms of shorter-end SLEDAI,proteinuria,and serum creatinine,compared with the control in individuals with lupus nephritis.

经皮椎体后凸成形术治疗椎体压缩性骨折瘦素、脂联素及CTX-Ⅰ水平分析

目的 探讨经皮椎体后凸成形术(PKP)治疗椎体压缩性骨折瘦素、脂联素及Ⅰ型胶原蛋白C末端异物肽(CTX-Ⅰ)水平。方法 选取2019年6月至2022年5月南京中医药大学附属南京市中西医结合医院收治的92例椎体压缩性骨折患者为研究对象,根据治疗方式的不同分为对照组45例[予经皮椎弓根螺钉内固定术(PPSF)]、观察组47例(予PKP治疗);比较两组瘦素、脂联素和CTX-Ⅰ水平、分析观察组不同临床特征与病理特征的瘦素、脂联素和CTX-Ⅰ水平、采用多元Logistic回归分析影响观察组瘦素、脂联素和CTX-Ⅰ水平的危险因素,比较两组临床疗效及并发症情况。结果 观察组血清瘦素水平高于对照组,脂联素和CTX-Ⅰ水平均低于对照组,差异具有统计学意义(P<0.05);观察组不同年龄段、有无骨折病史、术前骨折椎体数和术中骨水泥量之间瘦素水平比较差异有统计学意义(P<0.05);不同性别、不同年龄段、有无骨折病史和术中骨水泥量之间脂联素水平比较差异有统计学意义(P<0.05);不同性别、不同年龄段、有无骨折病史和术中骨水泥量之间CTX-Ⅰ水平比较差异有统计学意义(P<0.05);经多元Logistic回归分析可知,女性、年龄>62岁、有骨折病史、术前骨折椎体数≥2个及术中骨水泥量使用1~5 mL为影响瘦素、脂联素和CTX-Ⅰ水平的危险因素(P<0.05);观察组临床总有效率(95.74%)高于对照组(82.22%),差异具有统计学意义(P<0.05);观察组并发症总发生率(2.13%)比对照组(13.33%)低,差异具有统计学意义(P<0.05)。结论 经PKP治疗能有效提高椎体压缩性骨折患者的临床疗效,有效改善患者血清瘦素、脂联素及CTX-Ⅰ水平,通过检测上述三指标水平可对PKP术后治疗提供参考依据。

Immune enhancement effect of an herb complex extract through the activation of natural killer cells and the regulation of cytokine levels in a cyclophosphamide-induced immunosuppression rat model

Objective: To investigate the effects of a herb complex extract(HCE) prepared from Cornus officinalis Sieb. Et Zucc., Eriobotrya japonica Lindley, and olive leaves on immune response of mouse spleen NK cells in vitro and in vivo analysis. Methods: The activity of natural killer(NK) cells was measured in splenocytes and YAC-1 cells. Mice were immunosuppressed using cyclophosphamide(5 mg/kg body weight). Three different doses of HCE(200, 400, and 800 mg/kg body weight) and red ginseng extract(800 mg/kg body weight) which was used as standard immunomodulatory herb were administered orally for 4 weeks. The body weight, dietary, water intake, organs(liver, thymus, and spleen) weight, completed blood count, and cytokines(tumor necrosis factor alpha, interferon gamma, and interleukin-2) production was measured. Results: At the maximum concentration of HCE, the activity of NK cells was increased by 48.5%. HCE increased liver, spleen, and thymus weights without altering numbers of white blood cells, lymphocytes, and neutrophils in a cyclophosphamide-induced immunosuppression rat model. However, HCE recovered the inhibited cytokine expression; HCE(800 mg/kg) increased cytokines levels. The results indicate the immune enhancement potential of this HCE. Conclusion: The HCE enhances immunity by increasing NK cell activity, regulating cytokine levels, and maintaining spleen weight. Therefore, it may be used as a potential immunity enhancer.

Nephroprotective effect of Murraya koenigii on Cyclophosphamide induced nephrotoxicity in rats

Objective: To evaluate the nephroprotective effect of defatted mehtanolic extract and aqueous extract of Murraya koenigii against Cyclophosphamide drug. Methods: Nephrotoxicity was induced by Cyclophosphamide in 7 d at 150 mg/kg body weight through intraperitoneal route in rat model. Nephroprotective activity of Murraya koenigii(M. koenigii) extract(100 mg/kg and 200 mg/kg in intraperitoneal route) was measured, including nephrological source, oxidative stress parameters like superoxide dismutase, glutathione, the lipid peroxide and in vivo assay like blood urea nitrogen, creatinine were determined and analyzed by One way analysis of variance followed by Tukey's test. Results: The study result showed that important phytochemicals such as carbohydrates, flavonoids, tannin, alkaloids, glycosides, protein and steroids were found to be present in the extract of M. koenigii. The renal function markers like blood urea nitrogen and ceatinine level were found to be decreased significantly by M. koenigii extract treatment. A significant difference was found to be at P<0.01. Conclusions: The present study reveals the protective role of M. koenigii extract against Cyclophosphamide induced nephrotoxicity.

Sesamol Alleviates the Cytotoxic Effect of Cyclophosphamide on Normal Human Lung WI-38 Cells via Suppressing RAGE/NF-κB/Autophagy Signaling

Cyclophosphamide(CYL)is a chemotherapeutic medication commonly used in managing various malignancies like breast cancer or leukemia.Though,CYL has been documented to induce lung toxicity.Mechanism of CYL toxicity is through oxidative stress and the release of damage-associated molecular patterns(DAMPs).Sesamol(SES)is a natural antioxidant isolated from Sesamum indicum and its effect against CYL-induced lung toxicity is not studied yet.This study aims to inves-tigate whether SES could prevent any deleterious effects induced by CYL on lung using normal human lung cells,WI-38 cell line,without suppressing its efficacy.Cells were pretreated with SES and/or CYL for 24 h,then cell viability was estimated by MTS and trypan blue assays.The mode of cell death was determined by AO/EB staining.Additionally,caspase-3 level,oxidative stress,and inflammatory markers were evaluated by colorimetric and ELISA techniques.qRT-PCR was performed to evaluate RAGE,NF-κB,and Beclin-1 mRNA-expression.CYL-treated WI-38 cells developed a significantly increased cell death with enhanced oxidative and RAGE/NF-κb/Autophagy signaling,which were all attenuated after pretreatment with SES.Thus,we concluded that SES offered a protective role against CYL-induced lung injury via suppressing oxidative stress and RAGE/NF-κB/Autophagy signaling,which is a natural safe therapeutic option against CYL toxicities.

Cyclophosphamide and Etoposide as a Salvage Treatment in Metastatic Osteosarcoma Patients

Background and Objective: Osteosarcoma is a rare bone cancer with approximately 30% - 35% of patients who will relapse either systemically or locally, with the lung being the commonest site of relapse. The objective of this trial was to evaluate the efficacy of cyclophosphamide and etoposide, in treatment of metastatic osteosarcoma patients progressed after one or more chemotherapy lines, with the progression free survival and treatment response as the primary endpoints, while the secondary endpoints were overall survival and treatment toxicity. Patients and Methods: Twenty seven metastatic osteosarcoma patients were enrolled into this trial and received cyclophosphamide and etoposide chemotherapy. Cyclophosphamide was given at a dose of 500 mg/m2 per day, I.V for 5 days and etoposide (100 mg/m2 per day I.V for 5 days). Response was assessed after 3 cycles according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Chemotherapy Toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE). Results: The median overall survival time and progression-free survival were 12 months and 8 months, respectively. Four patients (14.8%) achieved partial response;14 patients (51.9%) had stationary disease (SD);and 9 (33.3%) expressed tumor progression. Hematologic toxicity was the main toxicity. None of the patients had G4 or life threatening toxicities. Conclusion: The combination of cyclophosphamide and etoposide represents an efficient and tolerable treatment option for patients with metastatic osteosarcoma.

Cyclophosphamide abrogates the expansion of CD4^(+)Foxp3^(+) regulatory T cells and enhances the efficacy of bleomycin in the treatment of mouse B16-F10 melanomas

Objective:Promotion of the proliferative expansion of CD4^(+)Foxp3^(+)regulatory T cells(Tregs)is one of the side effects that limits the use of bleomycin(BLM)in the treatment of tumors.In this study,we examined the hypothesis that cyclophosphamide(CY),a chemotherapeutic agent with the capacity to eliminate tumor infiltrating Tregs,abrogated BLM-induced expansion of Tregs and consequently resulted in a better anti-tumor effect.Methods:The in vitro effects of BLM,with or without mafosfamide(MAF,the active metabolite of CY),on both TGF-β-induced differentiation of Tregs(iTregs),and TNF-induced expansion of naturally occurring Tregs(nTregs)were assessed.The in vivo effect of low doses of BLM and CY on tumor-infiltrating Tregs,as well as on the growth of mouse B16-F10 melanomas,was also studied.Results:In vitro treatment with BLM promoted the differentiation of iTregs,as well as TNF-induced expansion of nTregs.These effects of BLM were completely abrogated by MAF.Furthermore,in the mouse B16-F10 melanoma model,treatment with low doses of BLM increased the number of tumor-infiltrating Tregs,and this effect of BLM was also abrogated by CY.Importantly,combination therapy with low doses of BLM and CY showed synergistic anti-tumor effects.Conclusions:CY abrogated the effect of BLM on the expansion of Tregs.The combination of these 2 chemotherapeutic agents may represent a safer and more effective therapy in the treatment of cancer patients,and thus merits future clinical evaluation.

新疆部分地区动物源CTX-M大肠埃希氏菌的多重耐药性分析

为了解新疆动物源产CTX-M大肠埃希氏菌携带的CTX-M基因亚型和多重耐药性的特点,采用PCR方法检测新疆猪、牛、羊、骆驼、马、鸡、鹅、鸽、犬和猫源产CTX-M大肠埃希氏菌的CTX-M基因亚型(bla_(CTX-M-1)、bla_(CTX-M-2)和bla_(CTX-M-9)亚群),利用K-B纸片法对产CTX-M大肠埃希氏菌进行药物敏感性检测。结果显示,在148株产CTX-M大肠埃希氏菌中,bla_(CTX-M-1)亚群的检出率最高为76.35%(113/148),bla_(CTX-M-9)亚群次之为20.27%(30/148),2.70%(4/148)的菌株同时携带bla_(CTX-M-1)和bla_(CTX-M-9)亚群,0.68%(1/148)不可分型,未检出bla_(CTX-M-2)亚群。药敏试验结果显示,148株产CTX-M大肠埃希氏菌中对氨苄西林、复方新诺明、阿莫西林、四环素、头孢噻肟和头孢曲松的耐药率在93.24%~99.32%,对环丙沙星、庆大霉素、左氧氟沙星、头孢他啶和多黏菌素B的耐药率在27.03%~50.00%,对氨苄西林-舒巴坦、哌拉西林-他唑巴坦和亚胺培南的耐药率为1.35%~10.14%,98.65%呈多重耐药(146/148),其中以5重耐药菌株为主(45.95%,68/148)。结果表明,新疆动物源产CTX-M大肠埃希氏菌以bla_(CTX-M-1)亚群为主,bla_(CTX-M-9)亚群次之,多重耐药情况严重。

Protective effect of ascorbic acid on cyclophosphamide induced testicular gametogenic and androgenic disorders in male rats

Aim:To study the detrimental effects of cyclophosphamide on the testicular androgenic and gametogenic activities through endocrine inhibiton and/or induction of oxidative stress in male albino rats and to evaluate the protective effect of ascorbic acid.Methods:The testicular△^5,3β-hydroxysteroid dehydrogenase(HSD),17β-HSD,peroxidase and catalase activities along with the levels of malondialdehyde(MDA)and conjugated dienes in testicular tissue were measured for the evaluation of testicular oxidative stress.The plasma testosterone(T)level was measured by immunoassay7.Various germ cells at stage VⅡof spermatogenic cycle were quantified from testicular stained sections.Results:Cyclophosphamide treatment results in a significant inhibition in the testicular△^5,3β-HSDand17β-HSDactivities,a decrease in plasma T level and a diminution in the coumts of various gern cells,Moreover,this treatment was also associated with a significant inhibition of the peroxidase and catalase activities along with high levels of MDA and conjugated dienes in the testis.All these changes were reversed by ascorbic acid co-administration.Conclusion:Cyclophosphamide treatment at the dosage used caused testicular gametogenic and androgenic disor-ders as well as induced testicular oxidative stress that can be reversed by ascorbic acid co-administration.

Severe cyclophosphamide-related hyponatremia in a patient with acute glomerulonephritis

Cyclophosphamide is frequently used to treat cancer,autoimmune and renal diseases,such as rapidly progressive glomerulonephritis.Its side effects are well-known,including bone marrow depression,infections,alopecia,sterility,bladder malignancy and hemorrhagic cystitis.Moreover,in some cases cyclophosphamide use has been related to the onset of hyponatremia,by development of a syndrome of inappropriate antidiuresis.Indeed,severe hyponatremia has been previously reported in patients treated with high-dose or moderate-dose of intravenous cyclophosphamide,while only few cases have been reported in patients treated with low dose.Here,we discuss a case of a syndrome of inappropriate antidiuresis followed to a single low-dose of intravenous cyclophosphamide in a patient with a histological diagnosis of acute glomerulonephritis,presenting as acute kidney injury.After cyclophosphamide administration(500 mg IV),while renal function gradually improved,the patient developed confusion and headache.Laboratory examinations showed serum sodium concentration dropped to 122 mmol per liter associated with an elevated urinary osmolality of 199 mO sm/kg,while common causes of acute hyponatremia were excluded.He was successfully treated with water restriction and hypertonic saline solution infusion with the resolution of the electrolyte disorder.This case,together with the previous ones already reported,highlights that electrolyte profile should be strictly monitored in patients undergoing cyclophosphamide therapy in order to early recognize the potentially lifethreatening complications of acute water retention.

An open add-on study on cyclophosphamide in patients with refractory myasthenic crisis

Objective:To assess the efficacy and side effects of cyclophosphamide on refractory myashenic crisisn.Methods:Five patients of myasthenic crisis refractory to usual comprehensive treatment,entered an open additional study with cyclophosphamide 200 mg VD q.d or 400mg VD q.o.d with 6-10g of total dosage.The patients were followed up for 1-8 years.Results:All the 5 patients were effectively treated with obvious remission in 3 and improvement in 2.Two patients have returned to partial work.The side effects were tolerable.Conclusion:The present clinical trial showed that cyclophosphamide was effective,particularly in a long term as an additional therapy for treating MG patients with refractory crisis of myasthenia gravis.

EFFICIENT ACTIVATION OF ANTITUMOR IMMUNITY BY IL-6 GENE-MODIFIED LEUKEMIA VACCINE IN COMBINATION WITH LOW DOSE CYCLOPHOSPHAMIDE AND LOW DOSEIL-2

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Chemoprotective activity of aqueous leaf extract of Acalypha wilkesiana against cyclophosphamide-induced toxicity in rats

Objective:To investigate the protective effect of aqueous leaf extract of Acalypha(A.)wilkesiana Muell.Arg(Euphorbiaceae)against cyclophosphamide-induced toxicity in albino rats.Methods:Twenty male albino rats were randomly divided into five groups of four animals each.The control group(Ⅰ)was fed with pellets and distilled water,while group Ⅱ was orally administered with only 20 mg/kg cyclophosphamide.Groups Ⅲ,Ⅳ and Ⅴ were coadministered with 20 mg/kg body weight cyclophosphamide and 110,220 and 440 mg/kg body weight A.wilkesiana leaf extract,respectively,for 7 d.After treatment,liver and kidney function biomarkers,haematological parameters,liver antioxidants,and mitochondrial membrane permeability transition pore opening were investigated.Results:A.wilkesiana leaf extract significantly reduced(P<0.05)cyclophosphamide-induced increase in plasma aspartate aminotransferase,alanine aminotransferase,creatinine,uric acid and urea.It increased superoxide dismutase,catalase,glutathione-S-transferase activities and reduced glutathione levels.It also increased packed cell volume count,hemoglobin concentration and white blood cell count while inhibiting the induction of mitochondrial swelling.Conclusions:This study demonstrates that aqueous extract of A.wilkesiana leaf protected tissues against cyclophosphamide-induced oxidative damage.