[The Levels of Inflammatory Regulatory Factors in Acute Leukemia Complicated by Infection and Its Clinical Significance].

OBJECTIVE: To explore the expression levels and clinical significance of helper T cell 1/helper T cell 2 (Th1/Th2) cytokine and interleukin-6 (IL-6) in patients with acute leukemia (AL) complicated by infection. METHODS: 68 patients with AL complicated by infection admitted to Wuhan Fifth Hospital from May 2017 to January 2020 were enrolled as study group, 50 AL patients without infection were enrolled as AL group, and 30 healthy volunteers checked in physical examination center were enrolled as healthy control group. The levels of serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10), and peripheral blood Th1/Th2 cells subsets were measured and compared among the three groups. The serum IL-6, IL-10, TNF-α and Th1/Th2 were compared between the patients with mild to moderate infection (n=52) and septic shock (n=16). The relationship between IL-6, IL-10, TNF-α, Th1/Th2 and AL infection was analyzed. RESULTS: The levels of IL-6, IL-10 , TNF-α, and the proportion of Th2 of the patients in study group and AL group were significantly higher than those in healthy control group (P<0.001), while the proportion of Th1 and Th1/Th2 were significantly lower than those in healthy control group (P<0.001). The levels of IL-6, IL-10 and TNF-α, and the proportion of Th2 the patients in study group were significantly higher than those in AL group (P<0.001), while the proportion of Th1 and Th1/Th2 were significantly lower than those in AL group (P<0.001). The serum IL-6, IL-10 and TNF-α level of the patients in septic shock group were significantly higher than those in mild-to-moderate infection group (P<0.001), while Th1/Th2 was lower than those in mild-to-moderate infection group (P<0.001). The results of ROC curve analysis showed that the area under the ROC curve (AUC) values of IL-6, IL-10, TNF-α and Th1/Th2 alone for the diagnosis of septic shock were 0.779, 0.761, 0.724 and 0.718, which were lower than that their combination (0.910) (P<0.05). CONCLUSION: The levels of serum IL-6, IL-10 and TNF-α are high in patients with AL complicated infection and septic shock, while Th1/Th2 cell subsets is low. The combined detection of serum IL-6, IL-10, TNF-α and Th1/Th2 is a good diagnostic value for predicting the occurrence of severe septic shock.

[Analysis of the risk factors of radiation-induced caries in patients with head and neck cancer].

OBJECTIVE: This study aimed to evaluate the risk factors of radiation-induced caries by using a multiple linear regression equation and to provide the basis for the effective prevention of radioactive caries. METHODS: A total of 166 patients with head and neck cancer who underwent radiotherapy were selected as subjects. The number of decayed, missing or filled surfaces were recorded. Questionnaire contents included age, sex, radiation dose, and radiotherapy techniques. Multiple stepwise regression analyses were performed to identify the risk factors of radiation-induced caries. RESULTS: Multiple stepwise regression analyses indicated that the main risk factors of radiation-induced caries were plaque index, radiotherapy techniques, time after radiotherapy, and radiotherapy dose. CONCLUSIONS: The awareness of dental care and caries treatment should be improved to reduce the occurrence of radiation-induced caries in patients with head and neck cancer. In addition, intensity modulated radiation therapy should be employed to decrease the radiation exposure dose received by teeth.

[CRISPR/Cas9 System and Its Advances in Gene Therapy of Hematologic Diseases--Review].

In recent years, with the development of gene editing technology, the site-specific genome can be modified. The curability of genetic disease may be achieved by the use of gene editing techniques. As the simplicity, high specificity and economical efficiency, much attention has been paid to the CRISPR/Cas9 system, which was been widely used in research of molecular biology and other fields of life science. In this review, the mechanism for CR1SPR/Cas9 system and the progress of gene therapy, such as for hemophilia, betathalassaemia and chronic myeloid leukemia were summarized briefly.

[Research Progress on the Role of Pyroptosis in the Pathogenesis of Myelodysplastic Syndrome -Review].

Pyroptosis is a novel type of programmed cell death, which is closely related with the pathogenesis of myelodysplastic syndromes (MDS). The recent studies showed that all of S100A9/TLR4, S100A9/CD33 and Nox/ROS signaling pathways can activate oxygen-sensitivity NLRP3 inflammasome and then induce the pyroptosis of hematopoeitic stem cells (HSC) / hematopeitic pregenitor cells (HPC), resulting in ineffective hematopoiesis in patients with MDS. Further studies on the role and molecular mechanism of pyroptosis in the pathogenesis of MDS will provide the potential opportunity for the diagnosis and treatment of MDS. Here, the recent advances in the role and mechnism of pyroptosis in the pathogenesis of MDS are reviewed.

[Interforaminal regions of 287 Han adults evaluated by cone-beam computed tomography].

PURPOSE: The mandibular anatomical structures including mental foramen, accessory mental foramina, anterior loop were measured and analyzed by cone-beam CT (cone-beam computed tomography, CBCT) , in order to provide some information during surgical procedures in interforaminal regions. METHODS: Two hundred and eighty-seven Chinese Han patients who visited Stomatological Department of Xiangya Hospital were included in this study. Patients were scanned by cone-beam computed tomography, and the information of interforaminal region was collected from the images. SPSS17.0 software package was used for statistical analysis. RESULTS: The mental foramen was usually apical to the second premolar or between the premolars（60.80% and 30.14%, respectively). The accessory mental foramina was observed in 4.88% of the mandibles, most of which were located under the second premolar, superiorly and distally to the mental foramen. The anterior loop was identified in 89.20% of cases with the mean length being (1.99±1.39) mm. The distance from the apex of the second mandibular premolar to the anterior loop or the inferior alveolar nerve was (5.21±2.50) mm. CONCLUSIONS: Accessory mental foramina is present in some mandibles. The anterior loop is highly prevalent in Chinese Han people, and its length is highly variable.

Association Between TP53 Gene Codon 72 Polymorphism and Acute Myeloid Leukemia Susceptibility: Evidence Based on a Meta-Analysis.

BACKGROUND: Many studies have reported that the p53 codon 72 polymorphism is associated with acute myeloid leukemia (AML) susceptibility; however, the conclusions are inconsistent. Therefore, we performed this meta-analysis to obtain a more precise result. MATERIAL AND METHODS: We searched PubMed to identify relevant studies, and 6 published case-control studies were retrieved, including 924 AML patients and 3832 controls. Odds ratio (OR) with corresponding 95% confidence interval (95%CI) was applied to assess the association between p53 codon 72 polymorphism and AML susceptibility. The meta-analysis was performed with Comprehensive Meta-Analysis software, version 2.2. RESULTS: Overall, no significant association between p53 codon 72 polymorphism and AML susceptibility was found in this meta-analysis (Pro vs. Arg: OR=0.94, 95%CI=0.81-1.10; Pro/Pro vs. Arg/Arg: OR=0.93, 95%CI=0.71-1.22; Arg/Pro vs. Arg/Arg: OR=0.79, 95%CI=0.55-1.13; (Pro/Pro + Arg/Pro) vs. Arg/Arg: OR=0.84, 95%CI=0.62-1.13; Pro/Pro vs. (Arg/Arg + Arg/Pro): OR=1.06, 95%CI=0.83-1.35). Similar results were also found in stratified analysis according to ethnicity and source of controls. CONCLUSIONS: Our meta-analysis demonstrates that p53 codon 72 polymorphism may not be a risk factor for AML, which should be verified in future studies.

The Role of TP53 Gene Codon 72 Polymorphism in Leukemia: A PRISMA-Compliant Systematic Review and Meta-Analysis.

The purpose of this meta-analysis was aimed to evaluate the association of tumor protein p53 (TP53) gene codon 72 polymorphism with leukemia susceptibility. We searched PubMed to identify relevant studies, and 16 case-control studies from 14 published articles were identified as eligible studies, including 2062 leukemia patients and 5826 controls. After extracting data, odds ratio (OR) with the corresponding 95% confidence interval (95%CI) was applied to assess the association between TP53 codon 72 polymorphism and leukemia susceptibility. The meta-analysis was performed with the Comprehensive Meta-Analysis software, version 2.2. Overall, no significant association between TP53 codon 72 polymorphism and leukemia susceptibility was found in this meta-analysis (Pro vs Arg: OR = 1.05, 95%CI = 0.90-1.21; Pro/Pro vs Arg/Arg: OR = 1.13, 95%CI = 0.84-1.52; Arg/Pro vs Arg/Arg: OR = 0.94, 95%CI = 0.76-1.15; [Pro/Pro + Arg/Pro] vs Arg/Arg: OR = 0.99, 95%CI = 0.80-1.21; Pro/Pro vs [Arg/Arg + Arg/Pro]: OR = 1.19, 95%CI = 0.93-1.51). Similar results were also found in subgroup analysis by ethnicity, source of controls, and types of leukemia (either acute myeloid leukemia or acute lymphocytic leukemia). Our meta-analysis demonstrates that TP53 codon 72 polymorphism may not be a risk factor for acute leukemia; however, due to the limitations of this study, it should be verified in future studies.

[BMP2/BMP4 genetic evaluation in 40 patients with tooth agenesis].

PURPOSE: To evaluate the potential mutation in BMP2/BMP4 genes in Chinese patients with non-syndromic hypodontia. METHODS: Genomic DNA was isolated from blood samples of 40 non-syndromic hypodontia Chinese patients. One hundred unrelated individuals, who were not affected with tooth agenesis (excluding third molars), were used as controls. PCR was performed to amplify each exon of BMP2/BMP4 genes. Gel-purified PCR fragments were sequenced to detect mutations. SPSS13.0 software package was used to analyze the data. RESULTS: We identified 4 single nucleotide polymorphisms (SNPs) BMP2, c.109T>G p.Ser37Ala; c.261A> G p.Ser87Ser; c.570A>T p.Arg190Ser; BMP4 c.455T> C p.Val152Ala; and a novel mutation BMP2 c.166C> G p.Arg56Gly within the family. CONCLUSIONS: Our finding suggests that all the identified SNPs and the new mutation of BMP2 may be responsible for tooth agenesis in the participants, but the possible association requires further research.

[Effect of clinical experience on the shade matching accuracy].

PURPOSE: To evaluate the effect of clinical experience on the shade matching accuracy. METHODS: Thirty-seven dental students (group A) who had 1 to 2 years of clinical experience and 57 dental students (group B) who didn't have clinical experience took part in this experiment. Participants were divided into two groups (TTB group and TT group) and used the Toothguide Training (TT) and Toothguide Training Box (TTB) respectively. All participants received training session once a week for 3 weeks. Before training and each time after finished training all participants were asked to identify ten unlabeled tabs which had been randomly chosen from Vita 3D-master shadeguide. SPSS 16.0 software package was used for Wilcoxon signed rank test. RESULTS: Before training, the accuracy rate of group A and group B was (65.67±20.4)% and (70.17±17.57)% respectively. After training, the accuracy rate of group A and group B was (78.91±22.82)% and (80.17±17.77)% respectively. No significant difference was found between group A and B, but significant difference was found between before and after training. CONCLUSIONS: This study shows clinical experience is not found to be a significant factor to the teeth shade matching. The training can improve the accuracy of shade matching.

[Influence of multiple sintering on wear behavior of Cercon veneering ceramic].

OBJECTIVE: To investigate the influence of multiple sintering on wear behavior of Cercon veneering ceramic. METHODS: Samples were fabricated according to the manufacture's requirement for different sintering times (1, 3, 5, 7 times). The wear test was operated with a modified MM-200 friction and wear machine in vitro. The wear scars were characterized by scanning electron microscope (SEM) and atomic force microscopy (AFM). RESULTS: With the sintering times increasing, the wear scar width became larger. The correlation was significant at the 0.01 level. Significant difference was observed in wear scar width among different samples (P < 0.05). SEM and AFM results showed that veneering ceramic wear facets demonstrated grooves characteristic of abrasive wear. CONCLUSION: Multiple sintering can decrease the wear ability of Cercon veneer, and the wear pattern has the tendency to severe wear.

[Erythropoietin promotes proliferation of human bone marrow mesenchymal stem cells in vitro].

This study was aimed to investigate the effects of recombinant human erythropoietin (rhEPO) on proliferation of human bone marrow-derived mesenchymal stem cells (MSCs) in vitro. The aspirates of the bone marrow from healty volunteers were seeded in culture medium. Then MSCs were isolated according to characteristics adhering to the plastics. After three passages in culture, bone marrow-derived adherent cells were identified by growing morphological features, cell surface antigens and differentiation into multi-lineages. Then P3-MSCs which had been identified were incubated with different concentrations of rhEPO (0.5, 1, 5, 10 and 50 U/ml). Subsequently, proliferation of MSCs was measured by MTT assay, as well as cell counts. At the same time, cell cycle was detected by flow cytometry (FCM). The results indicated that the expressions of CD90 and CD105 in P3 bone marrow-derived adherent cells were positive, while the expressions of CD34 and CD45 were negative, and these cells could differentiate into adipocytes, osteocytes and chondrocytes in induction media. MTT assay showed that the optical density (OD) of group treated with EPO was significantly higher than that in the control group (p<0.05), and the group treated with 50 U/ml EPO achieved the most predominant effects. The results of cell count were coincident with that of MTT assay. Furthermore, the cell cycle analysis by FCM revealed that rhEPO could relatively decrease the cell ratio in G0/G1 phase, and increase the cell ratio in S and G2/M phases. As compared with the control group, all those differences were statistically significant (p<0.01). It is concluded that erythropoietin can promote proliferation of human bone marrow mesenchymal stem cells in vitro, which may be correlated with the increased entry into S and M phases of cell cycle of MSCs adjusted by EPO.

[Wear behavior of enamel and veneering ceramics].

OBJECTIVE: To compare the wear between the enamel and two types of dental decoration porcelains for all-ceramic restorations (Vita-alpha, Vintage AL). METHODS: Friction coefficients, wear scar width, element concentrations and wear surface evolution were considered relatively to the tribology of that in vivo situation. The wear scars of the samples were characterized by means of dynamic atomic force microscopy (DFM). The different element concentrations of the surface before/after the wear test were determined with energy dispersion spectrometry (EDS). RESULTS: The friction coefficient varied from time in each kind of material. The statistical differences between materials were observed in wear scar width and properties of materials (P<0.05). DFM results showed wear surface of natural tooth full of abrasive particles and denaturation of dental texture. Wear surface of veneering ceramics consisted mainly of abrasive particles, plough and microcracking. EDS results showed that the element concentration of Fe was obviously found on the samples after wear. CONCLUSION: The main underlying mechanisms of natural teeth wear are abrasive, and denaturation of dental texture. Abrasive wear, adhesion and fatigue of veneering ceramics characterize the wear patterns which plays different role in Vita-alpha and Vintage AL. The wear patterns of veneering ceramics can be described as mild wear.

[Effect of astragalus polysaccharides on the proliferation and ultrastructure of dog bone marrow stem cells induced into osteoblasts in vitro].

OBJECTIVE: To observe the growth and osteogenic property of cultured dog bone marrow stem cells (BMSCs) by investigating the effects of astragalus polysaccharides (APS) on the proliferation and ultrastructure of BMSCs into osteoblasts in vitro. METHODS: BMSCs osteogenic property was detected by improved Wright-Giemsa, Gomori and alizarin dyeing method. The proliferation and differentiation of the induced BMSCs with APS in different concentration and time were detected by MTT assay and the morphologic change of the induced BMSCs was observed by transmission electron microscope (TEM). RESULTS: BMSCs osteogenic property was detected with Wright-Giemsa deep-bluing, Gomori method blacking and with more mineral nodules alizarin dyeing method carmining. APS with concentration of 0.005 mg/mL can promote the proliferation of the induced BMSCs in short-term culture (1th, 3th day) and 50 mg/mL can decrease the effect through long-term culture (5th day). Observed by TEM (5th day), the number of mitochondria, rough endoplasmic reticulum increased and the extracellular matrix was excreted more in the induced BMSCs by APS with concentration of 0.005 mg/mL. However, not only the number of mitochondria, rough endoplasmic reticulum reduced but also the structure was swollen, degenerative, membrance damaged in the induced BMSCs by APS with concentration of 50 mg/mL. CONCLUSION: APS with lower concentration in short-term culture may promote BMSCs proliferation and differentiation.

[Effects of rhG-CSF on mobilization of mouse mesenchymal stem cells].

To evaluate the effects of rhG-CSF on mobilization of mesenchymal stem cells (MSCs) of mouse bone marrow at different time point, thirty mice were randomly divided into rhG-CSF treatment group and control group. The mice were subcutaneously injected with rhG-CSF in a dose of 80 microg/kg or saline for 5 days. The bone marrow and peripheral blood were obtained at time points of 6, 12, 168 hours after final injection of rhG-CSF or saline. Bone marrow mononuclear cells (BMMNCs) were seeded at density of 1 x 10(6) MNCs onto 12-well plate for culture expansion in DMEM supplemented with 10% FBS, and the number of colony forming unit - fibroblast (CFU-F) was counted after 14 days. The cells were collected by trypsinization and the surface antigens CD34, CD133, CD90 and CD105 were analyzed by flow cytometry. The multi-differentiation of MSCs were done in the culture condition of induced-adipocyte and osteocyte. Peripheral blood MNCs examination was same as the bone marrow. The results indicated that the number of CFU-F of bone marrow in rhG-CSF group was more than that in control group (p < 0.01), the number of CFU-F in rhG-CSF group at 6 hours was more than that at 12 hours and 168 hours, respectively (p < 0.01). There was no obvious difference between CFU-F at 12 hours and at 168 hours (p > 0.05). MSCs were positive for CD90, CD105 and negative for CD34 and CD133. MSCs were found to differentiate into adipocyte and osteocyte in vitro. The CFU-F of PBMNCs obtained and cultured in vitro in the same culture conditions could be observed after the rhG-CSF injection at 6 hours, but cloning efficiency was (0.50 +/- 0.11) x 10(-6) MNCs and showed statistical difference as compared with control. It is concluded that rhG-CSF to mobilize hemopoietic stem cells can be used to induce mouse MSCs in vivo expansion, which showed the peak value within 6 hours after final injection of rhG-CSF. rhG-CSF have the mini-mobilization effect on murine MSCs derived from bone marrow.

[Effects of astragalus polysaccharides-chitosan/polylactic acid scaffolds and bone marrow stem cells on repairing supra-alveolar periodontal defects in dogs].

OBJECTIVE: To explore the effect of astragalus polysaccharides-chitosan/polylactic acid (AP-C/PLA) scaffolds and bone marrow stem cells (BMSCs) on periodontal regeneration of experimentally horizontal periodontal defects in dogs. METHODS: Dog BMSCs were isolated from the bone marrow and then cultured in a conditioned medium to be induced for osteogenesis. The expressions of Type I collagen and alkaline phosphatase (ALP) were examined by immunohistochemistry and histochemistry in the induced BMSCs, respectively. The BMSCs were harvested and implanted with astragalus polysaccharides-chitosan/polylactic acid (AP-C/PLA) and chitosan/polylactic acid (C/PLA) scaffolds. Horizontal alveolar bone defects (5 mm depth, 2 mm width) were produced surgically in the buccal side of the mandibular premolar 3 and 4 of the 10 dogs. The defects were randomly repaired with a cell-scaffold construction (10 teeth per group): root planning only (surgical control), AP-C/PLA with a conditioned medium (medium control), C/PLA with BMSCs (scaffolds control), and AP-C/PLA with BMSCs (experimental group) . The dogs were killed at 4 weeks and 8 weeks after the surgery, and block sections of the defects were collected for the histologic and histometric analysis. RESULTS: BMSCs induced in vitro exhibited an osteogenic phenotype with expressing Type I collagen and ALP histologically. The bone nodule structure was observed in the experimental group 4 weeks postsurgically. The engineered bone became more mature,similar to the native bone 8 weeks postsurgically. The amount of new bone regeneration and the rate of new bone filling to the defect height of the experimental group were significantly different from those of the surgical control, medium control, and scaffolds control [(2.90+/-0.41) mm vs (0.83+/-0.30) mm, (1.46+/-0.55) mm, (2.67+/-0.26) mm; 57.46% vs 15.68 %, 30.13%, 51.87%)] (P<0.01, P<0.01, P<0.05). CONCLUSION: Astragalus polysaccharides can promote the new bone formation on the periodontal defects. The technology of tissue engineering with AP-C/PLA scaffolds and induced BMSCs may contribute to the periodontal regeneration.

[The effect of HGF on graft-versus-host disease and graft-versus-leukemia after allogeneic bone marrow transplantation in acute lymphoblastic leukemia mice].

OBJECTIVE: To investigate the effect of hepatocyte growth factor (HGF) on graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) after allogeneic bone marrow transplantation (allo-BMT) and related mechanism in acute lymphoblastic leukemia (ALL) mice. METHODS: Twenty nude mice were randomly divided into control (group A) and test (group B) groups for monitoring relapse, and 20 BALB/c mice into control (group C) and test (group D) groups for GVHD. HGF as injected from day 0 to day 7 after BMT for groups B and D, while PBS for A and C. CD4(+) and CD8(+) T cell were evaluated by flow cytometry. The survival of mice after BMT was recorded. The level of tumor necrosis factor-alpha (TNF-alpha) was evaluated by ELISA. RESULTS: The median past-BMT survival were 7.00 +/- 1.58, 9.00 +/- 1.58, 11.00 +/- 3.95 and 24.00 +/- 13.44 days for groups A, B, C, D, respectively, being prolonged in group D. HGF could decrease the quantity of CD4(+) T cells [group D (10.39 +/- 1.15)% vs group C (13.50 +/- 1.80)%, P < 0.01] and increase CD8(+) T cell [group D (12.25 +/- 2.85)% vs group C (6.12 +/- 1.99)%, P < 0.01], decrease the level of TNF-alpha in transplanted ALL mice [group D (112.10 +/- 18.99) pg/ml vs group C (143.90 +/- 25.35) pg/ml, P < 0.01] and reduce the degree of GVHD. CONCLUSION: HGF could alleviate post-allo-BMT GVHD but retain GVL effect.

[Effect of bone marrow mesenchymal stem cells on acute graft versus host disease and graft versus leukemia after allogeneic bone marrow transplantation].

To investigate the effect of bone marrow mesenchymal stem cells (BMMSC) on acute graft versus host disease (aGVHD) and graft versus leukemia (GVL) after allogeneic bone marrow transplantation (allo-BMT), both bone marrow cells and BMMSC obtained after three to four weeks of culture from donor mice were transplanted into the recipient mice injected with acute lymphocytic leukemia cells 5 days before, the control group was injected with bone marrow cells alone. The survial time after allo-BMT was recorded; the general manifestation and pathological changes of aGVHD in recipient mice were observed; the effects of BMMSC on the quatity of CD4(+) and CD8(+) T cell in vivo after allo-BMT were evaluated by flow cytometry; chimerism was detected by sex chromosome. The results showed BMMSC could increase obviously the survival time, and delay onset of aGVHD, BMMSC could decrease the amount of CD4(+) T cell and increase CD8(+) T cell in vivo. It is concluded that cotransplantation of bone marrow cells with BMMSC from the same donor mice has GVL effect. BMMSC can alleviate aGVHD and maintain GVL effect after allo-BMT.

[Effects of HGF on GVHD and Th1/Th2-related cytokines in ALL mice after allo-BMT].

To observe the effects of hepatocyte growth factor (HGF) on graft-versus-host disease (GVHD) and Th1/Th2 related cytokines in mice with acute lymphoblastic leukemia (ALL) after allogenic bone marrow transplantation (allo-BMT), BALB/c mice were conditioned by total body irradiation with 11 Gy and then were transplanted with allogeneic bone marrow after establishing ALL model. BALB/c mice were divided into groups A and B. The mice of group A were injected subcutaneously with HGF from day 0 to 7 after allo-BMT, and the mice of group B were injected subcutaneously with PBS from day 0 to 7 after allo-BMT. The symptoms of GVHD and the GVHD pathological changes of liver and small intestine and skin were observed. The serum levels of both IFN-gamma and IL-4 were determined by ELISA. The results showed that the score of GVHD in group A was lower than that in group B (P < 0.05). The levels of IFN-gamma in both groups A and B were all higher than that in normal group (P < 0.05 and P < 0.001, respectively), However, the level of IFN-gamma in group A was lower than that in group B (P < 0.01). The levels of IL-4 in both group A and B were all lower than that in normal group (P < 0.05), but the level of IL-4 in group A was higher than that in group B (P < 0.05). It is concluded that HGF can alleviates the severity of GVHD, because of its balancing the Th1/Th2-related cytokines after allo-BMT.

[Expression of costimulatory molecules on peripheral blood lymphocytes of patients with idiopathic thrombocytopenic purpura].

OBJECTIVE: To investigate the expressions of costimulators on peripheral T and B lymphocytes in patients with idiopathic thrombocytopenic purpura (ITP). METHODS: The expression of B7-CD(28) and CD(40) of peripheral lymphocytes was measured by flow cytometry in 21 ITP patients and 9 normal subjects. The expression of PAIgG was measured by ELISA method. RESULTS: The expression of CD(4)(+)CD(28)(+) was lower in ITP patients than in normal controls, but the expression of CD(86)(+) and CD(86)(+)CD(19)(+) was higher in ITP patients than in normal controls, while the expression of CD(80)(+), CD(40)(+), CD(28)(+), CD(19)(+)CD(86)(+), CD(19)(+)CD(40)(+), CD(4)(+)CD(28)(+)/CD(4)(+), CD(19)(+)CD(80)(+)/CD(19)(+) and CD(19)(+)CD(40)(+)/CD(19)(+) in ITP patients was normal. The PAIgG level was higher in 16 patients with a mean of (184.62 +/- 38.00) ng/10(7) plt. A positive correlation was found between PAIgG and CD(19)(+)CD(86)(+)/CD(19)(+) expression. CONCLUSION: There is no deficiency in expression of CD(28) on CD(4)(+) T lymphocytes in ITP patients. The change of CD(86) expression on B lymphocytes is possibly involved in pathophysiology of ITP, which may provide a theoretical instruction for ITP patients immunological therapy.