[Prognosis factors analysis of 56 cases of non-Hodgkin's lymphoma originating from the nasopharynx].

Objective:To investigate the prognosis of non-Hodgkin's lymphoma originating from the nasopharynx.Method:The clinical data of 56 patients with a primary diagnosis of non-Hodgkin's lymphoma originating from the nasopharynx treated between January 2010 and December 2015 were studied.The association between clinical parameters and survival rate was evaluated by Kaplan-Meier method and Cox regression model.Result:The 1,3,5-year overall survival were 91.1%, 73.1%,and 49.6% respectively.Single factor analysis displayed that age,Ann-Arbor staging,iactate dehydrogenase,combined with B symptoms at the time of diagnosis,international prognostic index and the expression level of Ki-67 were related to the prognosis factors.Multivariate analysis showed that the international prognostic index greater than or equal to 2 points and the positive rate of Ki-67 greater than or equal to 60% were the independent risk factors for the prognosis of non-Hodgkin's lymphoma originating from the nasopharynx.Conclusion:International prognostic index and the expression level of Ki-67 may be independent prognostic factors for non-Hodgkin's lymphoma originating from the nasopharynx.

[A retrospective analysis of the efficacy and safety of imatinib in children with chronic myeloid leukemia during chronic phase].

Objective: To evaluate the efficacy and safety of imatinib in the treatment of newly diagnosed chronic myeloid leukemia during chronic phase (CML-CP) in children and to analyze the difference of the efficacy and safety between imported original imatinib (Gleevec) and domestic generic imatinib (Xinwei). Methods: Clinical data of 35 children with newly diagnosed CML-CP in Beijing Children's Hospital from January 2014 to January 2018 were collected, among which 15 cases were treated with the imported original imatinib (original drug group) and 20 cases were treated with the domestic generic imatinib (generic drug group). The hematological, cytogenetic and molecular reactions and safety of the treatments were monitored at months 3, 6 and 12. Chi square test or rank sum test was used for the comparison between two groups. Results: A total of 35 cases were treated for over 3 months, 31 cases were treated for over 6 months and 25 cases were treated for over 12 months. At 3 months, main cytogenetic response was obtained in 15 (100%) cases in the original drug group and 16 (80%) cases in the generic drug group respectively (χ(2)=3.387, P=0.119). At 6 months, complete cytogenetic response was obtained in 12 (80%) cases in the original drug group and 10 (63%) cases in the generic drug group (χ(2)=1.435, P=0.390). At 12 months, BCR-ABL(IS) ≤ 0.1% was obtained in 11 (92%) cases in the original drug group and 10 (77%) cases in the generic drug group (χ(2)=1.009, P=0.593). There was no significant difference at all stages (all P>0.05). Hematologic toxicity occurred in 7(20%) cases. The non-hematologic adverse reactions include nausea in 8 (23%) cases, pain in 8 (23%) cases, edema in 6 (17%) cases, emesis in 2 (6%) cases, fever in 2 (6%) cases, weakness in 1 (3%) case, rash in 1 (3%) case. The adverse reactions were easy to control and no drug toxicity related deaths occurred. There was no significant difference in the adverse reactions between original drug group and generic drug group (P>0.05). Conclusions: Imatinib had a good efficacy and safety in the early treatment of newly diagnosed CML-CP in children. The efficacy and safety of generic imatinib is similar to that of imported imatinib.

[Experience on postoperative complications of laparoscopic pancreaticoduodenectomy].

Objective: To summarize the incidence and characteristics of postoperative complications after laparoscopic pancreaticoduodenectomy(LPD), and to share our experience on management of complications. Methods: The clinical data of 320 LPD performed by a single team in Sir Run Run Shaw Hospital and Zhejiang Provincial People's Hospital between September 2012 and September 2017 were retrospectively analyzed, among which there were 196 males and 124 females with age of (60.2±11.6) years old.There were 306 patients who underwent standard LPD, and 14 patients who underwent extended LPD. The patients were divided into 2 groups of former 160 LPD and later 160 LPD according to the time order. By analyzing the differences of clinical outcomes between the two groups, especially focusing on the incidence of postoperative complications.The experience on management of complications was concluded. The prior surgical history of latter group was significantly higher than the former group(30.0%(48/160)vs. 18.8%(30/160), χ(2)=5.49, P=0.019), and the rest of baseline characteristics remained the comparable (P>0.05). For resectable lesions, LPD was performed by "No back" approach, following the principle of "From distal to cephalad, from ventral to dorsal, and from left to right" . As for the borderline resectable patients, LPD was performed by "Easy first" strategy. Student t test, χ(2) test or Fisher test was used to analyzed the data between the two groups respectively. Results: Of 320 LPD patients, 306 cases underwent standard LPD, 14 cases underwent LPD with resection of other organs.There were 278 LPD cases who followed "No back" approach, and 42 cases who followed "Easy first" strategy because of difficulty in creating the retro-pancreatic tunnel. And the overall morbidity was 32.2%(103/320) with reoperation rate of 5.3%(17/320). The perioperative mortality was 0.6%(2/320). The operation time of latter group was ((346.6±48.8)minutes), which was shorter than that of former group((358.0±54.4)minutes)(t=1.97, P=0.048). The blood loss of former and latter group remained comparable((207.9±135.8)ml vs.(189.6±121.4)ml, P=0.205). However, in subgroup analysis, the patients with blood loss less <200 ml of latter group decreased significantly from 59.4%(95/160) to 47.5%(76/160)(χ(2)=4.53, P=0.033). The overall morbidity of latter group was 28.8%(46/160), indicated a decrease from 35.6%(57/160) of former group without significant difference(P=0.188). Moreover, Grade A/B/C pancreatic fistula rate, Grade A/C bile leakage rate, Grade B/C postoperative hemorrhage rate of the later group tended to decrease, although they also didn't reach a significant difference. However, the abdominal infection rate decreased significantly(χ(2)=3.93, P=0.047). The length of hospital stay remained comparable(P=0.156). Conclusions: The most common complications after LPD were postoperative hemorrhage and pancreatic fistula. With specialized team and accumulated experience, the morbidity can decrease progressively by analyzing the leading cause and improving the technical skills.

[CD23 on B cells determines Breg-facilitated IL-10 secretion as well as activation of T cells].

Objective:To explore whether or not the IL-10 mediated by Bregs modulate the secreting T cells activation by the anti-CD23 antibody, to find a new target for the treatment of allergic rhinitis. Method:The rat model of allergic rhinitis was established. Anti-CD23 antibody was used to observe the behavioral changes, passive skin allergen test, enzyme-linked immunosorbent assay, hematoxylin and eosin staining, immunofluorescence and flow cytometry serological indicators, systemic and nasal mucosa. Result:Compared with the blank control group, allergic rhinitis group rats sneezing, flexible nose, runny nose, subcutaneous mass increases;The levels of IL-10, IFN-γ and Bregs in blood decreased, the levels of IL-4, CD23+ B cells and CD4+ T cells increased;Nasal mucosa CD23 fluorescence intensity increased, CD19 and IL-10 fluorescence intensity decreased. Compared with the allergic rhinitis group, the number of sneezing, the frequency of nasal flexion, the symptoms of runny nose and the subcutaneous mass in the antibody intervention group were significantly improved;The levels of IL-10 in the blood, IFN-γ, the percentage of Bregs cells in whole blood increased, the levels of IL-4, CD23+ B cells and CD4+ T cells decreased;Nasal mucosa CD23 fluorescence intensity decreased, CD19 and IL-10 fluorescence intensity increased. There is little difference between the two routes of administration. Conclusion:The enhanced expression of CD23 on B cells is involved in the development of allergic rhinitis. The anti-CD23 antibody may control the symptoms and signs of allergic rhinitis. There is no significant difference between subcutaneous administration and improved nasal-drip way. As the preferred method of anti-CD23 antibody application, anti-CD23 is expected to become a new method to control and treat allergic rhinitis. Anti-CD23 antibodies can exert a therapeutic effect by T cell activation,which rely on the Bregs-mediated secretion of IL-10.

G-CSF Indirectly Induces Apoptosis of Osteoblasts During Hematopoietic Stem Cell Mobilization.

The objective of this study was to explore the mechanism underlying osteoblast suppression in the process of hematopoietic stem cells mobilization induced by granulocyte colony-stimulating factor (G-CSF). The apoptosis of human and mouse osteoblasts was examined by detecting caspase 3. The levels of serum DKK1 and osteocalcin in the supernatant of co-culture of mouse osteoblasts and mouse bone marrow nucleated cells were measured. The number of mouse osteoblasts co-cultured with mouse bone marrow nucleated cells was measured and the osteocalcin mRNA level was also measured. The G-CSF-induced decrease in osteoblast function was partly due to the apoptosis of osteoblasts. There was no significant difference in the level of serum DKK1 in healthy donors before and 5 days after mobilization. The osteocalcin gene and protein expression was significantly different in co-cultured osteoblasts with bone marrow nucleated cells treated with and without G-CSF. Osteoblasts undergo apoptosis during mobilization and G-CSF affects osteoblasts through bone marrow nucleated cells.

[Preventive effect of mecobalamin combined with glutathione on neurotoxicity induced by FOLFOX4 chemotherapy].

OBJECTIVE: To analyze the preventive effect of mecobalamin combined with glutathione on neurotoxicity induced by FOLFOX4 chemotherapy. METHODS: Ninety-four patients receiving FOLFOX4 chemotherapy between January 2012 and December 2013 were randomized into experimental group and control group. Patients in the experimental group were given mecobalamin tablets and glutathione injection during chemotherapy while the patients in control group received glutathione injection only. The status of neurotoxicity was evaluated by the Levi neurotoxicity criteria 1992. RESULTS: After six cycles of chemotherapy, the incidence of grade Ⅰ-Ⅱ neurotoxicity in the experimental and control groups were 34.7% (17/49) and 55.6%(25/45), respectively (P=0.042), the incidence of grade Ⅲ neurotoxicity in the experimental and control groups were 2.0%(1/49) and 13.3%(6/45), the difference is also statistically significant (P=0.037). After nine cycles of chemotherapy, significantly less grade Ⅰ-Ⅱ neurotoxicity was observed in the experimental group (44.6%) than that in the control group(70.3%, P=0.019). Incidence of grade Ⅲ neurotoxicity in the experimental group was significantly lower(4.26%) than that in the control group(18.9%, P=0.031). CONCLUSION: Mecobalamin combined with glutathione can significantly reduce the incidence and severity of neurotoxicity induced by FOLFOX4 chemotherapy, therefore, worthy of clinical application.

The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children.

OBJECTIVE: The aim of this study was to improve the understanding of FBA in children and to decrease the rate of misdiagnosis, missed diagnosis and morbidity. PATIENTS AND METHODS: We analyzed the clinical features and the three-dimensional reconstructed CT images of 590 children with foreign body aspiration (FBA) in the Xuzhou area of the Jiangsu province. RESULTS: CT imaging revealed common complications of FBA including emphysema (n = 379), pneumonia (n = 174), and atelectasis (n = 26). The remaining 120 patients had no visible complications on the three-dimensional reconstructed CT images. Serious complications including pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumatorrhachis could also be observed. The types of foreign bodies were diverse: the most common were peanuts and sunflower seeds. The diagnostic accuracy of the three-dimensional CT imaging was high, with a sensitivity and specificity of 99.83% and 99.89%, respectively. CONCLUSIONS: 3D CT imaging is an accurate, non-invasive technique to evaluate children with suspected FBA that can help decrease the rate of misdiagnosis and eliminate a delay in treatment for this potentially life-threatening condition.

Imbalance between bone formation and resorption in hematopoietic stem/progenitor cells mobilization.

Mobilization is now used worldwide to collect large numbers of hematopoietic stem and progenitor cells (HSPCs) for transplantation. It is the result of a process impelling stem cell detachment from their niche, meanwhile gaining cellular features required for proliferation and migration. Mobilization remarkably affects the endosteal stem cell niche, which must be adjusted to support retention and quiescence versus mobilization and proliferation. The endosteal bone-lining cells, osteoblasts and osteoclasts, not only maintain bone balance but also participate in HSPC mobilization. The aim of this paper was to review recent advances in our understanding of HSPC mobilization and how these advances are being translated into the clinic for more efficacious mobilizing agents.

Gene therapy progress and prospects: non-viral gene therapy by systemic delivery.

Non-viral vectors continue to be an attractive alternative to viral vectors due to their safety, versatility and ease of preparation and scale-up. Over the past few years, investigators have been successful in developing gene carriers that can be targeted to the disease site. Several different delivery vectors for systemic use have been developed by different groups for plasmid DNA and oligonucleotide. Most of them are designed for targeted tumor therapy. The mechanism of inflammatory toxicity, the major toxicity of cationic lipoplex, has been studied and managed. In this review, we focus on the progress made over the last 2 years. We also discuss some future prospects for gene delivery.

Use of orbicularis oculi muscle flap for undercorrected blepharoptosis with previous frontalis suspension.

The frontalis muscle and its fascia are connected with the orbicularis oculi muscle at the level of the eyebrow. Therefore, the superiorly based orbicularis oculi muscle flap, when advanced and attached to the tarsal plate, can dynamically elevate the upper lid and correct blepharoptosis with previous frontalis sling. Six patients with undercorrected blepharoptosis after frontalis sling suspension were included in this study. The superiorly based orbicularis oculi muscle flap was advanced to the tarsal plate in these patients and the redundant portion of the distal flap was resected. Postoperative results were satisfactory after 1-year follow-up.

Association between body mass index and adenocarcinoma of the esophagus and gastric cardia.

Obesity is an increasing problem for industrialized nations. The incidence of adenocarcinoma of the esophagus and gastric cardia has also risen during the past two decades. A recently published population-based study attempted to relate this rise to increases in obesity or body mass index. Obesity may not only increase the risk for adenocarcinoma of the upper gastrointestinal tract, but it may also increase the risk of colon cancer and overall mortality. More research is needed to understand obesity's health impact and ways to control this epidemic.

Multiple genes in the left half of the cag pathogenicity island of Helicobacter pylori are required for tyrosine kinase-dependent transcription of interleukin-8 in gastric epithelial cells.

Helicobacter pylori strains that contain the cag pathogenicity island (PAI) elicit increased synthesis of gastric C-X-C chemokines, promote neutrophilic infiltration into the gastric epithelium, and stimulate the synthesis of interleukin-8 (IL-8) in cultured gastric epithelial cells. To investigate the effects of cag PAI genes on the transcription of the IL-8 gene, the Kato-3 gastric epithelial cell line was stably transfected with plasmid DNA containing the IL-8 gene promoter fused to a luciferase reporter gene. The resulting reporter cell line, L5F11, was used to monitor the effects of infection in cell culture by H. pylori 26695 and isogenic derivatives with null mutations in genes in the cag PAI on transcription of the IL-8 gene. We found that null mutations in eight open reading frames, including homologs of the Agrobacterium virB9, virB10, and virB11 genes, in the left half of the cag PAI abrogated the induction of IL-8 gene transcription. Further studies with the L5F11 cell line showed that IL-8 gene transcription induced by H. pylori was blocked by the protein tyrosine kinase inhibitor herbimycin A but not by the protein kinase C inhibitor calphostin C or by the protein kinase G inhibitor KT5823. IL-8 gene transcription in L5F11 cells could also be induced by the cytokine tumor necrosis factor alpha (TNF-alpha) without exposure to H. pylori. This TNF-alpha-induced IL-8 transcription was inhibited by the protein kinase A inhibitor H7, which had no significant effect on H. pylori-induced IL-8 transcription. These studies show that multiple genes in the left half of the cag PAI are essential for the transcription of the IL-8 gene in gastric epithelial cells and that this depends on protein tyrosine kinase activation.

Modulation of Helicobacter pylori induced interleukin-8 synthesis in gastric epithelial cells mediated by cag PAI encoded VirD4 homologue.

BACKGROUND: Strains of Helicobacter pylori carrying the virulence associated cag pathogenicity island (PAI) induce gastric epithelial synthesis of the chemokine interleukin-8 (IL-8), a neutrophil chemoattractant, and thereby a strong inflammatory response during chronic infection of the human gastric mucosa. Previous mutational analyses have shown that many genes in the cag PAI are needed to elicit IL-8 synthesis in gastric epithelial cells, and also that some genes are not involved. AIM: To test the possibility that certain genes in the cag PAI also downregulate (modulate) the inflammatory response elicited by cag+ H pylori infection. METHODS: Cells of L5F11, a derivative of the Kato-3 gastric epithelial cell line that carries an engineered IL-8 promoter-luciferase reporter gene fusion, were cocultured with H pylori strain 26695 or with an isogenic mutant in which most of the cag PAI ORF 10 gene, an Agrobacterium virD4 homologue, was deleted. Luciferase activity was measured to assess IL-8 gene transcription and secreted IL-8 was measured by enzyme linked immunosorbent assay to assess synthesis and release of IL-8 protein from gastric epithelial cells. RESULTS: Inactivation of ORF10 led to a 2.8-fold increase in IL-8 gene transcription and a 3.6-fold increase in IL-8 synthesis and secretion. CONCLUSIONS: The results suggest that this VirD4 homologue participates in the control of inflammation that H pylori infection elicits by downregulating (modulating) the strong induction of IL-8 synthesis mediated by other cag encoded proteins.

Breast-conserving radiation therapy: potential of inverse planning with intensity modulation.

PURPOSE: To evaluate inverse planning with beam-intensity modulation in breast-conserving radiation therapy. MATERIALS AND METHODS: A prototype inverse treatment-planning system was used in five patients with early-stage breast tumors. The prescription for the breast was 5,040 cGy in 180-cGy fractions, with the primary tumor site receiving 6,000 cGy in 214-cGy fractions. Isodose distributions from the prototype were compared section by section with those from conventional three-dimensional planning. RESULTS: The inverse planning system showed dose variation of 84%-98% to 111%-113% in the primary tumor site. For whole-breast irradiation, 95% of the target volume received at least 4,000 cGy. High-dose areas were adjacent to the primary site. Lower-dose areas were in the most medial part of the breast. Compared with the conventional system, target doses were similar. The volume of lung and heart that received high doses was smaller; however, larger lung and heart volumes received doses of less than 1,200 cGy. CONCLUSION: Intensity modulation may accomplish "concomitant boost" treatment. Acceptable dose gradients are achieved in the target volumes, with lower volumes of high-dose treatment in normal tissue. Plans that required comprehensive nodal radiation, in particular, were improved relative to conventional plans. Optimization of the planning system is needed to minimize the lung and heart volumes that receive low-dose radiation.

A method of analyzing rectal surface area irradiated and rectal complications in prostate conformal radiotherapy.

PURPOSE: To develop a method of analyzing rectal surface area irradiated and rectal complications in prostate conformal radiotherapy. METHODS AND MATERIALS: Dose-surface histograms of the rectum, which state the rectal surface area irradiated to any given dose, were calculated for a group of 27 patients treated with a four-field box technique to a total (tumor minimum) dose ranging from 68 to 70 Gy. Occurrences of rectal toxicities as defined by the Radiation Therapy Oncology Group (RTOG) were recorded and examined in terms of dose and rectal surface area irradiated. For a specified end point of rectal complication, the complication probability was analyzed as a function of dose irradiated to a fixed rectal area, and as a function of area receiving a fixed dose. Lyman's model of normal tissue complication probability (NTCP) was used to fit the data. RESULTS: The observed occurrences of rectal complications appear to depend on the rectal surface area irradiated to a given dose level. The patient distribution of each toxicity grade exhibits a maximum as a function of percentage surface area irradiated, and the maximum moves to higher values of percentage surface area as the toxicity grade increases. The dependence of the NTCP for the specified end point on dose and percentage surface area irradiated was fitted to Lyman's NTCP model with a set of parameters. The curvature of the NTCP as a function of the surface area suggests that the rectum is a parallel structured organ. CONCLUSIONS: The described method of analyzing rectal surface area irradiated yields interesting insight into understanding rectal complications in prostate conformal radiotherapy. Application of the method to a larger patient data set has the potential to facilitate the construction of a full dose-surface-complication relationship, which would be most useful in guiding clinical practice.

Nucleotide sequence of a 1446 base pair SalI fragment and structure of a novel early gene of Leucania separata nuclear polyhedrosis virus.

A 1446 bp SalI fragment of LsNPV was sequenced by the silver staining method, and two large open reading frames (ORFs, ORF1 and ORF2) were found, both contain typical characteristics of the 5' regulatory elements of baculovirus early genes. ORF1 is 345 bp long with the capacity to encode a putative protein of 114 amino acid residues with MW about 13 kDa and was designated p13 gene, ORF2 comprises 248 bp from the 3' end of the fragment. In the untranslated region (UTR) of ORF1, a 33 bp mini cistron (ORF3), a core recognition sequence (CGTCG) for many bHLHzip transcription factors and a late promoter sequence TTAAG are present. In the UTR of ORF2, two host transcription factor binding elements (CACGTG and GATA motif) and two CGT motifs were found. Some regular leucine zipper-like structures, designated leucine trans-conformation structure and LVT repeat, were found near the N-terminus and the middle of p13 protein. The leucine trans-conformation structure that is near the N-terminus consists of 4 leucines and 7 other amino acids between every two leucines, and every leucine is located at a conformation shift point of the predicted secondary structure of the p13 protein. In LVT repeat, L-6aa-V-6aa-T-6aa is repeated once. The functions of those structures remain unclear, and the two ORFs, not found in the genome of Autographa californica nuclear polyhedrosis virus, are possibly two new genes.

[Cytogenetic study on a human colorectal carcinoma cell line (HR-8348)].

Cytogenetics of a human colorectal carcinoma cell line (HR-8348) established in China were described. The early (29th passage) and late passages (93th passage) of this cell line were used for chromosome analysis. HR-8348 was a cell line essentially with near triploid karyotype. The distribution of chromosome number was rather dispersed in the early passage, whereas it was concentrated to 65-70 range in the late passage. G-banding stain showed that the numerical distribution of different chromosomes was also dispersed in the early passage associated with abundant abnormal chromosomes. In the late passage, it turned to be more stable and the number of abnormal chromosomes reduced. In 60 metaphases analysed, 10 marker chromosomes were found. The frequency of M1, M3 and M2 was 100% in both early and late passages. The morphologic characteristics and their possible origin and role in the pathogenesis of colorectal carcinoma were discussed.