Haploidentical haematopoietic stem cell transplantation for the treatment of severe aplastic anaemia patients with high-risk factors who lack an HLA-matched sibling donor.

This study aimed to analyse the efficacy of haploidentical donor (HID) haematopoietic stem cell transplantation as a first-line treatment for severe aplastic anaemia (SAA) with high-risk factors (infection or very severe aplastic anaemia,VSAA) in patients who lack an HLA-matched sibling donor (MSD). The patients with infection were treated with anti-infection therapy, and allogeneic haematopoietic stem cell transplantation (HSCT) was carried out after the infection being effectively controlled was in accordance with the stable infection (SI) standard. A total of 44 SAA patients receiving MSD transplantation (n=19) and HID transplantation (n=25) were included in this study. There was no significant difference in neutrophil engraftment between the two groups [MSD vs. HID, 19 (11-38) vs. 22 (15-47).P=0.241], and the difference in platelet engraftment was statistically significant [MSD vs. HID, 11(7-33) vs. 20 (12-69), P=0.034]. The HID group exhibited a higher incidence of grade II-IV acute graft-versus-host disease (aGVHD) (HID vs. MSD, 48.0% vs10.5%, P=0.034)and a higher incidence of chronic GVHD (cGVHD) than the MSD group (64.0% vs. 21.1%, P=0.026). There was no significant difference between overall survival (OS) following HID and MSD transplantation (84.0% vs. 89.5%, P=0.664) and failure-free survival (FFS)(80.0% vs. 84.2%, P=0.965). The interval from diagnosis to transplantation (>50d) and ECOG (>2) were independent factors associated with OS and FFS. HID HSCT may be an effective and safe option for SAA patients with high-risk factors who lack an MSD.

[Giant trichilemmal carcinoma of the retroauricular: a case report].

The trichilemmal carcinoma is a rare tumor that usually occurs on sun-exposed skin, especially on the face, scalp, neck and back of hands, mainly in elderly subjects but commonly between the 4th and 9th decades of life. We report a case of giant trichilemmal carcinoma. A 65-year-old man presented with a 5-year history of a slowly developing mass arising from his right retroauricular region, with local destruction of the auricle. The lesion appeared as a 8.0 cm×6.5 cm×2.0 cm sized, with surface ulceration and erosion, subcutaneous nodule, and mild tenderness. Preoperative pathological biopsy showed: "retroauricular" trichilemmal carcinoma. The patient underwent right retroauricular tumor resection, partial auriculectomy, neck adjacent skin flap repair and auricle reconstruction. Postoperative pathological report: "retroauricular" trichilemmal carcinoma. The margin of incision was negative, and the lymph nodes in zone II were negative. Immunohistochemistry: Tumor cells were CK5/6（++）, p63（++）, p40（++）, CD10（-）, EMA（-）, Ki-67（+, about 60%）.

Circ-0104631 promotes cell proliferation and invasion in colorectal cancer and predicts poor prognosis.

OBJECTIVE: The aim of this study was to elucidate the effect of Circ-0104631 on the progression of colorectal cancer (CRC) and to demonstrate the underlying mechanism. Our research might provide new biological markers and molecular therapeutic targets for the diagnosis and therapy of CRC. PATIENTS AND METHODS: Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to detect Circ-0104631 expression in human colorectal cancer tissues and normal control tissues. To further explore the effect of Circ-0104631 on CRC in vitro, we first knocked down Circ-0104631 in colorectal cancer cells (SW480 and LoVo) by shRNA transfection. Subsequently, we detected its effect on cell proliferation and invasion by cell counting kit-8 (CCK-8) assay, colony formation assay and cell invasion assay, respectively. The regulation of Circ-0104631 on the expressions of phosphate and tension homology deleted on chromosome ten (PTEN)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway-related proteins was detected by Western blot. Besides, the regulatory mechanism of Circ-0104631 on the progression and metastasis of CRC was further verified by recovery experiments. RESULTS: QRT-PCR results showed that Circ-0104631 was highly expressed in tissues of patients with CRC when compared with that of normal control tissues. At the same time, we also found that the expression of Circ-010463 was significantly up-regulated in CRC tissues with high topography lymph node metastasis (TNM) stage and distant metastasis. Survival curve analysis indicated that high expression of Circ-010463 predicted poor prognosis of CRC patients. In vitro experiment demonstrated that inhibition of Circ-0104631 in SW480 and LoVo cells could markedly decrease cell growth and metastasis abilities. Meanwhile, Western blot results indicated that the protein expression of PTEN increased significantly, while p-Akt and p-mTOR decreased remarkably after knock-down of Circ-0104631 in CRC cells. Furthermore, recovery experiments illustrated that knockdown of PTEN in SW480 and LoVo cells partially attenuated the inhibitory effect of shRNA-Circ-0104631 on cell growth and metastasis. CONCLUSIONS: Circ-0104631 was highly expressed in CRC tissues. Furthermore, knockdown of Circ-0104631 could inhibit the growth and metastasis of CRC cells by regulating PTEN/Akt/mTOR signaling pathway.

[Efficacy and safety of IA regimen containing different doses of idarubicin in de-novo acute myeloid leukemia for adult patients].

Objective: To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m(2), 10 mg/m(2) or 12 mg/m(2) as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) . Methods: A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m(2)) as induction chemotherapy in newly diagnosed patients of adult AML. Results: Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m(2) group, IDA 10 mg/m(2) group and IDA 12 mg/m(2) group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m(2) group and IDA 12 mg/m(2) group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m(2) group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m(2) was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m(2) when compared with the IDA 8 mg/m(2) was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×10(9)/L in IDA 8 mg/m(2) group, IDA 10 mg/m(2) group and IDA 12 mg/m(2) group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×10(9)/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) . Conclusions: For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m(2) is clinically superior to IDA 8 mg/m(2) and IDA 12 mg/m(2) in favorable intermediate AML subgroup. However, idarubicin 12 mg/m(2) is more suitable to adverse AML subgroup.

[Clinical research of second resection on early stage primary bladder adenocarcinoma and literature review].

OBJECTIVE: To investigate the clinical and pathological characteristics, as well as the diagnosis and treatment of primary bladder adenocarcinoma in the early stage. METHODS: The clinical features, pathological results, diagnosis and treatment profiles of 7 cases of primary bladder adenocarcinoma admitted in Affiliated Hospital of Nantong University from January 2010 to July 2015 were analyzed ret rospectively. RESULTS: All seven cases were diagnosed pathologically as primary bladder adenocarinoma.Histological staging T1 was revealed in six cases, while T2 in one case after the first resection.After four weeks, all patients received the second resection while one patient underwent immediately radical cystectomy. Multimodality therapy such as radiotherapy or chemotherapy was performed for longer postoperative survival.only one man died while another patient had been healthy for 6 years till January 2016. CONCLUSION: Primary bladder adenocarcinoma is a highly malignant disease in bladder cancer.According to the results of the second resection, multimodality therapy for patients in early stage with no lymph node or other organs metastasis can improve the quality of life without affectiong their lives.