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AIM: To investigate the molecular mechanism through which DKK1 is transcriptionally regulated in HCC (hepatocellular carcinoma) cells. METHODS: Real time PCR was used to explore whether EGFR was involved in regulating DCLK1 mRNA expression in HCC cells; Western blot assay was used to examine whether EGFR-mediated the up-regulation of DCLK1 protein in HCC cells; Immunohistochemical (IHC) analyses were used to examine the protein expression of EGFR and DCLK1 in 39 human HCC tumor specimens. RESULTS: EGF promoted the expression of DCLK1 mRNA and protein in HepG2 and Huh-7 cells (P<0.05, P<0.01), while knockdown of EGFR with two specific siRNA could reverse EGF-induced the up-regulation of DCLK1 mRNA and protein (P<0.01). IHC analyses revealed that the amount of EGFR correlated significantly with that of DCLK1 (r=0.669 6). CONCLUSION: EGFR promoted DCLK1 transcription in HCC.
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[Abstract] Objective To investigate the relationship between the Han, Zhuang and the World populations by comparing the frequency of dental non-metric traits. Methods From 2015 to 2019, ten dental non-metric traits were sampled from He’nan, Jiangsu and Guangxi Zhuang Autonmous Region, with sample size of 1785(674 He’ nan, 547 Jiangsu, 388 Guangxi Han, 176 Guangxi Zhuang). Principal component analysis, multidimensional scaling and neighbor network were carried out. Results East Asian populations could be clearly divided into two major groups, Northeast Asian and Southeast Asian. Han and Zhuang populations were close to the Northeast Asian populations, but were far from the Southeast Asian populations. There were also some north-south differences within Han populations. Conclusion Both Sundadonty and Sinodonty are existed in East Asian populations. Han and Zhuang populations dental non-metric traits are closer to the Sinodonty.
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OBJECTIVE@#To retrospectively analyze the efficacy and complications of our institution's modified nonmyeloablative allogeneic hematopoietic stem cell transplantation (NST) in treating intermediate-risk acute myeloid leukemia (AML) - first complete remission (CR1) and prognostic factors.@*METHODS@#Clinical data of 50 intermediate-risk AML-CR1 patients who underwent matched related NST at the Fifth Medical Center of Chinese People's Liberation Army General Hospital from August 2004 to April 2021 were collected, the hematopoietic recovery, donor engraftment and complications were observed, and overall survival (OS) rate, leukemia-free survival (LFS) rate, treatment-related mortality (TRM), and cumulative relapse rate were calculated. Statistical analysis of factors affecting prognosis was also preformed.@*RESULTS@#The median times for neutrophil and platelet recovery after transplantation were 10 (6-16) and 13 (6-33) days, respectively. One month after transplantation, 22 patients (44%) achieved full donor chimerism (FDC), and 22 patients (44%) achieved mixed chimerism (MC), among whom 18 cases gradually transited to FDC during 1-11 months, 4 cases maintained MC status. The overall incidence of acute graft-versus-host disease (aGVHD) was 36%, with a rate of 18% for grade II-IV aGVHD and a median onset time of 45 (20-70) days after transplantation. The overall incidence of chronic GVHD (cGVHD) was 34%, with 20% and 14% of patients having limited or extensive cGVHD, respectively. The incidence rates of infections, interstitial pneumonia, and hemorrhagic cystitis were 30%, 10%, and 16%, respectively. The 5-year OS rate, LFS rate, TRM, and cumulative relapse rate were 68%, 64%, 16%, and 20%, respectively. The increase of the number of CD34+ cells infused had shortened the recovery time for neutrophils and platelets (r =0.563, r =0.350). The number of CD34+ cells infused significantly influenced the occurrence of extensive cGVHD (OR =1.36, 95%CI : 1.06-1.84, P =0.024).@*CONCLUSION@#Modified NST is effective in treating intermediate-risk AML-CR1 patients, however, further expansion of sample size is needed to study prognostic factors.
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Humans , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation/adverse effects , Leukemia, Myeloid, Acute/complications , Prognosis , Recurrence , Retrospective Studiesالملخص
Objective To investigate the relationship between the head and face traits of Han, Li, Uygur and Tibetan population. Methods From 2008 to 2011, sixteen head and face measurement traits were measured in Chinese young individuals from Jiangsu, Hainan, Xinjiang and Tibet, with sample size of 1034 (348 Han, 165 Li, 305 Uygur, 216 Tibetan). The gender difference analysis, commonalities and differences between populations and principal component analysis were earned out. Results Most of the sixteen head and face measurement traits showed significant gender differences, the mean measurements of most features of males were bigger than those of females in four populations. Samples of the four populations usually had brachycephaly and hyperbrachycephaly. Most Han, Li and Uygur belonged to euryprosopy. Han, Li and Tibetan were typically mesorrhiny. The homogenous features of head and face of the four populations were shown. However, the head and face of the four populations also had some heterogeneous features. For instance, Han had the broadest face and Li had the broadest nose among all four populations. Furthermore, Uygur had the narrowest nose and Tibetan had the narrowest face. The result in population relationships presented that the head and face measurement traits of Han and Li were relatively similar, while those of Uygur and Tibetan were narrower. Conclusion There are commonalities and differences in the head and face measurement traits among the four populations. The group relationship between Han and Li is relatively similar, and that between Uygur and Tibetan is relatively close. The homogeneity and heterogeneity between populations can provide data and theoretical support for genetics, forensic science and other fields.
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OBJECTIVE@#To assess the association of CYP2C19 and CYP3A5 gene polymorphisms with the risk of myocardial infarction.@*METHODS@#Five hundred patients with myocardial infarction and 500 healthy controls were randomly selected. Fluorescent PCR and Sanger sequencing were used to detect the CYP2C19 and CYP3A5 gene polymorphisms. Logistic regression was used to analyze the correlation between the polymorphisms and myocardial infarction. Quanto software was used to evaluate the statistical power.@*RESULTS@#The two groups had significant difference in the frequency of AG, GG genotypes and A allele of the CYP2C19 gene rs4986893 locus and the AA, AG, GG genotypes and G allele of the CYP3A5 gene rs776746 locus ( P<0.05), but not in the frequency of genotypes and alleles of CYP2C19 gene rs4244285 and rs12248560 loci, and the AA genotype of the rs4986893 locus. After correction for age, gender, and body mass index, Logistic regression indicated that the AG genotype and A allele of the CYP2C19 gene rs4986893 locus, and the GG genotype and G allele of CYP3A5 gene rs776746 locus are associated with susceptibility of myocardial infarction, while rs4986893 GG genotype and AA and AG genotypes of rs776746 may confer a protective effect. Based on the sample size and allele frequency, analysis with Quanto software suggested that the result of this study has a statistical power of 99%.@*CONCLUSION@#CYP2C19 and CYP3A5 gene polymorphisms may increase the risk for myocardial infarction.
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Humans , Cytochrome P-450 CYP2C19/genetics , Cytochrome P-450 CYP3A/genetics , Gene Frequency , Genotype , Myocardial Infarction/genetics , Polymorphism, Genetic , Polymorphism, Single Nucleotideالملخص
Objective@#Hypoglossal nerve-facial nerve 'side'-to-side neurorrhaphy is a new method for the treatment of potential incomplete facial paralysis after acoustic neuroma. However, there are differences in postoperative outcomes among patients. This study analysed preoperative factors that may influence the treatment outcomes of neurorrhaphy.@*Methods@#We performed a retrospective study of 53 patients who were treated by neurorrhaphy for facial paralysis after acoustic neuroma resection. After a one-year follow-up period, the patients were divided into two groups according to facial functional outcome: better recovery or ordinary recovery. We analysed the following factors: gender, age, tumour size, and characteristics, tumour adhesion to the facial nerve, the duration of facial paralysis (DFP) and F wave appearance prior to neurorrhaphy (F wave).@*Results@#Univariate analysis showed significant differences between the two groups in DFP ( = 0.0002), tumour adhesion to the facial nerve ( = 0.0079) and F waves ( = 0.0048). Logistic regression analysis of these factors also showed statistical significance with values of 0.042 for the DFP, 0.043 for F waves, and 0.031 for tumour adhesion to the facial nerve.@*Conclusions@#Tumour adhesion to the facial nerve, F waves appearance and DFP prior to neurorrhaphy are the predominant factors that influence treatment outcomes.
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In recent years, the incidence rate of malignant tumors has been ever increased. As the persistent advancement of various therapeutic techniques, the therapeutic plans of cancer have been improved. Radiotherapy takes effect mainly by killing the topical tumor cells by radiation. During radiotherapy, the anti-tumor immune response can be induced or enhanced. Appropriate radiotherapy dose and segmentation model combined with certain immunotherapy plays a more and more significant role in the treatment of tumors. In this article, the underlying mechanisms of radiation-enhanced anti-tumor immune response and the current status and research prospects of radiotherapy combined with immunotherapy were reviewed.
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Objective To observe the retinal thickness of macular in type 2 diabetic mellitus (T2DM) patients without clinical features of diabetic retinopathy (DR).Methods Totally 40 patients (40 eyes) with T2DM without DR and 70 healthy volunteers (70 eyes) from August 2017 to October 2017 were enrolled in this study.Usage of spectral domain optical coherence tomography (SD-OCT) and the software of automatic segmentation to measure the average thickness of total retinal (R),inner retinal layer (IRL) and outer retinal layer namely photoreceptor layer (PL) in macular.The foveal center was divided according to three concentric circle with the diameter of 1 mm,3 mm and 6 mm (including the partition of R total,R-1,R-3,R-6,IRL-1,IRL-3,IRL-6,PL-1,PL-3 and PL-6),and the average retinal thicknesses of these partitions between these two group were compared and analyzed.Results The thickness of PL-1 and PL-3 in no DR group was significantly thinner than that in the normal control group [(71 ± 4)μm vs.(73 ± 3) μm and (66 ± 2) μm vs.(67 ± 2) μm,respectively] (both P ＜ 0.05).In the normal control group,except the IRL-6 and PL-1,the difference of the thickness was significant in the other macular regions between various genders (all P ＜ 0.05).In the male subjects,the thickness of PL-3 and PL-6 in no DR group was significantly thinner than that in the normal control group [(67 ± 2) μm vs.(68 ± 2) μm and (65 ± 2) μm vs.(66 ± 2) μm,respectively] (both P ＜ 0.05).In the female subjects,the mean thicknesses of PL-3 and PL-6 in no DR group was significant thinner than those in normal control group [(65 ± 2) μm vs.(67 ± 2) μm and (63 ± 2) μm vs.(64 ± 2) μm,respectively] (both P ＜ 0.05).There was no obviously difference in the other parts between these two groups,Conclusion The mean retinal thicknesses of the parafovea and perifovea are significantly thinner in no DR group than that of the normal control group.The measurement of the PL thickness of macular by SD-OCT may promote the study of early stage of DR,and become an important biological marker for early monitoring of DR.
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Objective To investigate the clinical features of patients with inflammatory bowel disease (IBD) complicated with Pneumocystis Jiroveci Pneumonia (PJP). Methods We retrospectively analyzed the clinical data of 5 patients who were hospitalized in Peking Union Medical College Hospital from January 2012 to July 2017 for treatment of IBD complicated with PJP. Demographic characteristics,clinical manifestations,treatments,and outcomes were descriptively analyzed. Results Of these five patients,four had ulcerative colitis (UC) and one had Crohn's disease (CD). All patients were males,with an average age of (61.8±1.9) years. All patients were in active disease status and had symptoms including cough and suffocation. Three patients had hypoxemia,among whom two developed type 1 respiratory failure. Three patients were treated with immunosuppressive medications (corticosteroids and/or immunosuppressant drugs) before the diagnosis of PJP. Lymphocyte counts in three patients were less than 0.6×10/L. CD4+T cells in two patients were less than 200×10/L. Four patients had elevated serum cytomegalovirus DNA. The level of β-D-glucan was elevated in four patients. Chest CT showed bilateral diffuse ground glass opacification. PJP-DNA was positive in sputum or bronchoalveolar lavage fluid in all patients. Two patients with type 1 respiratory failure required invasive mechanical ventilation. All patients received trimethoprim-sulfamethoxazole and methylprednisolone treatment. Four patients recovered completely and one died. Conclusion Elderly (aged>55 years) IBD patients who are receiving immune-suppressive therapy or with decreased peripheral blood lymphocyte count are at higher risk of PJP.
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Objective To explore the role of focus intervention mode in improving the self-efficacy and subjective well-being of newly-contracted nurses. Methods A total of 100 nurses selected as the survey subjects by means of convenient sampling method, were numbered consecutively and divided into observation group and control group by random digit number table. The observation group was intervened with conventional mental consultation and the observation group with the WeChat-based focus intervention mode, which included the use of past-oriented questions and answers for understanding their strength and sources, future-oriented presuppositions and miracle-oriented questions for their thinking of resolutions to future problems. The two groups were compared in terms of general self-efficacy and well-being by the general self-efficacy scale (GSES) and the overall well-being scale (GWB). Results Before intervention , the total scores on GSES and GWB of the observation groups were insignificantly higher than those of the control group (P > 0.05). After intervention, the scores of observation group were significantly higher than those in the control group (P < 0.01). Conclusion The We-Chat-based focus intervention mode can effectively improve the self-efficacy and subjective well-being of newly-contracted nurses.
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Objective To analyze and investigate the correlation between the CYP2C19 gene polymorphism and clopidogrel cura-tive effect in the patients with coronary heart disease (CHD) to provide valuable reference information for the future clinical work. Methods A total of 128 cases of CHD undergoing PCI in our hospital from January 2015 to January 2016 were selected as the re-search subjects.All of them were treated with clopidogrel ,the loading dose was 300mg ,and the maintenance dose was 75mg.The subjects were divided into the clopidogrel resistance group and response group.The drug-metabolizing CYP2C19 genotype was com-pared between the two groups and the effect of CYP2C19 genotype on the clopidogrel response was observed.Results Among the subjects ,27 cases were clopidogrel resistance.A total of 16 cases of CYP2C19 slow metabolic gene carriers were detected.There was statistically significant difference between the patients with chronic metabolic genotype VASP-PRI with fast metabolic geno-type and intermediate metabolic genotype(P<0.05).The incidence rate of adverse end point events had statistical difference be-tween the clopidogrel resistance group and clopidogrel response group(P<0.05).Conclusion In the risk factors of clopidogrel re-sistance ,slow metabolism CYP2C19 genotype and clopidogrel resistance will increase the risk of clinical adverse endpoint events oc-currence ,clinic should give adequate attention.
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Objective To compare the accuracy of somatosensory evoked potentials(SSEPs), motor evoked potentials(MEPs), regional cerebral oxygen saturation(rSO2)and multimodal monitoring in monitoring cerebral ischemia in patients undergoing carotid endarterectomy(CEA). Methods Eighty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 46-76 yr, scheduled for elective CEA, were enrolled in the study. SSEPs, MEPs and rSO2were monitored during CEA. The event of intraoperative cerebral ischemia was defined as:(1)SSEP escape latency prolongation of 10% and∕or amplitude decrease of 50%;(2)disappearance of MEP amplitude;(3)decrease in rSO2>20% of the baseline value;(4)When multimodal monitoring was applied, the event of intraopera-tive cerebral ischemia could be defined as long as one variable previously described met the condition. The gold standard of perioperative cerebral ischemia was defined as:(1)the National Institutes of Health Stroke Scale score≥4 at 1, 3 and 5 days after operation than before operation was considered as neurologi-cal dysfunction;(2)cranial CT showed a new ipsilateral cerebral focal ischemia, and postoperative in-tracranial hemorrhage diseases were excluded. Results Five cases developed cerebral ischemia after opera-tion. The sensitivity and specificity of SSEPs in predicting cerebral ischemia were 80% and 83%, respec-tively;MEPs 80% and 80%, respectively; SSEPs+MEPs 100% and 79%, respectively; rSO260% and 93%, respectively;SSEPs+MEPs+rSO2100% and 7%, respectively. Decrease in rSO2> 20% of the base-line value was consistent with SSEP escape latency prolongation of 10% and∕or amplitude decrease of 50%in diagnosis of cerebral ischemia(Kappa value 0.67, P<0.01); decrease in rSO2>20% of the baseline value was consistent with disappearance of MEP amplitude in diagnosis of cerebral ischemia(Kappa value 0.54, P<0.01). Conclusion rSO2has a good agreement with SSEPs and MEPs in diagnosis of cerebral ischemia during CEA; combination of SSEPs and MEPs produces better accuracy in monitoring cerebral is-chemia.
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<p><b>OBJECTIVE</b>To explore the biological characteristics of microvesicles(MV) derived from bone marrow mesenchymal stem cells (BM-MSC) and their capability supporting ex vivo expansion of hematopoietic stem cells(HSC).</p><p><b>METHODS</b>The MV from cultured BM-MSC supernatant were isolated by multi-step differential velocity contrifugation; the morphological characteristics of MV were observed by electron microscopy with negative staining of samples; the protein level in MV was detected by using Micro-BCA method; the surface markers on MV were analyzed by flow cytometry. The peripheral blood HSC(PB-HSC) were isolated after culture and mobilization; the experiment was diveded into 2 group: in MV group, the 10 mg/L MV was given, while in control group, the same volume of PBS was given; the change of PB-HSC count was observed by cell counting; the change of surface markers on PB-HSC was detected dynamically by flow cytometry; the cell colony culture was used to determin the function change of PB-HSC after co-culture with MV.</p><p><b>RESULTS</b>MSC-MVs are 20-100 nm circular vesicles under electron microscope. About 10 µg protein could be extracted from every 1×10MSC. The flow cytometry showed that CD63 and CD44 were positive with a rate of 96.0% and 50.2%, while the HLA-DR, CD34, CD29 and CD73 etc were negative. When being co-cultured with GPBMNC for 2 days, the cell number of MV groups was 1.49±0.15 times of the control group (P>0.05). When being co-cultured for 4 days, the cell number of MV groups was 2.20±0.24 times of the control group(P<0.05). The CD34cell number of MV groups was 1.76±0.30 times the control group after culture for 2 day and 1.95±0.20 times after culture for 4 day.</p><p><b>CONCLUSION</b>The MV has been successfully extracted from MSC culture supernatant by multi-step differential velocity centrifugation. MSC-MV can promote HSC expansion in vitro.</p>
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<p><b>OBJECTIVE</b>To explore the value of dynamically monitoring minimal residual disease (MRD) by flow cytometry before and after non-myeloablative allo-HSCT (NST) for prediction of acute leukemia(AL) relapse after transplantation.</p><p><b>METHODS</b>The clinical data of 51 AL patients underwent NST were analyzed retrospectively in Department of Hematology of Affiliated Hospital of Academy of Military Medical Sciences from January 2011 to December 2015. All AL patients achieved the morphologic complete remission of bone marrow before transplantation. The bone marrow samples were collected for monitoring of MRD within 35 days before transplant, every month till 3 months after transplant, every 3 months till 24 months after transplant, and then every 6 months after 2 years of transplant. According to the MRD cutoff value of 0.2%, the AL patients were divided into high level MRD group (18 cases) which was defined as MRD≥0.2% after transplantantion at least for 1 time, and low level MRD group (33 cases) which was defined as MRD<0.2% after transplant all the time. 2 year cumulative relapse rate in 2 groups were compared.</p><p><b>RESULTS</b>Two-year relapse rates were 6.1% and 50% in low-level MRD group and high-level MRD group post NST(P=0.001)respectively. Multivariate analysis indicated that the risk of relapse in high level MRD group was 5.84 times of low level MRD group(P=0.036). MRD≥0.2% post transplant was an independent risk factor for leukemia relapse post NST. The mortality rate was 81.8% and 46.3%(P<0.05) in relapse and non-relapse groups respectively.</p><p><b>CONCLUSION</b>Dynamically monitoring MRD by FCM is a crucial tool for early relapse estimation of acute leukemia in adult patients after allogeneic nonmyeloablative hematopoietic stem cell transplantation. MRD≥0.2% after transplant can be used as a early valuable evidence for predicting relapse and guiding active medical intervention.</p>
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<p><b>OBJECTIVE</b>To explore the effect of infusing G-CSF mobilized recipient spleen cells at different time after haploidentical stem cell transplantation(HSCT) on graft-versus-host disease (GVHD) in mice and its possible mechanism.</p><p><b>METHODS</b>Forty mice after HSCT were randomly divided into 4 groups (n=10): GVHD positive control group (control group), 1st d recipient cell infusion group after transplantation (+1 d group), 4th d recipient cell infusion group after transplantation(+4 d group), 7th d recipient cell infusion group after transplantation(+7 d group). The mice in control group were injected the normal saline of same equivalent with experimental group which were given the same amount of G-CSF-mobilized recipient spleen cells. The general manifestation and pathological change of GVHD were observed. The expression changes of CD3CD4, CD3CD8cell subsets and FasL in peripheral blood were detected by flow cytometry.</p><p><b>RESULTS</b>The incidence of GVHD was significantly decreased in +4 d group and the median survival time was longer than 60 days, which was significantly higher than that of control group (24 d), +1 d group (21 d), +7 d group (28 d). (P<0.01, P<0.01, P<0.01). The Fasl expression of peripheral blood T lymphocytes in +4 d group were significantly lower than that in the other 3 groups(P<0.05).</p><p><b>CONCLUSION</b>The +4 d infusion of G-CSF mobilized recipient spleen cells on 4th day after haploidentical HSC transplantation can inhibit the expression of FasL in donor T lymphocytes, and significantly reduce the incidence of GVHD.</p>
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<p><b>OBJECTIVE</b>To investigate the effects of microvesicles(MV) isolated from human peripheral blood hematopoietic stem cells(PB-HSC) on immune regulation and hematopoiesis.</p><p><b>METHODS</b>PB-HSCs were separated by density-gradient centrifugation and cultrued. The supernatants of PB-HSC at 48 h were harvested for isolation and purification of MV by using ultracentrifugation. The electron microscopy was used to observe the morphology of MV. The protein level in MV was quantified through bicinchoninic acid(BCA) protein assay. Flow cytometry was used to detect the immunophenotype of MV. Human peripheral blood mononuclear cells(PB-MNC) were isolated from healthy donor and treated with isolated MV. After being co-cultured for 12 h, confocal microscopy was used to observe the action mode of MV on PB-MNC. After being co-cultured for 48 h, the levels of IL-2, IL-6, IL-8, IL-10, IFN-γ and TNF-α were detected by ELISA. Flow cytometry was used to detect the changes of T cell subsets and the activation of T cell subsets as well as intracellular cytokine staining after co-culture for 48 h. The methylcellulose was used to assess the hematopoiesis-supportive function of MV as well as co-cultured supernatants.</p><p><b>RESULTS</b>The eletron microscopy revealed that MV were elliptical membrane vesicles. The protein amount in MV ranges from 29 to 110 µg. Flow cytometry showed that MV expressed mix markers on the surface, especially highly expressed MV specific marker CD63(85.86%) and hematopoietic stem cell marker CD34(33.52%). After being co-cultured for 12 h, confocal microscopy showed that MV were merged with PB-MNC. After being co-cultured for 48 h, ELISA showed that the secretion of cytokines IL-6,IL-8, IL-10 as well as TNF-α was increased while the level of IL-2 and IFN-γ was not changed much. The results of flow cytometry showed that there was no significant change in T cell subsets and T cell activation. Staining of intracellular factor showed that IL-8 was increased significantly in CD11ccells. The colony-forming experiments revealed that MV and the co-cultured supernatants could facilitate the colony formation.</p><p><b>CONCLUSION</b>MV isolated from PB-HSC have immune-regulatery function and can prornote hematopoiesis.</p>
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<p><b>OBJECTIVE</b>To establish a new mouse model of H-2 haploidentical stem cell transplantation from double donors (DHSCT) and compare with conventional haploidentical hematopoietic stem cell transplantation (HSCT) so as to alleviate transplant-related complications.</p><p><b>METHODS</b>The recipients CB6F1 of conventional HSCT group were pretreated by 8 Gy total body irradiation(TBI), and received 3×10donor (male C57) spleen mononuclear cells (spMNC) mobilized by G-CSF within 2 hours after TBI. Recipients CB6F1 of D-HSCT groups accepted 2 Gy TBI, and received total 12×10spMNC mobilized by G-CSF from 2 donors within 2 hours after TBI, each donor donated 6×10cells. According to the different strains and sex of donors, DHSCT were divided into 3 groups: in group A, the stem cells were from male C57 and female BALB/c; in group B, stem cells were from male C57 and male BALB/c, while the stem cells in group C were from male C57 and male C3H. Hematopoietic reconstruction, engraftment, GVHD and survival were observed among these 4 groups.</p><p><b>RESULTS</b>The nadir of white blood cell count after conventional HSCT were lower than 1×10/L and lasted for 3 to 5 days, while not less than 3×10/L after D-HSCT among either group A, B or C. The complete chimerism (CC) in conventional HSCT group was achieved quickly within only 1 week in peripheral blood. Mixed chimerism (MC) in peripheral blood was found within the first week after DHSCT among either group A, B or C, and transformed into stable CC within the second week eventually. Both GVHD morbidity and mortality of conventional HSCT were 100% at 34th day after transplantation.Among DHSCT groups,the overall GVHD morbidity and mortality at 34th day after transplant were 49.6% and 50%(P<0.01,P<0.05), respectively,and 60.4% and 81.2% at 50th day after transplant. Overall survival of 50 days was 50.9% that indicated a long survival in such mice DHSCT. The differences of hematopoietic reconstruction, donor cell engraftment, GVHD incidence, GVHD mortality and OS were not statistically significant among group A, B and C(P>0.05).</p><p><b>CONCLUSION</b>A new mouse model of H-2 haploidentical peripheral blood stem cell transplantation from double donors (DHSCT) has been successfully established by reducing conditioning intensity and increasing graft cell numbers from double haploidentical donors without GVHD prophylaxis. DHSCT successfully achieved stable complete chimerism, less GVHD morbidity and mortality and longer OS without hematopoietic suppression. This study provides experimental evidence for clinical application of HLA haploidentical peripheral blood stem cell transplantation from double donors.</p>
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<p><b>OBJECTIVE</b>To explore the clinical features and prognosis of primary acute myeloid leukemia (AML) with trisomy 8.</p><p><b>METHODS</b>The clinical data of 24 cases diagnosed as primary AML with trisomy 8 were collected. The clinical characteristics such as sex, age, subtype of FAB, blood routine and bone marrow blast at the first visit were analyzed and the relationship of the characteristics with CR rate and the prognosis was explored.</p><p><b>RESULTS</b>12 out of 24 AML patients were diagnosed as M5 (50%), while M2, M3, M4 and M6 had 3 cases, respectively (12.5%); one case did not receive the chemotherapy. 23 cases received 1-2 cycles of standard induction chemotherapy. Among them 3 cases of M3 achieved complete response (CR) and survived until the last following up with 100% 5-year OS rate. Among 20 cases of non-M3, 12 cases achieved CR1 (60%), 4 cases achieved partial response (PR) (20%), 4 cases did not respond (NR); 5 cases relapsed in follow-up for 3 years after CR1 (41.7%), 3 cases achieved CR2 after re-induction chemotherapy, and 2 cases remained NR. Among 20 cases of non-M3, 1 case failed to be followed-up after diagnosis within 1 month. The mean follow-up time of 19 cases was 26.2 (1.5-84) months, 9 cases died (6 cases of M5, 1 case of M4 and 2 cases of M2), who achieved PR and NR, or relapsed after CR1; the 3-year DFS and OS were 21%, 31.5% respectively. 2 cases of non-M3 accepted allo-HSCT with HLA-matched sibling donor and kept disease-free survival until the last following up, and survived for 58 and 66 months respectively. Except for 3 cases of M3, 2 cases received allo-HSCT and the cases without chemotherapy, the other 18 cases with initial WBC count less than 10×10(9)/L had OS and DFS longer than those of 10 cases with initial WBC count no less than 10×10(9)/L (P<0.05, P<0.01). The OS of 10 cases with CR1 was longer than OS of those cases without CR1 (P<0.01).</p><p><b>CONCLUSION</b>The incidence of trisomy 8 in M5 is higher than the other AML subtypes, and the prognosis of M5 is poor. The initial WBC count above 10×10(9)/L is a high-risk factor. M3 with trisomy 8 and RARA gene has a very good prognosis. Trisomy 8 may increase the risk of primary AML except for M3, so allo-HSCT with HLA-matched sibling donor should be carried out as much as possible after CR1. The gene mutation of FLT3, MLL, HOX11, C-kit, NPM1 may possess an important significance on prognosis.</p>
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Humans , Bone Marrow , Pathology , Chromosomes, Human, Pair 8 , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Induction Chemotherapy , Leukemia, Myeloid, Acute , Diagnosis , Genetics , Therapeutics , Leukocyte Count , Prognosis , Remission Induction , Trisomyالملخص
<p><b>OBJECTIVE</b>To investigate the expression level of WT1 gene in bone marrow of patients with acute myeloid leukemia (AML) and its relationship with prognosis.</p><p><b>METHODS</b>The copy numbers of WT1 and internal reference gene in bone marrow samples from 75 newly diagnosed AML patients were detected by using real-time quantitative PCR. The gene WT1 expression level was determined by the ratio of the copy numbers of WT1 to reference gene. And the clinical characteristics, the complete remission (CR) rate after induction chemotherapy, 2-year overall survival (OS) rate and event-free survival (EFS) rate were calculated and analysed.</p><p><b>RESULTS</b>The expression level of WT1 did not significantly correlate with common clinical parameters such as age, sex, molecular abnormality, FAB classification and risk stratification. The CR rate in the high WT1 expression group before treatment was 65.4%, which was lower than that of 93.9% in the low expression group (χ2=8.25, P<0.01). The 2-year overall survival rate and event-free survival rate of the two groups were statistically significantly different (P<0.05), and the OS and EFS rates in high WT1 expression group were lower than those in low expression group. After the induction chamotheropy for about 1, 3 month and 6 months, the 2-year OS rate significantly increased in patients with decrease of WT1 gene expression level by one log or more (P<0.05).</p><p><b>CONCLUSION</b>The expression level of WT1 gene in bone marrow may be an effective marker to evaluate therapy efficacy and prognosis for AML patients (non APL).</p>
الموضوعات
Humans , Bone Marrow , Metabolism , Disease-Free Survival , Genes, Wilms Tumor , Induction Chemotherapy , Leukemia, Myeloid, Acute , Diagnosis , Genetics , Prognosis , Real-Time Polymerase Chain Reaction , Remission Induction , Survival Rate , WT1 Proteins , Genetics , Metabolismالملخص
Objective To determine the accuracy of femoral components sizing predicted by standardized digital templating in total knee arthroplasty (TKA).Methods Fifty consecutive patients (50 knees),who underwent primary TKAs for endstage osteoarthritis,were prospectively studied.The intra-operative and radiographic data were collected.All operations were performed by the same surgical techniques with PS type,open box Vanguard Complete Knee System.All patients underwent lateral and AP radiography of the involved knee under fluoroscopy before and after surgery.The distal femoral anteroposterior dimension (DFAP) were measured and the femoral components size were predicted on preoperative radiographs by two different methods:measurement of DFAP did not include (group A) the cartilage thickness of the medial posterior condyle or included that (group B).Cutting errors were corrected gradually,and DFAP was measured consequently.The most appropriate size was chose after each step respectively based on postoperative radiographs.The accuracy of femoral size predicted under different conditions was compared within two groups.Results During correction of cutting errors,the correct rate ranged from 18％ to 44％ in group A and from 26％ to 34％ in group B,the accuracy within one size ranged from 54％ to 84％ in group A and from 58％ to 84％ in group B.The cartilage thickness of medial posterior condylar,external rotation of femoral component,under-resected of anterior condylar,flexion of femoral component,and over-resected of posterior condylar can change the DFAP by 1.97±0.85 mm,1.56±2.06 mm,1.15±1.31 mm,-2.86±1.52 mm,and-0.87±0.77 mm,respectively.Conclusion Variation of intraoperative cutting errors and the cartilage thickness of medial posterior condyles can influence the accuracy of templating to some extent.Standardized digital radiography templating cannot predict femoral sizes accurately.