The novel HLA-DPB1*03:01:29 allele, identified by sanger dideoxy nucleotide sequencing in a Chinese individual.

HLA-DPB1*03:01:29 differs from HLA-DPB1*03:01:01:01 by one nucleotide in exon 2.

Multiple risks analysis for aplastic anemia in Zhejiang, China: A case-control study.

To understand the risks associated with aplastic anemia (AA) in 4 cities of Zhejiang Province, China, with special focus on the joint contributions of multiple risks.Based on an Electronic Data Capture (EDC), a case control study was carried out. Data regarding socio-demographic, diseases history, living habits, and exposures to toxic substances, etc., were collected through survey questionnaires. t Test, chi-square test, or non-parametric rank sum test, and univariate and multivariate Logistic regression analysis were conducted to analyze data.The univariate logistic regression analysis results indicated that among all study participants (n = 1802), AA was associated with over 30 risks, in terms of their individual behaviors, daily and environmental exposures, diseases history, and family history. Multivariate logistic regression analysis further confirmed that the independent risks related to AA included presence of chemical factory within 3 km of living residence (odds ratio [OR] = 8.73, 95% CI: 1.42-53.74, P = .019), living in a newly decorated house/apartment (OR = 25.37, 95% CI: 4.44-144.81, P < .001), vegetarian diet (OR = 131.60, 95% CI: 3.45-5020.16, P = .009), preference of sugar (OR = 89.38, 95% CI: 7.22-1106.44, P < .001), preference of oily food (OR = 55.68, 95% CI: 5.12-605.26, P = .001), drinking lake water or pond water (OR = 58.05, 95% CI: 3.21-1049.81, P < .001), habit of staying up late (OR = 11.87, 95% CI: 3.43-41.02, P < .001), infection history (OR = 10.08, 95% CI: 2.75-36.93, P < .001). Result of receiver operating characteristic curve (ROC) analysis on the joint contribution of multiple risks indicated that AA was 13.835 times likely to occur when exposed to ≥1 risks than those exposed to 0 risks (95% CI: 9.995-19.149).Our study results demonstrated a comprehensive epidemiological pattern, in which the joint contributions of individual inherited health status, environment exposure, and individual behaviors lead to the occurrence of AA.

Effect of Chinese medicine treatment based on pattern identification on cellular immunophenotype of myelodysplastic syndrome.

OBJECTIVE: To observe the influence of treatment based on Chinese medicine pattern identification on cellular immunophenotype of the myelodysplastic syndrome (MDS). METHODS: Sixty patients with MDS were randomly and equally assigned to the treatment group and the control group using a randomized digital table. Thirty patients in each group included 3 risk levels (low, moderate and high risks) with each level 10 patients according to the international prognostic scoring system. The control group was given conventional therapy which was also used in the treatment group. While the treatment group was given Zuogui Pill () and Yougui Pill () for low risk patients; Qingwen Baidu Decoction () and Bazhen Decoction () for moderate risk patients; Gexia Zhuyu Decoction () and Qinghao Biejia Decoction () combined with Shiquan Dabu Decoction () for high risk patients. After the treatment, the differences of overall response rate and immunophenotype (CD13, CD14, CD15, CD33 and CD34) of each group were analyzed. RESULTS: The overall response rate of the treatment group was significantly higher than the control group in low risk and moderate risk patients (P=0.029), there was no statistical differences of overall response rate between the treatment group and the control group in high risk patients (P=0.089). The expressions of CD13, CD14, CD33 and CD34 in all three risk levels of the treatment group were obviously decreased after the treatment, while CD15 in all three risk levels of the treatment group was obviously increased after the treatment (P<0.05 or P<0.01). Meanwhile, the difference values of CD13 and CD33 in low risk level of the treatment group, CD33 and CD34 in moderate risk level of the treatment group as well as CD34 and CD15 in high risk level of the treatment group, were all greater than the control groups and they were statistically significant (P<0.05 or P<0.01). CONCLUSIONS: It shows a better therapeutic effect if the MDS patients treated with Chinese medicine pattern identification in addition to conventional therapy. Since the treatment may inhibit the malignant clones and improve the dysmaturity of granulocyte differentiation, it is a feasible option in clinical practice.

[Analysis of clinical features of traditional Chinese medicine symptoms and syndromes of 220 patients with chronic aplastic anemia].

OBJECTIVE: To study Chinese medicine (CM) syndrome types of chronic aplastic anemia (CAA) patients and the distribution laws of typical CM symptoms in different genders. METHODS: From June 2002 to June 2012, 220 CAA outpatients/inpatients at Department of Hematology, Zhejiang Chinese Medical Hospital were recruited. Patients' symptoms and signs, as well as four diagnostic information at the first onset were collected. CM syndrome differentiation was performed. The syndrome types and typical symptoms were analyzed. RESULTS: (1) In the 220 CAA patients, there were 121 cases of Shen yang deficiency syndrome (55.0%), 18 of Shen yin deficiency syndrome type (8.18%), 81 cases of Shen yin-yang deficiency syndrome (36.82%). (2) The distribution of typical symptoms: fatigue and shortness of breath (77.12% males and 73.53% females), pale complexion (64.41% males and 57.84% females), low temperature of four limbs (12.71% males and 26.47% females), spontaneous perspiration and night sweating (32.20% males and 26.47% females), dry mouth and throat (6.78% males and 6.86% females), feverish feelings in palms and soles (14.41% males and 20.59% females), loose stool (6.78% males and 2.94% females), petechiae and ecchymosis (42.37% males and 43.14% females). CONCLUSIONS: Shen yang deficiency syndrome was most often seen in CAA patients at the initial diagnosis, followed by Shen yin-yang deficiency syndrome. Shen yin deficiency syndrome was the least seen. In CM symptoms, fatigue and shortness of breath were most common seen, followed by pale complexion, skin petechia and ecchymosis.

The expression of TMPRSS4 and Erk1 correlates with metastasis and poor prognosis in Chinese patients with gastric cancer.

PURPOSE: The present study investigated the clinical significance of transmembrane protease, serine 4(TMPRSS4) and extracellular signal-regulated kinases 1 (Erk1) in the development, progression and metastasis of gastric cancer. METHODS: Immunohistochemistry was employed to analyze TMPRSS4 and Erk1 expression in 436 gastric cancer cases and 92 non-cancerous human gastric tissues. RESULTS: Protein levels of TMPRSS4 and Erk1 were up-regulated in gastric cancer lesions compared with adjacent noncancerous tissues. High expression of TMPRSS4 correlated with age, size, Lauren's classification, depth of invasion, lymph node and distant metastases, regional lymph node stage and TNM stage, and also with expression of Erk1. In stages I, II and III, the 5-year survival rate of patients with high TMPRSS4 expression was significantly lower than in patients with low expression. Further multivariate analysis suggests that up-regulation of TMPRSS4 and Erk1 were independent prognostic indicators for the disease, along with depth of invasion, lymph node and distant metastasis and TNM stage. CONCLUSIONS: Expression of TMPRSS4 in gastric cancer is significantly associated with lymph node and distant metastasis, high Erk1 expression, and poor prognosis. TMPRSS4 and Erk1 proteins could be useful markers to predict tumor progression and prognosis of gastric cancer.

Clinical observation on the treatment of male neoplastic anemia with Yixuesheng capsule combined with recombination human erythropoietin.

OBJECTIVE: To explore the efficacy and mechanism of Yixuesheng capsule (, YXS) combined with recombination human erythropoietin (RHE) in treating male neoplastic anemia (NA). METHODS: Sixty-five patients were randomized into two groups, the 33 patients in the treated group treated with a combined therapy of YXS and RHE, and the 32 in the control group treated with RHE alone, all for 12 weeks. Related clinical indexes, including hemoglobin (Hgb), red blood cell (RBC), hematocrit (HMC), testosterone (T), estradiol (E(2)) and prolactin (PRL), were measured before and after treatment.) RESULTS: After treatment, Hgb in the treated group and the control group was 108+/-5 g/L and 104+/-8 g/L respectively, showing marked improvement as compared with that before treatment (P<0.01), and the improvement in the former was more significant than that in the latter (P<0.05). Further, the level of T was also increased in the treated group after treatment (P<0.05), and showed a significant difference from that of the control group (P<0.05). CONCLUSIONS: YXS capsule combined with RHE shows a better therapeutic effect in treating NA than that of RHE alone, and the effect might be through stimulation by YXS of erythropoiesis which could promote the secretion of testosterone.

[Differential diagnosis of pancreaticobiliary ductal and duodenal union carcinomas with MRI 3D-VIBE sequence combined with MRCP].

OBJECTIVE: To evaluate the value of MRI 3-dimensional volumetric interpolated breath-hold examination (VIBE) sequence combined with MR cholangiopancreatography (MRCP) in the differential diagnosis of pancreaticobiliary ductal and duodenal union carcinomas (PDDUC). METHODS: Fifty nine patients with PDDUC confirmed by surgical-pathological findings or unequivocal clinical follow-up results were recruited in the study, which included 34 pancreatic head carcinomas, 14 distal common bile duct carcinomas, and 11 ampullary carcinomas. In addition to the routine MRI examinations for the upper abdomen, MRCP and Gadolinium-enhanced 3D-VIBE tri-phase (early arterial phase, late arterial phase and portal venous phase) were performed. The morphological features of the lesions, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the lesions were analyzed. The distance between the ends of the dilated pancreaticobiliary duct, the distance from the duodenal lumen to the distal end of the dilated duct, the diameter of the common bile duct and the pancreatic duct were measured. RESULTS: The differences among the carcinomas in max-diameters, locations, edge features and degrees of signal equality of the lesions showed statistical significance (P < 0.05). The percentage of peripancreatic vascular involvement was significantly higher in the pancreatic head carcinoma than in the others. The pancreaticobiliary conjunction angle, the distance between the ends of dilated pancreaticobiliary ducts, the distance from the duodenal lumen to the distal end of dilated duct were larger in the pancreatic head carcinoma than in the distal common bile duct carcinoma and ampullary carcinoma. The pancreatic head carcinoma showed four-segment signs. During portal venous phase, the mean SNR of the distal common bile duct carcinoma was higher than the pancreatic head carcinoma and ampullary carcinoma (P < 0.05), while in the other phases, no statistical significant differences were found (P > 0.05). The signal intensity of distal common bile duct carcinoma was higher than the pancreatic head parenchyma during portal venous phase. CONCLUSION: MRI 3D-VIBE sequence combined with MRCP can demonstrate the morphologic features and enhancement characteristics of PDDUC, and display the details of abnormalities of pancreaticobiliary duct. It is valuable in the differential diagnosis of pancreatic head carcinoma, distal common bile duct carcinoma and ampullary carcinoma.

[Apoptosis in Jurkat cells induced by bortezomib combined with adriamycin].

OBJECTIVE: The aim of this study was to observe the suppressive effect of bortezomib alone and the synergistic suppressive effect of bortezomib and adriamycin on the proliferation of the cell line Jurkat cells, and to discuss the mechanism of apoptosis induced by bortezomib. METHODS: The suppressive effect of bortezomib and adriamycin on the proliferation of Jurkat cells in vitro was detected by MTT colorimetry, and the morphology of the cells was examined by histology. The cell apoptosis was measured by flow cytometry with Annexin V/PI staining and cell cycle analysis. The effect of bortezomib and adriamycin on the expression levels of caspase-3, caspase-8 and PARP were measured by Nestern blot. RESULTS: The proliferation of Jurkat cells was significantly inhibited by bortezomib treatment (between 10 - 320 ng/ml) for 24 h, 48 h and 72 h, and the growing inhibition ratio showed a positive correlation with the drug concentration (r(24 h) = 0.900, P < 0.01; r(48 h) = 0.849, P < 0.01; r(72 h) = 0.679, P < 0.01), in a concentration-dependent manner. The IC(50) of Jurkat cells treated with bortezomib in a dose of 10 - 320 ng/ml was 137.64 +/- 6.82 ng/ml, but the IC(50) of Jurkat cells treated with bortezomib combined with adriamycin (125 ng/ml) for 24 h was significantly decreased to 20.44 +/- 2.85 ng/ml. The apoptosis rate had a positive correlation with the concentration of bortezomib (P < 0.01). After the Jurkat cells were treated with bortezomib, apparent shear bands of caspase-8, caspase-3 and PARP proteins were observed. CONCLUSION: There is an effect of Bortezomib to induce apoptosis in Jurkat cells, and the extrinsic pathway is one of the apoptosis-inducing mechanisms. There is a synergistic suppressive effect of the combination of bortezomib and adriamycin on the proliferation of Jurkat cells and enhances their chemosensitivity.

Peliosis and gummatous syphilis of the liver: a case report.

Peliosis hepatis is a rare benign vascular disorder of the liver that may be associated with malignancy, infection and drugs. The imaging manifestation of this disorder is often variable and nonspecific making its diagnosis difficult. We describe a rare case of peliosis hepatis and gummatous syphilis of the liver with emphasis on CT findings. Image characteristics of our patient included pseudotumoral appearance of peliosis hepatis, isodensity to the adjacent liver parenchyma on unenhanced and dual-phase scanning. To our knowledge, peliosis hepatis associated with syphilis and unique enhancement pattern has not been reported. Considering the imaging features of peliosis hepatis, it should be considered in the differential diagnosis of atypical focal hepatic lesion.

[Immune response of dendritic cells capturing antigens from apoptotic U937 cells induced by artesunate].

The objective of study was to investigate whether U937 cells-loaded dendritic cells (DCs) could induce anti-leukemic immune activity. The apoptosis of U937 cells was induced by artesunate (ART). DCs derived from peripheral blood mononuclear cells of health donors were loaded with apoptotic U937 cells, and induced to maturation in the presence of TNF-alpha. Matured DCs were cocultured with autologous T-lymphocytes, and combined with IL-2 in order to induce the leukemia-specific CTL. The phenotypes of DCs and T lymphocytes were tested by flow cytometry. The ability of DC capturing antigens was measured by Dextran-FITC endocytosis. The IL-12p70 level was assayed by ELISA kit. The proliferation of CTL and CTL activity were measured by MTT assay. The results showed that the apoptotic rate of the U937 cells was 51.2% when U937 cells were induced by 1 microg/ml ART for 48 hours in vitro. DCs had the most powerful ability of endocytosis in its immature phase. Apoptotic U937 cells could not induce the features of DC maturation, and apoptotic U937 cell-pulsed immature DCs could be matured with TNF-alpha. The IL-12p70 level secreded by apoptotic U937 cell-loaded mature DCs (mDC-(Apo)U937) was higher than that of non-loaded mDC. The proliferation of autologous T lymphocytes co-cultured with mDC-(Apo)U937 was significantly remarkable and the content of CD8(+) CTL was significantly higher in comparison with any other groups. CTL induced by mDC-(Apo)U937 had stronger killing effect on U937 cells than NB4 (p < 0.01). It is concluded that the mDC-(Apo)U937 can effectively generate T cell-mediated dendritic antileukemic responses in vitro.

[Apoptosis of HL-60 cells induced by artesunate in vitro].

The study was aimed to investigate the effect of artesunate (ART) on the apoptosis of HL-60 cells in vitro and the expression of Bcl-2 and ICAD in the process of apoptosis induced by ART. The inhibition of ART on HL-60 cells were evaluated by means of MTT assay; cell apoptosis was detected by light microscopy, agarose gel electro-phoresis, flow cytometry; Western blot was used to analyze the expression of Bcl-2 and ICAD in cells during apoptosis induced by ART. The results showed that ART could significantly inhibit the proliferation of HL-60 cells in time-and dose-dependent manner. After treating HL-60 cells with ART for 48 hours, the IC(50) values was 18.33 microg/ml and its inhibition effect contributed to the induced apoptosis. Bcl-2 and ICAD proteins both all expressed in HL-60 cells, the level of expression declined as concentration increased. It is concluded that artesunate may induce apoptosis of HL-60 cells in vitro, Bcl-2 and ICAD may be an important control factor in the signal transduction pathway of ART-induced apoptosis.