Biological Characteristics and Therapeutic Efficacy of 103 Patients with Acute Erythroleukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the biological characteristics and therapeutic efficacyt of acute erythroleukemia (AEL,AML-M6).</p><p><b>METHODS</b>Blood cell count, liver function, lactate dehydrogenase level, coagulation, morphology, immunology, cell genetics and molecular biology were retrospectively analyzed in 103 cases of acute erythroleukemia patients admitted in our department from May 2016 to June 2009. The therapeutic efficacy was observed by means of remission rate, relapse rate, relapse-free survival and overall survival.</p><p><b>RESULTS</b>The medians of white blood cells, granulocyte, hemoglobin and platelet were 3.04×10/L, 0.67×10/L, 66 g/L, and 45×10/L,respectively. Nucleated red blood cells were found in the peripheral blood smears from 71.1% of AEL patients. None of the patients showed abnormal coagulation function. Flow cytometry analysis indicated that CD13 (93.5%),CD117(89.1%), HLA-DR(87.0%), and CD34 (80.0%) were highly expressed in AEL, and lymphoid antigens of CD4 (42.9%) and CD7(28.9%) were expressed in partial patients. Karyotype analysis in 82 patients showed 52.4% (43/82) normal karyotype, 41.5% (34/82) abnormal karyotype, and 6.1% (5/82) failed tests. In the 34 cases with abnormal karyotype, there were 14(41.2%) cases with simple chromosomal abnomality and 20(58.8%) cases with complex karyotype. The positive rate of fusion gene accounted for 16.7% in 60 patients, and the gene mutations accounted for 77.8% in 27 patients. Among 103 cases of AEL, 81 cases were treated with chemotherapy, but 66 cases can be used for therapeutic analysis, as a results the total complete remission rate derived from 2 courses of treatment was 45.5% (30/66). The relapse rate was 36.7% (11/30), and the median relapse time was 15.5 months (6.2-50 months). The median survival time of 66 patients for therapeutic analysis was 29 months. The median survival time of CR patients was very significantly longer than that of the non-CR patients(P=0.001). The 5 year survival rate of CR patients was 65%, the median time of relapse-free survival (RFS) was 46.2 months and 3-years RFS was 58%.</p><p><b>CONCLUSION</b>AEL is characterized by the highly expressed CD34 antigen, and complex karyotype. Although AEL has lower CR rate and poor prognosis, CR patients can achieve long-term survival and have good quality of life.</p>

Expression of MCL-1 in Primary Acute Myeloid Leukemia Cells and Its Clinical Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect the expression of MCL-1 in patient with acute myeloid leukemia(AML) with normal karyotype and to investigate the relationship of its expression level with clinical parameters and prognosis.</p><p><b>METHODS</b>The expression of MCL-1 in the bone marrow from 37 newly diagnosed AML patients was measured by real-time fluorescent quantitative PCR(FQ RT-PCR) and Western blot, and the relationship between its expression level and clinical parameters such as the age, sex, WBC count, Hb level, Plt count, blast ratio in BM, and sensitivity to chemotherapeutic drugs in vitro prognosis was analyzed.</p><p><b>RESULTS</b>The expression level of MCL-1 did not correlate with the age, sex, WBC count, Hb level, Plt count and the percentage of blast cells. There was no significant difference of MCL-1 expression in AML patients with or without extramedullary infiltration. The higher level of MCL-1 existed in AML patients who did not achieve complete remission with classical regimen. The resistant rate to chemotherapeutic drugs in vitro was higher in the patients with higher level of MCL-1.</p><p><b>CONCLUSION</b>Overexpression of MCL-1 is closely related with the resistance to chemotherapeutic drugs, and may be used as an early indicator for judging multi-drug resistance and prognosis of AML.</p>

Combination of Homoharringtonine with Arsenic Trioxide Induces Apoptosis of Human Acute Myeloid Leukemia Cell Line U937 / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects and mechanisms of the combination of homoharringtonine (HHT) with arsenic trioxide(AsO) on human myeloid cell line U937 in vitro.</p><p><b>METHODS</b>MTT method was used to determine the antiproliferating effect of different concentrations of HHT, AsOand their combination on U937 cells; the flow cytometry with Annexin-V-FITC/PI double staining was used to determine the apoptosis-induced effect of HHT and AsOalone or their combination; Western blot method was used to detect the protein expression of P-Akt,P-Akt,BCL-XL, BID,MCL-1,P-MCL-1 and so on.</p><p><b>RESULTS</b>HHT and AsOcould significantly inhibit proliferation of U937 cells and induce their apoptosis. The combination of these 2 drugs could significantly enhance the early apoptosis of U937 cells. After combination of these 2 drugs was used, the protein expressions of P-Akt,P-Akt,MCL-1,P-MCL-1 and BCL-XL were obviously down-regulated, but the expression of BID protein did not change.</p><p><b>CONCLUSION</b>The combination treatment of HHT and AsOcan synergistically inhibit the growth of U937 cells through inhibition of PI3K/Akt signal way and MCL-1 protein.</p>

Expression of HIF-1α in primary acute myeloid leukemia cells and its relationship with prognosis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>This study was aimed to detect the expression of HIF-1α in acute myeloid leukemia (AML) except acute promyelocyte leukemia (APL) and investigate the relationship of its expression levels with clinical parameters and prognosis.</p><p><b>METHODS</b>The primary AML cells were collected from peripheral blood of 53 newly diagnosed AML patients by using CD3 negative sorting. The expression of HIF-1α was measured by real-time fluorescent quantitative PCR (FQ-PCR) , and the relationship between expression level of HIF-1α and clinical parameters (age, sex, WBC count, clinical typing, prognosis) was analysed according to relative expression level. Furthermore, Western blot was used to detect the protein level of HIF-1α in AML patients with or without extramedullary infiltration.</p><p><b>RESULTS</b>The expression level of HIF-1α did not correlate with age, sex, WBC count, Hb level, Plt count and the percentage of blast. There was no significant difference of HIF-1α expression between different AML subtype based on FAB. The higher level of HIF-1α was found in AML patients who did not get complete remission after one or two courses of chemotherapy, however, the difference was not statistically significant. The relapse rate was higher in AML patients with the higher expression of HIF-1α. In addition, the higher level of HIF-1α mRNA and protein were found in bone marrow of AML patients with extramedullary infiltration (P < 0.01). The negative correlation between HIF-1α and PTEN was observed (r = -0.48, P = 0.001).</p><p><b>CONCLUSIONS</b>Overexpression of HIF-1α are closely related with extramedullary infiltration and prognosis of acute myeloid leukemia, and may be used as an early indicator of extramedullary infiltration and prognosis.</p>

Role of CyclinD1/IgH Detection by FISH in Differential Diagnostic Significance between Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of CyclinD1/IgH detection by FISH in diferential diagnosis between mantle cell lymphoma (MCL) and chronic lymphocytic leukeamia (CLL).</p><p><b>METHODS</b>The FISH detection was performed for CyclinD1/IgH fusion gene. A comprehensive analysis was carried out for clinical features, such as age, sex , WBC count and lymphocyte count, the bone marrow morphology and immunohistochemical staining were carried for CyclinD1/IgH.</p><p><b>RESULTS</b>It is often difficult to distinguish MCL from CLL by bone marrow morphology, when the cell morphology was not typical; there was no difference in age, sex, WBC count and lymphocyte count between MCL and CLL groups; 9 out of 52 patients were diagnosed as MCL, and the direction of CyclinD1/IgH by FISH was positive in 7 of 9 MCL, while 3 of the 7 patients were negative by immunohistochemical staining for CyclinD1.</p><p><b>CONCLUSION</b>Detection of CyclinD1/IgH by FISH can be used as a specific and feasible method for differential diagnosis of mantle cell lymphoma from chronic lymphocytic leukeamia.</p>

Pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios do not predict survival in patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A few inflammatory markers were studied to evaluate their possible prognostic roles in various cancers. The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are hypothesized to reflect the systemic inflammation. The objective of the present study was to investigate whether or not the pretreatment neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio can predict the survival of patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy.</p><p><b>METHODS</b>We performed a retrospective study on cervical cancer patients (FIGO stage Ib2-IIb) who had undergone neoadjuvant chemotherapy and radical hysterectomy at Peking Union Medical College Hospital between January 1999 and December 2010. Data on demographics, clinical prognostic markers and histopathology were collected and analyzed. Univariate and multivariate analyses for prognostic factors were performed.</p><p><b>RESULTS</b>A total of 111 patients were identified. The median neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were 2.4 and 142.2, respectively. Overall survival and progression-free survival were neither significantly different between patients with high and low neutrophil-to-lymphocyte ratio (P = 0.149 and P = 0.108) nor in high and low platelet-to-lymphocyte ratio (P = 0.336 and P = 0.510). On multivariate analysis, lymph node status (P = 0.000 and P = 0.007) and lymphovascular space involvement (P = 0.001 and P = 0.001) were independent prognostic factors of progression-free survival and overall survival.</p><p><b>CONCLUSIONS</b>Lymph node status and lymphovascular space involvement were found to be independent prognostic factors for patients with cervical cancer who underwent neoadjuvant chemotherapy and radical hysterectomy. The pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios seemed not to predict the survival of patients with cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy.</p>

Comparison between peritoneal tuberculosis and primary peritoneal carcinoma: a 16-year, single-center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125. The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis, compare them with features of primary peritoneal carcinoma, and establish definitive diagnostic procedures.</p><p><b>METHODS</b>We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital. During this time, the data of 38 patients with primary peritoneal carcinoma were reviewed.</p><p><b>RESULTS</b>The median age was 34 years (range, 19 - 80 years). The most common symptoms were abdominal distension (16/30, 53.3%) and an abdominal mass (12/30, 40.0%). The serum CA125 level was elevated in 25 patients (83.3%). The median level of cancer antigen CA125 was 392.5 U/ml (range, 0.6 - 850.0 U/ml). Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients. Diagnostic laparoscopy was performed in 15 patients (50.0%) and exploratory laparotomy was performed in 12 patients (40.0%), and 3 patients (10.0%) who underwent laparoscopy converted to laparotomy because of severe adhesions. The intraoperative findings were adhesions, multiple white tubercles, and ascites. Frozen tissue sections were obtained in 17 patients, and 14 of whom showed chronic granulomatous reactions. Final pathological examinations confirmed the diagnosis.</p><p><b>CONCLUSIONS</b>Peritoneal tuberculosis should be considered as a differential diagnosis, especially for young women with an abdominal mass, ascites, and elevated serum CA125 levels. Laparoscopy is a useful diagnostic method for peritoneal tuberculosis, and intraoperative frozen sections are recommended when the diagnosis is in doubt.</p>

Regulation of all-trans retinoic acid and arsenic trioxide on CD44v6 expression in NB4 cells / 中国实验血液学杂志

The adhesion molecule CD44 variant isoform (CD44v6) closely associates with progress of acute myeloid leukemia (AML). This study was purposed to investigate the effects of all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) on the expression of CD44v6 and the associated signal pathway phosphatidylinositol 3-kinase (PI3K)/Akt in acute promyelocytic leukemia (APL) cell line NB4 cells. The differentiation of NB4 was detected by morphologic observation and flow cytometry; the NB4 cell apoptosis was assayed by flow cytometry with Annexin V-FITC/PI double staining; the CD44v6 mRNA expression in NB4 cells was determined by real-time RT-PCR, the CD44v6 protein expression and changes of PI3K/Akt signal pathway in NB4 cells were analysed by Western blot. The results demonstrated that in ATRA-induced differentiation, the transcriptional level of CD44v6 was dominantly down-regulated, the translational level of CD44v6 did not change and the PI3K/Akt signal axis was activated. In As2O3-induced apoptosis, both the transcriptional level and translational level of CD44v6 were remarkably reduced, and the PI3K/Akt pathway was inhibited. It is concluded that the regulation of ATRA on expression of CD44v6 in NB4 cells differs from that of As2O3. The results provide an experimental basis to reveal the different mechanism of ATRA and As2O3 in view of the intercommunication between leukemia cells and hematopoietic microenvironment.

Homing characteristics of graft cells in leukemia mice after allogenic bone marrow transplantation with different conditioning regimens / 中国实验血液学杂志

The aim of this study was to investigate the homing characteristics of bone marrow cells in leukemia mice after allogenic bone marrow transplantation with different conditioning regimens on the basis of a leukemia mouse model. Allogenic bone marrow transplantation was performed after three different kinds of conditioning regimen, including nonmyeloablative conditioning regimen (5 Gy (60)Co γ ray total body irradiation, A group), radiotherapeutic myeloablative conditioning regimen (9 Gy (60)Co γ ray total body irradiation, B group) and chemotherapeutic myeloablative conditioning regimen (large dose chemotherapy, C group). In the recipient mice, the nucleated cell number in peripheral blood, bone marrow and spleen was counted, the percentage of positive cells capable of connecting with FITC labeled anti-mouse H-2K(b) antibody was detected by flow cytometry and the homing ratio in bone marrow and spleen was calculated at 24, 48, 72, 96 h after bone marrow transplantation. The results showed that donor myeloid cells displayed homing and then mobilization (going out of home) in group A; homing, mobilization, and rehoming in group B and C, and there was a little delay of homing in the spleen in group C. In bone marrow, the homing efficiency of A group was the highest in early period and the lowest [(0.90 ± 0.09)%] in the fourth day with the mobilization of myeloid cells (P < 0.05), and the homing efficiency of B and C groups was lower in the early period and the highest [(2.17 ± 0.26)%, B group] in the fourth day with the rehoming of myeloid cells (P < 0.05). In spleen, the homing efficiency was similar to that in bone marrow and there still was a little delay in C group. It is concluded that the homing ratio is high in the early period and decrease obviously in 72 h after bone marrow of leukemia mice treated with nonmyeloablative conditioning regimen. The homing ratio is low in the early period and increases obviously in 72 h after bone marrow of leukemia mice treated with radio-or chemotherapeutic myeloablative conditioning regimens. The homing ratio does not obviously change between the early period and 72 h after bone marrow of leukemia mice treated with chemotherapeutic myeloablative conditioning regimen, and lies between group A and B.

Direct contact with bone stromal HS-5 cells reduces the sensitivity of HEL to drugs / 中国实验血液学杂志

This study was proposed to investigate the sensitivity and resistence of HEL cells co-cultured with bone marrow stromal HS-5 cells to chemotherapeutic drugs. HEL cells were cultured in direct contact with HS-5 cells for 6, 12, and 24 h. Cell Counting Kit-8 (CCK-8) was used to determine the sensitivity of HEL cell to cytarabine, methotrexate, VP16, and daunomycin. Cell cycle distribution was determined by using flow cytometry. Real-time RT-PCR was performed to detect the transcription levels of p19, p21, p27, MDR1, ABCG2 and bcl-2. Western blot was performed to determine the protein levels of p-Akt(Ser473), p-glycogen synthase kinase 3β (p-GSK3β(Ser9)), p-signal transducer and activator of transcription (p-STAT3(Tyr705)), Bcl-2, cleaved-Notch1(V1754), and Hes1. The results showed that chemo-sensitivity of HEL cells was remarkably reduced when co-cultured with HS-5 cells. HEL cells were arrested in the G(0)/G(1) phase after co-culture for 24 h. Transcription of p21 was significantly up-regulated at 6 h. Transcription of p19 decreased at 12 h and returned to baseline at 24 h. No significant changes in the mRNA expression of other genes were found. The expressions of p-Akt(Ser473), p-GSK3β(Ser9), cleaved-Notch1(V1754) and Bcl-2 proteins were significantly up-regulated in HEL cells, and Hes1 protein was significantly down-regulated. There was no change in p-STAT3(Tyr705) expression. It is concluded that the direct contact with HS-5 cells can reduce the chemo-sensitivity of HEL cells.

Leukemia SH-1 cells purged by ZnPcH(1)-based photodynamic therapy / 中国实验血液学杂志

The objective of this study was to investigate the effect of a novel Zinc phthalocyanine (ZnPcH(1)) based photodynamic therapy (PDT) on acute monocytic leukemia cell lines SHI-1 and its mechanism, so as to provide theory basis for bone marrow purging in vitro for patients with leukemia. The killing effect of ZnPcH(1)-PDT on SHI-1 cells were assessed by MTT method; the SHI-1 cell death patterns were analyzed by AO/EB fluorescence staining, TdT-mediated dUTP nick end labeling (TUNEL), DNA ploidy analysis, and Annexin V-FITC/PI double staining.Cell mixture was established by integrating SHI-1 cells with normal bone marrow MNC (by 1:100-1:10 000). Purging effect of ZnPcH(1)-PDT against SHI-1 mixed into normal MNC was assessed by analyzing the expression of fusion gene MLL/AF6 mRNA using nested RT-PCR. The results showed that ZnPcH(1)-PDT could effectively inhibit SHI-1 cell proliferation in dose-dependent manner, and ZnPcH(1)-PDT could induce cell apoptosis in time-dependent manner. 0.5 µmol/L ZnPcH(1)-PDT could completely photoinactivated kill SHI-1 cells in the simulated remission bone marrow. It concluded that ZnPcH(1)-PDT may be a effective and convenient promising purging technique for leukemia.

Expression pattern of myeloid differentiation-related transcription factor mRNA in differentiation of NB4 and HL-60 cells induced by all-trans retinoic acid / 中国实验血液学杂志

Hematopoiesis is coordinated by a complex regulatory network of transcription factors that involves proliferation, differentiation and maturation of a very small population of pluripotent hematopoietic stem cells with self-renewing and differentiating into various specialized and distinct blood cell types. Malfunction of transcription factors may lead to diseases such as acute myeloid leukemia (AML). The purpose of this study was to investigate the expression pattern of transcription factor mRNA in acute myeloid leukemia (AML) cells during in vitro differentiation. The 2 human leukemic cell lines HL-60 and NB4 had been used as model cell lines. Differentiation of HL-60 and NB4 cells was induced by all-trans retinoic acid (ATRA) for 4 days. Morphological changes were observed by May-Grunwald Giemsa stainings, the CD11b expression level was detected by flow cytometry. Transcription factor mRNA profiles (PU.1, C/EBPα, ε, γ, GATA-1, GATA-2) were determined by real time RT-PCR during in vitro HL-60 and NB4 differentiation; The expression level of transcription factor mRNA was relatively quantitatively analyzed by using 2(-ΔΔCT) and compared with control group. The results showed that the expression levels of PU.1 and C/EBP ε mRNA in NB4 differentiation group were 5.75 and 6.16, respectively, which were significantly higher than those in untreated group; while the expression level of C/EBPα, γ, GATA-1, GATA-2 mRNA in NB4 differentiation group were 62%, 31%, 63% and 8.7% respectively, which were significantly lower than those in untreated group; In HL-60 differentiation group, the expression levels of PU.1, C/EBPα, ε were 1.97, 1.95 and 2.35 respectively, which were significantly higher than those in untreated group; while the expression levels of C/EBPγ, GATA-1, GATA-2 in HL-60 differentiation group were 20%, 21% and 18% respectively, which were significantly lower than those in untreated group. It is concluded that dysregulation of transcription factors is a key contributing factor in the pathogenesis of acute myeloid leukemia.

Primary sarcoma of the ovary: clinicopathological characteristics, prognostic factors and evaluation of therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The primary ovarian sarcoma is a very rare malignancy. The objective of this study was to further investigate the clinicopathologic features and outcome in patients with primary sarcoma of the ovary.</p><p><b>METHODS</b>Between 1988 and 2007, 24 patients with primary ovarian sarcoma who underwent treatment at Peking Union Medical Hospital were reviewed retrospectively. Response to treatment, progression and overall survival were analyzed.</p><p><b>RESULTS</b>Patients with ovarian sarcoma had a mean age of (54.3 ± 10.3) years, and 16 of them were postmenopausal. The most common symptom was abdominal pain, present in 14 patients. Of the 24 patients, 16 patients were pathologically diagnosed as carcinosarcoma (known as malignant mixed mesodermal tumor (MMMT)), 2 as ovarian leiomyosarcoma (LS) and 6 patients as ovarian endometrial stromal sarcoma (ESS). The patients in optimal debulking group had a median survival period of 28 months and 1-year survival rate of 71%. The patients in suboptimal debulking group had a significantly lower median survival of 6 months (P = 0.02) and 1-year survival rate of 29%. Among the patients, 23 patients received chemotherapy and most of regimens were based on platinum, 3 patients received chemoradiation. The mean number of courses of combined chemotherapy was 6.6 ± 5.0, and the response was unsatisfactory. The median survival for the entire group was 18.7 months. The one-year survival rate was 58%, and two-year survival rate only 29%.</p><p><b>CONCLUSIONS</b>Ovarian primary sarcoma has a poor overall prognosis. Optimal debulking surgery appears to be of prognostic significance. There is a clear need for further study to explore the role and the regimen of platinum-based chemotherapy in primary ovarian sarcoma.</p>

Expression change of IL-3 receptor system in all-trans retinoic acid induced differentiation of NB4 cells / 中国实验血液学杂志

Interleukin-3 receptor (IL-3R) is a heterodimeric membrane receptor. The α subunit is essential for ligand binding and confers ligand specificity to the receptor. The common beta chain (βc) subunit, which is shared by the granulocyte macrophage-colony stimulating factor (GM-CSF), IL-3 and IL-5 receptors, is required for high-affinity ligand binding and signal transduction, mediating growth and survival of hematopoietic progenitor cells and the production and activation of mature hematopoietic cells. In order to investigate the role of IL-3 receptor system (IL-3Rα, GM-CSFRα and hβc) in myeloid differentiation, the expression level of IL-3 receptor system gene in all-trans retinoic acid (ATRA)-induced NB4 cell differentiation was detected by quantitative real time RT-PCR. At the same time, DNA sequence change was analyzed by cDNA sequencing. The results showed that the expression level of IL-3Rα mRNA was obviously down-regulated in NB4 cells treated with ATRA for 24 hours, but during differentiation of ATRA induced NB4 cells, the expression level of IL-3Rα mRNA was gradually restored, while the expression levels of GM-CSFRα mRNA and hβc mRNA were gradually up-regulated. The sequence of IL-3Rα and GM-CSFRα gene did not change before and after NB4 cells differentiation, but the sequence of hβc gene changed when NB4 cells were treated with ATRA, the expression of hβc mRNA sequence before NB4 cell differentiation taken truncated mutation as dominant, as regards expression of hβc mRNA sequence after NB4 cell differentiation, the truncated mutation of hβc mRNA had restored to wild type. It is concluded that the IL-3 receptor abnormality exists in NB4 cells, over expression of IL-3Rα and truncated mutation of hβc may be involved in proliferation and differentiation block in NB4 cells.

Age-specific prevalence of human papillomavirus by grade of cervical cytology in Tibetan women / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Human papillomavirus (HPV) is believed to be the most common sexually transmitted infection. However, little is known about the prevalence and distribution of HPV types in China. We aimed to assess the prevalence and the distribution of HPV types as well as risks for abnormal cervical cytology in women who reside in the Tibetan Autonomous Region of China.</p><p><b>METHODS</b>A cross-sectional study was performed involving a sample of 3036 women. An epidemiological questionnaire was applied and cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included chi-square and Logistic regression model.</p><p><b>RESULTS</b>In this population, 3.66% (111/3036) had atypical squamous cells of undetermined significance (ASCUS), 1.45% (44/3036) low-grade squamous intraepithelial lesions (LSIL) and 1.09% (33/3036) had high-grade squamous intraepithelial lesions (HSIL). Tibetan women (5.74%, 137/2387) exhibited lower abnormal cytology rates than non-Tibetan women (8.01%, 52/649, P = 0.03). The overall prevalence of HPV infection was 9.19% (279/3036). We failed to identify any differences in HPV prevalence by age. In the groups with normal, ASCUS, LSIL and HSIL, the overall HPV prevalences were 7.41% (211/2847), 24.32% (27/111), 56.82% (25/44) and 45.45% (15/33), respectively. HPV 16 (1.52%, 46/3036) was the most common type, and was also the most prevalent in women with ASCUS (8.11%, 9/111) and HSIL (15.15%, 5/33). The most common HPV type for Tibetan women was HPV 16 (1.42%, 34/2387), whereas for non-Tibetan individuals it was HPV 33 (2.31%, 15/649). Of the 279 HPV-infected women, 40 individuals (14.34%) presented with multiple HPV positivity. Women who had two pregnancies were more likely to have abnormal cytology smear (OR = 1.67; 95%CI: 1.07 - 2.61).</p><p><b>CONCLUSIONS</b>A low prevalence of HPV positivity was observed in women who reside in the Tibetan Autonomous Region of China. The prevalence of abnormal cervical cytology and HPV type distributions were different between Tibetan and non-Tibetan women.</p>

Mullerian adenosarcoma of the uterus: A clinicopathologic analysis of 9 cases / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features, diagnosis, treatment and prognosis of uterine mullerian adenosarcoma.</p><p><b>METHODS</b>The clinicopathological data of 9 cases of uterine mullerian adenosarcoma in PUMC hospital from January 2003 to February 2009 were retrospectively analyzed.</p><p><b>RESULTS</b>There were 6 uterine endometrial adenosarcomas and 3 cervical adenosarcomas. The main clinical manifestations were abnormal vaginal bleeding and pelvic pain. Physical examination showed cervical/vaginal mass, enlarged uterus or pelvic mass. The adenosarcoma was characterized by benign or atypical-appearing neoplastic glands within a sarcomatous stroma. This stroma could appear as periglandular cuffs or intraglandular polypoid projections of increased cellular structure. The primary diagnostic rate was 66.7% and the most common clinical stage was stage I (7/9). All patients received surgical treatment and seven had postoperative chemotherapy, radiotherapy or hormone therapy. Conservation of unilateral ovary or bilateral ovaries was performed in 5 cases. Three patients underwent local excision, which resulted in the preservation of reproductive function. During the follow-up, 2 cases of uterine endometrial adenosarcoma recurred. One patient of clinical stage III containing sarcomatous overgrowth died from recurrence 13 months after surgery. The other one recurred 2 years after local excision of the tumor in the uterine cavity and she remained healthy since hysterectomy.</p><p><b>CONCLUSION</b>Uterine mullerian adenosarcoma is a rare tumor without specific clinical symptoms and signs. The diagnosis depends on pathomorphologic examination. The tumors show low malignant potential and the vast majority are at early stage. Surgical excision is the main treatment strategy with a good prognosis in the early stage disease with complete removal of tumors. The prognosis is poor in advanced adenosarcoma with sarcomatous overgrowth. Due to the relatively high rate of recurrence, long-term follow-up is recommended.</p>

Killing effect of ZnPcH(1)-PDT on lymphoma cells / 中国实验血液学杂志

The objective of this study was to investigate the effect of ZnPcH(1)-PDT on the lymphoma cells and its mechanism. Human Burkitt's lymphoma cell line CA46 and mouse lymphoma cell line P388 were selected as objects for study. The killing effect of ZnPcH(1)-PDT on cells were assessed by MTT method and colony formation assay; the cell death patterns were analyzed by AO/EB fluorescence stain, TdT-mediated dUTP nick end labeling (TUNEL), DNA ladder assay; and the different proportions of each death pattern were determined by Annexin-V(-FITC)/PI double stains. The results showed that ZnPcH(1)-PDT displayed anti-proliferation effect on both CA46 cells and P388 cells in dose-dependent manner. CA46 cells were less sensitive to PDT than P388 cells (p < 0.05). Furthermore, PDT could induce cell apoptosis in time-dependent manner. The rate of cell apoptosis increased in the PDT-treated cells. The results of Annexin-V(-FITC)/PI stain indicated that early apoptosis was the main death pattern in the PDT-treated CA46 cells, while early apoptosis and necrosis were the main death model in the PDT-treated P388 cells. It is concluded that ZnPcH(1)-PDT can effectively inhibit lymphoma cell proliferation and induce cell apoptosis.

Seven cases of epithelial ovarian carcinoma with brain metastasis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To summarize the clinical characteristics, treatment, and prognosis of brain metastasis in patients with epithelial ovarian carcinoma.</p><p><b>METHODS</b>Retrospective analysis was conducted in 7 cases of brain metastases of epithelial ovarian carcinoma from January 1986 to March 2007 in Peking Union Medical College Hospital for summarizing therapy results and prognosis-affecting factors.</p><p><b>RESULTS</b>Incidence of brain metastases of epithelial ovarian carcinoma was about 0.66% (7/1055). Serous adenocarcinoma was the predominant pathological type in 4 cases and the subsequent was adenocarcinoma in 3 cases. All the patients were diagnosed at late stage, 6 cases with the International Federation of Gynecology and Obstetrics (FIGO) stage IIIc and 1 with FIGO stage IV. The mean duration from diagnosis of ovarian carcinoma to brain metastasis was 32.7 +/- 20.0 months (range, 23-73 months). Single metastasis focus occurred in 43% of cases and multiple metastases in 57% of cases. Fifty-seven percent of patients presented extracranial metastasis. Serum CA125 played a role in monitoring reoccurrence and brain metastases. The average survival time was about 12 months. Better treatment with prolonged survival could be achieved by combination of operation and chemotherapy or combination of radiotherapy with chemotherapy.</p><p><b>CONCLUSIONS</b>As a rare condition, brain metastasis of epithelial ovarian carcinoma is rising in incidence with improved treatment of ovarian carcinoma and prolonged survival. However, brain metastasis indicates bad prognosis which can be improved by combined therapy.</p>

Phase II study of gemcitabine combined with platinum chemotherapy for recurrent epithelial ovarian cancer / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer.</p><p><b>METHODS</b>Phase II study of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50.5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractory. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients' response rate (RR) and toxicity of gemcitabine combined with platinum chemotherapy were evaluated.</p><p><b>RESULTS</b>A total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10.0 months (95% CI: 7.0-13.0) after initiation of gemcitabine combined with platinum chemotherapy. There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group (P = 0.061). Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8% of patients. Grade II/III anemia (54.5%) and grade III/IV neutropenia (54.5%) were most common toxicities. Ten (45.5%) patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen (63.6%) patients received granulocyte colony-stimulating factor to relieve neutropenia, and 8 (36.4%) patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treat-ment-associated death.</p><p><b>CONCLUSION</b>Gemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.</p>

High-sensitive C-reactive protein and Insulin Resistance in Elderly Hypertension Patients / 中华高血压杂志

Objective To investigate the relationship between high-sensitive C-reactive protein(hsCRP)and insulin resistance(IR)in elderly hypertension patients.Methods The levels of ambulatory blood pressure mo- nitoring(ABPM),fasting plasma glucose(FPG),fasting insulin(FINS),von Willebrand factor(vWF),hsCRP were measured in elderly patients with hypertension alone(n=260),hypertension coexit with diabetes(n=230), and healthy matched subjects(n=250).Results The levels of FINS,FPG,vWF,hsCRP,systolic blood pres- sure(SBP),diastolic blood pressure(DBP)in the HT and HT+DM group were significantly higher than that in the NC group(P