Caspase1 Inhibitor Ac-YVAD-CMK Prevents and Treats the Acute Graft Versus Host Disease in Mice / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the effect of Caspase 1 inhibitor Ac-YVAD-CMK on acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation(allo-HSCT) and its mechanism.</p><p><b>METHODS</b>Experiments were divided randomly into 3 groups: allogeneic hematopoietic stem cell transplantation combined with splenic cell infusion group (TS group, n=12), allogeneic hematopoietic stem cell transplantation combined with splenic cell infusion plus injection of low dose Caspase 1 inhibitor group (TS+low dose of C group, n=16) and plus high dose Caspase1 inhibitor (TS+high dose of C group, n=19). The body weight of mice in each group was dynamically detected, and the clinical manifestation of GVHD and score of aGVHD were determined, and the chimerism rate of mice was detected after transplantation for 14 days. Th1, Th2 and Th17 cells in peripheral blood were examined by flow cytometry. Peripheral proinflammatory cytokines IL-1β, IFN-γ, IL-1α and IL-18 were examined by enzyme-linked immunosorbent assay(ELISA). The tissues sections of GVHD target organs (liver, lung, colon and skin) were stained with HE for histopathologic examination and histopathologic score.</p><p><b>RESULTS</b>Ac-YVAD-CMK could alleviate murine aGVHD and pathological injury, decreare the incidence and severity of aGVHD in recipient mice. The detection of Th cell subsets in peripheral blood by flow cytometry showed that compared with TS group, the Th1 cell ratio in TS+low dose of C and TS+high dose of C groups was significantly reduced (P<0.05), while the Th2 and Th17 cell ratio was significantly enhanced (P<0.05) in TS+low dose of high dose of C groups. The detection of peripheral inflamematory cytokines by ELISA demonstrated that the inflammatory cytokines including IL-1β,IFN-γ,IL-18 and IL-1α were reduced significantly (P<0.05).</p><p><b>CONCLUSION</b>Ac-YVAD-CMK can improve aGVHD by inhibiting Caspase 1 and reducing the release of some inflammatory cytokines, thereby alleviated the aGVHD pathological damage.</p>

Clinical study of standard dose of rituximab for the treatment of refractory primary immune thrombocytopenia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of rituximab on B-lymphocytes and anti-platelet glycoprotein-specific antibodies in patients with refractory primary immune thrombocytopenic (ITP).</p><p><b>METHODS</b>Thirty-one ITP patients with a median age of 36 years (range 16 - 56 years) received solely intravenous rituximab at the dose of 375 mg/m(2) once weekly for consecutive 4 weeks. Lab studies included complete blood count, serum concentrations of IgG, IgM and IgA. CD3(+), CD4(+), CD8(+), CD19(+) and CD20(+) cell numbers were assayed by flow cytometry and anti-platelet glycoprotein-specific antibodies (GPIIb/IIIa, GPIb/IX) were assayed by monoclonal antibody-specific immobilisation of platelet antigens (MAIPA) prior to and following rituximab therapy. The response was evaluated according to the response criteria of international working group of ITP.</p><p><b>RESULTS</b>Complete responses were achieved in 12 cases, response in 7 cases, and no response in 12 cases. Responses were sustained 2 to 28 months (median 6 months) with 4 cases relapsed. After 4 weeks of rituximab therapy, GPIIb/IIIa and GPIb/IX disappeared in responded patients, and CD 19(+)/CD20(+) cells were almost depleted in all patients. As expected, the serum concentrations of IgG, IgM, IgA, and the T cell counts were not changed after therapy. Four patients developed infusion-related reaction, 1 impaired renal function, and 3 secondary infections.</p><p><b>CONCLUSION</b>Rituximab is effective and safe, and the adverse reaction is tolerable.</p>

Analysis of color doppler ultrasonography of chronic Keshan disease / 中国地方病学杂志

Objective Color doppler ultrasonography of chronic Keshan disease (CKD) was evaluated to provide evidences for clinic diagnosis of the disease. Methods From September to Novermber 2009, according to "Diagnostic criteria of Keshan disease" (GB 17021-1997), 64 cases of CKD were randomly sampled from five Keshan diseased districts in Shandong province, Zoucheng, Sishui, Yishui, Wulian, Jvxian, and Pingyi as patient group. Thirty four healthy volunteers being checked up by Shandong Institute for Endemic Diseases Control and Research were put in control group. All the subjects were examined with Color doppler ultrasonography. The indexes of cardiac structure, left ventricular (LV) systolic function and LV diastolic function were measured.Results Left atrial internal diameter, LV end-diastolic internal diameter, LV end-systolic internal diameter, right ventricular diameter, aorta diameter, right atrial transverse diameter, right atrial long diameter and left ventricle mass of the patient group[(35.38 ± 6.89), (61.57 ± 8.61), (45.39 ± 10.29), (17.22 ± 3.79), (28.69 ± 2.81),(38.00 ± 6.05), (42.68 ± 8.65)mm, (283.22 ± 103.12)g] were higher than that of control group[(26.70 ± 3.27),(45.41 ± 4.93), (26.91 ± 4.35), (13.76 ± 2.27), (24.09 ± 2.89), (31.50 ± 3.32), (35.82 ± 3.14) mm, (156.03 ±39.86)g, t = 6.93, 10.09, 9.98, 4.87, 7.64, 5.81, 4.46, 6.90, all P＜ 0.05]. The LV ejection fraction and fractional shortening of the left ventricular of the patient group[(49.25 ± 14.33)%, (26.11 ± 9.17)%] were lower than that of control group[(73.88 ± 4.04)%, (42.88 ± 3.62)%, t = - 9.79, - 10.22, all P＜ 0.05]. Diffuse hypokinetic motion of the left ventricle reduced in 95% (61/64) of CKD patients, and 5% (3/64) of CKD patients had segmental LV dyskinesia. Seventy five per sent(48/64) of the patients accompanied with mitral regurgitation, and 39% (26/64) of these cases accompanied with tricuspid regurgitation. Meaningful Mitral or tricuspid regurgitation was not found out in control group. Conclusions The CKD patients' bore of atrio-ventricular cavity and LV mass are enlarged, and their motion of ventricle is reduced or partly reduced. They have poor heart function. Mitral regurgitation are more than tricuspid regurgitation. Color doppler Ultrasonography is important in diagnosis of chronic Keshan discase.

Analysis of SCCmec genotyping and antimicrobial susceptibility tests in methicillin resistant Staphylococcus aureus / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the SCCmec genotyping, subtype and antimicrobial susceptibility tests in methicillin resistant staphylococcus aureus to guide the clinical treatment and provide the proof for molecular epidemiology.</p><p><b>METHODS</b>To detect mecA gene and SCCmec genetyping and subtype in 50 MRSA by PCR. According to CLSI's guideline, antimicrobial susceptibility tests were performed with disk diffusion.</p><p><b>RESULTS</b>All 50 MRSA had mecA genes. 45 strains were SCCmec III types; 3 strains were SCCmec III A types; 2 strains were SCCmec II types. There were no SCCmec I and SCCmec IV types. SCCmec II, SCCmec III and SCCmec III A type strains were all multiresistant.</p><p><b>CONCLUSION</b>50 MRSA are all multiresistant. SCCmec III are the main types.</p>

Analysis of liver function index and clinical characters in 122 patients with acute hepatitis E virus coinfection with other hepatitis virus / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To compare the liver function index and clinical characters in 122 patients with acute hepatitis E virus overlapping with other infection.</p><p><b>METHODS</b>The liver function index and clinical characters of 122 patients with acute hepatitis E virus overlapping infection and 40 patients with acute hepatitis E were retrospectively analyzed.</p><p><b>RESULTS</b>No significant differences of ALT, AST, TBIL, DBIL were found between acute hepatitis E groups and overlapping infection hepatitis A or hepatitis B (P > 0.05). However, there were significant differences of Albumin (ALB) and Globulin (GLO) were found between acute hepatitis E groups and overlapping infection hepatitis B (P < 0.01). In acute hepatitis E overlapping infected hepatitis B or hepatitis A patients, more and severe complications were also observed.</p><p><b>CONCLUSION</b>The patients with acute Hepatitis E virus, especially Hepatitis E virus overlapping infection, need to pay more clinical monitor, prevent complication early and lower death rates.</p>

A clinical analysis of HBV reactivation in patients with malignant tumors / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To observe the anti-viral therapy effect on HBV reactivation in malignant tumor patients and hepatitis B virus carriers after their cancer chemotherapy.</p><p><b>METHODS</b>Thirteen cancer patients but also chronic hepatitis B virus carriers were enrolled in this study. They were randomly put into two groups. Eight patients were put in the therapeutic group. They all had abnormal liver functions induced by the reactivation of HBV after their cancer chemotherapy. Then they were treated with lamivudine. The other 5 cases were treated with lamivudine before their cancer chemotherapy when their serum HBV DNA levels were less than 10(3) copies/ml (preventive therapeutic group). The two groups were followed-up with liver function tests and serum HBV DNA level measurements.</p><p><b>RESULTS</b>Among the 8 cases of the therapeutic group, 5 cases died of liver failure; cancer chemotherapy was postponed or even terminated in 3 patients due to liver function abnormality and anti-virus treatment was started. In the preventive therapy group, no HBV reactivation was observed in any of the 5 cases.</p><p><b>CONCLUSION</b>For HBV carrier cancer patients, an anti-viral therapy before their cancer chemotherapy seems to be very important.</p>

The diagnostic value of platelet glycoprotein-specific autoantibody detection in idiopathic thrombocytopenic purpura / 中国实验血液学杂志

To detect levels of platelet glycoprotein-specific autoantibody in idiopathic thrombocytopenic purpura (ITP), chronic aplastic anemia (CAA), hematologic malignancies and healthy volunteers, and evaluate the clinical significance of platelet glycoprotein-specific autoantibody level in diagnosis for ITP, anti-GPIb/IX, anti-GPIIb/IIIa, anti-GPIV and anti-GPV auto-antibodies were detected contemporaneously by a modified monoclonal antibody immobilization of platelet antigen assay (modified MAIPA). The results showed that the total positive rate of antibodies against platelet GPIb/IX, GPIIb/IIIa, GPIV, GPV were 69.99%, 10%, 20% and 0% in ITP, CAA, hematologic malignancy group and healthy volunteers respectively. There was significant difference between ITP and CAA (chi(2) = 20.71, P < 0.005), between ITP and hematologic malignancy group (chi(2) = 12.22, P < 0. 005). There was no positive finding in the healthy control. It is concluded that platelet glycoprotein-specific autoantibody has high value for the diagnosis of ITP,many kinds of antibodies detection at one time can enhance sensitivity, MAIPA is a specific assay for the diagnosis of idiopathic thrombocytopenic purpura.

The contrast study of Pre-S1 protein, HBV-DNA and HBeAg in diagnosing viral replication in patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the role of Pre-S1 protein in diagnosing viral replication in patients with chronic hepatitis B.</p><p><b>METHODS</b>104 consecutive patients with chronic hepatitis B were included in the study, liver biopsy were performed in all patients. Serial serum samples were studied with the quantitative determination of HBV-DNA by a quantitative PCR assay, determination of Pre-S1 protein by ELISA.</p><p><b>RESULTS</b>The positive rates of HBV-DNA and Pre-S1 protein in patients with HBsAg HBeAg anti-HBc (+) both were 96.5%. The positive rates of HBV-DNA and Pre-S1 protein in patients with HBsAg anti-HBe anti-HBc (+) were 81.5%, 72.3%, respectively. The positive rates of HBV-DNA and Pre-S1 protein in patients with HBsAg anti-HBc (+) were 87.5%, 75.0%, respectively. It represented some patients with HBeAg (-) anti-HBe (+/-) still had viral replication. HBV-DNA>10(3) copy/ml as positive criteria for diagnosing viral replication, the positive rate of HBeAg, Pre-S1 were 31.5% (28/89), 80.9% (72/89) in patients with HBV-DNA>10(3) copy/ml, respectively. The concordance rates of HBeAg, Pre-S1 with HBV-DNA were 40.0% (42/104), 82.0% (85/104), respectively.</p><p><b>CONCLUSION</b>It showed that Pre-S1 was more sensitive than HBeAg in diagnosing viral replication in patients with chronic hepatitis B.</p>

The relationship among the counts of platelet, thrombopoietin and spleen index in patients with liver cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the reason of thrombocytopenia in patients with liver cirrhosis, we studied the relationship among platelet counts, serum thrombopoietin (TPO) level and spleen index.</p><p><b>METHODS</b>Serum TPO, platelet counts and spleen index were measured in 71 cirrhotic patients. TPO was measured with ELISA method, spleen index were measured on ultrasonography by the same doctor.</p><p><b>RESULTS</b>Platelet counts in patients with cirrhosis were lower than that of healthy group [(109.20+/-53.39) vs (169.63+/-26.60) x 10(12)/L, P<0.05]. Serum thrombopoietin level in patients with cirrhosis was similar to that of healthy group [(436.42+/-258.97) vs (412.63+/-132.80) pg/ml, P>0.05]. However, serum thrombopoietin level decreased as liver disease aggravated, [(526.13+/-317.44) pg/ml in Child-Pugh grade A, (445.22+/-214.90) pg/ml in grade B and (311.45+/-182.66) pg/ml in grade C, grade A vs. Grade C, P<0.05]. However, decline in platelet counts was accompanied with incline in spleen index coordinately. 35 of 71 cirrhotic patients had normal platelet counts whereas 36 of them had thrombocytopenia. Thrombopoietin levels were higher in non-thrombocytopenia group than in thrombocytopenia group [(529.43+/-282.64) vs. (351.27+/-228.25)pg/ml, P<0.01]; but spleen index of two groups showed no difference [(29.65+/-12.00) vs. (36.35+/-12.68) cm2, P>0.05]. Correlation was found between thrombopoietin level and platelet counts (r=0.252, P=0.025); no correlation was found between spleen index and platelet counts (r=-0.238, P=0.062).</p><p><b>CONCLUSION</b>The decline serum TPO levels might play an important role for thrombocytopenia in patients with liver cirrhosis.</p>