Management of internal hernia after radical gastrectomy for gastric cancer / 中华全科医师杂志

A total of 1 789 patients with gastric cancer underwent radical gastrectomy in our hospital from September 2015 to August 2017, internal hernia (IH) developed in 7 cases with a incidence rate of 0.4%. The general condition, the symptoms, imaging findings, treatment methods and prognosis as well as the types of digestive tract reconstruction of patients were retrospective analyzed. There were 4 cases of Petersen′s hernia, 2 cases of jejuno-jejuno mesenteric hernia and 1 case of diaphragm hernia. All patients developed mechanical obstruction. Imaging examination showed mesenteric vessels overriding sign and double whirl sign. Six patients recovered smoothly, 1 patient gave up treatment due to extensive small bowel infarction. It is indicated that the formation of abnormal channels in the abdominal cavity after radical gastrectomy may lead to IH. The mesenteric vessels overriding sign and the double whirl sign are the unique imaging findings of IH after radical gastrectomy. Closing the abnormal channel can prevent the occurrence of IH after gastrectomy.

Expression of CD45 in newly diagnosed multiple myeloma and the relationship with prognosis / 中华血液学杂志

Objective@#To explore the expression of CD45 in newly diagnosed multiple myeloma (MM) and its relationship with clinical efficacy and prognosis.@*Methods@#This study retrospectively analyzed expression and distribution of CD45 in 130 cases of newly diagnosed MM, comparing clinical efficacy and prognosis in CD45+/CD45- groups.@*Results@#①The CD45+ group was 33 cases (25.38%) , and CD45- group was 97 cases (74.62%) . ②The objective remission rate (ORR) of CD45+ and CD45-group was 33.33% and 64.95%, respectively. The difference was statistically significant (P=0.002) . For patients in Bortezomib regimen, the ORR of CD45+ and CD45- group was 35.71% and 66.25%, respectively. The difference was statistically significant (P=0.005) . ③The median progress free survival (PFS) of CD45+ group and CD45- group was 29.8 (95%CI 10.0-59.0) months vs 34.5 (95%CI 6.0-69.0) months (χ2=14.59, P<0.001) and the median overall survival (OS) was 32.5 (95%CI 10.0-68.0) months vs 37.6 (95%CI 6.0-78.0) months (χ2=11.42, P=0.001) , respectively. Among the patients in bortezomib regimen, The median PFS and median OS of CD45 + group and CD45- group were 30.3 (95%CI 10.0-59.0) months vs 36.3 (95%CI 6.0-69.0) months (χ2=14.75, P=0.001) and 34.0 (95%CI 10.0-68.0) months vs 39.5 (95%CI 6.0-78.0) months (χ2=10.62, P=0.001) . ④Cox risk regression model analysis showed that serum creatinine≥176.8 μmol/L (HR=5.078, 95%CI 1.744-14.723, P=0.001) , CD45 positive (HR=14.504, 95%CI 0.168-0.42, P=0.001) , LDH≥220 IU/L (HR=1.308, 95%CI 1.16-2.417, P=0.015) were independent risk prognostic factors.@*Conclusion@#CD45 expression is a risk prognostic factor of MM patients. Bortezomib did not improve the poor prognosis of CD45+ MM patients.

Management of internal hernia after radical gastrectomy for gastric cancer / 中华全科医师杂志

A total of 1 789 patients with gastric cancer underwent radical gastrectomy in our hospital from September 2015 to August 2017,internal hernia (IH) developed in 7 cases with a incidence rate of 0.4％.The general condition,the symptoms,imaging findings,treatment methods and prognosis as well as the types of digestive tract reconstruction of patients were retrospective analyzed.There were 4 cases of Petersen's hernia,2 cases of jejuno-jejuno mesenteric hernia and 1 case of diaphragm hernia.All patients developed mechanical obstruction.Imaging examination showed mesenteric vessels overriding sign and double whirl sign.Six patients recovered smoothly,1 patient gave up treatment due to extensive small bowel infarction.It is indicated that the formation of abnormal channels in the abdominal cavity after radical gastrectomy may lead to IH.The mesenteric vessels overriding sign and the double whirl sign are the unique imaging findings of IH after radical gastrectomy.Closing the abnormal channel can prevent the occurrence of IH after gastrectomy.

Efficacy observation of gemcitabine regimen and CHOP-like regimen as the first-line treatment of extranodal NK/T-cell lymphoma / 白血病·淋巴瘤

Objective To compare the efficacy and safety of combined regimen of gemcitabine and CHOP-like regimen as the first-line treatment for primary extranodal NK/T-cell lymphoma. Methods A retrospective analysis was carried out in 39 newly treated patients with extranodal NK/T-cell lymphoma in Henan Provincial People's Hospital from March 2012 to March 2017, in which 11 patients were treated with gemcitabine regimen and 28 patients were treated with CHOP-like regimen. The complete remission (CR) rate, partial remission (PR) rate, overall remission rate (ORR), overall survival (OS) rate, progression free survival (PFS) rate, and adverse reactions in the two groups were compared. Results In gemcitabine group and CHOP-like group, there were 5 and 8 cases achieved CR, 3 and 5 cases achieved PR. There was no statistically significant difference in CR rates and ORR between the two groups (P= 0.453, P= 0.073). The estimated 3-year OS rate in the two groups were 75 % and 33 %, and the estimated 3-year PFS rate were 70%and 29%, respectively. There was statistically significant differences in OS and PFS between the two groups (χ2 = 5.606, P= 0.018; χ2 = 3.924, P= 0.048). The univariate analysis showed that the treatment program (P=0.018) and the high lactate dehydrogenase (LDH) (P= 0.007) affected the prognosis of patients. Multivariate analysis showed that the high LDH increased the risk of death in patients (RR= 6.331, 95% CI 2.339-17.136, P< 0.001). Treatment with gemcitabine regimen reduced the risk of death in patients (RR=0.101, 95 %CI 0.023-0.452, P= 0.003). Most of the adverse events were 1-2 levels, and the patients were well tolerated. Conclusion Compared with CHOP-like regimen, the combined regimen of gemcitabine can improve the survival time of the patients with extranodal NK/T-cell lymphoma and significantly improve the long-term efficacy.

Analysis of clinical characteristics and prognostic factors in patients with non-Hodgkin lymphoma and HBV infection / 中华血液学杂志

Objective@#To explore the clinical characteristics and prognostic factors of the patients with non-Hodgkin’s Lymphoma (NHL) complicated with HBV infection, so as to provide a basis for clinical accurate diagnosis and prognosis evaluation.@*Methods@#The data of 313 newly diagnosed NHL patients from August 2012 to July 2016 were collected. The HBV serological markers were detected by ELISA, and HBV DNA was quantified by full automatic microparticle chemiluminescence immunoassay (≥1×105 copies/ml as high copy group, 1×103-<1×105 copies/ml as low copy group). The relationship between HBV infection and prognosis was analyzed combined with the clinical features of the patients, and the HBV detection rate was compared with that of the common population (from the national HBV sero epidemiological data).@*Results@#①The positive rate of HBsAg in NHL patients was 12.5% (39/313), which was higher than 7.2% in the general population (χ2=14.596, P<0.001). HBV infection in the past (HBsAg negative but HBcAb positive) in 114 cases (36.4%), the incidence was slightly higher than that in the general population (34.1%). ②Compared HBsAg positive group with the negative group, the proportion of B cell type (87.2% vs 70.3%, P=0.027), Ann Arbor stage Ⅲ-Ⅳ(69.2% vs 34.6%, P<0.001), IPI score 3-5 (74.4% vs 50%, P=0.004), LDH level (79.5% vs 47.8%, P<0.001) and liver involvement (45.5% vs 31.7%, P=0.006) were all higher. The difference was statistically significant. ③Compared the HBV infected group (114 cases) with the non-infected group (160 cases), the difference had statistical significance in the proportion of Ann Arbor stage Ⅲ-Ⅳ (P=0.023) and IPI score 3-5 scores P=0.035). ④Compared HBV DNA positive group (30 cases) with negative group (71 cases), Ann Arbor stage Ⅲ-Ⅳ (P=0.011), IPI score 3-5 score (P=0.030), LDH level (P=0.025) and liver involvement (P<0.001) in the proportion of patients had statistical significance. The positive patients were divided into HBV DNA high and low copy groups with 1×105 copies of /ml as the boundary. The results showed that there was no statistical difference between the two groups (P>0.05).@*Conclusions@#The HBV infection rate of NHL patients is significantly higher than that of the general population, and HBV infection is more closely related to B cell type NHL. Patients with HBV infection and HBV DNA positive had late Ann Arbor stage, high IPI score, high LDH level and liver involvement, and the prognosis is poor.

Effects of Compressive Stress on Osteoclast Activation / 医用生物力学

Objective To establish the 3D hydrogel cell model and apply compressive stress with different intensities, frequencies and durations on osteoclasts, so as to observe the effect of compressive stress on osteoclast differentiation and investigate the appropriate compressive stress solution for inhibiting osteoclast differentiation. Methods M-CSF and RANKL were used to induce bone marrow mononuclear cells into osteoclasts. After the 3D cell-agarose mixture was seeded in compression culture plate, compressive stress was applied on osteoclasts with different intensities, frequencies and durations the next day. The cells in control group were not interfered. The cells were divided as following: G0 (control group), G1 (1%, 0.5 Hz, 4 h), G2 (2%, 0.5 Hz, 4 h), G3 (3%, 0.5 Hz, 4 h), G4 (1%, 1.0 Hz, 4 h), G5 (2%, 1.0 Hz, 4 h), G6 (3%, 1.0 Hz, 4 h). After the loading plan with the most effective intensity and frequency was calculated by statistical analysis, compressive stresses were applied on cells with different durations as following: D1(4 h), D2(8 h), D3(12 h), D4(16 h), and each group had two samples. Once compressive loading was finished, the total RNA extraction from cell-gel constructs were performed and Ctsk mRNA, NFATc1 mRNA, TRACP mRNA, M-CSF mRNA and RANK mRNA were measured by quantitative testing. Results RANK and TRACP mRNA expression significantly depended on intensities and frequencies of the compressive stress (P<0.01), and Ctsk mRNA significantly depended on intensities(P<0.01) while it differed notably with different frequencies (P<0.01). M-CSF mRNA expression with 8 h was much lower than that with 12 h (P<0.01) and 16 h (P<0.05). RANK mRNA expression with 8 h was lower than that with 12 h (P<0.05) and 16 h (P<0.01). In addition, Ctsk and NFATc1 mRNA expression with 16 h was higher than that with 4 h and 8 h (P<0.05). Conclusions In the 3D hydrogel model, 1% intensity, frequency of 0.5 Hz, cyclic compression intervention with 8 h can suppress the differentiation of osteoclasts. The research findings provide the theoretical basis for preventing osteoporosis and improving the peak bone mass by appropriate exercise.

Efficiency and safety of endoscopic therapy for early esophageal cancer and precancerous lesions with length more than 5 cm / 中华消化内镜杂志

Objective To compare the effectiveness and safety of endoscopic submucosal dissection ( ESD) with endoscopic piecemeal mucosal resection ( EPMR) for early esophageal cancer and precancerous lesions with length more than 5 cm. Methods A retrospective analysis was performed on data of 85 patients diagnosed as early esophageal cancer and precancerous lesions with length more than 5 cm in Fujian Medical Association of Early Esophageal Carcinoma from January 2012 to July 2017. The patients were divided into ESD group (52 cases) and EPMR group (33 cases), and the effectiveness and safety between the two groups were compared. Results There was no significant difference on the complete resection rate between the two groups[86. 5％ (45/52) VS 87. 9％ (29/33), P>0. 05]. The operative time (58. 53±30. 50 min VS 32. 06±9. 12 min), postoperative fasting time (4. 18±1. 30 d VS 3. 67±0. 96 d), postoperative hospital-stay time (7. 45±2. 44 d VS 6. 54±1. 73 d), and postoperative antibiotics using time (3. 48±2. 33 d VS 1. 96±2. 20 d) in ESD group were higher than those in EPMR group (all P<0. 05). There were no significant difference in the rate of intraoperative complication and short-term postoperative complication, such as fever, chest pain, and postoperative bleeding, between the two groups ( all P>0. 05 ) . But the postoperative stricture rate of ESD group was higher than that of EPMR group[23. 1％ (12/52) VS 6. 1％(2/33), P<0. 05]. During the follow-up of 3-63 months, 5 cases recurred in ESD group and 1 case in EPMR group, with no significant difference ( P>0. 05). Conclusion ESD and EPMR have equivalent efficacy and safety on the treatment of early esophageal cancer and precancerous lesion. EPMR has a shorter operative time, lower rate of post-operative stricture, and is easier to master.

Surgical treatment and prognosis of Borrmann type IIII( gastric cancer involving the whole stomach / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the surgical treatment and prognosis of Borrmann type IIII( gastric cancer involving the whole stomach.</p><p><b>METHODS</b>Clinicopathological characteristics and survival data of 223 patients with Borrmann type IIII( gastric cancer involving the whole stomach (defined as the tumor infiltrating 3 regions of the stomach) receiving surgical treatment at the Department of Abdominal Surgery of Zhejiang Cancer Hospital between January 2002 and December 2015 were analyzed retrospectively. The survival time of patients with different clinicopathological features and different treatment methods was compared. Cox regression was used to analyze the independent prognostic factors.</p><p><b>RESULTS</b>Two hundred and twenty-three patients with Borrmann type IIII( gastric cancer involving the whole stomach accounted for 24.0% (223/930) of all Borrmann type IIII( gastric cancer cases undergoing surgical resection at the same period. There were 147 males and 76 females with an average age of 57.8 years. All the patients underwent total gastrectomy. Of these patients, radical resection was performed in 149 cases(66.8%) and palliative resection in 74 cases (33.2%). Combined organ resection was performed in 43 patients (19.3%), including 25 splenectomies, 6 pancreatic body and tail plus spleen and transverse colon resections, 2 transverse colon plus spleen resections, 2 right colon resections, 2 transverse colon resections, 2 ovariectomies, 1 partial jejunal resection, 1 pancreatoduodenectomy, 1 pancreatic tail plus transverse colon resection, and 1 partial pancreatectomy. Postoperative complications occurred in 28 patients(12.6%), including 10 patients with combined organ resection. Esophagojejunal fistula was the most frequent complication, accounting for 39.3%(11/28). Perioperative mortality occurred in 3 patients (1.3%). Thirty-nine patients underwent preoperative adjuvant chemotherapy (clinical stage: cT4aN0M0 in 1 patient, cT4bN1-2M0 in 12 patients, cT4aN1-2M0 in 20 patients, and cT4aN3M0 in 6 patients). Among these 39 patients, post-chemotherapeutic degenerative response was detected in 25 postoperative pathological specimens (64.1%), radical resection was performed in 21 patients (53.8%), distant metastasis was observed in 7 patients (17.9%) and peritoneal metastasis was found in 17 patients (43.6%) during operation. The average maximal tumor diameter was 13.2 cm (range from 6 to 22). Histological types included 23 moderate-poorly differentiated adenocarcinomas (10.3%), 146 poorly differentiated adenocarcinomas (65.5%), 41 signet ring cell carcinomas (18.4%), 11 mucinous adenocarcinomas(4.9%), 1 squamous cell carcinoma (0.4%) and 1 undifferentiated carcinoma (0.4%). Tumor-infiltrating duodenum was found in 57 patients (25.6%) and tumor-infiltrating esophagus in 132 patients (59.2%). The positive margin was found in 66 patients (29.6%): upper margin in 35 patients (15.7%), lower margin in 22 patients (9.9%), and both margins in 9 patients(4.0%). Immunohistochemical positive HER2(3+) was detected in 4 patients (1.8%). Tumor infiltrating into serosa(T4a) was found in 197 patients (88.3%) and infiltrating into adjacent organ (T4b) in 26 patients(11.7%). One hundred and forty-three cases (64.1%) had lymphatic or venous invasion, 187 (83.9%) had neural invasion, and 35 (15.7%) had cancer nodules. Of 149 patients undergoing radical resection, 5 patients were stage II(b, 9 patients were III(a, 20 patients were III(b and 115 patients were III(c. Of 145 patients(65.0%) undergoing postoperative chemotherapy, the average cycles of chemotherapy was 3.6 (median 3 cycles) and only 69 patients (47.6%) completed 4 cycles or more. Patients were followed up for 1-102 months (average 17.3 months). The median overall survival time was 13.8 months and the 1-, 3-, and 5-year survival rate was 57.9%, 14.1% and 6.8% respectively. The median survival time of the 149 cases with radical resection was 16.7 months and the 1-, 3- and 5-year survival rate was 67.5%, 16.5% and 8.4% respectively; the median survival time of the 74 cases with palliative resection was 10.3 months and the 1-, 3- and 5-year survival rate was 42.6%, 8.5% and 1.7% respectively, whose differences were statistically significant (all P=0.000). Multivariate analysis showed that tumor staging (P=0.005), radical resection (P=0.009), lymphatic or venous invasion (P=0.017) and postoperative chemotherapy (P=0.001) were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Surgical treatment for Borrmann type IIII( gastric cancer involving the whole stomach is safe. Radical resection can improve the prognosis though the overall survival is poor.</p>

The analysis of prognosis-associated factors in adults with acute promyelocytic leukemia / 中华血液学杂志

Objective@#To explore the prognostic value of CD34, CD2, CD56 expressions and FLT3-ITD mutation in adults with acute promyelocytic leukemia (APL) .@*Methods@#The immuno-phenotypic and molecular characteristics of 137 adult patients with APL (from January 2010 to March 2016, in Henan Provincial People’s Hospital) were investigated. And the relationships between CD34, CD2, CD56 expressions, FLT3-ITD mutation and the outcomes of high WBC counts at onset, complete remission (CR) rate, early mortality, relapse rate (RR) , overall survival (OS) , disease free survival (DFS) were explored.@*Results@#①Among the 137 patients, the positive ratios of CD34, CD2, CD56 expressions and mutation rate of FLT3-ITD were 26.3%, 25.5%, 10.2% and 17.5%, respectively. The morbidities of positive CD34, CD2, CD56 expressions and FLT3-ITD mutation in the high-risk group were 43.2%, 47.7%, 18.2% and 27.3% respectively, while those in the low-/intermediate-risk groups were 18.3%, 15.1%, 6.5% and 12.9%, respectively (P<0.05) . ②At a median follow-up of 41 months, the total CR rate of the 137 adults APL patients was 96.9%, early mortality 6.6% and relapse rate 7.3% respectively. And RR of positive CD34 or CD2 expression patients was higher than negative CD34/CD2 expression ones (18.8% vs 3.3%, χ2=8.462, P=0.004; 16.1% vs 4.3%, χ2=4.382, P=0.028, respectively) . In addition, the early mortality of patients with positive CD56 expression or FLT3-ITD mutation was extremely higher than in negative ones (21.4% vs 4.9%, χ2=5.610, P=0.018; 16.7% vs 4.4%, χ2=4.833, P=0.028, respectively) . ③The whole OS and DFS were 88.3% and 84.7%, respectively. Wherein, OS and DFS in patients with CD34+, CD56+ or FLT3-ITD mutation were worse (P<0.05) .@*Conclusions@#Positive CD34, CD2, CD56 expression and FLT3-ITD mutation were latent poor prognostic factors in adults with APL.

Efficacy of combination of ATRA, ATO and anthracyclines induction therapy in patients with acute promyelocytic leukemia / 中华血液学杂志

Objective@#To explore the efficacies of regimens of three-drug induction therapy (ATRA+ATO+anthracyclines) versus two-drug induction therapy (ATRA+ATO) in patients with acute promyelocytic leukemia (APL).@*Methods@#Of 184 patients diagnosed with APL from January 2009 to March 2016, 58 patients underwent three-drug induction therapy, while the rest were treated with two-drug induction therapy. Three-drug induction therapy was of ATRA (20 mg·m-2·d-1, d1-28) + ATO (0.16 mg·kg-1·d-1, d1-28) + Idarubicin (8 mg·m-2·d-1, d3-5) /daunorubicin (40 mg·m-2·d-1, d3-5) , while two-drug induction therapy ATRA+ATO with the same doses and methods as above. Of 184 cases, 69 cases accompanied with WBC counts>10×109/L, 115 cases with WBC counts≤10×109/L at onset.@*Results@#①Short-term efficacy: After one cycle induction therapy, the rates of hematologic remission, genetic remission, molecular remission and induced differentiation syndrome (DS) in three-drug regimen group were 98.3%, 87.9%, 72.4% and 0 respectively, while those in two-drug regimen group were 87.3%, 65.9%, 51.6% and 12.7% respectively. In patients with WBC >10×109/L, DS rate and early mortality in three-drug regimen group were lower than in two-drug regimen group (0 vs 15.6%, 4.2% vs 15.6%, respectively). In patients with WBC≤10×109/L, DS rate in three-drug regimen group was also lower than in two-drug regimen group (0 vs 12.3%) , but there were no statistical differences in terms of relapse and early mortality. ② Long-term efficacy: The relapse rate, overall survival (OS) and disease free survival (DFS) in three-drug regimen group were 0, 98.5%, 96.6% respectively, while those in two-drug regimen group were 8.6%, 86.5% and 84.1% respectively; the advantages of three-drug over two-drug regimen, especially in cases of WBC >10×109/L were observed. ③ Side effects: the incidences of gastrointestinal reaction, liver dysfunction, myocardial damage and headache in three-drug regimen group hardly increased.@*Conclusion@#The efficacies of three-drug induction therapy were superior to two-drug one.

Clinical value of serum cystatin C measurements in patients with HBV related acute-on-chronic liver failure / 中华实验和临床病毒学杂志

Objective@#To study the clinical value of serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and matrix metalloproteinase (MMP)-9/NGAL-1 measurements for early diagnosis of acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF).@*Methods@#This study included 102 patients with hepatitis B virus related ACLF and 31 patients with chronic hepatitis B (CHB) were enrolled as controls. Biomarkers including serum cystatin C, NGAL and MMP-9/NGAL-1 were measured twice in the patients with ACLF at admission and at the time progressed to AKI and once in the controls.@*Results@#In patients with ACLF, serum cystatin C levels was higher than that of the CHB control (t=3.609, P=0.000), whereas NGAL and MMP-9/NGAL-1 levels were lower in patients with ACLF than that of CHB controls (t=3.016, P=0.003; t=7.514, P=0.000, respectively). Thirty-three patients (32.4%) progressed to AKI during hospitalization period. In AKI group of the patients serum cystatin C levels was higher than that of non-AKI group of the patents (t=4.543, P=0.000). MMP-9/ NGAL-1 and NGAL levels were not different in patients with and without AKI (t=0.905, P=0.368; t=0.061, P=0.952). Serum cystatin C in patients with mild AKI (serum creatinine<1.5 mg/dl) and AKI serum creatinine>1.5 mg/dl were 33.59± 9.19 ng/ml and 43.32±9.02 ng/ml respectively. That was higher than that of non-AKI patients (27.94±7.93 ng/ml, P=0.022, 0.000, respectively). Serum cystatin C was the independent risk factors associated with development of AKI by a multivariate logistic regression in patients with ACLF.@*Conclusions@#Serum cystatin C measurement may contribute to more earlier diagnosis of AKI even in patients with S. creatinine<1.5 mg/dl. NGAL and MMP-9/NGAL-1 may be the biomarker of progress for ACLF.

Prognostic value of dynamic monitoring of RUNX1-RUNX1T1 transcript in pediatric acute myeloid leukemia / 中华血液学杂志

Objective@#To investigate the prognostic value of dynamic monitoring of RUNX1-RUNX1T1 transcript in pediatric patients with t (8;21) acute myeloid leukemia (AML) .@*Methods@#The clinical features and RUNX1-RUNX1T1 transcript levels of 55 pediatric t (8;21) AML patients, newly diagnosed from Jan. 2010 to Apr. 2016, were analyzed retrospectively. The relationship between the minimal residual disease (MRD) and prognosis was analysed by dynamic monitoring of RUNX1-RUNX1T1 transcript levels using real-time quantitative PCR (RQ-PCR) technology.@*Results@#The RUNX1-RUNX1T1 transcript levels in bone marrow cells at diagnosis was not related to relapse. After one course of induction therapy, patients with a more than 2 Log reduction of RUNX1-RUNX1T1 transcript levels (>2 Log) had lower 5 years cumulative incidence of relapse (CIR) [ (24.3±8.4) % vs (52.6±9.7) %, χ2=9.046, P=0.003], relapse-free survival (RFS) [ (71.6±12.7) % vs (48.1±13.2) %, χ2=5.814, P=0.016], and better overall survival (OS) [ (76.9±12.5) % vs (48.9±14.7) %, χ2=6.346, P=0.012], compared to patients with a less than 2 Log reduction (a<2 Log) . Multivariate Cox survival analysis suggested that a>2 Log reduction in RUNX1-RUNX1T1 transcript levels after a course of induction therapy was an independent prognostic factor for RFS (HR=0.263, 95%CI 0.081-0.851, P=0.026) and OS (HR=0.214, 95% CI 0.057-0.808, P=0.023) . During consolidation therapy and follow-up period, molecular relapse of 16 cases and hematologic relapse of 13 cases were identified by continuous dynamic monitoring of RUNX1-RUNX1T1 transcript levels, with a median interval of 4.0 (1.5-5.8) months from the molecular relapse to hematologic relapse. 2 cases of molecular relapse who received timely allogeneic hematopoietic stem cell transplantation did not experience hematologic relapse.@*Conclusion@#Dynamic monitoring RUNX1-RUNX1T1 transcript levels by RQ-PCR technique can subdivide patients into relatively low and high risk group, early screen patients at high risk of relapse and provide a scientific basis for precision stratification and risk-adapted therapy for pediatric t (8;21) AML children.

3D Hydrogel Compression Model and Effect of Cyclic Compression on Osteoblast Differentiation / 中国生物工程杂志

Objective:3D hydrogel cell model was established,and cyclic compressive loading on MC3T3-E1 cell with different intensities,frequencies and durations was applied,in order to research the suitable solution about promoting the osteoblast differentiation with cyclic compression.Methods:Cyclic compressive loading on MC3T3-E1 cell was applied with different intensity,frequency and time.After compressive loading finished,the total RNA extraction from cell-gel constructs were performed and quantified ATF4,ALP,Runx2,Osteocalcin,RANKL and RANK mRNA.Results:RANKL and RANK mRNA expression significantly with different frequencies cyclic compressive loading (P ＜ 0.05),and ALP mRNA (P ＜ 0.05) and Runx2 mRNA (P ＜ 0.01) expression significantly with different intensities and frequencies cyclic compressive loading (P ＜ 0.05).Meanwhile,Runx2 mRNA expression with 4h significant higher than 12h (P ＜ 0.05),and RANKL mRNA expression with 4h significant lower than 12h (P ＜ 0.05).Conclusion:Determine the stress intensity and frequency,1％ intensity,frequency of 0.5 Hz,4 h of cyclic compression intervention could promote the growth of osteoblasts-like cells in the 3D hydrogel model.

Advance in Exercise for Bone Metabolism Pathways (review) / 中国康复理论与实践

The process of exercise regulating bone metabolism is complicated, which involves a number of signaling pathways. A large number of studies in vitro have indicated that mechanical stress regulates bone metabolism by Wnt, bone morphogenetic protein (BMP), and osteoprotegerin (OPG)/receptor activator of NF-κB ligand (RANKL)/receptor activator of NF-κB (RANK) signaling pathways. Both the in-tensity and frequency of mechanical stress have varing impact on bone tissue and cells. Plenty of studies in vivo also have shown that exer-cise regulates bone metabolism by key factors in bone metabolism signaling pathways. This paper reviewed the effects of exercise on bone metabolism pathways and their mechanisms.

Induction of furanodiene on apoptosis of human gastric adenocarcinoma MGC-803 cells / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect of furanodiene(FDE),a diterpene derived from the medicinal plant Zedoary,on apoptosis of human gastric cancer MGC-803 cells induced in vitro. METHODS MGC-803 cells were treated with FDE 46.29~740.74μmol·L-1 for 24,48 and 72 h,and the cell viability was detected with MTT assay. Cell morphology was observed by light microscopy and Hoechst33342 staining. Flow cytometry was used to detect cell apoptotic rate and cell cycle. Rh123 staining and fluorescence probe DCFH-DA were employed to detect the changes in mitochondrial membrane potential (MMP) and reactive oxygen species(ROS). RESULTS MTT Results showed that FDE 46.29-740.74μmol · L-1 exhibited significantly higher cytotoxicity to gastric cancer MGC-803 cells. IC50 for MGC-803 of 24,48 and 72 h treatment was 347.91,257.41 and 101.01μmol·L-1,respectively. Treatment with FDE 92.58-370.32μmol·L-1 for 24 h also caused significant morphological changes in MGC-803 cells. AnnexinⅤ-FITC/PI double staining showed that the apoptotic rate increased after FDE 92.58-370.32μmol·L-1 treatment for 24 h(P<0.05). FDE enabled MGC-803 cell cycle arrest in S phase. DCFH-DA staining showed that FDE resulted in an increase in intracellular ROS levels(P<0.05) when PDE concentration was 370.37μmol·L-1(P<0.05). MMP decreased after FDE treatment when PDE concen?tration was 370.37μmol·L-1(P<0.05). CONCLUSION FDE Possesses potent tumor selected toxicity and can induce apoptosis of MGC-803 cells through cell cycle arresting,which is related to inhibition of DNA biosynthesis.

Clinical significance of indoleamine 2,3-dioxygenase expression in human acute leukemia / 白血病·淋巴瘤

Objective To determine the expression of indole-2,3 dioxygenase (IDO) in human acute leukemia,and to investigate its correlations with clinicopathological parameters and prognosis in acute leukemia.Methods The expression of IDO in protein and RNA levels was detected by immunohistochemistry and real-time quantitative RT-PCR,respectively,and the correlations of IDO with clinicopathologic features and prognosis of acute myeloid leukemia (AML)-M5 were analyzed.Results The positive rate of IDO protein was 63.3 ％ (38/60) in human acute leukemia,while it in AML (34/49,69.4 ％),especially in AML-M5 patients (29/35,82.9 ％),was significantly higher than that of acute lymphoblastic leukemia (4/11,36.4 ％).The expression of IDO protein in healthy human peripheral blood mononuclear cells was negative.The RNA expression level of IDO in AML-M5 or non AML-M5 patients were significantly higher than that of healthy people (P ＜ 0.001),and AML-M5 patients had significantly higher IDO RNA level than that in non AML-M5 patients (P ＜ 0.05).The IDO gene expression was not correlated with sex,age and drug sensitivity,while it was closely related with these factors in the patients without complication of pulmonary infection.IDO could not act as an independent prognostic marker.Conclusion The expression of IDO in AML-M5 patients is significantly higher than that in non AML-M5 patients and healthy people.The positive expression of IDO is associated with poor prognosis of AML-M5 patients,but it is not an independent poor prognostic indicator.

The effect of reoperation on the prognosis of gallbladder carcinoma patients found by first cholecystectomy / 中华普通外科杂志

Objective To investigate the effect of the second resection for unsuspected gallbladder carcinoma discovered after cholecystectomy.Methods A retrospective clincopathological analysis was conducted for 45 cases of unsuspected gallbladder carcinoma receiving second operation at our hospital from January 2000 to December 2010.Result Of the 45 cases with unsuspected gallbladder carcinoma (33 pT2,12 pT3 ),40 cases received second radical reeection of the liver bed with lymph dissection; the remaining 5 cases received palliative operation.Amongst 45 patients lymph metastasis (4 pT2,6 pT3 ) was found in 10 cases,liver metastasis ( 2 pT2,1 pT3 ) in 3,parietal seeding in 1 ( pT3 ) and distant metastasis ( pT2 ) in one.The 5 patients receiving palliative operation died in 3 ～ 8 months and 40 patients receiving the radical operation achieved long-term survival ( 40.4 ± 2.7 months) after the operation.The effect of second operation which was done within 4 weeks after the first cholecystectomy was better than that of the operation done beyond 4 weeks ( survival time 37.1 ± 2.2 vs 22.4 ± 5.8months).Conclusions Radical resection for unsuspected gallbladder carcinoma discovered after the initial cholecystectomy helps improve prognosis and prolong patients survival time.

Advances in familial pancreatic cancer / 国际肿瘤学杂志

Familial pancreatic cancer is a known hereditary cancer syndrome with autosomal dominant inheritance and accounts for about 3% of all pancreatic cancers. With the development of molecular genetics,several genes have been identified related with the familial pancreatic cancer, including breast cancer susceptibility gene 2, Palladin, cyclin-dependent kinase inhibitor 2A, et al. In particular, mutations in some of these genes have been defined as the hereditary basis of particular cancer syndromes. Molecular genetics surveillance for high risk populace can lead to the diagnosis of asymptomatic, early-stage pancreatic cancer or precancerous lesions.

Efficacy of leukemia vaccine combined 1-MT immune treatment of tumor-bearing mice / 白血病·淋巴瘤

Objective To explore the active immunotherapeutic effects of whole-cell leukemia vaccine combined with 1-methyl-tryptophan (1-MT, inhibitor of idoleamine 2,3-dioxygenase, IDO) treatment on leukemia. Methods The tumor-bearing mice model was made by hypodermic injection of FBL-3 cells. Then these mice were divided into 5 groups, normal group, PBS control group, CTX chemotherapy group, vaccine treated group and vaccine combined with 1-MT treated group (1-MT group), respectively. The main outcome measures including general condition, response rate, tumor size, metastasis and survival time were investigated. Results The mice of PBS control group were slow to move and much heavier (including tumor nodules) than the other groups. No obvious difference was observed in activity, eating behavior and weight between normal group, vaccine treated group and 1-MT treated group. The mice of CTX chemotherapy group were observed epilation, arched body and worn, and those weights decreased significantly compared with other group. The treatment-related mortality of vaccine-treated group and 1-MT group was lower than that of CTX chemotherapy group significantly (0, 0 vs 40 %). There were no significant difference in complete remission rates between vaccine treated group and 1-MT group (61.1 % vs 70.0 %, χ2 = 0.221, P >0.05). But the recurrence rate of 1-MT group was lower than vaccine treated group (0 vs 36.36 %). The tumor nodules growth of recurrent mice could be inhibited by 1-MT. The mean survival time of vaccine treated group and 1-MT group were longer than that in CTX chemotherapy group and PBS control group (χ2 = 52.13, P <0.01). Conclusion Whole-cell leukemia vaccine can inhibit tumor growth and prolong tumor-bearing mice survival time with remarkable curative effects and few side effects. Vaccine combined with 1-MT treatment can significantly reduce tumor recurrence rate, and 1-MT was still effective in inhibiting recurrence of tumor nodules growth after vaccine treatment.

Postoperative early intrahepatic recurrence and the prognosis in patients of hepatocellular carcinoma / 中华普通外科杂志

Objective To investigate the predictive factors and prognosis of early intrahepatic recurrence after curative resection of hepatocellular carcinoma(HCC).Methods Clinicopathological dats of 184 HCC patients with intrahepatic recurrence after curative resection were collected.Thirteen clinicopathological factors and prognosis after recurrence were retrospectively analyzed. Results Univariate analysis showed that preoperative scrota alpha-fetoprotein(AFP)>100 ng/ml,tumour size>5 cm,venous invasion and intra-operative blood transfusion were predictive factors of early intrahepatic recurrence,and selum albumin<35 g/L was marginally predictive factor.Multivariate analysis showed that serum AFP>100 ng/ml,tumour size>5 cm and venous invasion were independent predictive factots of early intrahepatic recurrence.The survival of patients suffering from early recurrence was significantly shorter than those with late recurrence.with median survival period of 12 mos vs 18 mos(P=0.012).Conclusion Serum AFP,tumour size and venous invasion were independent predictive factors of early intrahepatic recurrence in HCC patients after radical resection of the primary tumor.Early intrahepatic recurrence implies poor prognosis.