Heartbeat-aware convolutional neural network for R-peak detection of wearable device ECG data / 南方医科大学学报

OBJECTIVE@#To develop a method for R-peak detection of ECG data from wearable devices to allow accurate estimation of the physiological parameters including heart rate and heart rate variability.@*METHODS@#A fully convolutional neural network was applied to predict the R-peak heatmap of ECG data and locate the R-peak positions. The heartbeat-aware (HA) module was introduced to enable the model to learn to predict the heartbeat number and R-peak heatmap simultaneously, thereby improving the capability of the model for extraction of the global context. The R-R interval estimated by the predicted heartbeat number was adopted to calculate the minimum horizontal distance for peak positioning. To achieve real-time R-peak detection on mobile devices, the deep separable convolution was adopted to reduce the number of parameters and the computational complexity of the model.@*RESULTS@#The proposed model was trained only with ECG data from wearable devices. At a tolerance window interval of 150 ms, the proposed method achieved R peak detection sensitivities of 100% for both wearable device ECG dataset and a public dataset (i.e. LUDB), and the true positivity rates exceeded 99.9%. As for the ECG signal of a 10 s duration, the CPU time of the proposed method for R-peak detection was about 23.2 ms.@*CONCLUSION@#The proposed method has good performance for R-peak detection of both wearable device ECG data and routine ECG data and also allows real-time R-peak detection of the ECG data.

Effect of Beclin-1 gene silencing on autophagy and apoptosis of the prostatic hyperplasia epithelial cells

Abstract Objectives: This study aims to explore the effect of silencing Beclin-1 gene on autophagy and apoptosis of Benign Prostatic Hyperplasia (BPH) (BPH-1) cells under the condition of Androgen Deprivation (AD) and Autophagy Inhibition (AI). Methods: Control group (BPH-1 group), empty carrier group (sh-RNA-BPH-1 group) and Beclin-1 silenced group (sh-Beclin1-BPH-1 group) were set. The Beclin-1 gene silencing efficiency was detected by RT-PCR and Western blot. Autophagic flux was monitored by GFP-LC3 cleavage assay and cell apoptosis was analyzed by flow cytometry. The protein expression levels of LC3, Caspase-3, PARP-1, Bcl-2, and Bax were detected by Western blot. Results: The transfection of sh-Beclin-1 obviously down-regulated the expression of Beclin-1 at both mRNA and protein levels. Under the conditions of AD and AI, silencing of Beclin-1 restrained the autophagy of BPH-1 cells, as evidenced by a decreased number of autophagosomes and down-regulation of LC3-II protein (p < 0.001). The results of flow cytometry showed that the apoptotic rate of sh-Beclin-1 group was elevated significantly compared to the other two groups (p < 0.01). Western blot results showed that silencing of Beclin-1 promoted 89 kd fragmentation of PARP-1 (p < 0.001) and Caspase-3 activation (p < 0.01). Moreover, silencing of Beclin-1 resulted in declined Bcl-2 and augmented Bax protein expression in BPH-1 cells (p < 0.01), which ultimately led to a decreased Bcl-2/Bax ratio. Conclusions: The results indicated that the silencing of Beclin-1 gene hampered autophagy while activating apoptosis in BPH-1 cells. Thus, Beclin-1 may participate in an antagonistic relationship between autophagy and apoptosis in BPH.

Synovial chondromatosis of temporomandibular joint: a case report and literature review / 口腔疾病防治

Objective@#To explore the diagnosis, treatment and prognosis of synovial chondroma in the temporomandibular joint and to provide a reference for clinical diagnosis and treatment.@*Methods @#A case of right temporomandibular joint synovial chondromatosis admitted to the Stomatological Hospital, Southern Medical University was reported, and the related literature was reviewed and analyzed.@*Results @#During the movement of the mandibular opening, noise and obvious pain were found. The imaging features showed that several free calcification shadows of different sizes were seen around the condyle in the right articular fossa. The right temporomandibular joint mass resection and articular disc reduction were performed under general anesthesia, and the postoperative pathological results showed synovial chondromatosis. The patient′s symptoms were relieved 3 months after the surgery, and the imaging examination showed no residual lesions. A review of the literature shows that synovial chondromatosis usually occurs in large joints, such as the knee, hip, elbow, and shoulder joints, and rarely occurs in the temporomandibular joint. It occurs in middle-aged patients, manifesting as pain, swelling, and limited movement. Imaging studies play an important role in diagnosis, but the final diagnosis requires pathological diagnosis. Surgical treatment is effective, and synovial chondromatosis does not easily relapse.@*Conclusion@#The diagnosis of TMJ synovial chondroma should be combined with clinical manifestations, imaging features, and pathological examination. Surgery is an effective treatment. After completely removing the diseased and affected tissues, the disease has a good prognosis and does not easily relapse.

Effects of DACT1 methylation status on invasion and metastasis of nasopharyngeal carcinoma

BACKGROUND: The purpose of the present study was to investigate the role of the methylation status of the DACT1 gene on the invasion and metastasis of nasopharyngeal carcinoma cells. METHODS: The levels of methylation and expression of the DACT1 gene in nasopharyngeal carcinoma tissues and CNE2 cells were determined by methylation-specific PCR and RT-PCR, respectively. CNE2 cells were treated with 5-aza-2-deoxycytidine, and the variation in the methylation status of the DACT1 gene was detected, as well as the influence of methylation on invasiveness of nasopharyngeal carcinoma cells. RESULTS: The DACT1 gene was hyper-methylated in 44 of 62 cases of nasopharyngeal carcinoma. The DACT1 gene was hyper-methylated in 32 of 38 cases of nasopharyngeal carcinoma with lymph node metastasis, and the DACT1 gene was hyper-methylated in 7 of 24 cases of nasopharyngeal carcinoma without lymph node metastasis. The DACT1 mRNA level was weakly expressed or not expressed in all nasopharyngeal carcinoma tissues with hyper-methylated DACT1 genes; however, the DACT1 mRNA level was highly expressed in nasopharyngeal carcinoma tissues with low expression of the methylated DACT1 gene. The DACT1 gene was hyper-methylated and not expressed in CNE2 cells that did not have 5-aza-2-deoxycytidine treatment. After 5-aza-2-deoxycytidine treatment, the DACT1 gene was demethylated and the expression of DACT1 was restored. Moreover, the invasion ability was inhibited in CNE2 cells treated with 5-aza-2-deoxycytidine. CONCLUSION: The expression of DACT1 was related to the methylation status. High expression of DACT1 may inhibit the invasion and metastasis of nasopharyngeal carcinoma cells.

Application of Flipped Classroom Teaching Model in Teaching Reform of Science of Tuina Technique Based on MOOC / 中国中医药信息杂志

Objective To discuss the application of flipped classroom teaching model in the teaching reform of Science of Tuina Technique based on MOOC; To provide references for promoting teaching quality of Science of Tuina Technique. Methods Flipped classroom teaching model based on MOOC and traditional teaching model were conducted in 2 classes of 2013 in Guangxi University of Chinese Medicine, one experimental groups and one control group. After the end of the course, theoretical knowledge and techniques skill scores of the two classes were compared. Questionnaire was given to students in the experimental class to understand their satisfaction towards flipped classroom based on MOOC. Results The scores of theoretical knowledge, performance demonstration test results, mannequin test and practices mechanics test of experimental group were high than the control group, with statistical significance (P<0.05). The results of questionnaire showed that the satisfaction of students in the experimental group towards flipped classroom based on MOOC was 95. Conclusion Flipped classroom teaching model based on MOOC applied to the teaching of Science of Tuina Technique can improve the students' learning interest and initiative, and then improve academic performance.

Combined use of adipose-derived stem ceIIs and eIectrospun membrane for preparing sandwich-Iike cardiac ceII sheets / 中国组织工程研究

BACKGROUND: Increasing studies have shown that cell-sheet engineering is a more promising method for the treatment of myocardial infarction. OBJECTIVE: To construct sandwich-like myocardial cell sheets with electrospun chitosan-collagen membrane as support membrane and with adipose-derived stem cells as seed cells. METHODS: In this study, we prepared electrospun chitosan-collagen membranes at different mass ratio (7:3, 5:5) as a support membrane. Adipose-derived stem cells at passage 4 that were cultured in a thermo-sensitive petri dish for 3 days were seeded onto the two kinds of electrospun membranes at 20 ℃ for 15 minutes until the cell sheets rolled up. Then, the electrospun membranes and cell sheets with the cell layers facing up were placed together onto another thermo-sensitive petri dish in which adipose-derived stem cells were confluent completely. After 30 minutes of culture, the cell sheets were cultured in myocardial cell medium. Two weeks later, cell morphology was observed using multi-photon microscopy. Immunocytochemistry, western blot and flow cytometry were used to detect the expression of TnI and Cx43 in the myocardium. Real-time quantitative PCR was used to detect cardiomyocyte-specific gene expression. RESULTS AND CONCLUSION: From the results of scanning electronic microscopy (SEM) and propidium iodide (PI) staining, we could found that ADSCs grew easily on the chitosan-collagen (5:5) membrane, and there were more dead cells on the chitosan-collagen (7:3) membrane than on the chitosan-collagen (5:5) membrane. After 2 weeks of differentiation with the myocardial cell medium, higher troponin I and Cx43 protein expressions were observed on the chitosan-collagen (5:5) membrane (P＜0.05). Moreover, the mRNA levels of α-skA, β-MHC, TnI, Cx43, ANP, GATA-4 and Nkx2.5 were higher in the chitosan-collagen (5:5) membrane group than the chitosan-collagen (7:3) membrane group. All these results indicate that the chitosan-collagen (5:5) membrane is better for the growth and differentiation of adipose-derived stem cells, as well as for sandwich-like cell-sheet construction.

The eyelid morphology analysis of 2,183 outpatients in plastic surgery clinic / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the eyelid's characteristics of outpatients who visited the plastic surgery clinic in 3rd Hospital of Peking University.</p><p><b>METHODS</b>From Jan. 2007 to Feb. 2011, we collected facial images and general data of 2,183 outpatients, and divided them into groups according to their genders. The eyelid images were analyzed and epicanthus or foldless eyelid were recorded. Then the incidence rates of epicanthus and foldless eyelid were calculated.</p><p><b>RESULTS</b>In 2,183 patients (4,366 eyes), the incidence rate of epicanthus is 86.1% (3,760/4,366), and the incidence rate of foldless eyelid is 35.3% (1,541/4,366). In 178 males (356 eyes) and 2,005 females patients (4,010 eyes), the incidence rates of epicanthus are 78.4% (279/356) and 86.8% (3,481/4,010), respectively. The incidence rates of foldless eyelid are 48.0% (171/356) and 34.2% (1,370/4,010), respectively.</p><p><b>CONCLUSIONS</b>The incidence rates of epicanthus and foldless eyelid are relatively high for the outpatient population in the plastic surgery clinic of Third Hospital of Peking University.</p>

Role of IFN-γ + 874 genetic polymorphisms in allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the impact of IFN-γ + 874 polymorphisms on the outcome in HLA matched sibling HSCT.</p><p><b>METHODS</b>We used PCR-sequence-specific primer analysis (PCR-SSP) to analyze the polymorphisms of IFN-γ + 874 T/A in 80 recipient and donor pairs from October 2005 to March 2008.</p><p><b>RESULTS</b>Recipients having donors who possessed IFN-γ + 874 A/A genotype had significantly earlier neutrophil recovery compared with those having donors with non-A/A genotype (15 (11 - 27) days vs 18 (12 - 30) days, P = 0.029). And IFN-γ + 874 A/A in both recipients and donors further facilitated neutrophil recovery compared with others (13 (11 - 25) days and 19 (12 - 31) days, P = 0.019). Besides, IFN-γ + 874 A/A in recipients increased the probability of grade II-IV acute graft versus disease (aGVHD) and cytomegalovirus viraemia compared with IFN-γ + 874 T/A or T/T genotype (20% vs 4% P = 0.041, 43.6% vs 16.0% P = 0.032), which lead to increased 5-year transplant-related mortality (TRM) (33.7% ± 6.8% vs 12.0% ± 6.5%, P = 0.050) and decreased 5-year event free survival (EFS) \[(58.2 ± 6.7)% vs (84.0 ± 7.3)%, P = 0.032\] compared with the latter. IFN-γ + 874 A/A in both recipients and donors also significantly increased the probability of grade II-IV aGVHD and cytomegalovirus viraemia compared with the other (21.7% vs 5.9%, P = 0.050; 45.7% vs 20.6%, P = 0.020), which caused increased 5-year TRM \[(31.6 ± 7.5)% vs (13.6 ± 6.5)%, P = 0.048\] and decreased 5-year EFS \[(56.8 ± 7.3)% vs (79.4 ± 6.9)%, P = 0.037\] compared with the other.</p><p><b>CONCLUSION</b>In HLA-matched sibling HSCT setting, the presence of IFN-γ + 874 T allele in recipients or in both recipients and donors significantly decreased the risk of grade II-IV aGVHD and CMV infection and increased EFS. While IFN-γ + 874 A/A in donors or in both recipients and donors was associated with shorter duration to neutrophil recovery.</p>

Starch degradation and nutrition value improvement in corn grits by solid state fermentation technique with Coriolus versicolor

The study was conducted to evaluate effect of Coriolus versicolor mycelia on degrading starch and improving nutrition value in corn grits through solid state fermentation technique. The results showed that using soybean meal as a nitrogen source, á-amylase secreted from C. versicolor expressed 407.25U/g of activity, leading to 45.15 percent of starch degraded. The activity grew with fermentation time until the 15th day, after that the amylase was deactivated rapidly. An orthogonal experiment designed for the study illustrated that degradation rate of starch in corn grits attained to maximum, 50.51 percent, when 100g of corn grits, added 16g of soybean meal, were fermented by C. versicolor for 12 days, in an initial pH 5.5. After fermenting, compared to the nonfermented control, contents of amino acids, total sugar, crude fat and crude protein were increased by 21.00 percent, 38.45 percent, 55.56 percent, 69.15 percent respectively. The significant improvement of nutrition value in corn grits is probably attributed to the intense metabolism of C. versicolor.

Analysis of the clinical effects of the modified halo pelvic frame for the treatment of severe scoliosis with rigidity / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical curative effect of the modified Halo pelvic frame and surgery for the treatment of severe scoliosis with rigidity.</p><p><b>METHODS</b>From January 2004 to May 2010,50 patients with severe scoliosis patients with rigidity were treated in our hospital. Twenty-three patients were male and 27 patients were female, with a mean age of 10.8 years old, ranging from 4 to 16 years. Twenty-four patients were congenital scoliosis and 26 patiens were idiopathic scoliosis. The mean body height were (152.1 +/- 11.1) cm and the average Cobb angle of scoliosis and kyphosis were (91.8 +/- 14.5) degrees and (69.5 +/- 14.0) degrees respectively. All the patients were treated with three-stages modified Halo pelvic traction, the second stage anterior release and the third stage posterior correction. The amount of correction was determined by measuring the change of body height, the Cobb angles and correction rate of scoliosis as well as kyphosis before and after the operation.</p><p><b>RESULTS</b>The mean body height were correct to (158.5 +/- 10.5) cm. The average Cobb angle of scoliosis were correct to (30.8 +/- 7.9) degrees. The average Cobb angle of kyphosis were correct to (31.6 +/- 10.1) degrees. After the first stage, the average Cobb angle of scoliosis and kyphosis were changed with the mean of (30.4 +/- 6.6)% correction and (22.3 +/- 5.2)% respectively; after the second stage, the average Cobb angle of scoliosis and kyphosis were changed with the mean (26.7 -/+ 5.1)% correction and (21.2 -/+ 6.0)% respectively; the third stage, above data were (33.7 -/+ 7.2)% and (27.1 +/- 5.3)%. Correction rate of scoliosis and kyphosis were (66.5 +/- 7.2)% and (55.1 +/- 6.4)% respectively by the modified Halo pelvic frame traction and surgery. Body height, the Cobb angles and correction rate of scoliosis and kyphosis on radiographs were different in all stages (P<0.05).</p><p><b>CONCLUSION</b>Operative complications of severe scoliosis with rigidity can be reduced and better deformity correction and trunk balance achieved by the modified Halo pelvic frame traction and surgery.</p>

Combination of rabbit antithymocyte globulin and cyclosporine A as first-line therapy for adult severe aplastic anemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the efficacy and side-effects of combination of rabbit antithymocyte globulin (ATG) and cyclosporine A (CsA) as the first-line immunosuppressive therapy (IST) for adult severe aplastic anemia (SAA) patients.</p><p><b>METHODS</b>Adult SAA or very severe aplastic anemia (VSAA) patients treated with rabbit ATG + CsA as first line therapy in our hospital from 2003 to 2008 were retrospectively analysed and the therapeutic response relevant factors were analysed.</p><p><b>RESULTS</b>Seventy-nine patients were enrolled. Of all these patients, 6 died within 3 months after IST. The overall response rate was 82.2% and the median time to transfusion independent was 60 days. The therapeutic response rate in 32 SAA patients (100%) was significantly higher than that in 41 VSAA cases (68.3%) (P = 0.001). Patients with neutrophil response to G-CSF treatment had a higher IST response rate than those without response to G-CSF (100% vs 67.5%, P = 0.001). Sixty-one patients (77.2%) occurred serum sickness reaction. Three patients relapsed and two developed clonal hematological abnormalities after IST. The 3-year overall survival for all the patients was 88.9%.</p><p><b>CONCLUSIONS</b>Rabbit ATG in combination with CsA as first-line IST for adult SAA can lead to excellent treatment outcomes with minor adverse effects.</p>

Risk factors and prognosis of invasive fungal infections in patients with hematological diseases / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the incidence, risk factors, prognosis and high risk patients of invasive fungal infections (IFI) in patients with hematological diseases.</p><p><b>METHODS</b>: Over 2-week hospitalized patients from January 2007 to December 2008 were retrospectively reviewed. Logistic regression was used to analyze the risk factors of IFI, and recursive partitioning to reveal high risk patients. Incidence of IFI was estimated by cumulative incidence function, and the prognosis by Kaplan-Meier method.</p><p><b>RESULTS</b>A total of 1048 assessable treatment cycles were recorded and 93 cases of IFI were diagnosed, with an incidence of 8.87 per 100 treatment cycles. Multivariate logistic regression revealed the following risk factors: age (OR 1.025, 95% CI 1.010-1.041, P = 0.002), duration of neutropenia (OR 1.028, 95% CI 1.014-1.042, P < 0.0001) and uncontrolled underlying diseases (OR 2.620, 95% CI 1.608-4.268, P = 0.0001). Recursive partitioning found two groups of high risk patients: (1) patients with uncontrolled underlying diseases and neutropenia duration > or = 58 days (7/12, 58.3%), (2) patients with uncontrolled underlying diseases and age > or = 33 years (40/208, 19.2%). At the end of follow-up, 111 cases of IFI were recorded in 451 patients, with a 1-year cumulative incidence of 27.1%. In patients with established IFI, overall survival rate and IFI related mortality rate at 12 weeks after diagnosis were 83.4% and 13.5% respectively.</p><p><b>CONCLUSION</b>Age, duration of neutropenia and uncontrolled underlying diseases are risk factors of IFI; patients with uncontrolled underlying diseases and age > or = 33 years were at high risk of IFI and need major concern. IFI has a better prognosis and a lower related mortality in this study.</p>

Preliminary analysis of therapeutic efficacy and prognosis of allogeneic hematopoietic stem cell transplantation in patients with advanced chronic myeloid leukemia / 中国实验血液学杂志

Chronic myeloid leukemia (CML) at advanced and blastic phase is a disease with poor prognosis, for which allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment choice with curative potential. This study was purposed to investigate the therapeutic efficacy of allo-HSCT and prognosis of advanced CML patients. The 28 cases of CML in accelerated phase or blast crisis received allo-HSCT were analysed retrospectively in terms curative efficacy, basic characteristics before transplant and prognosis, therapeutic strategy before transplant and prognosis, events after transplant and prognosis. The results indicated that 10 out of 28 patients were in complete remission, showing a 3-year overall survival and disease-free survival rate of 34.9% and 35.7% respectively; 18 patients died. Univariate analysis revealed that the clonal evolution and blast amount are baseline risk factor of poor prognosis, and combination of them can be used to predict the outcome of patients; application of imatinib before transplant and achievement of complete hematologic remission could not improve the prognosis; severe aGVHD among post-transplant events was proven to be a negative prognostic factor. It is concluded that for advanced CML patients received allo-HSCT, clonal evolution and blast percentage are prognostic factors, and the pre-transplant use of imatinib did not influence the outcome.

The influence of hepatitis B virus infection on patients undergoing allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the prognosis and hepatitis B serologic marker changes in patients with HBV infection or with HBV infected donors after allogenic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>The clinical outcomes of 79 patients receiving allo-HSCT, including 55 with HBV infection and 24 from HBV infected donors were analyzed retrospectively.</p><p><b>RESULTS</b>(1) HBV infection did not interfere with the clinical outcome of allo-HSCT. (2) In 20 HBsAg(+) patients, 13(65.0%) developed HBV reactivation between 0.5 and 10 months after transplantation, 9(45.0%) developed HBV-related hepatitis. (3) For the 35 HBsAg(-) and HBcAb/HBeAb positive patients, 4 (11.4%) occurred HBV seroconversion, 1 of the 4 complicated with severe chronic graft-versus-host disease (cGVHD). (4) There was a significant difference in HBV reactivation rate between the HBsAg(+) and HBsAg-groups (P < 0.01). The incidence of hepatitis occurred within 100 days after HSCT was high in HBsAg(+) patients (P < 0.05). (5) Clearance of HBsAg was observed in 2 HBsAg(+) patients, both of whom received graft from HBsAb positive donors.</p><p><b>CONCLUSIONS</b>Donors or recipients infected with HBV is not considered an absolute contraindication for HSCT, but HBsAg positivity is a high risk factor for HBV reactivation and prophylactic lamivudine treatment may be helpful. For patients with HBcAb/HBeAb positivity, seroconversion can be observed, especially after immunosuppressant withdrawal. Adoptive immunity is effective in clearing HBV in these patients.</p>

Dysregulation of E-cadherin in Chronic Rhinosinusitis with Nasal Polyps / 华中科技大学学报（医学）（英德文版）

E-cadherin is a key epithelial protein and adhesive molecule.This study detected the E-cadherin expression in patients with chronic rhinosinusitis with nasal polyps(CRSwNP)and controls,and analyzed its possible role in the pathogenesis of CRSwNP.The expression of E-cadherin was detected by using Western blotting and immunohistochemistry in controls and patients with CRSwNP.Computed tomography(CT)scan findings were scored.The results showed that the E-cadherin expression was up-regulated in patients with CRSwNP as compared with controls(P=0.039)and the positive staining was predominantly localized on the epithelial cell membrane.E-cadherin level was correlated negatively with Lund-Mackay scores in patients with CRSwNP(r=-0.604,P=-0.005).It is suggested that E-cadherin may be involved in the pathogenesis of CRSwNP and correlated with disease severity.

The significance of hematopoietic cell genetic instability in aplastic anemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate bone marrow hematopoietic cells genetic instability (BMHCGI) in patients with aplastic anemia (AA) and to explore its influence on immunosupressive therapy for AA and significance on late clonal hematologic disorders.</p><p><b>METHODS</b>Genetic instability of bone marrow mononuclear cells (BMMNC) was measured by Comet assay. The relationship between bone marrow failure parameters and genetic instability results was evaluated. The reciprocity of genetic instability and treatment responses to immunosuppressive therapy (IST) was investigated.</p><p><b>RESULTS</b>Comet assay parameters \[tail moment (TM), olive TM (OTM), comet %\] of AA patients were significantly higher than that of control group (P < 0.05). There was no statistic correlation of comet parameters of severe AA (SAA) BM hematopoietic cells with age, gender and peripheral blood cell count (P > 0.05). For the treatment response rate at six months after IST there was no statistical difference between comet cells of < 21.64% and of >/= 21.64%, and so did between OTM < 1.58 and >/= 1.58 in SAA patients. IST had no effect on SAA BMHCGI, whereas, the Comet%, TM and OTM in SAA PR patients and Comet% in CR patients were significantly decreased than those before treatment. Comet parameters of two SAA patients were significantly increased before the development of clonal cytogenetic abnormalities.</p><p><b>CONCLUSIONS</b>Increased BMHCGI may be one of the elements in the pathogenetic mechanisms in AA. The genetic instability is irrelevant to the SAA patients overall response rate of IST at six months, but IST can alleviate the genetic instabilities in responded SAA patients.</p>

Allogeneic stem cell transplantation for 75 cases of acute myeloid leukemia in complete remission: outcome and prognostic analysis / 中国实验血液学杂志

This study was purposed to evaluate the outcome of patients with acute myeloid leukemia (AML) who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in complete remission, and to study the prognostic factors. 75 cases of AML in complete remission receiving allo-HSCT from January 2000 to December 2007 were retrospectively analyzed. Major end points of study included overall survival (OS), disease free survival (DFS), relapse rate and transplantation related mortality (TRM). The results showed that 3-year OS and DFS of the study population reached to 58.4% and 53.9% respectively, and the relapse rate and TRM leaded to 16.9% and 29.9% respectively. Incidence of acute GVHD was 59.6%, with 18.7% II-IV aGVHD. Different prognosis was observed between HSCT recipients of alternative donor and HLA-matched related donor (MRD) (3-year DFS was 34.3% vs 60.0%, p = 0.019), between patients of refractory leukemia and the control (3-year DFS was 35.7% vs 58.2%, p = 0.048), between recipients with and without severe aGVHD (3-year DFS was 35.7% vs 54.4%, p = 0.059). Further analysis revealed significantly high TRM in recipients receiving allo-HSCT of alternative donor (p = 0.033) and high rate of severe aGVHD (p = 0.010). Multivariate analysis revealed three negative prognostic factors: donor availability (alternative vs MRD) (p = 0.049, RR = 2.09, 95%CI 1.01 - 4.36), refractory leukemia (p = 0.038, RR = 2.33, 95%CI 1.05 - 5.20) and severe aGVHD (p = 0.040, RR = 2.33, 95%CI 1.04 - 5.20). It is concluded that allo-HSCT is a choice for the AML case at complete remission and TRM is the major cause of the transplantation failure. Donor availability, refractory leukemia and severe aGVHD are confirmed as risk factors of poor prognosis for allo-HSCT patients with AML in CR.

Combination of rabbit antithymocyte globulin plus cyclosporin A as first-line immunosuppressive therapy for the childhood with severe aplastic anemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyse the efficacy and side-effects of rabbit antithymocyte globulin (ATG) and cyclosporin A (CsA) as the first-line therapy for childhood severe aplastic anemia (SAA).</p><p><b>METHODS</b>Seventy-one childhood SAA patients treated with rabbit ATG + CsA as first line therapy were retrospectively analysed.</p><p><b>RESULTS</b>Seventy-one SAA patients, including 38 SAA and 33 very severe aplastic anemia (VSAA), were enrolled. The median age was 12 years. Of these patients, 3 died within 3 months after the immunosuppressive therapy (IST). The overall response rate was 67.6% (46/68) and the median time to transfusion independent was 53 days. Thirty-three patients (48.5%) obtained remission in 3 months after the IST and 45 (67.2%) in 6 months. The response rates were 57.7% (15/26), 56.5% (13/23) and 94.7% (18/19) for patients less than 10 years old, 10 - 15 year-old and 15 - 18 year-old, respectively. Sixty patients suffered from serum sickness on the IST. Three patients relapsed and another 3 unrespond patients received retreatment of IST, and one patient progressed to myelodysplastic syndromes (MDS).</p><p><b>CONCLUSION</b>Rabbit ATG in combination with CsA as first line therapy for childhood SAA/VSAA can lead to overall response rate of 67.6% with minor adverse effects.</p>

The clinical characteristics of T cell large granular lymphocyte leukemia associated with pure red cell aplasia / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the characteristics of acquired pure red cell aplasia (PRCA) secondary to T cell large granular lymphocyte leukemia (T-LGLL).</p><p><b>METHODS</b>Fourteen patients with T-LGLL associated with PRCA between 2000 and 2006 in our hospital were retrospectively analyzed.</p><p><b>RESULTS</b>The median age at diagnosis was 61 years with equal gender distribution. The PRCA had indolent process, mainly presenting with anemia. Of the 14 patients, 9 had mild to moderate splenomegaly, one hepatomegaly and one lymphadenopathy. The median Hb level was 61.5 g/L and the median WBC count 4.3 x 10(9)/L. The median percentage and count of LGL in peripheral blood were 0.36 and 1.9 x 10(9)/L respectively. The median percentage of LGL in BM was 0.165 (0.085 - 0.410). Some patients had serologic abnormalities. All the 12 cases with available bone marrow cell cytogenetics showed normal karyotypes. With cyclosporine A or glucocorticoid immunosuppressive therapy, the overall response was 91%.</p><p><b>CONCLUSION</b>T-LGLL was one of the major causes of acquired PRCA. This type of PRCA has the similar clinical and laboratory feature to that of other type of PRCA and has a good response to immunosuppressive therapy.</p>