Application of two RT-PCR methods for detection of norovirus in market-sold oysters and norovirus genetic characteristic analysis, a survey conducted in Beijing / 中华流行病学杂志

Objective: To evaluate the application of real-time RT-PCR and semi-nested RT-PCR in the detection of norovirus in oysters and analyzing the genetic characteristics of the isolates. Methods: Real-time fluorescent RT-PCR and semi-nested RT-PCR were used to detect norovirus GⅠ/GⅡ in fresh oysters collected from the markets in Beijing from November 2014 to October 2015. The detection rate of the parallel test was also analyzed. In addition, the reliability of semi-nested RT-PCR was evaluated by agreement rate and consistency test (Kappa value). The positive products of norovirus GⅠ/GⅡ capsid protein region gene by semi-nested RT-PCR were sequenced. Software BioEdit 7.0.9.0 was used for sequence alignment, and software Mega 6.0 was used to construct the evolutionary tree. Results: In 72 samples, the detection rate of norovirus was 31.94% (23/72) by real-time RT-PCR, 38.89% (28/72) by semi-nested RT-PCR and 48.61% (35/72) by parallel test. The coincidence rate of the two methods was 73.61%, a moderate degree (Kappa value =0.43). A total of 13 norovirus strains were successfully sequenced, and 11 strains (7 GⅡ.17 strains, 2 GⅡ. 4 Sydney_ 2012 strains, 1 GⅡ. 1 strain and 1 GⅡ. 21 strain) were obtained from norovirus positive samples by two RT-PCR methods, two strains (1 GⅡ. 17 strain and 1 GⅡ. 3 strain) were obtained from real-time RT-PCR negative samples which were positive for norovirus by semi-nested RT-PCR. The similarity between these strains and reference strains from diarrhea patients, environmental sewage, and shellfish products were 84.4% - 100.0%. Conclusions: The parallel test of norovirus in oysters by two RT-PCR methods can improve the detection rate and detect more genotypes. Norovirus strains in oysters were highly homologous with reference strains from diarrheal patients, environmental sewage, and shellfish products. Therefore, surveillance, prevention and control for norovirus should be carried out in people who have frequent contacts with oysters and related environments.

Impact on compliance and pattern visual evoked potential of optical drugs suppress combine with auxiliary therapy for children with ametropic amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the impact on compliance and pattern visual evoked potential of optical drugs suppress combine with auxiliary therapy for children with ametropic amblyopia. <p>METHODS: Totally 122 cases(189 eyes)children with ametropic amblyopia from October 2014 to October 2015 were divided into observation group, 61 cases(95 eyes)and control group, 61 cases(94 eyes). The control group given comprehensive therapeutic apparatus, CAM training comprehensive therapy, the observation group received above-mentioned combined with optical drugs suppress therapy. At 4mo after treatment, therapy compliance, pattern visual evoked potential, clinical efficacy were compared between two groups. <p>RESULTS: At 4mo after treatment, the efficient rate of observation group was 92.6% which was significantly higher than that of control group 81.9%(<i>χ</i>²=4.895, <i>P</i><0.05). Therapy compliance rate was 96.7%, significantly higher than that of control group 83.6%(<i>χ</i>²=4.895, <i>P</i><0.05). P100 amplitude of observation group(15.18±1.68μV)was significantly higher than that of the control group(12.34±1.34μV). P100 latency of observation group(93.75±10.01ms)was significantly lower than the control group(106.37±10.21ms)(<i>t</i>=10.322, 7.865; <i>P</i><0.05, <i>P</i><0.001). <p>CONCLUSION: Optical drugs suppress combine auxiliary therapy helps to improve visual acuity level in children with ametropic amblyopia, which may be related to enhance children's compliance, adjust pattern visual evoked potential.

Two Kinds of HLA-mismatched Allogeneic Hematopoictic Stem Cell Transplantation for Treatment of Hematologic Malignancies / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the safety and effectiveness of HLA-mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT) combined with related haploidentical bone marrow infusion for treatment of hematologic malignancies and to explore the mathod for reduction of aGVHD incidence and clinical significance.</p><p><b>METHODS</b>A total of 30 patients with hematologic malignancies (8 cases of AML, 17 AML, 2 MDS and 3 Mix-AL) received related haploidentical and unrelated HLA-mismatched allo-HSCT combined with related haploidentical bone marrow infusion. Among them 20 cases received related haploidentical transplantation of the first donor, 10 cases received unrelated HLA-mismatched treaplantation. The new conditioning regimen for the patients underwent allo-HSCT consisted of fludarabine, busulfan, Me-CCNU and cyclophosphamide. The drugs for GVHD prophylaxis included cyclosporine A and methotrexate, while mycophenolate mofetil and rabbit anti-T-lymphocyte globulin (ATG) were used.</p><p><b>RESULTS</b>All the patients achieved full engraftment. The median time for neutrophils to reach over 0.5 × 10(9)/L was 14 days (8-26 days), while the median time for platelets to reach over 20 × 10(9)/L was 11.5days (10-24 days). The incidence of I-II grade of aGVHD at 100 d was 22.28% (95% CI 9.9%-34.7%), the incidences of II-IV and III-IV grade of aGVHD were 22.7% (95% CI, 10%-35.4%) and 12.7% (95% CI 6.9%-15.5%) respectively. The incidences of I-II and III-IV cGVHD were 13.3% (95% CI, 1.4%- 26.8%) and 3.3 % (95% CI, 0%-12.2%), one case (3.3%) was in extensive cGVHD. DFS and OS of 2 years were 81.1% (95% CI, 66.0%-96.2%) and 68.2% (95% CI 51.0%-85.4%).</p><p><b>CONCLUSION</b>These data suggest that the incidence of grade II-IV grade of aGVHD in recipients of 2 partially HLA-matched units was lower, co-infusion of haplo-BM and partially matched units in allogeneic transplantation is safe and effective for reducing the incidence of aGVHD and improving the survival in DFS.</p>

Etiological surveillance and analysis of infectious diarrhea in Beijing in year 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the pathogenic form, epidemic features and serotype distribution of the pathogenic bacteria causing infectious diarrhea in Beijing.</p><p><b>METHODS</b>A total of 2118 samples of rectal swabs and stool specimens of diarrheal patients were collected from 6 surveillant intestinal tract clinics during the period between April and October, 2010. Enteric multiple pathogens including Vibrio cholerae, Vibrio parahaemolyticus, Salmonella, Shigella and diarrheagenic Escherichia coli were detected by the isolation culture, biochemical identification and serotyping methods. The population distribution, temporal distribution and serotype distribution of the above pathogenic bacteria were analyzed by descriptive statistical methods.</p><p><b>RESULTS</b>478 strains isolated from the total 2118 specimens were positive for pathogen detection, accounting to 22.6%. Among the 478 strains of pathogenic bacteria, Shigella accounting for 40.8% (195/478) was the most frequent pathogen, followed by Vibrio parahaemolyticus accouting for 23.8% (114/478), Salmonella accounting for 19.0% (91/478) and diarrheagenic Escherichia coli accounting for 4.8% (23/478). Enteric pathogenic bacteria spread mainly among adults aging between 20 and 39; and the distribution was different among different age groups, while the highest detected rate was in 30 - 39 age group, accounting for 27.2% (92/338). The detected rate of pathogenic bacteria showed evident seasonal variations, with a peak from July to October, whose detected rates were 23.5% (114/486), 32.8% (176/536), 36.1% (90/249) and 25.9% (29/112) respectively. The detected rates in other months were all under 16.0%. Shigella Sonnei was the dominant serotype, accounting for 83.1% (162/195). O3:K6 was the dominant serotype among Vibrio parahaemolyticus, accounting for 63.2% (72/114). Salmonella Enteritidis and Salmonella Typhimurium were dominant serotypes among Salmonella, accounting for 13.2% (12/91) and 12.1% (11/91) separately. Enterpathogenic Escherichia coli and enterotoxigenic Escherichia coli were the dominant serotypes among Diarrheagenic Escherichia coli, accounting for 69.6% (16/23) and 30.4% (7/23) respectively.</p><p><b>CONCLUSION</b>The three main pathogenic bacteria causing infectious diarrhea in Beijing are Shigella, Vibrio parahaemolyticus, Salmonella; and there are obvious changes in the serotype distribution of Shigella and Samonella compared to previous years.</p>

Etiology of hand-foot-and-mouth disease and genetic characteristics of Coxsackievirus A16 in Beijing, 2009 / 病毒学报

This study aimed to reveal the pathogen spectrum of hand-foot-and-mouth disease (HFMD) and genetic characteristics of Coxsackievirus A16 (CoxA16) isolates in Beijing in 2009. From 1044 clinical specimens collected from 975 HFMD cases at Beijing Pediatrics Hospital, Beijing You'an Hospital and Beijing Ditan Hospital in 2009, viral nucleic acids of enterovirus were detected by reverse transcriptase polymerase chain reaction (RT-PCR). Enterovirus isolations were conducted with rhabdomyosarcoma (RD) cell line on 200 throat swabs having positive RT-PCR results. Sequencing and analyses of VP1 encoding gene were performed on 9 CoxA16 isolates in this study. The results showed that CoxA16 (49.4%) and EV71 (36.4%) were the major pathogens for the epidemics of HFMD in 2009 in Beijing, and CoxA16 was the predominant serotype, while there were also other enterovirus co-circulating, such as CoxA4, CoxA10, and CoxA9; the CoxA16 strains prevalent in Beijing in 2009 belonged to subgenotype B1a and B1b.

Etiological characteristics of influenza A (H1N1) 2009 virus in Beijing / 中华流行病学杂志

Objective To analyze the results of detection on influenza A (H1N1) 2009 virus in Beijing from May 2009 to December 2009 and to understand the epidemiologic characteristics during the pandemic period. Methods The study was conducted from the May 1 to December 27,2009. A total of 101 852 throat swab samples were detected with the real-time RT-PCR assay by the Beijing Network Laboratory. Data was statistically analyzed. Results 9843 samples showed influenza A (H1N1) 2009 positive, with an overall positive rate as 9.66%. In terms of the positive rates, they were 2.85% from May to June, 3.32% from July to August and 8.35% from September to October. The peak month fell in November (29.67%) and December (24.33%). The positive rates among the following subpopulations were: 8.40% among the suspected cases, 4.75% among close contact cases, 11.46% among the influenza-like illness cases and 7.33% among the cluster cases with fever. Positive cases mainly fell in age groups 5-14 and 15-24. The ratio of male to female was 1.5:1.Conclusion During the pandemic period of influenza A (H1N1) 2009, positive cases gradually increased during May to November but slowly decreasing in December.

T3098C and T53C mutations of HBV genotype C is associated with HBV infection progress / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To analyze the association between mutation(s) in preS region of HBV and hepatitis B disease progress in Chinese patients with genotype C chronic HBV infection.</p><p><b>METHODS</b>Ninety-three patients with chronic genotype C HBV infection, including 24 asymptomatic carriers (ASC), 26 patients with chronic hepatitis B (CHB), 22 patients with liver cirrhosis (LC) and 21 HCC patients were investigated. Levels of HBV DNA, HBeAg, alanine aminotransferase (ALT), asparate transaminase (AST) were measured. HBV preS region was analyzed by PCR direct sequencing.</p><p><b>RESULTS</b>The prevalence of preS T3098C and T53C mutations of genotype C HBV was significantly higher in LC and HCC patients than ASC and CHB patients. The rate of T3098C mutation in ASC, CHB, LC, and HCC patients were 0.00% (0/24), 3.85% (1/26), 9.09% (2/22), and 30.77% (8/22), respectively (P=0.0015), while the rate of T53C mutation was 12.50% (3/24), 3.85% (1/26), 40.91% (9/22), and 42.31% (11/26), respectively (P=0.0012).</p><p><b>CONCLUSION</b>The frequency of genotype C HBV preS T3098C and T53C mutations is associated with hepatitis B infection progression</p>

Etiological analysis of enteric infectious diseases during Beijing Olympic Games / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand pathogen patterns of enteric infectious diseases and its impact on this pattern due to aggregation of a great deal of foreign visitors during Beijing Olympic Games.</p><p><b>METHODS</b>The diarrheal patient's rectal swabs and stool specimens were collected from Olympic stadium and hospitals of four districts, including Dongcheng, Xicheng, Haidian and Chaoyang. Enteric multiple pathogens were detected from the total 45 specimens. The culture method was used for the enteric bacteria, ELISA and RT-PCR for the enteric viruses. Molecular typing of Salmonella Enteritidis isolation was completed by PFGE.</p><p><b>RESULTS</b>It was found that 26 out of 45 cases were positive with 57.8 percent for pathogen detection, and 24 were identified as enteric pathogenic bacteria, including Vibrio parahaemolyticus, Salmonella, diarrheagenic Escherichia coli and Campylobacter jejuni, two as norovirus. There were mixed infections of two pathogenic bacteria for three cases. Ten kinds of pathogens were detected from foreign cases, while five kinds from Chinese cases. A total of 5 PFGE patterns were identified in 10 Salmonella Enteritidis isolates from national and foreign diarrheal cases, which were concentrative in some extent.</p><p><b>CONCLUSION</b>Vibrio parahaemolyticus, Salmonella, diarrheagenic Escherichia coli and Campylobacter jejuni were found to be the primary bacterial pathogens during the Olympic Games. Enteric virus infection existed in summer diarrhea.</p>

Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The definite pathogenesis of hemorrhagic cystitis (HC) after allogenic hematopoietic stem cell transplantation (allo-HSCT) has not been well elucidated. The role of cytomegalovirus (CMV) reactivation and graft-versus-host disease (GVHD) in the development of HC remains obscure. This study determined the incidence and risk factors for HC after allo-HSCT and analyzed its association with CMV reactivation and GVHD.</p><p><b>METHODS</b>We retrospectively studied 250 patients at high risk for CMV disease who underwent allo-HSCT all based on busulfan/cyclophosphamide (BU/CY) myloablative regimens. The incidence, etiology, risk factors and clinical management of HC were investigated.</p><p><b>RESULTS</b>HC developed within 180 days of transplant in 72 patients, with an overall incidence of 28.8% and an incidence of 12.6% in patients with HLA-matched related donors (MRD), 34.38% in those with HLA-matched unrelated donors (MUD), 49.45% in those with mismatched related donors (MMRD). CMV-viremia significantly increased the incidence of later onset HC (LOHC); however, only 9 out of 15 patients with CMV viruria actually developed LOHC. Multiple regression analysis identified grade II - IV acute GVHD (RR = 2.75; 95% CI 1.63 +/- 4.66; P < 0.01) and grafts from MUD or MMRD (RR = 2.60; 95% CI 1.52 +/- 5.20; P < 0.01) as independent risk factors for HC. Event sequence analysis indicated a majority of HC episodes began around GVHD initiation.</p><p><b>CONCLUSIONS</b>CMV-viremia is a high risk factor for LOHC. Our data also showed a correlation between acute GVHD and HC, which suggested that alloimmunity may be involved in the pathogenesis of HC.</p>

Study on the epidemiologic characteristics of norovirus infection in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of norovirus infection in Beijing.</p><p><b>METHODS</b>Both outbreaks and sporadic cases of acute gastroenteritis were studied through questionnaires while the stools of patients were collected. Noroviruses were detected by ELISA or RT-PCR, and PCR products were cloned and sequenced.</p><p><b>RESULTS</b>Eight outbreaks were reported between November 2006 and March 2007, which were confirmed as nosocomial infections. A total of 158 positive cases were detected among 409 sporadic cases of acute virus gastroenteritis with a positive rate of 38.63%. The highest positive rate (55.00%) was found in group aged from 40 to 44, while the lowest positive rate (21.74%) fell into groups aged from 55 to 59. The positive cases aged from 6 months to 91 years with the mean age of 40 years old including 84 males and 74 females. Data from sequence analysis showed that norovirus epidemic strains helonged to the GII/4 variants in Beijing, which were almost identical to the variants causing epidemics both in the Netherlands and in Japan.</p><p><b>CONCLUSION</b>Norovirus was important, causing virus-borne diarrhea between 2006 and 2007 in Beijing, and the epidemic strains were consistent with those isolated from both the Netherlands and Japan in 2006.</p>

A preliminary study on molecular characteristics of noroviruses detected in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the molecular characteristics of noroviruses detected in Beijing.</p><p><b>METHODS</b>From January to March 2007, cases from both outbreaks and sporadic episodes of acute nonbacterial gastroenteritis were investigated in Beijing, and the fecal specimens of the patients were collected. Noroviruses were detected by a reverse transcription polymerase chain reaction (RT-PCR), and then the PCR products were cloned and sequenced.</p><p><b>RESULTS</b>A total of 27 positive cases were identified as caused by noroviruses among the 38 patients with acute viral gastroenteritis, and four PCR products were randomly selected for further studies on sequencing. When comparing to the nucleotide sequences of norovirus reference strains from GenBank, the highest homology was found between the four isolates and the norovirus GII/4 strains. The four strains isolated from Beijing were almost identical to the GII/4 variants that causing epidemics in the Netherlands and in Japan with the homology of 97.8%-98.5% and 95.2%-95.9%, respectively. Phylogenetic analysis revealed that the four isolates were located at the same branch as the norovirus GII/4 variants in Netherlands and Japan.</p><p><b>CONCLUSION</b>New norovirus GII/4 variants were found in Beijing, and data from sequence analysis showed that the four isolates and the epidemic strains isolated from both the Netherlands and Japan in 2006 belonged to the same group of norovirus GII/4.</p>

HSC transplantation-associated intestinal thrombotic microangiopathy: clinical pathological features, diagnosis criteria and treatment / 中国实验血液学杂志

Thrombotic microangiopathy (TMA) is a lethal transplantation-associated complication which exactly likes acute intestinal graft-versus-host disease (GVHD) in the clinical manifestation. 373 consecutive patients with hematological diseases received family HLA matched or mismatched HCT from May, 2002 to July, 2004. To analyse the clinical and pathological characteristics of TMA, 30 patients who suffered from severe diarrhea and received colonoscopic examination and gut biopsy were retrospectively analyzed. The results indicated that 7 patients originally diagnosed as gut GVHD showed the pathological evidence of enteric TMA. The incidence of TMA was 7 out of 30 specimen (23.3%). Pathological evidence of enteric TMA shown microvascular disorder characterized by thrombus in the capillary without infiltration of lymphocytes and perivascular hemorrhages in the mucosa, swelling and focal denudation of epithelial cells. All patients with TMA were associated with cytomegalovirus (CMV) antigenemia/disease. Among these patients, 4 cases, who only showed TMA without the evidence of gut GVHD pathologically, displayed treatment-resistant bloody diarrhea, renal failure, veno-occlusive disease, hemorrhagic cystitis, hemolytic anemia as well as thrombocytopenia. But the other 3 cases, with co-existence of both TMA and GVHD pathological characteristics had better treatment response. Survival analysis indicated that 3 patients with TMA-GVHD survived for 461 to 536 days but three out of four TMA patients died from VOD with liver failure as well as multiple organ failure during 101 to 254 days after HCT. In conclusion, to better diagnose those patients with severe and refractory diarrhea following HCT, pathological examination may indicate crux evidence to identify intestinal TMA from gut GVHD. Furthermore, this primary report has first evidenced that TMA and TMA-GVHD are two pathologically well-recognized subtypes with the difference between the pathological characteristics, treatment response and clinical outcomes.

Alterations in coagulation in patients during transplant conditioning regimen before allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the alterations in coagulation in patients during conditioning with modified busulfan plus cyclophosphamide (BU/CY) +/- antithymocyte globulin (ATG) regimen before allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to assess the effect of ATG on coagulation system.</p><p><b>METHODS</b>Thirty-five patients with various hematological malignancies undergoing allo-HSCT were assessed. Of them, 19 patients with HLA-matched sibling donors (group A) were conditioned with modified BU/CY regimen, 16 with HLA-mismatched family members or HLA-matched unrelated donors (group B) were conditioned with modified BU/CY + ATG regimen. Blood samples were collected before the beginning of conditioning till d + 1 after allo-HSCT. The following parameters were measured: prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), antithrombin (AT), D-Dimer, fibrin degradation product (FDP), platelet (BPC), liver enzymes and bilirubin. FVIII: C, FIX: C, FXI: C and FXII: C in prolonged APTT blood samples were also determined. Clinical hemorrhagic symptoms were monitored.</p><p><b>RESULTS</b>During conditioning, temporary lengthening of APTT, persistent rising in Fg and declining of BPC were observed in the two groups. Alterations of Fg and BPC were more significant in group B than in group A. Transient D-Dimer increase occurred only in group B on administration of ATG. Among intrinsic pathway coagulation factors, FXII: C and FXI: C were commonly decreased while APTT prolonged. No difference between the two groups was found with regard to PT, FDP, AT and liver parameters which remained in normal ranges. Most of patients in the two groups did not have overt bleeding manifestations.</p><p><b>CONCLUSIONS</b>Modified BU/CY +/- ATG conditioning regimen can induce subclinical alterations in coagulation. The regimen containing ATG has more significant effect on coagulation parameters.</p>

Allogenic stem cell transplantation from genotypically HLA-identical siblings for 30 patients with myelodysplastic syndromes / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the indication and optimum time for treating myelodysplastic syndrome (MDS) by allogeneic hematopoietic stem cell transplantation (allo-HSCT) with HLA identical sibling grafts.</p><p><b>METHODS</b>From June 1997 to Sep. 2004, a total of 30 patients with MDS were treated with allo-HSCT from HLA-identical sibling donors in our institute. On HSCT, 4 patients had refractory anemia (RA) , 2 RA with ringed sideroblasts (RARS) , 7 RA with excess blasts(RAEB) , 14 RAEB in transformation (RAEB-t) , 3 already progressed to secondary AML. For IPSS system, 6 patients were in intermediate- I risk group, 11 in intermediate- li risk group, and 13 in high risk group. The modified BU/CY conditioning regimen was used. Four patients received bone marrow transplantation (BMT), 8 received peripheral blood stem cell transplantation (PBSCT) , and 18 received BMT + PBSCT.</p><p><b>RESULTS</b>The 3-year expected overall survival (OS) was 63.61%, 3-year expected disease-free survival ( DFS) 61.41%, and relapse rate 5.26%; OS for RA/ RAS, RAEB and RAEB-t/AML subgroup was 83.33%, 34.29% and 66.67% , respectively, and all had no statistic difference among them. OS for IPSS-intermediate and high risk subgroup was 64.7% , and 69.0% respectively, also had no statistic difference. 3-year expected OS in no aGVHD,grade I - II aGVHD and grade III - IV aGVHD group was 57.75% , 100% and 0% , respectively (P = 0.009). Pre-HSCT chemotherapy, disease subtype and cGVHD all had no correlation with LFS or OS (P > 0.05).</p><p><b>CONCLUSION</b>For young MDS patients having HLA-identical sibling donors, HSCT should be the first line therapy and performed as soon as possible.</p>

Analysis of 66 cases received hematopoietic stem cell transplantation from unrelated donors / 中华血液学杂志

<p><b>OBJECTIVE</b>To improve the outcome of hematopoietic stem cell transplantation from unrelated donors.</p><p><b>METHODS</b>Sixty-six patients with hematological diseases (40 cases of acute leukemia, 24 chronic myeloid leukemia, and one each severe aplastic anemia and beta-thalassemia) received bone marrow (BMT, n = 48) or peripheral blood stem cell transplantation (PBSCT, n = 18) from HLA-compatible unrelated donors after BUCY or TBI conditioning. Forty patients received longer and intensive GVHD prophylaxis (cyclosporin A from day -10 combined with mycophenolate mofetil).</p><p><b>RESULTS</b>Sixty-four patients achieved sustained donor engraftment. The median time of leukocyte engraftment was 15 days, being significantly earlier in PBSCT group compared with BMT group (12 vs 16 days, P = 0.002). The cumulative incidence rates of grades I-II and III-IV acute GVHD at day 100 were 57.15% and 32.25%, respectively. Chronic GVHD was seen in 21 of the 36 evaluable cases and ten of them were extensive type. Six patients relapsed and 27 dead, the overall survival at 5 years was 52.91%. The COX method analysis showed that HLA-compatible level and source of graft affected the incidence of aGVHD. The patients transplanted from HLA-matched donor with high resolution and PBSCT had the less probability for aGVHD. Patients without GVHD or with longer and intensive GVHD prophylaxis had significantly improved OS.</p><p><b>CONCLUSION</b>The key to improvement the outcome of HCT from unrelated donor is to reduce the incidence and severity of aGVHD by selecting the HLA-matched donor, intensifying the immunosuppression at the early stage of transplantation.</p>

Analysis of risk factors for the development of acute graft-versus-host disease in 151 cases of allo-hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the incidence and risk factors of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT).</p><p><b>METHODS</b>The clinical data of 151 cases of allo-HSCT in 150 patients from Nov 2001 to Jan 2004 was analyzed.</p><p><b>RESULTS</b>aGVHD was developed in 60 cases (40.2%), including 43 cases with grade I - II and 17 with grade III - IV aGVHD, the mean time of aGVHD development was 21 days (range 1 - 85 days) after allo-HSCT, 35 out of 55 cases achieved complete response (CR) (63.6%). The early survival rate for grade I - II aGVHD was more than 90%, while that for grade III - IV aGVHD was 46%. Nineteen factors possibly correlated with the development of aGVHD were analyzed. The univariate analysis showed that recipient age, donor's sex, recipient's sex, sex and ABO blood group disparity between donor and recipient, diagnosis, the status of disease, the stage of disease, stem cell source, conditioning regimen (TBI/without TBI), CD34(+) cell number, CD3(+) cell number, early engraftment and neutropenic infection were not closely associated with the occurrence of aGVHD (P > 0.05). On the Cox regression model, 2 independent factors for grade I - IV aGVHD were identified:HLA mismatch (RR = 1.681, P < 0.05) and positive surface antigen (HBsAg) (RR = 1.907, P < 0.05). In addition, the univariate analysis showed aGVHD was strongly associated with CMV infection (P < 0.01).</p><p><b>CONCLUSION</b>aGVHD is a common complication after HSCT, HLA mismatch and HBsAg positivity are independent risk factors for aGVHD.</p>

Study on non-programmed process using dimethyl sulfoxide and hydroxyethyl starch as cryoprotectants in cryopreservation of cord blood hematopoietic cells / 中国实验血液学杂志

This study was aimed to search for effective cryoprotectants and freezing methods used in cord blood bank (CBB) for cryopreservation of cord blood hematopoietic stem cells. The non-programmed group using 8% final concentration of dimethyl sulfoxide (DMSO) and 5% final concentration hydroxyethyl starch (HES) (molecular weight 120,000) as protectants and group of conventional of programmed controller method using 10% DMSO only as cryoprotectant in cryopreservation of cord blood hematopoietic stem cells were compared. In each of the two groups, 15 cord blood units were used. In non-programmed group, cord blood units put in -80 degrees C refrigerator for 24 hours as a transitional step before deep-freezing in liquid nitrogen, when both of DMSO and HES had been added. The recoveries of the nuclear cells number, the yield of granulocyto-macrophage colony forming units (CFU-GM) and the cells viability in cord blood units before preservation and after thawing were tested for both methods. The results showed that no significant difference was found in above assays between two groups. The clinical application results also showed that hematopoietic engraftment rates after infusion were similar in both groups. It is concluded that the non-programmed method by -80 degrees C refrigerator as a transitional step and using the combined two protectants seems simple in operation and effective in clinical transplantation as well as the conventional programmed method.

Exploration of acute graft versus host disease and its risk factors after allo-hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the incidence, prognosis and risk factors of the acute graft versus host disease (aGVHD) after allo-hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>The clinical data of 118 cases undergone 120 times of allo-HSCT were analyzed.</p><p><b>RESULT</b>aGVHD was observed in 63 cases (52.57%) including 17 severe cases (14.17%). The patients with aGVHD had a poor outcome, the 2-year overall survival rates were 61.40%, 64.08% and 17.65% for the non aGVHD, mild (degree I-II) and severe (degree III-IV) aGVHD groups respectively (P < 0.01). However, the relapse rates were 12.48%, 20.53% and 0% with no statistic significance. Unrelated transplantation and HLA-mismatch were the risk factors for aGVHD.</p><p><b>CONCLUSION</b>aGVHD is a common complication after allo-HSCT, the earlier it takes place, the poorer the prognosis.</p>