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Liver is the most common location for hematogenous spread of solid tumors. Clinically acute hepatic failure ( ALF) secondary to either a solid organ tumor or a hematologic malignancy is rare,but with a poor prognosis and high mortality. The time between the onset of symptoms and ALF was relatively rapid. Malignancy is one of the causes of pediatric acute liver failure (PALF). Common clinical symptoms were jaundice,haemorrhage,and hepatic encephalopathy. It is lack of specific clinical features and difficult to diagnose in early phase. Delayed diagnosis and treatment contribute to poor prognosis. How to combine the treatment of primary tumors and liver protection is critical issue to clinician. The effective therapy for patients with PALF is liver transplantation. In recent years,the development of artificial liver support is to provide a facilitating recovery chance and to prolong the window of opportunity for liver transplantation.
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Organ donation policy changes often seek to increase organ donation rates in an attempt to close the gap between the number of organs available for transplantation and the demand for transplantable organs. The ex-traordinary gap between the number of organs donated from deceased donors and the number of people awaiting transplantation in China has left Chinese policy-makers looking for alternatives. In developing organ donation poli-cies and practices, China should avoid ethical problems that exist in the US system and in other Western approa-ches to organ donation. Despite their higher donation rates, these Western systems would be inappropriate for China because they do not reflect Chinese cultural values. There also are practical considerations that make it unlikely that adopting Western approaches to organ donation would translate into higher donation rates in China. Instead of looking to the West, China should look within to its rich cultural resources as it develops organ donation policies and implements new practices.
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Objective:To search for differences in early immune reconstitution after allogenic or autolo-gous hematopoietic stem cell transplantation (HSCT).Methods:The peripheral blood (PB)from 31 adult patients undergoing allogenic HSCT (allo-HSCT,1 5 patients)or autologous HSCT (auto-HSCT, 1 6 patients)for the treatment of hematological malignancies and from 20 related healthy controls (HC) from December 201 1 to August 201 4 was used to analyze the kinetic recovery of lymphocyte subsets by means of flow cytometry during 1 2 months after HSCT.The T cell receptor rearrangement excision circle (TREC)levels among CD3 + T cells were measured in the patients and HC to evaluate the thymic-dependent T cell reconstitution.Results:The allo-and auto-HSCT recipients did not differ significantly in CD4 + T cells,CD8 na?ve T cells,effecter memory T cells (TEM),CD4 central memory T cells (TCM),mid-activated T cells and dendritic cells (DC)during the follow-up (P >0.05).But they both differed significantly from HC (P 0.05).B cells in both the groups were lower than those in HC (P 0.05). Conclusion:The differences of the nature and the speed of lymphocyte reconstitution observed between the two patents groups were minor.This leads us to conclude that in allografted patients,immune recons-titution and subpopulations of peripheral blood lymphocytes are probably not related to the allogenicity of the graft,but due to the impaired thymus functions and slow differentiation of T lymphocytes in thymus.
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Objective To investigate the role of stromal cell-derived factor-1α(SDF-1α)/CXCR4 signal pathway in the therapeutic effects of hypoxic preconditioning endothelial progenitor cell (HEPC) transplantation on acute myocardial in-farction Methods Bone marrow endothelial progenitor cells (EPCs) were isolated from syngeneic adult male Wistar rats. EPCs were cultured under normoxic condition for 4 days and 1%O2+5%CO2+94%N2 condition for 3 days. The effect of HEP-Cs on the migration ability of 100μg/L SDF-1αwas observed. Western blot assay was used to detect the expression of CX-CR4, the solo receptor of SDF-1α on cells surface. Then, 26 syngeneic adult male Wistar rats were randomized into 3 groups:control group (n=8),EPCs group (n=9) and HEPCs group (n=9). The acute myocardium infarction animal model was established. At infarction, the rats received 5-points peri-infarct intramyocardial injections of PBS 200μL, 2×106 EPCs and 2 × 106 HEPCs. After 4 weeks, the haemodynamics parameters of cardiac function were analyzed by echocardiography. Results Compare with EPCs, the migration ability of HEPCs towards SDF-1α was increased significantly. The result of Western blot analysis showed an increased CXCR4 expression on the cell surface. After 4 weeks of transplantation, the left ventricular end systolic diameter and ejection fraction (EF%) were much improved in HEPCs group than those of EPCs group and control group (P＜0.05). Compare with control group, the left ventricular end-diastolic diameter was significantly im-proved in EPCs and HEPCs groups (P＜0.05). There was no significant difference in the improvement of the left ventricular end-diastolic diameter between HEPCs and EPCs groups (P>0.05). Conclusion SDF-1α/CXCR4 pathway was up-regu-lated by HEPCs, which showed the therapeutic effects via EPCs. The adjustment of SDF-1α/CXCR4 signaling pathway is an effective method for the treatment of ischemic heart diseases.
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Objective To locally inject human umbilical cord blood (HUCB) mesenchymal stem cells (MSCs) to rat traumatic brain injury (TBI) model to investigate expression of neural markers and neurological functional improvement. Methods HUCB-MSCs were labeled by bis-benzimide for over 24 hours and stereotactically transplanted into the brain of the rats. All rats were divided into four groups, ie, sham injury group, TBI group, control (TBI + PBS) group and treatment (TBI + MSCs) group, Im-munohistochemical methods and immanofluorescence staining were used to observe the survival, migration and differentiation of the transplanted cells. The neurological functional improvement was evaluated by u-sing the neurological severity score (NSS). Results There existed a large number of MSCs survived in local region of the brain that received transplants, when some MSCs differentiated into neurons or astro-cytes and expressed the neurocyte markers including NSE and GFAP around the grafted site. Treatment group had significantly improved scores compared with sham injury group, TBI group and control group. Conclusions HUCB-MSCs transplantation can potentially improve neurological functional after TBI and may be a good alternative to bone marrow cells for stem cell transplantation or cell therapy.
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BACKGROUND: Rapid platelet engraftment has several economic benefits by reducing the cost of supportive therapy as well as reducing the risk of fatal bleeding due to severe thrombocytopenia. Based on these considerations, we genotyped human platelet alloantigens (HPA) to evaluate the effect of minor transplantation antigen mismatches on the rate and speed of platelet recovery and clinical outcome of transplantation. METHODS: Thirty-five patients with various hematologic diseases transplanted between January 2001 and August 2004 were included. Genomic DNA was isolated from peripheral blood of donor-recipient pairs before transplantation. HPA-1, -2, -3, -4, -5, and -6 genotyping was performed by poly-merase chain reaction (PCR)-sequence specific primers (SSP). The effects of HPA compatibility on platelet recovery, incidences of graft-versus-host disease (GVHD) and relapse, and overall survival was investigated. RESULTS: There were no significant differences in platelet recovery according to HPA matching status. We observed no statistically significant differences in the occurrence of relapse and overall survival according to HPA-1, -2, and -3 matched/mismatched groups of patients, whereas HPA-3 mismatching was found to have a significant effect on GVHD development. There was also no difference in GVHD occurrence according to HPA-1 and -2 matched or mismatched transplants. CONCLUSIONS: Since platelet recovery in the HPA-1, -2, -3, and -5 matched/mismatched groups is not significantly different, the seems that platelet glycoprotein (GP) does not seem to act as a factor influencing the homing of hematopoietic stem cells. The finding that HPA-3 incompatibility may be involved in GVHD can be of importance. If a role for HPA-3 as minor histocompatibility antigens is confirmed by additional studies, we can ameliorate the outcome of allogeneic stem cell transplantation by typing of HPA and selecting the most closely related donors.
Subject(s)
Humans , Antigens, Human Platelet , Blood Platelets , DNA , Glycoproteins , Graft vs Host Disease , Hematologic Diseases , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Hemorrhage , Incidence , Minor Histocompatibility Antigens , Recurrence , Stem Cell Transplantation , Thrombocytopenia , Tissue DonorsABSTRACT
Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.
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ObjectiveTo set up the porcine combined liver/small bowel orthotopic allotransplantation model.MethodThe donors including liver, about 2 to 3?m proximal jejunum, duodenum and a sma ll part of pancreas head were transplanted to the hybridized long-white recipie nt pigs after the resection of their livers and the majority of small bowels.ResultWithout using immunosuppressive drugs, the median survival time of the animals w as 92?h with the longest survival time being 196?h, and there was about 75?% of the animals lived for more than 24?h after operation.ConclusionThe successful establishment of the combined liver/small bowel transplantation m odel will do great favor to our future clinical practice and further study of th e combined liver/small bowel transplantation.
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Objective To report a case of psoriasis vulgaris associated with acute myelogenous leukemia(AML)(type M4EO).Methods Clinical data from the patient were collected.Histopathologic examination,and examination of bone marrow and peripheral blood smear were performed.The immunologic types of bone marrow cells were analyzed with FACS.Chromosome and G-banding analyses were carried out with cultured bone marrow cells.Results A33-year-old woman had a history of chronic plaque psoriasis for20years.Her cousin had the same disease history.The patient was treated with various therapeutic regi-mens,most of which were traditional Chinese medicines.Recently the patient suffered from myalgia and chest bone pain,periodic bleeding on gums,fever and so on.The abnormal infantile monocytes and promye-locytes were found with bone marrow smear,and crassitude basophilic granules were noticed in eosinophils.The diagnosis of acute myelogenous leukemia type M4EO was made.The diagnosis was confirmed with the immunologic analysis of born marrow cells with FACS.Chromosome and G-banding analyses revealed her karyotype of46,XX,inv(16)/47,XX,inv(16),+8(2/22).The plaque lesions of psoriasis were regressed after allogeneic bone marrow transplantation and the symptoms of AML were resolved.Conclusion It is the first case report of psoriasis vulgaris associated with acute myelogenous leukemia M4EO which responded to allogeneic bone marrow transplantation.