Imatinib Combined with VP Low Dose Regiment for Treating Newly Diagnosed Adult Patients with Ph-positive ALL / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the inductive therapeutic effects of imatinib combined with VP low dose regiment on adult patients with Ph-positive acute lymphoblastic leukemia (Ph(+) ALL).</p><p><b>METHODS</b>Fourteen newly diagnosed adult patients with Ph(+) ALL were treated with VP regimen, and imatinib (400 mg/d) was added at the 8(th) day. VP regimen would be stopped when neutropenia lasted for 1 week or complicated with infection, fever, etc. Therapeutic effects were assessed by bone marrow morphology and quantitative analysis of BCR/ABL:ABL at the 28(th) - 33(rd) day. Patients could be treated with imatinib combined with chemotherapy for consolidation and maintenance therapy or were treated with allogeneic hematopoietic stem cell transplantation after complete remission.</p><p><b>RESULTS</b>Fourteen cases obtained CR1 after first course of treatment, the median decline of BCR/ABA:ABL was 55.89 (10.25 -180.97) %; during the induction chemotherapy, pulmonary infection occurred in 3 patients, diarrhea in 1 patients, facial edema in 3 patients, however, all these patients were cured after symptomatic treatment, only 1 patient died of relapse after transplantation.</p><p><b>CONCLUSION</b>In the period of tyrosine kinase inhibitor (TKI), inductive chemotherapy combined with imatinib and low dose VP can obtaine satisfactory CR rate and decrease the toxicity of the traditional drugs. It is suggested that TKI combined with VP regimen chemotherapy can achieve CR1 and make possible for allo-HSCT, from which patients can achieve the long-term survival.</p>

Acute blood glucose fluctuation affects GSH-Px, IL-6, and NF-κB in aorta / 中国医师杂志

Objective To investigate the effect of acute blood glucose on the level of glutathione peroxidase (GSH-Px),interleukin-6 (IL-6),and the expression of nuclear factor-κB (NF-κB).Methods The Wistar rats were infused intermittently or consistently with 50％ glucose solution.The level of GSH-Px was investigated with colorimetry.The level of IL-6 was measured with enzyme-linked immunosorbent assay (ELISA).The expression of NF-κB was investigated with immunohistochemisty.Results The level of GSH-Px in aorta homogenate in the acute blood glucose fluctuation group [(6.26 ± 0.38) nmol/mgprot] was evidently lower than that of consistently high blood glucose group [(8.98 ± 0.56) nmol/mgprot] and the control group [(10.02 ±1.10)nmol/mgprot] (P ＜0.05).The level of IL-6 [(20.56 ±3.78)pg/ ml] and the expression of NF-κB in the aorta in the acute blood glucose fluctuation group [(16.35 ±2.45) pg/ml] were evidently higher than the other two groups (P ＜ 0.05).Conclusions Acute glucose fluctuations induced the enhancing of oxidative stress and expression of inflammatory cytokines in the aorta,which leads to start NF-κB signaling pathway.

Application of interactive online teaching in the laboratory diagnostics teaching / 中华医学教育探索杂志

Objective In order to investigate the impact of interactive online teaching in Laboratory Diagnosis, a randomized experimental study was conducted among the medical students in Grade 2009.Methods A total of 65 subjects were randomized into the experimental group (N=31) and the control group (N=34).In addition to the standard in-class presentation/discussion and school-wide refined online courses offered in the control group, interactive online teaching was added to experimental group.After completion of the course, the impact of interactive online teaching in the experimental group was compared to that in the control group through a final exam and a question-naire concentrating on motivation of study, problem solving and team working skills.Statistical signifi-cance of the comparison was evaluated using t-test.Results The results from the final exam showed that the average score in the experimental group was higher than the control group (87.20 ± 5.25 vs.82.69 ± 5.76), It is statistically significant (P=0.002).The average scores of short answer and case study questions in the experimental group was higher than the control group (26.16 ± 1.57 vs.25.31 ± 1.73, 18.94 ± 1.05 vs.15.53 ± 1.15), It is statistically significant (P=0.043,P=0.000).The satisfaction evaluation of interest in learning, timely answers to questions, learning, analytical skills, teamwork culture reflected by the questionnaire indicated statistically higher (P=0.041,0.000,0.000,0.000,0.000) average scores in the experimental group as compared to its counterparts in the control group (4.30 ± 0.65 vs.3.97 ± 0.62, 4.63 ± 0.49 vs.3.25 ± 0.88, 4.43 ± 0.57 vs.3.49 ± 0.65, 4.46 ± 0.57 vs.3.37 ± 0.73, 4.33 ± 0.66 vs.3.68 ± 0.58).Conclusion Interactive online teaching helps to improve the study performance of medical students in Laboratory Diagnosis.Incorporating interactive online teaching into the current course regarding Laboratory Diagnosis merits recommendation.

Prevalence and subtype distribution of HPV infection among women in Beijing urban area and their correlation with age / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and subtype distribution of human papillomavirus (HPV) infection and its correlation with age among women in Beijing urban area, and provide some epidemiological evidence for the clinical application of HPV vaccines.</p><p><b>METHODS</b>We collected cervical specimens from 1999 women in the Outpatient Department of our hospital, performed genetyping of HPV-DNA, and analyzed the incidence of HPV infection in different age groups.</p><p><b>RESULTS</b>HPV infection was detected in 502 (25.2%) of the 1999 women patients, with 391 (19.6%) cases of high-risk HPV, which included 326 (83.4%, 326/391) cases of single infection. HPV-16 was the most common type (21.2%, 69/326), followed by HPV-52 (19.3%, 63/326) and HPV-58 (16.0%, 52/326). The prevalence of HPV infection was the highest among the women aged 41 -50 years and the lowest among those over 60 years.</p><p><b>CONCLUSION</b>The subtype- and age-specific distribution of HPV infection among women in Beijing urban area shows an obvious heterogeneity, which deserves due consideration in the clinical application of HPV vaccines.</p>

Analyses of clinical features and outcomes of 57 patients with non-gastric MALT lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To further understand the clinical features of non-gastric mucosa-associated lymphoid tissue (MALT) lymphoma and investigate its suitable treatment.</p><p><b>METHODS</b>A retrospective survey of 57 non-gastric MATL lymphoma patients pathologically confirmed in our hospital from 1999 to 2011.</p><p><b>RESULTS</b>The median age was 58 years (range 14-86 years). Common presenting sites of non-gastric MALT lymphoma included lungs and upper respiratory tract (17 patients, 29.8%), intestinal tracts (16 patients,28.1%), orbital and ocular adnexal (7 patients, 12.3%), and salivary glands (8 patients, 14.0%). Stage Ⅰ-Ⅱdisease presented in 35 patients (61.4%), stage Ⅲ-Ⅳ disease in 22 patients (38.6%). A total of 26 patients had nodal involvement and 7 patients multiple organ involvement. Regimens included surgery alone, chemotherapy alone, surgery followed by chemotherapy or chemoradiotherapy. The complete response (CR) rate was 66.0% and the overall response rate 85.7%. At a median follow-up of 52 months, the 5-year overall survival (OS) and the 5-year progression free survival (PFS) were 91.6% and 77.7%, respectively. The 5-year survival rate of surgery, chemotherapy, surgery+chemotherapy, surgery + chemotherapy + radiotherapy groups were 87.5%, 100.0%, 90.2% and 100.0%, respectively, without significant differences. The 5-year PFS of the four groups were 62.3%, 80.0%, 90.2% and 75.0% respectively.</p><p><b>CONCLUSION</b>Non-gastric MALT lymphoma is characterized by disseminated onset, favorable response to treatments and good outcomes. There is no statistically significant difference in the overall survival of the various treatments. But the recurrence rate of surgery alone is relatively high (22.3%).</p>

In vitro study of biological characteristics of mesenchymal stem cells in patients with low-risk myelodysplastic syndrome / 中国实验血液学杂志

The myelodysplastic syndromes (MDS) include a diverse groups of clonal and potentially malignant bone marrow disorders. Evidences exist that microenvironment cells from MDS marrow show functional abnormalities, which may be relevant to the incidence of such a disease. Mesenchymal stem cells (MSCs) are a very important component of hematopoietic microenvironment. This study was supposed to investigate the biological characteristics and functions of MSC derived from patients with MDS in low-risk. MSCs from bone marrow samples of 11 low-risk MDS patients were isolated, cultured and expanded. Morphology, immunophenotype and osteoblasts differentiation were analyzed. Their capacity of proliferation and hematopoietic supporting in vitro were measured. A real-time quantitative reverse transcriptase polymerase chain reaction method (RQ RT-PCR) was used for detecting the expression levels of relative cytokines and chemokines in MSC. MSCs from healthy donors were used as controls. The results showed that the culture-expanded cells from MDS patients displayed a typical fibroblast-like morphology. Cells were positive for SH2 (CD105), SH3 (CD73), Thy-1 (CD90), while negative for CD34 and CD45. After induction, these cells could differentiate into osteoblasts. The proliferative ability of MSCs in MDS patients were not different from those of MSC isolated from normal bone marrow (p > 0.05), however, their capacity of hematopoietic supporting in vitro were significantly weaker (p < 0.05). RQ RT-PCR detection indicated that the SDF-1 gene expression level in MSCs of low-risk MDS patients was significantly higher than that in MSC derived from healthy donors (p < 0.01). It is concluded that the abnormal function of MSC influences the regulation of hemotopoiesis in the bone marrow microenvironment of MDS patients. It is worthy to further investigate the new clue in etiological mechanism and therapeutic strategies for MDS.

Effects and mechanism of glucagon-like peptide-1 on injury of rats cardiomyocytes induced by hypoxia-reoxygenation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although the insulinotropic role of glucagon-like peptide-1 (GLP-1) in type 2 diabetes mellitus has been substantiated, its role in cardioprotection remains largely unknown. This study aimed to determine the effects of GLP-1 on injury of rats cardiac myocytes induced by hypoxia-reoxygenation (H/R) and the possible mechanisms.</p><p><b>METHODS</b>The cultured neonatal rats cardiac myocytes were randomly divided into seven groups: the normal control group, the H/R group, the GLP-1 + H/R group, the GLP-1 + H/R + UO126 (the p42/44 mitogen-activated protein kinase (MAPK) inhibitor) group, the GLP-1 + H/R + LY294002 (phosphatidylinositol 3-kinase (PI3K) inhibitor) group, the H/R + UO126 group, and the H/R + LY294002 group. The lactate dehydrogenase (LDH) activity, apoptosis rate of cardiac myocytes, and caspase-3 activity were detected after the injury of H/R.</p><p><b>RESULTS</b>Compared with the normal control group, the activity of LDH, cardiac myocyte apoptosis rate, and caspase-3 activity all increased significantly in the H/R group (P < 0.01). Compared with the H/R group, these three indices all decreased in the H/R + GLP-1 group (P < 0.01). However, the changes of LDH activity, apoptosis rate, and caspase-3 activity were inhibited by LY294002 and UO126 respectively.</p><p><b>CONCLUSIONS</b>GLP-1 can directly act on cardiac myocytes and protect them from H/R injury mainly by inhibiting their apoptosis. Its mechanism may be through the PI3K-Akt pathway and the MAPK signaling pathway.</p>

Late-onset noninfectious pulmonary complications after allogeneic peripheral blood stem cell transplantation / 中国实验血液学杂志

The aim of study was to explore the incidence, risk factors, outcome and efficacious treatment of late-onset noninfectious pulmonary complications (LNIPC) after allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Seventy patients received allo-PBSCT were analyzed retrospectively. The results showed that 9 out of 63 patients surviving more than 3 months occurred late-onset noninfectious pulmonary complications (14.3%). Five out of the 9 patients developed secondary pulmonary infections. In 4 patients, LNIPC caused death directly. Advanced stage of disease at transplantation and extensive chronic graft-versus-host disease (GVHD) happened in association with LNIPC. However, other transplantation-related factors including age at transplantation, gender of patient, conditioning regimen, HLA matching and GVHD prophylaxis were not significantly correlated with the incidence of LNIPC. It is concluded that performing pulmonary function test (PFT) and thoracic computer tomography should be taken routinely after transplantation. Most patients who get correct and early diagnosis for LNIPC will show a positive response to prednisone with or without CsA.

Clinical study on pulmonary complications after allogeneic peripheral blood stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the incidence, pathogenesis, risk factors and effective treatment of pulmonary complications after allogeneic peripheral blood stem cell transplantation (allo-PBSCT).</p><p><b>METHODS</b>Pulmonary complications in 70 patients received allo-PBSCT were analyzed.</p><p><b>RESULTS</b>Thirty one episodes were observed in 26 patients. Among them episodes were infectious complications, including bacteria pneumonia, pulmonary fungus disease, CMV interstitial pneumonia and tuberculosis, some cases were caused by two pathogens, and 11 episodes were noninfectious complications, including late-onset noninfectious pulmonary complications (LONIPCs) (n=9), pulmonary edema (n=1) and interstitial pneumonia (n=1). The overall mortality was 12.9%. Graft-versus-host disease (GVHD) prophylaxis without MTX, severe acute GVHD and extensive chronic GVHD were high risk factors for pulmonary complications and advanced disease at transplantation, extensive chronic GVHD were significantly associated with the incidence of LONIPCs.</p><p><b>CONCLUSION</b>Pulmonary disease is the main complication occurred in patients undergoing allo-PBSCT. It is of greatly importance to treat pathogens specifically and diagnose LONIPCs in its early stage.</p>