Efficacy and safety of alfentanil hydrochloride injection in general anesthesia: A multicenter, double-blind, controlled study / 中国药理学通报

Aim To investigate the effectiveness and safety of alfentanil in general anesthesia.Methods In this study, a multicenter randomized double-blind con¬trolled study was conducted.A total of 352 subjects were selected and randomly assigned to fentanyl group (group A, n =176) and alfentanil group (group 15, n = 176).Anesthesia induction: intravenous midazolam 0.03 mg • kg-1 + fentanyl 25 p.g • kg"'(group A) or alfentanil 4 p,g • kg-1 ( group 15) + propofol 2 mg • kg"1 + rocuronium 0.8 mg • kg"1.Sevoflurane + fent¬anyl ( group A ) or alfentanil ( group B ) + rocuronium were used for anesthesia.The vital signs of patients re¬covery time and extuhation time, anesthesia-related complications and the use of related remedial drugs during anesthesia induction and maintenance were compared between the two groups.Results During the induction and maintenance period of anesthesia, alfentanil and fentanyl could equally effectively inhibit the stress response induced by endotracheal intubation and surgical stimulation.Alfentanil also showed more effective inhibition on stress response induced by endo¬tracheal intubation and surgical stimulation than that of fentanyl ( P < 0.05 ) .However, there was no signifi¬cant difference in the incidence of intraoperative hypo¬tension and hypertension and the time of anesthesia re¬covery and extubation between the two groups.Conclu¬sions Both alfentanil and fentanyl can effectively in¬hibit the stress response induced by surgical stimulation and could be safely used in general anesthesia in sur¬gery.Alfentanil has more advantages in maintaining the stability of blood pressure and heart rate during an¬esthesia induction and maintenance.

The features of MRI in spectrum of fetal cloaca malformation / 中华放射学杂志

Objective:To explore the features and application value of MRI in the spectrum of fetal cloaca malformation.Methods:The clinical, MRI and ultrasound data of 6 fetuses with spectrum of cloaca malformation were retrospectively analyzed in Guangzhou Women and Children′s Medical Center Affiliated to Guangzhou Medical University from January 2017 to February 2021, and the MRI features of each subtype were analyzed.Results:Among the 6 fetuses of spectrum of the cloaca malformation, 5 were confirmed by postnatal imaging and surgery, and 1 was confirmed by induced labor autopsy, including 3 persistent cloaca, 1 posterior cloaca, 1 cloaca variant, and 1 urogenital sinus. The high signal on T 1WI of the rectal meconium disappeared or became weaker, and the signal on T 2WI of meconium of the dilated colon increased in the 3 cases of persistent cloaca and 1 case of posterior cloaca. All 6 cases showed colonic dilatation. All cases except 1 persistent cloaca showed vaginal and/or uterine effusion. Two cases of persistent cloaca, 1 case of posterior cloaca and 1 case of cloaca variant showed duplicated genital tract. Two cases of persistent cloaca showed only 1 perineal opening, which opened at the urethral orifice. One case of cloaca variant showed 2 openings, which opened at the urethral orifice and in front of the normal anus, respectively. Conclusion:Prenatal MRI can help to clarify the diagnosis of cloacal malformation spectrum and to determine its specific classification.

Progress of Bevacizumab in the Front-line Treatment of Advanced Non-small Cell Lung Cancer / 中国肺癌杂志

As the first anti-angiogenesis monoclonal antibody, bevacizumab has been an vital component of front line regimen of advanced nonsqaumous non-small cell lung cancer (NSCLC). It increase the efficacy of chemotherapy, epithelial growth factor receptor tyrosine kinase inhibitors and immune checkpoint inhibitors. This article is an important review of existing randomized controlled clinical research, hoping to provide a reference for clinical treatment. The addition of bevacizumab reduces the risk of disease progression in patients with advanced non-squamous NSCLC significantly. Specific combinations can also reduce the risk of death. The best combination plan needs to be confirmed by new randomized controlled studies.

Genetic Mutation Screening of DNA Polymerase in Human Lung Cancer / 中国肺癌杂志

BACKGROUND@#DNA polymerase β is one of the key enzymes for DNA repair and it was reported that about 30 percent of different types of cancers carried mutations in its coding gene Polb. However, it is still controversial whether it is true or false because of the small sample size in these studies. In current study, we performed genetic screening of promoter and coding regions of Polb gene in 69 Chinese lung cancer patients using Sanger sequencing method, so as to elucidate real mutation frequency of Polb mutations in Chinese Han population.@*METHODS@#Salting out extraction method was used to get the genome DNAs from tumor and normal matched tissues of 69 lung cancer patients. The promoter and 14 coding regions of Polb gene were then amplified using these DNAs as the template. After purification, amplicons were sequenced and aligned to the wild type Polb gene in NCBI database, in order to find out the mutated sites of Polb gene in Chinese lung cancer patients.@*RESULTS@#In this study, we totally found only 5 mutated sites in Polb gene. In detail, 3 mutations (-196G>T, -188_-187insCGCCC, -168C>A) were located in the promoter region; 2 mutations (587C>G, 612A>T) were found in coding regions. Specially, mutations of -188_-187insCGCCC and 587C>G (resulting to the amino acid substitution of Thr to Ser at position 196) had never been reported by other groups before. However, all these 5 mutated sites could be detected in both tumor and matched normal tissues, which inferred that they are not lung tumor specific mutations.@*CONCLUSIONS@#No lung tumor specific mutations of Polb gene could be found in Chinese lung cancer patients and Polb gene mutation might not be a molecular marker for Chinese lung cancer patients.

Clinical analysis of seven cases of H1N1 influenza-associated encephalopathy in children / 中华儿科杂志

Objective@#To investigate the clinical manifestations, diagnosis, and treatment of H1N1 influenza A-associated encephalopathy (IAE) in children.@*Methods@#The clinical manifestations, laboratory tests, cranial magnetic resonance imaging (MRI), electroencephalography (EEG) examinations and treatments of seven children with H1N1 IAE hospitalized in Guangzhou Women and Children′s Medical Center from December 2018 to January 2019 were retrospectively analyzed.@*Results@#Five of the seven children with H1N1 IAE were female. The age at admission was 4 years and 5 months (range 7 months-9 years). Neurological symptoms occurred simultaneously or early (0-3 days) after the flu-like symptom appeared. The main clinical manifestations of neurological symptoms were seizures (repeated seizures in five cases and status convulsion in two cases, including one case of unexpected fever and repeated seizures in a nine-year old girl) accompanied with altered consciousness (drowsiness in five cases and coma in two cases). Cranial MRI in three cases displayed multifocal lesions, mainly in the bilateral thalamus, brainstem and cerebellar hemisphere. MRI also showed reversible splenial lesion in the corpus callusumin in three cases. EEG tracings were characterized by diffuse slow wave activity in four cases, and status epilepticus was monitored in one case. All the 7 cases were treated with oral oseltamivir. Three cases were treated with pulsed methylprednisolone and intravenous immunoglobulin. One case was treated with intravenous immunoglobulin alone and all the patients received oral oseltamivir. All the patients survived, with three patients had minor neurological sequelae at discharge.@*Conclusions@#The main clinical manifestations of H1N1 IAE are seizures and altered consciousness. Cranial MRI combined with EEG is helpful for early diagnosis. Intravenous immunoglobulin and (or) methylprednisolone should be considered for severe cases.

Efficacy of first line epidermal growth factor receptor tyrosine kinase inhibitor in advanced lung adenocarcinoma patients with different epidermal growth factor receptor mutation status / 肿瘤研究与临床

Objective To investigate the clinical characteristics of advanced lung adenocarcinoma patients with different epidermal growth factor receptor(EGFR) mutation status, and to analysis the efficacy of first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) for these patients. Methods The clinical data of 193 advanced lung adenocarcinoma patients with EGFR gene sensitive mutation (exon 19 deletion and exon 21 L858R mutation) were collected in the Beijing Hospital from January 2011 to December 2015.The relationship between EGFR mutation status and objective response rate (ORR), progression free survival (PFS) were analyzed. Results Of the 193 patients, 104 patients expressed exon 19 deletion, 89 patients expressed exon 21 L858R mutation.Compared with the patients with EGFR exon 21 L858R mutation, the patients with EGFR exon 19 deletion were younger, and the patients younger than 60 years old accounted for 47.1 %(49/104),while the L858R point mutation in this age group was 28.1 %(25/89),and the difference was statistically significant (χ2= 7.343, P = 0.007), but there were no significant differences in gender, smoking status, and metastasis site (all P>0.05). The ORR of patients with exon 19 deletion were same to those of patients with exon 21 L858R mutation [71.2 % (47/66) vs. 61.1 % (33/54), χ2= 1.364, P= 0.243]. The median PFS of patients with exon 19 deletion was significantly higher than that of patients with exon 21 L858R mutation (11.0 months vs. 8.6 months, U= 1.984, P = 0.046). Conclusions Lung adenocarcinoma with EGFR exon 19 deletion is associated with longer PFS compared with those with exon 21 L858R mutation. Different mutation status of EGFR can be used as a predictor of PFS in patients with advanced lung adenocarcinoma treated with first-line EGFR-TKI.

Advances of immune checkpoint blockades in the treatment of digestive cancers / 国际肿瘤学杂志

Immune checkpoint blockade is a hot spot in treatment of cancers recently,and their effi-cacy in digestive cancer cannot been ignored.Nivolumab is superior to sorafenib in the terms of prolonging survival period for the patients with advanced live cancer.The effective rate of Pembrolizumab for advanced PD-L1 positive expression esophageal cancer can reach 30%.Nevertheless,Ipilumumab shows no significant efficacy in advanced pancreatic carcinoma.More researches are on the way,such as Avelumab in advanced gastric cancer,and Pembrolizumab in advanced esophageal squamous carcinoma.

Efficacy evaluation criteria for immunotherapy in solid tumors / 国际肿瘤学杂志

Immunotherapy has become an important therapy for solid tumors,which is in addition to surgery,radiotherapy,chemotherapy and targeted therapy.However immune treatment mechanism is different from those previous treatment.The effect of immunotherapies is on the immune system and not directly on the tumor.The kinetics of immunotherapy is characterized by a cellular immune response followed by potential changes in tumor burden and survival period.They are not captured by the traditional World Health Organiza-tion (WHO)or the Response Evaluation Criteria in Solid Tumors (RECIST).New immune-related response criteria are defined which more comprehensively capture all response patters and gradually applied in clinical practice.

Treatment after acquired resistance to EGFR-TKI of non-small cell lung cancer / 中国肿瘤临床

Epidermal growth factor receptor tyrosine-kinase inhibitors (EGFR-TKIs) have elicited curative effects on patients with advanced non-small celllung cancer and with activating mutations in the EGFR gene. However, acquired resistance to EGFR-TKIs is eventually developed after an initial response is induced;as such, patients with acquired resistance must be treated with more ef-fective strategies to delay or possibly overcome the resistance. This article reviews available data on the treatment of patients who have failed to respond to EGFR-TKI.

Impact analysis of comorbidity and age on the tolerance of first-line single-agent chemotherapy in elderly patients with advanced non-small cell lung cancer / 中华老年医学杂志

Objective To evaluate the impact of comorbidity and age on the tolerance of firstline single-agent chemotherapy in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods Clinical data of 61 elderly patients with advanced NSCLC(aged over 70 years,median age 72 years) receiving first-line single agent chemotherapy were retrospectively analyzed in this study.Performance status(PS) between 0-1 score was in 52 patients,PS 2 score in the other 9 patents.Patients were treated with gemcitabine or docitaxel as the first line chemotherapy,and the median number of chemotherapy cycles was 3.4.Comorbidity was assessed by Charlson comorbidity index (CC1).Patients with CCI equal to 0 were classified as non comorbidity group(n=26),and patients with CCI≥1 were classified as comorbidity group(n=35).Adverse reactions were graded by using the criteria of NCI-CTC v3.0.Results Age and PS could not predict adverse effects of grade 3 or 4.The incidence of hematologic toxicity of grade 3 or 4 was higher in comorbidity group than in noncomorbidity group(40.0％ vs.15.4％,x2 =4.36,P=0.037).The incidences of febrile neutropenia,non hematologic toxicity of grade 3 or 4 and treatment suspension were higher in comorbidity group than in non-comorbidity group.The most common types of comorbidity were diabetes and chronic pulmonary disease.The incidence of non-hematologic toxicity of grade 3 or 4 was increased in patients with chronic pulmonary disease as compared with patients without chronic pulmonary disease(41.4 ％vs.11.5％,x2=6.061,P=0.032).Conclusions The incidences of adverse reactions,especially hematologic toxicity of grade 3 or 4 are significantly increased in patients with comorbidity after singleagent chemotherapy.Evaluation of comorbidity before treatment is helpful to predict the tolerance of single-agent chemotherapy in elderly NSCLC patients.

Epidemiologic survey on the prevalence and distribution of childhood functional constipation in the northern areas of China: a population-based study / 中华流行病学杂志

Objective Functional constipation (FC) is a common complaint in childhood but the prevalence still remains unclear, the aim of this study was to explore the prevalence of FC in childhood in the northern parts of China. Methods A screening program on FC in childhood was carried out in 5 northern cities (Beijing, Tianjin, Shenyang, Changchun, Harbin) of China according to symptoms under the Rome Ⅲ criteria. Random clustered sampling of the inhabitants was carried out under stratification of cities, geographic zones, schools or nurseries.Sample size of each area was in proportion to the population of the area. The range of age was 4-14. All subjects under study were requested to fill in a questionnaire distributed by the teachers. The screening program was carried out immediately after a section survey was completed. All together, 20 000 questionnaires were distributed with 19 638 retrievals. According to the result of the screening, a small number of patients who met the criteria were further selected to undergo a detailed clinical examination in the hospital including laboratory examination, colonic transit time, defecography or/and barium enema, electromyologram and anorectal manometry to exclude organic disease of the colon. Simultaneously, a detailed questionnaire was requested to fill under the assistance of trained doctors or medical students.Prevalence of FC of the population was adjusted by the rate of correct diagnosis from the detailed study. Results The adjusted point prevalence of FC in 5 northern cities of China according to Rome Ⅲ criteria was 4.73% with higher prevalence rate of FC seen in the Beijing area (5.02%) than in other cities (4.82%, 4.76%, 4.27%, 4.40%, with P＜0.001 ). Male to female ratio was 1.26:1 with majority of the FC fell in the 4-6 year olds (5.76%). Conclusion FC appeared a common disorder in childhood in the northern parts of China which called for greater attention. Higher prevalence was noted in the age groups of 4-6.

Efficacy and safety of bevacizumab plus capecitabine for metastatic colorectal cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of bevacizumab plus capecitabine in treating metastatic colorectal cancer(mCRC).</p><p><b>METHODS</b>Eleven patients with mCRC (6 females and 5 males) were enrolled in this study. Bevacizumab was given with 5 mg/kg every two weeks in five patients, 10 mg/kg every two weeks in four patients and 15 mg/kg every three weeks in two patients. All patients received capecitabine 2000 mg/m2 per day for 14 days.</p><p><b>RESULTS</b>Five of 11 patients had partial response and five patients had stable disease and two patients had progressive disease. The disease control rate was 90.9%. The progress-free survival were 4 months and the median overall survival time were 15 months. The adverse events related to bevacizumab were grade 2 hypertension in 3 patients (27.3%) and grade 1 or 2 proteinuria in 4 patients (36.4%). Other adverse events such as mucositis, fatigue, subcutaneous haemorrhage were also observed. No thromboembolism or severe haemorrhage happened. No other grade 3 or 4 adverse events were observed.The adverse events in the combined therapy were hand-foot-syndrome (54.6%), diarrhea (27.3%), and neutropenia (18.2%), mainly due to capecitabine.</p><p><b>CONCLUSIONS</b>The combination of bevacizumab plus capecitabine has definite benefit in patients with mCRC. However,these benefits can not be maintained after the withdrawal of bevacizumab. The adverse drug reactions are well tolerated.</p>

Drug therapy of advanced non-small cell lung cancer in the elderly / 中国医学科学院学报

About half of the elderly patients with advanced non-small cell lung cancer (NSCLC) can not receive effective treatment due to the decreased organ function and complication. Monotherapies using the third generation new drugs have became a standard first-line therapy for NSCLC, as documented by prospective phase 3 clinical trials. Combined chemotherapies that contain platin and single agent are considered optional first- and second-line treatment for patients with good physical performance and few complication. The epidermal growth factor receptor tyrosine kinase inhibitors may become a key therapeutic agent,while the role of anti-vascular endothelial growth factor monoclonal antibody remains unclear. More prospective phase 3 targeting at the elderly patients should be designed and conducted.

3 T MR 3D fast imaging employing steady state acquisition demonstrating branches of intraparotid facial nerve, parotid duct, and relation with parotid tumors / 中华放射学杂志

Objective To investigate the usefulness of 3 T MRI 3D-FIESTA in the evaluation of the intraparotid components of the facial nerve and parotid duct, and compare them with surgical findings. Methods Twenty-two cases with parotid benign tumors were scanned with conventional and 3D-FIESTA sequences on 3 T MRI scanner. Postprocessed multiplanar images were obtained with the workstation. Parotid ducts and facial nerves and tumors were identified on these images. The relationship of the tumors to the facial nerves and Parotid ducts was confirmed at surgery. Results Various types of parotid benign tumors had their characteristics on 3 T MR imaging. Parotid benign tumors mainly showed hypo-intensity on T_1WI in 21 cases, and hyper-intensity on T_2WI in 22 cases. But on 3D-FIESTA images, they appeared hypo-intensity (10 cases) or high intensity (12 cases) due to different types. Facial nerves in parotid appeared as linear structures with hypo-inteusity. The indication of the main trunks were 16 and 18 cases for T_1WI and T_2WI images, while on 3D-FIESTA images, the main trunks and cervicofacial and temporofacial divisions of the facial nerves were found in 22, 21,22 cases. Parotid ducts appeared as structures with hypo-intensity on T_1WI and hyper-intensity on multiplanar images (14, 20, 22 cases). Compared with surgical results, the main trunks of the facial nerve were correctly showed by 3D-FIESTA images in 20 cases. However, in 2 cases they were not located in the operation because of shifting. Conclusion 3 T MR 3D-FIESTA imaging could depict the extracranial facial nerve and the parotid duct in the parotid gland, which is useful for preoperative evaluation of parotid gland tumors.

Phase I safety and pharmacokinetic study of bevacizumab in Chinese patients with advanced cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>bevacizumab is a humanized recombinant vascular endothelial growth factor (VEGF) monoclonal antibody, which specifically binds to VEGF and inhibits tumor cell growth, proliferation and metastasis. We aimed to investigate the safety and pharmacokinetics of bevacizumab in Chinese patients with advanced cancer.</p><p><b>METHODS</b>Thirty-nine Chinese patients with metastatic or relapsed cancers who failed prior therapy were enrolled in this phase I study of bevacizumab. Bevacizumab was infused by a calculated pump at doses from 5 mg/kg to 15 mg/kg in 90 minutes. Patients underwent serial pharmacokinetic evaluations. Patients that received at least one infusion of bevacizumab were included in the safety study.</p><p><b>RESULTS</b>Thirty-five patients finished all 5 infusions following protocol. One patient withdrew after 3 infusions due to grade 3 proteinuria. Common adverse events possibly related to the study drug were proteinuria (17/39, 43.6%), hypertension (13/39, 33.3%), gingival bleeding (7/39, 17.9%), epistaxis (6/39, 15.4%), pharyngeal inflammation (6/39, 15.4%), fatigue (6/39, 15.4%) and stomatitis (4/39, 10.3%). Bevacizumab pharmacokinetics was linear within the range of 5 mg/kg q2w--10 mg/kg q2w and 15 mg/kg q3w. CL (clearance), Vd (volume of distribution at elimination) and Vss (volume of distribution at steady state) were similar after single and multiple doses at 5, 10 and 15 mg/kg.</p><p><b>CONCLUSIONS</b>Bevacizumab is well tolerated in Chinese patients. No unexpected adverse events were observed. There is no racial difference in the pharmacokinetics.</p>

Effects and mechanisms of L-glutamate microinjected into nucleus ambiguus on gastric motility in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>L-glutamate (L-GLU) is a major neurotransmitter in the nucleus ambiguus (NA), which can modulate respiration, arterial pressure, heart rate, etc. This study investigated the effects and mechanisms of L-GLU microinjected into NA on gastric motility in rats.</p><p><b>METHODS</b>A latex balloon connected with a pressure transducer was inserted into the pylorus through the forestomach for continuous recording of the gastric motility. The total amplitude, total duration, and motility index of gastric contraction waves within 5 minutes before microinjection and after microinjection were measured.</p><p><b>RESULTS</b>L-GLU (5 nmol, 10 nmol and 20 nmol in 50 nl normal saline (PS) respectively) microinjected into the right NA significantly inhibited gastric motility, while microinjection of physiological saline at the same position and the same volume did not change the gastric motility. The inhibitory effect was blocked by D-2-amino-5-phophonovalerate (D-AP5, 5 nmol, in 50 nl PS), the specific N-methyl-D-aspartic acid (NMDA) receptor antagonist, but was not influenced by 6-cyaon-7-nitroquinoxaline-2,3-(1H,4H)-dione (CNQX) (5 nmol, in 50 nl PS), the non-NMDA ionotropic receptor antagonist. Bilateral subdiaphragmatic vagotomy abolished the inhibitory effect by microinjection of L-GLU into NA.</p><p><b>CONCLUSIONS</b>Microinjection of L-GLU into NA inhibits the gastric motility through specific NMDA receptor activity, not non-NMDA receptor activity, and the efferent pathway is the vagal nerves.</p>

Clinical analysis of 170 cases head and neck lymphoma / 中南大学学报(医学版)

OBJECTIVE@#To study the characteristics of head and neck lymphoma in order to improve its diagnose rate.@*METHODS@#Review and analysis 170 patients with head and neck lymphoma in department of otolaryngology of Xiangya hospital from 1997 to 2005.@*RESULTS@#Nasal cavity and nasal sinuses, neck, tonsil were the common place of the origin of head and neck lymphoma. There are 9 cases Hodgkin disease and 161 cases non-Hodgkin lymphoma (NHL). T cellularity, B cellularity lymphoma, the mixed pattern and nullityping accounted for 60.9%, 36.0% and 3.1% of these patients with NHL, respectively. CHOP and radiotherapy were the main treatment method.@*CONCLUSION@#The clinical and imageology manifestation of head and neck lymphoma were of diversification and no specificity, whose final diagnosis depended on immunohistochemistry.

Studies on effects and mechanism of water immersion restraint stress on bile secretion in rats / 中国应用生理学杂志

<p><b>AIM</b>To probe into the operation mechanism of stress, through the studies on the effects of bile secretion in rats at the condition of water immersion restraint.</p><p><b>METHODS</b>The animals were divided into six groups (n=8): Group A: restraint alone under room temperature + saline; Group B: water immersion restraint + saline; Group C: restraint alone under room temperature + Atropine; Group D: water immersion restraint + Atropine; Group E: restraint alone under room temperature + Phentolamine; F group: water immersion restraint + Phentolamine.</p><p><b>RESULTS</b>Compared with group A, the capacity of bile secretion in group B decreased significantly (P < 0.05), changes of bile increased remarkably (P < 0.01), but there were no significant decreases on the capacity of bile secretion in group C (P > 0.05) compared with A, Group C only decreased appreciably. Compared with group A, the capacity of bile secretion in group E decreased appreciably (P < 0.05). Compared with group B, the capacity of bile secretion in group D decreased significantly (P < 0.05), pH of bile had no significant changes in group D. Compared with group B, the capacity of bile secretion in group F decreased significantly (P < 0.05), pH of bile had no significant changes in group F. Compared with group D, the capacity of bile secretion and pH of bile in group F had no significant changes.</p><p><b>CONCLUSION</b>Water immersion restraint stress inhibited evidently on the capacity of bile secretion, and the capacity of bile secretion in water immersion groups decreased significantly, moreover pH of bile increased greatly. At the condition of restraint alone under room temperature, vagus and sympathetic nerve had no significant effects on the bile secretion, but they played important roles in decreases of bile secretion evidently induced by water immersion restraint stress in rats (P < 0.05).</p>

Expression of adhesion molecules on CD34+ cells of BM and PB stem cell samples during high-dose chemotherapy combined with transplantation of autologous PB stem cells / 中国实验血液学杂志

This study was aimed to investigate the expressions of adhesion molecules such as CD54, CD49d and CD62L by CD34(+) cells sampled from different stages of bone marrow (BM) and peripheral blood (PB) before/after G-CSF mobilization and after transplantation through the direct labeling with three colour-immunofluorescence and flow cytometry, and to explore the differences in expression of adhesion molecules on CD34(+) cells from different origins and their clinical significance. Mononuclear cells collected from BM and PB before mobilization, after collection of stem cells and hematopoietic recostruction of BM at the end of transplantation were marked with CD54-FITC, CD49d-FITC and CD62L-FITC separately, as well as CD34-PE and CD45PerCE. 3-color fluorescene analysis was carried out by FACS. The expression differences of CD34(+) and adhesion molecules between BM and APBSC were compared. The results showed that expression differences of CD54, CD49d and cd62Lon CD34(+) cells belore mobilization, after collection and reconstraction of transplantation were not statiscally significant, the difference of CD54, CD49d and CD62L on CD34(+) between 1st and 2nd collections of hematopoietic stem cells also were not statiscally significant. In the collected APBSC, the expression level of CD34(+) CD49d(+) was significantly lower than those in BM before mobilization (P = 0.001). It is concluded that the method of chemotherapy combined with G-CSF mobilization can down-regulate CD49d expression in BM CD34(+) cells, thus can mobilize and move theirs into peripheral blood. After the reconstitution by transplantation, the expression of CD49d on CD34(+) cells tends to normal, the clinical significance needs to be elucidated by accumulation of much more cases.

Mobilization of autologous peripheral blood stem cells with etoposide and recombinant human granulocyte colony stimulating factor in malignant tumor patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the combined effect of etoposide (Vp-16) and recombinant human granulocyte colony-stimulating factor (rhG-CSF) on mobilization of autologous peripheral blood stem cells (APBSC) in malignant tumor patients and find out the suitable dose of Vp-16.</p><p><b>METHODS</b>Thirty patients were randomly divided into two groups, 15 in each group. In group A, Vp-16 1000 mg/m(2) was injected intravenously in six divided doses, for 2 hours every 12 hours on day 1, 2 and 3. In group B, Vp-16 1500 mg/m(2) was injected intravenously in six divided doses for 3 hours every 12 hours on day 1, 2 and 3. rhG-CSF was given as a single daily injection subcutaneously at the dose of 300 microg.body(-1).day(-1) from the day of the nadir of white blood cell (WBC) to the day before the end of APBCS harvest. APBSC harvest started when WBC > or = 5.0 x 10(9)/L and finished when accumulated mononuclear cells (MNC) > or = 5 x 10(8)/kg or CD34+ cells > or = 2 x 10(6)/kg.</p><p><b>RESULTS</b>There was no significant difference between the time of nadir, nadir of WBC, absolute neutrophil count (ANC), the beginning time and continuous time of rhG-CSF given, the beginning time and continuous time of APBSC harvest. When the blood volume, flow rate and continuous time of apheresis were similar in each apheresis in the two groups, the number of APBSC in each harvest and total number of APBSC were also not significantly different between the two groups. The side effects induced by Vp-16 were also not significant different between the two groups.</p><p><b>CONCLUSION</b>Vp-16 combined with rhG-CSF is a safe and highly effective method for APBSC mobilization, 1000 mg/m(2) and 1500 mg/m(2) of Vp-16 possess similar efficiency and side effects for APBSC mobilization.</p>