Prognosis of 64 cases of myelodysplastic syndrome patients with abnormal karyotypes / 白血病·淋巴瘤

ObjectiveTo investigate the correlation between the chromosomal abnormalities and prognosis of the myelodysplastic syndrome(MDS)patients, and analyze the effects of treatment. Methods Karyotype analysis of 122 patients according to the international human cytogenetics(ISCN) criteria.Treatment of RA and RAS were mainly dependent on agents to induce differentiation of hematopoietic cells and drugs based.RAEB,RAEB-t,CMML treatment were dependent on low-dose chemotherapy and low-dose combination chemotherapy regimens.The treatments of 64 MDS patients with abnormal karyotype were analyzed and compared with control group, and 58 normal karyotype MDS patients were hospitalized in the same period.ResultsAfter treatments,17 cases gained complete remission among 64 patients with abnormal karyotype MDS patients.The CR rate was 26.6 ％.While in control group,30 gained CR in 58 MDS patients with normal karyotype. The CR rate was 51.7 ％. Comparing with the CR patients of normal karyotype, the number of patients with abnormal karyotype of CR was significantly lower (x 2 =8.1 3,P ＜ 0.05).Conclusion Karyotype analysis shows important significance in the diagnosis and prognosis of MDS.Karyotype transformation demonstrates differently in the risk of leukemia progress.

Combination of kidney transplantation with hematopoietic stem cell infusion / 中华全科医师杂志

Ninety six female patients with chronic renal failure were randomly allocated into combination group (n =48) and control group (n =48).In combination group patients received both kidney transplantation and hematopoietic stem cell infusion,in control group patients underwent kidney transplantation only.The results showed that chronic rejection in the combination group was lower than that in the control group [2％(1/48)vs.17％ (8/48),P＜0.05)].The 1-,3-,5-and 10 y-survival rates of kidney in the combination group were 98％ (47/48),94％ (45/48),83％ (34/41) and 9/17,respectively,those in control group were 98％ (47/48),90％ (43/48),76％ (31/41) and 7/17,respectively.Infusion of donor hematopoietic stem cells can augment chimerism in early postoperative period and significantly reduce the rate of graft rejection,which is beneficial for the quality of life of the recipients.

Analysis of the risk factors of central nervous system complications after allogeneic hematopoictic stem cell transplantation / 白血病·淋巴瘤

Objective To analyse the etiology,clinical characteristics and risk factors of central nervous system (CNS) complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The clinical features of CNS complications in patients who underwent allo-HSCT were observed,and analysis its causes and risk factors.Results 8 cases of CNS complications occured in 69 patients within 6 months after allo-HSCT and the incidence was 11.6 ％,the occurrence rate of CNS complications was 21.4 ％ (6/28) in HLA mismatched group,higher than HLA matehed group [49 ％ (2/41)] (P ＜ 0.05).Analogously,the incidence was 44.4 ％ (4/60) in patients with graft-versus-host disease (GVIID) (＞grade 2),which was significantly higher than patients with 2 or below grade 2 GVHD [6.7 ％ (4/9)] (P ＜ 0.01).But there was no significant difference in the incidence of CNS complications between ≤14 years old and ＞14 years old,with or without ATG,different stages of diseases,whether pretreatment with maryland respectively (P ＞0.05),either.Epilepsy and intracranial infection were the most common CNS complications in allo-HSCT,followed by intracranial hemorrhage.Conclusion HLA mismatched and above grade 2 GVHD are the risk factors of CNS complications in allo-HSCT.Epilepsy,intracranial infection and bleeding are common CNS complications in allo-HSCT.

Autologous hematopoietic stem cell transplantation for systemic lupus erythematosus 10-year follow-up / 中华风湿病学杂志

Objective To investigate the long-term efficacy of autologous stem cell transplantation for systemic lupus erythematosus (SLE). Methods Long-term follow up of 48 SLE patients with autologous stem cell transplantation were studied. All patients were followed up for 10 years. Among the patients, 24 cases were treated with purified CD34+ cells transplantation and 24 cases were treated with non-CD34+ cell transplantation. Comparison between groups was performed by x2 test. Results Among 5 dead patients, 4 died of transplantation related complications including 3 cases treated with CD34+ transplantion. The survival rate of those patients with more than 10 years duration of lupus was 90%(43/48). Among 43 patients, 7 had disease flare, 6 were treated with non-CD34+ cell transplantation. Eight patients went to college, 26 returned to normal life and 4 of them had children. Conclusion The long-term effect of SLE treated with autologous hematopoietic stem cell transplantation and anti-thymocyte globulin (ATG) is good. The recurrence of CD34+ transplant patients is lower than those treated with non-CD34+ transplantation. The quality of life in SLE patients treated with transplantation is better than those treated with conventional therapy.

Induction or inhibition of cytochrome P450 2E1 modifies the acute toxicity of acrylonitrile in rats: biochemical evidence.

The present study was designed to examine the effects of the inhibition or induction of CYP2E1 activity on acute acrylonitrile (AN) toxicity in rats. Increased or decreased hepatic CYP2E1 activity was achieved by pretreatment with acetone or trans-1,2-dichloroethylene (DCE), respectively. AN (50 mg/kg) was administered by intraperitoneal injection. Onset of convulsions and death were observed in rats with increased CYP2E1 activity, whereas convulsions and death did not appear in rats within 1 h after treatment with AN alone. Convulsions occurred in all AN-treated animals with increased CYP2E1 activity at approximately 18 min. The levels of cyanide (CN(-)), a terminal metabolite of AN, were significantly increased in the brains and livers of the AN-treated rats with increased CYP2E1 activity, compared with the levels in rats treated with AN alone, DCE + AN or acetone + DCE + AN. The cytochrome c oxidase (CcOx) activities in the brains and livers of the rats treated with AN or AN + acetone were significantly lower than those in the normal control rats and the rats treated with DCE, whereas the CcOx activities in the brains and livers of rats with decreased CYP2E1 activity were significantly higher than those in AN-treated rats. Brain lipid peroxidation was enhanced, and the antioxidant capacity was significantly compromised in rats with decreased CYP2E1 activity compared with rats with normal or increased CYP2E1 activity. Therefore, inhibition of CYP2E1 and simultaneous antioxidant therapy should be considered as supplementary therapeutic interventions in acute AN intoxication cases with higher CYP2E1 activity, thus a longer window of opportunity would be got to offer further emergency medication.

Curcumin pretreatment protects against acute acrylonitrile-induced oxidative damage in rats.

Acrylonitrile (AN) is widely used in the manufacturing of fibers, plastics and pharmaceuticals. Free radical-mediated lipid peroxidation is implicated in the toxicity of AN. The present study was designed to examine the ability of curcumin, a natural polyphenolic compound, to attenuate acute AN-induced lipid peroxidation in the brain and liver of rats. Male Sprague-Dawley rats were orally administered curcumin at doses of 0 (olive oil control), 50 or 100 mg/kg bodyweight daily for 7 consecutive days. Two hours after the last dose of curcumin, rats received an intraperitoneal injection of 50 mg AN/kg bodyweight. Acute exposure to AN significantly increased the generation of lipid peroxidation products, reflected by high levels of malondialdehyde (MDA) both in the brain and liver. These increases were accompanied by a significant decrease in reduced glutathione (GSH) content and a significant reduction in catalase (CAT) activity in the same tissues. No consistent changes in superoxide dismutase (SOD) activity were observed between the control and AN-treatment groups in both tissues. Pretreatment with curcumin reversed the AN-induced effects, reducing the levels of MDA and enhancing CAT activity and increasing reduced GSH content both in the brain and liver. Furthermore, curcumin effectively prevented AN-induced decrease in cytochrome c oxidase activity in both liver and brain. These results establish that curcumin pretreatment has a beneficial role in mitigating AN-induced oxidative stress both in the brains and livers of exposed rats and these effects are mediated independently of cytochrome P450 2E1 inhibition. Accordingly, curcumin should be considered as a potential safe and effective approach in attenuating the adverse effects produced by AN-related toxicants.

Induction of immune tolerance using kidney-bone marrow transplantation: Does it promote chimerism formation? / 中国组织工程研究

BACKGROUND: Infusion of hemopoietic stem cell from donors can promote the chimeric formation and induce specific immunologic tolerance in the allograft recipients. However, the pretreatment for cell transplantation has great toxicity to recipients. So immunosuppressant combined bone marrow infusion is introduced to anti graft versus host reaction. OBJECTIVE: Based on microchimerism, to study the security and associativity of chimera formation induced by kidney-bone marrow transplantation and immunologic tolerance.DESIGN, TIME AND SETTING: The contrast observation was performed at the department of urinary surgery, The Third People's Hospital of Zhengzhou City from January 1998 to December 2005.PARTICIPANTS: According to ABO/Rh blood type and HLA matching, 96 female patients with chronic renal failure and waiting for kidney transplantation were divided into 2 groups, In the combination group, patients received kidney combined bone marrow transplantation; the other uremia patients received the other kidney of cadavers were served as control group. The donors were 48 healthy males. METHODS: Bone marrow of donors was collected simultaneously with kidney obtain and preserved with cryoprotectant at -198 ℃ in nitrogen canister. After kidney transplantation, large dose of anti-human lymphocyte immune globulin were used for 2 weeks, then (0.9-2.5)×10~8/kg mononuclearcell was reinfused. PCR-SRY was used to identify donor derived cell-chimerism. Lymphocyte subgroup of recipients was determined by blood test; and interleukin 10 was measured by enzyme linked immunosorbent assay; in addition, the mass concentration of tumor necrosis factor α and tumor necrosis factor β was detected. MAIN OUTCOME MEASURES: Chimerism, lymphocyte subsets and cytokines were detected at various time points following transplantation. Simultaneously, the transplantation results and complication status of recipients were observed. RESULTS: The positive rate of chimera in the combination group was greater than that of the control group (P < 0.05). The 3-year follow-up showed that incidence differences of acute rejection between recipients with positive chimera and recipients with negative chimera had significance (13%, 35%, P < 0.05). There was no graft versus host disease occurred in the combination group. CONCLUSION: Kidney-bone marrow transplantation can augment chimerism in early postoperative period, and significantly reduce the rate of acute rejection, which is safe and beneficia1to induce specific immunologic tolerance in the renal allograft recipients.