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Objective To investigate the effect of the intervention of Hufu Tongbian scraping combined with Traditional Chinese Medicine(TCM) iontophoresis on relieving symptoms of Fontaine's stage II arteriosclerosis obliteration(ASO). Methods Totally 130 cases of hospitalized patients with Fontaine's stage II ASO were randomly divided into 4 groups: group A (control group, n=31) and group B (Hufu Tongbian Scraping group, n=31), group C (TCM Iontophoresis group, n=34), group D (combination group, n=34). Group A was given specialist nursing, group B was given specialist nursing combined with Hufu Tongbian scraping intervention, group C was given specialist nursing combined with TCM iontophoresis intervention, group D was given specialist nursing combined with Hufu Tongbian scraping and TCM iontophoresis intervention. Symptom quantitative score and Visual Analogue Score (VAS)of pain were measured before and 15 days. after intervention. Results After intervention, there were significant differences in each dimension of symptom score and pain score among the four groups (P＜0. 05). the scores of each dimension of symptom score and pain score in groups B, C and D were decreased after intervention compared with those before intervention(P＜0. 05), and the scores in the three groups were lower than those in group A after intervention (P＜0. 05). After intervention, the scores of each dimension of symptom score and pain score in group D were lower than those in groups B and C (P＜0. 05), but there was no significant difference between groups B and C after intervention (P＞0. 05). Conclusion The intervention Hufu Tongbian scraping combined with TCM iontophoresis can significantly reduce the symptom score of ASO patients, relieve the symptoms of acid swelling and numbness, relieve the pain of patients, promote comfort, and provide better nursing for ASO patients. (目的 探讨虎符铜砭刮痧联合中药离子导入干预缓解FontaineⅡ期下肢动脉硬化闭塞症(ASO)患者临床症状的影响。方法 选取河北省中医院周围血管科2020年11月—2021年10月收治的符合诊断的FontaineⅡ期ASO住院患者130例, 随机分为4组: A组(对照组)、B组(虎符铜砭刮痧组)、C组(中药离子导入组)、D组(联合组)。A、B组各31例, C、D组各34例。A组给予专科护理, B组专科护理联合虎符铜砭刮痧干预, C组专科护理联合中药离子导入干预, D组专科护理来讷河虎符铜砭刮痧和中药离子导入干预。共干预15 d, 分别于干预前和干预后测定症状量化评分及疼痛视觉模拟评分。结果 干预后4组症状评分各维度评分和疼痛评分差异有统计学意义(P＜0. 05); 与干预前相比, B、C、D组干预后症状评分各维度评分和疼痛评分均下降(P＜0. 05), 且干预后三组各评分均低于A组(P＜0. 05); 干预后D组症状评分各维度评分和疼痛评分均低于B、C组(P＜0. 05), 但B、C组干预后各评分差异无统计学意义(P＞0. 05)。结论 虎符铜砭刮痧联合中药离子导入干预可更显著地降低ASO患者症状评分, 缓解患者酸胀、麻木等症状, 并可减轻患者疼痛, 促进舒适, 为ASO患者提供更优质护理。)

Objective To analyze the safety of perioperative prophylactic anticoagulant therapy in patients undergoing laparoscopic nephron-sparing surgery. Methods Clinical data of 84 cases underwent laparoscopic nephron-sparing surgery were retrospectively analyzed. The baseline data, intraoperative blood loss, intraoperative blood transfusion rate, postoperative rebleeding rate, postoperative hemoglobin reduction value, and postoperative length of hospital stay were recorded. These parameters were statistically compared between patients treated with perioperative prophylactic anticoagulant therapy （medicine group, n = 50） and without perioperative prophylactic anticoagulant therapy （non-medicine group, n = 34）. Results There was no significant difference in intraoperative blood loss （50.0 （30.0,100.0）mL vs.50.0 （45.0,100.0）mL）, intraoperative blood transfusion rate （0 vs.2.9%）, postoperative rebleeding rate （4.0% vs.2.9%）, postoperative hemoglobin reduction value （14.0（8.0,23.0） g/L vs.17.7（9.3,28.5） g/L）, and postoperative length of hospital stay （6.0（5.0,7.0）d vs.7.0（4.0,9.3）d）between the medicine and non-medicine groups （all P > 0.05）. Conclusion Perioperative prophylactic anticoagulation is safe and feasible for patients undergoing laparoscopic nephron-sparing surgery.

The airworthiness development status of civil aircraft in China was taken as the starting point of review. The airworthiness alternative methods of compliance method of the materials used in civil aircraft products were sorted out, and the relevant provisions requirements of materials used in civil aircraft products such as civil aircraft, engines and helicopters in China’s civil airworthiness regulations were analysed. In the process of materials airworthiness conformity verification, the establishment of standards (specifications) based on statistical analysis is the core of material conformity verification. MOC1, MOC2, MOC4 methods are mainly used to verify airworthiness conformity of materials approved with the model. Facing the future, the application of materials with independent intellectual property rights, the construction of materials independent verification technology and capacity are the key to realize the industrialization development of advanced civil aircraft.

The community detection algorithm is very important for analyzing the topology and hierarchical structure of complex networks and predicting the evolution trend of complex networks.Traditional community detection algorithm does not have high accuracy and ignores the importance of network embedding.Aiming at such problems,a parameter-free community detection algorithm based on node similarity and network embedding Node2Vec method is proposed.First,we use the network embedding Node2Vec method to map network nodes into data points represented by low-dimensional vectors in Euclidean space,calculate the cosine similarity between the data points represented by the low-dimensional vector,construct a preference network according to the maximum similarity between the corresponding nodes,obtain the initial community detection,and use the maximum degree node of each initial community as a candidate node.Then we find the central node among the candidate nodes according to the average degree of the network and the average shortest path.Finally,the data points and their numbers corresponding to the central node are used as the initial centroid and cluster number,and the data represented by the low-dimensional vector are calculated by K-Means algorithm.The points are clustered,and the corresponding network nodes are divided into communities.This algorithm is a method of community division without parameters,which can independently extract parameters from the network without setting different hyper-parameters according to different networks,so that it can automatically and quickly identify the community structure of complex networks.In 8 real networks and artificial networks above,by comparing with other 5 well-known community discovery algorithms,numerical simulation experiments show that the proposed algorithm has good community discovery effect.

The attribute network not only has complex topology,its nodes also contain rich attribute information.Attribute network represent learning methods simultaneously extracts network topology and node attribute information to learn low-dimensional vector embedding of large attribute networks.It has very important and extensive applications in network analysis techniques such as node classification,link prediction and community identification.In this paper,we first obtain the embedded vector of the network structure according to the topology of the attribute network.Then we propose to learn the attribute information of adjacent nodes through global attention mechanism,use convolutional neural network to convolve the attribute information of the node to obtain the hidden vectors,and the weight vector and correlation matrix of global attention are generated from the hidden vectors of convolution,and then the attribute embedding vector of nodes is obtained.Finally,the structure embedding vector and the attribute embedding vector are connected to obtain the joint embedding vector which reflects the network structure and the attribute simultaneously.On three real data sets,the new algorithm is compared with the current eight network embedding models on tasks such as link prediction and node classification.Experimental results show that the new algorithm has good attribute network embedding effects.

Since December 2019, COVID-19 has broken out in Wuhan and spread rapidly across the country. In order to effectively prevent and control the spread of the disease, most provinces and cities in China initiated to restrain traffic, blocked access and other public health control measures, which have brought great challenges to the emergency transfer process of patients. In order to effectively encourage patients to hospital for treatment, the Emergency Department of West China Hospital, Sichuan University, established an innovative medical isolation transport system for COVID-19 patients, and applied to the emergency transport process of the first case. The patients were admitted to hospital smoothly, and received treatment as planned without secondary infection.

With the increase of diagnosed COVID-19 cases, the prevention and control of epidemic in Wuhan became tougher. To support Wuhan, West China Hospital of Sichuan University sent the third round of medical team to the city. In order to ensure a safe and relax condition for medical team members after busy works, it was crucial to manage the medical team station well comprehensively. This article summarized the management experience of West China Hospital medical team as a reference for others to fight against the epidemic.

A paleo-provenance system is an important link in deep-time source-to-sink system research. With the development of sedimentology theory and technology, the characterization of provenance tracing has changed from single to comprehensive, and from qualitative to quantitative, which allows for a more comprehensive reveal of the development characteristics of the parent rock, provenance tectonic background, sediment path system, etc. Then we can establish a more reliable development model of the paleo-provenance system. The research on U-Pb dating of de-trital zircon and other multi methods indicates that the sandstone samples of the lower 4th member of Shahejie Formation (E.?4) in the Bonan Sag of Zhanhua Depression develop magmatic zircons. These zircons have a good degree of automorphism and a clear magmatic ring, with Th/U>0.4. Rare earth elements (REE) generally display a "positive anomaly in Ce and negative anomaly in Eu . Geochemical indicators and petrological characteristics reveal that the terrigenous clasts of the E.s4 in the study area are magmatic island arc/active continental margin acid granitic source rocks. The development of the source rocks is closely related to the geodynamic setting of the North China Craton in the Late Archean to Early Proterozoic and Late Paleozoic to Mesozoic. Based on the dominant age contribution, parent rock attributes, petrological characteristics and geodynamic background, the development model of the paleo-provenance system in the E.s4 from the Bonan Sag is established. Two routing systems of ' near-source accumulation ' and ' far-source supply ' developed simultaneously in the E.?4. Developing an Eastern-Mesozoic magmatic rock dominated provenance system, the Southern-Neoarchean/ Lower Proterozoic/ Paleoproterozoic/ Mesozoic parent rock jointly controlled the provenance system, and the central mixed provenance system developed. The eastern and central provenance systems are closely related, meaning they belong to the same sediment routing system. In contrast, the southern provenance system is relatively independent. [ABSTRACT FROM AUTHOR]

The present study compared and analyzed the simulation results of Typhoon Lekima based on six optional atmospheric boundary layer parameterization schemes provided by the Weather Research and Forecasting (WRF) mesoscale numerical model, namely, BouLac, MYJ, UW, YSU, ACM2, and SH. The results show that different boundary layer schemes have little influence on the simulated track of Typhoon Lekima, but have a significant impact on the simulated intensity and structural evolution. The intensities simulated by the local closure scheme UW are the strongest, followed by those by the local closure scheme BouLac, while the simulated intensities by the local closure scheme MYJ and the three non-local schemes including YSU, ACM2, and SH are weaker. Among them, the lowest air pressure simulated by BouLac is the closest to the real situation. Through comparison between the results from different boundary layer schemes, it is found that typhoon intensity is affected by both thermal and dynamic factors. The larger the surface latent heat flux and turbulent diffusion coefficient in the boundary layer are simulated, the larger the radial winds and low-level convergence will be generated, and thus the stronger the simulated typhoon, and vice versa. [ABSTRACT FROM AUTHOR]

In order to effectively draft a smoke control design standard of the rail transit underground parking lot, this paper takes an underground two-level parking lot in a subway as the object and conducts a deep analysis on the relevant smoke control design standard. Starting from aspects of fire danger level of buildings, occupant density and safety evacuation time, and combining with industry standards launched in recent years, the paper makes a research on smoke control design plan and principles for rail transit underground parking lot. By establishing the most disadvantageous fire scene, the paper adopts theoretical analysis and three-dimensional numerical simulation methods to perform simulation analyses on smoke flow and safe evacuation environment to obtain available time for occupant evacuation. The results show that fire source distribution and smoke diffusion in the parking lot have a longitudinal characteristic, and it is suggested that the length of a train should be taken as the length of the long side for smoke control area; in the event of a fire in the parking lot, the occupant evacuation time should be short, and the required smoke exhaust rate can be calculated with reference to the empirical formula proposed by Japanese scholars. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of transurethral flexible ureteroscope and minimally invasive percutaneous nephrolithotomy in treatment of renal calyceal stones. Methods The clinical data of 116 cases of solitary renal calyceal calculi were collected, 54 cases accepted transurethral flexible ureteroscope lithotripsy treatment as ureter soft lens group, 62 cases accepted Percutaneous nephrolithotomy treatment as percutaneous nephrolithotomy group. Then we compared the operation time, complications and the success rate between the two groups. Results When the renal calyceal calculi' diameter was greater than 2cm, minimally invasive percutaneous nephrolithotomy lithotripsy group was significantly better than the flexible ureteroscopy group in operation time and success rate, the difference was statistically significant (P< 0.05). When the calculi' diameter was smaller than 2cm in the upper and middle renal calyceal, the lithotripsy successful rate had no significant difference between two groups (P > 0.05), but the operation time of flexible ureteroscope was shorter (P < 0.05). When the calculi' diameter was smaller than 2cm in the lower renal calyceal, minimally invasive percutaneous nephrolithotomy group was obviously better than the flexible ureteroscopy group in operation time and lithotripsy success rate (P<0.05). Conclusions Minimally invasive percutaneous nephrolithotomy should be chosen when the renal calyceal calculi's diameter is greater than or equal to 2cm, regardless the location where it was; when the diameter is smaller than 2 cm, transurethral flexible ureteroscope lithotripsy should be chosen when calculi' is in the upper and middle renal calyceal, while when calculi is in the lower renal calices, minimally invasive percutaneous nephrolithotomy should be the first choice. [ABSTRACT FROM AUTHOR]

21 hydroxylase deficiency (21-OHD), the most common form of congenital adrenal hyperplasia, is caused by defects in CYP21A2 gene, which encodes the cytochrome P450 oxidase (P450C21) involved in glucocorticoid and mineralocorticoid synthesis. The diagnosis of 21-OHD is based on the comprehensive evaluation of clinical manifestation, biochemical alteration and molecular genetics results. Due to the complex structure of CYP21A2, special techniques are required to perform delicate analysis to avoid the interference of its pseudogene. Recently, the state-of-the-art diagnostic methods were applied to the clinic gradually, including the steroid hormone profiling and third generation sequencing. To standardize the laboratory diagnosis of 21-OHD, this consensus was drafted on the basis of the extensive knowledge, the updated progress and the published consensuses and guidelines worldwide by expert discussion organized by Rare Diseases Group of Pediatric Branch of Chinese Medical Association, Medical Genetics Branch of Chinese Medical Doctor Association, Birth Defect Prevention and Molecular Genetics Branch of China Maternal and Child Health Association. and Molecular Diagnosis Branch of Shanghai Medical Association.

Objective: To investigate the clinical biological characteristics and prognosis of the patients with mixed phenotype acute leukemia with t(9;22)(q34;q11.2) and/or BCRABL1 (Ph + MPAL)., Methods: The morphological, immunological, cytogenetic, and molecular features of 33 in patients with Ph + MPAL were retrospectively analyzed in our center from June 2002 to June 2016 according to the scoring proposal of European Group for the Classification of Acute Leukemia(EGIL )1998 and WHO 2008 criteria. All the cases were either treated with acute lymphoblastic leukemia (ALL) induction regimen or combined chemotherapy regimens for both acute lymphoblastic and acute myeloid leukemia,part of which also received tyrosine kinase inhibitor(TKI) and 5 cases underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after complete remission., Results: Ph + MPAL occurred predominantly in male patients (ratio of M/F was 1.75∶1), and a high WBC counts at diagnosis; the WBC count was higher than 30×10 9 /L in 25 patients( 75.8% )， and appeared higher than 100 ×10 9 /L in 13 patients ( 39.4%). Among all the 33 Ph + MPAL patients, 32 (97.0%) had a myeloid / B-lymphoid (M/B) phenotype， and 1 case(3.0%) had a myeloid/ B-lymphoid/ T-lymphoid/ (M/B/T) phenotype. There was no patients displayed myeloid / T-lymphoid (M/T) or B-lymphoid/ T-lymphoid/ (B/T) phenotype. 19 of all cases(57.6%) met the diagnosis criteria of Ph + MPAL based on EGIL 1998 criteria, while the remaining 14 cases can be diagnosed as Ph + MPAL by WHO 2008 classification,but excluded as Ph + MAPL by EGIL 1998.Karyotype analysis was successfully performed in 31 cases, and out of them 13 (41.9%) had a sole Ph chromosome, 10 (32.3%) had additional chromosome aberration and Ph chromosome was not found in 8 cases (25.8%) .In 31 patients the fusion gene BCR/ABL (P190、P210) was detected,including 17 (54.8%) cases with the p190 BCR/ABL transcript, 8 (25.8%) cases with the p210 BCR/ABL transcript, 4 (12.9%) expressing both transcripts and 2 (6.5%) without any one of these 2 transcripts. 24 out of 33 patients (77.4%) achieved complete remission after induction therapy. The median time achieving CR was 43(26-98)days. The CR rate of patients treated with and without imatinib after the first inducion treatment was 81.3% and 46.7%,respectively (P + 0.05). Within the 17 patients treated with imatinib at induction stage，2 of which became BCR/ABLnegative．At consolidation chemotherapy stage, 9 out of 16 patients became BCR/ABL negative, including 3 patients already subjected to HSCT. The median time reached to BCR/ABL negative was 2.87（1.13-9.20）months., Conclusion: Ph + MPAL is more common in male, and inclined to high WBC counts at diagnosis. Myeloid/B lymphoid phenotype is more common, and the prognosis of patients with Ph + MPAL is poor. Imatinib and allogeneic hematopoietic stem cell transplantation may improve survival of patients with Ph + MPAL.

Objective: To explore the effects of serum ferritin (SF) and iron overload (IO) pre-immunosupressive treatment (IST) on hematologic response of severe aplastic anemia (SAA/VSAA) patients treated with IST., Methods: 257 SAA/VSAA patients who underwent first-line IST from Feb, 2003 to Dec, 2011 in Anemia Therapeutic Centre, Institute of Hematology and Blood Diseases Hospital were retrospectively analyzed, the status of SF before IST and the IO-affected factors were studied. The effects of IO on hematologic response of SAA/VSAA patients were evaluated as well., Results: The median level of SF of 257 patients was 387 (6-2 004) μg/L. 36 patients (14%) had IO, including 20 SAA and 16 VSAA patients. According to univariate logistical regression analyses, IO was influenced by age>14 years (P=0.010) and blood transfusion (P<0.001). The multivariate logistic regression analysis showed that blood transfusion [P=0.001, OR=0.218 (95% CI 0.092-0.520)] was the only independent prognostic factor. SAA (but not for VSAA) patients with IO had much lower hematologic response rate in 6 month after IST (P=0.037). Absolute reticulocyte count and IO correlated with response at 6 month by univariate logistical regression analysis (P=0.014, 0.037). The multivariate logistic regression analysis showed that IO [P=0.021, OR=4.092 (95% CI 1.235-13.563)], ARC ≥20×10(9)/L [P=0.040, OR=2.743 (95% CI 1.049-7.175)] were independent prognostic factors., Conclusion: 84.8% patients had high serum ferritin before IST, and 14.0% reached IO. Adult and more blood transfusion caused IO more likely. IO correlated with response at 6 month, and was independent prognostic factor.

Objective: To analyze early hematopoietic response and long-term survival of very severe aplastic anemia (VSAA) patients with different absolute neutrophil counts (ANC) after frontline immnunosuppressive therapy (IST)., Methods: Clinical data and outcome of 145 VSAA patients treated with rabbit antithymocyte globulin combined with cyclosporine were retrospectively analyzed. Hematopoietic responses to IST and long-term survival were statistically analyzed for VSAA patients in different ANC subgroups., Results: Pre-IST ANC=0.05×10(9)/L acted as the best cutoff level to predict IST response at 3, 6 months. For 145 VSAA patients, early death rate was 13.4% (11/82) vs 1.6% (1/63), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group (P<0.05). Hematopoietic response rates to IST was 22.0% vs 54.0% (P=0.000) at 3 months, 34.1% vs 63.5% (P=0.000) at 6 months; the overall five-year survival rate was only (62.5±5.4) % vs (91.4±3.7) % (P=0.000) and five-year event-free survival rate was (42.3±5.5) % vs (63.1±6.5) % (P=0.003), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group., Conclusion: VSAA patients with extremely low ANC (≤0.05×10(9)/L) had high early death rate and with very low response rate to frontline IST and poor survival, so it is urgent to seek for the alternative frontline therapy that will bring faster and better outcome for these patients.

Objective: To investigate the genetic instability in patients with Dyskeration congenita., Methods: The spontaneous chromosome instability of lymphocytes from 4 DC patients, 29 FA patients and 24 healthy volunteers was assessed with comet assay. The percent of DNA in comet head (HeadDNA%）, the percent of DNA in comet tail (TailDNA%）, tail moment (TM), olive tail moment (OTM), the comet cell percentage (CCP) were compared between groups. And the results of MMC test, PNH clones and karotype were analysed additionally. The correlation between TM, OTM, CCP and the severity degree of bone marrow failure in DC group were evaluated., Results: ①PNH clones and karotype abnormalities were not found in 4 DC patients. ②TM (6.77 ± 0.90), OTM（6.19 ± 0.80) and CCP [(46.00 ± 5.03) %] in DC were significantly higher than those in normal control group [0.61 ± 0.49, 0.66 ± 0.42, (5.91 ± 3.19)%, P<0.05], however, not distinguished from FA patients [7.81 ± 3.58, 6.65 ± 2.21, (56.03 ± 13.47) %, P ≥ 0.05]. The aberrant cell percent at the MMC concentration of 80 μg/L in DC group was significantly lower than that in FA group [(21.00 ± 3.16) % vs (31.97 ± 6.33)%, P=0.003]. ③The correlation between TM, OTM, CCP and the severity of bone marrow failure in DC group were not found (P>0.05)., Conclusion: DC patients were of significantly increased genetic instability and normal DNA repair, which was different from that in FA patients. And there was no correlation between the degree of genetic instability and the severity of bone marrow failure in DC patients presenting as aplastic anemia.

Objective: To explore the effects of peri-immunosuppressive treatment（IST）infection on outcomes of severe and very severe aplastic anemia（SAA/VSAA）patients., Methods: Medical record and follow-up data of 105 SAA/VSAA who underwent first-line IST were retrospectively analyzed to find out the characters of infections（1 month before to 3 months after IST）, and its effects on hematologic response and survival., Results: Of 105 patients, a total of 270 febrile episodes were recorded in 97 patients（92.4%）during their peri- IST periods, with the median infections of 2（1-7）episodes in each patient with the median febrile duration of 7（1-47）days. Respiratory system（35.1%）was the primary anatomic site of infection. Bacteria（88.2%）were common causes of total 169 pathogenic bacteria in 96 clear pathogenic bacteria episodes. And patients who got infection 1 month before IST had much lower 6- month hematologic response rate than their counterpart ones（50.8% vs 80.0%, P=0.004）. Multiple febrile episodes （ ≥3 times） and the total febrile duration ≥4 days showed the best sensitivity and specificity according to the ROC curve analysis. The 5-year overall survival of the 105 patients was 76%. The 5- year OS of patients with multiple febrile episodes （ ≥3 times） were much lower than their counterpart ones［（59.6±7.2）% vs（89.5±4.0）%］（P＜0.01）. The 5-year OS of the total febrile duration ≥4 days was much lower than their counterpart ones［（63.4±5.8）% vs 100.0%］（P＜0.01）., Conclusion: Infections 1 month before IST were associated with hematologic response. Multiple febrile episodes（≥3 times） and infections with the febrile duration ≥4 days presented inferior hematologic response and survival.

Objective: To evaluate the impact of recombinant human thrombopoietin (rhTPO) on short-term response of immunosuppressive therapy (IST) in patients with newly diagnosed acquired severe aplastic anemia (SAA)., Methods: The clinical data of forty adult acquired SAA patients, who treated with IST combined with rhTPO, were retrospective analyzed and the hematologic recovery were compared with patients by the IST alone during the same period. The factors affecting the short-term response were also analyzed., Results: At 3 months after IST, both the total response rate and CR+GPR rate in rhTPO group were much higher than those in control group (75.0% vs 50.0%, P=0.022; and 17.5% vs 2.5%, P=0.025). At 6 months after IST, there was no difference of total hematologic response rate in rhTPO group and control group (77.5% vs 57.5%, P=0.058), while the CR+GPR rate was still higher in rhTPO group (45.0% vs 22.5%, P=0.033). The median time of platelet transfusion independence was much shorter in rhTPO group [33(0-90) vs 53(0-75) d, P=0.019]. Patients in rhTPO group needed less platelets transfusion support. The median platelet count in rhTPO group was 29(4-95)×10⁹/L at 3 months after IST, which was much higher than that in control group [29(4-95)×10⁹/L, P=0.006]. There was no significant difference regarding overall survival between the two groups (100.0% vs 91.0%, P=0.276)., Conclusion: rhTPO is effective in promoting platelet recovery and improving the hematopoietic response for SAA patients with IST.

Objective: To elevate the prognostic value of minimal residual disease (MRD) detection by four-color flow cytometry with the antibody panel in childhood B-cell acute lymphoblastic leukemia (B-ALL)., Methods: The clinical data of 183 children with newly-diagnosed acute B-ALL and who accepted MRD detection between October 2010 and March 2012 was retrospectively reviewed. According to the detection time and result of MRD, the 183 children were classified into four groups: MRD negative (n=37) and positive (n=18) in the induction chemotherapy and MRD negative (n=113) and positive (n=15) in the maintenance chemotherapy., Results: During both induction and maintenance chemotherapy, the percentage of patients at high and median risk in the MRD positive group was higher than in the MRD positive group (P<0.05). In the maintenance chemotherapy group, the 3- year cumulative incidence of relapse in MRD positive patients was higher than negative patients (P=0.04). The Cox's proportional hazards regression analysis showed that insensitive reaction for prednisone (RR=1.005, 95%CI: 0.864-1.170, P=0.032), bone marrow morphology that did not meet M1 on the 15th day (RR=6.454, 95%CI: 2.191-19.01, P=0.002) and MRD≥0.01% (RR=1.923, 95%CI: 0.750-4.933, P=0.043) were risk factors for relapse in children with B-ALL., Conclusions: The four-color flow cytometry with the antibody panel can distinguish from MRD positive patients from negative patients with B-ALL. The result of MRD detection, as prednisone sensitivity and bone marrow morphology on the 15th day, is also a independent prognostic factor in children with B-ALL.

Objective: To evaluate the prognostic value of residual bone marrow hematopoiesis in severe aplastic anemia (SAA) patients with immunosuppressive therapy (IST)., Methods: Clinical data and hematologic responses of 38 SAA patients treated with IST regimen (antithymocyte globulin combined with cyclosporine) in our hospital were retrospectively analyzed. Correlation of pre-IST baseline reticulocyte (Ret), absolute neutrophils count (ANC), soluble transferrin receptor (sTfR) concentration, corrected TPO value and hematologic response rate were statistically analyzed and receiver operating characteristic (ROC) curve was used to estimate the value of Ret, ANC, sTfR, and corrected TPO in predicting early IST response., Results: Responders to IST had significantly higher pre-IST baseline Ret, ANC, sTfR concentration [19.9(2.7-84.4)×10⁹/L, 0.59(0.12-2.67)×10⁹/L, 0.82(0.22-1.58) mg/L] and lower corrected TPO value [142.9(31.8-1 035.0)] than non-responders [5.1(1.5-23.1)×10⁹/L, 0.20(0.04-1.33)×10⁹/L, 0.45(0.19-0.72)mg/L and 2 335.0(1 308.3-7 771.2)](P<0.05). Optimizing parameter cutoff levels obtained from ROC curve was Ret 6.75×109/L, ANC 0.30×109/L, sTfR 0.76 mg/L and corrected TPO 148.6, respectively. Combining the four parameters to predict 6 month hemotologic response showed that all the 7 patients with high Ret, ANC, sTfR and low corrected TPO, while only 1 among those 9 with low Ret, ANC, sTfR and high corrected TPO., Conclusion: Such parameters evaluating residual bone marrow hematopoiesis as Ret, ANC, sTfR, corrected TPO are practical in predicting early IST response in SAA.

Objective: To testify whether absolute neutrophil count (ANC) response to preimmunosuppressive-therapy (pre-IST) granulocyte-stimulating factor (G-CSF) treatment could predict early response to IST in severe aplastic anemia (SAA)., Methods: Clinical data and hematologic response of 125 SAA patients treated with antithymocyte globulin (r-ATG) combined with cyclosporine were retrospectively analyzed. Correlation of ANC response to pre-IST G-CSF treatment and early response to IST were statistically analyzed, and receiver operating characteristic (ROC) curve was used to estimate the value of increased ANC (∆ANC) in predicting early IST response., Results: The hematologic response (HR) rate to IST in ANC reponded patients was significantly higher than non-responded group (3-month HR 49.0% vs 28.9%, P=0.023; 6-month HR 61.2% vs 40.8%, P=0.026). With ∆ANC≥0.5×10⁹/L as cutoff level, the best point to predict early IST response was 10 days after G-CSF (d 10). Response of ANC to pre-IST G-CSF treatment at d 10 was among the independent factors of predicting 3-month (P=0.004), but not for 6-month response to IST. The overall 5-year survival rate was 92.8% and 69.5% in ANC responded and non-responed groups, respectively (P=0.025)., Conclusion: Responding to pre-IST G-CSF treatment reflected the residual bone marrow hematopoiesis, and could act as a convenient and practical predictor to early IST response as well as long-term survival in SAA.

Objective: To identify the characteristics of chronic natural killer cell lymphocytosis (CNKL)., Methods: The clinical data of eight cases defined by the World Health Organization classification was retrospectively analyzed and related literatures were reviewed., Results: Half of the 8 patients were asymptomatic. Among them, the most common abnormalities were leukocytosis with the median of 11.8(4.5-20.0)×10⁹/L and high proportion of lymphocytes [0.78(0.51-0.89)], while anemia and thrombocytopenia only in 1 patient respectively. The absolute CD3⁻CD16⁺ NK cell count with the median of 5.7(2.4-9.6)×10⁹/L increased in peripheral blood. By the end of follow-up, except one case was lost, the other seven patients were in stable condition,including four cases without any medications and three patients receiving chlorambucil or glucocorticoid., Conclusion: As an indolent chronic lymphoproliferative disease, CNKL was presented with mild clinical symptoms and increased number of CD3⁻CD16⁺ NK cells in peripheral blood. Patients with symptoms could be treated with immunosuppressive therapy while those asymptomatic could be followed up without intervention.

Objective: To report the clinical data of a case of iron-refractory iron deficiency anemia (IRIDA), so as to improve the understanding of IRIDA., Methods: The IRIDA patient's hematological characteristics were summarized and analyzed. The hepcidin levels were tested by ELISA kit. The TMPRSS6 gene was amplified by PCR reaction and its mutation was analyzed by sequencing. The effect of TMPRSS6 gene mutation on TMPRSS6 protein tertiary structure was predicted by Swiss-Model., Results: The patient was characterized by typical microcytic hypochromic anemia, low transferrin saturation, more reduction of intracellular iron than exocellular iron. The plasma hepcidin level was 213.77 μg/L which was significantly higher than that of IDA patients [5.19(3.31-12.02) μg/L]. The patient also carried a homozygous missense mutation of K253E in exon 7 of TMPRSS6., Conclusion: In children and younger IDA patients with no reason for iron deficiency but unresponsiveness to routine iron treatment, the diagnosis of IRIDA needs to be considered. Serum hepcidin level and TMPRSS6 gene mutation should be detected.

Objective: To evaluate the value of serum soluble transferrin receptor (sTfR) concentration in predicting early response to immunosuppressive therapy (IST) in severe aplastic anemia (SAA)., Methods: Clinical data and hematologic responses of 140 SAA patients treated with rabbit antithymocyte globulin (rATG) combination with cyclosporine in our hospital were retrospectively analyzed. Correlation of pre-IST baseline of sTfR and IST responses was statistically analyzed and receiver operating characteristic (ROC) curve was used to estimate the sensitivity and specificity of sTfR in prediction of early responses., Results: Serum concentration of sTfR in very SAA (VSAA) patients were significantly lower than SAA and transfusion dependent non-SAA cases (P=0.001). The responders, especially at 3 months, had significantly higher pre- IST baseline of sTfR [median, 0.89 (range, 0.21-2.42) mg/L] than that [median, 0.58 (range, 0.13-1.88) mg/L] of non-responders (P=0.005). The cutoff level of 0.91 mg/L and 0.88 mg/L for predicting responses at 3 and 6 months were established based on the ROC curve, with the degree of accuracy of 65.0% and 60.7% respectively. Multivariate analysis showed that pre-IST baseline of sTfR was the independent factor of predicting response at 3 months (P=0.007) and at 6 months (P=0.021)., Conclusion: As a indicator of bone marrow failure severity, sTfR could predict early response to IST therapy in aplastic anemia.

Objective: To investigate the clinical and laboratory features of 2 cases of pure red cell aplasia (PRCA) with thymoma/T-cell large granular lymphocyte leukemia (T-LGLL), and to improve the recognition of the disease and the role of lymphocyte in its mechanism., Methods: Two cases of PRCA with thymoma/T-LGLL were reported and the related literatures were reviewed., Results: Case 1 was a 63-years old male with hemoglobin level of 54 g/L at admission. Case 2 was a 52-years old female with hemoglobin level of 79 g/L at admission. They were both diagnosed as PRCA with thymoma before admission to our hospital and had no benefit from their thymectomy. Further examinations in our hospital showed that CD3⁺CD4⁻CD8⁺CD57⁺ large granular lymphocytes amplified with clonal TCR rearrangement in their peripheral blood. The diagnosis of PRCA with thymoma/T-LGLL was clarified. Case 1 did not respond to any of the frontline therapies while case 2 responded completely to cyclosporine., Conclusion: Both thymoma and T-LGLL could be the cause of secondary PRCA, lymphocyte proliferation may play critical role in the pathogenesis.

Objective: To investigate the clinical features and therapeutic method for severe aplastic anemia (SAA) associated with β-thalassemia, and to improve the recognition of the disease., Methods: One patient hospitalized for pancytopenia was reported and the related literatures were reviewed., Results: A 14-years old girl who presented with anemia from her childhood was hospitalized for acute onset of pancytopenia. Routine blood test showed that WBC count was 1.28×10⁹/L, hemoglobin 65 g/L, platelet count 18×10⁹/L, reticulocyte count 2×10⁹/L, neutrophil count 0.03×10⁹/L and mean corpuscular volume 59.6 fl, respectively. Both bone marrow aspiration and biopsy showed hypoplasia. Her red blood cells presented as microcytic hypochromic and target erythrocytes were common on peripheral blood smear. DNA analysis of the patient and her mother showed exon 17 heterozygous β-thalassemia (c.52 A>T). A diagnosis of SAA associated with β-thalassemia was clarified and high-dose cyclophosphamide (HD-CTX, 1.2 g/d×4 d) plus cyclosporine were offeved, which eventually led to a complete hematologic remission 12 months later., Conclusion: This was the first report of SAA associated with β-thalassemia, and the regimen of HD-CTX led to a complete hematologic remission.

Objective: To observe the effects of comprehensive therapy on serum secreted protein acidic and rich in cysteine (SPARC) levels in ankylosing spondylitis (AS) patients accompanied with osteoporosis (OP), and to explore the possible mechanisms for SPARC in AS patients accompanied with osteoporosis., Methods: Totally 48 AS patients accompanied with OP (Group A) were treated with massage, intravenous infusion of Cervus and Cucumis Polypeptide Injection, and Bushen Quhan Zhiwang Decoction (BQZD) for 3 months. At the same time, 45 normal healthy subjects were recruited as the normal control group (Group B). Serum SPARC levels were measured by ELISA in Group A before and after comprehensive therapy and in those of Group B. The levels of bone mineral density of femoral neck (FN BMD), bone mineral density of 2 -4 lumbar spine (L2-4 BMD), bone specific alkaline phosphatase (BSAP), tumor necrosis factor alpha (TNF-alpha), and transforming growth factor beta-1 (TGF-beta1) were detected. Meanwhile, Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) were detected in Group A before and after treatment. The correlations between the aforesaid indices and serum SPARC levels were analyzed., Results: Serum SPARC levels were significantly lower in those of Group A than in those of Group B (175. 30 +/- 72.04 micro/L vs 190. 52 +/- 86. 13 microg/ L, P <0. 01). Serum SPARC levels in those of Group A were negatively correlated with TNF-alpha (r = -0.261, P <0.01), positively with L2-4 BMD, TGF-beta1, and BSAP (r =0.437,0.256, 0.385, P <0.05, P <0.01). L2-4BMD and BSAP were independently predictors of serum SPARC in patients of Group A. After comprehensive therapy, the levels of TNF-alpha, BASDAI, and BASFI obviously decreased, TGF-beta1, BSAP, L2-4 BMD, and FN BMD obviously increased (P <0. 05, P <0. 01). The serum SPARC levels also significantly increased (188.32 +/- 87.50 microg/L, P <0. 05)., Conclusion: Comprehensive therapy could effectively improve the bone metabolism, clinical symptoms and the activity function of joints, and elevate serum SPARC levels.

Objective: To explore the relationship between EGIL 1998 and WHO2008 criteria for the diagnosis of mixed phenotype acute leukemia (MPAL)., Methods: The same group patients were diagnosed for MPAL by EGIL 1998 and WHO2008 criteria, respectively. The coincidence rate of diagnosis and therapeutic response of two diagnosis standards were compared., Results: A cohort of 1835 de novo acute leukemia (AL) patients admitted to our hospital from February 1996 to October 2010 were retrospectively analyzed by applying both EGIL1998 and WHO2008 classification criteria. Seventy four patients were diagnosed with MPAL according to EGIL 1998, accounting for 4.0% of all AL cases. The main subtype is M/B (54 cases, 73.0%). While 81 patients were diagnosed as MPAL, accounting for 4.4% based on WHO 2008 criteria. The most common type is also M/B (63 cases, 77.8%). Fifty nine (79.7%) cases met both criteria. In the subtypes of M/B, M/T, M/B/T and B/T, the coincidence rate is 85.2% (46/54), 56.3% (9/16), 0(0/2) and 50.0% (1/2), respectively. In the 1761 cases excluded as MPAL by EGIL1998, 22 cases can be diagnosed as MPAL by WHO 2008 classification. (2) Among the patients diagnosed as B/M MPAL by WHO2008, 13 were MPAL with t (9; 22) (q34; q11.2)/BCR-ABL1, 1 was MPAL with t (v; 11q23)/MLL-rearranged, 49 was B/myeloid not otherwise specified (NOS), 14 was T/myeloid NOS and 4 was MPAL NOS-rare types. (3) The overall final complete remission rate of the patients diagnosed by EGIL1998, 2008 WHO, met both criteria, EGIL1998 but excluded by 2008 WHO and by 2008 WHO but excluded by EGIL1998 was 69.0%, 73.5%, 73.5%, 44.4% and 73.7%, respectively, with no significant difference between any two groups based on χ(2) test (P > 0.05)., Conclusions: EGIL 1998 and WHO2008 criteria have reciprocity in the diagnosis of MPAL.

Objective: To investigate the clinical and laboratory features of congenital dyserythropoietic anemia type II (CDA-II) in order to improve the recognition of the disease., Methods: A case of CDA-II was reported and the related literatures were reviewed., Results: The 32-years old female presented with moderate anemia, jaundice and hepatosplenomegaly from her childhood and was misdiagnosed as hereditary spherocytosis for a long time. There were no increased reticulocytes in the peripheral blood and her bone marrow showed erythroid hyperplasia with 43% of binucleated erythroblasts. Electron microscopy examination revealed stretches of double membrane lining the inner surface of the erythroblast cell membrane., Conclusions: CDA-II is a rare congenital anemia characterized by ineffective erythropoiesis with unique laboratory features, and is relatively easy to be misdiagnosed. It is necessary to improve the awareness of CDA-II, and to set-up its responsible gene analysis, i.e., CDAN2 gene and SEC23B gene detection.

Two soil cores were collected from the Yuepu Park and a vegetable field near the Yunchuan Road in Baoshan district, Shanghai. Particle size, Pb content and Pb stable isotopic ratios were measured to examine Pb contamination status and its source. The results indicate that Pb concentration in the vegetable field soil and Yuepu park soil varies from 17.2 mg x kg(-1) to 34.8 mg x kg(-1) and 17.5 mg x kg(-1) to 36. 5 mg x kg(-1), respectively. The observed Pb isotopic ratios of vegetable field samples vary from 0.827 to 0.849 for 207Pb/206Pb, and 2.082 to 2.101 for 208Pb/206Pb, while those of Yuepu Park samples range from 0.839 to 0.848 and 2.089 to 2.097, respectively. Pb content, its enrichment factor (EF) and Pb stable isotopic ratios increase upward in both soil cores. EF values of surfacial (top 10 cm) vegetable field samples and park samples are mostly greater than 1.5, suggesting that higher Pb contents in topsoils are caused by anthropogenic activities. Compared with previous reports on Pb isotope signatures of different environmental materials in Shanghai, Pb isotopic ratios in the two soil cores are between those of Yangtze River intertidal sediments and the dust of coal combustion, and those of soil samples with EF > 1.5 are closer to the isotopic ratios of coal combustion dust. It indicates that topsoil in the Baoshan district is contaminated by dust derived from coal combustion.

Objective: To evaluate the effects of cyclosporine A (CsA) whole-blood concentration on the early response to immunosuppressive therapy (IST) in severe and very severe aplastic anemia (SAA/VSAA)., Methods: Ninety SAA/VSAA patients treated with rabbit antithymocyte globulin (ATG) plus CsA as first line therapy in our hospital were retrospectively analysed. CsA levels between the response group and non-response group, and response rates of patients with variant CsA levels were compared respectively., Results: (1) There was no significant difference in the beginning unmodified CsA blood concentration between IST responded and non-responded SAA/VSAA patients. The beginning unmodified C(0) 133.91 ug/L in IST 2-month responders was higher than that of 49.9 ug/L in non-responded SAA patients (P = 0.009); (2) The mean CsA C(0) and C(2) levels during the third month following IST were significantly different in responders and non-responders(197.52 µg/L vs 161.49 µg/L, P = 0.024, and 738.76 µg/L vs 615.46 µg/L, P = 0.009), and no significant difference in other periods of IST (P > 0.05); (3) The response rate (87.5%) was significantly higher in patients with CsA C(0) ≥ 200µg/L the third month following IST than those of 55.6% in patients with CsA C(0) 150 - 200 µg/L (P = 0.023) and 59.3% in patients with CsA C(0) < 150 µg/L (P = 0.046), respectively. The response rate was significantly higher of C(2) ≥ 700 µg/L group than that of C(2) < 700 µg/L group (80.5%vs 55.3%, P = 0.012)., Conclusions: The CsA concentration related to the early IST response. The third month CsA concentrations was the most important for the response and maintaining CsA levels with C(0) ≥ 200 µg/L and C(2) ≥ 700 µg/L may improve the response to IST in SAA/VSAA.

Aim: To study the CD8(+);NKT cell stability function., Methods: Splenic lymphocytes from C57BL/J mice were treated with Staphylococcal enterotoxin B (SEB) and then cultured in vitro. Day 10, 20, 30 and freezen effector cells were harvested and used. The cells were cultured in medium containing ConA and LPS for 72 hours and measured their response to mitogens. The inhibitory action of the effector cells were examined. The effector cells were co-cultured with normal lymphocytes and above mitogens for 72 hours. The cells proliferation was assessed with MTT method. The effector cells were cultured with heterogenic lymphocytes and were assessed with MTT method. The NKT cell subsets among these effector cells were analyzed by flow cytometry., Results: The response of these effector cells to ConA and LPS was significantly decreased compared with that of normal lymphocytes. The A values of cell proliferation were decreased from 0.67 and 0.61 to 0.30 and 0.31, 0.28 and 0.20, 0.26 and 0.24, 0.22 and 0.23 (P<0.05, n=3). The inhibitory ability of effector cells aginst the response of normal lymphocytes to ConA and LPS were clearly observed. They inhibited the response of normal lymphocytes to above mitogens. And the A values of cell proliferation were decreased from 0.67 and 0.61 to 0.33 and 0.39, 0.30 and 0.43, 0.36 and 0.43, 0.26 and 0.29(P<0.05, n=3). The response of effector cells to heterogenic lymphocytes was significantly decreased compared with normal lymphocytes. The A values of cell proliferation were decreased from 0.70 to 0.42, 0.42 and 0.54 on day 20, 30 and freezen effector cells respectively(P<0.05, n=3). The CD8(+);NKT cell subsets among these effector cells with tolerance function were significantly increased(P<0.05, n=3)., Conclusion: The anergic CD8(+);NKT cells could culture in vitro. And the anergic function of these cells were still existing.

Aim: To measure the in vitro cell division ability of CD8(+);NKT cells by CFSE staining and flow cytometry(FCM)., Methods: Fresh spleen lymphocytes of C57BL/J mice were separated and stained with CFSE, and then stimulated by ConA and LPS for 3 d, and by SEB for 5 d and 10 d respectively. The stimulated cells were harvested and analyzed for CD69 expression on the cell surface and the ability of cell division using FCM. The SEB-activated effector cells for 10 d further stimulated with IL-2 for the consecutive 10 days, and were analyzed for their cell division ability, CD69 expression and NKT cell subsets by FCM., Results: ConA, LPS and SEB stimulated the proliferation of spleen cells. ConA and LPS made the cells divide 3 times within 3 d, and increased CD69 expression up to 74.19% and 41.56% respectively. SEB made the cells divide 5 times within 5 d and 7 times within 10 d respectively, with increased CD69 expression of 32.09% and 48.66% respectively. Ten-day IL-2 stimulation of SEB-activated cells caused population expansion for 7 times with the CD8(+);NKT cell subsets significantly increased from 0.36% to 38.58% and CD69 expression significantly increased from 0.11% to 83.74%., Conclusion: The SEB-activated CD8(+);NKT cells proliferated in vitro and their cell division capability could be determined by CFSE staining and FCM.

Objective: To evaluate the effects of red clover isoflavones on the proliferation and apoptosis of human benign prostatic hyperplasia (BPH) stromal cells., Methods: We treated human prostate stromal cells with red clover isoflavones at the concentration of 12.5, 25, 50 and 100 microg/ml, and established a PBS blank control, a dimethyl sulphoxide (DMSO) negative control and four finasteride positive control groups (at the concentration of 12.5, 25.0, 50.0 and 100.0 microg/ml). We determined the effects of different concentrations of red clover isoflavones on the proliferation of the cells by MTT assay and on their apoptosis by Annexin V/PI double staining flow cytometry., Results: Red clover isoflavones inhibited the proliferation of the BPH stromal cells by 18.86% at 25.0 microg/ml, compared with 5.17% in the blank control group (P < 0.05), and more obviously at a higher concentration. At 50.0 microg/ml, red clover isoflavones exhibited a weaker inhibitory effect than finasteride (28% vs 69.88% , P < 0.05). Annexin V/PI double staining flow cytometry showed that red clover isoflavones at 25.0 microg/ml induced the apoptosis of the prostate stromal cells by (18.54 +/- 2.5)%, with significant differences from the negative control and blank control (P < 0.01)., Conclusion: Red clover isoflavones can inhibit the proliferation and promote the apoptosis of human BPH stromal cells.

Background: Recently the maintenance therapy of non-small-cell lung cancer (NSCLC) patients who completed required treatment cycles has caused widespread interests in the medical field. Traditional Chinese medicine may be a useful complement in maintenance treatment of mid-to-late stage NSCLC., Objective: To observe the effects of Feitai Capsule, a compound traditional Chinese herbal medicine for expelling blood stasis and phlegm, on the quality of life of the NSCLC patients as a maintenance treatment., Design, Setting, Participants and Interventions: A total of 62 mid-to-late stage NSCLC patients from Fuzhou General Hospital of Nanjing Military Region were included and randomly divided into treatment group (31 cases) and control group (31 cases). Patients in the treatment group were treated with Feitai Capsule, and patients in the control group did not accept any intervention. Regular observations and follow-up were performed for patients in the two groups., Main Outcome Measures: Analysis of variance, nonparametric test, and analysis of covariance were used to compare clinical features, amelioration of clinical symptoms, physical constitution and energy, and quality of life., Results: There were two dropouts and 60 valid cases. The baseline characteristics of the two groups were similar. In the treatment group, symptom response and physical energy level were improved by 36.6% (Z=-2.632, P=0.008) and 26.7%(Z=-2.182, P=0.029), respectively. There was a positive correlation between these two factors (r=0.917, P<0.001). The patients in treatment group had a significantly improved quality of life after treatment. No serious adverse events were observed., Conclusion: Feitai Capsule as maintenance treatment can improve the quality of life of the patients with mild-to-late stage NSCLC.

Aim: This study is to explore the biological characteristics of NKT subsets through investigating their morphology and differentiation pathways., Methods: Splenic lymphocytes from C57BL/J mice were treated with either Staphylococcal entertoxin B (SEB) or ConA and then cultured in vitro. On day 5 and day 10, the lymphocytes were harvested. Normal adherent macrophages and normal lymphocytes were harvested on day 0. Expression of CD69 molecule on the cell surfaces of the lymphocytes and large lymphocytes by SEB-activated was measured using staining of fluorescent antibody and flow cytometry (FACS). And the percent (%) of NKT subsets was determined and analyzed the differentiation pathways of the NKT subsets. Appearance of subsets was observed and compared under a light microscope at x400 magnification., Results: Expression levels of CD69 molecule on the SEB-activated lymphocytes and the giant lymphocytes were significantly increased to 55% and 68.95% respectively as compared to the level (0.11%) detected on the normal lymphocytes (both P<0.01; n=3). The percent (%) of CD8(+) NK1.1(+) and TcRVbeta8(+) NK1.1(+) NKT subsets in the giant lymphocytes was significantly enhanced to 30.29% and 31.48% (84.0 or 38.9 folds) originally from 0.36% and 0.81%, respectively. Based on the cell distribution shown in the upper part of the FACS picture, they should be large-scale selection. The SEB-activated lymphocytes in size were larger than not only the ConA-activated cells but also the adherent macrophages with an increase of 5 fold observed under a microscope. They are no-adherent cells. There were a few granule seen in cytoplasm . The value of cytoplasm vs nuclei was less than 1.0. The SEB-activating CD8(+) and TcRVbeta8(+) NKT subsets were not relative to a NK source. They were produced directly from T cells differentiation., Conclusion: The SEB-activating NKT cells are giant lymphocytes in size, consisting predominantly of CD8(+) NK1.1(+) NKT cells. They are considered as a subsets of T lymphocytes.

Objective: To explore the effects of dexamethasone on nuclear factor-KappaB (NF-KappaB) expression in brain tissue after traumatic brain injury (TBI)., Methods: Forty rats were randomly divided into two groups: dexamethasone treatment and no treatment, and severe brain injury was produced by gas percussion in both groups. At 0, 6, 24, 72 and 120 hours after injury, 5 rats of each group were executed and the histopathological changes in brain tissue in rats were observed by hematoxylin-eosin (HE) stain. The expression of NF-KappaB in brain tissue of rats was detected by immunohistochemical method., Results: NF-KappaB expression was significantly up-regulated at 6 hours in brain tissue of rats after TBI (P<0.05), reaching the highest level at 24 hours (P<0.01). It showed a tendency to lower, but was still high at 120 hours after TBI (P<0.05 or P<0.01). After treatment with dexamethasone, NF-KappaB level was lowered at 6, 24 and 72 hours (all P<0.01)., Conclusion: NF-KappaB expression is up-regulated in brain tissue in early period after TBI, and keeps on a high level, thus inducing inflammatory response to produce secondary injury to brain tissue. Dexamethasone shows protective effects by regulating the levels of NF-KappaB and prevents secondary injury which is caused by the inflammatory cytokines in rat brain tissue after TBI.

Objective: To establish HPLC fingerprint of HQSM capsules,and a new method for correlativity analysis between fingerprint peaks of HQSM and its relevant herbs based on the fingerprint analysis., Method: The chromatographic fingerprints of HQSM and its relevant herbs were analyzed by HPLC configured with DAD. The similarity of the HPLC fingerprints between HQSM and its relevant herbs and the comparison of UV spectra of the main peaks in both of fingerprints were used as indices to evaluate the correlativity., Result: The HPLC fingerprint with 16 common peaks was established and the chromatographic peaks were determined., Conclusion: The established method effectively controlled the quality of HQSM and establised the correlativity between HQSM and its relevant herbs, which would contribute to deduce the chemical components or sources of traditional Chinese medicine prescription.

Aim: To study the NKT cell subsets and their differentiation., Methods: Splenic lymphocytes from C57BL/J mice that had received SEB treatment were collected as effector cells on the 10(th) day. The cells were cultured in medium containing ConA, LPS and IL-2 for 3 days and measured their response to mitogens and cytokine. The inhibitory action of the effector cells was examined. The effector cells were cultured with normal lymphocytes and above mitogens or cytokine for 3 day. The cells proliferation was assessed with MTT method.The NKT cell subsets among these effector cells with the tolerance function were analyzed and their differentiation sources and correlation of functions were detected by flow cytometry., Results: The response of SEB-activated effector cells to ConA, LPS and IL-2 was significantly decreased compared with that of normal lymphocytes. The A values of cell proliferation were decreased from 0.80+/-0.04, 0.60+/-0.03 and 0.55+/-0.07 in control groups to 0.60+/-0.05, 0.30+/-0.05 and 0.27+/-0.04 in effector groups, respectively (P<0.01, n=3).The inhibitory ability of effectors cells against the response of normal lymphocytes to ConA, LPS and IL-2 were clearly observed. They inhibited the response of normal lymphocytes to several mitogens and cytokine. And the A values of cell proliferation were decreased to 0.26+/-0.02, 0.48+/-0.04 and 0.34+/-0.02, respectively (P<0.01, n=3). The CD4(+)NK1.1(+), CD8(+)NK1.1(+), TcRV8(+)NK1.1(+) NKT cell subsets among SEB-activated effector cells with tolerance function were significantly increased and shown that they come from T cell population. And the CD4(-)CD8(-)/NK1.1(+)CD3(+)NKT cells by ConA or SEB-activated were shown coming from NK cell population., Conclusion: The effector cells with tolerance function activated by superantigen SEB relate to CD4(+)NK1.1(+), CD8(+)NK1.1(+), TcRVbeta8(+)NK1.1(+) NKT cell subsets. The NKT cell subsets come from T cells. The CD4(-)CD8(-)/NK1.1(+)CD3(+)NKT cells differentiating from NK cells are not involved in the regulation of tolerance.

Objective: To reassess the natural history of polycythemia vera (PV) in Chinese and evaluate the relationship between the incidence of thrombosis, post-polycythaemic myelofibrosis with myeloid metaplasia( PPMM) , leukemia transformation and the therapeutic outcome and prognostic factors., Methods: The clinical manifestations, laboratory parameters and treatment were retrospectively analyzed in 287 patients with PV. Univariate analysis of prognostic factors was performed using Log-rank model and multivariate analysis using COX model in term of the incidence of thrombosis, PPMM, hematologic or non hematologic cancers and mortality., Results: Of the 287 patients, the median follow-up time was 46 (8-360) months. 208 thromboses were recorded in 115 patients. Twice or more thrombotic events occurred on 59 patients (51.34%). Most of these episodes occurred either at presentation or in the 2 years before diagnosis. Elder patients, prior thrombosis, poor response to therapy were associated with poor prognosis. With these three adverse prognostic factors, the patients could be separated into different risk groups. The incidence of thrombosis was higher in high risk group. 36 patients progressed to PPMM, the median time to PPMM was 80 (7-190) months. Higher WBC count, splenomegaly and treatment with alkylating agent and hydroxy-carbamide (HU) were associated with poor prognosis. 2 cases progressed to AML. 1 to lymphoma and 1 to nonhematologic cancer. 13 patients died, the cause of death was fatal thrombosis in 9 and AML in 2., Conclusion: The incidence of thromboembolism is higher and the time to myelofibrosis was shorter in Chinese PV patients than in western PV patients. The main factors that influence the survival of PV patients are thromboembolism and leukemia transformation.

Objective: Leprechaunism is an inherited insulin resistance syndrome, caused by homozygous or compound-heterozygous mutations in the insulin receptor gene (INSR). Clinical and molecular genetic research was carried out in one 17-year old girl with leprechaunism and her family members., Methods: History and laboratory tests were routinely taken. DNA samples were obtained from the proband and 4 of the family members. PCR was done on all exons of INSR and the products of PCR were sequenced directly., Results: The proband had the following features: apparent cessation of growth, elfin-like face, emaciation, hirsutism and acanthosis nigricans. She had hyperglycemia (fasting blood glucose 15.8 mmol/L; glycosylated forms of hemoglobin 12%) and it was resistant to the treatment of insulin. She was found to have W659R mutation at 9 exon and V1054M mutation at 17 exon of INSR as heterozygotes. This compound mutation is a newly found type. For her father there was only V1054M mutation and her mother only W659R mutation. No mutation was identified in her sister., Conclusion: The patient was diagnosed as leprechaunism according to her clinical presentations and biochemical examinations. The new transition mutation W659R at 9 exon and V1054M at 17 exon in INSR is the pathologic cause in this patient with leprechaunism.

Objective: To report a Chinese Charcot-Marie-Tooth disease type 2 (CMT2) family., Methods: All the members in the family were studied clinically,and 6 patients were studied electrophysiologically. Sural nerve biopsy was performed in the proband. PMP22 gene duplications were detected by highly polymorphic short tandem repeat. Point mutation analysis of PMP22, MPZ and NEFL gene was screened by PCR-SSCP combined with DNA direct sequencing. A genome-wide screening was carried out to the family., Result: Except 2 who had weakness and atrophy in both proximal and distal muscles of the lower limbs, all patients presented muscle wasting and a predominating weakness of distal parts of the lower limbs, and mild to moderate sensory impairments. In 6 patients who were subjected to elctrophysiological examinations, median-nerve conduction velocity (NCV) of the median nerve was normal. Electromyograms (EMGs) revealed signs of denervation with large motor unit potentials, fibrillation potentials and positive sharp waves. Sural nerve biopsy of the proband confirmed the presence of axonal neuropathy with an important loss of large myelinating fibers and a large number of clusters with mostly thinly myelinated axons. PMP22, MPZ and NEFL gene mutations were not found. The results of genome-wide screening revealed a linkage of CMT2 to a locus at chromosome 12q24., Conclusion: The results are consistent with the diagnosis of CMT2. This family represents a rare genetic type of CMT2 which can be designated as CMT2L.

Objective: To compare the thermal conductivity of the related tissues along meridian line and non-meridian area., Methods: Forty healthy volunteers were observed with a infrared thermal imaging system., Results: During heating the acupoint or the non-acupoint along the meridian line, the velocity of spreading of the temperature-increasing response along the meridian line was more easy and rapid, with a definite direction. However, during heating the non-meridian spots, the change of temperature was confined to the local area, with no definite direction. The spreading of skin temperature response along the meridian line was more rapid than the non-meridian area during both the two were heated simultaneously, and finally, 3 infrared radiant tracks along the meridian courses conformed basically with that of the classical three yin- meridians of the hand appeared., Conclusion: The thermal conductivity of the related tissues along the meridian line is better than that of non-meridian area and has definite direction, with differences in physical characteristics between them.