Progress toward improving management of myelodysplastic syndromes (MDS) occurred every year.This review focused on the new developments of classification,diagnoses,prognostic stratification and therapy on MDS in recent five years.In addiction,a brief introduction of pediatric MDS was presented here.All this were for a better exploration in the future.

Viral infections remain a major cause of morbidity in patients with immunodeficiency,such as recipients of hematopoietic stem cell transplantation (HSCT).Adoptive transfer of donor-derived virusspecific cytotoxic T lymphocytes is a strategy to restore virus-specific immunity to prevent or treat viral diseases and has been tested in the clinical setting for more than 20 years.The 55th ASH annual meeting reported lots of basic and clinical experience about CTL and summarized lots of trails to evaluate it,which will give us some new thought about the antivirus therapy after HSCT.

Objective To study the relationship between Epstein-Barr virus(EBV) and Hapatocellular carcinoma (HCC). Methods Polymerase chain reaction (PCR) and immunohistochemical staining were applied to detect EBV in paraffin tissue sections from 78 HCC patients. Results EBV DNA was detected in 22 patients (28 2%) by PCR. Immunohistochemical staining of EBV LMP1 revealed that the positive signals were mainly localized in the tumor cells. Conclusions These observations suggest that EBV may pay a role in the development of HCC.

Objective To evaluate the clinical signifi ca nce of retroperitoneoscopic ureterolithotomy for upper ureteral calculi. Methods Retroperitoneoscopic ureterolithotomy was carried out in 22 p atients with upper ureteral calculi. The operation was performed in the retroper itoneal space. After the upper ureter and calculi were exposed, a scalpel was ut ilized to cut the ureter longitudinally for the removal of calculi. A double-J t ube was inserted into the ureter routinely and the ureterotomy closure was perfo rmed with sutures. Results A conversion to open surgery was needed in 1 patient because the calculi had moved into the kidney. One patient e xperienced urinary leakage at 500～800 ml/d postoperatively, and received an ope n surgery of double-J tube insertion 3 days later. Of the remaining 20 patients, the procedure was successfully accomplished, with the operation time of 50~240 min (mean, 110 min) and the blood loss of 30~100 ml (mean, 50 ml). The time to t he recovery of intestinal functions was 12~30 h (mean, 18 h).The postoperative h ospital stay was 5~8 days (mean, 6.8 days). Follow-up with B-ultrasonography and intravenous urethrography for 1~12 months in the 20 patients found no residual calculi or ureteral stricture. Hydronephrosis disappeared in 15 patients and mil d hydronephrosis was detected in the rest of 5 patients. Conclusions Retroperitoneoscopic ureterolithotomy is a safe and effective option for upper ureteral calculi. It may be considered as the first-line treatment for re latively large-sized upper ureteral calculi.

Objective To study the relationship between the expression of human Stanniocalcin-1(hSTC-1) mRNA in the peripheral blood from patients with colorectal cancer and its malignant behavior. Methods RT-PCR was used to detect hSTC-1 mRNA in the peripheral blood from 57 patients with colorectal cancer. The peripheral blood from 14 patients with gastrointestinal inflammatory diseases, 15 healthy volunteers and 5 pregnant women were served as controls. Results The positive rate of hSTC-1 mRNA in 57 patients with colorectal cancer was 49.12% (28/57), and the mRNA expression of hSTC-1 was significantly related with the clinical stage of colon cancer (P

AIM: To analyze the lovastatin-induced differential gene expression in HepG2 cells using a cDNA microarray assay. METHODS: Total RNA was extracted from the lovastatin-treated HepG2 cells and control group. cDNA was synthesized from RNA with Cy3/Cy5-labelled dCTP. Then the hybridization was conducted. The result was analyzed using Imagene and Genespring software. RT-PCR was carried to confirm the hybridization results. RESULTS: 30 genes were up-regulated while 11 genes were down-regulated in lovastatin-treated HepG2 cells, involved in some major functional areas including signal transduction, cell cycle regulation, tumor immunity, and so on. CONCLUSION: The analysis of differentially expressed genes in lovastatin-treated HepG2 cells is helpful to explore the mechanism of the anti-tumor activity of statins.

The Expert Consensus on the Diagnosis and Therapy of myelodysplastic syndrome (MDS) (2014) will be interpreted in this paper focusing on whether it is scientific and reasonable.Some advises and views will be put forward,hoping that it will be useful to improve the diagnostic and therapeutic ability on MDS for clinicians in our country.

Objective To introduce a new design of interlocking system which is easy in use, makes the distal fracture fragments well aligned and rigidly fixated, reduces exposure to radiation for the surgeon and patient, and allows for a decrease in operating time. Methods The new interlocking system was designed to be a self-locking nail with bevels (b-SLN). According to the bevel principle, the axial force of the nail should be turned into a transverse force so as to control the transverse nail's movement. 10 dry-bone simples were made into the fracture model of the middle-femur to test the prototype nail. The retention of the nail in the intramedullary cavity was evaluated by the radiogram. The mechanical properties of a simulated model of single leg loading were tested on the instron-1342 type MTS. Results The prototype nail performed well as designed. The process was stable and reliable. The retention in the intramedullary cavity was fine. The shearing force between the transverse nail and main nail was enough to cut anything around them. The mechanical properties of b-SLN were similar to those of the Grosse-Kempf nail, better than auto fork compress locked intramedullary nail, and much better than MHUA nail and Ender's nail. Conclusions The structure of b-SLN is simple and reliable. There is no focus-point under stress. Its biomechanic properties are satisfactory. It is easy to use with no need of fluoroscopes in the operating theatre.

BACKGROUND: The graft versus host disease (GVHD) is the main reason for allogeneic hematopeic stem cell transplantation (allo-HSCT) failure, and oral tolerization is a newly developed treating method.OBJECTIVE: To evaluate the inhibition effect of acute GVHD induced by feeding donors with recipient splenocytes orally before allo-HSCT in a murine model and to compare the immune tolerance with immunosupression agents currently used in clinical treatment.DESIGN, TIME AND SETTING: A randomized grouping design of contrast observation was performed at the Center Laboratory of School of Medicine, Southeast University in December 2008.MATERIALS: The male C57BL/6J(H-2~b) mice were served as donors, and the female (BALB/C) mice (H-2~d) were served as recipients.METHODS: The mice were prepared allo-HSCT/GVHD models, and divided into 5 groups, which received prevent scheme. ①Oral tolerization group: C57BL/6J mice were fed with BALB/C (H-2~d) splenocytes before the transplantation, with dose of 10 μg per time, 1 day interval, for 3 times. ②Rapamycin group: mice were intragastric administrated rapamycin from the 1st after transplantation with dose of 1.5 mg/(kg·d). ③Ciclosporin A+ methotrexate group: mice were intragastric administrated ciclosporin A with 1.5 mg/(kg·d), increased to 5 mg/(kg·d) when mice were recovered the gastrointestinal function, and received intragastric administrated 0.4 mg/(kg·d) methotrexate at days 1, 3, 6 and 11 after transplantation. ④Blank control group: no medication after transplantation. ⑤Irradiation group: mice were received no transplantation.MAIN OUTCOME MEASURES: The presence of GVHD after allo-HSCT, and the difference of immune tolerance index.RESULTS: Typical GVHD symptoms occurred in all mice after transplantation. In the blank control group, most mice dead at days 14-18 and the mortality was nearly 100%. Compared to the blank control group, the symptoms were significantly ameliorated and the median survival times were extended in the other 3 transplantation groups (P < 0.05). The pathological structures in liver, intestine and skin tissue in the oral tolerization group were significantly decreased. Flow cytometry assay showed that oral tolerization significantly increased the CD4~+/CD8~+ lymphocyte ratio and the percentage of the CD4~+CD25~+ cells.Oral tolerization also induced the decrease of GVHD-related cytokine level. The MTT results also showed that the immunologic tolerance in the oral tolerization group was significantly enhanced and the proliferation of lymphocyte was suppressed.CONCLUSION: Oral tolerization has obviously inhibitory effect towards GVHD after allo-HSCT, its exact mechanism may be due to the suppressing the proliferation of lymphocyte and increase the immunologic tolerance in recipients. Compared to the widely used immunosuppressive drugs, oral tolerization exhibits strong ability in ameliorating GVHD.

AIM:To investigate the immune function of dendritic cells(DCs)in patients with hepatocellular carcinoma(HCC).METHODS:The DCs were cultured from human peripheral blood mononuclear cells(PBMC)by using GM-CSF and IL-4 for 7 days.Surface molecules CD86,HLA-DR of DCs were detected by flow cytometry.IL-12 production by DCs and IFN-? production by T cells was measured with ELISA and ELISPOT,respectively.Allogenic mixed lymphocyte reaction was detected by MTT assay.RESULTS:CD86 expression in DCs in HCC patients were markedly lower than that in health control(91.7% vs 83.5%,P0.05].However,after stimulated DCs with LPS,IL-12 production in HCC patients was significantly lower than that in health control [(478.6?142.7)ng/L vs(630.0?151.9)ng/L,P