Objective To improve the understand of the clinical characteristics of mycosis fungoides and provide guidance for the clinical work. Methods The clinical data of 21 patients with mycosis fungoides in our hospital were retrospectively analyzed including the ages at diagnosis, clinicopatholagic characteristics of skin lesions, systemic manifestation, misdiagnosis and treatment of these patients. Results The mean age was (57.3±2.31) years at the diagnosis. Most patients were at the stage of plaques. Clinical manifestations included generalized lesions (52.4 %) and itchy (66.7 %). Epidermotropism (66.7 %) and pautriers microabscesses(57.1%) were common histopathologic features. Previous misdiaguosis rate was 66.7 %. Skin targeted therapies and biologic therapies were effective approaches to relieve the skin rash at early stage, and combined chemotherapy was typically applied in more advanced cases. Conclusion Mycosis fungoides has various clinical characteristics and careful differential diagnosis should be made in clinical practice.

BACKGROUND:Distraction osteogenesis is one of the most important tissue engineering technologies. However, the exact signaling pathway controling mesenchymal stem cel-osteoblast lineage (MSC-OB) migration during distraction osteogenesis has not yet been elucidated. More efforts should be paid to make a ful understanding of the mechanism on MSC-OB lineage migration, which can improve the clinical efficacy of distraction osteogenesis.
OBJECTIVE:To evaluate the effects of mechanical stretch on the ability of MSC-OB mobility and expression of mammalian target of rapamycin (mTOR) signaling pathway as wel as matrix metaloproteinases (MMPs) in MSC-OB, and to make clear the mechanism by which controls MSC-OB migration during distraction osteogenesis.
METHODS:Twelve Sprague-Dawley rats were randomized into two groups: experimental group (n=6), anin vivo rat mandibular distraction osteogenesis model was established on the right side of rats; non-stretch group (n=6), only the mandibular resection was done but with no distraction osteogenesis. Immunohistochemical staining was used to detect phosphorylated mTOR expression in new osteotylus at 15 days after operation. In addition, an in vitro cel stretch model was made in the mandibular mesenchymal stem cels from healthy Sprague-Dawley rats under resting tension force (6%, 4 hours); no distraction was done in control group. The ability of MSC-OB mobility, the expression of mTOR, Raptor, p70S6K and MMPs were evaluated using experiment methods including immunohistochemistry staining, real-time PCR and scratch assay.
RESULTS AND CONCLUSION: The expression of phosphorylated mTOR in MSC-OB was upregulated in the mandibular bone calus of the stretch group than the non-stretch group (P < 0.05). In thein vitro experiments, MSC-OB applied with mechanical stretch (6%, 4 hours) showed elevated gene expression levels of mTOR, Raptor, p70S6K, MMP-2, MMP-9 and MMP-13 compared with the control group (0%, 4 hours). Meanwhile, MSC-OB in the experiment group (6%, 4 hours) showed a greater ability of mobility, as demonstrated by a farther distance after 48 hours of observation (P < 0.05). The present study suggests that the enhancement of MSC-OB mobility correlates with increase of the gene expression of MMPs and mTOR signaling pathway. Mechanical stretch may promote MSC-OB migration through activation of mTOR/MMPs signaling pathway.

Acute lymphoblastic leukemia is the commonest pediatric malignancy caused by the disturbed differentiation of hematopoietic stem cells. Due to the effective measure of individualized therapy, the outcome of ALL therapy has been improved dramatically in recent decades. The reduction of treatment intensity in favorable patient groups decreases acute and long-term toxicity, only for the high-risk groups the intensive chemotherapy is of value, and the different therapies should be used, depending on their different biologic features.Even with intensive therapy or new drugs, the outcome of relapsed ALL remains poor, the treatment could be turned to the molecularly defined targeted drugs and stem cell transplantation. What is more, the progress in the detection technique for minimal residual disease and pharmacogenomics help to estimate the sensitivity of chemotherapy and judge the prognosis, so as to provide the reliable objective foundation for the individualized therapy.In this review, the present states of individualized therapy in childhood acute lymphoblastic leukemia is discussed and summarized.
Child ; Genomics ; Humans ; Neoplasm, Residual ; drug therapy ; Precision Medicine ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

This study was aimed to explore whether hyperglycemia during chemotherapy influences the prognosis of children with acute lymphocytic leukemia (ALL). The clinical medical records of all newly diagnosed patients with ALL at SUN Yat-Sen Memorial Hospital from June 2008 to May 2012 were analyzed retrospectively. The median time of follow-up for patients was 2.6 years (range 0.08 to 4.9 years). Patients were divided to hyperglycemia and euglycemia groups according to their blood glucose concentrations during chemotherapy which contains L-asp and dexamethasone. The variables between two groups were compared using χ(2) test, the RFS and OS among two groups were compared by use of Kaplan-Meier and Cox-proportional hazard analyses. The results showed that the hyperglycemia correlated with older age (43.33% vs 19.23%, P = 0.008) and high-risk disease at diagnosis (26.62% vs 4.76%, P = 0.017) , but did not associate with sex (P = 0.059). Patients with hyperglycemia had worse OS (94.2 ± 2.9% vs 83.1 ± 6.3%, P = 0.014) and more poor RFS (64.1 ± 8.9% vs 88.6 ± 3.8%, P < 0.001) at 5 years than their counterpart. It is concluded that the incidence rate of hyperglycemia during chemotherapy correlated with older age and high-risk disease in ALL children, and the patients with hyperglycemia during chemotherapy may have poorer prognosis.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Child ; Child, Preschool ; Female ; Humans ; Hyperglycemia ; chemically induced ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; diagnosis ; Prognosis ; Retrospective Studies ; Risk Factors

Metabonomics is a new method to study on the metabolic network and the relationship between body and environment, which conforms to the way of traditional Chinese medicine (TCM) research. In the study process of modernization of traditional Chinese medicine, effectively conjunction with metabonomics method will facilitate the integration of TCM with modern biological science and technology, and promote the modernization of TCM. This paper introduce the application of metabonomics in the research of toxicity mechanism of TCM, compatibility mechanism of TCM formula, pharmacology effect of TCM and processing mechanism of TCM. This paper summarize the problems in the TCM metabonomics research and prospect its bright future.
Animals ; Drug Therapy ; Drugs, Chinese Herbal ; adverse effects ; analysis ; metabolism ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; trends ; Metabolomics ; methods ; trends

OBJECTIVETo investigate the failure mode of various types of glass ionomer cements by Hertzian indentation test.

METHODSDiscs of 10 mm diameter and 2 mm thickness were prepared for six glass ionomer cement products (A-D: conventional type setting through an acid-base chemical reaction, A and B without reinforcement, C with silver reinforcement, D with ceramic reinforcement; E and F: resin-modified type), ten for each. These were tested on top of glass-reinforced polyamide-nylon 6, 6 substrates by a universal testing machine, loading centrally with a 20 mm diameter ball. Load at the first crack was recorded. Failure mode was observed under scanning electron microscope.

RESULTSThe former four products presented typical brittle fracture, while the latter two usually fractured incompletely. The failure loads at the first crack of the six glass ionomer cements were (258.86 +/- 10.49), (230.88 +/- 21.66), (281.90 +/- 25.39), (282.11 +/- 9.60), (756.67 +/- 83.50) and (1 148.00 +/- 147.78) N, respectively. Significant difference was found between the former four and the latter two products.

CONCLUSIONSThe type (setting mode) of glass ionomer cement controls its failure mode. Inclusion of metallic or ceramic filler has little effect on increasing the load bearing capacity of glass ionomer cement.

Compressive Strength ; Dental Porcelain ; chemistry ; Glass Ionomer Cements ; chemistry ; Materials Testing ; methods ; Resins, Synthetic ; chemistry ; Silver ; chemistry

This study was purposed to compare the efficacy and safety of two different doses of rabbit anti-thymocyte globulin (r-ATG) combined with cyclosporine (CsA) for treating children with severe aplastic anemia (SAA). From January 2005 to July 2010, a total of 95 children with SAA accepted intensive immunosuppressive therapy (IIST) in our department, out of them 55 cases were treated with r-ATG 2.5 mg/(kg·d) for 5 days in combination with CsA (group I) and other 40 cases were treated with r-ATG 3.5 mg/(kg·d) for 5 days in combination with CsA (group II). The responsive rate, adverse reactions, early mortality, relapse and clonal disease were analyzed retrospectively and results between the two groups were compared. Out of 95 patients 43 were boys and 52 were girls, their ages were from 1 to 16 years. The sex, age, severity and course of the disease were comparable between the two groups. The results showed that after treating for 3 and 6 months, the response of patients in group II was higher than that of patients in group I (50% vs 32.1%, P = 0.08 and 65% vs 45.3%, P = 0.059), at 9 and 12 months the response rate of patients in group II and group I did not show significant difference (70.0% vs 71.1%,P = 0.904 and 82.5% vs 80.8%,P = 0.832); at 12 months of treatment, the complete response rate of patients in group II was significantly higher than that of patients in group I (40.0% vs 23.1%,P = 0.08); at 3, 6, 9 months of treatment, the complete response rate of 2 groups showed no obvious difference. The incidence of serum disease, early infection and early mortality did not show statistical difference between two groups. There was no statistical difference in 2 year overall survival rate of two groups. In group I 39 patients were followed-up for more than 2 years, among them 3 patients relapsed, 1 patient died and 1 patient was diagnosed as acute monocytic leukemia (M5). In group II 15 patients were followed up for more than 2 years, there were no relapse, death and clonal disease. It is concluded that the r-ATG combined with CsA is an effective and safe therapeutic regimen for the SAA children. The effect of r-ATG 3.5 mg/(kg·d) is better than the 2.5 mg/(kg·d). The early safety is comparable between the two groups. However, the long-term effect, complications and survival rate need longer follow-up study to evaluate.
Anemia, Aplastic ; drug therapy ; Animals ; Antilymphocyte Serum ; administration & dosage ; Child ; Cyclosporine ; therapeutic use ; Drug Combinations ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; therapeutic use ; Leukemia, Monocytic, Acute ; Male ; Rabbits ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo study the relationship of Blimp-1 hypoexpression with abnormality of Treg level and pathogenesis of aplastic anemia (AA).

METHODSThe mouse model with AA was established by adminis tration of IFN-γ combined with busulfan. The samples were collected at different day establishing AA model, and the spleen Treg number was detected, the Treg cells were sorted and expression level of prdm-1 was detected.

RESULTSThe number of Tregs in mice with AA was lower than that in control mice, moreover, the level of Treg decrease positively correlated with the AA severity (r=0.805), the higher the expression level of prdm-1, the higher the ratio of Treg/lymphocytes, showing positive correlation between them (r=0.548).

CONCLUSIONBlimp-1 expression may promote the proliferation and differentiation of Treg. The hypoexpression of Blimp-1 mediates the pathogenesis of AA and promotes progression of AA through reducing the proliferation of Treg, and decreacing the number of Treg.

OBJECTIVETo evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achilles tendon-bone allografts.

METHODSAssociated meniscus injuries were treated according to established methods prior to ligament reconstructions during arthroscopic surgery. Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively.

RESULTSwere analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (larger than 3-8 weeks), 3 for acute ligamentous deficiencies (less than or equal to 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the difference was statistically significant (t- test, P less than 0.001) before and after operation.

CONCLUSIONSAchilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

Achilles Tendon ; transplantation ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone Transplantation ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Posterior Cruciate Ligament ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Transplantation, Homologous

OBJECTIVETo investigate the role of Caspase-3 in retinal damage caused by light exposure in rats.

METHODSLight injury to retina was induced by persistent exposure to illumination (intensity: 30 000 +/- 50 lux) of operating microscope for 30 minutes in the right eyes of Sprague-Dawley rats. The pathological changes of retina were observed under optical and electron microscopies at different time points, which were 6 hours, 1, 3, 7, and 15 days after the light exposure. Apoptosis of retinal cells was analyzed by flow cytometry. The activity of Caspase-3 was evaluated by using the Caspase-3 assay kit. At the same time, the expression of Caspase-3 protease was determined with Western blot analysis.

RESULTSThe examination results of optical and transmission electron microscopes showed that edema of inner and outer segments of the retina, especially the chondriosome inside the inner segment, became obvious 6 hours after the light exposure. The change was deteriorated along with the increasing time. The structures of the discoidal valve dissociated in the outer segment simultaneously. Disorderly arranged nuclei, karyopycnosis, and thinning in the outer nuclear layer were observed. The retinal pigment epithelium almost disappeared during the later stage. The staining results of Annexin-V combined with PI demonstrated that the proportion of apoptotic cells increased with time. The proportion between 7th day (82.7%) and 15th day (80.4%), however, showed no significant difference. Caspase-3 became remarkably active with the lapse of time, which increased from 0.02 at 6th hour to the peak of 9.8 at 7th day before it started to descend. The Western blot detected a expression of the active form of Caspase-3 at 7th day and 15th day.

CONCLUSIONApoptosis of photoreceptor cells is markedly involved in the light damage and Caspase-3 protease may play an important role in the apoptotic process of the retina after light exposure in rats.

Animals ; Apoptosis ; radiation effects ; Caspase 3 ; genetics ; metabolism ; radiation effects ; Dose-Response Relationship, Radiation ; Enzyme Activation ; Gene Expression Regulation, Enzymologic ; radiation effects ; Light ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Retina ; enzymology ; pathology ; radiation effects ; ultrastructure