T-cell acute lymphoblastic leukemia (T-ALL) is a highly aggressive hematologic malignancy associated with poor prognosis.Increasing data regarding to alteration of gene expression signatures of oncogenes and tumor suppressors involved in the pathogenesis of T-ALL and the major mechanisms of T-cell transformation may contribute to define the biological markers for treatment response and prognosis,and has important clinical implications.In this review,advance knowledge concerning the characteristics of early T-cell precursor ALL,the alteration of TAL1 and NOTCH1 related genes and target inhibiton effects based on these alterations from 2012 the 54th ASH annual meeting ars summarized.

The increased level of fibrinogen (Fg) is an independent factor that resulting in the occurrence of ischemic cardio-cerebrovascular diseases. The Fg level is correlated with heredity, age, sex, obesity, lipid, smoke, inflammation and infection, and the pathogenic effect of genetic factor has been increasingly receiving attention. In recent years, more than 10 FgBβ gene polymorphisms have been reported, among them, - 148C/T, - 455G/A, and - 854G/A are considered to be significantly correlated with the increased level of Fg, and may be one of the most key factors in influencing the genetic risk factors of the occurrence of ischemic cerebrovascular disease.

Objective To evaluate the therapeutic effect of autologous hematopoietic stem cell transplantation(AHSCT)on hematological malignancies and solid tumors.Methods Twenty patients with age from 18 to 50 years received AHSCT.Two or 3 of following agents,Cytarabine(Ara-C)3～4 g/m2,Cyclophosphamide(CTX)4～6 g/m2,Etoposide(VP-16)0.5～1.0 g/m2,Semustine(me-CCNU)300 mg/m2,Melphalan(Mel)140 mg/m2,Thiotep a(TSPA)600 mg/m2,Carboplatin(CBP)1.0 g/m2,Busulfan 16mg/kg,were combined as conditioning regimen in all patients.Among them 2 patients with ALL accepted additional total body irradiation(TBI).Results All the patients have reconstituted bone marrow hematopoiesis after transplantation.None of them had the transplantation-related mortality.Among 20 patients with CML and malignant lymphoma,15 achieved disease-free survival(DFS)with a median survival time of 39.5(2～109)months.Conclusion AHSCT might represent an effective approach to the treatment of some patients with chemosensitive solid tumor who are complete remission or part remission.It is suggested that the patients have got a obvious survival benefit from AHSCT.

ObjectiveTo systematically review the curative effect and safety of compound realgar and natural indigo tablet (CRNIT) therapy in acute promyelocytic leukemia (APL). MethodsThe clinical data of randomized trials on SinoMed, CNKI, VIP,WANFANG DATA,CBA, PubMed, MEDLINE, EMBASE, the Cochrane Library were searched by internet,in addition to manual retrieval and collecting all published literatures randomized controlled trials (RCT) about CRNIT therapy in APL home and abroad.Retrieval line was up to March 2011. According to the inclusion criteria and exclusion criteria, screening all literatures and evaluating their qualities. The rate of complete remission (CR), time to CR, recurrence rate, mortality, rate of adverse reaction and so on were used as evaluation indicators for meta-analysis by RevMan 5.1.Results Data from six RCTs involving 391 APL patients,including 2 RCTs about comparison of CRNIT and Arsenic Trioxide (ATO), 4 RCTs about comparison of CRNIT and all-trans retinoic acid (ATRA) (including adding 1 RCT about comparison of CRNIT + ATRA and ATRA). Time to CR: CRNIT was longer than ATRA and ATO (WMD = 3.14, 95 ％ CI 0.99-5.29, P= 0.004). Headache incidence: CRNIT was lower than ATRA (OR = 0.10, 95 ％ CI 0.02-0.45, P = 0.003). 5-year disease-free survival rate: CRNIT was better than ATRA (OR = 7.22, 95 ％ CI 1.40-37.25, P = 0.02). There were no statistical significance in the rest of the Meta-analysis results.ConclusionThe time to CR of CRNIT is longer than that of ATRA and ATO.The short-term effect of CRNIT is similar to that of ATRA and ATO.The 5-year disease-free survival rate of CRNIRT may be higher than that of ATRA.

Objective To observe the blood supply of the extra hepatic duct and prevent the ischemia of extra hepatic duct after liver transplantation. Methods Microdissection for the main arteries of extra hepatic duct in 15 samples was performed. Results The main arteries supplying extra hepatic duct included cystic artery’s branches and posterior superior pancreaticoduodenal artery’s branches. There were 1~3 cystic artery’s branches and 3~5 posterior superior pancreaticoduodenal artery’s branches to supply extra hepatic duct. Conclusion The posterior superior pancreaticoduodenal artery is one of the main arteries supplying extra hepatic duct. In orthotopic liver transplantation, this artery is considered to preserve.

0.05). The survival time of the second control group and experimental groups was much longer than that of the first control group (P

Gastrointestinal benign stricture is a common disease with symptoms of dysphagia,abdominal pain and difficult defecation,which severely impair the quality of life for patients.Endoscopic intervention is the first-line treatment,and the available methods include balloon dilation,local drug injection and stent insertion,etc.Endoscopic incision was first used for the treatment of Schatzki's rings,and later it was used for the treatment of other gastrointestinal benign strictures,and the promising results were achieved.

Objective To investigate the risk factors and incidence of gas-related complications in peroral endoscopic myotomy for easophageal achalasia.Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected.Potential risk factors for gas-related complications were analyzed by univariate and multivariate analysis.Results The incidence of gas-related complications was 10.2％ (22/216).Univariate analysis showed risk factors for complications were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,tunnel width ≤3 cm,degree of myotomy,and operation time (P ＜ 0.05),while multivariate analysis showed the risk factors were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,and tunnel width ≤3 cm(P ＜ 0.05).Conclusion Simple longitudinal incision for tunnel entry,tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas-related complications in POEM,while myotomy depth is not.

Objective To compare the efficacy and safety of full-thickness peroral endoscopic myotomy (POEM) and circular myotomy for patients with severe achalasia.Methods The clinical data of 123 patients with severe achalasia who were admitted to the Second Xiangya Hospital of Central South University from August 2011 to May 2013 were retrospectively analyzed.Seventy patients who received full-thickness POEM were in the full-thickness myotomy group,and the other 53 patieuts who received circular myotomy were in the circular myotomy group.The clinical efficacies and incidences of complications of the 2 groups were compared.Patients in the 2 groups were followed up at the out-patient department till May 2014.The consecutive measurement data were presented by (x) ± s and analyzed using thc t test; the non-consecutive data were presented by M (range) and analyzed using the Wilcoxon rank test.Data before and after operation were compared using the repeated measure of analysis of variance.The count data were analyzed using the chi-square test.Results All the patients successfully received POEM.The operation time of the full-thickness myotomy group and the circular myotomy group were (57 ± 8)minutes and (63 ± 12)minutes,with significant difference between the 2 groups (t =3.421,P ＜0.05).The incidences of complications of the full-thickness myotomy group and the circular myotomy group were 14.3％ (10/70) and 11.3％ (6/53),with no significant difference between the 2 groups (x2=0.234,P ＞0.05).Atotal of 119 patients were followed up,with the median time of 18 months (range,12-24 months).The Eckardt scores at postoperative month 6 and 12 were 0 (range,0-3) and 0 (range,0-3) in the full-thickness myotomy group,and 0 (range,0-2) and 0 (range,0-3) in the circular myotomy group,with no significant difference between the 2 groups (Z =0.525,1.476,P ＞ 0.05).The sussess rates of the full-thickness myotomy group and the circular myotomy group were 98.6％ (69/70) and 98.1％ (52/53),with no significant difference between the 2 groups (x2=0.040,P ＞ 0.05).The diameters of the esophagus at postoperative month 6 of the full-thickness myotomy group and the circular myotomy group were (3.2 ± 0.3) cm and (3.4 ± 0.4) cm,with no significant difference between the 2 groups (t =1.927,P ＞ 0.05).The diameters of the esophagus at postoperative month 6 and 12 were significantly lesser than (5.9 ± 1.0) cm and (5.9 ± 1.0) cm before operation (F =780.923,493.018,P ＜ 0.05).No recurrence was detected in the 2 groups during the follow-up.Conclusion The short-term efficacy and incidence of complications of full-thickness myotomy and circular myotomy are comparable,while the operation time of patients who received full-thickness myotomy is shorter.

Background:There have been several studies about peroral endoscopic myotomy( POEM)for treating esophageal achalasia( EA). Although the feasibility,safety and effectiveness of POEM have been demonstrated,comparative studies of full-thickness and circular muscle myotomy were rare. Aims:To evaluate the efficacy and safety of POEM for treating patients with EA. Methods:A total of 216 patients with EA admitted from Aug. 2011 to Nov. 2013 at the Second Xiangya Hospital of Central South University were treated with POEM,of whom 133 received full-thickness myotomy and 83 received circular muscle myotomy. Data about Eckardt ’s score, diameter of esophageal lumen, intra- and post-operative complications and recurrence before and/or during periodical follow-up were collected,and the efficacy of full-thickness and circular muscle myotomy was compared. Results:All the 216 patients successfully underwent POEM with an average operation time of 59. 1 minutes. Average length of tunnel and myotomy were 13. 3 cm and 10. 1 cm,respectively. Symptoms remitted in all of the 216 patients,Eckardt’s score decreased significantly,diameter of esophageal lumen was reduced(pre-treatment vs. 6 months after treatment,53. 7 mm vs. 30. 8 mm,P<0. 001),and complications occurred in 13. 0%(28/216)of the cases. Success treatment was achieved in 99. 1%(214/216)of the cases with a follow-up of 3-30 months( mean 13. 8 months),no recurrence was noted. The operation time,efficacy and complications were comparable between full-thickness and circular muscle myotomy(P>0. 05). Conclusions:POEM is an effective and safe method for treating EA. Full-thickness myotomy did not increase the operation time and procedure-related complications, however,its long-term efficacy and complications need to be further assessed.