Over the past few decades,the curative effect of leukemia has been improved significantly.But the effect of refractory acute lymphoblastic leukemia and about 50％ of acute myeloid leukemia has not been improved.At present,targeted therapy,which is unique to the incidence of leukemia,has become a hotspot,such as the antibody drugs targeted cell surface molecules or kinases.At the same time,many drugs have been applied into clinical treatment because of their better clinical results,such as imatinib,bortezomib.

By analyzed the problems of clinical medicine key disciplines in professional degree graduate education,such as pay more attention to the research rather than clinical work,pay more attention to using rather than cultivating,the new needs were identified in the focus adjustment of this education.The measurements and methodologies of focus adjustment were discussed to match the needs.

Cardiopulmonary Resuscitation ; adverse effects ; Chylothorax ; etiology ; Heart Arrest ; physiopathology ; Humans ; Infant ; Infant, Newborn ; Male ; Neonatology

Objective To investigate the possibility of affecting transgenic rescue for Wilson disease using the human ATP7B transgenic LEC rat.Methods The 7.1kb transgene constructed with human ATP7B cDNA and chicken ?-actin promoter was introduced into the fertilized oocytes of LEC rats, an animal model of Wilson disease, by microinjection. The expressions of human ATP7B protein in the transgenic rats were detected by Western blot. The plasma AST and ALT activities, and the total bilirubin levels in transgenic rats were measured continuously from 6 to 16 weeks using non-transgenic rats and LEA rat as controls. The pathological and histochemistry changes in the liver of the transgenic rats at 13 weeks were analyzed. Results The intact and correct product derived from human ATP7B was confirmed in the liver of transgenic rats. At the age around 12 weeks, the plasma AST and ALT activities, and the total bilirubin levels in transgenic rats were significantly decreased, while the inflammatory reation in the liver of transgenic rats was much mild as compared with that of non-transgenic rats, and the granules of stained copper were less in the hepatocytes of transgenic rats. By the age of 16 weeks, the transgenic rats were phenotypically normal, and the survival rate was 100%. These data showed that the LEC rats were successfully rescued from fulminant hepatitis after introducing of human ATP7B gene. Conclusion The hepatitis in Wilson disease is directly related to the toxicity of excessive accumulated copper, which attributed to the functional deficiency of the ATP7B. Gene transfer probably is the effective method for the therapy of Wilson disease.

Objective To investigate the possibility of affecting transgenic therapy for the hepatic cirrhosis and hepatoma in Wilson disease by human ATP7B cDNA. Methods The 7.1*!kb transgene consisting of human ATP7B cDNA and chiken ?-actin promoter was introduced into the LEC rats which is an animal model of Wilson disease by microinjection.The plasma AST and ALT activities in transgenic rats were measured continuously from weeks 17 to 30 using non-transgenic and LEA rats as controls.The histological and histochemistry changes of liver in the transgenic rats at 30 and 60 weeks of age were examined. Results The plasma AST and ALT activities in transgenic rats were kept at the relatvie lower levels from 17 to 60 weeks of age, as compared to the age-matched non-transgenic rats.By the age of 60 weeks,none of the transgenic males developed cholangiofibrosis or hepatoma,whereas all of the non-transgenic rasts had severe cholangiofibrosis at the age of 30 weeks and one male rat had hepatoma at 60 weeks.The transgenic rats were phenotypically normal,and the survival rate was 95.7%.In addition,the distribution and the numbers of the granules of stained copper in the hepatocytes of the transgenic rats did not show any significant difference between 30 and 60 weeks.Conclusion The human ATP7B successfully delayed the onset of hepatic cirrhosis,and suppressed the development of hepatoma in the LEC rats by gene transfer.The hepatic cirrhosis and hepatoma in Wilson disease may be not directly related to the copper accumulation.

Chemokine is a family of small chemotactic cytokines.Chemokine mainly locates in neutrophile granulocyte,monocyte,macrophage,T lymphocyte and B lymphocyte,and some cells and immunoactive cells also secret cytokines.Researches showed that chemokine plays important roles in many patho-physiological activities,such as inflammatory response,infection procedure,wound healing,regulation of immunity,angiogenesis,invasion and metastases of cancer,etc..Some chemokine factors,such as hyperglycemia,hypoxia,oxidative stress,stimulate the ocular histiocytes to up-regulate the expressions of CXC chemokines and CC chemokines,which participate in the development of choroidal neovascularization and ocular neovascular diseases.This article reviews current progress in chemokine and the relationship between chemokines and ocular neovascular diseases,especially in diabetic retinopathy (DR) and age-related macular degeneration (AMD) etc..

The method of acupuncture combined with rehabilitation training in the treatment of shoulder hand syndrome after stroke is reliablet, quick, with simple operation and less adverse reactions. Among them, characteristic acupuncture could focus on the targeted points with obvious effect than ordinary acupuncture, and the combination with rehabilitation training could greatly improve the curative effect. However, there still exist some problems in the current research, such as the difficulty of conducting blind clinical trials of acupuncture therapy; the lack of follow-up data in the evaluation of curative effect, the uncertainty of long-term curative effect; the small sample size of clinical research, etc., so multi-centered and large sample RCT research are still needed.

Objective To analyze the immune state and discuss the effects of immunoregulation therapy of combined use of ulinastatin and thymosin ?1 in the treatment of posttraumatic sepsis. Methods Forty-eight patients with posttraumatic sepsis admitted to ICU during Oct. 2005 to Oct. 2007 were included and randomly divided into treatment group and control group (24 each). Patients in control group received conventional SSC treatment, while those in treatment group received conventional SSC treatment plus immunoregulation therapy with a combination of ulinastatin and thymosin ?1. Peripheral blood CD14+ monocyte HLA-DR expression was detected by flow cytometry to determine the innate immunity of posttraumatic septic patients on day 1, 5, 7 and 28 (or death), and serum levels of IL-6 and IL-10 were assessed by ELISA to evaluate the nonspecific immunity at day 1 and 28 (or death). APACHE Ⅱ scores were recorded on day 1, 5, 7 and 28 (or dearth). Ten healthy volunteers were enrolled as healthy controls. Results At admission the expression of CD14+ monocyte HLA-DR was lower than 30% in 9 posttraumatic septic patients. The expression levels of CD14+ monocyte HLA-DR in the patients in treatment group were much higher than those in control group (P0.05). Before treatment, no significant difference existed in APACHE Ⅱ scores between treatment group and control group, while this score in the patients in treatment group was much lower than that in control group on day 5, 7 and 28 (P0.05). Conclusions There is immunosuppression in some posttraumatic patients with somplication of sepsis. All these patients manifest exaggerated nonspecific immunity at the early stage, and then manifest immunodepression as sepsis progresses. The immunoregulation effects of a combination of ulinastatin and thymosin may facilitate the balance of pro-inflammatory and anti-inflammatory media, thus ameliorating septic symptoms. No improvement in 28 day mortality has been seen, probably due to limited number of patients in present study.

BACKGROUND: Epidural resistance materials are an approach to prevent the epidural scar adhesion after laminectomy. A composite membrane of mechanical separation and fibroblast inhibition is promising to be widely studied.OBJECTIVE: To prepare the interferon (IFN)/poly (lactic-co-glycolic acid) (PLGA) and chitosan/PLGA composite membranes, and to observe their effects on preventing epidural scar adhesion after laminectomy in rabbits.METHODS: L2 laminectomy was performed in 120 rabbits, which were randomly and evenly divided into six groups. The control group received nothing on epidurals. In the autologous free fat group, the exposed dura was covered with subcutaneous fat. In the sodium hyaluronate group, 1 mL sodium hyaluronate was dripped onto the dura. In the PLGA, chitosan/PLGA, and IFN/PLGA groups, the exposed dura was covered with one of the three membranes at a sufficient size. The animals were sacrificed at 2, 4, 6, 8 weeks postoperatively. The scar formation and adhesion to the dura in L2 laminectomy sites were observed and scored by gross observation. At 4 weeks postoperatively, fibroblast ultrastructure was observed through the use of transmission electron microscope.RESULTS AND CONCLUSION: Widespread scars formed in the control group. The scars in the autologous free fat and PLGA groups were less compared with the control group, but there was no significant difference between these two groups. In the early stage, the scars in the sodium hyaluronate group were obviously less compared with the autologous free rat and PLGA groups, while in the later period, the difference between them was not significant, but the results from the sodium hyaluronate group were still better compared with the control group. The scars and slight adhesion to the dura were observed in the chitosan/PLGA and IFN/PLGA groups. The effect of preventing scar adhesion in these two groups was remarkably superior to that in the other groups, but there was no significant difference between these two composite membrane groups. At 4 weeks postoperatively, fibroblast morphology and function in the control, autologous free rat, and PLGA groups were better than those in the chitosan/PLGA and IFN/PLGA groups. Chitosan/PLGA and IFN/PLGA composite membranes are effective materials to prevent epidural scar adhesion after laminectomy.

Objective:To investigate the clinical value on the determination of the peripheral blood ICAM 1 level in Graves's disease(GD).Methods:The serum soluble Intercellular Adhesion Molecule 1(sICAM 1)concentration were analyzed by ELISA and the expression of ICAM 1(CD54 +) on PB lymphocytes in 37 GD patients and 22 normal subject were measured,while TsAb,TpoAb,TGAb;CD4 +,CD3 +,CD8 +,CD19 +,CD25 +were examined by FACS.Each marker between the two groups and the positive rate between the TsAb and sICAM 1 whe compared.In addition ,the relationship between the ICAM 1 level on PB and immunity markers in GD patients were analysed.Results:The mean sICAM 1 concentration was significantly higher in untreatd GD patients than in normal controls(P