AIM: To investigate the distribution and clonal expansion of TCR V? subfamily T cells in patients with acute monoblastic leukemia (M5). METHODS:The CDR3 of TCR V? 24 subfamily genes were amplified in peripheral blood mononuclear cells from 9 cases with M5 using RT-PCR and the PCR products were further labeled with fluorescent and analyzed by genescan technique for the CDR3 size, to evaluate clonality of the detectable TCR V? T cells. RESULTS:Only 1-10 V? subfamily T cells were identified in M5 cases. Genescan analysis showed that oligoclonal (clonal expansion) T cells were found in some V? subfamilies from 8 cases with M5, V? 2 oligoclonal T cells were identified in six cases, whereas V? 7- or V? 9 clonal expansion T cells were detected in the other two cases, respectively. In addition, except V? 2, V? 7 or V? 21 oligoclonal T cells could be detected in two cases, respectively. CONCLUSION:The skew distribution and clonal expansion of TCR V? subfamily T cells could be found in patients with M5. It may be a specific anti-leukemia immune response with which the host T cells were activated by the leukemia-associated-antigen. The clonal expansion T cells were tendentious in V? 2, which may be related to the M5 leukemia cells associated antigen.

Objective To evaluate the value of intra-cavitary contrast-enhanced ultrasound (IC-CEUS) via abdomen in fistulas difficult to diagnose before operation.Methods Clinical data of 12 patients with preoperative clinical suspicion of Crohn's Disease (CD) complications of fistula were enrolled in the study.Colonoscopy,cystoscope,or CT/MR has not confirmed the diagnosis of intra abdominal fistulas.IC-CEUS were performed by locally-injection of contrast agent in abdominal abscess,observing fistula and the relationship with the adjacent organs in CEUS mode.Diagnostic criteria were surgical findings.Results Fistulas in 10 patients were detected by IC-CEUS,including 7 cases of Ileo-mesenteric fistuls,2 cases of il eo-vesical fistulas,and 1 case of colo-vesical fistula.The accuracy rate of IC-CEUS in diagnosis of fistulas difficult to diagnose before operation in Crohn's disease was 83.3％ (10/12).No severe adverse events occurred during and after IC-CEUS procedure.Conclusions Our preliminary study shows that IC-CEUS is feasible in detecting abdominal fistula with high accuracy.It might be used as the alternative imaging tech nique for detecting fistulas when CT and MR are insufficient.

Objective To elucidate the association of interleukin (IL)-17F A7488G (p.His161Arg) polymorphism with gastric cancer susceptibility,clinicopathological features and survival.Methods DNA from 927 unrelated patients with gastric cancer and 777 age and gendermatched healthy controls was typed for IL-17F A7488G polymorphism by polymerase chain reactionrestriction fragment length polymorphism.Logistic regression analyses and Cox proportional hazards analyses were used to evaluate the associations between polymorphisms and gastric cancer susceptibility,clinicopathological features and survival.Results There was significant difference between healthy controls and patients with gastric cancer with respect to frequencies of IL-17FA7488G genotypes (X2= 16.55,P<0.01).After adjusted for age and gender,IL-17F A7488G GA and GG genotypes were associated with an increased risk of gastric cancer compared with the AA genotype (OR=1.51;95% CI:1.22-1.87 for GA;OR=1.61,95% CI:1.03-2.51 for GG).In comparison with AA genotype carriers,the risk of gastric cancer increased in those with GA or GG genotypes (OR= 1.53,95 % CI:1.25- 1.87,P<0.01 ).Further stratification analyses indicated that the effect of IL-17F A7488G GA genotype was especially noteworthy in gastric cancer patients of noncardia,intestinal type,poorly and moderately differentiated,and lymph node metastasis.Whereas there was no significant difference in survival among subjects with different polymorphisms of IL-17F A7488G gene (P= 0.534).Conclusions Genetic polymorphism of IL-17F A7488G involves in susceptibility to gastric cancer,which also influences certain subtypes of gastric cancer according to clinicopathological features,however,it is not the independent risk factor for prognosis of gastric cancer patients.

Objective To evaluate the influence of Helicobacter pylori (Hp) eradication on clinical manifestations, endoscopic features and pathological findings of chronic gastritis. Methods This was a multiple-center, prospective and randomized cohort study. Patients with non-atrophy chronic gastritis from January 2009 to December 2010 were randomized into 3 groups as Hp positive group with eradication, Hp positive group without eradication and Hp negative group. Clinical manifestations, endoscopic findings and pathologic changes of inflammation were compared before and after administration of gastric mucosal protective agent for 8 weeks. Results A total of 211 patients were recruited. Changes of symptom score, endoscopic erosion and mucosal inflammation were significantly different before and after treatment in 3 groups. The decrease in symptom scores of eradication group was ( 3.56 ± 1.37 ), which was significantly higher than that of non-eradication group (2. 80 ± 1.30, P ＜0. 01 ). The decrease of mucosal inflammation and inflammatory activity scores in eradicate group was 1.08 ± 1.34 and 1.42 ± 1.09, respectively, which were also significantly higher than those of the eradication group (0. 49 ± 1.47 and 0. 61 ± 1.34, P ＜0. 01 ). But the improvement of endoscopic erosion in 2 groups showed no significant difference. There were no significant differences in these variables between non-eradication group and Hp-negative group ( P ＞ 0. 05 ). Conclusion For chronic non-atrophic gastritis patients with positive Hp infection, combination of mucosal protective agents and Hp eradication can achieve better improvement in symptoms and gastric inflammation repair.

Objective:To analyze the long-term efficacy and safety of thalidomide on refractory Crohn′s disease (CD).Methods:A total of 79 patients with refractory CD in the First Affiliated Hospital of Sun Yat-sen University treated with thalidomide were enrolled in this retrospective study from September 2005 to July 2018. Clinical effects and adverse drug reactions were recorded and assessed.Results:In this cohort,69 patients were treated with thalidomide for ≥6 months. Sixty-eight patients among the 69 patients achieved complete clinical remission and were followed up for a median 33.5 months (range, 7-110 months). Seventeen cases relapsed during follow-up. The cumulative probabilities of remaining in remission at 12, 24, 60 months were 88.6% (95% CI 80.6%-96.6%), 80.7% (95% CI 70.3%-91.1%), 53.7% (95% CI 32.1%-75.3%) respectively. Disease activity was the only variable associated with relapse risk, with a hazard ratio ( HR) of 3.559 for Crohn′s disease activity index (CDAI) ≥220(95% CI 1.213-10.449, P<0.05). Adverse reactions were recorded in 42 (53.2%) patients including12 (15.2%) leading to discontinuation of thalidomide. No serious side effects were observed in all subjects. Conclusions:This study suggests a long-term benefit of maintenance treatment with thalidomide in refractory CD.Moderate to severe patients have an increased risk of relapse. The high incidence of drug adverse reactions may restrain the clinical application of thalidomide.