BACKGROUND:Mesenchymal stem cells(MSCs) have immunoregulation,can reduce the occurrence rate of graft versus host disease following transplantation,and treat autoimmune disease. OBJECTIVE:To observe the immunoregulation of human umbilical cord(UC) -MSCs on bone marrow T-lymphocyte of patients with aplastic anemia. DESIGN,TIME AND SETTING:A randomized grouping design,in vitro cytological controlled study. Cases were obtained from the Department of Hematology,First Hospital and Second Hospital Affiliated to Nanchang University. Experiments were conducted at the Institute of Hematology,Second Hospital Affiliated to Nanchang University from September 2007 to November 2008. PARTICIPANTS/MATERIALS:A total of 22 patients with aplastic anemia were enrolled at the Department of Hematology,First Hospital and Second Hospital Affiliated to Nanchang University. There were 6 cases of severe aplastic anemia(3 males and 3 females) ,with a median age of 38(16-68) years;16 cases of chronic aplastic anemia(9 males and 7 females) ,with a median age of 41(25-59) years. Umbilical cord was obtained from healthy full-term fetus by normal uterine-incision delivery for isolation,culture and determination of human UC-MSCs. METHODS:MSCs were extracted from human umbilical cord. T-lymphocytes were isolated from bone marrow of patients with aplastic anemia by density gradient centrifugation. MSCs were cocultured with T-lymphocytes. In the control group,T-lymphocytes were incubated at 1?105/well. In the UC-MSCs group,human UC-MSCs were incubated at various densities of 1?105/well,0.5?105/well,0.1?105/well and 0.05?105/well. In the experimental group,T-lymphocytes were cocultured with UC-MSCs at 1:1,1:0.5,1:0.1,1:0.05. MAIN OUTCOME MEASURES:Inhibitory rate of human UC-MSCs at various concentrations on T-lymphocytes of aplastic anemia patients was measured by MTT assay. CD4+/CD8+ changes of the T cells were analyzed by flow cytometry. Expression of the two marrow hematopoietic factors(interleukin-2 and ?-interferon) in the supernatant was evaluated by ELISA. RESULTS:The second passage of MSCs had typical morphology of fibroblast,and highly expressed CD166,CD29,CD54,but lowly expressed CD13,CD34,CD45. MSCs could be induced into adipocytes. UC-MSCs showed inhibitory effect on lymphocyte proliferation of aplastic anemia patients when UC-MSCs and lymphocytes mixed at the ratio of 1:1,0.5:1,0.1:1,and their inhibitory rate were(56.2?12.1) %,(43.7?10.4) %,(28.6?8.9) %. The effect was the strongest at the ratio of 1:1. UC-MSCs adjusted the proportion of CD4+ and CD8+,inhibited the secretion of interleukin-2 and ?-interferon by T cells of aplastic anemia patients. CONCLUSION:Human UC-MSCs can mediate an immunoregulation effect on T lymphocytes of aplastic anemia patients in vitro and the inhibitory effects are dependent on the amount of UC-MSCs.

Objective To observe the effect of Isoket on standard dobutamine stress echocardiography(DSE).Methods Thirty-seven patients were divided into three groups according to the results of quantitative coronary angiography(QCA):the control group(CON) including 12 patiens,the coronary artery disease group 1(CAD1) including 15 patients,and the coronary artery disease group 2(CAD2) including 10 patients.Among the three group,the DSE+Isoket was done in CAD2,while the standard DSE was done in the other two groups.The improvement of segments of left ventricular after percutaneous transluminal intervention(PCI) was looked as the standard evaluating DSE.Results Isoket could increase heart rate and decrease systolic blood pressure,but could hardly affect diastolic blood pressure.The rate of biphysic response was 62.5% in group CAD1,and the sensitivity of detecting viable myocardium was 61%,while the specificity was 76%.In group CAD2,the rate of biaphysic response was 72.2% ,and the sensitivity of detecting viable myocardium was 82%,while the specificity was 88%.The rate detecting viable myocardium and sensitivity was improved significantly in group CAD2.Conclusions DSE combined with Isoket was beneficial for detecting viable myocardium.

Objective To analyze the response rate and prognostic factors for patients with locally recurrent rectal cancer treated with hypofractionated chemoradiotherapy without reresection.Methods Totally 52 patients with locally recurrent rectal cancer received hypofractionated irradiation and concurrent chemotherapy from January 2006 to January 2013 were enrolled.All patients received intensity-modulated radiotherapy (IMRT).The median dose was 63.4 Gy (61.6-64.4 Gy) at 2.2-2.3 Gy/f,5 f/week.Thirteen patients underwent prophylactic irradiation at lymph nodes region,the total dose of 45-50.4 Gy with conventional fraction and a simultaneous integrated boost was used.All patients received concurrent chemotherapy,capecitabine at 1 650 mg·m-2 ·d-1,divided into 2 times,5 d/week.The variables were compared by the chi-square test or Fisher's exact test.Local control (LC) and overall survival (OS) were calculated with using the Kaplan-Meier method.Results For all patients,the clinical complete response (CR),partial response (PR),stable disease (SD) and progressive disease (PD) was 23.1％,38.5％,32.7％ and 5.8％,respectively.The response rate (CR + PR) for patients with previous irradiation to pelvis and without were 37.1％ and 71.1％,respectively (x2 =5.40,P ＜ 0.05);for patients with 1 and 2 or more recurrent subsites were 81.8％ and 46.7％,respectively (x2 =6.63,P ＜ 0.05).Acute grade 3 skin and hematologic toxicities occurred in 19 patients (36.5％) and 1 patient (1.9％),respectively.None occurred grade 4 toxicity and none occurred grade 3 or more gastrointestinal and urologic toxicities.Four patients showed severe late toxicity of anastomotic stricture and performed a stoma at transverse colon.No other severe late toxicities were observed.The LC at 5 years was 49.1％ and the OS was 23.1％.Conclusions For patients with locally recurrent rectal cancer,hypofractionated chemoradiotherapy without resection is an acceptable and effective regimen,the response rate and long-term outcomes are promising.

0.05). H/R injury significantly decreased the GSH level (P

Objective To study the therapeutic effect of tianluo decoction against hepatitis B virus(HBV) in vivo and vitro.Methods The inhibitive effect were observed in the duplication process of hepatitis B virus by fluorescence quantitative PCR(FQ-PCR) in vitro test and duck's hepatitis B animal model in vivo test.Results FQ-PCR in vitro test demonstrated that tianluo decoction had biological function to inhibit from duplication of hepatitis B virus,and there were significant difference in inhibit hepatitis B virus from duplicating in distilled water and tianluo decoction group(median:6.9?108/ml vs 2.6?104/ml,u=2.76,P

OBJECTIVE: To explore the application of double pedicle blood supply pectoralis major myocutaneous flap in reconstruction of laryngeal and hypo pharyngeal defect after carcinoma resection. METHOD: All the patients received initial treatment. Pectoralis major myocutaneous flap was Applied in one-stage reconstruction in 22 cases of laryngocarcinoma and hypopharyngeal carcinoma with post-operation defect. During operation, pectoral branches of thoracoacromial vessels and branch of lateral thoracic vessels were reserved and prepared to be double pedicle vessel fascia bundle without muscle at the beginning part, rearched to defect area through subclavian tunnel. After operation, it is necessary to closely observe the subcutaneous swelling, quantity and color of the drain and others of neck surgery area to exclude the occurrence of surgical hematoma. When there is suspicion, do timely exploration. RESULT: Pectoralis major myocutaneous flaps of 22 patients were all survived. Pharyngeal fistula occurred in 2 cases and was cured by change of dressing. Twenty-one cases received radiotherapy after operation without secondary flap necrosis. After follow-up of 6 months to 24 months, one case of roll repairment of circumferential defect in cervical esophagus,found to have anastomotic stenosis 8 months after radiotherapy and then underwent gastrostomy treatment,the other 21 cases showed good recovery of swallowing function. Among 13 cases with laryngeal function reserved, only 1 case wearing tube and the extubation rate was 92.3% without communication barriers, no patient died in the short follow-up period. CONCLUSION For double pedicle blood supply pectoralis major nyocutaneous flap, blood supply are fully guaranteed and does not require complicated equipment to observe and monitor the flap blood supply after operation, it is important to exclude factors that may lead to muscular flap necrosis to ensure the survival of pectoralis major myocutaneous flap.
Esophagus ; surgery ; Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Larynx ; surgery ; Myocutaneous Flap ; Pharynx ; pathology ; surgery ; Reconstructive Surgical Procedures

BACKGROUND: Progressive body mass losses and physical strength decrease are common complications of malignant tumors, and they are important factors that affect the quality of life of the patients.OBJECTIVE: To probe into the curative effect of a Chinese herbal compound Yiqi Xiaozheng granules combined with antitumor drugs in the treatment of malignant tumors and its effect on the quality of life.DESIGN: A randomized controlled observation.SETTING:Clinical Tumor College of Peking University.PARTICIPANT: Totally 61 patients with malignant pulmonary carcinoma,breast or intestinal carcinoma hospitalized in the Wards of Integrated Traditional Chinese and Western Medicine of Beijing Cancer Hospital from June 1999 to March 2002 were recruited.METHODS: Altogether 61 cases of malignant tumor were randomized into the treatment group (treated with Chinese herbal compound Yiqi Xiaozheng granules supplemented with chemotherapy)(n=34) and the control group (treated with only chemotherapy was used)(n=27). The difference in curative effect, survival period with tumor and the quality of life of the two groups were observed. The comparison of the curative effects of the two groups was performed according to Clinical Curative Effect Criteria for Solid Tumors stipulated by World Health Organization: completely response, partly response, stable disease, and progressive disease. X-ray examination was performed on the patients before the therapy and two courses of treatment after the therapy to evaluate the curative effect. Physical strength grading was made according to the evaluation criteria of Eastern Oneology Cooperative Group of the United States. The two groups were graded before and after the treatment. The group with decreased grade after the treatment was considered to be improving, but the group with increased grade after the treatment was considered to be worsening.symptom before and after therapyparison of the curative effect of the two groups: The cure rate of the treatment group was higher than that of the control group (partial response rate,stability rate and progression rate of the two groups was 36% ,7% ;52%,survival with tumors: The mean period of survival with tumors of the treatment group was longer than that of the control group until March 2002ing: Physical strength grading status was better after the therapy in the treatment group than that in the control group [ In the treatment group, 9cases (26%)were ameliorated, 25 (74%)appeared stable , none was aggravated; in the control group, 1 case (4%) was ameliorated, 25(93%) appeared of qi-deficiency symptoms in traditional Chinese medicine before and after the treatment between the two groups. Symptoms such as sweating and qi deficiency manifested as disclination to talk, listlessness, debility, etc. were significantly reduced in the treatment group (The numbers of cases before and after the treatment were 20, 9; 17,9; 20,13 respectively). In the control group, the cases either were stable or showed an increase in symptoms (There were 13, 13; 14, 17; 18, 20 respectively before and after treatment).CONCLUSION: Compared with the control group, in the treatment of malignant tumors, Yiqi Xiaozheng granules supplemented with chemotherapy not only enhanced curative effect, but also improved the quality of life and prolonged the period of survival with tumors.

Objective To investigate the enhanced effect of polysaccharide from B.jiangsiensis(PBJ) on the immune hypofunction mouse models and its dose-effect relationship.Methods The immune hypofunction mouse models were made by hypodermic injection with cyclophosphamide(Cy) in mice.PBJ's effect on hemolysin content in mouse body induced by chicken erythrocytes and the delayed-type hypersensitivity(DTH) induced by dinitrochlorobenzene in mice were observed and contrasted in the different mouse groups treated with Cy in vivo by hypodermic injection together with PBJ at doses of 400mg/kg,200mg/kg and 50mg/kg,respectively.Results The test showed that the index of hemolysin,hemolytic plaque formation and delayed hypersensitivity reaction in model group markedly decreased while the indexes of hemolysin test in the control group,high and middle dose groups increased(P

Objective To investigate the characteristic of MRS in patients suffered diffuse axonal injury (DAI)in acute and suba-cute stage,and the correlation between MRS changes and the severity of disease.Methods We reported MRI and proton magnetic resonance spectroscopy studies of 3 6 head-inj ured patients in acute and subacute stage.Proton magnetic resonance spectra were ac-quired from the white matter and gray matter of bibateral frontal lobe that on conventional MRI appeared normal by using 2D MRSI at 3.0T MRI .30 volunteers as contronl were studied at the same time.Results In patient group,N-acetylaspartate/creatine ratios were (2.14±0.15)and (1.71±0.08)choline/creatine ratios were(1.35±0.13)and (1.03±0.08)for the white matter and the gray matter,respectivily.The brain N-acetylaspartate/creatine ratio was reduced and the choline/creatine ratio was increased in pa-tient group compared with the controls.The increase in the choline/creatine ratio was significant even in the moderate and severe in-j ured groups.Furthermore,there was a significantly correlation between the severity of head inj ury and the N-acetylaspartate/cho-line ratio,and changes in patients with metabolite ratios of the GCS score had a strong correlation.Conclusion We conclude that DAI patients with normal conventional imaging manifestations of the frontal lobe appear metabolite ratio change,suggesting the existence of local cerebral inj ury,and it has a strong correlation between the prognosis and MRS changes.MRS may provide an useful method that can tell us the severity of the brain inj ury in patients with DAI .

Objective To compare acute toxicity for stage Ⅱ-Ⅲ patients with rectal cancer irradiated with helical tomotherapy (HT) and conventional five-field intensity-modulated radiotherapy (5-IMRT).Methods The data of 84 stage Ⅱ-Ⅲ patients with rectal adenocarcinoma treated with concurrent chemoradiotherapy (CRT) were retrospectively analyzed.19 patients underwent postoperative CRT,and 65 patients underwent preoperative CRT.43 patients received radiotherapy with HT and 41 patients with 5-IMRT.The delineation on clinical target volume (CTV) and gross tumor target (GTV) was similar for two groups.The CTV to plan tumor volume (PTV) margins were 1.0 cm for patients with 5-1MRT and 0.5 cm for patients with HT.For all patients,a dose of 45.0-50.4 Gy,in daily fractions of 1.8 Gy,was delivered to PTV.For 45 patients with high risk factors,simultaneous integrated boost (SIB) was given to the tumor or tumor bed of a total dose of 55.0-60.0 Gy,in daily fractions of 2.1-2.3 Gy.Before treatment,the patients treated with HT underwent scanning by the tomotherapy-integrated megavoltage computed tomography (MVCT) scan modality and were positioned by co-registration of these images to the original kilovoltage planning CT image set.Concurrent capecitabine every day 1 600 mg/m2,twice daily on every day in the week.Results The rates of grade ≥ 2 acute cystitis were 7.0 ％ (3 cases) in HT group and 2.4 ％ (1 case) in 5-IMRT group (P =0.616),and ≥3 grade acute diarrhea were 4.7 ％ (2 cases) and 12.2 ％ (5 cases),respectively (P =0.259).≥2 grade leukopenia were 48.8 ％ (21 cases) and 19.5 ％ (8 cases),respectively (P =0.005),≥1 grade anemia were 34.9 ％ (15 cases) and 14.6 ％ (6 cases),respectively (P =0.032),and ≥1 grade thrombocytopenia were 23.3 ％ (10 cases) and 14.6 ％ (6 cases),respectively (P =0.314).Conclusions There is no significant difference in acute diarrhea and cystitis for patients treated with HT and 5-IMRT.Leukopenia and anemia in patients treated with HT are worse than those in patients with 5-IMRT,and thrombocytopenia is similar in the two groups.