Objective To explore the regularity of hematopoietic materials during the clonal evolution of aplastic anemia(AA), paroxysmal nocturnal hemoglobinuria (PNH) , myelodysplastic syndrome (MDS) and acute leukemia(AL). Methods Patients diagnosed as AA, PNH, MDS and AL were recruited as cases and health volunteers were recruited as controls. Serum folic acid, vitamin B12 and ferritin levels were measured by radioimmunoassay and competitive enzyme immunoassay,before and after-treatment. Results Before treatment,the level of serum folic acid in PNH group were significantly lower than that in the control group(P<0. 05). Vitamin B12 and ferritin levels of MDS patients were higher than the control group (P < 0. 05); Serum Folic acid level in AL patients was significantly lower than the control group (P < 0. 05). In contrast, vitamin B12 and ferritin levels were higher than the control group(P <0. 05). Compared to pre-treatments AA patients, vitamin B12 and ferritin levels of MDS patients were significantly higher(P <0. 01) ;Serum folic acid level in AL patients was significantly lower(P < 0.05). However,vitamin B12 and ferritin levels were higher. Compared to pre-treatments MDS patients, serum folic acid level in AL patients was significantly lower(P < 0. 05) , whereas vitamin B12 and ferritin levels were higher(P < 0. 05). The comparison of hematopoietic materials between pre-and post-treatments among the groups showed that there was no significant difference for AA patients between pre- and post-treatments in the levels of serum folic acid and vitamin Bl2 (P > 0. 05), whereas ferritin was significantly higher after treatment caused by transfusion in AA patients(P<0. 05) ;ln PNH patients,serum folic acid was significantly higher after treatment(P<0. 05) ,and there was no significant difference in the levels of vitamin B12 and ferritin between pre-and post-treatments (P >0. 05). In MDS patients, there was no significant difference in the level of ferum folic acid between pre-and post-treatments (P > 0. 05) , whereas vitamin B12 and ferritin levels were significantly lower after treatment (P < 0. 05); In AL patients,serum folic acid was significantly higher after treatment(P <0. 05) .whereas the levels of vitamin B12 and ferritin were significantly lower after treatment (P <0. 05). Conclusions There are significant difference in serum folic acid,vitamin B12 and ferritin among the patitents of AA,PNH,MDS and AL and would be helpful in discovering the interrelationship among the four diseases pertinent to the clonal evolution,prognosis,treatment and prognosis.

Objective To evaluate the effects of four agents including cyclophosphomide,thalidomide,total glucosides of peony (TGP) and simvastatin on cell-proliferation and endothlin-1 secretion of human endothelial cells (ECs).Methods EA.by926 cells were cultured until confluence WSS achieved,then incubated separately for 24 h.48 h and 72 h with various concentration of these four agents.The proliferation of ECs waft detected with 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium-bromide (MTT).The amount of endothlin-1 in supernatants of ECs was determined with enzyme linked immunosorbent assay.Results (1)Cyclophosphomide,TGP and simvastatin inhibited ECs proliferation in a dose dependent manner at 72 h (P＜0.05).(2)Cyclophosphomide (50-2000 μmol/L) and simvastatin (5-10 μmol/L) decreased endothlin-1 secretion but not in dose dependent manner. Conclusion Cyclophosphomide.TGP and simvastatin can inhibit ECs proliferation.Cyelophosphomide and simvastatin can decrease endothlin-1 secretion of human ECs.

AIM and METHODS: Chemotactic migration of peripheral blood mononuclear cell(PBMNC) of healthy blood donors(BD) and patients with blood stasis syndrome(BSS) across polycarbonate membrane(PCM) and human umbilical vein endothelial cell(HUVEC) monolayer, IL-8 produced by migrat PBMNC and effects of protocatechuic aldehyde(PCA) on the process mentioned above were investigated. RESULTS: 1) The numbers of migrating PBMNC in group BSS was higher than that in group BD(P

Objective To study and investigate the changes of serum VEGF,EGF,EPO,TPO and oxidative stress of patients with aplastic anemia.Methods A total of 54 patients with aplastic anemia were selected as observation group,and 54 healthy people were selected as control group.The serum VEGF,EGF,EPO,TPO,enzymatic antioxidant indexes and non-enzymatic antioxidant indexes of two groups were detected and compared,and the serum VEGF,EGF,EPO,TPO,enzymatic antioxidant indexes and non-enzymatic antioxidant indexes were compared in patients with different Camitta types and classifications in the observation group.The relationship between those serum indexes and patients with aplastic anemia were analyzed by the Logistic analysis.Results The serum VEGF and EGF levels of observation group were significantly lower than those of control group,while the serum EPO and TPO levels were significantly higher than those of control group,the serum enzymatic antioxidant indexes including TAC,SOD and CAT of observation group were significantly lower than those of control group,serum MDA was significantly higher than that of control group,serum non-enzymatic antioxidant indexes including MT,GSH,Zn and Se were significantly lower than those of control group,serum Cu was significantly higher than that of control group,and the serum VEGF,EGF,EPO,TPO,enzymatic antioxidant indexes and non-enzymatic antioxidant indexes of observation group with different Camitta types all had significant differences,and those serum indexes all had close relationship with the aplastic anemia (P ＜ 0.05).Conclusion The serum VEGF,EGF,EPO,TPO and oxidative stress of patients with aplastic anemia are in abnormal state,and these indexes all have close relationship with the disease.

Objective To investigate the relationship between the serum high mobility group box-1 protein (HMGB1),prostaglandin E2 (PGE2),vasculaRendothelial growth factoR(VEGF),interleukin (IL) and acute lymphoblastic leukemia.Methods A total of 68 patients with acute lymphoblastic leukemia were selected as observation group,and 68 healthy people at the same time were selected as control group.The serum HMGB1,PGE2,VEGF and IL levels of two groups were detected and compared,the serum detection results of patients with different stages and types of acute lymphoblastic leukemia were compared in the observation group,and the relationship between those serum indexes and acute lymphoblastic leukemia was analyzed by the Logistic analysis.Results The serum HMGB1,PGE2,VEGF and IL levels of observation group were significantly higheRthan those of the control group,and the serum detection results of patients with different stages and types of acute lymphoblastic leukemia had significant differences in the observation group.Logistic analysis showed that the serum HMGB1,PGE2,VEGF and IL were closely correlated with acute lymphoblastic leukemia (P<0.05).Conclusion The serum HMGB1,PGE2,VEGF and IL of patients with acute lymphoblastic leukemia are in high expression state,and there are significant differences in patients with different stages and types.

Objective To study and investigate the changes of serum VEGF,EGF,EPO,TPO and oxidative stress of patients with aplastic anemia.Methods A total of 54 patients with aplastic anemia were selected as observation group,and 54 healthy people were selected as control group.The serum VEGF,EGF,EPO,TPO,enzymatic antioxidant indexes and non-enzymatic antioxidant indexes of two groups were detected and compared,and the serum VEGF,EGF,EPO,TPO,enzymatic antioxidant indexes and non-enzymatic antioxidant indexes were compared in patients with different Camitta types and classifications in the observation group.The relationship between those serum indexes and patients with aplastic anemia were analyzed by the Logistic analysis.Results The serum VEGF and EGF levels of observation group were significantly lower than those of control group,while the serum EPO and TPO levels were significantly higher than those of control group,the serum enzymatic antioxidant indexes including TAC,SOD and CAT of observation group were significantly lower than those of control group,serum MDA was significantly higher than that of control group,serum non-enzymatic antioxidant indexes including MT,GSH,Zn and Se were significantly lower than those of control group,serum Cu was significantly higher than that of control group,and the serum VEGF,EGF,EPO,TPO,enzymatic antioxidant indexes and non-enzymatic antioxidant indexes of observation group with different Camitta types all had significant differences,and those serum indexes all had close relationship with the aplastic anemia (P ＜ 0.05).Conclusion The serum VEGF,EGF,EPO,TPO and oxidative stress of patients with aplastic anemia are in abnormal state,and these indexes all have close relationship with the disease.

Objective To investigate the relationship between the serum high mobility group box-1 protein (HMGB1),prostaglandin E2 (PGE2),vasculaRendothelial growth factoR(VEGF),interleukin (IL) and acute lymphoblastic leukemia.Methods A total of 68 patients with acute lymphoblastic leukemia were selected as observation group,and 68 healthy people at the same time were selected as control group.The serum HMGB1,PGE2,VEGF and IL levels of two groups were detected and compared,the serum detection results of patients with different stages and types of acute lymphoblastic leukemia were compared in the observation group,and the relationship between those serum indexes and acute lymphoblastic leukemia was analyzed by the Logistic analysis.Results The serum HMGB1,PGE2,VEGF and IL levels of observation group were significantly higheRthan those of the control group,and the serum detection results of patients with different stages and types of acute lymphoblastic leukemia had significant differences in the observation group.Logistic analysis showed that the serum HMGB1,PGE2,VEGF and IL were closely correlated with acute lymphoblastic leukemia (P<0.05).Conclusion The serum HMGB1,PGE2,VEGF and IL of patients with acute lymphoblastic leukemia are in high expression state,and there are significant differences in patients with different stages and types.

Objective To explore the use of biological agents in Neuro-Beh(c)et's disease (NBD).Methods We retrospectively reviewed the clinical data of five NBD patients treated with biological agents who were in-patients at Peking Union Medical College Hospital between June 2009 and June 2016.The continuous variables were analyzed by t test.Results All five cases (4 male and 1 female) were severe and/or refractory patients with parenchymal involvement (pNBD).Their age at neurological onset was (31±12) years old.Four cases presented with multiple lesions.The brainstem,spinal cord,cerebral hemisphere and cerebellum involvement were presented in 4,3,3 and 2 patients,respectively.The Rankin score at the onset of NBD was (4.0±0.7).The biological agents were administrated when corticosteroids and immunosuppressant were ineffective.Three cases received tumor necrosis factor (TNF)-α inhibitors therapy,among whom one patient had gastrointestinal ulceration.One patient with refractory retinal vasculitis received interferon-α therapy.One patient treated with tocilizumab [interleukin (IL)-6R inhibitor] had high level IL-6 in the cerebrospinal fluid.All patients achievcd clinical improvements and the Rankin score significantly decreased to (2.2±0.8) when compared with the baseline (t=4.81,P＜0.01) after the treatment with biological agents.The corticosteroid dose was tapered in all cases and the numbers of immunosuppressants were reduced in most cases,indicating a potential steroid and immunosup-pressant-sparing effect.No serious adverse events were observed during the follow-up.Conclusion Neurological involvement is a severe complication of Behqet's disease.We can take appropriate biological agents such as TNF-α inhibitors or interferon-α into consideration when patients have severe/refractory pNBD.

Objective:To explore the efficacy and safety of anti-tumor necrosis factor alpha (TNFα) monoclonal antibodies (mAbs) for severe/refractory vasculo-Behcet′s disease (BD).Method:The clinical data of severe/refractory vasculo-BD patients treated with anti-TNFα mAbs were retrospectively analyzed. Response of anti TNFα mAbs was analyzed. The dosage changes of glucocorticoid, the level of erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hsCRP) before and after treatment were recorded, as well as side effects.Result:Sixteen patients were enrolled. Arterial lesions were reported in 12 patients, including 9 with arterial aneurysm, 6 with arterial dilation, 2 with stenosis and 2 with occlusion. Seven patients presented venous thrombosis, including lower extremity veins ( n=6), cerebral venous sinus ( n=2) and inferior vena cava system ( n=2). Two cases had both arterial and venous involvement. Before the application of TNFα mAbs, all 16 patients failed to response to prednisone or its equivalent dose of 40 (7.5-90) mg/d in combination with cyclophosphamide, methotrexate, thalidomide or azathioprine for median 4 (0-156) months. After a mean duration of treatment for (17.1±6.5) months, 15 patients achieved complete remission and 1 patient achieved partial remission. Three patients received surgery without any postoperative complications. After using anti TNFα mAbs, the dosage of prednisone [5(0-12.5)mg/d vs. 40(7.5-90)mg/d, P<0.01], ESR [(7.3±4.6) mm/1h vs. (33.5±26.7) mm/1h, P<0.01] and hsCRP [1.9(0.2-11.4) mg/L vs. 24.3(0.4-113.9) mg/L, P<0.01] were significantly decreased. Side effects were observed in 2 patients. One developed pulmonary infection 12 months after adalimumab with conventional treatment. Another patient had allergy to infliximab then switched to adalimumab. Conclusion:In combination with corticosteroids and immunosuppressants, anti-TNF α mAbs are effective and well-tolerated in severe/refractory vasculo-BD, with a favorable steroid -sparing effect and rare postoperative complications.