152 patients with pseudobulbar paralysis resulting from ischemic cerebral infarction were treated with polysaccharide sulphate (PSS) or Troxerutin (TR) and their clinical curative effect and laboratory parameters were studied. 76 patients (M46,F30,mean ages 62+6 y),were treated with PSS:PSS 150 mg in 5% Glocose Solution 500 mL iv. drip. qd,for 14 days as a course. The other 76 patients (M46,F30,mean age 63 + 7 y) were treated with (TR);TR 600 mg in hydroxyethyi-starch 500 mL iv. drip ,qd .for 14 days as a course. The results showed that the total effective rates of the two groups were 94. 74% and 77. 63% .respectively. Moreover the plasma levels of cholesteral and triglyceride were decreased significantly ( P

AIM: To find new methods for heavy metals pollution in traditional Chinese medicine(TCM) with macroporous chelating resins. METHODS: We emulsificated crude extracts of TCM and adjusted its pH to 7 first and the pretreated crude extracts was treated by three kinds of macroporous resins(D401,D402 and D001) respectively,then we detected the concentrations of 5 heavy metals(Cu,Pb,Cd,Hg,As) and flavonoids in the crude extracts with or without treatment. RESULTS: The concentrations of all heavy metals decreased significantly after treatment of D401 and D402.The concentrations(mg/L) of Cu,Pb,Cd changed from 0.500,0.521,0.078 to 0.117 and 0.236,0.174 and 0.165,0.024 and 0.045,respectively,and Hg and As became beyond the detection limit after the treatment,but the use of D001 affected a bit quantities of 5 heavy metals.Moreover,the concentration of flavonoids kept almost the same after treatment of such 3 resins.On the condition of room temperature,we found that a fluent velocity of 30 m/s and pH of 7 would bring the superior treatment of D401 to excessive heavy metals in TCM. CONCLUSION: Macroporous chelating resins(D401 and D402) can be employed in the treatment of excessive heavy metals in crude extracts of TCM.

Objective To study and observe the engraftment of donor cells from unrelated cord blood into adult patients with severe aplastic anemia (SAA) and the outcome of allo-CBSCT. Methods Six patients received cord blood provided by Guangzhou Cord Blood Bank, for three of which one unit of cord blood was given in a procedure, whereas for other 3 patients, 2 units of cord blood were infused at the same time in a transplant protocol. In all 9 units of umbilical cord blood (UCB) infused, UCB units contained 1.6 ～ 10.7 nucleated cells/kg body weight of the recipient after thawing. The patients were conditioned with decreased dosage of immunosuppressive agents of CTX (60?mg/kg) and ALG (120?mg/kg). The engraftment state of the donor cells into recipients was confirmed by microsatellite DNA fingerprinting and fluorescent quantitative PCR analysis. Results Engrafted evidence has been found in 5 patients by molecular biology analyses showing donor-recipient mixed chimerism post transplant which was stable and persistent. After a median follow-up of 21 months (range 7～50), 4 patients were alive and disease free. One patient died of severe infection in the 3rd month from transplant, though the evidence of engraftment was obvious. Another patient also died in the early stage posttransplant of serious aspergillus infection without the engrafted proof.Conclusion Durable donor-recipient stable mixed chimerism can be achieved by unrelated UCBT in patients with SAA. Umbilical cord blood could be employed as a source of hematopoietic stem cell for adult transplantation.

Objective To explore clinical features of graft-versus-host disease (GVHD) after allogeneic non-myeloablative stem cell transplantation (NST) for haematologic diseases.Methods Eighteen patients were divided into three groups. Group A: Six severe aplastic anemia (SAA) adult patients underwent unrelated umbilical cord blood transplantation (UCBT). Group B: Combined transplantation of G-CSF primed allogeneic bone marrow and peripheral blood stem cells (PBSCs) was performed for 5 SAA patients. Group C: Seven malignant haematologic patients underwent transplantation of bone marrow cells for 3 patients or PBSCs for 4 patients. The protocol consisted of nonmyeloablative conditioning regimens based on anti-themocyte globulin (ATG) or anti-T-lymphocyte globulin (ALG). GVHD prophylaxis consisted of cyclosprine (CSA) and methylprednisolone (MP) for groups A and B, and methotrexate and CSA for group C. Mixed chimerism (MC) patients in group C were subjected to donor lymphocyte infusion (DLI).Results Four patients in group A achieved and sustained MC status, among them, one patient died of fungal septemia and one patient left hospital voluntarily. Three patients in group B achieved short period MC with donor chimerism more than 94 % at early stage post transplantation and converted into full donor chimerism (FDC) with long-term disease-free survival (DFS) and one patient developed chronic GVHD (cGVHD) 8 month post- trasplantation . Another two patients receiving donor stem cell infusion (DSI), one died of secondary mediastina lymphoma after 6 months and one patient recovered haematopoiesis. All patients achieved MC with haematologic partial remission (PR), and did not complicated acute GVHD (aGVHD) prior to DLI. Two cases died of severe infection and lost follow-up respectively. Another 5 patients gradually converted into FDC and achieved haematologic complete remission after 4, 3, 7, 5 and 4 DLIs, but they developed cGVHD (n=4), aGVHD (n=2) and myelosurppression (n=2).Conclusion The treatment of NST for SAA patients achieved better clinical effect with lower incidence of GVHD, and characterized by lower incidence of aGVHD and early mortality and higher incidence of cGVHD and infection for malignant haematologic diseases.

Objective To evaluate the application of donor lymphocyte infusion (DLI) after nonmyeloablative stem cell transplantation (NSCT) for hematologic malignancies. Methods Donor lymphocyte infusion was performed on 5 hematologic malignant patients with mixed chimera (MC) and hemato logic partial remission of case 1, 2, 3, 4 or progression of case 5 after NSCT. The patients received the first DLI on the 4th to 5 th week posttransplant. The first T cell dose of ( 0.5 ～ 1.0 )?10 5/kg was followed by the escalated doses to the range of ( 0.5 ～ 2.0 )?10 8/kg. The total of procedures were performed at an average of 4.6 procedures (range 3～8) at intervals of 3～4 weeks. Results The MC was converted gradually into complete chimera (CC) after DLI in case 1, 2, 3 and 4 who were subjected to 7, 2, 3, 3 procedures respectively, and eventually converted into hematologic complete remission (CR), while case 5 remained MC and progression. The micro residual disease (MRD) of case 2 and 3 disappeared after DLI. Grade Ⅰ/Ⅱ acute graft versus host disease (aGVHD) in case 1, 2 and extensive/limited chronic graft versus host disease (cGVHD) in case 3 and 4 were found, and myelosuppression in case 2 and 4 was found as well. Conclusion Transient mixed donor recipient hematopoietic cell MC may be successfully converted into complete CC by DLI post transplant, and DLI can eliminate MRD. GVHD and myelosuppression remains major complications of DLI.

Background Refractive surgery has propelled itself forward to become widely performed surgical procedure nowadays.After the surgery,corneal biomechanics decreases lead to keratoconus and corneal ectasia.Doctors pay more attention to biomechanics changes after refractive surgeries.Objective This clinical study was to investigate the influence of different laser refractive surgeries on corneal biomechanics.Methods A prospective nonrandomized and controlled clinical study was designed.One hundred and sixty-four eyes of 82 patients with moderate myopia were enrolled.The patients were divided into sub-Bowman keratomileusis (SBK) group (60 eyes of 30 patients),laser in situ keratomileusis (LASIK) group (54 eyes of 27 patients) and laser subepithelial keratomileusis (LASEK) group (50 eyes of 25 patients),with the matched demography among the three groups.Corneal hysteresis (CH) and corneal resistance factor (CRF) were detected by ocular response analyzer (ORA) before and 1 week,5 months after refractive surgery.The correlations between stromal ablation depth and postoperative changing values of CH or CRF were analyzed.Results Significant differences were found in CH and CRF at different time points in the three groups (Ftime =41.90,P =0.00;Ftime =49.65,P =0.00),and the CH and CRF values were significantly lower 1 week and 5 months after surgery than those before surgery (all at P =0.00).However,no significant difference of CH or CRF was seen at all time points among the three groups (Fgroup =2.17,P =0.08;Fsroup =2.67,P =0.07).No correlation was found between corneal ablation depth and CH in 1 week and 5 months after surgery (both at R2 =0.000),however,weaker correlations were seen between corneal ablation depth and CRF 1 week and5 months after surgery (Y=3.253+ 0.010X,R2=0.007;Y=1.073+0.021 X,R2=0.004).Conclusions SBK,LASIK and LASEK lead to the change of corneal biomechanics by altering CH and CRF,they play the same influence on cornea.CRF appears to be an useful indicator in evaluating corneal biomechanical changes after laser refractive surgery.

Background Dry eye is a common disease worldwide.Cyclosporine A(CsA) is provided to be a immunosuppressive agent and is effective on dry eye.But in China,0.05％ CsA is not yet applied in dry eye treatment.Objective This study was to evaluate the efficacy and safety of 0.05％ CsA eye drops in the treatment of dry eye.Methods This was a randomized,double-blind,vehicle-controlled parallel group study.Forty eyes of 40 patients with moderate to severe dry eye were randomly divided into two groups,with the corresponding treatment of 0.05％ CsA eye drops or the vehicle emulsion.The patients in both the groups received non-preserved artificial tear.Symptoms and signs were observed before administration,(7±1),(28±2),(56±3),and (84±3) days and also 14 days after withdrawal.The clinical effective rate was considered as the primary outcome.The subjective assessment of the patients including total symptom scores and ocular surface disease index (OSDI) scores,Schirmer Ⅰ test (S Ⅰ t) with topical anaesthesia,tear film breakup time (BUT),rose Bengal and fluorescein staining scores were evaluated.The safety profile was evaluated by adverse events,visual acuity and ocular tolerance.Results At the end of this trial,the ocular symptoms scores,conjunctival hyperemia,BUT,S Ⅰ t and keratoconjunctiva staining scores of the two groups had statistically significant difference.The total effective rate of 0.05％ CsA treatment group was 75％ (15/20) and vehicle group was 25％ (5/20).There was a statistically significant difference between groups (P =0.000),and the 95％ confidence interval (C1) of the difference value of total effectiveness between the two groups was 30.80％-53.75％.At the end of this trial,there was no statistically significant difference in visual acuity distribution (P =0.890).No obvious discomfort was found in the patients received 0.05％ CsA eye drops.There were no adverse events during the follow-up duration.Conclusions 0.05％ CsA ophthalmic emulsion is an effective and safe treatment for dry eyes.

OBJECTIVE To investigate the drug resistance of Gram-negative bacteria in our hospital′s intensive care unit(ICU).It′s important to apply rationally antibiotics in clinic.METHODS We recruited all samples from infected patients of ICU during from Jan 2005 to Feb 2006.Totally 245 strains were identified to be Gram-negative bacteria.Kirby-Bauer method was performed to test extended spectrum ?-lactamases.RESULTS The first 3 of 245 strains were Pseudomonas aeruginosa(22.4%),Escherichia coli(20.8%) and Klebsiella pneumoniae(16.3%).Antibiogram analysis shew that CTX-M was the major type.CONCLUSIONS Imipenem keeps the highest sensitivity and antibacterial activity for Enterobacteriaceae and nonfermenters.Cefoperazone/sulbactam,cefepime,ceftazidime and amikacin keep the higher antibacterial activity.

AIM:Allogeneic hematopoietic stem cell transplantation for treatment of acute lymphoblastic leukemia characterized with high rate of relapse,especially in Ph+ patients.Presently,researchers focus on how to resolve relapse.Transplantation time,transplantation schedule and adoptive immunotherapy after transplantation are important.The study was performed to preliminarily observe treatment effectiveness after myeloablative stem cell transplantation,non-myeloablative transplantation after donor lymphocyte infusion and non-myeloablative transplantation followed by low-doses of Cyclosporin A.METHODS:Five patients were admitted at Department of Haematology of First People's Hospital between December 1998 and May 2007.Acute lymphoblastic leukemia patients were informed consent for allogeneic hematopoietic stem cell transplantation.The experiment was approved by hospital ethics committee.Among them,one patient was used the traditional preconditioning of busulfan and cyclophosphamide.Four cases were performed with non-myeloablative hematopoietic stem cell transplantation,and one of them was treated with reduced intensity regimen based on anti-thymocyte globulin donor lymphocyte infusion after transplantation;Three cases with fludarabine-based non-myeloablative transplantation were used low-dose Cyclosporin A after engraftment.Graft-versus-host disease prevention regimen was consisted of short-range methotrexate combined with Cyclosporin A.Haematopoiesis,chimerism,graft-versus-host disease and infection were observed after transplantation.RESULTS:All patients achieved successful engraftment.①One patient with mixed chimerism received eight donor lymphocyte infusion based on anti-thymocyte globulin-non-myeloablative transplantation and gradually converted into full donor chimerism with disease-free survival,and complicated acute graft-versus-host disease of skin and liver.②Three patients achieved full donor chimerism based on fuladarabine-non-myeloablative transplantation,one patient relapsed without graft-versus-host disease,and other two cases eliminated BCR/ABL fusion gene-positive cells with acute and chronic graft-versus-host disease.③One case after myeloablative transplantation relapsed and complicated with acute and chronic graft-versus-host disease.CONCLUSION:①The traditional,anti-thymocyte globulin or fludarabine-based non-myeloablative conditioning for transplantation in the treatment of adults with acute leukemia will be eligible for the successful implantation,and adoptive immunotherapy have graft-versus-leukemia effect.②The efficacy and complications of three transplantation strategies should be further studied.

Eight patients with severe aplastic anemia received unrelated cord blood transplantation at the Guangzhou First People’s Hospital from June 1998 to December 2007. The patients were conditioned with decreased dosage of immunosuppressive agents of cyclophosphamide and antilymphocytic globulin. The median infused donor total nucleated cell were 5.69?10 7/kg of recipient weight, and the CD34+ cell was 4.10?105/kg of recipient weight. Methotrexate and corticoid methylprednisolone were used for prophylaxis of graft versus host disease (GVHD). The time to reach an absolute neutrophil count of 0.5?109/L ranged from 7 to 25 days (median: 17 days) and the time to reach a platelet count of 20?109/L ranged from 13 to 102 days (median: 35 days) after transplantation. DNA finger print map of 7 patients showed donor and recipient chimera. Two patients developed grade I to II acute GVHD, which was controlled. One patients developed grade II chronic GVHD, which was controlled by using methylprednisolone. Five patients had lived for 10-108 months, with no diseases. Taken together, unrelated umbilical cord blood transplantation is effective for adult patients. Partial conditioning regiment could ensure engraft of unrelated umbilical cord blood transplantation.