Tunneling nanotubes(TNT) are cellular communication and transport mechanism discovered recently. TNTs play important role in immunological response and viral spread, also may involve embryonic development, regulation of gene expression and carcinogenesis. However, it was not easy to study TNT for clinical samples since intricate assay method for TNT. We suggested using histochemical assay PAS staining in cell drip to show TNT in leukemia and lymphoma samples.

Objective To clinically validate the precision of diagnostic Sepsis-3 criteria, and to guide and generalize its clinical application.Methods A multicenter retrospective observational study was conducted. The patients admitted to intensive care unit (ICU) of 6 tertiary hospitals in Zhejiang Province from January to June 2015 were enrolled, and the patients satisfying the diagnostic criteria of Sepsis-2 and Sepsis-3 were screened. Population characteristics between the patients satisfying two editions were compared, and the diagnosis accuracy rate in different degree hospitals were investigated. According to the doctor's diagnosis, the patients who met the criteria of Sepsis-2 were divided into diagnosis group and non-diagnosis group, and the factors influencing the diagnosis of sepsis were analyzed by logistic regression. The patients meeting Sepsis-2 but no meeting Sepsis-3 were served as exclusion group, and those meeting Sepsis-2 and Sepsis-3 were served as enroll group, and the characteristics of patients between the two groups were compared. Receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of systemic inflammatory response syndrome (SIRS) score, sepsis-related quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA) on death, and whether the consistency of qSOFA and SOFA would affect the sensitivity of definition. The patients meeting Sepsis-2 were divided into non-survived group and survived group, and the factors associated with death were analyzed by logistic regression.Results Finally, 1423 patients were enrolled, 3 patients with age < 18 years and 19 patients with missing data were excluded. There were 363 patients and 329 patients met Sepsis-2 and Sepsis-3, respectively. No significant differences were found in populationcharacteristics between the groups of Sepsis-2 and Sepsis-3 (allP > 0.05) except for acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score [19.10 (8.00) vs. 20.28 (8.00),P < 0.05]. It was shown on the clinical data analysis of the hospitals that the patients meeting Sepsis-2 and Sepsis-3 in hospital 3 had the highest 28-day mortality (60.4% and 60.0%) with the lowest rate of diagnosis (0). While in the hospital 1, the patients had the lowest 28-day mortality (22.9% and 27.2%), and the rate of diagnosis was 19.5%. Interestingly, the patients in hospital 4 had the highest diagnosis rate of sepsis (44.8%), but 28-day mortality was both 58.6%. It was shown by logistic regression analysis that the patients with old age [odds ratio (OR) = 0.970,P = 0.021], high blood lactate (OR= 0.443,P = 0.004), high blood pressure (OR = 0.957,P = 0.009) and low oxygenation index (OR = 1.004,P = 0.024) were easy to neglect diagnosis. Compared with Sepsis-3 exclude group, the patients in Sepsis-3 enroll group were older [years: 68.52 (26.00) vs. 53.75 (18.00),P < 0.01] with higher APACHEⅡ score [20.38 (8.00) vs. 7.72 (6.00),P < 0.01], higher blood lactate [mmol/L: 3.45 (3.00) vs. 1.95 (1.20), P > 0.05], longer length of ICU stay [days: 22.42 (22.00) vs. 15.13 (16.00),P < 0.01], and higher 28-day mortality [45.29% (149/329) vs. 14.71% (5/34),P < 0.01], indicating that the diagnostic efficiency of Sepsis-2 was low, the diagnostic specificity of Sepsis-3 was high, and the prognosis of Sepsis-3 patients was worse. It was shown by ROC curve analysis that the prognostic value of SIRS, qSOFA and SOFA to mortality was gradually increased [area under ROC curve (AUC) was 0.567, 0.597, 0.683, respectively], but the prognostic value were all low. Comparing patients meeting qSOFA and (or) SOFA in Sepsis-2, significant differences were found in APACHE Ⅱ score [17.55 (7.00) vs. 23.24 (8.00)] and 28-day mortality [38.75% (31/80) vs. 58.59% (75/128), bothP < 0.01]. The patients who just met the qSOFA or SOFA, their 28-day mortality was up to 38.75%, suggesting that qSOFA should not be ignored. Compared with survived group, the patients in survived group were older with higher APACHE Ⅱ score and shorter length of ICU stay (allP < 0.05). It was shown by logistic regression analysis that APACHE Ⅱ score (OR = 1.199,P = 0.000) and length of ICU stay (OR = 0.949,P = 0.000) were related with death.Conclusion Patients satisfied Sepsis-3 were easier to develop more organ failure, Sepsis-3 and higher death prediction than Sepsis-2 and higher diagnosis specificity, but data shows that there is extra room for improvement.

Objective To study the relationship between the expression of ICAM-1,HLA-DR in the renal allograft of chronic rejection. Methods The expression of ICAM-1 and HLA-DR was assessed in 20 cadaveric renal allografts with chronic rejection using immunohistological techniqu(ABC method). Results In the renal allograft with chronic rejection,the expression of ICAM-1 was increased on the tubular epithelial cells and interstitial microvascullar endothelium,whereas the expression of HLA-DR was up-regulated,especially on the distal tubules. In addition, the expression of ICAM-1 and HLA-DR was associated with lymphcytes infiltration in the local perivascullar and intertubular structure. Conclusions It is suggested that the increased ICAM-1 and HLA-DR expressions might mediate allograft injury and have a role in the augmentation of the response,either in its induction,especially in the interstitial lymphocytes infiltration and antigen presenting or as a target for the effector arm of the reaction.

Objective To study the role of anti-HLA-IgG antibodies levels in serum before renal transplantation.Methods Anti-HLA-IgG antibodies levels were detected by means of ELISA-LATM in 184 patients before renal transplantation from Jan. 1999 to Dec 2002. Acute rejection occurrence was compared between anti-HLA-IgG class-Ⅰantibody positive group and anti-HLA-IgG class-Ⅱantibody positive group, and between both class-Ⅰand class-Ⅱantibody positive groups and anti-HLA-IgG antibody negative group, respectively. Results In the 155, 7, 9 and 13 cases respectively negative for Anti-HLA-IgG antibodies, positive for anti-HLA-IgG class-Ⅰantibodies, anti-HLA-IgG class-Ⅱantibodies and both class-Ⅰand class-Ⅱantibodies, there were 18, 2, 4, 8 cases of acute rejection with the occurrence rate being 11.6?% , 28.57?% , 44.44?% , 61.53?% , respectively ( P

As novel organisms,tumors undergo microevolution in limited time and space in vivo.Due to genetic mutations and epigenetic mechanisms,tumor cell clones undergo linear or branching evolution.In most clinic patients,tumors develop through branching evolution pathways,causing tumor heterogeneity and affecting tumor progression.Microevolution is the biological basis for the refractoriness and recurrence of tumors and has been paid attention in research and clinic recently.In this paper,acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are used as examples to demonstrate tumor microevolution and the concept of linear and branching evolution.Questions and perspective in the field of tumor microevolution research are also discussed.

Cell death as the partner of cell proliferation is one of the basic mechanism in cell biology. Recently, it became obscure since more and more patterns of cell death were reported. However, the classification of cell death, which was recommended by the Nomenclature Committee on Cell Death (NCCD) in 2009, clarified the criteria. The theme of the recommendation and recent data from the literature were discussed in this review. The significance of studies on cell death was discussed.

After near a century of research,the diverse and complicated relationship between viruses and tumors has been elucidated gradually.Last century it was demonstrated that some retroviruses and some herpes viruses could induce lymphoma and leukemia in some animals.However,it is more complicated in human.During the last two decades it has been confirmed that several types of hepatitis viruses could cause hepatocellular carcinoma and the relationship between human papillomaviruses and cervix carcinoma has been established.These viral vaccines became useful tools to prevent prevalence of these carcinomas.Because of the successful inoculation of live attenuated viral vaccines all around the world in recent 15 years,oncolytic virotherapy is revived,and provides a novel strategy for treatment of refractory tumors.

Human herpesvirus 6 (HHV-6) is recognized as a ubiquitous dsDNA virus in human with widespread cell tropism in vivo, which could induce lifelong latent infection and be reactivated in some immunocompromised individuals leading to serious diseases. With the increasing application of hematopoietic stem cell transplantation (HSCT), it is obvious that HHV-6 reactivation has a close relationship with several complications including encephalitis after transplantation. On the other hand, among about 1 % infected people, HHV-6 and subtelomeric region of cell chromosomes in the state of endogenous persistent infection play a part in activated virus infection. As the detection methods make a great progress in HHV-6 detection, clinical data reveals the relationship between HHV-6 reactivation and lots of chronic diseases, especially lymphoma, leukemia as well as some chronic hematopoietic and immunological diseases.

Dormant follicular lymphoma, prostate carcinoma and breast carcinoma are frequently detected by autopsy of non-tumor patients. Dormancy of malignant cells in hematopoietic malignancies is associated with genesis, development and treatment of these diseases. Dormancy is the universally applied strategy by living organism during survival competition. As the in vivo neoplasm, tumor cells keep this property. Recently, much attention has been paid to the mechanisms of tumor dormancy. These studies not only have theoretical significance, provide new ways for the prevention and treatment of tumors, but also help the understanding of over-diagnosis, over-treatment and provide clues for precise medicine. This paper reviewed cellular mechanism of tumor cell dormancy,immunological and vascular regulation of dormant tumors. The clinical significance,application of these mechanisms and direction of further study, which will provide new clues for the treatment of hematopoietic malignancies, were also discussed.

Human herpesviruses (HHV) are widespread all over the world,and persist in human in latent infection.When reactivated,HHV plays an important role in the pathogenesis and development of tumor and other diseases.Much attention has been paid on EB virus which can cause different tumors and other diseases.Studies within this half century have elucidated the mechanism of oncogenesis of γ-HHV.Recently it was reported that other HHV may have oncomodulation functions.