To systematically evaluate the importance of protein synthesis in ischemic preconditioning (PC)-induced ischemic tolerance (IT), temporary middle cerebral artery occlusion (MCAO) by Longa (20 min) was used for PC (ischemic precondioning). Twenty-four hours of reperfusion was allowed after PC and before permanent MCAO to establish ischemic tolerance (IT) to compare with non-PC (sham-operated) rats (n = 5 for each group). Infarct size and neurological deficits were measured 24 h after PMCAO. Samples of brain were taken for the determination of HSP70 expression by Western blot analysis. The effects of the protein synthesis inhibitor cycloheximide administered just before PC or administered long after PC but just before PMCAO on IT were also determined (n = 5 for each group). Our results showed that hemispheric infarct was significantly reduced (P < 0.01) only if PC was performed after 24 h, and PC significantly (P < 0.05) reduced neurological deficits (similar to reductions in infarct size). Cycloheximide eliminated ischemic PC-induced IT effects on bothbrain injury and neurological deficits if administered before PC but not if administered long after PC but before PMCAO. PC produced no brain injury but did increase HSP70 protein 24 h after PC. Cycloheximide eliminated that effect. The results suggest that PC is a powerful inducer of ischemic brain tolerance as reflected by the preservation of brain tissue and motor function. PC induces IT that is dependent on de novo protein synthesis.

ObjectiveTo investigate the correlation between the chromosomal abnormalities and prognosis of the myelodysplastic syndrome(MDS)patients, and analyze the effects of treatment. Methods Karyotype analysis of 122 patients according to the international human cytogenetics(ISCN) criteria.Treatment of RA and RAS were mainly dependent on agents to induce differentiation of hematopoietic cells and drugs based.RAEB,RAEB-t,CMML treatment were dependent on low-dose chemotherapy and low-dose combination chemotherapy regimens.The treatments of 64 MDS patients with abnormal karyotype were analyzed and compared with control group, and 58 normal karyotype MDS patients were hospitalized in the same period.ResultsAfter treatments,17 cases gained complete remission among 64 patients with abnormal karyotype MDS patients.The CR rate was 26.6 ％.While in control group,30 gained CR in 58 MDS patients with normal karyotype. The CR rate was 51.7 ％. Comparing with the CR patients of normal karyotype, the number of patients with abnormal karyotype of CR was significantly lower (x 2 =8.1 3,P ＜ 0.05).Conclusion Karyotype analysis shows important significance in the diagnosis and prognosis of MDS.Karyotype transformation demonstrates differently in the risk of leukemia progress.

Objective To investigate the long-term efficacy of autologous stem cell transplantation for systemic lupus erythematosus (SLE). Methods Long-term follow up of 48 SLE patients with autologous stem cell transplantation were studied. All patients were followed up for 10 years. Among the patients, 24 cases were treated with purified CD34+ cells transplantation and 24 cases were treated with non-CD34+ cell transplantation. Comparison between groups was performed by x2 test. Results Among 5 dead patients, 4 died of transplantation related complications including 3 cases treated with CD34+ transplantion. The survival rate of those patients with more than 10 years duration of lupus was 90%(43/48). Among 43 patients, 7 had disease flare, 6 were treated with non-CD34+ cell transplantation. Eight patients went to college, 26 returned to normal life and 4 of them had children. Conclusion The long-term effect of SLE treated with autologous hematopoietic stem cell transplantation and anti-thymocyte globulin (ATG) is good. The recurrence of CD34+ transplant patients is lower than those treated with non-CD34+ transplantation. The quality of life in SLE patients treated with transplantation is better than those treated with conventional therapy.

BACKGROUND: Infusion of hemopoietic stem cell from donors can promote the chimeric formation and induce specific immunologic tolerance in the allograft recipients. However, the pretreatment for cell transplantation has great toxicity to recipients. So immunosuppressant combined bone marrow infusion is introduced to anti graft versus host reaction. OBJECTIVE: Based on microchimerism, to study the security and associativity of chimera formation induced by kidney-bone marrow transplantation and immunologic tolerance.DESIGN, TIME AND SETTING: The contrast observation was performed at the department of urinary surgery, The Third People's Hospital of Zhengzhou City from January 1998 to December 2005.PARTICIPANTS: According to ABO/Rh blood type and HLA matching, 96 female patients with chronic renal failure and waiting for kidney transplantation were divided into 2 groups, In the combination group, patients received kidney combined bone marrow transplantation; the other uremia patients received the other kidney of cadavers were served as control group. The donors were 48 healthy males. METHODS: Bone marrow of donors was collected simultaneously with kidney obtain and preserved with cryoprotectant at -198 ℃ in nitrogen canister. After kidney transplantation, large dose of anti-human lymphocyte immune globulin were used for 2 weeks, then (0.9-2.5)×10~8/kg mononuclearcell was reinfused. PCR-SRY was used to identify donor derived cell-chimerism. Lymphocyte subgroup of recipients was determined by blood test; and interleukin 10 was measured by enzyme linked immunosorbent assay; in addition, the mass concentration of tumor necrosis factor α and tumor necrosis factor β was detected. MAIN OUTCOME MEASURES: Chimerism, lymphocyte subsets and cytokines were detected at various time points following transplantation. Simultaneously, the transplantation results and complication status of recipients were observed. RESULTS: The positive rate of chimera in the combination group was greater than that of the control group (P < 0.05). The 3-year follow-up showed that incidence differences of acute rejection between recipients with positive chimera and recipients with negative chimera had significance (13%, 35%, P < 0.05). There was no graft versus host disease occurred in the combination group. CONCLUSION: Kidney-bone marrow transplantation can augment chimerism in early postoperative period, and significantly reduce the rate of acute rejection, which is safe and beneficia1to induce specific immunologic tolerance in the renal allograft recipients.

Objective To explore the feasibility of employing a risk category system in evaluating the treatment outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated by intensitymodulated radiation therapy (IMRT) alone,and offering evidence for relevant perspective studies.Methods Totally 185 locoregionally advanced NPC patients were divided into high-risk and low-risk groups for evaluation and comparison.The patients who met at least one of the following criteria were defined as high-risk group and others as low-risk group:GTVnx ＞ 30 cm3;Clinical stage T4N2M0;multiple neck node metastases with 1 node size ＞4 cm,and N3 with any T stage.Results With a median follow up of 110.9 months (6.7-152.4 months),the 5-year overall survival,locoregional relapse-free survival,distant metastasis-free survival for the high-risk group vs.the low-risk group were 61.0％ vs.90.5％ (x2 =30.298,P＜0.05),78.3％ vs.91.5％ (x2 =6.352,P＜0.05)and 71.6％ vs.92.0％ (x2 =16.346,P ＜0.05).Conclusions As a simple and practicable method,the risk category system is helpful for discriminating locoregionally advanced nasopharyngeal carcinoma with different risk-group of treatment failure and in further perspective clinical research.

Objective:To detect the inhibitory effects of CAL-101, a selective inhibitor of phosphoinostitide-3'-kinase delta (PI3Kδ), on Burkitt's lymphoma cell line Raji and diffused large B-cell lymphoma cell line SUDHL-10 and elucidate its relative mechanism. Methods:Raji and SUDHL-10 cells were treated with various concentrations of CAL-101. Methyl thiazolyl tetrazolium (MTT) assay was performed to determine the inhibitory effect of CAL-101 on lymphoma cells, and cell apoptosis was measured by Annexin V/PI and DAPI staining. Migration assays were performed with transwell to detect the migration of lymphoma cells derived from the stromal cell line HK. Western blot was used to detect the phosphorylation status of the ERK pathway. MTT and CalcuSyn software analyses were preformed to detect whether or not combining CAL-101 with bortezomib induces synergistic cytoxicity. Results:CAL-101 at con-centrations of 5, 10, 15, and 20μmol/L inhibited cell proliferation in a dose-dependent manner. The proliferation rates of the Raji cells treated with 5, 10, 15, and 20μmol/L for 48 h were 29.17%± 1.23%, 38.15%± 1.51%, 46.46%± 1.78%, and 55.8%± 2.01%, respec-tively, which were significantly higher (P<0.05) than that of the control group (1.15% ± 0.02%). Similar results were found in the SUDHL-10 cells after treatment with CAL-101 (P<0.05). CAL-101 also exerted an apoptotic effect on the lymphoma cells. The apop-totic rates of the Raji cells treated with CAL-101 for 21 h were 22.69%± 3.83%and 49.96%± 7.36%, respectively, which were signifi-cantly higher (P<0.05) than that of the control group (5.23%± 2.04%). Similar results were found in the SUDHL-10 cells (P<0.05). Treatment with 5 and 10 μmol/L CAL-101 dose-dependently inhibited the migration activity of lymphoma cells to stromal cells (P<0.05). Western blot analysis showed that the expression level of ERK phosphorylation protein was significantly downregulated in the cells treated with CAL-101. A synergistic effect between CAL-101 and bortezomib was verified. That is, these two drugs can signifi-cantly inhibit the proliferation of lymphoma cells with CI values less than 1. Conclusion:The PI3Kδ-specific inhibitor CAL-101 sup-pressed the proliferation of Raji and SUDHL-10 cells, induced apoptosis, and inhibited stromal cell-derived migration. This inhibitory effect may be induced by blocking the ERK pathway. Overall, our study indicated that CAL-101 is a novel and potential agent in the therapeutic strategy against aggressive B-cell lymphoma.

Objective To evaluate the short and long term efficacy of self-expandable metallic stent implantation through bronchoscope in the management of the patients with malignant airway stenosis.Methods Seventy-four hospitalized patients with malignant airway stenosis during a 10-year period were selected as our subjects from Dec.2002 to Nov.2012 in the Respiratory Department of the Central Hospital of Wuhan.All these patients underwent bronchoscope for nitinol self-expandable metallic stent implantation.Clinical improvement,6min walking distance (6MWT),mMRC index,arterial blood gas,as well as early and late postoperative complications were investigated.Results A total of 77 stents were implanted,including 34 covered metallic stents and 43 uncovered metallic stents.All patients showed the obvious relief of dyspnea after the operation.6MWT at pre-operation was (172 ± 45)m and (288 ± 36)m at 28 week post-operation.Arterial blood gas was (61.34 ±6.44)mmHg at pre-opemtion and (72.12 ±6.87) mmHg at 28 week post-operation.mMRC was 3.56 ± 0.44 at pre-operation and 1.96 ± 0.37 at 28 week post-operation.All these differences were significant(P ＜ 0.01).The operation succeeded in releasing bucking of patients with esophago-tracheal fistula.Symptoms such as fever,cough,pharyngodynia,foreign body sensation and hemoptysis were observed,and all the above side effect could be solved while no serious complications arose.Conclusion Bronchoscopic insertion of metallic airway stents for malignant airway stenosis is a safe and effective procedure that could obviously relieve respiratory distress and improve the quality of life.

Objective To evaluate the effect of intensity-modulated radiation therapy(IMRT) on parotid function in nasopharyngeal carcinoma(NPC). Methods Eighty-three NPC patients received prima-ry IMRT between 2001 and 2003. Xerostomia before radiotherapy, at the end of radiotherapy, at 6-month, 1-,2-,3-,4- and 5-year after radiotherapy were investigated, respectively. The relation between xerostomia and parotid dose distribution was analyzed. Results Of all the patients,4,31,31 and 17 had stage Ⅰ,Ⅱ,Ⅲ and ⅣA disease, respectively. Sixteen patients received chemo-radiotherapy. The median followed-up time was 65 months. The 5-year local control and regional control rate were 96% and 95% ,respectively. The 5-year overall survival rate was 80%. The mild xerostomia rate at the seven time points was 42%, 51%, 71%, 77%, 58%, 38% and 26%. The corresponding moderate xerostomia rate was 52%, 53%, 21%,8%, 3%, 2% and 2%, respectively. No serious xerostomia was observed. The mean dose of the bilateral parotid glands was 34.34 Gy. Xerostomia at 6-month after radiotherapy was positively correlated with the mean dose of the parotid glands, and D50 was the independent factor in predicting the xerostomia. Parotid function was well protected when the mean dose and D50 were no more than 33 Gy and 29 Gy,respectively. Conclusions IMRT can improve the local-regional control of NPC and protect the parotid glands from radiation-induced in-jury.

Objective To observe the physique and anatomy changes in patients with nasopharyngeal carcinoma (NPC) during intensity-modulated radiotherapy (IMRT), using repeated CT images and deformable registration technique, and analyze their impact on delivery dose distribution.Methods Ten NPC patients were randomly selected from those who had received IMRT treatment.Gross tumor volume of nasopharyn (GTVnx), GTV of metastastatic lymph node (GTVnd), clinical target volume (CTV) and normal tissue or organ (OAR) were re-contoured on the in-course repeated CT images using a kind of deformable registration and auto-segmentation software according to the original planning contouring.Changes in volume of treatment targets and organs at risk were evaluated and the trends were then analyzed.Dose distributions were recalculated with repeated CT images and compared to the original plans.Results The volume of GTVnx were decreased by 6.44%,10.23% and9.72%(F=1.34,P=0.278) in the 2-,4-and 6-week after IM RT comparing with before IM RT, with 6.59%, 30.98 % and 35.13 % (F = 9.22, P =0.000) in GTVnd, 0.73%, 1.86% and 1.41% (F=0.33,P=0.722) in CTV1, -1.78%, -6.47%and -9.34% (F =16.89 ,P =0.000) in CTV2, 13.96%, 32.97% and 37.77%(F=17.17,P=0.000)in the left parotid , and 3.56% , 29.57% and 35.63% (F = 13.49 , P = 0.000) in the right parotid.The mean dose change rate of GTVnx were -0.39%, 0.08% and 0.32% (F =0.15 ,P =0.860) in the 2-,4- and 6-week after IMRT comparing with planning faction dose, with 0.53%, 1.19% and 0.69% (F=0.81,P=0.455) in GTVnd, 1.95%, 2.70% and 3.78% (F=0.61,P=0.552) in the spinal cord,0.32%, 0.81% and 0.62% (F=0.03,P=0.975) in the brain stem, 4.50%, 4.66% and 7.20% (F=0.33,P=0.725) in the left parotid, 2.20%, 7.17% and 7.12% (F= 1.24,P=0.306) in the right parotid.Conclusions The GTVnd, CTV2 and parotids shrinks obviously along with the treatment times for NPC patients during IMRT.Although changes in fraction dose of GTV, CTV, spinal cord, stem and parotids are not significant, further study with larger samples is needed.

Objective To evaluate the detection rate and the efficiency of the modified crushing-cercariae escaping method.Methods The detection rates of the modified crushing-cercariae escaping method and the crushing methods were compared by using a double-blind control experiment with the latter as a gold standard.meanwhile the number of the cercariae was quantified.The efficiency of the two methods aforementioned and the cereariae escaping method were compared in field.Results The detection rate of the modified crushing-cercariae escaping method was 100%.the average number of cercariae in each infected snail was (4 778±1 157);and the number in certain volume of water sample was positively correlated with the number of infected snails.The efficiency of the modified menthed Was 18.2 times and 17.3 times as high as those of the crushing method and cereariae escaping method,respectively.Conclusions The modified crushing-cercariae escaping method Can detect the infected snails quicky and Can quantify the number of infected snails and cercariae,and is suitable for the detection of infected snails in large number.