Chinese herbal medicine has the double attribute of treatment aiming at symptom and syndrome. The use of formula according to symptoms is the basis of determination of treatment based on differentiation of indications and formula, and the use of formula according to TCM syndrome type is the basis of determination of treatment based on differentiation of symptoms and signs. The determination of treatment based on differentiation of formula and sign is a therapy deriving from experience, but determination of treatment based on differentiation on syndrome and signs a method from theoretical medical science. Both of them are difficult to master. Therefore, it suggests that do not try to master the other unless one of them has being mastered.

To elucidate the relationship between WT1 expression and differentiation of leukemia cells and the role of WT1 gene in differentiation of leukemia cells, HL 60 and K562 cell lines were induced for 5 days by all trans retinoic acid(ATRA).Then the degree of differentiation and WT1 expression of cell lines were determined by NBT reduction assay and RT PCR respectively. The resultsshowed that only differentiation of HL 60 cells but no K562 cells could be induced by ATRA. When HL 60 cells were induced to differentiate to granulocytes by ATRA, the expression of WT1 decreased markedly during differentiation. However, WT1 transcripts were not significantly altered in K562 cells in which differentiation wasn't found. It suggested that WT1 gene expression may relate to the differentiation of leukemia cells.

Objective To find out the clinical characteristics of the group of lymphoma patients with original appearance of abdominal mass through analysis of their clinical manifestation,pathology and treatment outcome.Methods Retrospective study of clinical data of 35 cases,who were admitted to PLA General Hospital from 1998 to 2003,was made as to their age,sex,pathological pattern,size of the mass at diagnosis,and accompanying symptoms,blood examination,therapy and effect with follow-up of 16~96 months.Results Seventy-four point 3 percent of the patients were male,and most of them(71.4%)with enlarged post peritoneal lymphatic nodes.Ninety-one point four percent of the patients were non-Hodgkin lymphoma and nearly half of them aged between 40 to 50.NHL patients(65.6%)of B-cell origin were more than those of T-cell origin(28.1%).One out of three HL patients died of disease relapse.Nine NHL patients died,including 6 who received conventional chemotherapy and 3 who underwent stem cell transplantation.Half of the patients(2/4)who had hepatic dysfunction and acites died.Conclusion Lymphoma patients with original appearance of abdominal mass are mostly seen in male,and most are of B cell origin.Huge mass,acites and hepatic dysfunction indicate unfavourable prognosis.LDH and ?_2-MG may be two of the prognostic factors.

Objective To establish a rat model of hyperlipidemia and analyze the effect of conjugated linoleic acid (CLA) on lipid metabolism and expression of visfatin gene. Method High fat diet was used to establish the hyperlipidemia rat model. Blood was taken at four weeks after high fat diet feeding to analyze the level of glucose (GLU), cholesterol (CHO) and triglyeride(TG). The rats were divided into experimental group and control group after the hyperlipidemia rat model was established successfully. The experimental group rats were treated with CLA(0.8 mL /0.1 kg)orally for four weeks. The food intake and body weight were recorded. The rats were sacrificed, and both body fat and serum lipid levels were measured. Semi-quantitative RT-PCR was used to measure the expression level of visfatin mRNA. Result The hyperlipidemic rat models were induced by high fat diet successfully. The body weight, food intake and body fat in the rats of CLA experiment group were significantly decreased compared with that of the control group (P< 0.05). The level of GLU, CHO, TG and LDL in the experimental group were significantly lower than that in the control group (P< 0.05), but the serum HDL-C was increased in the experimental group. Semi-quantitative RT-PCR demonstrated that the expression level of visfatin gene of the experimental group was lower than that in the control group. Conclusion CLA can reduce the expression of visfatin gene and improve the lipid metabolism in hyperlipidemic rats.

Objective To identify the sequence of cDNA of human leptin coding region, construct a prokaryotic expression vector, and express human leptin in E.coli. Methods RNA was extracted from human placenta tissue. Leptin gene was amplified from RNA by RT-PCR method. The PCR product was ligated with T vector. The ligation reaction was transformed to E.coli DH5? competent cells. The recombinant plasmid was checked by sequencing and restriction analysis. The human leptin gene was cloned into prokaryotic expression vector PET-28a and tranformed into E.coli BL21. The recombinant strain was constructed and induced by IPTG. The product was analyzed with SDS-PAGE and Western blotting. The expressive product was purified by sodium deoxycholate. Results Analysis indicated that the sequence of human leptin cDNA was the same with the reported sequence. Leptin gene was inserted into prokaryotic expression vector. The fusion protein expressed with high efficiency in recombinant E.coli BL21.The results of SDS-PAGE analysis indicated that the molecular weight of the fusion protein was about 20kD. Conclusion Hunam leptin gene was successfully identified from placenta. The leptin gene prokaryotic expression strain was constructed and a high expression of leptin was achieved in E.coli.

Objective To determine the characteristics of treatment and diagnosis,surgical timing and surgical methods in severely head-injured patients with central herniation.Methods Twenty patients with central herniation caused by contusions and lacerations of the bilateral frontal lobes hospitalized from July 2010 to December 2012 were retrospectively reviewed.There were 11 males and 9 females,at mean age of 42 years (range,18-70 years).Injury was caused by traffic accidents in 15 patients,falls in 3 and fighting events in 2.Eight patients were treated immediately on admission and twelve patients underwent emergency operation.All the operations involved simultaneous bilateral craniectomy for decompression,including bilateral decompressive craniectomy in 6 patients and unilateral decompressive craniectomy in 14 patients.Glasgow Outcome Scale (GOS) and Montreal Cognitive Assessment were used to evaluated outcome evaluation and cognitive impairment respectively.Complications were recorded.Results All patients were followed up for 6-12 months (mean,8 months).According to GOS,good recovery was presented in 10 patients,moderate disability occurred in 6,severe disability in 2,vegetative state in 1,and death in 1.Eleven patients suffered severe mental disorders especially personality change and disturbance of intelligence,and restored after 12 months.Five patients were complicated by epilepsy and two hydrocephalus.Conclusions For central herniation in patients with severe head injury,an emergent surgery is necessary if there exist conscious disturbance and pupil aggravations,hematoma enlargement and significant displacement of midline structure.Timely bilateral balance decompressive craniectomy is effective to reduce the mortality and disability and improve quality of life.

This study was aimed to explore the possibility of reducing postoperative inflammatory response and lung injury degree by observing the effect ofTan-Re-Qing(TRQ) Injection on perioperative period of lung cancer patients complicated with chronic obstructive pulmonary disease (COPD). A total of 39 lung cancer cases complicated with COPD (phlegm-heat obstructing the lung) were randomly divided into the tested group of 18 cases and the control group of 21 cases. All patients underwent small incision surgery with video-assisted thoracoscopic surgery (VATS). The control group was treated with routine western medicine. TRQ injection was added in the tested group. On the preoperative 1D (T1), 1D after operation (T2), 3D after operation (T3), 7D after operation (T4), serum samples were collected for the determination of serum concentrations of TNF-α, IL-6, IL-8 and IL-10. At T1 and T2 time, there were no significant differences on levels of TNF-α, IL-6, IL-8 and IL-10 between two groups of patients (P > 0.05). At T3 time, levels of TNF-α, IL-6, IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The level of IL-10 in the tested group was higher than that of the control group with statistical significance (P < 0.05). At T4 time, the levels of TNF-α, IL-6 and IL-8 of the tested group were lower than that of the control group with statistical significance (P < 0.05). The levels of TNF-α, IL-6 and IL-8 of both groups gradually declined at T3 and T4 time, compared with T2 time level with statistical significant (P < 0.05). It was concluded that TRQ injection reduced the releasing of inflammatory cytokines during perioperative period, increased levels of anti-inflammatory cytokine, thereby reducing the degree of inflammatory reaction and relieving lung injury for the protection of lung function of lung cancer patients complicated with COPD.

Objective To investigate the changes to eotaxin,tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in plasma from patients with chronic urticaria treated with the combination of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) and cetirizine.Methods Totally,123 patients with chronic urticaria were enrolled into this study,and classified into two groups:the combination therapy group (n =60) treated with intramuscular BCG-PSN 2 ml every other day and oral cetirizine 10 mg once daily,and the monotherapy group (n =63) treated with oral cetirizine 10 mg once daily alone.The treatment lasted 54 days.Clinical efficacy was evaluated.Venous blood samples were collected from the patients before and after the treatment,as well as from 56 healthy controls.Enzyme-linked immunosorbent assay was performed to quantify the plasma levels of eotaxin,TNF-α and IFN-γ.Results At the end of the treatment,the total response rate was significantly higher in the combination therapy group than in the monotherapy group (88.3％ vs.63.4％,P ＜ 0.05).Before the treatment,no significant differences were observed in the plasma levels of eotaxin,TNF-α or IFN-γ between the two treatment groups,whereas the patients showed higher plasma levels of eotaxin and TNF-α but lower plasma level of IFN-γ compared with the healthy controls (all P ＜ 0.5).Both the combination therapy and monotherapy resulted in a statistical decrease in plasma eotaxin and TNF-α but an increase in plasma IFN-γ (all P ＞ 0.05),and the absolute values of changes in the three parameters were significantly higher in the combination therapy group than in the monotherapy group (eotaxin:(13.27 ± 4.11) μg/L vs.(8.12 ± 2.58) μg/L,t =8.3654,P ＜ 0.05; TNF-α:(12.38 ± 3.95) ng/L vs.(10.32 ± 3.41) ng/L,t =3.1005,P ＜ 0.05; IFN-γ:(17.06 ± 5.24) μg/L vs.(12.54 ± 4.07) μg/L,t =5.3573,P ＜ 0.05).Further more,the differences between the patients and healthy controls in the three parameters disappeared at the end of the treatment (all P ＞ 0.05).Conclusion BCG-PSN combined with cetirizine seems superior to cetirizine alone for the treatment of chronic urticaria.

Objective:To evaluate the expression of CXCR4 and the migration rate of bone marrow stromal CD34+cells in differ-ent risk groups with myelodysplastic syndromes (MDS) using correlation analysis. Methods: Forty MDS patients were divided into low-and high-risk groups based on the International Prognosis Scoring System (IPSS). The former was composed of 20 patients with IPSS<1.5, whereas the latter was composed of 20 patients with IPSS≥1.5. Bone marrow (BM) samples of these patients and 10 nor-mal controls were collected. CD34+cells were separated and purified. The expression of CXCR4 was determined by flow cytometry. The migration rate of CD34+cells on the chemotactic effect of SDF-1αand on the effect of bone marrow stromal cells were measured. Results:The expression rate of CXCR4 was higher in the high-risk MDS group than in the low-risk and control groups (P<0.000 1). No significant differences existed between the low-risk and the control groups (P>0.05). The migration rate of CD34+cells on the ef-fects of SDF-1αand marrow stromal cells were significantly increased in the high-risk MDS group compared with those in the low-risk and control groups (P<0.000 1). Migration rate of CD34+cells on the effect of marrow stromal cells was positively correlated with CX-CR4 expression (P=0.000 1). Conclusion:The CXCR4 expression and migration rates of CD34+cells on the effect of marrow stromal cells are significantly higher in the high-risk MDS group than in the low-risk group. Migration rate has a positive correlation with the CXCR4 expression, which further indicates that MDS is a heterogeneous group of hematopoietic stem cell malignancies. The expres-sion and function of SDF-1 and its receptor CXCR4 differ within each group with various risks. SDF-1 and CXCR4 may be involved in MDS pathogenesis.

Objective To observe the clinical safety and efficacy of foscarnet prophylaxis and pre-emptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Ninety-six patients undergoing allo-HSCT from October 2014 to December 2016 were retrospectively analyzed. Plasma CMV-DNA was monitored with real-time quantitative polymerase chain reaction (RQ-PCR) from beginning to 180 days after transplantation. Foscarnet was used not only for prophylaxis but also for first-line pre-emptive therapy when plasma CMV-DNA turned to positive. Foscarnet was given 60 mg·kg-1·d-1 and 120 mg·kg-1·d-1 respectively in prevention and pre-emptive therapy. Incidences of CMV infection and CMV disease were observed, influencing factors on CMV in faction and the efficacy and safety of foscarnet prophylaxis were analyzed, and survival of patients treated by all-HSCT was evaluated. Results Of the total 96 patients, 42 cases (43.8%) had CMV infection with the median time of 42 days after allo-HSCT. CMV-DNA became negative in 36 patients (85.7%, 36/42) after pre-emptive therapy. Six patients (14.3 %, 6/42) developed CMV disease, including 5 patients with CMV negative and 1 patient died for CMV pneumonia. Haploidentical donor and grade Ⅱ-Ⅳacute graft versus host disease (GVHD) were the risk factors for CMV reactivation (χ2 = 3.834, P< 0.05; χ2 = 16.807, P< 0.001). The side effects of foscarnet prophylaxis were mild without hematologic toxicities. 12 patients (28.6 %) died in 42 patients with CMV infection, and 6 patients (11.1 %) died in 54 patients without CMV infection. The difference of survival rates between both groups was not statistically significant. Conclusion Foscarnet is an effective agent for prophylaxis and pre-emptive therapy in CMV infection after allo-HSCT with mild adverse reactions, especially for patients following with hematopoietic recovering.