Chimeric antigen receptor T cells (CAR-T), one of the most promising cancer immunotherapy, has attracted much attention in the 57th American Society of Hematology (ASH) annual meeting. CAR-T therapy has obtained significant effect on leukemia and lymphoma and the latest research results are also inspiring in the 57th ASH annual meeting. It is an important task that how to combine CAR-T therapy with the traditional methods of treatment and the immune checkpoint blocking antibodies and small-molecule-targeted drugs to achieve the best effect. This paper will review the progress of CAR-T in the treatment of hematologic malignancies.

With the further study on heterogeneity and molecular mechanism of diffuse large B-cell lymphoma (DLBCL),many novel targeted drugs have been developed,which also showed clinical benefit in early-stage studies.Therapeutic targets for DLBCL mainly include the surface antigens of B lymphocyte,B cell receptor signaling and the cellular microenvironment.Several new clinical trials about targeted therapy for DLBCL had been reported in the 55th ASH annual meeting,and the results were encouraging.The advances in this field will be summarized in this paper based on the new reports in the 55th ASH annual meeting.

Objective To investigate the characteristics of peripheral lymphocytic subsets and cytokines in patients with primary biliary cirrhosis( PBC) and their changes after therapy. Methods Eighty two patients with untreated PBC were divided randomly into three groups. Group U (28 patients) were treated with ursodeoxycholic acid ( UDCA) , group UP (27 patients) were treated with UDCA and prednisonlone, while group UA (27 patients) were treated with UDCA and azatharaprine. Levels of peripheral lymphocytic subsets and cytokines were monitored at 0, 3, 6 months after therapy. Twenty healthy people were included as healthy control ( HC). Results Compared with HC, the percentage of CD/ T cell (P = 0. 044) increased in PBC; the levels of IFNγ(P = 0. 001), IL-2 (P =0. 000) , IL-4 (P =0. 010) , IL-6 (P = 0. 029) , tumor necrosis factora ( TNFα ) ( P = 0. 000) , IL-1β ( P = 0. 008 ) and transforming growth factorβ(TGFβ) (P =0. 069) increased in PBC. The level of TNFa in peripheral was correlated with those of ALT (P=0.005), AST (P=0.002), total bilirubin(Tbil) (P=0.001), direct bilirubin( Dbil) (P=0. 002) , and mayo risk score(MRS) (P=0. 020). The percentage of CD_4~+T cell decreased in group U. In group U, the levels of IFNγ,IL-4,IL-6 all decreased after therapy at the third month, but rebounded thereafter. In group of UP and UA, the levels of IFN-γ, IL-4, IL-6 were suppressed below the levels of baseline after therapy.Levels of TNFa and IL-2 decreased in all three groups after therapy. Conclusions Levels of both Thl and Th2 related cytokines are abnormal in the peripheral blood of patients with PBC. The abnormal levels of Thl related cytokine indicated that PBC is a cell immunity based autoimmune disease. IFNγ,TNFα are directly related to the disease. The three treatments have different effects on the adjustment of the immune system.

Objective To evaluate the health status ,dyspnea and exercise endurance in the patients with chronic obstructive pul-monary disease(COPD) by the CAT scale ,modified medical research council(mMRC) dyspnea scale and 6-min walk test(6MWT) and to analyze the correlation between their evaluation results with the percentage (FEV1% pred) of the forced expiratory volume at 1 second(FEV1) in the predict value and whether complicating pulmonary hypertension (PH) .Methods 70 patients with COPD were performed the examinations of the lung function ,CAT scale ,mMRC score and 6MWT .The correlation among the various e-valuation systems and between each evaluation system with the severity of the pulmonary function airway limitation were compre -hensively evaluated .The CAT scores ,mMRC scores and 6 min walking distance(6MWD) were compared between the COPD com-plicating PH group and the simple COPD group .Results The CAT scale was negatively correlated with 6MWD(r= -0 .623 ,P<0 .01) and had no correlation with FEV1% pred(P=0 .159) .The CAT scale was positively correlated with mMRC (r=0 .492 ,P=0 .000) .mMRC was negatively correlated with 6MWD(r= -0 .514 ,P= 0 .000) and had no correlation with FEV1% pred(P>0 .05) .The CAT scores had statistical difference between the COPD complicating PH group and the simple COPD group (P<0 .01) .6MWD had the highest accuracy for screening COPD whether complicating PH ,followed by CAT .The diagnostic cut-off point by adopting CAT for judging the risk of COPD complicating PH was 21 .Conclusion The CAT scale has good correlation with 6MWD and no correlation with FEV1% pred .The CAT scale is more suitable for the overall assessment of the total severity of COPD .Patients with the high CAT scores have higher risk of suffering from PH .

Objective: The experiment was designed to evaluate the in vitro creation of tissue engineered heart valve leaflets. Methods: Aortic artery was harvested from 6 hybrid young pigs. The endothelial and myofibroblast cells were isolated and cultured to get enough cells for seeding. The myofibroblast and endothelial cells were seeded on the scaffolds sequentially. The cellular scaffolds were cultured 28 days and sent for scanning electron microscopy (SEM), histological and hydroxyproline examination. Results: SEM showed that a large amount of cells attached on the scaffolds. The cell had covered a large area of scaffold with a lot of matrix synthesized. The HE stain showed large amount of cells growing on the scaffolds and some cells were found in the central part of scaffolds. Gomori stain showed that there was elastin synthesized on the scaffolds. Hydroxyproline content is (10.93?2.89) ?g/g (scaffolds). Conclusion: With vascular cell, it is possible to seed them onto biodegradable scaffolds and create a viable tissue-engineered heart valve leaflets in vitro.

0.05), but significantly lower than 8.3% in Guangzhou area(P

Objective: To study the long-term effects of mitral valve replacement with bioprostheses in rheumatic heart valve disease. Methods: 166 patients with rheumatic heart valve disease underwent isolated mitral valve replacement from Jan.1978 to Dec.1985. 79 Patients were male and 87 female. Patients' age ranged from 11 to 53 years[mean (29.4?9.9) years]. The patients were classified into two groups: group 1(age

Objective The aim of this study was to describe the clinical and pathological features of primary biliary cirrhosis(PBC) and their correlation.Methods Liver biopsy specimens were obtained through percutaneous needle puncture from twenty four patients with PBC who had not been diagnosed or treated before.These samples were fixed in formaldehyde and embedded in paraffin for routine histological examination.Pathologic stages based on Ludwig criteria,fibrosis,portal and periportal inflammation,lymphocytic periportal piecemeal necrosis,ductular proliferation,intralobular hepatocyte necrosis,the degree of ductopenia and relevant laboratory results were recorded.Statistics method used was x2 or t-test,Mann-whitmey U nonperametric test and Pearson's or Spearman's correlation analysis.Results The pathological stages,degree of fibrosis were positively correlated with total bilirubin (TBIL) level,total bile acid (TBA),cholesterol (CHO),IgG levels,and were negatively correlated with serum albumin(ALB) level(r=-0.527,P=0.030; r=-0.503,P=0.039) ,percentage of eosinophilic cells (EOS) ( r=-0.554,P=0.021; r=-0.502,P=0.040).Lymphocytic periportal piecemeal necrosis was positively correlated with alkaline phosp-hatase (ALP),TBIL,DBIL,TBA,and also tumor necrosis factor-αt (TNF-αα) levels(r=0.617,P=0.006).Conclusion TBIL,DBIL,TBA,CHO,IgG and ALB,EOS are good surrogate markers for disease sever ity and reversibility of PBC,while ALP,TNF-Cα,TBIL,DBlL,TBA can be used as markers for disease activity.

Objective The aims of this study were to compare the clinical and laboratory responses to ursodeoxycholic acid (UDCA) monotherapy with the combination therapy of UDCA plus prednisolone/azathioprine in primary biliary cirrhosis(PBC),and to investigate the risk factors affecting the therapeutic responses.Methods Eighty-two patients with untreated PBC were divided randomly into three groups.Group U (28 patients) received UDCA alone,group UP(27 patients) received UDCA and pr ednisolone,while group UA (27 patients ) received UDCA and azathioprine.The clinical and laboratory data were recorded after treated for 3,6 and 12 months.Repeated measures ANOVA and COX regression model were used for statistical analysis.Results Fatigue and pruritus were improved only in group UP(P=0.015 and P=0.037 respectively).Alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),gamma-glutamyl transferase (GGT),total bilirubin (TBIL),direct bilirubin (DBIL) and IgM in the 3 groups were decreased (P＜0.05),while there was no statistical significant difference between the three groups (P＞0.05).The patients with disease progression had higher Mayo risk score (MRS) (P=0.018) and prolonged prothrombin time (PT)(P=0.042).In group UP,side-effect associated with glucocorticosteroids occurred in eight patients while there was no side-effect in group U.High baseline levels of ALP、GGT and CHO were risk factors for biochemical remission(P=0.015).The increase of DBIL,TBIL,total bile acid(TBA) and PT did not contribute to the prediction of biochemical remission ( P=0.075 ).Conclusion There are no differences among the three groups in the improvement of hepatic biochemical data and IgM.The combination therapy of UDCA with prednisolone could relieve fatigue and itching.The disease of patients with higher Mayo risk score and prolonged PT tend to progress.High baseline levels of ALP,GGT and CHO are risk factors for biochemical remission.High baseline levels of TBIL,DBIL,TBA and PT could not predict biochemical remission.The incidence of adverse effect is lowest when treated with UDCA alone.

Objective To study the characteristics of granulomatosis with polyangiitis (GPA) accompanied by pneumothorax.Methods We described a case of GPA accompanied by hydropneumothorax who was successfully treated.Relevant literature was also reviewed.Results A total of 25 cases were identified,consisting of 18 males and 7 females [the average age was (44±16)(16-70) years old].The time from disease onset to pneumothorax was 26±51 (0.83-216) weeks.Pneumothorax,hydropneumothorax,pyopneumothorax and hemopneumothorax occurred in 11,5,8 and 1 respectively.Nodules or excavated nodules on chest radiography or CT were seen in 22 cases.Erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were elevated in all cases.Sixteen cases received glucocorticoid and immunosuppressive agents treatment.Sixteen cases received drainage and 7 received open operation.Pseudomonas aeruginosa was the most commonmicrobiology findings.Granulomatosis with active vasculitis,bronchopleural fistula,pleural bleb with intensefibrosis,rupture of subpleural nodule were seen on lung biopsy or autopsy.Nine cases died of infections,respiratory failure,sepsis and respiratory arrest.Conclusion Pneumothorax in GPA can be caused by multiple factors such as rupture of subpleural nodule and with high mortality.Patients always died of infections and respiratory failure.Regular treatment of the underlying disease,apply sensitive antibiotics for infection and reasonable surgical intervention should be considered.