BACKGROUND: BuCy2 composed of large-dose oral busulfanum and cyclophosphamide has been one of the main conditioning regimens before transplantation, but oral busulfanum can result in many side effects.OBJECTIVE: To evaluate the efficacy and safety of the conditioning regimen with intravenous busulfanum (Ⅳ Bu) in hematopoietic stem cell transplantation (HSCT) for malignant hematopathy.DESIGN: Case observation.SETTING: Department of Hematology, Union Hospital,Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 13 patients with chronic myelogenous leukemia (CML) and 6 patients with acute leukemia,who received allogeneic HSCT with the conditioning therapy of modified BuCy2, were enrolled at Institute of Hematopathy, Union Hospital, Huazhong University of Science and Technology from May to December 2006. There were 12 males and 7 females aged 14-50 years with an average of 33 years, and there were 9 cases of related transplantation and 10 cases of unrelated transplantation. Hematopoietic stem cells (HSCs) were harvested from peripheral blood of 18 subjects and bone marrow of 1 subject. All patients and their family members signed the informed consent.METHODS: All patients were treated with allogeneic HSCT with the conditioning therapy of intravenous BuCy2.All patients received the modified combination of busulfanum and cyclophosphamide that was commonly utilized currently.Hydroxycarbamide 40 mg/kg was orally taken ten days before transplantation. Arabinosylcytosin (Ara-C) 2 g/m2 was injected via vein nine days before transplantation. Busulfanum ampule 0.8 mg/kg (equal to 1 mg/kg oral administration)was given by central venous cannula eight, seven and six days before transplantation. The injection was performed over 2 hours controlled by infusion pump, once every 6 hours, totally 12 times. Busulfanum was diluted by saline or 5% glucose to about 0.5 g/L (about 10 times) before Ⅳ Bu. Cyclophosphamide 1.8 g/m2 was intravenously injected every day from five and four days before transplantation. Methyl-CCNU 250 mg/m2 was taken orally three days before transplantation. Occurrence of hepatic vano-occlusive disease (HVOD) and its side effects were determined. Follow-up was performed at month 6.5 after operation to observe disease recurrence and patient survival.MAIN OUTCOME MEASURES: Occurrence and side effects of HVOD 100 days after transplantation, and results of follow-up.RESULTS: Totally 19 patients were involved in the result analysis. In 13 days after transplantation, blood conversion,chromosome karyotype and DNA polymorphism tests verified that reconstruction of hematopoietic function was obtained and two patients got recurrence, of which one patient got complete remission after receiving fludarabine plus cytarabine plus granulocyte colony-stimulating factor (G-CSF) and HSCs from peripheral blood. DNA polymorhism test verified that re-engraftment was obtained. Another patient received chemotherapy. Other patients lived well.

BACKGROUND: Chinese herbs of common yam rhizome, balsampear fruit and bagasse fiber have good effects on decreasing blood glucose and lipid, but its mechanism is unclear.OBJECTIVE: To observe the effect of compound preparation of common yam rhizome and balsampear fruit on blood glucose, lipid, blood insulin and anti-infection of rats with type 2 diabetes mellitus (DM).DESIGN: Randomized controlled animal study.SETTING: Technological Developing Center, Pharmacological Department, Experimental Animal Center, and Central Laboratory of Guangdong Medical College.MATERIALS: A total of 80 female SD rats with 4 months old and of SPF grade were selected in this study. Flumamine (Jilin Dongbeiya Pharmaceutical Co., Ltd., batch number: 040126); total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and triacylglycerol (TG) (Beijing Zhongsheng Biotechnological Co. Ltd.); Surestep Life scan blood glucose meter and test paper (Johnson Company, USA); insulin radio-immunity kit (Shanghai Navy Medical Institute); UV-3010 ultraviolet spectrophotometer (Japan Shimadzu); compound preparation of common yam rhizome and balsampear fruit (Technological Developing Center of Guangdong Medical College, batch number: 040321); suspension was extracted from common yam rhizome, balsampear fruit and dietary fiber of bagasse through water with 1 kg/L raw materials.METHODS: Animal breeding and samples collecting were carried out in the Experimental Animal Center and Technological Developing Central Laboratory of Guangdong Medical College from June 2004 to December 2005; meanwhile, detection of marker was carried out in the Pharmacological Department and Central Laboratory of Guangdong Medical College. ①Twenty rats were randomly selected as normal control group and perfused with 5 mL/kg saline every day. Other 60 rats were perfused with 5 mL/kg fat emulsion once a day for 4 weeks, and then, rats were fasted for 12hours and peritoneally injected with 2 g/L streptozotocin (30 mg/kg). Rats in normal control group were peritoneally injected with the same volume of citromalic acid buffer. Three days later, blood glucose was measured ranomly and measured again after 2 weeks. If level of blood glucose was igher than 13.5 mmol/L or urinal glucose was ＞ ++ for two weeks, the models were successful (n=48). ② According to random lot method, 48 rats were divided into three groups: model group, flumamine group and comound preparation group with 16 in each group. Rats in model group were perfused with 5 mL/kg fat emulsion; moreover, rats in flumamine groupr and compound preparation group were perfused with 5 mL/kg fat emulsion and then with 1 mg/kg flumamine and 5 mL/kg compound preparation including 1 kg/L raw drug, respectively. Rats in normal control group were perfused with 5 mL/kg saline. All rats in each group were perfused once a day for 6 weeks in total. ③ Value of blood glucose was measured at one day before the experiment finished. Twelve hours after fasting, level of plasma insulin was measured with radio-immunity method; levels of plasma total protein and albumin were measured with spectrophotography; levels of TG, TC and HDL-C were measured with the related kits. ④ Measurement data were compared with analysis of variance (ANOVA). Levene's test was firstly used to evaluate regularity of variance. Bonferroni test was used for regular variance; however, Tamhane's T2 was used.MAIN OUTCOME MEASURES: Effect of compound preparation on levels of blood glucose, insulin, lipid and plasma protein of rats with type 2 DM.RESULTS: Twelve rats were lost because of failure in modeling, and 4rats in model group and 2 in flumamine group died during the experiment,respectively. Therefore, 62 rats were involved in the final analysis. ①Measurement of fasting blood glucose and plasma insulin: Value of fasting blood glucose in normal control group was lower than that in other three groups (t=2.673-4.224, P ＜ 0.05-0.01), but level of plasma insulin was higher than that in other three groups (t=3.780-5.824, P ＜ 0.05-0.01).Fasting insulin in model group was lower than that in compound prepara tion group (t=2.825, P ＜ 0.05); fasting blood glucose was higher than that in flumamine group and compound preparation group (t=3.906, 3.056, P ＜ 0.05); * level of insulin in flumamine group was lower than that in compound preparation group (t=3.014, P ＜ 0.05); level of fasting blood glucose in flumamine group was close to that in compound preparation group (P ＞ 0.05). ② Measurement of lipid: Levels of TC and TG in normal control group were lower than those in other three groups, but level of HDL-C was higher than that in other three groups (t=2.521-4.892, P ＜ 0.05-0.01).Plasma TC in model group was higher than that in flumamine group and compound preparation group (t=2.466-2.512, P ＜ 0.05), value of TG was higher than that in compound preparation group (t=2.612, P ＜ 0.05), and level of HDL-C was lower than that in compound preparation group (t =3.688, P ＜ 0.05). Plasma TG in flumamine group was higher than that in compound preparation group (t=2.620, P ＜ 0.05). ③ Measurement of plasma protein: Levels of plasma total protein were close to each other (P ＞ 0.05). Plasma albumin in normal control group was higher than that in model group and flumamine group (t=3.773, 3.104, P ＜ 0.05), but that was close to that in compound preparation group (P ＞ 0.05). Ratio between albumin and globulin in normal oln that in other groups (t=2.830-3.056, P ＜ 0.05). Level of plasma albumin and ratio between albumin and globulin were lower in model group than those in compound preparation group (t=2.604, 3.808, P ＜ 0.05).CONCLUSION: Compound preparation can decrease levels of blood glucose and lipid, increase content of insulin, and improve anti-infection ability of rats with type 2 DM.

Objective To investigate the neural processing of stimulus salience and behavioral relevance with spatiotemporal patterns of event-related potentials (ERP).Methods The ERP was recorded from 20 subjects while they performed Eriksen task.Each stimulus picture contained 3 symbols:a central target (grey symbol ＜/ ＞ or X) represented pressing the corresponding button or withdrawing response respectively.And the flanking distractors were classified by both behavioral relevance ( ＜/ ＞-facilitory,X-inhibitory,H-irrelevant) and color salience (red,grey).Results Significant interaction effect was found for the reaction time(F(1.85,3521)=13.015,P＜0.001).Significant difference was found between the salient ((411.91 ±40.39) ms) and the non-salient ((420.42±38.58) ms) under the facilitory condition(t (19) =-4.858,P＜0.001).The significant ERP effects were revealed by statistical parametric mapping of F-value.The saliency effects appeared in the right occipital-temporal regions (100-125 ms),the bilateral dorsal attentional network (DAN) (150-300 ms) and the right-lateralized ventral attentional network (VAN) (300-450 ms).The effects of the behavioral relevance occurred in the occipital regions (150-200 ms),the VAN (200-300 ms) and the DAN (300-600 ms).The interaction effects of behavioral relevance between the target and the distractor occurred in the DAN (200-350 ms).Conclusion The information of the distractor salience and behavioral relevance access VAN and DAN in different stages respectively.The ERP effect in the DAN may be the neural correlation of contingent attentional capture.

Objective To evaluate the effect of cytokine-induced killer cells (CIKs) as an adoptive immunotherapy option for treatment of leukemia relapse after allo-hematopoietic stem cell transplantation (allo-HSCT).Methods Two cases of infusion of donor CIKs in patients with leukemia relapse after allo-HSCT were retrospectively analyzed.Patient one relapsed 986 days (+986d) after HLA-matched unrelated donor allo-HSCT.Applications of chemotherapy only resulted in short term remission,but allo-CIKs were successfully expanded from the patient's peripheral blood mononuclear cells of donor origin.Totally five cycles of CIKs infusion were infused as an alternative of adoptive immunotherapy.Patient two had recurrent in the + 158d after HLA-matched sibling alloHSCT.At + 204d and + 294d,two cycles of CIKs which were expanded from donor peripheral blood mononuclear cells were infused.Results One cycle of CIKs was given to patient one after the application of chemotherapy to reduce the tumor burden,and the patient successively achieved complete remission.Again after additional four cycles of CIKs infusion,consistent remission was maintained during the following seven months.Patient two who had relapsed disease posttransplantation,achieved cytological complete remission after withdrawal of immunosuppressants and undergoing chemotherapy combined with G-CSF mobilized stem cell infusion.However,at + 187d,the patient suffered from side-effect of acute graft versus host disease and extramedullary infiltration.The symptoms were alleviated markedly after one cycle of CIKs infusion at + 204d.Moreover,the pain disappeared after an additional infusion at + 294d.And up to the present,the bone marrow aspiration showed complete remission while the extramedullary disease vanished.Conclusion The use of CIKs in the treatment of leukemia relapse after allogeneic bone marrow transplantation can be feasible and well tolerated.

Objective To apply a complete evaluation system for clinical teaching quality and improve the objective and method of the quality control of clinical teaching procedure. Methods Clinical teachers and staff from four clinical medical colleges(Ruijin,the Sixth,the Ninth,and Tongji) were investigated.The data of their cognition about clinical teaching,weakness in teaching procedure,situation,and quantity and quality control of clinical teaching were collected and analyzed. Results The appraisal system for clinical teaching quality was established in all four clinical medical colleges.The improvement was required in evaluation of executive supervision of the present system.The quality control about clinical ability teaching was the key point to perfect the system. Conclusion It is necessary to further discuss consummation of system,establishment of evaluation method and standard so as to perfect the evaluation system of clinical teaching.We should begin with the weakest procedure,and then improve the present condition step by step.

Objective To investigate the changes in brain MRI scan in neuromyelitis optica (NMO).Methods MRI images in 27 cases with NMO were examined in a retrospective study.Results Twenty-two of 27 patients (81.5%) had abnormal brain MRI findings,which were classified as nonspecific (7 cases),atypical (1 case),multiple sclerosis-like (3 cases) and ventricle-aqueduct-syringocoele lesions (11 cases).The lust type is the most common (40.7%).Furthermore,the analysis showed that the number of brain lesions positively correlated with lag time from the onset to the last MRI scan (r=0.475,P=0.025).Conclusions Brain lesions in NMO are diverse,which might result from different pathogenesis.However,ventricle-aqueduct-syringocoele is the most common lesion.Early brain MRI examination of suspected cases is essential.

Objective To assess the value of salivary gland scintigraphy in diagnosis of Sj(o)gren's syndrome (SS).Methods A total of 44 patients with clinically suspicious SS were included.The data of salivary gland scintigraphy were retrospectively analyzed and the time-radioactivity curve (TAC) was obtained by outlining ROI in bilateral parotid glands and submaxillary glands.Uptake index (UI) and excretion fraction (EF) were defined.Both UI and EF were compared with the visual assessment and final diagnosis respectively.Results UI and EF of bilateral parotid glands and submaxillary glands in SS patients were significantly lower than those in non-SS patients (all P＜0.05).The impaired salivary gland function was classified as 0-3 grades by visual assessment.The UI of bilateral parotid glands and submaxillary glands were negatively correlated with the qualitative classification.While there were no significant correlations between EF and qualitative classification (all P＞0.05),except for that of right submaxillary gland (r=-0.312,P=0.039).The comprehensive diagnostic efficacy of UI on SS patients was higher than those of visual assessment,but their area under curves of ROC were not significantly different (all P＞0.05).Conclusion UI and EF can effectively evaluate salivary gland function and serve as objective tools to distinguish patients with SS.

AIM: To establish the hyperlipemic rat model by long-term gastric perfusion of intralipid and investigate the effects of hyperlipidemia on bone. METHODS: Eighteen SD rats were randomly divided into control group (C) and high-fat-diet group (HDF), with 9 rats per group. Rats of C group were treated orally with normal saline, and rats in HDF group were oral gavage of intralipid at dose of 5.0 mL/kg, once a day for 20 weeks. At the end of experiment, their serum levels of lipid were measured. Bone histomorphometric analysis of thighbone was performed in undecalcified sections, and the length and width of ulnar were measured. RESULTS: Compared with the C group, serum TC and low density lipoproteins (LDL) were increased (P

Objective To develop an RP-HPLC method for simultaneous determination of mangiferin, tectoridin, iridin, tectorigenin, iristectorigenin B, iristectorigenin A, irigenin, dichotomin and irisflorentin in Belamcandae Rhizoma.Methods Separation was carried out on an LeapsilTM C18 column (100 mm×2.1 mm, 3 μm) with an isocratic mobile phase consisting of acetonotrile and formic acid at a flow rate of 0.5 mL/min; The detection wavelength was set at 265 nm; the column temperature was 40℃.Results The linear ranges of mangiferin, tectoridin, iridin, tectorigenin, iristectorigenin B, iristectorigenin A, irigenin, dichotomin and irisflorentin were 0.214 0– 2.568 μg (r=0.999 5), 0.437 0–5.244 μg (r=0.999 3), 0.460 0–5.520 μg (r=0.999 9), 0.078 40–0.940 8 μg (r=0.999 6), 0.138 0–1.656 μg (r=0.999 3), 0.051 00–0.612 0 μg (r=0.997 5), 0.113 0–1.356 μg (r=0.999 9), 0.051 63–0.619 6 μg (r=0.999 8) and 0.151 0–1.812 μg (r=0.999 9), respectively. The average recoveries were 97.73%, 96.81%, 97.78%, 97.55%, 96.86%, 98.60%, 97.77%, 98.04% and 97.89%, respectively; the relative standard deviations were 0.70%, 1.1%, 2.3%, 2.1%, 1.3%, 1.4%, 2.3%, 1.6% and 1.9%, respectively. This method was used to determine the contents of nine active ingrients in 5 batches of Belamcandae Rhizoma.Conclusion The method is accurate and reliable, which can be used for the quality control of Belamcandae Rhizoma.

Objective To observe the effectiveness of Antithymocyte globulin/antilymphocyte globulin(ATG/ALG)in the treatment of nonsevere aplastie anemia(NSAA)patients who didn't respond to cyclosporine A(CsA)or relapsed and review the literature.Methods We administered ATG/ALG to 5 NSAA patients who relapsed or showed no re- sponse after CsA therapy.Results 3 patients were cured,2 patients improved,4 patients became transfusion inde- pendent in 90 days,none relapsed or progressed to clonal disease.Conclusion Those NSAA patients who relapsed or showed no response after CsA therapy should be asministered ATG/ALG,so as to reduce transfusion complications and prevent sustained immune attack to the bone marrow.