Objective To explore the clinical significance of the serum Epstein-Barr virus determined nuclear antigen 1 (EBNA1)/latent membrane protein 1 (LMP1) in patients with extranodal NK/T-cell lymphoma,nasal type (ENKL).Methods The serum EBNA1 and LMP1 were detected by realtime PCR in 36 ENKL patients hospitalized in Beijing Tongren Hospital from August 2010 to August 2013.Twenty healthy volunteers were recruited as controls.Results The median serum EBNA1 was 1.9 × 104 (ranged from 0 to 11.0 × 104) copies/μl in ENKL patients and 8.0 (ranged from 0 to 43.8) copies/μl in healthy volunteers.The median serum LMP1 was 3.9 × 103 (ranged from 118.3 to 24.0 × 103) copies/μl in ENKL patients and 3.3 (ranged from 0 to 33.3) copies/μl in healthy volunteers.Both EBNA1 and LMP1 were higher in ENKL patients than healthy volunteers (all P ＜ 0.01).The median EBNA1 and LMP1 in ENKL patients posttreatment were 1.0 × 103 (ranged from 0 to 2.0 × 103) copies/μl and 300.8(ranged from 0 to 825.7) copies/μl respectively,which were both significantly decreased than pretreatment (all P ＜ 0.05).The EBNA1 and LMP1 were decreased in effective treatment group versus ineffective treatment group (P ＜0.05).The serum EBNA1 and LMP1 were positively correlated with lactic dehydrogenase (LDH) level (r =0.364,0.546 ; P =0.040,0.012).Conclusions (1) The measurement of EBNA1/LMP1 may be useful in evaluating the therapeutic effect.(2)The serum EBNA1/LMP1 may reflect the tumor load in ENKL patients.

The expression of CD107a,NKG2D on the surface of natural killer (NK) cells and serum soluble major histocompatibility complex class Ⅰ chain-related A (sMICA) level in patients with extranodal NK/T cell lymphoma,nasal type (ENKL) were detected.We found that CD107a expression was reduced on the surface of NK cells,suggesting impaired NK cell activity in ENKL patients,which may result from decreased NKG2D expression.

Objective To study the effect of Qi - Xiong mixture on neurotransmitter in AD rats. Methods Assessments were carried out with diving platform and light - electricity contrasting color. Results As compared with model group,the prevented and treated rats showed longer period of time in getting electric shock ( P

Objective To investigate the synergetic effect of combined astaxanthin ( AST) and lith-ium chloride ( LiCl) treatment on cognitive dysfunction of chronic omethoate poisoned mice. Methods 8 mice were selected randomly as control group from 55 healthy adult male Kunming mice,and the rest were used to establish chronic organophosphate poisoning cognitive impairment models by injecting omethoate 5 mg/kg subcutaneously every day for 4 weeks. Totally 40 successfully established models were randomly divid-ed into model group,AST group,edaravone group,LiCl group and AST+LiCl group with 8 in each. Morris wa-ter maze test was used to examine the learning and memory ability of mice. Contents of reactive oxygen spe-cies (ROS) in hippocampus were measured by enzyme-linked immunosorbent assay (ELISA). Activity of superoxide dismutase ( SOD) in hippocampus was measured by colorimetric assay. Morphology of hippocam-pus area was observed by HE staining. The distribution and expression of p-PI3K,p-Akt,p-GSK3β and p-CREB were determined by immunohistochemical staining ( IHC staining) and Western blot. Results The average escape latency of 5 days in each group was statistically significant (F=1662.147, P<0.05) . The av-erage escape latency of 5 days in AST+LiCl group was significantly lower than that in model group ( all P<0.05) and was lower than other treatment groups. Compared with the control group (0.087±0.007,0.084± 0.009,0.097±0.002,0.076±0.012),the hippocampal neuronal injury in model group was serious,the expres-sions of p-PI3K (0.032±0.008),p-Akt (0.03±0.006),p-GSK3β (0.028±0.007) and p-CREB (0.020± 0.008) was significantly lower ( all P<0.05) . The injuries of hippocampal neurons in AST+LiCl group were slightly lighter than that in model group,and the expression of p-PI3K (0.067±0.008),p-Akt (0.065± 0.005),p-GSK3β (0.068±0.009) and p-CREB (0.062±0.008) in hippocampus was significantly higher than that in model group ( all P<0.05) . Conclusion Combined AST and LiCL treatment exerts neuroprotec-tive effect on cognitive dysfunction induced by chronic organophosphate poisoning via up-regulating the ex-pression of Akt/GSK3β/CREB.

Objective: To explore clinical significance by detecting the expression of HLA-DR antigen in peripheral blood T lymphocyte subsets of patients with cirrhosis after splenectomy. Methods: Twenty eight patients with cirrhosis received splenectomy were enrolled in the study, meanwhile, thirty eight patients with cirrhosis without splenectomy and twenty-two health donors were followed-up as the controls. The expressions of HLA-DR antigen in peripheral blood T lymphocyte subsets were detected by flow cytometry. Results: The levels of CD3+, CD4+ and CD8+ were(41.59?6.79)% ,(22.64?6.87)% and(19.16?7.28)% respectively in peripheral blood of patients with splenectomy, which were significantly lower than that of the controls. The ratio of CD4+/CD8+ was higher than that of the health control. The expressions of HLA-DR on CD3+, CD4+ and CD8+ were (25.42?5.51)% , (22.36?4.90)% and (28.53?8.35)% respectively in peripheral blood of patients with splenectomy. The expression of HLA-DR on CD4+ and CD8+ in patients with splenectomy was significantly higher than that of patients without splenectomy. Conclusion: There is cellular immune deficiency in patients with splenectomy. The expression of CD3+, CD4+ and CD8+ decrease significantly, and the levels of activated antigen HLA-DR on T cell subsets are low.

Objective To explore the expression of frizzled-7 and β-catenin proteins in hepatocellular carcinoma (HCC),and determine their relationship with clinicopathological features and prognosis.Methods Expression levels of frizzled-7 and β-catenin proteins were detected by the SP immunohistochemical technique in 64 cases of HCC and 15 normal liver tissues.Results Frizzled-7 and β-catenin proteins were found in 42 (65.6％) and 45 (70.3％) of tumor specimens respectively,which was significantly higher than that in normal liver tissues.The expression of frizzled-7 protein was significantly positively correlated with that of β-catenin (P ＜ 0.05) in HCC.The high expression of frizzled-7 was closely correlated to tumor size (P =0.014),histologic grade (P =0.020),portal vein tumor thrombus (P =0.034),tumor recurrence (2 years,P =0.030),TNM stage (P =0.022),and HBsAg (P =0.025),and negatively correlated with 5-year postoperative survival (47.6％ vs.13.2％).The expression of β-catenin protein was significantly associated with histologic grade (P =0.012),tumor recurrence (2 years,P =0.010),and TNM stage (P =0.026),and negatively correlated with 5-year postoperative survival (36.8％ vs.20.0％).Conclusions Frizzled-7 is overexpressed in HCC and associated with decreased postoperative survival.Moreover,frizzled-7 may up-regulate the expression of β-catenin and promote β-catenin-mediated tumor invasion and recurrence.

BACKGROUND:Extracorporeal membrane oxygenation(ECMO)adopts heparin-coated oxygenator as key membrane oxygenation,which is a covalent bonding of artificial material surface with mucopolysaccharide on one side of heparin.Thas artificial materials can stimulate human vascular endothelial function partly,leading to decrease production of lactic acid,increase biocompatibility of the matedals,prevent thrombogenesis and relieve inflammatory reaction after operation.OBJECTIVE:To discuss the relationship between the plasma lactic acid level and the prognosis of patients after ECMO applied with heparin-coated oxygenator.DESIGN:Self-controlled clinical study,grouping by age and survival prognosis.SETTING:Department of Cardiopuimonary Bypass,Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences.PARTICIPANTS:Forty patients received ECMO in Fuwai Cardiovascular Hospital,Chinese Academy of Medical Sciences were selected from December 2004 to September 2006.They suffered from failing weaning of cardiopulmonary bypass postcardioctomy,cardiogenic shock based on dilated cardiomyopathy or cardiogenic shock based on coronary heart disease.All patients were divided into four groups according to age and survival prognosis:adult survival group,adult death group,infant survival group and infant death group.METHODS:All the patients received venoarterial ECMO support treatment.ECMO perfusion system consisted of centrifugal pump,water tank,heparin-coated membrane oxygenator(Jorstra Novalung,Germany)and corollary circuits (Bioline Coating,Germany,batch number:SFDA-I-20063450801).MAIN OUTCOME MEASURES:The concentrations of lactic acid were measured at the ECMO institution,6 hours later,the median time at ECMO support,6 hours before weaning off and at the time of weaning.RESULTS:①In 26 patients of adult groups,20 of them(76.9%)weaned from ECMO,16 of them(61.5%)survived and 10 of them died.In 14 patients of infant groups,7 of them weaned from ECMO(50%),5 of them(35.7%)survived and 9 of them died.②The concentrations of lactic acid in two survival groups were significantly lower than those in death groups(P＜0.05 or 0.001).The concentration decreased significantly at the time points of median time,6 hours before weaning off and at the weaning time,compared with the level at the time of ECMO institution(P＜0.01),indicating a decreasing concentration of lactic acid.CONCLUSION:①The concentration of lactic acid in patients after ECMO decreascs obviously.②Patients with high lactate level at the weaning time show unfavourable prognosis.

Objective To explore the clinical related prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in treating malignant hematological diseases. Methods From September 1997 to August 2008,a total of 26 patients with hematological diseases were treated with allo-HSCT from HLA identical-sibling and haplo-identical donors in our hospital, including 14 patients with acute leukemias,10 with chronic myeloid leukemias,and 2 myelodysplastic syndromes. Results All patients achieved sustained full donor type engraftment. The cumulative overall survival (OS) was 63.9 %,and cumulative disease free survival (DFS) was 62.6 %. Fifteen patients had graft-versus-host disease (GVHD) (57.7 %),including 8 acute GVHD(aGVHD) (30.8 %) (grade Ⅲ-Ⅳ aGVHD was 15.4 %) and 7 chronic GVHD. GVHD between HLA identical-sibling and haplo-identical donors was different and there was statistic difference between the two groups (P=0.014). 4 patients relapsed,7 patients died. The univariate analysis showed OS were correlated with grade Ⅳ aGVHD (P=0.05) and CMV infection (P=0.027). Conclusion Allo-HSCT is effective for the cure of patients with malignant hematological diseases. The key to improve the efficacy of HSCT is to reduce the incidence of transplant-related complications,especially GVHD and infection.

Objective To investigate the efficacy and safety of rituximab in the treatment of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods Three patients with anti-NMDAR antibodies in cerebrospinal fluid and serum hospitalized from May 2012 to July 2014 were retrospectively reviewed.The clinical syndrome,investigations,and therapeutic interventions by rituximab when first line immunotherapy failed were evaluated.Results All 3 patients were females with median age of 17 years (12,17,and 22 years).One patient had ovarian teratoma.All 3 patients presented with psychiatric symptoms and movement disorders,2 of which developed into a state of unresponsiveness.Brain magnetic resonance imaging of 2 patients was unremarkable,and 1 showed T2 and FLAIR hyperintensity among the areas of medulla,pons,caudex cerebri and callosum.Fluoro-2-deoxy-D-glucose-PET showed variable multifocal cortical and subcortical abnormalities that changed during the course of the disease.Electroencephalograms were abnormal in all patients,showing non-specific,slow,and disorganised activity,1 showing extreme delta brush.The cerebrospinal fluid showed lymphocytic pleocytosis.All patients showed no response to treatment with first line immunotherapy (corticosteroids,intravenous immunoglobulin (400 mg · kg-1 · d-1 × 5 d,2-3 courses of treatment)).After the administration of rituximab,1 patient responded slower,whereas the other 2 patients who recovered dramatically (375 mg/m2 every week for 3-4 weeks) continued immunosuppression with mycophenolatemofetil for 1 year.Relapse occurred in 1 patient when the immunotherapies discontinued 6 months later.During the treatment of rituximab,2 patients had grade 3 infectious adverse events (hospitalization and intravenous administration of antibiotics).Conclusions Rituximab is effective for the patients with anti-NMDAR encephalitis who fail to respond to the first line immunotherapy.However the utility of rituximab is still a challenge due to the risk of infectious complications and off-label use.

Objective To determine whether peripheral nerve ultrasound can differentiate CharcotMarie-Tooth type 1 (CMT1) from chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).Methods Eighteen patients with CIDP,13 patients with CMT1 and 16 healthy controls were recruited prospectively from Peking Union Medical College Hospital between January 2014 and July 2015 for this study.Ultrasonographic tests were performed via nerve tracing from wrist to axilla on median and ulnar nerve with a 10 MHz linear array probe.The cross sectional areas (CSAs) were measured at 10 defined sites of the nerves,respectively.Results CSAs (mm2) at all sites of median nerve were significantly increased in CMT1 than in CIDP (10.5 ±5.3 vs7.8 ±2.4,10.9 ±3.6 vs 6.8 ±1.9,11.5 ±5.0 vs7.3 ±1.8,13.5 ± 4.4vs7.2±2.5,16.0±4.5vs7.2±2.1,17.1±5.1vs7.0±2.8,21.0±4.5vs9.5±4.8,24.3±6.9 vs 9.5 ±4.3,23.9 ±6.0 vs 10.2 ±4.3,22.4 ±6.7 vs 9.8 ±2.1;t=2.141,4.766,2.935,4.858,6.715,6.602,7.148,7.100,8.078,6.498,respectively,all P ＜ 0.05).CSAs (mm2) at all sites of ulnar nerve were significantly increased in CMT1 than in CIDP (7.9 ± 1.8 vs 4.0 ± 1.3,8.9 ± 2.0 vs 4.9 ± 1.3,13.5±1.9 vs6.5±2.4,15.0±4.3 vs 6.5 ±1.5,15.8 ±4.4 vs 6.8 ±3.3,11.6±2.3 vs6.9± 3.1,10.2±3.2vs7.6±2.8,14.0±3.0vs6.6±2.1,19.2±3.7vs7.6±4.4,18.1±3.6vs6.3± 2.5;t =7.652,7.414,9.194,6.893,6.443,4.766,2.561,7.897,8.113,11.554,respectively,all P ＜ 0.05).CSAs at 8 sites of median nerve and 8 sites of ulnar nerve were significantly increased in CIDP than in healthy controls.Receiver operation characteristic curve analysis revealed that CSA was suited for differentiating CMT1 from CIDP,and the area under curve in 8 sites of median nerve and 9 sites in ulnar nerve was more than 0.9.Conclusions CSAs measured at different sites by peripheral nerve ultrasound in CMT1 were significantly increased than in CIDP.Measurement of CSAs by peripheral nerve ultrasound can be used for differentiating CMTI from CIDP.