CD40 and its receptor CD40L are a very important pair of co-stimulating molecule in immune response, which have extensive biological effects. After stimulating CD40 signal, it can exert corresponding function through MAPK (JNK, ERK, p38) pathway, PI3K cascade, as well as NF-κB and STAT. The CD40 signal is closely related to tumor immunity, this moleculer has already become targeted-molecule for cancer treatment. Recently, there have been many anti-CD40 monoclonal antibodies displaying good anti-cancer effect, among which CHIR-12.12, SGN-40 and CP-870, 893 developed rapidly and successively have entered clinical research stage. This review focuses the status of anti-CD40 monoclonal antibody, including distribution of CD40, physiological function of CD40, CD40 and tumor immunity, anti-CD40 monoclonal antibodies and so on.
Animals ; Antibodies, Monoclonal ; CD40 Antigens ; immunology ; Humans ; Neoplasms

β-Amyrin synthase (β-AS) genes of Glycyrrhiza uralensis from 6 different regions were analyzed by PCR-SSCP and sequenced, then the correlationship between β-AS SNP and regions of Glycyrrhiza uralensis were determined. According to the 1 coding single nucleotide polymorphism on the first exon of β-AS gene at 94 bp site, Glycyrrhiza uralensis could be divided into 3 genotypes. In these genotypes, the percentage of 94A type in genuine regions was much higher, and it had significant differences with the percentage in non-genuine regions (P < 0.001). The results of the experiment proved that different β-AS genotypes at 94 bp site from different regions may be one of the important reasons to result in the genuineness of Glycyrrhiza uralensis.
Exons ; Genotype ; Glycyrrhiza uralensis ; classification ; enzymology ; genetics ; Intramolecular Transferases ; genetics ; Plant Proteins ; genetics ; Polymorphism, Single Nucleotide ; Polymorphism, Single-Stranded Conformational

OBJECTIVETo explore the treatment of chronic calcaneal osteomyelitis with bone defect after debridement and evaluate its clinical outcomes.

METHODSFrom June 2009 to June 2011, 52 patients with chronic calcaneal osteomyelitis were treated with stage-one compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone,including 12 females and 40 males with an average age of 43 years old ranging from 18 to 67. According to Cierny-Mader classification, there were 34 cases with stage III and 18 with stage IV. There were 32 cases on right side and 20 on left,with a course of 6 months to 3 years. The area of soft tissue wound ranged from 3.0 cm x l.5 cm to 23.0 cm x l2.0 cm. The clinical effects were evaluated according to infection controlling, calcium sulfate absorption,bone defect repair and heel functional recovery.

RESULTSAll patients were followed up for 2 to 3.8 years (averaged 2.8 years). Primary healing was achieved in 52 patients. Two cases of recurrence were found post-operatively, 1 case in 3 months and another in 5 months,which were cured after a second operation. Bone repair healing was gained in 1.5 to 3.5 months (averaged 2.5 months). Complete radiological absorption of calcium sulfate was found in 1.2 to 3 months(averaged 2.2 months). Local exudation after removal of drainage tube had been persisting in 10 patients for 2 to 3 months, which was consistent with the time when cacium sulfate were totally absorbed. Flap had partial necrosis in 4 cases,and the wounds were closed after appropriate treatment finally. The mean Maryland score was 88.15±7.70. There were excellent results in 32 cases, good in 14, fair in 6.

CONCLUSIONA satisfactory short-term clinical results can be gained by one-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone in chronic calcaneal osteomyelitis, but the long-term results need further follow-up. And much more study is also demanded to reduce the exudation of calcium sulfate.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bone Transplantation ; Calcaneus ; injuries ; surgery ; Calcium Sulfate ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteomyelitis ; drug therapy ; physiopathology ; surgery ; Surgical Flaps ; Wound Healing ; Young Adult

Objective To explore the differences in clinical and laboratory parameters between elderly and non-elderly patients with acute lymphoblastic leukemia (ALL).Poor prognostic factors in elderly patients were explored to guide the individualized treatment.Methods Two hundred and seventy-nine ALL patients were divided into two groups:elderly group with their age more than 60 years (60-79 years) and nonelderly group with their age less than 60 years (14-59 years).The differences in clinical and laboratory parameters,abnormal molecular genetics on related genes,including IKZF1,PAX5,NOTCH1,PHF6,SH2B3,LEF1,and JAK1,as well as the correlations with treatment response and clinical outcome were compared between the two groups.Results Males accounted for a smaller part in elderly group [42.9 ％ (21/49) vs.61.7 ％ (142/230),P =0.015].The percentage of B cell lineage ALL (B-ALL),Philadelphia chromosome positive (Ph+) and CD33 positive rate were higher in elderly group compared with those in non-elderly group [87.8 ％ (43/49) vs.70.4 ％ (162/230),P=0.009;47.8 ％ (22/49) vs.27.4 ％ (58/230),P=0.007;56.8 ％ (21/49) vs.39.0 ％ (64/230),P =0.049,respectively].While both lymphodenopathy and total complete remission (CR) rate gained the upper hand in non-elderly group [38.9 ％ (81/230) vs.20.0 ％ (9/49),P=0.016;91.3 ％ (178/195) vs.68.3 ％ (28/41),P＜ 0.001,respectively].Moreover,elderly group had lower 3-month,6-month,12-month and 24-month overall survival (OS) rates (64.6 ％ vs.84.4 ％,P=0.001;50.0 ％ vs.73.8 ％,P=0.001;29.2 ％ vs.52.4 ％,P=0.003;6.2 ％ vs.26.2 ％,P=0.003,respectively) than those of non-elderly group.No significant differences in mutation rates of PAX5,NOTCH1,PHF6,SH2B3,LEF1 and JAK1 were found (all P ＞ 0.05).Conclusions Compared with non-elderly ALL patients,elderly ones harbor their intrinsic characteristics which might give rise to inferior outcomes.As a consequence,more attention should be poured into treating this particular group of ALL patients to improve their prognosis.

Objective To evaluate the conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in diagnosis of splenic trauma including its grading diagnosis. Methods US and CEUS in 42 patients with splenic trauma confirmed by CT and/or operation were performed during 9.2004-10.2007. All the data were compared and analyzed retrospectively. Results Of 42 patients with splenic trauma, 28 cases were detected and 14 cases were missed on US examination, whereas, 40 cases were detected and only 2 mild cases were missed on CEUS examination. The detection rate of lesions with CEUS was significantly higher than that of US (P<0.001) . Ten cases in grading the injury were underestimated by US, however, none of them were underestimated by CEUS. CEUS had good concordance with CT and/or operation in grading diagnosis of 42 cases except two mild cases. Conclusions CEUS has very good concordance with CT and/or operation in detecting injury and grading the splenic trauma compared with conventional US. CEUS as a new imaging technology has made great advance of ultrasoongraphy in evaluation of splenic trauma including injury grading,and it is very useful in clinical application.

Diabetic ulcer is recognized as a chronic nonhealing wound, often associated with bacterial infection and tissue necrosis, which seriously affect patients' health and quality of life. The traditional treatment methods exist some problems, such as bacterial resistance and secondary trauma, so it is urgent to find new methods to meet the requirements of diabetic ulcer treatment. In this study, we prepared a drug delivery system (DFO@CuS nanoparticles) based on hollow copper sulfide (CuS) nanoparticles loaded with deferoxamine (DFO), which realized the synergistic therapy of promoting angiogenesis and photothermal antibacterial. The morphological structure and particle size distribution of DFO@CuS nanoparticles were characterized by transmission electron microscopy and particle size analyzer, respectively. The antibacterial effect of DFO@CuS nanoparticles was evaluated by the plate coating method. The effects of DFO@CuS nanoparticles on the proliferation, migration, and tube formation of human umbilical vein endothelial cells (HUVECs) were evaluated by CCK-8 (cell counting kit-8) assay, cell scratch assay, and tube formation assay. The results showed that DFO@CuS nanoparticles were hollow and spherical in shape with an average particle size of (200.9 ± 8.6) nm. DFO@CuS nanoparticles could effectively inhibit the growth of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PA) under near-infrared (NIR) light irradiation. DFO@CuS nanoparticles showed negligible cytotoxicity and effective acceleration of cell migration and tube formation in a certain concentration range. In conclusion, the prepared DFO@CuS nanoparticles exhibit good photothermal antibacterial properties and pro-angiogenic effects, providing a basis for their application in the treatment of diabetic ulcer.

OBJECTIVETo discuss the epidemiological and clinical characteristics of the hospitalized children with hand foot and mouth disease (HFMD) in Yantai area.

METHODSEpidemiological and clinical data of HFMD children from 2009 to 2010 were summarized and analyzed retrospectively.

RESULTSMost of the infected (94.6%) were under 5 years old and the ratio between male and female was 1.5: 1. Oral mucosal pox or ulcer as well as hand and foot rashes were observed in all 931 patients. Fever and neurological disorders occurred in 840 (90.2%) and 121 (13.0%) patients respectively. The incidence was positively correlated with air temperature (r = 0.887, P < 0.001), with a peak in April to September (88.9%). The ratio of children from countryside, total duration of fever, serum concentration of c-reacting protein (CRP) and fasting blood glucose (FBG) were significantly higher in severe cases than in those mild ones. Multivariate analysis showed longer mean duration of fever( Odds ratio [OR], 1.491; 95% confidence interval [ CI] 1.170-1.901; P = 0.001) and hyperglycemia (OR, 1.124; 95% CI 1.016-1.245; P = 0.024) were independent risk factors of severity.

CONCLUSIONChildren younger than 5 years old are susceptible to HFMD and most cases occur in April to September. The monthly incidence is positively correlated with temperature of that month. Longer duration of fever and hyperglycemia are independent risk factors for severity. Most cases could have a favorable prognosis after timely diagnosis and proper intervention.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Epidemiologic Studies ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Incidence ; Infant ; Male ; Retrospective Studies ; Seasons ; Temperature

OBJECTIVETo develop a RP-HPLC method for determination of three glycosides in Swertia punicea.

METHODChromatographic column: Alltimal C18 (4.6 mm x 250 mm, 5 microm). Mobile phase: methanol-water (including 0.05% H3PO4), and gradient elution. Flow rate: 1 mL x min(-1). Wavelength: 254 nm. Column temperture: 30 degrees C.

RESULTThe calibration curves of gentiopicroside, mangiferin and swertrianolin were in good linearity over the range of 31.3-281.7, 0.31-2.78, 0.55-4.91 microg, (r = 0.9996, 0.9993, 0.9995). The average recoveries were 103.36%, 101.42% and 97.39%, with RSD less then 3% (n = 5).

CONCLUSIONIt is a simple and sensitive meathod in controlling the quality of S. punicea.

Calibration ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; standards ; Glucosides ; analysis ; Glycosides ; analysis ; Iridoid Glucosides ; Iridoids ; analysis ; Plants, Medicinal ; chemistry ; Quality Control ; Reproducibility of Results ; Swertia ; chemistry ; Xanthones ; analysis

OBJECTIVETo investigate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) coincidence SPECT imaging versus computed tomography (CT) for malignant lymphoma in the initial staging, early response to therapy, evaluation after completion of therapy and long-term follow-up.

METHODS18F-FDG SPECT scans was performed on 61 patients with pathologically proven malignant lymphoma. The mean age of this series was 55 years ranged from 12 to 85 years. The data of these patients were retrospectively analyzed, and the result of 18F-FDG SPECT scan was compared with the CT imaging result performed within 2 weeks before or after FDG scan. 161 18F-FDG SPECT scans were performed for initial tumor staging (n=61), early response to therapy (n=42), evaluation after completion of therapy (n=26) and long-term follow-up (n=32). Each patient had a follow-up >6 months.

RESULTS(1) Compared with CT scan, 18F-FDG SPECT imaging accurately upstaged the disease for 34.4% (21/61) of these patients at initial staging. It detected the lesions which were undetected by CT including bone marrow infiltration (n=17), foci of lymph node (n=3) and liver involvement (n=1). However, 3 patients were incorrectly staged, either downstaged or upstaged by 18F-FDG SPECT imaging. Of 212 lesions in 61 patients, 18-FDG SPECT imaging detected more lesions than CT (P < 0.01). The correspondence rate of '18-FDG SPECT imaging with marrow histology was 80.3% (49/61). (2) In early evaluation of the response to treatment, the accuracy, positive predictive value and negative predictive value of 18F-FDG SPECT imaging was 85.7%, 92.0% and 76.5% respectively, which is much higher than that of CT (64.3%, 75.0% and 50.0%), therefore, the therapeutic scheme in 21.4% (9/42) of these patients was changed by 18F-FDG SPECT imaging. Of 17 cases with negative 18F-FDG SPECT scan in early evaluation of therapy, clinical remission (13 complete remission and 3 partial remission) were achieved in 16 patients. Of the 25 patients with positive ones, 13 were considered as having progressive disease. (3) In the evaluation at the end of therapy or during follow-up, 58 18F-FDG SPECT imagings were performed in 26 patients. The specificity and positive predictive value were 85.7% and 68.4% versus 59.5% and 43.3%, respectively, by CT scan. Of 14 patients with residual masses detected by CT scan, 8 were diagnosed as complete remission (CR) by 18F-FDG SPECT imaging based on persistently negative FDG scans; The other 6 were interpreted as CR (n=1), partial remission (PR, n=2), non-remission (n=1) and progressive disease (n=2), thus there was only one false-positive FDG scan in these 14 patients.

CONCLUSION18F-FDG imaging is quite effective and superior to CT scan for malignant lymphoma in initial staging, evaluation of early response to therapy and after completion of therapy, and long-term follow-up, especially for evaluating the residual masse.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Diagnosis, Differential ; Disease Progression ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Lymphoma ; diagnostic imaging ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplasm, Residual ; Radiopharmaceuticals ; Remission Induction ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon ; methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective To determine the relationship between chronic diseases and cognitive function in elderly patients, for the purpose of preventing and alleviating cognitive malfunction. Methods A total of 100 retired high intellectuals with age older than 65 years were enrolled.They were hospitalized in Zhongshan Hospital and were requested to complete a conventional questionnaire.Cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) Scale.Their chronic diseases including hypertension, coronary artery disease, diabetes mellitus were recorded and compared among subjects with different cognitive function levels. Results Based on MoCA Scale, 34 cases were sorted as having normal cognitive function, 50 cases as mild cognitive impairment, and 16 cases as moderate cognitive impairment.Patients with moderate cognitive impairment showed a significantly higher percentage of hypertension (93.8%), coronary artery disease (75.0%), stroke (56.3%), diabetes mellitus (56.3%) while the patients with normal cognitive function exhibited relatively lower percentage of the above-mentioned diseases (61.8%, 41.2%, 17.6%, 20.6%, respectively, P < 0.05).However such difference was not observed for respiratory disease and neoplastic disease among patients with different cognitive conditions (P>0.05).In addition, cardiovascular and metabolic diseases were found to be important risk factors of mild-to-moderate cognitive impairment (P=0.002). Conclusion Prevention and treatment of cardiovascular and metabolic diseases could be imperative to alleviate the process of cognitive impairment.