Objective To investigate the efficacy, safety and prevention of complications of haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HSCT) in patients with severe aplastic anemia (SAA). Methods The clinical data of 8 SAA patients treated with Haplo-HSCT were retrospectively analyzed, with male in 5 cases, female in 3 cases, and an average age of 14 years. The donors of hematopoietic stem cells were patient′ s parents. The preparative regimen was cyclophosphamide + fludarabine + anti-human lymphocyte immune globulin, and 2 patients combined with total body irradiation. The recipients received cyclosporine, short- term methotrexate and mycophenolate mofetil (MMF) for preventing graft versus host disease (GVHD). The hematopoietic reconstitution, the chimerism rate of donor cells, and the incidence of postoperative complications such as infection, GVHD, liver veno- occlusive disease (VOD), hemorrhagic cystitis (HC), and cytomegalovirus (CMV) were observed. Results Hematopoietic reconstitution was achieved in all the 8 patients, the neutrophil engraftment time was (14.80 ± 3.24) d, and the platelet engraftment time was (15.00 ± 3.42) d. One month after transplantation, all the patients had complete DNA chimerism. Seven patients occurred acute GVHD, includingⅠ-Ⅱgrade in 5 cases, Ⅲgrade in 1 case, andⅣgrade in 1 case. Two patients occurred chronic GVHD, including 1 case with localized GVHD in the oral cavity and 1 case with extensive type chronic GVHD in the whole body skin. No liver VOD or HC occurred. No transplantation-related death occurred at average follow-up time of 8.5 (2 - 18) months. Conclusions Haplo-HSCT is safe and effective in patients with SAA.

Objective:To investigate the clinical efficacy of chidamide combined with BEAC (camustine+etoposide+ cytarabine+cyclophosphamide) preconditioning regimen in high-risk or refractory diffuse large B-cell lymphoma (DLBCL) receiving autologous stem cell transplantation.Methods:The clinical data of 10 high-risk or refractory DLBCL patients with autologous stem cell transplantation after receiving chidamide combined with BEAC preconditioning regimen who were admitted to Xuzhou Central Hospital from March 2022 to May 2023 were retrospectively analyzed. The related complications during preconditioning and hematopoietic reconstruction process, the time of hematopoietic stem cell reconstruction after transplantation, and the short-term efficacy were summarized.Results:Of the 10 patients, 6 were women and 4 were men; the median age was 58 years old (27-68 years old). Hematopoietic reconstruction was achieved in all 10 patients after transplantation. The median time of neutrophil engraftment was 11 d (range 7-12 d), and the median time of platelet engraftment was 12 d (range 9-16 d) after transplantation. Hematological adverse reactions were described as follows: 2 cases had grade 3 febrile neutropenia, 1 case had grade 4 febrile neutropenia, 3 cases had grade 2 anemia, and 1 case had grade 3 anemia. Non-hematological adverse reactions were described as follows: 1 case had grade 2 nausea with vomiting, and 1 case had diarrhea. Eight patients were followed-up for >3 months after transplantation, 6 patients achieved complete remission, 1 patient achieved partial remission, and 1 patient with TP53 deletion developed disease progression 1 month after transplantation.Conclusions:Autologous hematopoietic stem cell transplantation with chidamide combined with BEAC preconditioning regimen is effective for patients with high-risk or refractory DLBCL, and the adverse reactions are tolerable.

The transcriptional repressor RE1 silencer transcription factor(NRSF/REST) is an important factor that restricts some neuronal traits in neurons.Since these traits are also present in pancreatic islet cells,NRSF-regulated genes involved in islet function are searched.A NRSE-like motif was analysed in human insulin promoter.The role of NRSE was evaluated by generating a model of insulin-secreting cells that firmly express NRSF.The presence of NRSF led to a decrease in activity of human insulin promoter by stable or transient transfection with human insulin-promoter luciferase.The predicted NRSE-like motif also confers NRSF-dependent transcriptional repression in the context of a surrogate gene promoter.Specific binding activity of NRSF/REST to the NRSE-like motif was confirmed by EMSA.Moreover,the binding activity is competed by consensus NRSE sequence.These data showed that human insulin promoter is regulated by the transcriptional repressor NRSF/REST via the NRSE-like motif.

OBJECTIVETo explore the isolation, purification and expansion of human umbilical cord blood mesenchymal stem cells (MSCs) into neuron-like cells in vitro.

METHODSHuman cord blood samples were obtained sterilely with 20 U/ml preservative-free heparin. MSCs were isolated by lymphocyte separation medium (density 1.077 g/ml), and purified and expanded with Mesencult trade mark medium. The surface antigen expression of MSCs was detected by flow cytometry. The passage 2, 5 and 8 of the expanded MSCs were induced to differentiate to neuron-like cells. Specific markers and structures were detected by immunohistochemistry and histochemistry methods.

RESULTSThe number of MSCs increased two- to three-fold with each expanded passage. 6.6 x 10(5) primary MSCs were expanded ten passages to reach a number of 9.9 x 10(8), and was increased about 1.5 x 10(3)-fold. Flow cytometry showed that MSCs did not express antigens CD(34), CD(11a) and CD(11b), but expressed strongly CD(29) and weakly CD(71), which was identical to human bone marrow-derived MSCs. 70% cells exhibited typical neuron-like phenotype after induction. Immunohistochemistry staining showed that all of the induced different-passage MSCs expressed neurofilament (NF) and neuron-specific enolase (NSE). Special Nissl body was found by histochemistry.

CONCLUSIONMSCs in human umbilical cord blood can expand in vitro and differentiate into non-mesenchymal cells.

Antigens, CD ; analysis ; Antigens, Differentiation, B-Lymphocyte ; analysis ; Cell Count ; Cell Differentiation ; Cell Division ; Fetal Blood ; cytology ; Flow Cytometry ; Humans ; Immunohistochemistry ; Integrin beta1 ; analysis ; Mesoderm ; chemistry ; cytology ; Neurofilament Proteins ; analysis ; Neurons ; cytology ; Phosphopyruvate Hydratase ; analysis ; Receptors, Transferrin ; Stem Cells ; chemistry ; cytology

Objective To investigate the efficacy of domestic porcine antihuman lymphocyte immunoglobulin (p-ALG) in the treatment of severe aplastic anemia (SAA) with allogeneic hemopoietic stem cell transplantation (HSCT). Methods The clinical data of 5 SAA patients who received allogeneic HSCT from January 2015 to May 2018 were retrospectively analyzed. The conditioning regimen included p-ALG + cyclophosphamide + fludarabine. The method of peripheral stem cell and bone marrow blood was used in allogeneic HSCT (the total amount of bone marrow blood was less than 400 ml and the puncture point was not replaced). The p-ALG related complications, post-transplantation hemopoietic stem cell reconstitution time and efficacy were recorded. Results Allergic reaction occurred in 1 patient when using p-ALG, and there was no serum reaction. Hemopoietic reconstitution was achieved in all the 5 patients. The time for neutrophilic granulocyte > 0.5 × 109/L was 11 to 17 d, and the time for platelet count > 20 × 109/L was 11 to 15 d after transplantation. The results of short-strand repeat polymerase chain reaction assays showed all complete donor chimera. Graft versus host disease occurred in 3 cases, and was successfully controlled by methylprednisolone and tacrolimus. The time for stopping red blood cell transfusion was 9 to 87 d. The patients were followed up for 1 to 37 months, and the patients all survived well. Conclusions The efficacy of p-ALG in SAA patients of allogeneic HSCT is affirmative, and the cost is obviously reduced. It is worthy of clinical use.

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ² test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.