Objectives: To investigate the changes of brainstem auditory evoked potential (BAEP) in patients with vertebral artery dominant vertigo and to explore the possible mechanism of vertigo. Methods: Thirty-five patients with consecutive vertebral artery dominant vertigo detected by head magnetic resonance angiography (MRA) were included prospectively as the study group, and 29 patients without vertebral artery dominant vertigo as the control group. The age, sex, and other clinical histories were comparable in both groups. The degree of vertigo of the patients was graded and the BAEP examination was performed. The basilar artery and the changes of BAEP and its relationship with the dominant vertebral artery in patients of the two groups were analyzed. Results: Thirty-five patients with vertebral artery dominant vertigo and 29 patients without vertebral artery dominant vertigo were selected. Circled digit oneThe abnormal rate of basilar artery was 60% in the vertebral artery dominant group, and it was higher than 34.5% in the vertebral artery non-dominant group. There was statistically significant difference (χ2=4.135, P<0.05). The median value of basilar artery curvature was 3.67 mm in the dominant group, and it was larger than 1.73 mm in the non-dominant group. There was statistically significant difference (P<0.01). Circled digit twoThe peak latencies of I, III and V wave in the dominant group were longer than those in the non-vertebral artery non-dominant group (P<0.01). However, the difference of the peak latency of III wave did not reach statistical significance. Both the interpeak latencies of III - V and I - V in the vertebral artery dominant group were longer than those in the non-vertebral artery non-dominant group (P<0.05), and there was no statistical significance in the interpeak latencies of I - III (P > 0.05). The ratios of III - V/I - III in the vertebral artery dominant group was larger than those in the non-dominant group (P < 0.05). Circled digit threeThere was significant difference in the vertigo severity scale between the patients of vertebral artery dominant group (3.2±1.0) and those of vertebral artery non-dominant group(2.2±0. 7) (P<0.01). There were correlations between the vertigo severity scale of the vertebral artery dominance and each major abnormal item of BAEP. Of those, the correlations of III - V/I - III were the most significant (r = 0.617, P = 0.013). Conclusions: The abnormal rate of basilar artery, the abnormal rate of BAEP and the vertigo severity scales are higher in patients with vertebral artery dominance. There is correlation between the vertebral artery dominance and the abnormal BAEP.

In this paper, a model of three allogeneic mixed bone marrow transplantation of mice (BALB/c, H-2(d); C57BL/6, H-2(b); and CBA/N, H-2(k)) was established and whether or not prolongation of the survival time in recipient mice was observed. Lethally irradiated mice were transplanted with a mixture of a syngeneic plus two allogeneic bone marrow (A + B + C-->A, in a ratio of 1:4:4). At same time, mixed lymphocyte culture (MLC) with three allogeneic lymphocytes in vitro and two allogeneic antigens stimulated delayed type hypersensitivity (DTH) in vivo were performed. The results showed that the mice receiving mixed bone marrow transplant survived 56.6 +/- 27 days and the longest 103 days, however, only 15 +/- 5 days in the single allogeneic transplantation group. Whether two reacting cells to one stimulating cells or one reacting cells to two stimulating cells, all showed lower activity of MLC than that in one to one control group. In DTH assay, the mice sensitized with two allogeneic antigens showed lower reactivity than that in one antigen stimulated mice. It was concluded that the survival time of recipient mice was significantly prolonged after transplantation with three mixed allogeneic bone marrow.
Animals ; Bone Marrow Transplantation ; immunology ; mortality ; Graft vs Host Disease ; etiology ; Hypersensitivity, Delayed ; etiology ; Lymphocyte Culture Test, Mixed ; Mice ; Mice, Inbred Strains ; Models, Animal ; Survival Rate ; Transplantation, Homologous

This study was aimed to investigate the correlation between the serum levels of IL-18 and acute graft versus host disease (aGVHD) in patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to explore the role of serum IL-18 levels in the pathogenesis of aGVHD so as to provide a reliable and early indicator for the diagnosis of aGVHD. 62 patients received allo-HSCT were enrolled in this study. Before and after transplantation, as well as at onset of aGVHD. The serum levels of IL-18 were analyzed by ELISA. 62 patients were divided into 5 groups: group A without aGVHD (28 cases) referred to the patients who had no aGVHD after transplantation and whose specimen were collected before transplantation; group B with aGVHD before transplantation (34 cases) referred to the patients who had aGVHD after transplantation and whose specimen were collected before transplantation; group C before the onset of aGVHD (34 cases) referred to patients with I - II grade a GVHD whose specimen were collected before 3 - 4 days, and according to whether the I - II grade aGVHD patients developed III - IV grade or not after treatment, these patients were divided into two subgroups retrospectively, one subgroup had good curative effect (18 cases) and the other subgroup had not (16 cases); group D with I - II grade aGVHD; group E with III - IV grade aGVHD (16 cases). The results showed that 34 patients developed I - II grade aGVHD, then out of them 16 patients (16/34) developed III - IV grade aGVHD. The serum levels of IL-18 in these patients with aGVHD were higher than that in patients without aGVHD. About 3 days before onset of aGVHD, the serum levels of IL-18 started to increase. The serum levels of IL-18 were correlated with the severity of aGVHD, but no correlation was found with infection, conditioning regimens and disparity of HLA-typing. The serum levels of IL-18 in the early stage of aGVHD were correlated with prognosis. The aGVHD of patients with higher serum levels of IL-18 easy developed to III - IV grade aGVHD. It is concluded that the serum level of IL-18 in the patients received allo-HSCT is related to the occurrence of aGVHD. Detections of serum IL-18 are helpful for the early diagnosis of aGVHD, and the serum levels of IL-18 may be considered as a reliable indicator to evaluate the prognosis and severity of aGVHD.
Adolescent ; Adult ; Child ; Female ; Graft vs Host Disease ; blood ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Interleukin-18 ; blood ; Leukemia ; blood ; therapy ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To study the epidemiologic characteristics of human herpes virus (HHV) activated infection in the diseases of blood system and patients received allo-HSCT by statistically analyzing the screening results of 8 human herpes viruses (HHVs) of 4164 patients in Hebei Yanda LU Dao-Pei Hospital from 2012 to 2017. METHODS: PCR was used to screen 8 HHVs. RESULTS: Two thousand and fifty-two patients (49.28%) were HHV-positive among 4164 patients screened. Among these patients screened, the infection spectra of 8 human HHVs in hematological diseases as well as patients received allogeneic hematopoietic stem cell transplantation of totally 2994 patients were summarized as follows: the positive rate of EBV (29.49%) was the highest, that of HCMV (23.15%), HHV-6 was 18.77% and HHV-7 was 17.64%, while the remaining 4 HHVs all≤2.1%. The rate of co-infection of various HHVs was significantly higher than that of single infection of HHV among all these disease groups except familial hemophagocytic lymphohistiocytosis, for which single EBV infection was the most common. The differences of positive rates among these 8 human HHVs in hematological diseases as well as patients received allogeneic hematopoietic stem cell transplantation were statistically significant by Chi-square test of R*C tables (χ=54.99, P＜0.05). For each HHV, the differences of positive rates among the above-mentioned disease groups were also statistically significant except HHV-8 (P＜0.05). CONCLUSION The patients with various blood diseases have different activated infection spectra of HHVs. EBV, HCMV, HHV-6 and HHV-7 are most common in HHVs infection. Different HHVs infections correlate with different hematologion diseases.

Objective To investigate the effect of vertebral artery (VA) dominance on basilar artery (BA) curvature and pontine or cerebellar infarct occurring around the vertebrobasilar junction of VA. Methods Radiological data (infarct laterality,VA dominance,BA curvature and their directional relationships) were analyzed in 91 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarcts.Multiple regression analysis was performed to predict the moderate to severe BA curvature. Results The dominant VA frequently happened on the left side.Most patients had an opposite directional relationship between the dominant VA and BA curvature. Pontine infarct frequently happened opposite to the side of BA curvature and PICA infarct on the same side as the non-dominant VA side.The VA diameter was the only independent predictor for moderate to severe BA curvature (OR: 2.70; 95％CI: 1.22-5.98). Conclusion VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of BA curvature; VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarcts.

Intracranial arterial dolichoectasia (IADE), also known as dilatative arteriopathy of the brain vessels, refers to an increase in the length and diameter of at least one intracranial artery, and accounts for approximately 12% of all patients with stroke. However, the association of IADE with stroke is usually unclear. Cerebral small vessel disease (CSVD) is characterized by pathological changes in the small vessels. Clinically, patients with CSVD can be asymptomatic or present with stroke or cognitive decline. In the past 20 years, a series of studies have strongly promoted an understanding of the association between IADE and CSVD from clinical and pathological perspectives. It has been proposed that IADE and CSVD may be attributed to abnormal vascular remodeling driven by an abnormal matrix metalloproteinase/tissue inhibitor of metalloproteinase pathway. Also, IADErelated hemodynamic changes may result in initiation or progression of CSVD. Additionally, genetic factors are implicated in the pathogenesis of IADE and CSVD. Patients with Fabry’s disease and late-onset Pompe’s disease are prone to developing concomitant IADE and CSVD, and patients with collagen IV alpha 1 or 2 gene (COL4A1/COL4A2) and forkhead box C1 (FOXC1) variants present with IADE and CSVD. Race, strain, familial status, and vascular risk factors may be involved in the pathogenesis of IADE and CSVD. As well, experiments in mice have pointed to genetic strain as a predisposing factor for IADE and CSVD. However, there have been few direct genetic studies aimed towards determining the association between IADE and CSVD. In the future, more clinical and basic research studies are needed to elucidate the causal relationship between IADE and CSVD and the related molecular and genetic mechanisms.

OBJECTIVETo observe clinical therapeutic effects of acupuncture for pattern of liver-stagnation and spleen-deficiency in diarrhea-predominant irritable bowel syndrome (D-IBS) and its impact on cell factors.

METHODSForty cases were selected and divided into an acupuncture group (21 cases) in which acupuncture was applied and a medicine group (19 cases) in which oral administration of dicetel and bifidobacterium lactobacillus triple viable capsules were applied. The symptom scores, level of Th1-type cytokine (IFN-gamma, IL-2) and Th2-type cytokine (IL-4, IL-10) and ratio of IFN-gamma to IL-4 were compared in two groups before and after treatment to analyze acupuncture effect.

RESULTSThe clinical symptoms were improved after one-week treatment in the acupuncture group (P<0.05), which had faster onset than the medicine group (P<0.05). The total effective rate was 90.48% (19/21) in the acupuncture group, which was superior to 78.95% (15/19) in the medicine group (P<0.05). Compared with medicine treatment, imbalanced condition of Th1/Th2 was turning towards the direction of Th2 after acupuncture, indicating a tendency to recover the balance.

CONCLUSIONThe clinical efficacy of acupuncture for D-IBS has close relationship with effectively improving balance of Th1/Th2 in patients with liver-stagnation and spleen-deficiency.

Acupuncture Therapy ; Adult ; Aged ; Cytokines ; immunology ; Female ; Humans ; Irritable Bowel Syndrome ; immunology ; physiopathology ; therapy ; Liver ; physiopathology ; Male ; Middle Aged ; Spleen ; physiopathology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Young Adult

The aim of study was to investigate the pharmacokinetics and distribution of antithymocyte globulin (ATG) in recipients of partially HLA-matched hematopoietic stem cell transplantation. Fifteen patients with hematological disorders were received hematopoietic stem cell transplantation from partially HLA-matched related donor between October 2003 and October 2004 in the Institute of Hematology and People Hospital, Peking University. All patients including 5 cases of AML, 6 cases of CML, 3 cases of ALL, 1 case of AA were consecutively enrolled in the present study after providing written informed consent. Antithymocyte globulin was administered before allogeneic hematopoietic stem cell transplantation at a dose of 2.5 mg/kg daily for 4 consecutive days (total dose of 10 mg/kg) in the conditioning regimen. The concentration of rabbit ATG in the serum of 15 patients was measured using a new enzyme-linked immunoabsorbent assay (ELISA) for the Fc portion of rabbit IgG. The results showed that the washout phase of ATG elimination was analyzed over 0 - 120 days, results were well-fitted by a single exponential decay giving a mean elimination half-life (t(1/2) beta) of 29.67 +/- 2.60 days. A mean value for the apparent volume of distribution of ATG (V) obtained by analysis of data was 0.12 +/- 0.02 L/kg body weight. The serum concentration of ATG increased up to 44.8% at 5 day before transplantation, peak concentration of ATG was 136.0 +/- 10.3 mg/L, its concentration slowly descend at 0 day, fall up to 7.1 +/- 0.06 microg/ml at 90 day after dosing; t(max) 4.8 +/- 0.7 days; According to AIC (Akaike's information criterion), two compartment model of ATG was estimated. It is concluded that the conditioning regimen containing the dosage of 10 mg/kg of ATG is effective and safely in recipients of partially HLA-matched hematopoietic stem cell transplantation. There is no racial difference in the pharmacokinetics of ATG.
Adolescent ; Adult ; Antilymphocyte Serum ; metabolism ; Child ; Female ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Humans ; Male ; Middle Aged ; Tissue Distribution

OBJECTIVETo evaluate the detection of cytomegalovirus (CMV) by polymerase chain reaction (PCR) for predicting the development of CMV disease.

METHODSOne hundred and thirty one allo-HSCT patients performed in the past 2 years were analyzed retrospectively. PCR-CMV was used to monitor CMV viremia and vireuria once a week after transplantation.

RESULTSIn the dynamic detection, CMV viremia was positive for at least one chance in 89 patients, vireuria did in 99 patients. Thirty-seven patients developed CMV disease with an accumulative incidence of 32.5%. The incidence of CMV disease was 15.6% in plasma CMV-PCR negative group, 31.3% in positive once group, and 47.3% in positive over twice group. There was significant difference among the three groups (P = 0.0126). The incidence of CMV disease was 24.8% in urine CMV-PCR negative group, 43.5% in positive once group, and 33.0% in positive over twice group, being no significant difference among them (P = 0.845). On analysis, viremia could predict the development of CMV disease: the PPV (positive predictive value) is 40.5%, NPV (negative predictive value) is 84.4%, sensitivity is 75.0%, and specificity is 69.2%.

CONCLUSIONSDetected by CMV-PCR, MCV viremia may predict the development of CMV disease, but MCV vireuria cannot.

Adolescent ; Adult ; Child ; Child, Preschool ; Cytomegalovirus ; genetics ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; etiology ; DNA, Viral ; blood ; urine ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Retrospective Studies ; Sensitivity and Specificity ; Transplantation, Homologous ; adverse effects

The purpose of this study was to explore the significance of abnormal karyotype in diagnosis and prognosis estimation of myelodysplastic syndrome (MDS). Chromosome analysis were performed in 306 cases of MDS using the short-term culture of bone marrow cell and G-banding technique, and in partial cases FISH technique was used for this analysis. 93 out of 306 cases were followed up. The results showed that 144 cases (47.1%) had clonal chromosome aberrations. The most common chromosomal aberrations included +8, translocation, complex or high complex karyotype, -7/7q-, 20q-/-20, trisomy 1 or partial trisomy 1, +11/+11q-, -9/9q-, +9/9q+, -Y, dup(1q), +21. The rate of abnormal karyotype in refractory anemia with erythroblasts (RAEB) and refractory anemia with erythroblasts-transformation (RAEBT) were much higher than in refractory anemia (RA) and refractory anemia with sideroblasts (RAS) (P < 0.05). The rate of abnormal karyotype among those cases with mutagen contact history were higher than those in cases without mutagen contact history. The patients with abnormal karyotype had a mean survival time much shorter than patients with normal karyotype (P < 0.005) and had a higher risk transforming into acute leukemia (P < 0.05). The worst outcome was observed in those patients with a complex or high complex karyotype, -7/7q- and trisomy 11. In conclusion, MDS is highly heterogeneous disorders and karyotype analysis is helpful for its diagnosis, treatment selection and prognosis estimation.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Chromosome Aberrations ; Female ; Humans ; Karyotyping ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; mortality ; Prognosis