OBJECTIVEAllogeneic marrow transplantation is a curative therapy for thalassemia, but no more than 30% of patients have HLA-indentical sibling marrow donor. The selection of alternative donors of unrelative marrow and the study on the probability of treating thalassemia major with unrelated donor bone marrow transplantation are of importance.

METHODSNine children with thalassemia were included in the study, and their gene mutational type were homozygote of thalassemia and double heterozygote, respectively. All of them were finally diagnosed of thalassemia major, and treated with unrelated donor bone marrow transplantation. To high-resolution HLA typing, two patients were matched, five had one unmatched isoform and two had two unmatched isoforms. The erythrocyte blood type was not matched in six patients. The preparative regimen included busulfan (oral use, 16 mg/kg, divided for 4 days), cyclophosphamide (intravenous use, 200 mg/kg, divided for 4 days), antithymocyte immunoglobulin (intravenous use, 30 mg/kg, divided for 3 days), and fludarabine (intravenous use, 125 mg/m(2), divided for 3 days). Ciclosporin A and methotrexate were used for graft-versus-host disease (GVHD) prophylaxis.

RESULTSAll patients had allergen reactions. One had hypotension. Five patients experienced I degrees approximately III degrees acute GVHD in the skin, while one had II degrees acute GVHD in liver. One patient had III degrees GVHD of intestines and gradually developed chronic GVHD in the skin, lungs and brain. One patient died of pulmonary hemorrhage. The duration when peripheral blood neutrophil count exceeded 0.5 x 10(9)/L was 12 - 26 days. The recovery time of WBC was as long as 23 - 110 days. Thrombocytes exceeded 50 x 10(9) within 61 approximately 142 days. The time when hemoglobin reached 100 g/L varied from 23 to 116 days. The last blood transfusion was on 13 - 62 days. Eight patients were fully grafted, while one was not grafted. During the 6 - 24 months of follow-up, seven patients' genotype of thalassemia major became normal. The erythrocyte blood type of five patients also changed into the same as that of donor. The hemoglobin was kept over 110 g/L without blood transfusion.

CONCLUSIONThe transplantation of unrelated donor bone marrow for thalassemia major was successful. Unrelated donor bone marrow transplantation could cure thalassemia major, which expanded the marrow donor source for the transplantation of thalassemia major.

ABO Blood-Group System ; Bone Marrow Transplantation ; adverse effects ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graft Rejection ; Graft Survival ; Histocompatibility Testing ; Humans ; Infant ; Male ; Transplantation Tolerance ; Transplantation, Homologous ; adverse effects ; Treatment Outcome ; beta-Thalassemia ; diagnosis ; therapy

OBJECTIVETo explore the effects of the combined method of abdominal axial flap transposition and penile elongation for the treatment of the remnant penis.

METHODSFifty-two cases of the remnant penis treated with the combined method from 1984 April to February 2004 were analyzed retrospectively. Follow-up ranged from 0.5 to 20 years postoperatively.

RESULTSThe lengths (both in normal and erectile conditions) and the circumferences of the penis gained after operation were (5.6 +/- 1.4) cm, (6.8 +/- 2.5 cm and (6.9 +/- 2.3) cm respectively. The recovery rates of the sensory function were 94.2% and 100% in the glans (immediately and 3 months after operation) and 32.7%, 51.9% and 75% in the flap area (3, 6 and 12 months postoperatively). The two-point distinguishing sense in the glans and the flap area was (5.1 +/- 0.9) mm and(7.9 +/- 1.3) mm 5 years after operation. Early complications included distant flap necrosis (3 cases), disruption of the wound (2 cases), part necrosis of the skin graft in the abdominal wall (2 cases) and poor contours occurred in 4 cases in the later period because of the thickness of the flaps. All of them were corrected with satisfactory results.

CONCLUSIONThe combined method of abdominal axial flap transposition and penile elongation was recommendable for the treatment of the remnant penis because of its positive effects and less complications.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penis ; injuries ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps

OBJECTIVETo observe the efficacy and features of treating early-to-middle stage nontraumatic osteonecrosis of femoral head (NONFH) patients by Jianpi Huogu Recipe (JHR).

METHODSUsing retrospective paired control method, early-to-middle stage NONFH patients treated by JHR and followed-up for 2 years were recruited as the test group (47 cases). Those accepted surgery of core decompression, focus debridement and bone graft were recruited as the control group (48 cases). Radiographic images and clinical data of patients were collected before and after treatment. The stable rate and excellent rate of Harris score were taken as efficacy evaluation indicators.

RESULTS(1) There was no statistical difference in excellent rate of Harris score between the two groups (95.74% vs. 79.17%, P > 0.05). But better effects were obtained in the test group in relieving pain, improving joint deformation, joint mobility, and total Harris score (P < 0. 05, P < 0. 01). There was no statistical difference in the stable rate of radiography between the two groups (74.47% vs. 75.00%, P > 0.05). (2) There was no statistical difference in the stable rate of radiography at phase II and Ill [staging by Association Research Circulation Osseous (ARCO)] between the two groups (82.05% vs. 80.00%, 37.50% vs. 50.00%, P > 0.05). (3) The stable rate of radiography and excellent rate of Harris score were obviously higher in ARCO phase II patients than in ARCO phase Il patients (82.05% vs. 37.50%,97.44% vs. 87.50%, P < 0.01).

CONCLUSIONSEquivalent stable rate of radiography to that of surgery could be obtained in treating early-to-middle stage NONFH patients by JHR. But it was better than surgery in relieving pain, improving joint deformation and joint mobility.

Adult ; Case-Control Studies ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Femur Head Necrosis ; drug therapy ; etiology ; Humans ; Male ; Middle Aged ; Phytotherapy ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUNDPancreatic cancer is one of the most lethal human cancers with a very low survival rate of 5 years. Conventional cancer treatments including surgery, radiation, chemotherapy or combinations of these show little effect on this disease. Several proteins have been proved critical to the development and the progression of pancreatic cancer. The aim of this study was to investigate the effect of resveratrol on apoptosis in pancreatic cancer cells.

METHODSSeveral pancreatic cancer cell lines were screened by resveratrol, and its toxicity was tested by normal pancreatic cells. Western blotting was then performed to analyze the molecular mechanism of resveratrol induced apoptosis of pancreatic cancer cell lines.

RESULTSIn the screened pancreatic cancer cell lines, capan-2 and colo357 showed high sensitivity to resveratrol induced apoptosis. Resveratrol exhibited insignificant toxicity to normal pancreatic cells. In resveratrol sensitive cells, capan-2 and colo357, the activation of caspase-3 was detected and showed significant caspase-3 activation upon resveratrol treatment; p53 and p21 were also detected up-regulated upon resveratrol treatment.

CONCLUSIONResveratrol provides a promising anti-tumor strategy to fight against pancreatic cancer.

Apoptosis ; drug effects ; Blotting, Western ; Caspase 3 ; metabolism ; Cell Survival ; drug effects ; Humans ; Mitogen-Activated Protein Kinases ; metabolism ; Pancreatic Neoplasms ; metabolism ; Stilbenes ; pharmacology ; Tumor Cells, Cultured

OBJECTIVETo assess the efficacy and safety of reduced osmolarity oral rehydration salts (ROORS) in treatment of mild to moderate dehydration caused by acute diarrhea in children.

METHODSA multicenter, randomized, double-blind, positive drug controlled clinical trial was conducted in 125 cases aged 1 to 17 years. These children with acute diarrhea and signs of dehydration were randomly assigned to receive either ROORS (trial group, n = 62) or oral rehydration salts II (ORS II) (control group, n = 63). The volume of intravenous infusion were recorded. The improvements of systemic symtoms and signs, diarrhea, dehydration and total scores were compared between the two groups. The adverse events and changes of electrolyte and other laboratory tests during treatment were also observed and analyzed.

RESULTSThe overall effective rates in trial group and control group were 96.8% and 96.8%, respectively. The recovery of systemic symptoms, dehydration signs and diarrhea occurred in 96%, 97% and 78% patients in trial groups, and 96%, 98% and 85% patients in control group. The scores of symptoms and signs in both groups decreased significantly after treatment. All the above parameters and the number of cases who needed intravenous infusion (41 vs. 39) were not statistically different between two groups. However, the average volume of intravenously infused fluids in trial group was (450.98 +/- 183.07) ml, 24.5% less than that in the control group (597.30 +/- 343.37) ml (P < 0.05). The mean serum Na(+) concentration elevated from (137.48 +/- 4.55) mmol/L to (139.52 +/- 3.25) mmol/L (P < 0.01) in control group after treatment, but the change was not statistically significant in trail group. Serum K(+), Cl(-), HCO(3)(-) and other laboratory result did not change significantly after treatment. The total scores in both groups decreased obviously after treatment, but no significant difference was demonstrated between two groups (P > 0.05). A case in trial group had mild abdominal distention and recovered spontaneously.

CONCLUSIONROORS was shown to be effective and safe in the treatment of mild and moderate dehydration induced by acute diarrhea. Compared to ORS II, ROORS could decrease the intravenous supplement of fluid and lower the risk of hypernatremia.

Adolescent ; Child ; Child, Preschool ; Chlorides ; blood ; Dehydration ; etiology ; therapy ; Diarrhea ; complications ; therapy ; Double-Blind Method ; Female ; Fluid Therapy ; methods ; Humans ; Infant ; Infusions, Intravenous ; Male ; Osmolar Concentration ; Potassium ; blood ; Rehydration Solutions ; administration & dosage ; Sodium ; blood ; Treatment Outcome ; Water-Electrolyte Balance

To explore the cytogenetics and related clinical characteristics of adult acute leukemia with Philadelphia chromosome positive (Ph(+)AL), MIC classification by morphology, immunology and cytogenetics was used to retrospectively study 79 patients with Ph(+)AL hospitalized in the Institute of Hematology, People Hospital in Beijing from October 1991 to September 2003. The results showed that 6.9% cases were diagnosed as Ph(+)AL and classified into three subtypes: acute lymphoblastic leukemia (Ph(+)ALL) in 56 patients (18%), acute myeloid leukemia (Ph(+)AML) in 10 patients (1.2%) and mixed acute leukemia (Ph(+)MAL) in 13 patients. B-cell antigen expression was found in 52 out of 56 patients with Ph(+)ALL. 54.4% (43/79) patients had additional chromosome abnormalities including chromosome 7, double Ph and plus 8, etc. Complete remission (CR) rate of Ph(+)ALL and Ph(+)MAL was 57.0%, none of Ph(+)AML achieved CR. Median overall survival of Ph(+)ALL, Ph(+)MAL and Ph(+)AML were 10, 10 and 2.5 months respectively. It is concluded that Ph(+)AL has highly heterogeneity involving various differentiated stages of immature leukemic cells. Since the poor prognosis associated with this kind of AL, early diagnosis with MIC classification is a prerequisite to take more effective conditioning regimen and prospectively consideration of allogeneic stem cell transplantation to improve prognosis.
Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Cytogenetic Analysis ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Kaplan-Meier Estimate ; Karyotyping ; Leukemia, Myeloid, Acute ; genetics ; pathology ; therapy ; Male ; Middle Aged ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; pathology ; therapy ; Remission Induction

OBJECTIVETo study the relationship between genetic polymorphism of NAT2 and susceptibility to bladder cancer.

METHODSNAT2 genotypes were determined by PCR-RFLP method in 69 patients with bladder transitional cell carcinoma and 88 healthy controls.

RESULTSThe frequency of NAT2 slow genotypes was 26.1% (18/69) in patients compared with 14.8% (13/88) in controls (P < 0.05). Bladder cancer risk in patients with NAT2 slow genotypes was 2 fold as high as that in patients with NAT2 rapid genotypes. When NAT2 rapid genotypes/non-smoker were used as reference, bladder cancer risk increased to 5.8-fold (P < 0.05). Among the smokers with PY higher than 10, the patients showed a higher frequency of NAT2 slow genotype than controls (P < 0.05). It was also shown that the patients with slow NAT2 genotypes were more likely to have high grade tumor (P < 0.05) and advanced stage tumor (P < 0.01).

CONCLUSIONThe results suggest that NAT2 genetic polymorphism is associated with bladder cancer susceptibility. People with NAT2 slow genotype have higher bladder cancer risk.

Arylamine N-Acetyltransferase ; genetics ; Carcinoma, Transitional Cell ; enzymology ; genetics ; pathology ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Smoking ; Urinary Bladder Neoplasms ; enzymology ; genetics ; pathology

BACKGROUNDPancreatic cancer is one of the most common tumors and has a 5-year survival for all stages of less than 5%. Most patients with pancreatic cancer are diagnosed at an advanced stage and therefore are not candidates for surgical resection. In recent years, investigation into alternative treatment strategies for this aggressive disease has led to advances in the field of gene therapy for pancreatic cancer. E. coli purine nucleoside phosphorylase/6-methylpurine deoxyribose (ePNP/MePdR) is a suicide gene/prodrug system where PNP enzyme cleaves nontoxic MePdR into cytotoxic membrane-permeable compounds 6-methylpurine (MeP) with high bystander activity. hTERT is expressed in cell lines and tissues for telomerase activity. In this study we examined the efficacy of ePNP under the control of hTERT promoter sequences and assessed the selective killing effects of the ePNP/prodrug MePdR system on pancreatic tumors.

METHODSRecombinant pET-PNP was established. The protein of E. coli PNPase was expressed and an antibody to E. coli PNPase was prepared. Transcriptional activities of hTERT promoter sequences were analyzed using a luciferase reporter gene. A recombinant phTERT-ePNP vector was constructed. The ePNP/MePdR system affects SW1990 human pancreatic cancer cell lines in vitro.

RESULTSThe hTERT promoter had high transcriptional activity and conferred specificity on cancer cell lines. The antibody to E. coli PNPase was demonstrated to be specific for the ePNP protein. The MePdR treatment induced a high in vitro cytotoxicity on the sole hTERT-ePNP-producing cell lines and affected SW1990 cells in a dose-dependent manner.

CONCLUSIONSThe hTERT promoter control of the ePNP/MePdR system can provide a beneficial anti-tumor treatment in pancreatic cancer cell lines including a good bystander killing effect.

Cell Line, Tumor ; Escherichia coli ; enzymology ; Genetic Therapy ; Humans ; Pancreatic Neoplasms ; therapy ; Promoter Regions, Genetic ; Purine Nucleosides ; therapeutic use ; Purine-Nucleoside Phosphorylase ; genetics ; Telomerase ; genetics

Thrombotic microangiopathy (TMA) is a lethal transplantation-associated complication which exactly likes acute intestinal graft-versus-host disease (GVHD) in the clinical manifestation. 373 consecutive patients with hematological diseases received family HLA matched or mismatched HCT from May, 2002 to July, 2004. To analyse the clinical and pathological characteristics of TMA, 30 patients who suffered from severe diarrhea and received colonoscopic examination and gut biopsy were retrospectively analyzed. The results indicated that 7 patients originally diagnosed as gut GVHD showed the pathological evidence of enteric TMA. The incidence of TMA was 7 out of 30 specimen (23.3%). Pathological evidence of enteric TMA shown microvascular disorder characterized by thrombus in the capillary without infiltration of lymphocytes and perivascular hemorrhages in the mucosa, swelling and focal denudation of epithelial cells. All patients with TMA were associated with cytomegalovirus (CMV) antigenemia/disease. Among these patients, 4 cases, who only showed TMA without the evidence of gut GVHD pathologically, displayed treatment-resistant bloody diarrhea, renal failure, veno-occlusive disease, hemorrhagic cystitis, hemolytic anemia as well as thrombocytopenia. But the other 3 cases, with co-existence of both TMA and GVHD pathological characteristics had better treatment response. Survival analysis indicated that 3 patients with TMA-GVHD survived for 461 to 536 days but three out of four TMA patients died from VOD with liver failure as well as multiple organ failure during 101 to 254 days after HCT. In conclusion, to better diagnose those patients with severe and refractory diarrhea following HCT, pathological examination may indicate crux evidence to identify intestinal TMA from gut GVHD. Furthermore, this primary report has first evidenced that TMA and TMA-GVHD are two pathologically well-recognized subtypes with the difference between the pathological characteristics, treatment response and clinical outcomes.
Graft vs Host Disease ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Intestinal Diseases ; diagnosis ; etiology ; pathology ; Purpura, Thrombotic Thrombocytopenic ; diagnosis ; etiology ; pathology ; Reference Standards ; Retrospective Studies ; Thrombosis ; diagnosis ; etiology ; pathology

OBJECTIVETo observe the effect of acupuncture combined physical training and relearning on stroke patients.

METHODSA multi-center, randomized controlled trial design was adopted. A total of 364 stroke patients were recruited and randomly assigned to the experimental group (184 cases) and the control group (180 cases). Patients in the experimental group received acupuncture combined with physical training and relearning, while those in the control group only received physical training and relearning. All received four weeks of treatment. Effects on Fugl-Meyer motor function, neurological impairment, activities of daily living difference were compared before treatment, after treatment, 2 and 5 months after follow-ups between the two groups.

RESULTSTotally 353 patients completed this trial, 179 in the experimental group and 174 in the control group. (1) compared with before treatment, brief Fugl-Meyer motor functions scores and FIM scored obviously increased, and scores for neurological impairment obviously decreased in the two group. Besides, the increment of brief Fugl-Meyer motor functions scores and FIM scores was obviously higher in the experimental group than in the control group at month 2 and 5 of follow-ups; scores for neurological impairment was obviously lower in the experimental group than in the control group. The increment of FIM scores was obviously higher in the experimental group than in the control group at month 5 of follow-ups (P < 0.05, P < 0.01). (2) There was statistical difference in inter-group comparison of total Fugl-Meyer motor functions scores and FIM scores, or scores for neurological impairment (P < 0.01). The improvement of Fugl-Meyer motor functions grading and neurological impairment grading was obviously superior in the experimental group at month 2 and 5 of follow-ups. The distribution of FIM grading was also better in the experimental group at month 5 of follow-ups (P < 0.05, P < 0. 01).

CONCLUSIONSBoth acupuncture combined exercise training and relearning and physical training and relearning could effectively promote the rehabilitation of stroke patients, reduce their neurological impairment degrees, improve motor functions and independent capacities. Better long-term efficacy could be obtained by acupuncture combined exercise training and relearning.

Activities of Daily Living ; Acupuncture Therapy ; Biomedical Research ; Exercise Therapy ; Humans ; Research Design ; Stroke Rehabilitation ; Treatment Outcome