Relapse, which puzzled several generations of hematologists, is the bottle-neck of radical treatment for leukemias. The progress of Human Microbiome Project at the beginning of 21st century suggested that human body was a super-organism constituted by the core of human cells and symbiotic microorganisms. The elucidation and characterization of endogenous retrovirus and prion protein suggested the possible effects of co-evolutional microorganisms on human health. Recently, the elucidation of the roles of tunneling nanotubes in intercellular communication and transportation suggested a novel way for cellular communication and transport of oncogenic materials. The role and significance of in vivo cell fusion have been studied in more detail. On the other hand, donor cell leukemia was reported. All of these approaches provide novel insights for studying the mechanism of leukemia relapse. Based on previous work, the authors suggest the hypothesis: there are two possible mechanisms for the relapse of leukemias: the minimal residual disease (MRD) and intercellular transportation of oncogenic materials.
Cell Fusion ; Humans ; Leukemia ; pathology ; Neoplasm, Residual ; pathology ; Recurrence

Objective:To make an assessment on the genotoxicity caused by black carbon ( BC ) and ozonized black carbon (O3-BC).Methods: In this study, 74 healthy male ICR mice [weighed (28 ± 1.5) g] were randomly divided into 7 groups, including one phosphate buffer solution ( PBS) control group and six particles exposed groups by intratracheal instillation with either BC or O 3-BC at the doses of 50, 100, 200 μg/mouse, respectively.There were 12 mice in the groups of 200μg/mouse and 10 mice in others.The mice were sacrificed 24 h after four intratrachealinstillations .The activities of catalase ( CAT) in serum and the levels of malondialdehyde ( MDA) in lung tissue homogenate were measured . As the DNA damage mark , 8-hydroxyguanosine ( 8-OHdG ) in urine and serum were quantified with ELISA method.Micronucleus test was used for potential genotoxicity of BC and O 3-BC.Hematoxylin and eosin staining was used to stain lung paraffin section .Results:The mice were in good condition during instillation , and the liver coefficient of the test groups was significantly lower than that of the control group (P<0.05).The activities of CAT in serum significantly increased in the 100 μg/mouse and 200μg/mouse groups after being exposed to these two kinds of particles .The micronucleus rate in allthe BC and O3-BC exposed groups increased ( P <0.05), but there was no statistically significant difference among the groups in the levels of 8-OHdG in serum and urine and MDA in lung tissue homogenate .In-flammatory response was found in the lung tissue under the microscope after exposure to BC and O 3-BC. Conclusion:Intratracheal instillation of BC and O 3-BC induced increasing of oxidative stress and genetic damage in mice .But there was no significant difference between these two particles in toxicity .Whether the genotoxicity of O 3-BC is higher than that of BC or not is uncertain .Further research is needed .

BACKGROUND: Acute pancreatitis (AP) is a complex and heterogeneous disease. We aimed to design and validate a prognostic nomogram for improving the prediction of short-term survival in patients with AP. METHODS: The clinical data of 632 patients with AP were obtained from the Medical Information Mart for Intensive Care (MIMIC)-IV database. The nomogram for the prediction of 30-day, 60-day and 90-day survival was developed by incorporating the risk factors identified by multivariate Cox analyses. RESULTS: Multivariate Cox proportional hazard model analysis showed that age (hazard ratio [HR]=1.06, 95% confidence interval [95% CI] 1.03-1.08, P<0.001), white blood cell count (HR=1.03, 95% CI 1.00-1.06, P=0.046), systolic blood pressure (HR=0.99, 95% CI 0.97-1.00, P=0.015), serum lactate level (HR=1.10, 95% CI 1.01-1.20, P=0.023), and Simplified Acute Physiology Score II (HR=1.04, 95% CI 1.02-1.06, P<0.001) were independent predictors of 90-day mortality in patients with AP. A prognostic nomogram model for 30-day, 60-day, and 90-day survival based on these variables was built. Receiver operating characteristic (ROC) curve analysis demonstrated that the nomogram had good accuracy for predicting 30-day, 60-day, and 90-day survival (area under the ROC curve: 0.796, 0.812, and 0.854, respectively; bootstrap-corrected C-index value: 0.782, 0.799, and 0.846, respectively). CONCLUSION: The nomogram-based prognostic model was able to accurately predict 30-day, 60-day, and 90-day survival outcomes and thus may be of value for risk stratification and clinical decision-making for critically ill patients with AP.

OBJECTIVETo investigate electrocardiographic (ECG) and angiographic characteristics of patients with acute solitary posterior myocardial infarction. Patients complicated by inferior wall or right ventricular infarction were excluded.

METHODECG and angiographic changes in 11 patients with acute solitary posterior myocardial infarction admitted to our emergency room from 2001 to 2006 were analyzed.

RESULTSBesides typical ST segment elevation in V(7)-V(9) leads, other ECG manifestations in these patients included V(1)-V(2) R/S > or = 1 (9/11, 81.8%), 1 - 2 mm ST depression in V(1)-V(4) (5/11, 45.5%), 0.5 - 1.5 mm ST elevation in I, aVL leads (4/11, 36.4%) and 0.5 - 1.5 mm ST elevation in V(5)-V(6) leads (5/11, 45.5%). Coronary angiography showed that left circumflex artery (LCX) was the infarction related artery in all cases. The infarction area located before OM1 origination in 1 patient with a 95% pipe-like stenosis (1/11), after OM1 origination in 6 patients (6/11, 4 with total occlusion, 1 with sub-total occlusion and 1 with 90% long length stenosis), in OM1 in 4 patients (4/11, 2 with total occlusion, 1 with sub-total occlusion and 1 with 95% local stenosis). There were 3 patients (27.3%) with single vessel lesion, 4 patients (36.4%) combined with left anterior descending artery (LAD) lesion, 2 patients (18.2%) combined with right coronary artery (RCA) lesion and 2 patients (18.2%) combined with LAD and RCA lesions.

CONCLUSIONSAcute posterior myocardial infarction should be suspected with V(1)-V(2) R/S > or = 1 and V(1)-V(4) ST depression in standard 12 leads ECG. Besides symptoms and cardiac enzyme measurements, recording posterior leads electrocardiogram and performing coronary angiography will help to make the correct diagnosis.

Aged ; Coronary Angiography ; Coronary Vessels ; physiopathology ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; physiopathology ; Myocardium ; enzymology

OBJECTIVETo determine the normal value of right ventricle using one beat full-volume real-time three-dimensional echocardiography (RT-3DE) and assess the feasibility of this technique.

METHODSOne beat full volume images were acquired at the apical 4 chamber view in 129 healthy volunteers. The right and left ventricular volumes were examined with the eSie LVA and RVA. The subjects were divided into 2 gender groups (male and female) and 3 age groups (20 - 39 years old, 40 - 59 years old, 60 years old and above).

RESULTSAdequate data were obtained in 129 subjects. The RV-EDV was (92.4 ± 21.3) ml, RV-ESV (34.6 ± 9.2) ml, RV-SV (57.8 ± 13.9) ml, RV-EF (62.5 ± 5.0) ml. EDV, ESV, and EF were significant different while SV was similar between RV and LV (all P < 0.05). RV-EDV (r = 0.517, P = 0.001), RV-ESV (r = 0.588, P = 0.001) and RV-SV(r = 0.409, P = 0.001) were correlated well with BSA. RV-EDV, RV-ESV and RV-SV were significantly higher in males than in females (all P < 0.001). RV-EDV, RV-SV and RV-EF decreased with aging (P < 0.05).

CONCLUSIONSRight ventricle function can be measured noninvasively by RT-3DE with high feasibility. This novel method contributes to the detailed study of right heart function in various cardiovascular diseases.

Adult ; Aged ; Aged, 80 and over ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Male ; Middle Aged ; Ventricular Function, Right ; physiology ; Young Adult

We have shown previously that a Semliki Forest virus (SFV) replicon vectored DNA vaccine (pSFV1CS-E2) expressing the E2 glycoprotein of classical swine fever virus (CSFV) conferred full protection for pigs immunized three times with 600 microg of the vaccine. This study aims to evaluate the efficacy of the DNA vaccine with lower dosage and fewer inoculations. Pigs were immunized twice with 100 microg pSFV1CS-E2 (n = 5) or control plasmid pSFV1CS (n = 3), respectively. Pigs immunized with pSFV1CS-E2 developed high titers of specific neutralizing antibodies against CSFV after the booster, and the antibody titers increased rapidly upon challenge. The immunized animals showed no clinical symptoms except short-term fever and low-level viremia, whereas the control pigs immunized with the control plasmid produced no detectable antibody before challenge and showed obvious clinical signs following challenge, and 2 pigs died on 10 or 11 days post-challenge. All control animals developed extended viremia as detected by nested RT-PCR and real-time RT-PCR. Severe pathologic lesions typical of CSFV infection were observed at necropsy. We conclude that the alphavirus replicon-vectored DNA-based vaccine can be potential marker vaccine against CSFV.
Animals ; Antibodies, Neutralizing ; blood ; immunology ; Antibodies, Viral ; blood ; immunology ; Body Temperature ; immunology ; Classical Swine Fever ; blood ; immunology ; prevention & control ; Classical swine fever virus ; genetics ; immunology ; Genetic Vectors ; genetics ; Immunization ; Plasmids ; genetics ; Replicon ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Semliki forest virus ; genetics ; Swine ; virology ; Time Factors ; Vaccines, DNA ; administration & dosage ; genetics ; immunology ; Viral Envelope Proteins ; genetics ; immunology ; Viremia ; genetics ; immunology

OBJECTIVETo assess the effect of delayed opening of the infarct-related artery (IRA) by percutaneous coronary intervention (PCI) on the late left ventricular remodeling after acute anterior myocardial infarction (AAMI).

METHODSSixty four patients with initial Q-wave AAMI and with the total occluded IRA conformed by angiogram at 9.1 +/- 2.3 (2 - 14) days after the onset were divided into successful PCI group and control group (not receiving PCI or the IRA not re-opened). Two-D echocardiogram was performed at acute phase (about 3 weeks), 2 and 6 months after onset of AAMI respectively to detect the left ventricular function and left ventricular wall motion abnormality (VWMA). The total congestive heart failure events were recorded during 6 months follow-up.

RESULTSVWMA scores, left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) were similar in 2 groups at acute phase and 2 months after the onset of AAMI. There were no differences between the parameters above at acute phase and 2 months in each group too. VWMA scores and LVEF did not changed significantly at 6 months in each group compared with those at acute phase and 2 months (P > 0.05). But LVEDVI and LVESVI were significantly smaller in the successful PCI group than those in the control group (P < 0.01, P < 0.05). The rate of congestive heart failure events was 19% in control group and 2.0% in successful PCI group (P > 0.05) respectively.

CONCLUSIONSDelayed opening of IRA in AAMI could prevent the late phase but not the early phase of left ventricular remodeling after AMI.

Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; pathology ; physiopathology ; therapy ; Myocardial Reperfusion ; Ventricular Remodeling

Evolutionary medicine can give rational explanation for metabolism diseases via ecology and evolutionary theory. Recently, the view of somatic cell macroevolution was used in the study on the genesis and development of tumors, which provided new insight in the research work on tumors. In this article, the well-adopted tumor therapy strategy, "Dancing with Cancer", was analyzed preliminarily from the point of co-evolution game theory, based on the non-classical immunology theory and genome theory. The importance of increasing host fitness by changing host life-style to enhance tolerance was emphasized, which is the basis of the Dancing with Cancer strategy. On the other hand, the spreading tumor cells are not equally malignant and spreading tumors should be treated as other chronic diseases. Finally, basic and clinical research should be strengthened to improve the efficiency of the "Dancing with Cancer" strategy.
Biological Evolution ; Game Theory ; Neoplasms ; therapy

OBJECTIVETo retrospectively analyze a single institution's experience with surgery of the carotid artery performed as part of an oncological procedure and emergency hemostasis, with the aim to determine the preoperative methods for evaluation of cerebral circulation, selection of surgical procedures and perioperative complications.

METHODSFrom January 1999 to December 2004, a total of 35 patients underwent carotid artery surgery including repair of carotid artery in 7 cases, ligation or resection of carotid artery in 17 cases, and reconstruction of carotid artery in 11 cases. All the patients were evaluated for blood flow in the circle of Willis with DSA, DSA plus TBO plus SPECT, and TCD and followed up from 4 months to 4 years. The perioperative complications and surgical outcomes were recorded and analyzed.

RESULTSThere were 16 carotid body tumors, 1 malignant carotid body tumor, 17 malignant tumors involving the carotid artery and 1 traumatic arterio-venous fistula. Twenty-seven patients underwent carotid occlusion test, 10 were positive and 17 were negative (tolerable). Of 7 cases with repair of the carotid artery, 1 patient died of uncontrolled bleeding due to rupture of the anastomosis, and the remaining was uneventful. Of 17 cases with ligation or resection of the carotid artery, 4 developed neurologic deficit 2 weeks postoperatively. Three patients with malignant tumors died 1 month, 4 months, and 4 months postoperatively, respectively. One patient with carotid artery body tumor complained of inarticulate speech 4 months after operation; another patient complained of incapability and limited movement of the ipsilateral upper limbs; 5 patients complained of dizziness 4, 6, 12, 24 and 48 months postoperatively. Of 11 patients who underwent carotid reconstruction, no major cerebral complications were noted after operation. One patient died of recurrence, 1 patient with carotid body tumor complained inarticulate speech and incapability of the contralateral limbs, the remaining was uneventful. Color Doppler showed patent vascular graft 1 year postoperatively.

CONCLUSIONSTBO plus SPECT is a reliable method for evaluation of the circle of Willis currently. The short term and long term complications of ligation of carotid artery are high, therefore, resection and revascularization of the carotid artery is advocated for carotid artery tumors when possible.

Adolescent ; Adult ; Aged ; Balloon Occlusion ; Carotid Arteries ; diagnostic imaging ; surgery ; Carotid Artery Injuries ; diagnostic imaging ; surgery ; Carotid Body Tumor ; diagnostic imaging ; surgery ; Child ; Collateral Circulation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon ; Vascular Surgical Procedures ; adverse effects ; methods ; Young Adult

OBJECTIVETo observe the association between uroguanylin G-247A polymorphism and blood pressure/fluid and electrolytes homeostasis.

METHODSUroguanylin genotype was determined by restrictive fragment length polymorphism (RFLP) and blood pressure as well as fluid and electrolytes homeostasis were measured in 442 volunteers from Jing Ning County, ZheJiang Province. Data were analyzed by ANOVA, Generalized Estimating Equations (GEE), and Quantitative Transmission Disequilibrium Test (QTDT).

RESULTSTen uroguanylin gene polymorphisms were detected in 40 subjects by direct sequencing, all were reported in the NCBI SNP database. We selected the G-247A polymorphism for genotyping. Compared with G allele carriers, AA homozygotes had a higher urinary volume (P = 0.08), higher excretions of sodium (P = 0.07) and potassium (P < 0.001), but similar systolic and diastolic blood pressure (P > 0.32) both before and after adjustment for sex, age, body-mass index, current smoking, alcohol intake, and antihypertensive treatment.

CONCLUSIONSThe uroguanylin G-247A polymorphism was associated with urinary volume and sodium and potassium excretions.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Blood Pressure ; Child ; Female ; Genotype ; Humans ; Hypertension ; epidemiology ; genetics ; Male ; Middle Aged ; Natriuretic Peptides ; genetics ; Polymorphism, Restriction Fragment Length ; Water-Electrolyte Balance ; Young Adult