This article summarizes the progress of hematology in the recent tens years to show that experimental hematology used to pick up the 'hints' from clinical problems as the renewal of research directions and targets in experimental studies continuously. As the feedback, the results from lab investigations inserted into clinical practice and eventually made a quick modernization of hematology, which was actually a good model for the "translational research". The past few decades have witnessed tremendous advances in our understanding of normal hematopoiesis where genes dictate, epigenetics regulate, transcription factors mediate, and stem cells self-renew and differentiate. Dissection of disease pathogenesis not only elucidates molecular basis of disorders including hemoglobinopathy, aplastic anemia, hemophilia, hematopoietic malignancies such as leukemia and myeloproliferative disorders, but also provides therapeutic targets for drug development. Introduction of targeted therapies and combinatory targeting therapies greatly benefits hundreds of thousands of patients, and even turns acute promyelocytic leukemia from highly fatal to highly curable. In the 21st century the experimental hematology is entering the era of genomics and system biomedicine, and the pace of progress extrapolates to a prediction of hematologic neoplasms control in this century.
Animals ; Clinical Laboratory Techniques ; trends ; Hematologic Diseases ; genetics ; metabolism ; physiopathology ; Hematologic Neoplasms ; genetics ; metabolism ; physiopathology ; Hematology ; trends ; Humans

Objective To investigate the reliability of the Three-Column classification for fracture of tibial plateau and compared with the conventional Schatzker classification.Methods From December 2004 to March 2007,304 patients with tibial plateau fracture were treated in our department.The CT scans and 3D reconstruction were performed in all patients before operation.All the patients were classified by the Three-Column classification and then treated with open reduction and internal fixation via the corresponding approaches based on the Three-Column classification.To validate the Three-Column classification,four doctors classified 50 patients which were chosen randomly from 323 consecutive fracture cases.Schatzker classification was also classified at the same time.Inter-observer reliabilities of the Three-Column classification and the Schatzker classification were figured out respectively in the form of Kappa value.Results According to the Three-Column classification,there were 4 pure compression fractures (1.2％),181 one-column fractures(56.0％),108 two-column fractures(33.4％) and 30 three-column fractures (9.3％) in all 323 cases.In one-column fracture cases,the numbers of lateral,medial,and posterior column fractures were 114 (63.0％),53 (29.3％),and 14 (7.7％),respectively.Among two-column fracture cases,the lateral-medial column fractures (33.3％) were 36.While the number of medial-posterior column fractures and lateral-posterior column fractures were 34 (31.5％) and 38 (35.2％),respectively.There was a moderate inter-observer reliability when using Schatzker classification (Kappa=0.567; range,0.513-0.589).There was a substantial interobserver reliability when using the Three-Column classification (Kappa=0.766; range,0.706-0.890).Conclusion The Three-Column classification based on CT and 3D reconstruction is simple and more reliable for fracture of tibial plateau.It is suggested that the new classification system,the Three-Column classification,can be used and popularized in the orthopaedic surgery.

OBJECTIVETo compare the effect of transurethral resection of the prostate combined with endocrine therapy (TURP + ET) with that of αlA-blockers combined with ET ((αlA-b + ET) in the treatment of bladder outlet obstruction (BOO) in patients with advanced prostate cancer (PCa), and to investigate the safety of the TURP + ET for the treatment of PCa with BOO.

METHODSWe retrospectively analyzed 63 cases of PCa with BOO, 28 treated by αlA-b + ET and the other 35 by TURP + ET. We obtained the residual urine volume (RV), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and quality of life score (QoL) before and after treatment along with the overall survival rate of the patients, followed by comparison of the parameters between the two methods.

RESULTSAt 3 months after treatment, RV, IPSS, and QoL in the TURP + ET group were significantly decreased from (137.8 ± 27.6) ml, (22.3 ± 3.6), and (4.2 ± 0.8) to (29 ± 13.6) ml, (7.8 ± 2.1), and (1.6 ± 0.5) respectively (P < 0.05), while Qmax increased from (5.6 ± 2.1) ml/s to (17.6 ± 2.7) ml/s (P < 0.05); the former three parameters in the αlA-b + ET group decreased from (133.6 ± 24.9) ml, (21.5 ± 3.2), and (4.7 ± 1.1) to (42 ± 18.3) ml, (12.8 ± 2.6), and (2.5 ± 0.7) respectively (P < 0.05), while the latter one increased from (6.3 ± 2.4) ml/s to (11.7 ± 2.3) ml/s (P < 0.05), all with statistically significant differences between the two groups (P < 0.05). The overall survival rate of the TURP + ET group was not significantly different from that of the αlA-b + ET group (51.4% vs 46.4% , P > 0.05).

CONCLUSIONTURP + ET is preferable to αlA-b + ET for its advantage of relieving BOO symptoms in advanced PCa without affecting the overall survival rate of the patients.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Antineoplastic Agents, Hormonal ; therapeutic use ; Combined Modality Therapy ; methods ; Humans ; Male ; Prostatic Neoplasms ; complications ; drug therapy ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder Neck Obstruction ; drug therapy ; etiology ; surgery

OBJECTIVETo investigate the time trends and age-related characteristics of mortality and disease burden for cardiocerebrovascular diseases (CVD) in Hunan, China during three periods (1973-1975, 1990-1992 and 2004-2005).

METHODSThe cardiocerebrovascular death data of Hunan residents were collected by three national retrospective sample surveys of death. Cause-specific mortality, proportion, years of potential life lost (YPLL) and associated indicators were identified in the population of Hunan in above mentioned three periods. Time trends of age-specific mortality rate were assessed by fitting curvilinear regression lines and the increase rates of mortality with age were analyzed in each period.

RESULTSThe standard all-cause mortality of residents in Hunan decreased (chi2 = 189.947, P < 0.001, chi2 = 54.201, P < 0.001; chi2 = 27,396.898, P < 0.001) while the standard mortality for CVD increased (chi2 = 54.201, P < 0.001; chi2 = 27,396.898, P < 0.001) from 1973 to 2005. The age-specific mortality rate for CVD increased with age in all three periods, especially for citizens older than 60 years. There were age stages in each period in which the mortality increase rate was the fastest (10-14 and 15-19 years old in 1973-1975; 10-14, 15-19 and over 80 years old in 1990-1992; 15-19 and over 80 years old in 2004-2005). Exponential regression function (y = b0e(b1x)) can be used for the proper description of age-specific mortality change. The ratio of YPLL for CVD in all death causes showed increase trend (chi2 = 275,630.407, P < 0.001). YPLL rate (YPLLs per 1000) in 1973-1975 was higher than those in 1990-1992 and 2004-2005. YPLL rate was positively correlated with mortality in all periods.

CONCLUSIONSThe mortality for CVD increased with time and aging. People older than 60 years were threatened by CVD mostly. Mortality trend analysis also found higher CVD deaths in people age 15-19 in Hunan residents.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cardiovascular Diseases ; epidemiology ; mortality ; Cause of Death ; Cerebrovascular Disorders ; epidemiology ; mortality ; Child ; Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Life Tables ; Middle Aged ; Survival Rate ; trends ; Time Factors

OBJECTIVETo explore the specialty of diagnosis and surgery of tight carotid stenosis.

METHODFrom January 2000 to December 2009, 53 patients with tight carotid stenosis (> 95%) were operated on. All 53 patients had tight carotid stenosis more than 95% on one side in whom 28 had contralateral carotid stenosis or occlusion. The clinical and imaging data as well as surgical outcomes of the patients were retrospectively analyzed.

RESULTSForty-five patients had postoperatively done well without any complications. There were 3 cases of hemodynamic instability and one case of cardiac ischemia which resolved in one to two days. One patient developed mild hoarseness. One complicated with bacteremia due to deep vein catheter insertion. Two patients experienced brain hemorrhage. None of this series occurred perioperative brain ischemia.

CONCLUSIONSTight carotid stenosis indicates a need for expeditious carotid endarterectomy with very low rates of brain ischemia. Intraoperative shunting is seldom necessary. Postoperative hyperperfusion syndrome and brain hemorrhage should be worried. Micro-endarterectomy can effectively prevent from restenosis.

Adult ; Aged ; Carotid Stenosis ; diagnosis ; surgery ; Endarterectomy, Carotid ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents

OBJECTIVETo evaluate the indication, time and strategy of surgery for patients with bilateral carotid atherosclerotic stenosis.

METHODSSeventy-four patients with bilateral carotid atherosclecrotic stenosis were admitted to our hospital from February 1987 to December 2007. In 34 patients who presented with unilateral symptoms and underwent ipsilateral carotid endarterectomy (CEA), contralateral CEA or carotid artery stenting (CAS) was performed in 8 because of severe stenosis (> 70%) or unstable plaque. Thirty-eight patients presented with bilateral symptoms. Among them, 15 underwent CEA on both sides, 3 were performed CEA on one side and CAS on the other side, while 20 underwent unilateral CEA only. In 2 asymptomatic patients, CEA was also performed.

RESULTSNinety-three cases of CEA were performed in 74 patients. Sixty-eight patients were uneventful after operation. Neurological deficits deteriorated in 2 patients. Four patients developed cardiac ischemia, cerebral hemorrhage and hoarseness respectively. Sixty-seven patients were followed-up for 4.9 years. No cerebral ischemia relevant to operated carotid artery developed in 63 patients.

CONCLUSIONSIf the indication is obvious, CEA should be performed no matter how contralateral carotid artery is. The strategy of therapy is individual. Whether using shunt depends on intra-operative monitoring.

Adult ; Aged ; Atherosclerosis ; complications ; Carotid Stenosis ; etiology ; surgery ; Endarterectomy, Carotid ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents

To investigate the potential role and the mechanism of PLZF-RARalpha/RARalpha-PLZF double fusion gene in the pathogenesis of acute promyelocytic leukemia (APL) in vivo at systematic biological level, PLZF-RARalpha/RARalpha-PLZF double transgenic mouse model was established by intercross; the integration and expression of fusion genes were analyzed by PCR and RT-PCR; the disease phenotype was detected by morphological and pathological examination of peripheral blood and bone marrow cells, as well as flow cytometry assays; the effects of ATRA with or without tricostatin A on bone marrow blast cells from PLZF-RARalpha/RARalpha-PLZF double TM were observed. The results showed that leukemia occurred in 5 PLZF-RARalpha/RARalpha-PLZF double TM 7, 7, 9, 11 and 11 months respectively, out of them two (40%) with classic APL features, the others (60%) with chronic myeloid leukemia through an observation period of 18 months. The leukemia occurrence of PLZF-RARalpha/RARalpha-PLZF TM was about 10%, which was similar to PLZF-RARalpha TM as that reported before. The latency was over 6 months, not earlier than PLZF-RARalpha TM only. No morphologic changes of PLZF-RARalpha/RARalpha-PLZF double TM blast cells to ATRA were observed, but increased cytoplasmic-nuclear ratio and nuclear condensation in bone marrow blast cells were found in combination of ATRA with tricostatin A. It is concluded that PLZF-RARalpha/RARalpha-PLZF double fusion gene transgenic mice have heterogeneity of pathogenesis. HDAC inhibitors such as trichostatin A, in combination with ATRA, induce differentiation of the blast/promyelocytic cells from PLZF-RARa/RARa-PLZF double TM, but not ATRA alone.
Animals ; Antigens, CD34 ; blood ; Bone Marrow Cells ; drug effects ; immunology ; pathology ; Cell Differentiation ; drug effects ; Chorionic Gonadotropin ; genetics ; Disease Models, Animal ; Female ; Flow Cytometry ; Humans ; Hydroxamic Acids ; pharmacology ; Leukemia, Promyelocytic, Acute ; blood ; genetics ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Inbred CBA ; Mice, Transgenic ; Oncogene Proteins, Fusion ; genetics ; Pedigree ; Receptors, Chemokine ; blood ; Tretinoin ; pharmacology

OBJECTIVETo study the modulatory effect of Panax gingseng and coadministration with Veratrum nigrum on the activity and mRNA expression of cytochrome P450 isoenzymes in rat liver.

METHODRat liver microsomal cytochrome P450, b5, aminopyrine N-demethylase(APND), p-nitrophenol-hydroxylase(pNPH)activities were quantitated by UV chromatography. The mRNA expression level of five CYP isoenzymes CYP1A1, CYP2B1/2, CYP2C11, CYP2E1 and CYP3A1 were detected by semi-quantitative reverse transcriptase-polymerase chain reaction(RT-PCR).

RESULTP. gingseng coadministrated with V. nigrum obviously decreased the P450 contents of liver microsomes, and the b5 contents. Both single and combined used inhibited the activities of aminopyrine N-demethylase. At the mRNA level, the expression of CYP2C11 markedly induced exposure to V. nigrum, but combinative groups decreased the expression of CYP2C11. The combination of P. gingseng and V. nigrum induced the expression of CYP1A1. P. gingseng has inhibitory effect on CYP2B1/2 and inductive effect used with V. nigrum. The combination of P. gingseng with V. nigrum also induced the expression of CYP3A1.

CONCLUSIONP. gingseng used singly has some different modulation effects compared with combinative used, which may occur because of drug-drug interaction based on cytochrome P450. To elucidate the drug-drug interaction, it needs further analysis and metabolism research.

Aminopyrine N-Demethylase ; metabolism ; Animals ; Cytochrome P-450 Enzyme System ; biosynthesis ; genetics ; Cytochromes b5 ; metabolism ; Drug Incompatibility ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; In Vitro Techniques ; Isoenzymes ; biosynthesis ; genetics ; Male ; Microsomes, Liver ; metabolism ; Panax ; chemistry ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Rats, Wistar ; Veratrum ; chemistry

Dietary pattern has been revealed to be associated with metabolic syndrome. However, the association was not well documented in Chinese due to the complexity of Chinese foods. We mainly assessed the dietary patterns and examined their effects on metabolic syndrome among Chinese adults. Four dietary patterns including 'Refined Grains & Vegetables' Pattern, 'Dairy & Eggs' Pattern, 'Organ Meat & Poultry' Pattern, and 'Coarse Grains & Beans' Pattern were extracted. 'Dairy & Eggs' Pattern was associated with a decreased odds of metabolic syndrome in women, and 'Coarse Grains & Beans' Pattern was associated with a decreased odds of hypertension in men. These results provided a scientific basis for future research and dietary guideline perfection.
Adult ; Aged ; Diet ; Feeding Behavior ; Female ; Food ; classification ; Humans ; Male ; Metabolic Syndrome ; epidemiology ; etiology ; Middle Aged

Currently, the national schistosomiasis control program of China is moving from transmission interruption to elimination, and there are multiple challenges during the stage moving towards the progression of schistosomiasis elimination, including a high difficulty in shrinking snail-infested areas, unstable achievements for infectious source control, imperfect surveillance system and a reduction in schistosomiasis control and administration. Based on the core suggestions proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, recommendations on schistosomiasis surveillance system building, development of novel diagnostics, adjustment of the schistosomiasis control strategy and maintaining and improvements of the schistosomiasis control capability are proposed for the national schistosomiasis control program of China in the new era according to the actual status of schistosomiasis control in China. Formulation of the national schistosomiasis control strategy and goal from One Health perspective, verification of transmission interruption and elimination of schistosomiasis, precision implementation of schistosomiasis control interventions with adaptations to local circumstances, development and application of highly sensitive and specific diagnostics are recommended for elimination of schistosomiasis in China. In addition, the implementation of the 2022 WHO guideline on control and elimination of human schistosomiasis may guide the elimination of schistosomiasis in China.
Animals ; China/epidemiology* ; Goals ; Humans ; Schistosomiasis/prevention & control* ; Snails ; World Health Organization