C. Conclusion The optimal SINI TANG composition comprises three active components combined at clinical maximal dosage showed the best therapeutic efficacy, of which A is a key factor and B, C are necessary factors for the composition in SINI TANG.

AIM: To study apoptosis and the involved genes in malignant transformation of gastric carcinoma. METHODS: Apoptotic cell and apoptotic regulating gene p53,bcl-2,c-myc were detected in 46 cases with gastric carcinomas, 20 cases with precancerous lesions and 24 cases with normal mucosa in situ using TdT-mediated dUTP-biotin nick end labeling (TUNEL) technique and immunohistochemical stain. RESULTS: Apoptotic index in precancerous lesion(intestinal metaplasia and dysplasia) and gastric carcinoma were significantly higher than that in normal mucosa( P

AIM: To study the change of myocardial ceramide during myocardial ischemia/reperfusion and the relationship between ceramide and apoptosis and oxidative stress. METHODS: After inducing myocardial ischemia/reperfusion (I/R) injury in mice with pituitrin (Pit), myocardial SOD activity and MDA content were measured. DNA agarose gel electrophoresis and fluorescent staining of DAPI were done to check up apoptosis. The content of myocardial ceramide (?g/kg) was measured through HPTLC and scan of thin plate. RESULTS: The myocardium of I/R model group had the phenomenon of DNA ladder. Apoptosis index and ceramide content in I/R model group were higher than those in normal control group (P

AIM: To study the effects of Sini Decoction's effective component(SNDE) on myocardial apoptosis and ceramide content during myocardial ischemla/reperfusion. METHODS: The mice of Kunming species were randomly divided into 3 groups: control,myocardial ischemia/reperfusion and SNDE.After inducing myocardial ischemia/reperfusion injury of mice in vivo with pituitrin(Pit),myocardial SOD activity and MDA content were measured.DNA agarose gel electrophoresis and fluorescent stain of DAPI were done to check up apoptosis.The content of myocardial ceramide(?g/kg) was measured through HPTLC and scan of thin plate. RESULTS: The myocardium of model group has the phenomenon of DNA ladder.The apoptosis index and the ceramide content in model group were higher than those of control group(P

Objective To study the anti-myocardial ischemia-reperfusion injury effect of Sini Decoction's active fraction(SNDAF).Methods Experimental animals were randomly individed into normal,model,Sini Decoction(SND),and SNDAF groups.Rat hearts were perfused by the Langendorff method.The model of myocardial ischemia-reperfusion injury was reproduced by adjusting the flow of perfused liquid.The perfused liquid of normal and model groups was KH buffer saturated by oxygen.The perfused liquid with SND or SNDAF was mixed with KH buffer.The coronary flow and contract power of myocardium at 0 min of ischemia and 1,5,10,20,30,40,and 50 min of reperfusion were tested,respectively.The incidence of reperfusion arrhythmias(IRA) in the first 1 minute of reperfusion was calculated.Mice were given drugs by ig for 3 d and then myocardial ischemia-reperfusion models were established by ip pituitrin(20 U/kg).ECG of mice was recorded at 0—80 min after ip administration. SOD activity,and the contents of MDA and LA in myocardium of mice were measured.Results Both SND and SNDAF could reinforce myocardial contract and reduce the IRA in the first minute of reperfusion.SND had better effect on IRA than that of SNDAF.SNDAF had better effect on myocardial contract than that of SND.SND and SNDAF could significantly drop ECG J point raise induced by ischemia,and increase SOD activity,and decrease contents of MDA and LA significantly in ischemia myocardium.There were no significant difference between SND and SNDAF.Conclusion SNDAF could improve oxidative injury and suppress(ischemia) of myocardium,reinforce myocardial contract,and reduce the incidence of arrhythmias during(myocardia) ischemia-reperfusion.

AIM:To establish a microthrombus model by carrageenan (Ca)/ lipopolysaccharides (LPS) intraperitoneal injection in rats with hyperhomocysteinemia (HHcy) and endothelial dysfunction induced by L-methionine intake. METHODS: ① Male Sprague Dawley rats were randomly divided into 2 groups: control and endothelial dysfunction (HHcy) groups. L-methionine was administered by gavage in HHcy group for total 4 weeks. Purified water was administered by gavage in control rats. Plasma Hcy, NO and vWF were examined and the thoracic aorta were excised after 4 weeks of L-methionine treatment to evaluate endothelial function. ② Male Sprague Dawley rats were randomly divided into 3 groups to establish a microthrombus formation model with Ca/ LPS: control, microthrombus formation (Ca/LPS) and endothelial dysfunction plus mitoarothrombus formation (HHcy+Ca/LPS) groups. Control rats were injected with normal saline (NS). Ca/LPS rats were intraperitoneally injected with carrageenan (Ca) and followed by lipopolysaccharides (LPS) 16 h later. HHcy+Ca/LPS rats were intragastric gavaged by L-methionine for total 4 weeks, and then were injected with Ca/LPS in the same way as Ca/LPS group. Cruor parameters and platelet count were detected at 20 h after LPS or NS injection and the mesentery microcirculation was monitored. Plasma NO and vWF were also detected at 24 h after LPS or NS injection. RESULTS: ① Plasma Hcy concentrations and vWF level were significantly increased in HHcy group, while plasma NO content was significantly decreased compared with that in control group. Endothelial dependent relaxation (EDR) of aortic rings was significantly decreased in HHcy group, suggesting endothelial damage/dysfunction was induced by HHcy. ② Mesentery capillary was obviously blocked by microthrombus in Ca/LPS rats and was blocked more seriously in HHcy+Ca/LPS rats. Cruor parameter results suggested that Ca/LPS rats were in hypercoagulable phase and HHcy+Ca/LPS rats were in hypocoagulable phase at 20 h after LPS injection. Platelet count and plasma NO content in HHcy+Ca/LPS group were significantly decreased, while plasma vWF level was significantly increased compared with Ca/LPS group. CONCLUSION: L-methionine intake induces severe HHcy and causes endothelial dysfunction in rats. Microcirculation dysfunction and microthrombosis can be caused by Ca/LPS intraperitoneal injection and may be aggravated by endothelial dysfunction.

Objective To study the syndrome of inappropriate ADH secretion(SIADH)after all ogeneic hematopoietic stem cell transplantation(allo-HSCT)and the possible etiology.Methods SIADH was occurred in one patient with acute lymphoblastic leukemia who received secondary haploidentical stem cell transplantation after graft failure following umbilical cord blood transplantation.Results An 11-year-old boy was diagnosed as high-risk acute lymphoblastic leukemia,and the transplantation of unrelated double umbilical cord blood was performed for the first time,however,there was no engraftment at 28 days after the first transplantation.Secondary haploidentical stem cell transplantation was administered at day 33 after the first transplantion.The bone marrow and the peripheral blood stem cells from the patient's father transplantation was adopted.Pre-engraftment syndrome was developed in the patient at day 7 after secondary haploidentical HSCT followed by severe hyponatraemia(lowest serum sodium 115.8 mmol/L),natriuresis,hypo-osmolality of plasma,and twitch at day 26 after allo-HSCT.Then SIADH was diagnosed.The clinical condition was improved after restriction of water and administration of hypertonic saline,and eventually SIADH was controlled completely.By now,the patient had lived free of disease more than one year,with a normal diet and serum sodium in normal ranges.Conclusions SIADH after allo-HSCT is a rare fatal acute complication of central nervous system,whic h are probably associated with numerous transplant-related causes.Early accurate diagnosis and treatment promptly are great importance.

Objective To retrospectively analyze the engraftment, transplant-related complications and survival after unrelated cord blood transplantation (UCBT) in patients with hematologic malignancies. Methods Fifty consecutive patients with hematological malignancies (median age, 19 years; median weight, 53 kg) were treated with UCBT in single center from April 2000 to August 2009. Thirty-nine patients were high-risk or refractory. Double UCB grafts were used for 26 patients, while single UCB graft for 24 patients. Myeloablative conditioning was given to 45 cases and non-myeloablative regimens to 5 cases. All patients were given a combination of cyclosporin A (CsA) and mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis. Results The median total nucleated cell (TNC) dose was 4.0 (range, 1.95-16.24)×10~7 TNC/ kginfused, and CD34~+ cell dose was 2.74(range, 0.67-29.28)×10~5/kginfused. Forty-two of 50 patients acquired engraftment with implantation rate being 86%. The median time to engraftment (absolute neutrophil count>500/mm~3 and platelets 20 000/L) was 19 and 34 days. The cumulative incidence of neutrophil engraftment by day 42 was 86.3%(95% confidence interval [CI] 0.769-0.957); the cumulative incidence of platelets engraftment by day 120 was 72.3% (95% CI 0.620-0.821). Twenty cases developed acute GVHD, and the incidence of acute GVHD of grades Ⅲ/Ⅳ by day 100 was 7.1%. The incidence of chronic GVHD within 2 years was 17.4%. During a median follow-up period of 22 months (range 4-116), Overall 6-month, 1-year and 2-year survival rate was 66.2%(95% CI 0.590-0.734), 57.4%(95% CI 0.496-0.652), 54.2%(95% CI 0.462-0.622), respectively. For the patients with non-advanced hemotologic malignancies, 6-month, 1-year and 2-year survival rate was 73.2% (95% CI 0.659-0.805), 66.1% (95% CI 0.579-0.743), and 62.2% (95% CI 0.542-0.682) respectively. Five cases relapsed. The cumulative incidence of relapse within 2 years was 16.2% (95% CI 0.099-0.225). Twenty-one cases died mainly due to infection. Conclusion UCBT could be safely and effectively used for adult patients with hematologic malignancies.

Objective To investigate the efficacy and safety of posaconazole in the prophylaxis or salvage treatment of invasive fungal disease (IFD) in patients with hematological diseases.Methods 25 patients with hematological diseases receiving posaconazole treatment from Feb 2014 to Feb 2015 were analyzed retrospectively.The patients' average age was 32.6 years old (16-64 years old).18 patients received posaconazole for IFD prophylaxis, and 7 patients for IFD salvage treatment.Results 18 patients receiving posaconazole for IFD prophylaxis had no clinical manifestation of IFD (that is no case of breakthrough fungal infection) during treatment or in the 12 weeks after treatment, and the average prophylaxis period was 21 d (14-35 d).Among 7 patients receiving posaconazole for IFD salvage treatment, 6 patients were effective, including 4 cases cured and 2 cases effective.There were no obviously side effects of posaconazole in these patients.Conclusion Posaconazole has good clinical response for IFD in the hematologic diseases patients whether in prophylaxis or in salvage treatment.

AIM: To investigate p16 gene alterations in gastric carcinoma. METHODS: 36 fresh tumor specimens taken from gastric cancer patients were analyzed for p16 gene deletion and mutation by polymerase chain reaction (PCR) and DNA sequencing. RESULTS: Homozygous deletion of exon 1 and exon 3 was observed in 2 cases and 3 cases of diffuse carcinoma, respectively. The frequency of homozygous deletion was 13.89%. No p16 gene point mutation was detected. CONCLUSION: The deletion of p16 genes may be related to gastric carcinogenesis.