Objective To investigate early Epstein-Barr virus (EBV) reactivation and the outcome of preemptive therapy after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods From January 2007 to January 2009, totally 277 patients after allo-HSCT were studied (haploidentical 116,unrelated 75, matched sibling 86). Conditioning regimens were mainly busulfan (BU) + cyclophosphamide ( CY)/fludarabine(Flu) or total body irradiation (TBI) + CY/Flu. Antihuman thymocyte globulin (ATG)was added in haploidentical and unrelated transplants. Plasma EBV DNA was monitored once to twice weekly in the first 3 months after allo-HSCT with real time quantitative polymerase chain reaction (RQ-PCR). EBV viremia was diagnosed when EBV DNA was more than 5 × 102 copies/ml but without symptoms. Acyclovir (10 mg/kg, intravenous drip, 8 h) was used for preemptive therapy and immnuo-suppressants were decreased if possible. Results Totally 33 patients ( 11.9% ) developed EBV viremia with a median time at day 44 (day 19 to day 84). The incidences of EBV viremia in the transplants from matched sibling,haploidentical, unrelated donors were 0, 15.5%, 20. 0%, respectively. There was no significant difference between haploidentical and unrelated transplants ( P = 0. 09 ), but much less EBV viremia was seen in matched sibling transplant ( P = 0. 001 ). Twenty of 33 patients ( 60. 6% ) had complete response to preemptive therapy. The median time to reach EBV DNA negative in plasma was 11 (4-56) d. The median duration of preemptive therapy was 21 (14-60) d. Both univariate and multivariate analysis indicated that haploidentical and unrelated transplants, acute graft versus host disease (GVHD) were the risk factors for EBV viremia. Two-year overall survival in the patients with EBV viremia was significantly lower than that without EBV viremia (54. 2% vs 72. 1%, P = 0. 006 ). Conclusions Our large clinical study has demonstrated that preemptive therapy with acyclovir that is guided by EBV viremia is effective in majority of the patients with high-risk for EBV reactivation after allo-HSCT, which may further decrease the risk for developing life-threatening EBV disease or post-transplantation lymphoproliferative disorder. Haploidentical and unrelated transplants, acute GVHD are the risk factors for EBV viremia which has negative impact on survival.

Objective To investigate the expression of livin of kidney tissues in rats with acute kidney injury (AKI) induced by endotoxin ,and the role of livin in the cell apoptosis of AKI .Methods The rat models with AKI were induced by endotoxin .The de-gree of kidney injury was observed by hematoxylin and eosin stain ,measuring the levels of the serum creatinine and urea nitrogen . The expression of livin and caspase-3 in kidney tissue at different time points was analyzed by immunohistochemistry assay ,and the relationship between the expression of livin and caspase-3 and kidney injury was analyzed .Results Compared to the control group , the rats injected endotoxin had the performance of AKI ,with obviously pathomorphological damage in the kidney tissues ,signifi-cantly increasing in the serum creatinine and urea nitrogen (P<0 .01) .The livin and caspase-3 of kidney tissues in rats with AKI caused by endotoxin were positive expression (P<0 .01) .With the lapse of time ,the trend of increasing of caspase-3 showed gradu-ally slow after the highest expression of livin .Conclusion The livin involved in the pathogenesis of endotoxin-induced AKI ,it might relieve the kidney injury and protect renal function by inhibiting casepase-3 important apoptotic effector protein .

ObjectiveTo study effects of oral administering alfa calcidol and diphosphonates on the bone mineral density (BMD) of patients with spinal cord injury (SCI).MethodsChanges of BMD of the 4th lumbar spine (L4), the proximal femur (total) and all of its subareas were studied between SCI cases of taking (n=31) and not taking (n=42) alfa calcidol. Changes of BMD between cases of taking diphosphonates (n=22) and not taking (n=24) were also compared.ResultsThere were no significant differences in BMD of L4, the proximal femur and all of its subareas between SCI cases of taking and not taking alfa calcidol. While there was a significant difference in BMD of the proximal femur (total) between cases of taking and not taking diphosphonates (P<0.05), and the reducing degree of BMD in the former is less than that in the latter.Conclusion Oral administering diphosphonates has a protective effect on SCI patients' BMD of the proximal femur.

Objective: To investigate the clinical effect and safety of electroencephalographic biofeedback therapy in improving memory disorders in patientsin the recovery stage of acute severe toxic encephalopathy. Methods: A total of 52 patients in the recovery stage of acute severe toxic encephalopathy who were hospitalized in our hospital from March 2013 to December 2016 were enrolled and randomly divided into observation group with 27 patients and control group with 25 patients. Both groups were given the drugs to promote the metabolism of brain cells,and the patients in the observation group were given electroencephalographic biofeedback therapy in addition. The Chinese revised version of Wechsler Memory Scale Type A was used to measure memory ability before and after each course of treatment. The treatment outcome was evaluated for both groups. Results: There were no significant differences in the scores of long-term memory,short-term memory, immediate memory, and memory quotient between the two groups before treatment(P>0.05).After the first course of treatment ended, the observation group had significant increases in the scores of forward task,backward task,association,and memory quotient(P<0.05); compared with the control group, the observation group had a significant reduction in the score of backward task(P<0.05).After the second course of treatmentended, the observation group had significant increases in the scores offorward task,backward task,memorization of pictures,reproduction,association,comprehension,and memory quotient,and the control group had significant increases in the scores of reproduction,association,comprehension,and memory quotient(P<0.05); compared with the control group, the observation group had significant increases in the scores of forward task,backward task,memorization of pictures, reproduction, association, comprehension, and memory quotient(P<0.05).Two patients experiencedchest distress, palpitation, and dysphoria during treatment, which did not affect the treatment. Conclusion Electroencephalographic biofeedback therapy has a certain effect in the treatment of memory disorders in patients with acute severe toxic encephalopathy.

Objective: To investigate effectiveness of different intensities of basketball exercise on body compositions among obese junior middle school students, and to provide theoretical support for healthy weight loss among obese children and adolescents. Methods: From September to November 2020,a typical sampling method was used to select 48 obese junior middle school students were recruited from Wuhan Optical Valley Experimental Middle School according to body mass index(BMI), all the students were divided into high, moderate and low intensity basketball training group, as well as the control group, the 45 min per times basketball exercise intervention was administered three times per week for 12 weeks, while the control group did not received no intervention, body composition was assessed before and after intervention. Results: After 12 weeks of low intensity basketball exercise, the percentage of body fat of obese junior high school students after intervention was significantly higher than that before intervention[(32.16±2.26)% v.s. (34.33±2.35)%] ( t =3.52, P <0.05). There was no significant difference in other indexes body weight, body mass index, waist circumference, skeletal musclebetween before and after intervention ( t =2.31, 1.98, 1.26,-1.65, P >0.05). For moderate intensity basketball exercise group obdy weight, BMI, percentage of body fat and waist circumference showed statistical changes before and after intervention( t=3.44, 3.76, 6.56, 2.45, P <0.05). For high intensity basketball exercise group, all body composition indicators showed significant changes( t=4.14, 5.18, 11.26, 5.89, -2.56, P <0.05). Conclusion Twelve weeks of basketball exercise can effectively improve body composition of obese junior middle school students, with higher the intensity of exercise, the better the effectiveness.

Multiple sclerosis (MS) is regarded as a chronic inflammatory disease that leads to demyelination and eventually to neurodegeneration. Activation of innate immune cells and other inflammatory cells in the brain and spinal cord of people with MS has been well described. However, with the innovation of technology in glial cell research, we have a deep understanding of the mechanisms of glial cells connecting inflammation and neurodegeneration in MS. In this review, we focus on the role of glial cells, including microglia, astrocytes, and oligodendrocytes, in the pathogenesis of MS. We mainly focus on the connection between glial cells and immune cells in the process of axonal damage and demyelinating neuron loss.
Humans ; Multiple Sclerosis ; Neuroglia ; Inflammation/pathology* ; Brain/pathology* ; Spinal Cord/pathology*

Objective To observe the histopathological and ultrastructural changes,alterations in the expressions of type Ⅳ collagenases(MMP-2 and MMP-9),the tissue inhibitors(TIMP-1 and TIMP-2)and intercellular adhesion molecule-1(ICAM-1)in the internal carotid arteries(ICAs)of patients with moyamoya disease(MD),and explore the pathogenesis of MD.Methods The bilateral ICAs were obtained during autopsy from two MD patients.HE staining and Weigert staining was used for histological observation,and transmission electron microscopy Was employed to observe the ultrastructure of the ICAS.The expression of ICAM-1 in the ICAs was detected using immunohistochemical staining,and the mRNA expressions of MMLP-2,MMP-9,TMP-1 and TIMP-2 were assayed using in situ hybridization.The ICA specimens from two patients died from non-vascular diseases were used as the control.Restilts HE staining revealed thinning of the ICAs of the MD patients with luminal stenosis,obstruction and calcification.Weigert staining identified fibrous thickening of the intima,thinning and fragmentation of the elastica interna(EI)and elastica externa(EE),degenerafion of the smooth muscle cells in the media,and thinning and local exfoliation of the adventitia.Immunohistochemistry showed ICAM-1 expression in the ICAs of both MD and control patients,but the MD patients exhibited a stronger ICAM-1 positivity in the ICAs localized primarily in the tunica intima.The ICA wall was positive for MMP-9 mRNA expression,which Was especially intense in the elastica intema,as shown by in situ hybfidization.Conslusions The high expression of MMP-9 and ICAM-1,destruction of the elastic layer and adventitia,and collapse of the vascular wall result in luminal stenosis or everi obstruction of the ICAs,which can be associated with the occuITence of MD.

OBJECTIVETo study the significance of flow cytometric monitoring minimal residual diseases (MRD) in patients with acute leukemia (AL) after allogeneic hemapoietic stem cell transplantation (HSCT).

METHODSFrom January 2007 and January 2008 MRD were detected by flow cytometry (FCM) in 402 bone marrow (BM) in 102 AL patients without leukemic gene and chromosomal changes at first diagnosis after HSCT (1, 2, 3, 6,12 months after HSCT; adding detection frequency in part of high risk patients), The relationship between the MRD results and clinical prognosis were observed. Patients with significantly higher MRD were treated and the effectiveness was monitored by FCM (MRD > 0.01% considered as positive).

RESULTS(1) 71 cases were persistently negative for MRD after HSCT and all them were in hematologic complete remission (CR). Only 3 cases had extramedullary relapse. The disease free survival (DFS) and overall survival (OS) were 66.2% and 90.1%, respectively. (2) Of 27 MRD(+) cases 11 converted to MRD negativity after chemotherapy plus donor lymphocyte infusion (DLI), CIK, NK cells. The DFS and OS were 63.6% and 72.7%, respectively. Other 16 cases had hematologic relapse. The DFS and OS were 11.1% and 25.0%, respectively. The median time from MRD increasing to hematologic relapse was 48 days (7-69 day). (3) Four cases had hematologic relapse after HSCT and died in the end.

CONCLUSIONS(1) The DFS and the OS in MRD(-) cases are significantly higher than those of MRD(+) cases. (2)MRD(+) patients after HSCT coveted to MRD(-) after intervention. Therapy, whose DFS and the OS are still significantly higher than those of MRD(+) cases. (3) Patients with hematologic relapse after HSCT have the worst prognosis and the DFS and OS are significantly low. FCM monitoring of MRD in patients after HSCT is a sensitive, specific, quick and simple method. It can indicate recurrent state in time, facilitates early intervention, reduces the hematologic relapse risk and improves DFS.

Adolescent ; Adult ; Child ; Female ; Flow Cytometry ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; surgery ; Male ; Middle Aged ; Neoplasm, Residual ; diagnosis ; Postoperative Period ; Retrospective Studies ; Transplantation, Homologous ; Treatment Outcome ; Young Adult

OBJECTIVETo analyse the clinical features, diagnostic methods and risk factors of cytomegalovirus (CMV) enteritis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSAnalysis was made on 24 cases of CMV enteritis after allo-HSCT in Beijing Daopei Hospital from Aug. 2007 to Jul. 2009, including clinical data, endoscopic diagnosis, histopathological and virological results, and the association between CMV enteritis with viremia and graft-versus-host disease(GVHD).

RESULTS87.5% of the patients were over 18 years old. The median time to diagnosis of CMV enteritis was 63 days after HSCT. The mucosal lesions in enteroscopic examination had no significant differences between CMV enteritis and gastrointestinal GVHD complicated with the enteritis. The methods used in diagnosis included histopathology (32.1%) and virology (92.9%). The copies of CMVDNA in mucosal samples greater than 10(5)/10(6) PBNC was better diagnosis. A number of risk factors were compared between the survival and death groups: type of transplant, conditioning regimen, the time span of ganciclovir prophylaxis therapy, grade II-IV GVHD before enteritis, the time of diagnosis as GVHD, using MP > or = 1 mg/kg to treat GVHD, the time between GVHD and enteritis, CMV viremia before enteritis, the time of diagnosis as enteritis, CMVDNA quantitation, and there were no any statistic differences.

CONCLUSIONCytomegalovirus enteritis should be carefully diagnosed by histopathology and virology through endoscopic examination. It is better to undertake pan-colon endoscopy as well as terminal ileum examination for more accurate diagnosis. PCR can significantly improve the detection rate. CMVDNA detection in patients' stool may be helpful to diagnosis, especially for those patients who can not stand the endoscopy examination.

Adolescent ; Adult ; Cytomegalovirus ; Cytomegalovirus Infections ; etiology ; DNA, Viral ; isolation & purification ; Enteritis ; etiology ; virology ; Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Risk Factors ; Young Adult

OBJECTIVETo evaluate the effect of absolute alcohol treatment for renal cyst with percutaneous puncture and catheterization.

METHODSThis report presented 64 cases of renal cysts, 34 cases were treated with percutaneous puncture (A group) and 30 cases with percutaneous catheterization (B group). According to the size, the cysts were divided into 2 groups, more than 6 cm in diameter and less than 6 cm in diameter.

RESULTSAll the patients were followed up for 3 - 12 months by CT or B ultrasonography. Striking difference of the therapeutic results were existed when cystS were more than 6 cm in diameter.

CONCLUSIONPercutaneous catheterization is applicable to the sclerosing treatment of renal cyst whose diameter is more than 6 cm.

Adult ; Aged ; Catheters, Indwelling ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Humans ; Injections, Intralesional ; Kidney Diseases, Cystic ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Paracentesis ; methods ; Sclerosing Solutions ; administration & dosage ; Treatment Outcome ; Ultrasonography, Interventional