Objective To analysis the different causes of death among patients who underwent allogeneic hematopoietic stem cell transplantation in order to explore the disadvantageous factors which affecting the long‐term survival after transplantation . Methods The planned conditioning regimen we used was BU/Cy and associated with mobilized peripheral blood and/or bone mar‐row stem cell .Meanwhile ,we used infection prevention and GVHD control methods .Throughout the treatment we observed the death patients during the allogeneic hematopoietic stem cell transplan‐tation and posttransplant ,however ,the causes of death were retrospectively analyzed .Results Among the 35 death cases ,the reason for 11 patients were relapse ,15 with serious infection (9 cases combine GVHD ,Ⅰ - Ⅱ GVHD 3 cases ,Ⅲ - Ⅳ GVHD 6 cases) ,2 patients underwent hematopoietic failure ,2 patients died of intracranial hemorrhage ,1 patient had pulmonary edema ,1 patient sudden death ,1 patient suffered from intestinal tract because of serious GVHD ,1 patient had a progression of disease ,and 1 hemolytic crisis .With a 100 days transplantation related mortality (TRM ) was 5 .7% ,and transplantation within 100 days to 1 year of TRM was 8 .1% .We received a 3‐year and 5‐year mortality rates of 16 .2% and 16 .7% ,respectively .Conclusion Infection ,GV HD and disease relapse are the most common causes of death a‐mong patients who underwent hematopoietic stem cell transplantation .Deadly infection is commonly observed within one year after transplantation and with which accompanied by the GVHD usually .Patients associated with cGVHD have a lower rate of disease re‐lapse .

It is difficult for the patients of refractory leukemia to complete remission (CR) and long-term disease-free survival (DFS), and it was always been the hot spots of research in the field of hematologic malignancies. The diagnostic criteria of refractory leukemia were adjusted constantly at domestic and foreign, the high-risk factors about refractory leukemia were found constantly too. New molecular markers that represent mutations or gene overexpression have been identified such as FMS-like tyrosine kinase-3 and nucleophosmin,which will enhance the ability to more accurately prognosticate for patients with acute myeloid leukemia. The treatment of patients with refractory or relapsed acute myeloid leukemia remains challenging. Multiple new agents with tremendous potential were in development and clinical trials. Such as applying resistance reversal agents,enhancing molecular targeted therapy, improving the technology of hematopoietic stem cell transplantation,empoldering the new drugs, and forming a new chemotherapy program etc. Monoclonal antibodies and peptide vaccination with leukemia-associated antigens also brought the hopes of increasing the remission and cure rates for patients with acute myeloid leukemia.

Objective To investigate the clinical manifestations,treatment and prognosis of reversible posterior leukoencephalopathy syndrome (RPLS) after acute lymphoblastic leukemia chemotherapy.Methods The clinical and imaging data of one case with acute lymphoblastic leukemia were analyzed and literatures were reviewed.Results The main clinical presentation of the patient included abdominal distension,repeated fever with fatigue.Depend on the results of the blood routine test and bone marrow relative examinations,the patient was diagnosed as acute lymphoblastic leukemia pro-B cell high risk group.After the induction therapy and consolidation chemotherapy,hypertension and neurological symptoms were appeared.Combined with the imaging examination,it was diagnosed as RPLS.Recieved active treatment,the patient recovered completely,and the imaging test was improved rapidly.Conclusion The causes of RPLS are variety,and its clinical manifestations and imaging test are non-specific.RPLS has a favorable prognosis.The correct diagnosis and treatment are the key points.

Objective To investigate expression of 7 kinds of immune related human cytokines (IL-2, IL-4, IL-12, IL-13, IFN-γ TNF-α, MIP-1α) in CML patients. Methods Pure monoclonal antibody on the prepared NC membrane glass slides under certain environmental condition to make human eytokines protein microarray were spotted and serum samples (25 patients, 25 the normais) were collected. Cytokines concentration in the serum with the protein microarray were tested by ELISA. Results IL-4 and IL-12 serum concentration in CML patients are lower than that of the normal (P <0.05). However. No statistic difference of MIP-1α was found between CML patients the normal. Conclusion Cell mediated immunity and humoral immunity of CML patients are both inhibited in some extent and the expression of MIP-1α may be inhibited by p210 in CML patients.

Objective To observe the curative effects of bezafibrate combined medroxyprogesterone acetate in the treatment of AML .Methods 40 cases of AML patients were collected and devided into experimental group (bezafibrate combined medroxypro-gesterone acetate ,6 cases) ,control group (chemotherapy ,28 cases) and non-treatment group (6 cases) ,then through a prospective analysis we studied the curative effects and related results of bezafibrate combined medroxyprogesterone acetate in the treatment of AML .Results The median survival time of the experiment group (accepted bezafibrate combined medroxyprogesterone acetate ) was 15 weeks ;the median survival time of the control group (accepted chemotherapy ) was 24 weeks ;the median survival time of the giving up group(accepted any therapy ) was 8 weeks .Conclusion Bezafibrate combined medroxyprogesterone acetate could prolong the survival time of AML patients and there were no obvious adverse reactions .

Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is an effective therapy for acute leukemia. But some patients with relapse after transplantation lead to treatment failure. A few patients who have extramedullary relapse after transplantation. The treatment outcome is limited and the overall prognosis is poor. Purely in patients with mammary gland relapse is rare. One case of mammary gland relapse with acute myeloid leukemia after bone marrow transplantation is reported to to increase the understanding of such patients.

Objective To evaluate the effects of postconditioning with propofol on lipopolysaccharide (LPS)-induced inflammatory responses of microglial cells in rat brain tissues.Methods The primary cultured microglial cells in brain tissues of Sprague-Dawley rats were seeded in 24 multi-well plates at a density of 1 × 105 cells/ml,and the microglial cells of 100 wells were randomly divided into 5 groups (n =20 each) using a random number table:control group (group C),LPS group (group L),and propofol 25,50 and 100 μmol/L groups (P25,P50,P100 groups).The cells were cultured routinely in group C.LPS 1 μg/ml was added and the cells were incubated for 24 h in group L.In P25,P20,and P100 groups,when the cells were incubated for 24 h with LPS 1 μg/ml,propofol with the final concentrations of 25,50 and 100 μmol/L was added,respectively.The cells were collected at 1 h of incubation with propofol for determination of the expression of inducible nitric oxide synthase (iNOS) mRNA,cyclooxygenase-2 (COX-2) mRNA,tumor necrosis factor-α (TNF-α) mRNA and interleukin-1β (IL-1β) mRNA (by RT-PCR).The supematant was separated for determination of the concentrations of nitric oxide (NO) (by Griess method) and pmstaglandin E2 (PGE2),TNF-α and IL-1β (by ELISA).Results Compared with group C,the expression of iNOS mRNA,COX-2 mRNA,TNF-α mRNA and IL-1β mRNA was significantly up-regulated and the concentrations of NO,PGE2,TNF-α and IL-1β in the supematant were increased in group L (P ＜ 0.01).Compared with group L,the expression of iNOS mRNA,COX-2 mRNA,TNF-α mRNA and IL-1β mRNA was significantly down-regulated and the concentrations of NO,PGE2,TNF-α and IL-1β in the supernatant were decreased in P50 and P100 groups (P ＜ 0.05 or 0.01),while no significant change in the indexes mentioned above was found in P25 group (P ＞ 0.05).Conclusion Postconditioning with propofol 50 and 100 μmol/L can inhibit LPS-induced inflammatory responses of microglial cells in rat brain tissues.

OBJECTIVE:To study protective effects of glutamine (Gln) on cardiac muscle cell in septic model rats. METH-ODS:Rats were randomly divided into sham operation group (normal saline),model group (normal saline) and Gln low-dose, medium-dose and high-dose groups(0.5,0.75,1.0 g/kg)with 10 rats in each group. In these groups,septic rat model was induced by cecal ligation and puncture except sham operation group received sham operation. They were given relevant medicine intrave-nously 10 min after operation,and the characteristics and apoptosis of cardiac muscle cell were observed 12 h after operation. The serum contents of CK,LDH and TnⅠ,and the expression of Bcl-2 and p53 mRNA were all detected. RESULTS:Compared with sham operation group,myocardial necrosis of model group was found,and the serum content of CK,LDH and TnⅠ and apoptotic index increased,and mRNA expression of Bcl-2 in cardiac muscle cell decreased while that of p53 increased,with statistical signifi-cance(P<0.05). Compared with model group,myocardial injury relieved significantly in Gln high-dose and medium-dose groups, and serum contents of CK,LDH and TnⅠ and apoptotic index decreased;mRNA expression of Bcl-2 increased in cardiac muscle cell while that of p53 decreased,with statistical significance (P<0.05). CONCLUSIONS:Gln can improve myocardial injury of septic model rats significantly,by a possible mechanism of down-regulating the expression of p53 gene and up-regulating the ex-pression of Bcl-2 gene.

BACKGROUND:Autologous peripheral blood hemopoietic stem cell transplantation(HSCT)in combination with high-dose chemotherapy significantly improves complete remission and survival rate of multiple myeloma patients.However,the relapse rate is high.Bortezomib is 26S proteasomes inhibitor,and effective on the primary treatment of multiple myeloma.OBJECTIVE:To evaluate the curative effect of HSCT in combination with bortezomib and high dose-melphalan for multiple myeloma.METHODS:A retrospective analysis of 3 patients with a stage-ITT multiple myeloma admitted to Department of Hematology,Affiliated Hospital of Guiyang Medical College from October 2006 to May 2007,was conducted.Chemotherapy and granulocyte colony-stimulating factor were used to mobilize autologous peripheral blood hemopoietic stem cells.All patients were pretreated with 200 mg/m2 melphalan via intravenous drip 3 days before transplantation,followed by HSCT 48 hours after drug termination.RESULTS AND CONCLUSION:All patients obtained prompt and sustained hematopoietic reconstitution,and bone marrow depression restored 30 days following HSCT.Case 1 and 2 obtained complete remission,and case 3 obtained partial remission.Results show that HSCT in combination with bortezomib and high-dose melphalan is a safe and feasible treatment on multiple myeloma.The patients have good tolerance to pretreatment.

Objective To investigate the effect of CCAAT/enhancer-binding protein homologeus protein (CHOP) in Tan Ⅱ A treated acute promyelocytic leukemia (APL) cells.Methods APL cell differentiation was monitored by morphology and membrane differentiation antigens; expression of CHOP was inhibited by siCHOP; mRNA and protein expression of CHOP in Tan Ⅱ A-intervened APL cells were examined by RT-PCR and Western blot.Results Expression of CHOP was increased in Tan Ⅱ A induced differentiated APL cells (proteins levels 1.933±0.987 vs 0.537±0.110,F =114.852,P ＜ 0.01,mNRA levels 1.587±0.815 vs 0.713±0.090,F =52.256,P ＜ 0.01),combination of CHOP gene silencing with Tan Ⅱ A treatment induced strong APL cell differentiation [(50.767±1.241) ％ vs (16.167±2.122) ％,F =989.431,P ＜ 0.05] and apoptosis [(89.233±5.581) ％ vs (27.433±2.957) ％,F =308.961,P ＜ 0.05].Conclusion CHOP acts as a negative regulator in Tan Ⅱ A induced differentiation.Inhibition of CHOP may be a promising therapeutic strategy.