BACKGROUND:In recent years, the use of chimeric antigen receptor modified T cells (CAR-T cells) has achieved good results in the treatment of hematological malignancies. OBJECTIVE:To summarize the CAR-T technology, and its anti-tumor mechamism, progress in the treatment of hematological malignancies as well as its safety and coping strategies. METHODS:A search of PubMed, CNKI, Wanfang by computer was performed for articles related to CAR-T published from January 2010 to January 2016, using the keywords of CAR-T in English and Chinese, respectively. RESULTS AND CONCLUSION:The main principles that CAR-T cells fight against tumors are as follows: (1) resistance to immune escape through down-regulation of MHC; (2) production of interleukin-6, -10 indirectly influences the growth of tumor cells; and (3) tumor microenvironment changes inhibit tumor growth. The use of CAR-T in the treatment of hematological malignancies has been developed by leaps and bounds in recent years. Current studies concerning B cell lymphoma mainly focus on anti-CD19 CAR-T cells that have certain therapeutic effects on acute myeloid leukemia and acute lymphoblastic leukemia. However, its safety and effectiveness have yet to be studied.

Objective To study the effects of sodium arsenite on the mRNA expression of GTP cyclohydrolase (GTPCH) and 6-pyruvoyl-tetrahydropterin synthase (PTPS) in Chang liver cells. Methods Human Chang liver cells were cultured with sodium arsenite at doses of 0, 50, 200 and 400 ?mol/L for 12 hours. Cell viability was tested by MTT assay, and the expression of mRNA of GTPCH and PTPS was detected by RT-PCR. Results Cell viability in 50 ?mol/L group was almost the same as that in control, while the viability in the other two groups were significantly lower than that in control. All of the mRNA expression levels in the three groups were significantly lower than that in control with dose-dependent manner. Conclusion The down-regulated expression of GTPCH and PTPS, the main enzymes of the synthesis of BH4, induced by sodium arsenite exposure may be related with arsenic related skin depigmentation.

Objective To evaluate the efficacy of PTCRA+ PTCA in patients with complicated coronary disease Methods PTCRA+PTCA were performed on 16 lesions in 14 patients in our hospital Results In 14 lesions, PTCA was performed after direct PTCRA in order to achieve opital angigraphic result; PTCRA was performed in 5 coronary artery lesions after failed PTCA 14 patients (100%) had successful result Conclusion The combined use of PTCRA+PTCA can improve the success rate during revasculrization for patients with complicated coronary artery disease

Adolescent ; Adult ; Female ; Humans ; Male ; Methanol ; poisoning ; Occupational Diseases ; chemically induced ; diagnosis ; therapy ; Poisoning ; diagnosis ; therapy

Objective To research the lymphatic tropism and lymph cell apoptosis of cisplatin-nano carbon suspension in rats with the aim of proposing a new way for chemotherapy.Methods A total of 72 Wistar rats were randomly divided into two groups.For the experimental group,cisplatin-nano carbon suspension 0.3 ml (4 mg/ml) was injected subcutaneously into Wistar rats' plantar.For the control group,cisplatin 0.3 ml (4 mg/ml) was injected intravenously.Cisplatin concentration in the inguinal lymphatic tissue and plasma was determined by high performance liquid chromatography (HPLC) at 1,2,3,4,5 and 6 hours after drug administration.The apoptosis of lymph cell was detected by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay (TUNEL).Targeting ability were evaluated and compared by targeting index (TI),selecting index (SI) and relative extraction efficiency (RE).SPSS 17.0 statistical software was used to analyze the differentiation of the cisplatin concentration and apoptosis index (AI) among various groups.DAS software was used to evaluate the lymphatic tropism.Results The cisplatin concentration of lymphatic tissue in experimental group were respectively (1.03±0.32),(3.00±0.91),(2.20±0.73),(1.56±0.38),(1.30±0.74) and (0.78±0.34) μg/g after administration 1,2,3,4,5 and 6 hours,while in control group were (0.49±0.21),(1.02±0.70),(0.59±0.50),(0.56±0.21),(0.47±O.18) and (0.36±0.13) μg/g,in which there were significant difference at every times (all P＜0.05) except at 1 hour (P=0.173).The cisplatin concentration in plasma were significant higher in the experimental group than those in the control group at various times (all P＜0.05),the former were respectively (0.57±0.28),(1.22±0.45),(0.61 ±0.18),(0.51 ±0.13),(0.45 ±0.13) and (0.40±0.07) μg/ml,while the latter were respectively (3.12± 0.33),(4.09± 0.48),(2.56 ± 0.38),(2.05 ± 0.13),(1.81 ± 0.28) and (1.44± 0.40) μg/ml.Values of TI were respectively 2.12,2.93,3.73,2.78,2.76 and 2.19 and SI were 1.80,2.45,3.63,3.07,2.86 and 1.93.Value of RE was 2.86.The AI in experimental group were respectively (16.5±5.2)％,(30.2±2.8)％,(51.7±4.3)％,(69.8±3.2)％,(80.1 ±4.3)％ and (89.7±8.5)％,while in control group were respectively(1.3±0.8)％,(2.4±1.7)％,(3.2±1.1)％,(3.9±2.6)％,(5.1±2.1)％ and (6.3±2.3)％,in which there were significant difference at every points (all P＜0.05).Conclusions The nano carbon has the character of lymphatic tropism,and could send cisplatin to lymphatic tissue to achieve a higher concentration.The trait may break a new way for chemotherapy targeting lymph metastasis.

Objective To study the possibility of the exist of specific antibody against platelet in tumor patients and to evaluate the value of MAIPA in measure of specific antibody against platelet in malignant tumor patients with nonimmune thrombocytopenic purpura. Methods Anti- GPⅡb/Ⅲa and anti- GPⅠb/Ⅸ autoantibodies were detected by a modified monoclonal antibody immobilization of platelet antigens assay(modified MAIPA). Results The positive rate of the platelet antibody in nonimmune thrombocytopenic purpura is very low with MAIPA. Conclusions The platelet GP- specific autoantibody detection is considerably important in discriminating immune from nonimmune thrombocytopenia.

We summarized our accumulated clinical and teaching experiences and explored the regularity of acupuncture needling and teaching. It is of great importance in pressing hand during inserting needle. Stroking and pressing are two crucial parts which deserve more attention, and seldom useage of pressing hand should be abolished. Operating hand needs practice before inserting needle, while it should fully relaxed during inserting. Blending "touching", "stretch" "gathering" "erupting" and "advancing" in single moment, applying appropriate dynamic mode of inserting needle such as "join 3 forces as one" "3 points in a line" expertly and naturally. In addition, enough attention should be paid on "altering direction" and "shifting point". Inserting deftly and powerfully, no/slight sensation, deqi when inserting needle are the highest reflection as an acupuncturist.
Acupuncture ; education ; Acupuncture Therapy ; instrumentation ; methods ; China ; Humans ; Teaching

Objective We sought to compare the ability of MEWS score,APACHE Ⅱ score and combination of the two scoring systems to predict the prognosis of patients in emergency medical department.Methods During January to March 2014,640 patients in emergency medical department who met the criteria were set as the research object.The patients admission was the starting point for clinic observation.The relevant data were collected for carrying on the MEWS and APACHE Ⅱ ratings,tracking the patients' prognosis.The corresponding predictors for prognosis of patients such as sensitivity,specificity,positive predictive value,negative predictive value and ROC curve by MEWS score,APACHE Ⅱ score and combination of the two scoring systems were compared.Results The area under the receiver operating characteristic curve was 0.93,0.79 and 0.93 with MEWS score,APACHE Ⅱ score and combination of the two scoring systems.The comparison of either of the two scoring systems showed significant difference.When death was named as the prediction factor,the sensitivity,specificity,positive predictive value and negative predictive value were 76.92％,91.70％,51.02％,97.23％ for MEWS score; 83.08％,62.80％,20.15％ and 97.04％ for APACHE Ⅱ score; 92.31％,86.43％,43.48％ and 97.58％ for combination of the two scoring systems.Conclusions Combination of the MEWS and APACHE Ⅱ scoring systems can be used to predict the prognosis of patients in emergency medical department.It posesses high sensitivity,specificity,positive predictive value and negative predictive value,which indicating a high predictive capability.

Objective To evaluate the therapeutic effect of narrow band-ultraviolet B (NB-UVB) alone or in combination with interferon-alpha-2b (INF-alpha-2b) for mycosis fungoides (MF),and to assess the correlation between the therapeutic effect and peripheral blood regulatory T (Treg)/T helper type 17 (Th 17) cells.Methods Thirty-three patients with stage ⅠA to ⅡA MF were randomly divided into two groups:NB-UVB group (n =15) receiving NB-UVB radiation alone,combined group (n =18) treated with NB-UVB radiation and intramuscular injection of INF-alpha-2b.Ten healthy volunteers were selected as the control group.Peripheral blood samples were collected before and 9 months after the start of treatment.Flow cytometry was performed to determine the percentages of Treg cells and Th17 cells.Statistical analysis was carried out by using t test,one-way analysis of variance,and Fisher's exact test.Results The average treatment duration was 9 months among these patients.Therapeutic outcomes were significantly better in the combined group than in the NB-UVB group (P =0.023).Among the 15 patients in the NB-UVB group,6 achieved complete remission,3 partial remission,6 showed no response;of the 18 patients in the combined group,12 experienced complete remission,5 partial remission,and 1 showed no response.Before the treatment,the percentages of both Treg and Th17 cells in peripheral blood were significantly higher in the NB-UVB group and combined group than in the control group (both P ＜ 0.05),but similar between the NB-UVB group and combined group (both P ＞ 0.05).After the treatment,the percentages of both Treg and Th17 cells in the NB-UVB group and combined group significantly decreased compared with those before the treatment,but were still higher than those in the control group (both P ＜ 0.05).Additionally,the degree of decrease in the percentages of Treg and Th17 cells was significantly greater in the combined group than in the NB-UVB group (both P＜ 0.05).The seven patients with no response also showed a significant decrease in the percentage of Treg cells (P ＜ 0.05),but no obvious changes in that of Th 17 cells (P ＞ 0.05) after the treatment.Conclusions The therapeutic effect of NB-UVB radiation combined with intramuscular INF-alpha-2b is superior to that of NB-UVB radiation alone for MF,which may be associated with the degree of decrease in peripheral blood Treg and Th 17 cells.

Objective The study aimed to evaluate the application effect of clinical pathways in laparoscopic cholecystectomy patients by using the meta-analysis.Methods Published randomized controlled trials (RCT) about laparoscopic cholecystectomy patients were searched and screened in China National Knowledge Infrastructure (CNKI),China Scientific Journal Database by VIP,Wanfang Database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.2 software was used for analysis.Results Totally 29 studies including 5 570 cases were eligible to the criteria (2 753 in the experimental group and 2 853 in the control group) altogether.The meta-analysis showed that the hospitalization time and hospitalization costs in the clinical nursing pathway group were significantly less than those of the control group (SMD=-1.69 and-3.75),the satisfaction degree and the mastering of health knowledge in the clinical nursing pathway group were significantly higher than those of the control group (RR=1.16 and 1.26),the differece had statistical significance.Conclusions Application effect of clinical nursing pathways is superior to the traditional nursing method in laparoscopic cholecystectomy patients.