Purpose:To report three cases of myelodysplastic syndrome(MDS) transformed to atypical chronic myeloid leukemia(aCML).Methods:Compared the clinical findings,hemograms and bone marrow features in two different courses of the disease,discussed with review of related literatures.Results:The three patients were all old age.They onset with chronic anemia,the results of BM smear were MDS-RAS and MDS-RAEB;Then leukocytosis occurred in 6-65 months.The aCML were diagnosed according to the BM smear and normal chromosome.Conclusions:The MDS/MPD is a new category of the WHO classification that have both dysplastic and proliferative features.Atypical CML lacks the Ph chromosome and BCR/ABL fusion gene that are the hallmarks of classic CML.This kind of case is seldom seen.

Purpose:To evaluate the effect of Auto-PBSCT combined with long-time low-dose interleukin-2 (after transplant) for increasing the rate of 5-year disease-free survival of lymphoid malignancies (ALL and NHL).Methods:U- sing chemotherapy combined with low dose G-CSF to mobilize peripheral blood stem cells,we carried out auto-PBSCT in lymphoid malignancies (7 cases CR_1 ALL、1 case CR_2 ALL、3 cases CR_1 NHL、5 cases refractory NHL).After transplant, 15 cases used low dose interleukin-2 at 5.10~5U/d for one year or longer.Results:7 cases CR_1 ALL are still alive,the aver- age disease-free survival is 73 months.Median disease-free survival is 51.5 months.2 of 3 cases CR_1 NHL are still alive. The 6 years disease-free survival in 10 cases CR_1 lymphoid malignancies(CR_1 NHL and CR_1 ALL) is 0.90?0.11,the aver- age disease-free survival is 66.8 months.In another PR (refractory) group of NHL and ALL (CR_2),3 years disease-free survival was 0.33?0.18,and average survival time was 20.66 months,but a chemotherapy-sensitive NHL is still alive (63 months),a case of lymphoblast cell NHL also survived for 46 months and died after relapse.Conclusions:Auto-PBSCT combined with long-turm low dose IL-2(after transplant) could effectively increase the rate of 5-year disease-free survival in CR_1 lymphoid malignancies(ALL and NHL).

Objective To understand the roles of JAK STAT pathway in the process of differentiation of human cord blood CD34 + hematopoietic stem cells into dendritic cells (DCs) by detecting the expressions and activation of JAK2 and STAT5. Methods CD34 + hematopoietic stem cells isolated from human umbilical cord blood and cultured for two weeks were induced to differentiate into DCs in vitro . Total cellular JAK2 and STAT5 and tyrosine phosphorylated protein stimulated by granulocyte/macrophage colony stimulating factor (GM CSF) at different time points (0, 7, and 14) during DC differentiation were detected by Western blotting. Results The amount of JAK2 protein was similar at 0, 7, and 14 d without GM CSF stimulation. With the differentiation of cells into DCs, the amount of tyrosine phospho JAK2 induced by GM CSF increased markedly. Both total cellular and tyrosine phospho STAT5 expression increased markedly during DC differentiation. Maximal tyrosine phospho STAT5 expression was later than JAK2. Conclusion JAK STAT pathway may take part in the signal mechanism of DCs differentiation from CD34 + hematopoietic stem cells stimulated by GM CSF.

Small interfering RNAs (siRNAs) are an emerging class of RNA interference (RNAi) therapeutics with unique pharmacokinetic properties. Five siRNA drugs based on two delivery systems have been approved, and an increasing number of siRNA drugs have already moved to the clinical study phase. Physiologically-based pharmacokinetic (PBPK) modeling is a useful tool and has been demonstrated to have wide ranging utility in drug development and regulatory review. However, PBPK modeling is still in its infancy in guiding the development of siRNA-based drugs in the context of its widespread use in small and large molecule areas. This article reviews the pharmacokinetic profiles of siRNA drugs, outlines the current state of PBPK model building in siRNA drug development, and describes the key parameters required for model building. This article provides insights into the future applications of PBPK models and for optimizing the key parameters when building the model for siRNA drug development.

Objective To analyze the expression and significance of adiponectin in serum and placenta tissue in preeclampsia pregnancy women.Methods Serum adiponectin levels were measured by Enzyme-linked immuno sorbent assay (ELISA) in 52 cases of normal pregnant women (control group),58 cases of mild preeclampsia pregnancy women (mild preeclampsia group),and 55 cases of severe preeclampsia pregnancy women (severe preeclampsia group).Insulin resistance was estimated using the homeostatic model assessment-insulin resistance index (HOMA-IR).The expression of adiponectin in placenta tissue was detected by immunohistochemical SP methods in three groups.Results Fasting glucose level in severe preeclampsia group was higher than that in control group and mild preeclampsia group [(5.56 ± 1.37) mmol/L vs.(4.55 ± 0.51),(4.68 ± 0.66) mmol/L],fasting insulin level and HOMA-IR in mild preeclampsia group and severe preeclampsia group were higher than those in control group [(14.19 ±3.42),(14.90 ±6.64) mU/L vs.(9.87 ± 1.75) mU/L,1.04 ±0.37,1.18 ±0.56 vs.0.67 ±0.21],serum adiponectin level in severe preeclampsia group was higher than that in control group and mild preeclampsia group [(15.79 ± 4.86) mg/L vs.(11.47 ±3.50),(11.92 ± 2.96) mg/L],the differences were statistical significance (P ＜ 0.05).There was no difference of adiponectin expression levels in placenta tissue among three groups (P ＞0.05).There was no significant correlations between serum adiponectin level and HOMA-IR,expression levels of adiponectin in placenta tissue(P ＞ 0.05).Conclusions Serum adiponectin levels and HOMA-IR are higher in the severe preeclampsia pregnancy women.Increased serum adiponectin levels may be an appropriate feedback regulation in preeclampsia pregnancy women.

10.3969/j.issn.2095-4344.2013.26.010

Objective To clear the clinical efficacy of using early rehabilitation nursing model in the course of clinical nursing in patients with cerebral infarction.Methods Divided 60 patients with cerebral infarction into the observation group (30 cases) and the control group (30 cases) randomly,traditional nursing measures were used in the control group,the early rehabilitation nursing model was used in the observation group in addition.Compared the clinical efficacy,ADL scores,NIHSS scores and the satisfaction between the two groups.Results In the observation group,the satisfaction was 93.33％ (28/30),the efficiency was 90.00％(27/30),which were significantly higher than those in the control group [76.67％(23/30),[66.67％(20/30)].The ADL and NIHSS scores in the observation group was (91.25±11.38) and (8.01±1.05) respectively,which were significantly different with those of in the control group,the ADL and NIHSS scores was (79.37±10.27) and (10.22±1.27) respectively in the control group.Conclusions Early rehabilitation nursing model can effectively improve the never function of patients with cerebral infarction,and then improve their quality of life.

Objective To explore the application value of multi-ISO center planning method in intensity-modulated radiotherapy for carniospinal irradiation.Methods Ten patients treated with craniospinal irradiation with helical tomotherapy were selected.For these patients, new plans were designed with multi-ISO centers planning method on the treatment planning system (TPS) named Eclipse 11.0.Dose distribution to the tumor, OARs and normal tissue, the treatment time and the monitor units (MUs) of the two plans were compared.Results The plans designed in two groups satisfied all clinical requirements.For the tumor target (PTV) , the difference of D95％ between two groups was not statistical significant, while D9s ％ , D2 ％ and HI in HT group were superior to M-ISO group (t =2.822,2.333,4.743, P ＜0.05) , D50％ , D and CI in M-ISO group were superior to HT group (t =5.259,3.685,8.835 ,P ＜ 0.05).The dose of OARs such as cochlea, parotid, submandibular gland, thyroid gland and kidney in HT group was lower than M-ISO group (t =4.365,5.416,2.674,3.077,2.782,2.607,4.659,P ＜0.05) , and the dose of pancreas and small bowel was higher than M-ISO group (t =5.265,5.935, P ＜ 0.05).Differences were not significant for V5 of normal tissue between two groups;while V10, V20 and V36 of normal tissue in M-ISO group were lower than HT group (t =3.57,3.701,2.602, P ＜ 0.05).M-ISO group reduced 41.0％ of the treatment time by average and reduced 94.1％ MUs by average.Conclusions Intensity-modulated radiotherapy for carniospinal irradiation with multi-ISO centers planning method not only met the requirements of clinical dosimetry, but also shorten the treatment time, reduced the damage to the machine.Multi-ISO centers planning method might be promoted as a new design scheme.

Objective:To investigate the effect of Vitapex paste in the root canal for deciduous teeth with chronic apical periodontitis.Methods:200 children with chronic apical periodontitis were selected and divided into two groups.The observation group (108 cases)was given Vitapex paste.The control group (92 cases) was given Zinc oxide iodoform paste.The effect of Vitapex paste in root canal for deciduous teeth with chronic apical periodontitis was evaluated by filling quality after 1 month'treatment,the VAS scores before and after treatment,long-term curative effect were compared between two groups.Results:After 1 month'treatment,the suitable filling rate of observation group was higher than that of the control group(P＜0.05).There was no statistical significance in the VAS scores between two groups (P＞0.05).After 1 week'and 1 month'treatment,the pain feeling were alleviated in two groups and significantly lighter in the observation group(P＜0.05).After 6 months' follow-up,the success rate was 96.3％ in the observation group and 87.0％ in the control group,the success rate of observation group was higher than that of the control group (P＜0.05).Conclusion:The filling process of Vitapex paste was simple and easy,which had a good therapeutic effect on chronic apical periodontitis of deciduous teeth and could relieve the toothache of patients.

Iatrogenic gastrointestinal perforation is one of the severe adverse events of endoscopic therapeutic procedure. For acute iatrogenic perforation,management by endoscopic techniques is a simple and rapid modality to close the perforation with minimal invasiveness and avoiding the traditional surgical trauma. Endoclips,suture with special instruments,covered stents,degradable sheets combined with tissue adhesive,and combined endoscopic techniques such as snares combined with endoclips,are the major endoscopic therapeutic modalities for closure of iatrogenic gastrointestinal perforation. In this article,the current status and progress of endoscopic management for acute iatrogenic gastrointestinal perforation were reviewed.