A microcapsule is a spherical, with a diameter that can be controlled in the range of 200 -1500 μm and biocompatible semipermeable membrane, which allows the bidirectional diffusion of nutrients,oxygen, secreted therapeutic product, and waste but prevents the penetration of high molecular weight substances from the microcapsule, such as antibodies and immunocytes. In comparison to monolayer culture and multicellular tumor spheroid model, orthotopic injection of microencapsulated tumor cells has uncomparable advantages in cell proliferation, mimicking the in vivo situation, making orthotopic tumor model and distant organ metastases model. Microencapsulated tumor assay has the potential of being widely used for in vitro anticancer drug screening and evaluation of the effects. This article mainly reviews the advantages of microencapsulated tumor assay and its application.

Objective To study the relationship between interleukin-6(IL-6) and the newly diagnosed type 2 diabetes mellitus with Dampness-Heat Encumbering the Spleen syndrome and the relationship between overweight and IL-6. Methods The plasma levels of IL-6 were detected by radio immunoassay in 40 patients with the newly diagnosed type 2 diabetes mellitus (Dampness-Heat Encumbering the Spleen syndrome 10 cases and the deficiency of Qi and Yin syndrome 10 cases)and 10 healthy adults. The changes of body mass index (BMI) and waist-hip ratio (WHR) were observed and analyzed in each group. Results The level of IL-6 in blood plasma of patients with the newly diagnosed type 2 diabetes mellitus were obviously higher than that in normal group (P< 0.01); IL-6 level in patients with Dampness-Heat Encumbering the Spleen syndrome and overweight were obviously higher than those with the deficiency of Qi and Yin syndrome (P< 0.01). Conclusion Interaction between the high level of cytokines and (or) overweight may affect the normal immune function, and promote the development of diabetes, especially in patients with Dampness-Heat Encumbering the Spleen syndrome. The high level of IL-6 may indicate the large possibility of future T2DM and can be considered as a new diagnosis of T2DM syndrome differentiation.

Objective To explore the association between GNβ3 gene and depression,and to investigate the interaction of gene-environment(negative life events and childhood trauma) and potential possible pathogenesis of depression.Methods The sample of peripheral blood was collected from Chinese Northern patients(n=500) and controls(n=500).Snapshot technique was used to detect the genotype frequency and allele frequency of GNβ3 rs5443 polymorphism in cases and controls.The genotype and allele frequencies were analyzed by Chi-square test,the interactions of gene-environment were analyzed by Logistic regression.Results GNβ3 rs5443 genotype and allele frequencies were observed between patients and controls (x2 =20.249,P＜0.01;x2 =4.803,P＜0.05).There were genotype CC 102 and 158,genotype CT 280 and 217,genotype TT 118 and 125;allele C 484 and 533,allele T 516 and 467 between patients and controls,respectively.Logistic regression analysis showed that the interaction between rs5443 T+ and negative life events was associated with depression (P＜0.05,OR=1.957).In addition,individual carrying rs5443T+ genotypes and negative life events could increase risk of depression.Conclusion GNβ3 rs5443 is a possible susceptibility gene of depression.The interaction between rs5443 and negative life events is associated with depression.

Objective To analyze the outcomes and the prognostic factors of hematopoietic stem cell transplantation (HSCT) in combination with imatinib for Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). Methods All 32 patients with Ph+ ALL achieved hematologic complete remission (CR) at time of transplantation, including 27 cases in the first CR (CR1) and 5 in CR2. Nineteen patients achieved molecular remission (MR). Among 32 patients, 4 received autologous HSCT (AHSCT), and 28 allogeneic HSCT (allo-HSCT). The conditioning regimens comprised of total body irradiation (TBI), cyclophosphamide, fludarabine and cytarabine. The median number of transfused mononuclear cells was 5. 6 × 108/kg, and that of CD34+ cells was 2. 94 × 106 /kg. Thirty-one patients were administrated imatinib orally before transplantion, at a dose of 400～600 mg/day, and 16 patients after transplantation, including 7 for prevention at a dose of 300～400 mg/day and 9 for salvage treatment at a dose of 400 ～ 600 mg/day. Results Hematopoietic reconstitution was achieved in all 32 patients. Three-year estimate of overall survival (OS) was (62. 1±8. 6)%, leukemia-free survival (LFS) (59. 2 ± 8. 7)%, relapse rate (RR) (17. 7 ± 7. 2)% and transplant-related mortality (26. 2 ± 8. 0) %. All 4 undergoing AHSCT were alive, and 3 out of them were in continuous CR with durations of 14, 18 and 67 months respectively. The univariate analysis for prognosis in allo-HSCT showed that the OS of HLA-matched sibling donors group was 76. 5 %,higher than that of unrelated or haploidentical donors group (27. 3 %, P＜0. 05), and so was LFS (70. 6 % vs 27. 3 %, P＜0. 05). RR in patients achieving MR at time of transplantation was 5. 6 %,lower than that in those not achieving MR (40. 0 %, P＜0. 05). RR in patients in CR1 at time of transplantation was 12. 5 %, lower than that in those in CR2 (50 %, P ＜0. 05). Conclusion Imatinib improved the outcomes of HSCT for Ph+ ALL, especially to patients achieving MR at time of transplantation and transplantation in early stage (CR1).

Objective To explore the value of percutaneous oxygen partial pressure monitoring in prognosis evaluation of patients with acute heart failure (AHF). Methods A total of 91 patients with AHF due to various reasons admitted to the emergency department of the First Affiliated Hospital of China Medical University from July 2017 to June 2018 were enrolled. Dynamic monitoring data of arterial blood gas, percutaneous oxygen partial pressure monitoring and noninvasive cardiac output monitoring (NICOM) of all of the patients at the time of diagnosis (before treatment) and 6 hours after treatment were recorded, including arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), blood lactic acid (Lac), percutaneous oxygen partial pressure (TcPO2), percutaneous carbon dioxide partial pressure (TcPCO2), cardiac output (CO) and stroke volume (SV). The 10-minute oxygen challenge test value (OCT), oxygen and carbon dioxide offsets were calculated. The patients were divided into survival group and non-survival group according to 28-day survival situation, and the differences in above parameters were compared between the two groups. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of percutaneous partial oxygen pressure monitoring for the prognosis of patients with AHF. Results All the 91 patients were enrolled in the analysis, among whom 26 died on 28 days and 65 survived, with a mortality of 28.6%. Before treatment, 10-minute OCT in the non-survival group was significantly lower than that in the survival group [mmHg (1 mmHg = 0.133 kPa):41.0±3.9 vs. 45.6±3.2, P < 0.01], and the carbon dioxide offset was significantly higher than that in the survival group [(0.51±0.11)% vs. (0.37±0.11)%, P < 0.01]. However, there was no statistically significant difference in PaO2, PaCO2, TcPO2, TcPCO2, oxygen offset, CO, SV or Lac between the two groups. After 6 hours of treatment, TcPCO2, oxygen offset and carbon dioxide offset in the non-survival group were significantly higher than those in the survival group [TcPCO2 (mmHg): 36.0±2.8 vs. 33.2±2.8, oxygen offset: (0.25±0.05)% vs. (0.22±0.06)%, carbon dioxide offset: (0.29±0.12)% vs. (0.16±0.13)%, all P < 0.05], TcPO2, 10-minute OCT, CO and SV were significantly lower than those in the survival group [TcPCO2 (mmHg): 36.0±2.8 vs. 33.2±2.8, 10-minute OCT (mmHg): 49.1±4.5 vs. 53.6±5.5, CO (L/min):4.9±0.5 vs. 5.3±0.5, SV (mL): 57.8±3.5 vs. 64.4±4.8, all P < 0.01]. However, there was no statistically significant difference in PaO2, PaCO2 or Lac between the two groups. ROC curve analysis showed that the area under the ROC curve (AUC) of 10-minute OCT onset predicting the 28-day death of patients with AHF was 0.802; when the optimal cut-off value was 43.5 mmHg, the sensitivity and specificity was 77.3% and 68.0%, respectively. The AUC of carbon dioxide offset was 0.812; when the optimal cut-off value was 0.46%, the sensitivity and specificity was 86.4% and 68.0%, respectively. Conclusions Percutaneous oxygen partial pressure monitoring can be used as a reliable indicator for prognosis evaluation of patients with AHF. Increased carbon dioxide offset and decreased 10-minute OCT suggest poor prognosis, and the prognosis of patients with AHF should be evaluated by dynamic monitoring.

Objective To explore the impact of IL-10 gene polymorphisms on the outcome in HLA matched sibling hematopoietic stem cell transplantation (HSCT).Methods PCR-sequencespecific primer (PCR-SSP) assay was used to analyze the SNP of IL-10 in 77 recipient and donor pairs:-1082 A/G,-819 T/C,-592 C/A.Results IL-10 ATA/ATA (1082,-819,-592) genotype in recipients significantly decreased the incidence of grade Ⅱ-Ⅳ acute graft vursus-host disease (aGVHD) (6.1％ vs.25.0 ％,P＜0.05),reduced 5-year transplant-related mortality (TRM) (10.7 ％± 5.9％ vs.29.7％ ± 5.2％,P＜0.05) and increased disease free survival (DFS) (81.8％ ± 6.7％ vs.56.8％ ± 7.5％,P＜0.05).With regard to the donor genotype,the incidence of grade Ⅱ-Ⅳ aGVHD,extensive chronic GVHD,5-year TRM and DFS had no signicant difference between IL-10 ATA/ATA and non ATA/ATA subgroup.Multivariable analysis also revealed that IL-10 non-ATA/ATA genotype in recipients and high-risk status of disease were two independent risk factors for DFS (HR =2.911,P =0.029; HR =2.686,P =0.027).Conclusion In HLA-matched sibling HSCT,the presence of recipient IL-10 ATA/ATA significantly decreased the incidence of grade Ⅱ-Ⅳ aGVHD and TRM,and increased DFS.

Objective: To respectively analyze the impact of conditioning regimens with a dose-decreased cyclophosphamide (Cy) on the outcome in fully matched sibling donor (MSD) peripheral blood stem cell transplantation (PBSCT) for severe aplastic anemia (SAA) . Methods: Two conditioning regimens with different doses of Cy (150 mg/kg or 120 mg/kg) in combination with fludarabine (Flu) and antithymocyte globulin (ATG) for MSD-PBSCT were investigated in 51 patients with acquired SAA. Results: Overall survival and failure-free survival in patients received 150 mg/kg of Cy (Cy150 cohort) or 120 mg/kg (Cy120 cohort) were 93.5% vs 90.0% (χ²=0.170, P=0.680) and 90.3% vs 85.0% (χ²=0.285, P= 0.594) respectively. However, either acute or chronic graft-versus-host disease risks were higher in Cy120 cohort than in Cy150 cohort (HR=3.89, 95% CI 1.21-12.53, P=0.023; HR=4.48, 95% CI 1.40-14.32, P= 0.011, respectively) . No difference was found for opportunistic infections or graft failure between two cohorts. Conclusion Cy at a dose of 150 mg/kg, in combination with Flu and ATG, was more effective than that of 120 mg/kg Cy to produce improved clinical outcome in the setting of acquired SAA patients after MSD-PBSCT.

Objective: To evaluate the outcomes and prognostic factors of patients with refractory and relapsed acute myeloid leukemia (AML) who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The overall survival (OS) , disease free survival (DFS) , acute and chronic graft-versus-host disease (GVHD) , relapse rate (RR) , transplantation related mortality (TRM) and their related risk factors were analyzed retrospectively. Results: All the patients (median age 35 years, range 6 to 58) received myeloablative conditioning regimens. All patients had successful engraftment, and the median time of neutrophils engraftment was 14 days (range 9 to 25) . Of the patients who survived more than 100 days, the accumulative incidence of grade Ⅱ-Ⅳ acute GVHD and chronic GVHD (cGVHD) were 27.3% (95%CI 18.9%-36.3%) , 33.9% (95%CI 24.6%-43.5%) , respectively. Meanwhile, the accumulative incidence of extensive cGVHD was 9.3% (95%CI 4.5%-16.1%) . The 3-year OS, DFS, RR, and TRM was 45.0% (95%CI 34.6%-55.4%) , 45.0% (95%CI 34.8%-55.2%) , 36.6% (95%CI 26.9%-46.4%) and 19.7% (95%CI 12.4%-28.3%) respectively. Multivariate analysis revealed four independent risk factors: non remission status before transplantation[P=0.009, HR=2.21 (95%CI 1.22-4.04) ], WBC at diagnosis>50×10⁹/L[P=0.024, HR=2.11 (95%CI 1.11-4.02) ], donor age>35 years [P=0.031, HR=1.96 (95%CI 1.06-3.60) ]and without cGVHD[P=0.008, HR=0.38 (95%CI 0.18-0.78) ]. According to the risk factors before transplantation (non remission status, WBC at diagnosis>50×10⁹/L, donor age>35 years) , we then defined three subgroups with striking different OS at 3 years: no adverse factor (75.0%) ; one adverse factor (46.9%) ; two or three adverse factors (15.4%) (χ²=26.873, P<0.001) . Conclusion Allo-HSCT is a promising and safe choice for patients with refractory and relapsed AML and relapse is the major cause of the transplantation failure. Disease status before transplantation, donor age, WBC at diagnosis and cGVHD are confirmed as prognostic factors for these patients who received allo-HSCT.

Objective: To investigate the effects of donor-specific HLA antibodies(DSA) for graft failure in un-manipulated haploidentical hematopoietic stem cell transplantation(haplo-HSCT) and the feasible treatment for DSA. Methods: HLA antibodies were examined using the Luminex-based single Ag assay for 92 patients who were going on haplo-SCT and the correlations of graft failure and DSA among the patients who had finished SCT were analyzed. Results: Of the total 92 patients who were going on haplo-HSCT, sixteen (17.4%) patients were HLA Ab-positive, including six (6.5%) patients with antibodies corresponding to donor HLA Ags (DSA-positive). Among the patients who had finished the haplo-HSCT with conventional myeloablative conditioning regimen, the engraftment rate was significantly higher in DSA (-) patients than that in DSA (+) patients [92.3% (24/26) vs 25.0%(1/4), χ²=8.433, P=0.004] and DSA was the only factor relevant with graft failure in multiple-factor analysis [OR=12.0(95% CI 1.39-103.5), P=0.024]. Strategies to decrease antibody levels were taken for 4 patients, two were their first transplantations, and the other two patients were their second haplo-HSCT. Three of the four patients were HLA-I-DSA positive and had gained donor engraftment by means of donor platelet transfusions to decreased the level of DSA, the fourth patient with both HLA-I and HLA-II DSA also gained engraftment with the treatments of TBI, rituximab and donor platelet transfusion. Conclusion DSA is one of the key factors of graft failure in haplo-HSCT. Donors should be selected on the basis of an evaluation of HLA antibodies before transplantation. If haplo-HSCT from donors with DSA must be performed, then recipients should be treated for DSA to improve the chances of successful engraftment.

Objective: To assess the efficacy and toxicity of decitabine-based conditioning regimen in patients with myelodysplastic syndrome (MDS) , acute myeloid leukemia secondary to MDS (MDS-AML) or chronic myelomonocytic leukemia (CMML) . Methods: From March 1, 2013 to May 25, 2015, 22 patients who underwent allogenic hematopoietic stem cell transplantation (allo-HSCT) with decitabine-based conditioning regimen were analyzed retrospectively. Results: ①22 patients, 14 males and 8 females with a median age of 42.5 (24-56) years old, were diagnosed as MDS (n=14) , CMML (n=4) , MDS-AML (n=4) . ②15 patients were treated with the conditioning regimen of decitabine combined with busulfan, cyclophosphamide, fludarabine, and cytarabine, the other 7 cases were treated with decitabine, busulfan, fludarabine, and cytarabine. The dose of decitabine was 20 mg·m^-2·d^-1 for 5 days.Rabbit anti-human anti-thymocyte globulin (2.5 mg·kg^-1·d^-1 for 4 days) was involved in conditioning regimen in patients with unrelated donor or haploidentical transplantation. ③Except 1 patient died of infection in 2 months after transplantation, the other patients were engrafted successfully. The median time of granulocyte engraftment was 13 (12-18) days, and the median time of platelet engraftment was 16 (13-81) days. ④The incidence of acute graft versus host disease (aGVHD) was (41.3±10.6) %, and severe aGVHD (grade of III-IV) was (18.4±9.7) %. The incidence of chronic graft versus host disease (cGVHD) was (56.4±11.3) %, and extensive cGVHD was (36.4±12.1) %. ⑤8 patients were suffered with cytomegalovirus (CMV) viremia. Among the 18 patients with definitely infection, 6 occurred during myelosuppression and 12 cases occurred after hematopoietic reconstruction. The 2-year and 3-year non-relapse mortality was (13.9±7.4) % and (24.3±9.5) %, respectively. ⑥The 2-year and 3-year overall survival (OS) was (77.3±8.9) % and (67.9±10.0) %, respectively. The 2-year and 3-year relapse-free survival (RFS) was (72.7±9.5) % and (63.6±10.3) %, respectively. Conclusions allo-HSCT with decitabine-based conditioning regimen is feasible in the treatment of MDS, MDS-AML or CMML.