Humans ; Lymphoma, Large-Cell, Anaplastic ; diagnosis ; enzymology ; therapy ; Receptor Protein-Tyrosine Kinases

Pediatrics internship is a bridge that brings medical theory into clinical reality.Cultivate systematic clinical thinking during internship is the key to the growth of clinical doctors.Good outcome has been achieved among these eight-year medical students by using teaching methods such as case discussions,lectures,teacher instructions,which can cultivate proper clinical thinking and make students more active.

BACKGROUND: There are a lot of immunologic studies about limb allotransplantation in animal experiment. But, it is only early investigation in clinic; its clinical immunologic study needs further accumulation.OBJECTIVE: To dynamically analyze the early immunologic state change in patients following hand allotransplantation.DESIGN: Controlled trial.SETTING: Department of Orthopaedics, Guangzhou General Hospital,Guangzhou Military Area Command of Chinese PLA; Department of Traumatic Orthopaedics and Department of Laboratory Medicine, Nanfang Hospital, First Military Medical University of Chinese PLA.PARTICIPANTS: Two patients who underwent unilateral hand allotransplantation in the Department of Orthopaedics, Guangzhou General Hospital,Guangzhou Military Area Command of Chinese PLA were enrolled, serving as experimental group. The observation was between September 1999 and March 2000. Twenty persons, including 12 male and 8 female, who homochronously received health examination, aged 20 to 45 years, were enrolled, serving as healthy control group. They all had no reactive immune and infectious diseases, and voluntarily participated in the trial.METHODS: Peripheral blood was collected from 2 patients who underwent hand allotransplantation once respectively at pre-operative 1 day and 3 days. Blood collecting was performed once per day at post-operative 1 week, three times per week at post-operative 2 to 4 weeks, twice per week at 5 to 8 weeks post-operation, once per week at 9 to 16 weeks post-operation, twice per month at 5 to 6 months post-operation. ① Peripheral blood T cell subgroups (CD3+,CD4+,CD8+T cells)were detected by flow cytometer,serum panel reactive antibody (PRA) by ELISA method, serum C-reactive protein by turbidimetric immanoassay (TIA), serum creatine kinase (CK) by enzyme dynamics method. ②Mixed lymphocyte reaction(MLR): mitomycin C-treated donor peripheral blood lymphocytes were used as stimulator, and proliferative reaction of peripheral blood lymphocyte of patients to donor transplanted antigen was detected with the incorporation of 3H-TDR method (Negative: There was no significant difference between the mean value of stimulation index and 1, conversely positive). Autogenic peripheral blood lymphocytes treated with the same way replaced donor stimulator, serving as control. Stimulation index of each specimen was calculated (Stimulation index=Experiment cmp/controlcpm), serving as control index. Peripheral blood T-cell subgroups (CD3+,CD4+,CD8+T cell), serum PRA, C-reactive protein and CK were detected in 20 persons in healthy control group;Twenty persons were randomly divided into 10 groups. Two persons in each group were used as donor and recipient mutually and performed MLR.MAIN OUTCOME MEASURES: ① Peripheral blood T cell subgrpups (CD3+,CD4+,CD8+T cell). ②PRA. ③ C-reactive protein. ④CK. ⑤MLR.RESULTS: ①CD3+,CD4+,CD8+T cell levels were obviously decreased within one week after operation. CD3+ and CD4+T cell levels both recovered to be the pre-operative levels, but CD8+ level exceeded pre-operative level significantly [CD3+: (66.43±4.56); CD4+: (30.55±3.94); CD8 +:(33.45 ±2.69)]. There was no significant difference between experiment group and control group. ②Serum PRA was 0 to 10%, there was no significant difference as compared with control group. ③ Serum C-reactive protein was 0 to 0.359 mg/L, there was no significant difference as compared with control group. ④ Serum CK was 25 to 170 mmol/L, and there was no significant difference as compared with control group. ⑤ MLR after transplantation was negative, and it turned into be positive 5 months later.They were all positive in control group.CONCLUSION: Short-term change and long-term redistribution of T cell subgroups are closely related to immunosuppressive agent, suggesting that immunosuppressive agent has obvious effect on T-cell subgroup following hand allotransplantation. Immuno-induction schedule make patients be in immune suppression state, which effectively avoid early rejection. But patients cannot bear specificity yet; they need the inhibition of immunosuppressive agents.

BACKGROUND:Cytokines play an important role in the occurrence and development of graft-versus-host disease, but there is a current lack of reports on the association between cytokines and graft-versus-host disease after al ogeneic hematopoietic stem cel transplantation for treatment ofβ-thalassemia major.
OBJECTIVE:To investigate the association between cytokines and graft-versus-host disease after al ogeneic hematopoietic stem cel transplantation forβ-thalassemia major.
METHODS:We observed the dynamic variation of interleukin 6, interleukin 8, interleukin 12, tumor necrosis factor-αand macrophage migration inhibitory factor in 11 children withβ-thalassemia major before onset of graft-versus-host disease, when graft-versus-host disease occurred, at days 4 and 7 after onset of graft-versus-host disease, and when graft-versus-host disease disappeared.
RESULTS AND CONCLUSION:There was a significant difference in serum levels of interleukin-6, interleukin-12, tumor necrosis factor-α, macrophage migration inhibitory factor in different time points, and the highest levels of different cytokines appeared when graft-versus-host disease occurred, fol owed by those at 7 days after
graft-versus-host disease. There was a significant difference in serum levels of interleukin-8 in different time points, and the highest level appeared at 4 days after graft-versus-host disease. The dynamic expression of interleukin-6, interleukin-8, interleukin-12, tumor necrosis factor-α, macrophage migration inhibitory factor can estimate the immune function ofβ-thalassemia major patients who develops graft-versus-host disease after al ogeneic hematopoietic stem cel transplantation, and can be used as the immunobiology indicators for the early diagnosis of graft-versus-host disease.

Aim To examine the effect of ? opioid receptor agonist U50488H on the levels of interleukin-6(IL-6) and interleukin-8(IL-8) from angiotensinⅡ(AngⅡ) stimulated endothelial cells.Methods In the in vivo study,the modulation of U50488H(1.5 mg?kg~-1) intravenously on the level of AngⅡ was evaluated.In the in vitro study,endothelial cells from human umbilical vein(HUVEC) were cultured and divided into four groups:Control group,AngⅡ group,and AngⅡ plus U50488H and/or nor-BNI(a selective ? opioid receptor antagonist) group.These groups were treated respectively with phosphate buffered solution(PBS),AngⅡ(10~-9~10~-5 mol?L~-1),and AngⅡ in the presence of U50488H and/or nor-BNI for 0~24 hours.Culture supernatant and endothelial cells were collected at 0,3,6,12 and 24 h.IL-6 and IL8 levels in culture supernatant were measured by enzyme linked immunosorbent assay(ELISA).Results The level of AngⅡ in the blood was significantly decreased following U50488H intravenously,which was blocked by nor-BNI administration(2 mg?kg~-1).AngⅡ stimulated the productions of IL-6 and IL-8 from HUVEC in the dose-dependent and time-dependent manners.U50488H at 10~-5 mol?L~-1 significantly inhibited this process,and the inhibitory effect of U50488H was blocked by nor-BNI,which itself had no effect.Conclusion ? opioid receptor may play a role in the process of anti-inflammation via down regulation of AngⅡ level and inhibition of the AngⅡ-stimulated IL-6 and IL-8 productions from endothelium cells.

Objective To use the nested PCR technology to diagnose and identify a case of imported Plasmodium ovale wallikeri subspecies .Methods Blood sample was collected from 1 case of initially diagnosed imported tertian malaria and performed the ex‐amination of microscopy ,rapid diagnostic tests (RDTs) and nested‐PCR .Moreover the sequencing was conduced .Results RDTs showed the negative result ;the ring form and trophozoite of Plasmodium could be observed in the blood smear by microscopy ;the Plasmodium ovale wallikeri subspecies specific primer rOVA 1v/rOVA2v was adopted for conducting nested PCR ,the specicific am‐plification band appeared at 760 bp ,after sequencing and Blast aligning ,its coincidence with the partial sequence of Plasmodium ovale wallikeri subspecies in the Genbank database was 99% .Conclusion This patient is the first case of Plasmodium ovale wallik‐eri subspecies infection in Hubei province by nested PCR and sequencing analysis .

Objective:To investigate the effects of sensitized sera on bone marrow transplantation and clarify the role of antibody in the process of rejection.Methods:Two hundred microlitres sensitized sera or non-sensitized sera were injected into normal BALB/c one day before transplantation.Ten millions (1?107) bone marrow cells from C57BL/6 were transfused to the recipients after lethal irradiation.The donor-reactive antibodies in recipients before transplantation were measured by complement-dependent cytotoxicity (CDC) method.Moreover,the survival analysis and engraftment evaluation of the recipients were carried post transplantation.Results:The CDC results showed that donor-reactive antibodies existed in the recipients which had received sensitized sera transfusion.Eighty percent (80%) of the recipients received sensitized sera transfusion died of bone marrow failure about 10 days post transplantation,while the recipients received non-sensitized sera transfusion were long-term alive.Furthermore,the hematopoietic recovery and percentage of donor chimera analysis declined along with time in the sensitized sera transfusion recipients,and there were significant differences compared with those in the non-sensitized sera transfusion recipients (P

AIM: To evaluate the anatomic and visual outcomes of 25-gauge vitrectomies combined with air tamponade for the treatment of idiopathic macular hole (IMH).METHODS: Thirty eyes of 27 patients with IMH were included in this prospective interventional study.All patients underwent 25-gauge pars plana vitrectomy (PPV) combined with phacoemulsification and air tamponade.Best corrected visual acuity (BCVA, logMAR), perimetry and multifocal electroretinography (mfERG) were conducted before and after the operation.Anatomical changes were evaluated with optical coherence tomography (OCT).RESULTS: The macular holes closed successfully in 28 eyes after the primary vitrectomy.The mean BCVA improved from 0.72±0.22 logMAR preoperatively to 0.29±0.18 logMAR postoperatively (P<0.001).In the visual field of central 10°, the average mean deviation (MD) decreased from-3.59±1.83 dB preoperatively to-2.51±1.36 dB postoperatively (P<0.001) and the average pattern standard deviation (PSD) decreased from 1.86±0.68 dB preoperatively to 1.33±0.32 dB postoperatively (P=0.001).The retinal response densities of mfERG in the foveal and perifoveal area increased significantly, and implicit times of rings 4-6 prolonged significantly (P<0.05).The symptom duration and baseline N1 amplitude densities at ring 1 had a significant impact on postoperative BCVA (P<0.001, P=0.001, respectively).CONCLUSION: The 25-gauge PPV and air tamponade with 1 day prone positioning produce favorable anatomic and functional outcomes.

ALK negative anaplastic large cell lymphoma (ALK(-) ALCL) lacks the specific expression of ALK protein, although it also strongly expresses CD30 and resembles the morphologic characteristics of ALK positive anaplastic large cell lymphoma (ALK(+) ALCL). Recently, some new researches indicate that there exist molecular and genetic differences between these two types of ALCL. Moreover, the treatment response, prognosis, and long-term survival of ALK(-) ALCL are far worse than that of ALK(+) ALCL, such as ALK(-) ALCL is associated with older age persons, B group syndrome, disease advanced stage, high International Prognostic Index (IPI) and poor prognosis (< 49% 5-year survival). As a consequence, some new advances on basis (cell morphology and tissue pathology, immunophenotypes, cell genetics and molecular marker), diagnosis and treatment of ALK(-) ALCL are summarized in this review.
Biomarkers, Tumor ; Humans ; Lymphoma, Large B-Cell, Diffuse ; classification ; pathology ; Lymphoma, Large-Cell, Anaplastic ; classification ; pathology

Recently, along with the thorough investigation on the gene and molecular biology of peroxisome proliferators activated receptorgamma (PPARgamma), the therapeutic effects of PPARgamma ligand and its potential mechanism were gradually recognized. PPARgamma will probably become a new target of oncotherapy and is now extensively followed by researchers. This review focuses the advances of study on PPARgamma distribution in tissue, its function, its ligand in relationship with hematologic malignancies including acute myeloid leukemia, acute lymphocytic leukemia, chronic myeloid leukemia, lymphoma, multiple myeloma and so on.
Hematologic Neoplasms ; metabolism ; pathology ; Humans ; Ligands ; PPAR gamma ; metabolism