BACKGROUND: In recent years, the immunoregulatory effects of mesenchymal stem cells (MSCs) can be used to induce immune tolerance. OBJECTIVE: To evaluate the safety and feasibility of human umbilical cord-derived MSCs (hUC-MSCs) in liver transplantation patients. METHODS: hUC-MSCs were cultured and identified. After approved by the Medical Ethics Committee, a total of 50 patients were randomly divided into experimental group and control group according to the proportion of 1:1. In the experimental group, hUC-MSCs were perfused by the portal vein during the operation and infused into the jugular vein on the 3rd day after the operation. The injection dose was 1×106/kg (prepared as 50 mL of cell suspension). Both groups received standard immunosuppressive regimens. Blood biochemistry and immune function indicators were detected preoperatively and at postoperative days 3, 7, months 1, 2, 3, 6, 12. Acute and chronic rejection rates, incidence of infection, and incidence of transplantation-related complications were recorded. RESULTS AND CONCLUSION: (1) At 3 and 7 days after the operation, the percentage of peripheral blood CD4+CD25+ cells (regulatory T cells) in the experimental group was significantly higher than that in the control group (P < 0.05). The percentage of CD4+ cells (helper/inducer T cells) and ratio of CD4+/CD8+ T lymphocytes were significantly lower in the experimental group than the control group (P < 0.05). (2) There was no significant difference in postoperative alanine aminotransferase and total bilirubin levels between the two groups (P > 0.05). (3) The incidence of abnormal liver function in the experimental group was significantly lower than that in the control group (P < 0.05). (4) The incidence of transplantation-related complications and the rate of infection showed no significant difference between the two groups (P > 0.05). Overall, the intravenous infusion of hUC-MSCs is safe and feasible in liver transplantation patients, which in early stage can promote the the proliferation and activation of CD4+CD25+ cells (regulatory T cells), reduce the percentage of CD4+ cells (helper/inducer T cells) and lower the ratio of CD4+/CD8+ T cells, thereby improving the immune status in liver transplantation patients.

Objective To provide new information for treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods Through one case report and literature review of 48 BPDCN cases were reviewed retrospectively.The clinical characteristics,treatment choices and prognosis were analyzed.Results BPDCN patients were mainly elderly males,mostly presented as skin rash and bone marrow infiltration.Immunophenotype was characteristically expressed as CD4,CD56 and CD123.Lymphoid-like regimens could induce higher response rate,lower relapse rate and longer overall survival compared with myeloid-like regimens.Allogeneic hematopoietic stem cell transplantation may provide long-term survival.At the onset of the disease,The counts of white blood cells (WBC) and blood platelet (Plt) may be correlated with inferior overall survival.Conclusions BPDCN is a disease with distinct clinical characteristics and immunophenotype.Lymphoid-like regimen may be the better treatment of choice,while allogeneic hematopoietic stem cell transplantation should be taken into account in the first complete remission for longterm survival.

In the basis of a large amount of literatures, this article sumed up the characteristics and application of eggshell membrane.

OBJECTIVETo evaluate the clinical significance of the application of fluorescence in situ hybridization (FISH) in detecting chronic myeloid leukemia (CML).

METHODSChromosome preparation was made by using 24-hour culture. FISH technique using dual color dual fusion (DC-DF) BCR/ABL probe was performed in all 158 cases and R-banding was also employed for karyotyping in some patients.

RESULTSAmong the 158 cases, 98 cases were Ph positive, of which 69 cases (70.4%) were typical FISH pattern (1R1G2F), the other 29 cases (29.6%) showed 12 different types of atypical FISH pattern. The most frequent atypical patterns found were 1R1G1F in 7 cases (7.1%), 2R1G1F in 5 cases (5.1%), 1R1G2F and 1R1G3F in 4 cases (4.1%), 2R2G1F in 3 cases (3.1%). Karyotype analysis on 18 CML cases with atypical FISH patterns demonstrated that the atypical FISH patterns were due to variant translocation in 3 cases; the additional third signal was because of a supernumerary Ph chromosome. The karyotyping results did not conform to FISH results in four cases suggesting the conceivable mistakes in karyotyping. The 1R1G1F signal pattern seen in 3 cases with classical t(9;22) resulted from the deletion of derivative chromosome 9. The 1R1G2F signal pattern detected in 40% to 64% of interphase cells of 3 cases without Ph chromosome by conventional cytogenetic analysis suggested a submicroscopic translocation. Three cases treated with Glivec or bone marrow transplantation showed normal karyotypes with a small amount of BCR/ABL positive cells by FISH detection.

CONCLUSIONFISH technique is of great value for the diagnosis of CML and confirmation of variant translocation, occult Ph translocation, derivative chromosome 9 deletion, therapeutic effect of interferon and Glivec as well as detection of minimal residual disease after bone marrow transplantation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; analysis ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 22 ; Chromosomes, Human, Pair 9 ; Female ; Fusion Proteins, bcr-abl ; Gene Deletion ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; genetics ; Male ; Middle Aged ; Translocation, Genetic ; Young Adult

To investigate the frequency of derivative chromosome 9 [der (9)] deletions in patients with chronic myelogenous leukemia (CML), karyotype analysis in 138 patients with CML was performed with R-banding technique, and dual fusion fluorescence in situ hybridization (FISH) was used to detect der (9) deletion. The results showed that among 138 cases, 126 cases were Ph positive (91.3%) from which 122 cases were typical Ph translocation, 12 cases were Ph negative (8.7%). FISH detection revealed 23 with der (9) deletions out of 138 cases (16.7%), 20 out of 122 cases with typical Ph translocation showed typical Ph translocation (16.4%) and 3 out of 4 cases with variant Ph translocation had variant Ph translocation (75%). 20 cases were in chronic phase (CP) (17.2%), 3 cases were in blast crisis (BC) (17.6%), there was no significant difference in the frequency of the der (9) deletions between the cases in CP and in BC (p < 0.05). It is concluded that incidence of der (9) partial deletions in CML patients is 16.7%, FISH can effectively detect the der (9) deletions, and there is no correlation of der (9) deletion frequency between cases in different phases of CML.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chromosome Deletion ; Chromosomes, Human, Pair 9 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; genetics ; Male ; Middle Aged ; Sequence Deletion ; Young Adult

Objective To study the clinical efficacy of steroid-free immunosuppressive therapy after liver transplantation in patients with primary liver cancer.Methods A retrospective study was conducted on the clinical data from January 2010 to October 2016 on 112 patients with primary liver cancer.There were 59 patients who had no steroid immunosuppressive regimen after operation,and 53 patients were in the steroid group.The immunosuppressive regimen used in the postoperative steroid-free group was tacrolimus + mycophenolate mofetil + basiliximab.For the steroid group it was:tacrolimus + mycophenolate moxibustion.The steroid was reduced daily in the first day after transplantation and was discontinued 3 months after transplantation.Follow-up observation of the differences between the two groups of patients on rejection,infection,tumor recurrence,hepatitis B virus recurrence and survival were compared.Results The infection rate was 18.6％ in the postoperative steroid-free group,which was significantly lower than that in the steroid group (37.7％,P ＜0.05).The recurrence rate of hepatitis B virus in the postoperative steroid-free group was 5.1％,which was significantly lower than that in the steroid group (20.8％,P ＜ 0.05).For patients who exceeded the Milan Criteria,the tumor recurrence rate was 70.0％ in the postoperative steroid-free group,which was lower than the 100％ in the steroid group (P ＜0.05).The 1-year,3-year and 5-year survival rates in the postoperative steroid-free group were 96.4％,84.9％ and 69.3％,respectively,which were better than the 87.8％,64.9％ and 44.3％ (P ＜0.05) in the steroid group.The incidences of rejection were not significantly different (P ＞ 0.05).Conclusions The use of the steroid-free immunosuppressive regimen in patients with hepatocellular carcinoma after transplantation was safe and did not increase the incidence of acute rejection.The regimen reduced the incidences of postoperative infection and hepatitis B virus recurrence,especially in patients who exceeded the Milan Criteria.It reduced the risk of tumor recurrence and improved patient survival.

Objective To evaluate the effects of beraprost sodium com-bined with losartan potassium on kidney function and microalbuminuria index of patients with early diabetic nephropathy .Methods A total of 68 cases of patients with early diabetic nephropathy were divided into the trial group ( n=34 ) and control group ( n=34 ) .The patients of control group were treated with conventional symptomatic treatment and beraprost sodium 40 μg, tid.On the basis of control group , the patients of trial group were treated with losartan potassium 50 mg, qd.The treatment for patients of two groups all lasted for 12 weeks.The changes in renal func-tion ( serum creatinine , blood urea nitrogen , homocysteine , cystatin C levels ) , and microalbuminuria index (β2 microglobulin , urine mi-croalbumin , urinary microalbumin /urine creatinine , 24 h urinary albu-min excretion rate ) and blood pressure , blood glucose and glycosylated hemoglobin of the two groups before and after the treatment were ob-served.Results In the terms of urea nitrogen , homocysteine , cystatin C,β2 microglobulin, urine microalbumin, urinary microalbumin /urine creatinine , 24 h urinary albumin excretion rate , the patients of twogroups all significantly decreased than before treatment (P <0.05), and in the terms of homocysteine , cystatin C, mi-croalbuminuria index , the patients of the trial group got more significant decline ( P <0.05 ) , but in the terms of serum creatinine, urea nitrogen, there was no significant difference between the two groups (P>0.05).The blood pressure of two groups significantly decreased after treatment , but blood glucose and glycosylated hemoglobin of two groups all got no significant difference than those of before treatment ( P>0.05 ) .There was no serious adverse drug reactions in the two groups, including coughing , elevated serum potassium and so on .Conclusion The beraprost sodium com-bined with losartan potassium can protect the kidney endothelial cells and improve kidney function of patients with early diabetic nephropathy , effectively reduce urinary protein and slow the progression of disease with high safety .

OBJECTIVETo analyze the prognostic factors in patients with stage I non-small cell lung cancer (NSCLC).

METHODSFifty-eight patients with stage I NSCLC treated from 1991 to 1995 were retrospectively reviewed. The clinical features, histopathology and prognostic factors were analyzed by SPSS10.0 statistic software. The expression of c-myc, MDM2, c-erbB-2, EGFR, p53, p14(ARF), p16(INK4), p21(WAF1) and nm23 was detected by immunohistochemical assay. The overall survival rate, local-regional control rate and distant metastasis rate were observed.

RESULTSThe overall survival rate, local-regional recurrent rate and distant metastasis rate were 71.1%, 11.1% and 33.5%, respectively. In univariate analysis, tumor cell differentiation was an independent prognostic factor (P = 0.028); overexpression of c-myc or c-erbB-2 had significantly poor overall survival and high distant metastasis rate (P < 0.05). The total oncogene immunoreactive score (IRS) and comprehensive IRS were associated with poor overall survival. In multivariate analysis, tumor cell differentiation and comprehensive IRS were independent prognostic factors for overall survival. Among the high-risk group of patients, those who had received chemotherapy seemed to have a higher overall survival rate and a lower distant metastasis rate in this study, but the difference was not statistically significant.

CONCLUSIONFor stage I NSCLC patients, tumor cell differentiation and comprehensive IRS are independent prognostic factors for overall survival. Adjuvant chemotherapy might somehow improve the survival for the patients with high-risk factors.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Cell Differentiation ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Genes, Tumor Suppressor ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Oncogenes ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo analyze the complications and treatment results of intraoperative radiotherapy (IORT) for esophageal carcinoma.

METHODSSixty patients with thoracic esophageal carcinoma underwent esophagectomy through right thoractomy, 30 patients of whom received IORT of 15 - 25 Gy.

RESULTSIn patients who underwent IORT, 2 cases of pneumonitis, 1 case of anastomotic leak and 1 case of incisional wound infection were found. In patients underwent surgery only, 1 case of thoracic empyema and 1 case of anastomotic leak were found. All the complications ultimately healed. There was no operative mortality. During the follow-up of 3 years, in patients who underwent IORT, 2 of 3 died of radiation pneumonitis 24 and 26 months after IORT with one complicated with bronchoesophageal fistula. One of 3 died of multiple lung metastases. The 3-year survival rate was 88.0% (22/25) in IORT group and 76.0% (19/25) in surgery only group.

CONCLUSIONIntraoperative radiotherapy can reduce locoregional recurrence if performed to thoracic esophageal carcinoma patients without surgical contraindication or distant metastasis. Radiation pneumonitis, a common complication difficult to manage, implies a poor prognosis and, consequently, the lung and bronchus should be protected from the radiation.

Adult ; Aged ; Combined Modality Therapy ; Esophageal Neoplasms ; mortality ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy Dosage

OBJECTIVETo investigate the value of multislice spiral computed tomography (MSCT) in demonstrating the relationship between bronchus and peripheral lung cancer.

METHODSWe prospectively performed volumetric targeted scans of 0.5 mm collimation with MSCT and reconstructed images of multiplanar reconstruction (MPR), curved multiplanar reformations (CMPR) and surface shaded display (SSD) in 53 peripheral lung cancers. The results were compared with macroscopic and microscopic specimens.

RESULTS(1) The third- to seventh-order branches of the bronchi were clearly shown in all patients by the designed protocol. CT demonstrated the tumor-bronchus relationship in 29 (96.7%) adenocarcinomas and 13 (76.5%) squamous-cell carcinomas. Statistic analysis showed that there was no significant difference between the two groups (chi(2) = 2.8, P > 0.05). (2) The tumor-bronchus relationship was identified as four types with MSCT. Type I: bronchus was obstructed abruptly by the tumor, type II: bronchus penetrated into the tumor with tapered narrowing and interruption, type III: bronchus lumen shown within tumor was patent and intact, type IV: bronchus ran at the periphery of the tumor with intact or narrowed lumen. (3) Type I was shown in 31 of 53 (58.5%) tumors with squamous-cell carcinoma slightly more common than adenocarcinoma. Type II and type III were seen equally in 8 of 53 (15.1%) tumors which occurred only in adenocarcinomas. Type IV was seen in 15 of 53 (28.3%) tumors with adenocarcinoma being slightly more frequent than squamous cell carcinoma. (4) The tumor at the fourth-order bronchus was more common in squamous cell carcinoma, whereas that at the fixth-order bronchus was more likely in adenocarcinoma.

CONCLUSIONVolumetric targeted scan of ultra-thin section with MSCT and followed by MPR, CMPR and SSD reconstruction can greatly improve the manifestation of the bronchioles and accurately demonstrate the patterns of tumor-bronchus relationship, thereby reflecting pathologic changes to some extent.

Aged ; Aged, 80 and over ; Bronchi ; pathology ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Prospective Studies ; Tomography, Spiral Computed