Objective To investigate the expressions of CD133 and CD44 and their prognostic significance in gastrointestinal stromal tumors (GIST).Methods Streptavidin perosidase (SP) method of immunohistochemistry was used to detect expressions of CD133 and CD44 proteins in 42 cases of GIST, and the relationship between their expressions and tumor size, mitotic count were analyzed by univariate and multivariate factor analyses.Results The expressions of CD133 and CD44 proteins in GIST were 21.4％ (9/42) and 78.6％ (33/42), respectively.The expressions of CD133 and CD44 proteins were significantly correlated with tumor size and mitotic count (P ＜ 0.05).Univariate factor analysis showed that the overall survival of GIST patients with positive CD133 protein (23.2 months) was shorter than that of patients with negative CD133 protein(63.1 months) (P ＜ 0.05).The overall survival of GIST patients with negative CD44 protein (23.2 months) was shorter than that of patients with positive CD44 protein (63.3 months) (P ＜ 0.05).Multivariate factor analysis showed that tumor size, mitotic count and CD44 protein were independent prognostic indicators for survival time after operation.Conclusions The positive expressions of CD133 and CD44 proteins might be the prognostic factors of GIST patients.

Objective To evaluate the surgical treatment of splitting right hepatic duct with hepatolithiasis and stenosis. Methods The clinical data of 38 patients with splitting right hepatic duct and hepatolithiasis treated by operation were analyzed retrospectively. Results All the patients underwent operation. operative procedures were as follows: (1) in situ cholangioplasty of splitting right hepatic duct in 7 cases;(2) fenestration of splitting right hepatic with adjacent hepatic duct in 9 cases; (3) bilioplasty of splitting right hepatic duct with adjacent bile duct in 8 cases; (4) hepatic lobectomy or segmentectomy of splitting right hepatic duct in 14 cases. Postoperative complications developed in 6 cases, which were cured conservatively. There was no perioperative mortality. All patients were followed up for 5～16 years(averaged 9.2 years). Excellent rate was 78.9%,and residual stones were found in 26.3% of the patients . Conclusions Accurate localization and appropriate operation may get satisfactory result in treating patients with splitting right hepatic duct with hepatolithiasis and stenosis.

Objective To evaluate the procedure of surgical treatment of intrahepatic biliary calculi with blood vessel variation in hepatic hilus. Method The clinical data of 57 patients with intrahepatic biliary calculi and blood vessel variation in hepatic hilus treated by biliary operation were retrospectively analyzed.Results The simply biliary operation was performed on 13 cases ; variant blood vessels were cut off and ligated in 14 cases;The bile duct and blood vessel across conversion operation were performed on 22 cases;and the intrahepatic cholangiojejunostomy was carried out in 8 cases. There were no severe postoperative complications and perioperative mortality.51 patients(89.6%) were followed up for 4 to 15 years with the exellent results in 43(84.3%)cases. There were residual stones in 7 cases,of them,5 patients had intermittent abdominal pain in the right upper quadrant; reoperation was performed on another 2 cases because of recurrent cholangitis. One died of variceal bleeding 1.5 years after operation. Conclusions In order to accomplish the complex operations of biliary tract and avoid ischemic damage of liver, proper operation should be chosen for patients with intrahepatic biliary calculi with blood vessel variation in hepatic hilus.

With the wide usage of traditional Chinese medicine (TCM) and the diversity of its dosage-forms, the reports about adverse reaction (ADR) caused by TCM were gradually increased. As the cradle of TCM with tremendous manufacturing enterprise engaged for this purpose, to establish and perfect the TCM ADR monitoring is the problem that TCM industry should face to. In this paper, the key point of TCM ADR monitoring was made clear by analysing the current situation and the problems presented in TCM ADR monitoring in China, and indicated that the nowday developing goals of TCM ADR monitoring are to establish and perfect the technologic system for TCM ADR monitoring, strengthen the related basic research and enhance international communication and cooperation in this field.
Adverse Drug Reaction Reporting Systems ; trends ; China ; Drug Contamination ; Drug Interactions ; Drugs, Chinese Herbal ; adverse effects ; Humans ; Legislation, Drug ; trends ; Medicine, Chinese Traditional

BACKGROUND: Hemorrhagic cystitis (HC) is one of common complications in patients undergoing hematopoietic stem cell transplantation (HSCT). It is of great value for improvement in the HSCT outcome to describe the clinical characteristics of HC and risk factors. OBJECTIVE: To investigate the incidence of HC in children after HSCT, and to analyze its clinical characteristics and risk factors.DESIGN: Case analysis SETTING: Center of Hematopoietic Stem Cell Transplantation, Department of Pediatrics, Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Experiments were performed at the Center of Hematopoietic Stem Cell Transplantation, Department of Pediatrics of Second Affiliated Hospital of Sun Yat-sen University from October 1998 to June 2004. Eighty-eight patients receiving umbilical cord blood transplantation (UCBT) and peripheral blood stem cell transplantation (PBSCT) were enrolled; 49 were males and 39 were females. The age ranged from 2 to 18 years with an average of 8.0 years. Guardians of child patients signed informed consents. The experimental procedures were approved by Medical Ethics Committee.METHODS: ①Conditioning regimens included combination of cyclophosphamide (CY, 120-200 mg/kg) with busulphan (BU, 14-20 mg/kg)-based chemotherapy and combination of CY with total body irradiation (TBI, 2-8 Gy) or total lymphoid irradiation (TLI, 2-8 Gy)-based radiotherapy. ②HC was defined according to the criteria proposed by references 7 and 8. The incidence, clinical characteristics, laboratory examination, treatment and outcome for HC were described. The association of various clinical factors including age, gender, human leucocyte antigen (HLA) typing, diseases for transplant, the type of stem cell, the type of transplantation, the occurrence of acute graft-versus-host disease (aGVHD) and cytomegalovirus (CMV) infection with the development of HC were examined.MAIN OUTCOME MEASURES: ①Incidence of HC, ②HC patient characteristics and laboratory examination, ③HC treatment and outcome, and ④risk factors analysis. RESULTS: All 88 patients were included in the final analysis. ①The incidence of HC: 16 patients (18.2%, 16/88) developed HC post-transplant with the severity graded as mild in 11 cases (68.7%) and severe in 5 cases (31.3%). ②HC patient characteristics and laboratory examination: All had hematuria and 8 cases (50.0%) had typical pollakisuria, urinary urgency, odynuria and gross hematuria; 10 cases (62.5%) had gross hematuria and 11 had proteinuria (+ to +++); Leucocytes were detected in 7 cases. ③Treatment and outcome: All patients recovered at a median of 13.5 days (range 2-53 days). ④Risk factors analysis: The incidence of HC was significantly higher in the group of ≥ 6 years old, presence of aGVHD and development of cytomegalo-virus (CMV) infection (P < 0.05-0.01). CONCLUSION: ①HC has its own clinical characteristics following HSCT in children but with good prognosis. ②The risk factors for HC are ≥ 6 years old, presence of aGVHD and CMV infection.

Objective To investigate the mouse liver blood vessel images using phase contrast X-ray imaging with synchrotron radiation. Methods 6 female C57BL/6 mice were randomly divided into two groups, 3 mice in each group. In one group, livers excised after hgated arteries, veins and common bile duct. In another group, iodine infused via the portal vein and drained from inferior vena cave until all the blood in the portal veins and hepatic veins was displaced. After infusion, arteries, veins and common bile duct were ligated and livers were excised. Results Blood vessel images were clearly produced by diffraction enhanced imaging. This method can discriminate vessels down to about 40 μm in diameter without contrast agent. Using a contrasting agent more details could be produced. In one liver lobe, the entire branch of the portal vein could be clearly produced by one by one phase contrast image from the main axial blood vessels of liver lobe to the nine generation of branching. Conclusions Phase contrast imaging has the advantage of good contrast and high spatial resolution. [Key wnrds] Synchrotron radiation; Phase contrast imaging; Diffraction enhanced imaging; Blood vessel; X-rays

Objective To investigate the effects of evodiamine on autophagy of human colon a cleno carcinoma lovo cells, and to explore the role and mechanism of autophagy which was induced by evodiamine (EVO). Methods MTT assay combined with the morphologic changes were used to observe the cell viability. Monodansylcadaverine was used to detect autophagy by fluorospectrophotometer and the confocal laser fluorescence microscopy respectively. Immunoblotting assay was used to observe the microtubule-associated protein 1 light chain 3. Finally, evodiamine combined with 3-methyladenine to detect the cell viability with MTT assay and the apoptosis with the flow cytometry, respectively.Results Evodiamine inhibited the viability of Lovo cells in dose-dependent manner ( P ＜ 0. 05 ), especially in 60 μmol/L that was obviously(60% ). Further more, the cell lysis and cell gap widened was observed by the light microscope. Evo triggered the autophagy, and after inhibition the autophagy by 3-MA, the killing capacities of the Evo was enhanced ( P ＜ 0. 01 ). However, autophagy prohibited the apoptosis pathways.Conclusions Evodiamine can trigger the autophagy, which might play a self-defense role in evodiamineinduced cell death. The cytototoxicity of evodiamine can be augmented by the autophagy inhibitors. The joint application of autophagy regulators with the chemotherapeutic agents might enhance the cell killing effects of chemotherapeutic drugs and show a potent role in cancer drug resistance.

AIM: To study the isolation,expansion and purification of mesenchymal stem cells(MSCs) from human umbilical cord blood(UCB),and investigate some biological identities of MSCs.METHODS:(1) MSCs of UCB,adult bone marrow(BM) and fetus BM were isolated by centrifugation with Ficoll,and the different kinds of MSCs were observed everyday.(2) Surface markers of MSCs were identified by flow cytometry.(3) The level of HGFs(TPO,SCF,FLT-3L,IL-6) secreted by different sources of MSCs was checked by ELISA method.RESULTS:(1) No difference in morphology of the colonies between UCB MSCs and BM MSCs was observed.However,the mononuclear cells needed in culture of UCB MSCs was about 3 times more than that in culture of BM MSCs.The times of UCB MSCs colony formation and confluencing were longer than that of BM in primary culture.(2) After passaged,there was no significant difference in the proliferation rates of 3 kinds of MSCs.Only 4 of 15 UCB samples contained a homogeneous population of MSCs.(3) UCB MSCs shared the same markers with BM MSCs.Neither hematopoietic marker nor immunologic recognition antigens were expressed.(4) The level of hematopoietic growth factors(HGFs) secreted by 3 kinds of MSCs was similar.CONCLUSIONS:(1) MSCs were isolated from UCB,but the amount of MSCs in UCB was smaller than that in BM,and just seldom samples of UCB contained homogeneous MSCs.(2) MSCs from UCB and BM shared the same biological characteristics,such as proliferation ability,surface markers,immunophenotypes and HGFs secretion.

AIM: To investigate the efficacy of dendritic cells (DCs) that augments the cytotoxic activity of cytokine-induced killer (CIK) cells, natural killer (NK) cells from a same donor and the CD45RO expression on CIK cells. METHODS: The expanded killer cells were divided into two groups: group A was pre-cocultured with DCs for 6 days, group B was the control that without any stimulation. Cytotoxicity of CIK and NK cells was measured at different effect-target ratio against K562 and HL-60. CD45RO and CD45RA expression on CIK cells in different groups were detected by flow cytometry. RESULTS: Cytotoxicity of CB derived killer cells was positive correlation with effect-target ratio. The cytotoxicity of group A against HL-60 was higher than that of group B significantly. At 20∶1 effector-target ratio, the lytic activity of group A CIK, NK cells against K562 was higher than that of group B significantly, but no significant difference between them at 10∶1 effector-target ratio. The CD45RO expression on CIK cells in groups A was significantly higher than that in groups B. CONCLUSION: CIK and NK cells cocultured with DCs can augment the killer's cytotoxicity against tumor cells and promote the CD45RO expression on CIK cells.

Objective To investigate the diagnosis,treatment and prognosis of ankle fractures combined with rupture of lateral collateral ligaments.Methods A continuous series of 5 cases of ankle fracture combined with lateral collateral ligament injury were reviewed who had been treated by the authors from January 2014 through December 2014.They were one man and 4 women,33 to 47 years of age (average,39 years).All the patients were suspected of lateral clear space of the ankle in preoperative X-ray examination,and MRI indicated rupture of lateral collateral ligament in 3 of them.Lateral collateral ligament injury was confirmed in all of them by direct intro-operative findings.After anatomical reduction and osteosynthesis of lateral and medial malleoli,the ankle joints were checked under the varus stress and drawer test.After the ruptured lateral collateral ligaments were explored directly,they were repaired with suture anchor in 4 cases and with drilling holes in the lateral malleolus in one.The ankles were immobilized for 3 weeks postoperatively.The outcomes were evaluated by Philips and Schwartz clinical scoring system and American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale.Results All the 5 patients were followed up for an average of 9.6 months (range,from 8 to 12 months).All the fractures healed without pain.No instability was complained of.The mean degree of plantar flexion was 50.0°,with 2° (from 0° to 10°) less than the normal side;the mean degree of dorsiflexion was 17°,with 6° (from 0° to 20°) less than the normal side.The mean Philips & Schwartz score was 93.4 points (from 80 to 100 points).The mean AOFAS score was 95.2 points (from 88 to 100 points).Conclusions The ankle fractures in which the lateral malleolus is involved can be combined with lateral collateral ligament injury.X-ray stress view and MRI are useful in early diagnosis.It is highly recommended to repair the injured lateral collateral ligament simultaneously with reduction and osteosynthesis of lateral and medial malleoli.