OBJECTIVEThe purpose of this study was to evaluate the advantages and disadvantages of vascularized free fibula flap as a new method for mandibular reconstruction.

METHODS25 cases (17 male to 8 female) who have received mandibular reconstruction with free vascularized fibular flaps in our hospital were studied retrospectively. The average length of the fibula grafts is 10.0 cm (range from 5.5 to 16 cm). 3 cases received primary insertion of osteointegrated dental implants into the free fibula flap, and all these 5 implants survived.

RESULTSAll flaps except 1 were viable. 62% of the cases took normal diet postoperatively, and the remainder took soft diet as well. All patients spoke clearly. No ankle unstability was reported. And the aesthetic assessments in all patients were good or fair.

CONCLUSIONVascularized free fibular flap takes its distinct advantages to other autogeneous free bone flaps and is confirmed to be one of the optimal methods for mandible reconstruction by our study.

Adolescent ; Adult ; Aged ; Fibula ; blood supply ; transplantation ; Follow-Up Studies ; Graft Survival ; Humans ; Male ; Mandible ; surgery ; Mandibular Neoplasms ; rehabilitation ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

The culture medium and cultural conditions of solid-state fermentation of Streptomyces Menmyco-93-63 were tested in this study. The suitable medium which contains rice, sorghum, millet bran, and rice hull with the proportion of 2:2:3:3 was developed for the spore production of Streptomyces Men-myco-93-63 using single substrate screening, mixture substrate screening and orthogonal experiments, and the sporulation was up to 2.52?109 CFU/g. And then, initial charge, initial ratio of water to solid, inoculating quantity, and culture temperature impact to sporulation of Streptomyces Men-myco-93-63 were tested. The favorite cultural conditions are developed as the following: the initial charge is 15 g in 500 mL Erlenmeyer flask; initial ratio of water to solid is 1.7:1.0 (V/W, rice hull excluding), inoculating quantity is 7 mL, culture temperature is 28℃.

This study was aimed to investigate the effect of 1,4-benzoquinone (1,4-BQ) on growth of myeloid progenitor cells with IFN-gamma different genotypes and to compare its differences. Polymerase chain reaction (PCR) was used to amplify the polymorphism gene segment of IFN-gamma +874 A/T in 36 cord blood (CB) specimens. The specimens were divided into three groups (AA, AT and TT group). MNCs were planted on complete methylcellulose medium containing different concentrations of 1,4-BQ. The colony-forming units (CFU) were assayed, the differences of colony growth in specimens with different genotypes (AA, AT and TT) under 1,4-BQ exposure were analyzed. The results showed that frequencies of AA, AT and TT genotypes were 5.56%, 88.89% and 5.56% in the 36 CB samples respectively. Comparing colony numbers of IFN-gamma +874 AA, AT and TT genotype indicated that there was significant difference (p(AA) = 0.033, p(AT) = 0.009, p(TT) = 0.001, < 0.05). Significant cytotoxicity was observed after exposure to concentrations of 1,4-BQ > or = 5 micromol/L. Cytotoxic response of 1,4-BQ was dose-dependent. Under the same concentration of 1,4-BQ, there were no significant differences in capacity of cell colony growth between 3 groups (AA, AT and TT). Colony numbers of specimen No 3 in AT group and specimen No 2 in TT group were less than those of other specimens significantly. It is concluded that the hematopoietic myeloid progenitor cells cultured in the presence of 1,4-BQ show a dose-dependent cytotoxic response, but there are no significant differences in colony growth of IFN-gamma different genotypes (AA, AT and TT) under the same concentration of 1,4-BQ.
Benzoquinones ; pharmacology ; Bone Marrow Cells ; drug effects ; Fetal Blood ; cytology ; Genotype ; Hematopoietic Stem Cells ; drug effects ; Humans ; Interferon-gamma ; genetics ; Stem Cells

ObjectiveTo study the effect of enriched rehabilitative training on the functional recovery and neuronal dentritic growth following cerebral ischemia/reperfusion.Methods32 male Wistar rats,weighting 180～200 g,were randomly divided into a ischemic group(n=16) and a sham-operation group(n=16) after beforehand trainings.Rats were subjected to 2 h of right middle cerebral artery occlusion before reperfusion.After surgery,the ischemic group were randomly divided into a ischemia + enrichment(IE) group and a ischemia + standard housing(IS) group;the sham-operation group were randomly divided into a sham + enrichment(SE) group and a sham + standard housing(SS) group.After 24 h reperfusion,IE and SE groups were housed in enriched cages,and given enriched rehabilitative training according to the scheme.At the same time,IS and SS groups were housed in standard cages without any training.The functions of 4 groups were evaluated at 24 h,1 week,2 weeks,3 weeks and 4 week after operation.Dentritic growth of layer V pyramidal cells of the undamaged forelimb motor cortex was examined using Golgi-Cox procedure.ResultsIE group showed better function than IS group in all behavioral test.There was no significant difference in limb-placement test at 3 weeks(P>0.05) and in footfault test at 4 weeks(P>0.05) after operation between IE and SE group.The mean of basilar dentrite branching points in IE group was significantly greater than that of other groups(P<0.01).ConclusionEnriched rehabilitative training can promote functional recovery and enhance neural plasticity after cerebral ischemia/ reperfusion in rats.

OBJECTIVETo compare the differences in clinical therapeutic effect and safety between amphotericin B and its liposome form in treating invasive fungal infection (IFI) in hematological disorder with neutrocytopenia.

METHODSOf 111 patients with IFI, 82 were treated with amphotericin B and 29 with amphotericin B liposome. The mean cumulative dose of amphotericin B was 617 (60-1895) mg and the mean course was 18 (7-60) d, and those for amphotericin B liposome was 925 (140-3420) mg and 13 (7-50) d, respectively.

RESULTSThe total effective rates of amphotericin B and its liposome groups were 69% and 58%, respectively (P>0.05). The adverse effect rates of chill and fever in amphotericin B and its liposome groups were 21% and 10% (P>0.05), hypopotassemia 34% and 14% (P=0.03), hepatic impairment 22% and 17% (P>0.05), and renal impairment 9% and 3%, respectively (P>0.05).

CONCLUSIONThe therapeutic effect for IFI of amphotericin B and its liposome was similar. The severe adverse reaction of amphotericin B liposome was slightly lower than that of amphotericin B.

Agranulocytosis ; complications ; Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Hematologic Diseases ; complications ; Humans ; Liposomes ; administration & dosage ; therapeutic use ; Mycoses ; complications ; drug therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo analyse the outcome of newly diagnosed adult acute myeloid leukemia (AML) patients treated with HAA (homoharringtonine, cytarabine and aclarubicin) regimen and explore the efficacy and safety of this regimen.

METHODSEighty patients were treated with HAA regimen. The complete remission (CR) rate was observed. Kaplan-Meier method was used to estimate relapse free survival (RFS) rate and the differences were compared with 2-sided log-rank test.

RESULTSOf the 80 patients, 65 (81%) attained CR and the CR rate after the first course of induction was 75%. For the CR patients, the median follow-up was 26 (2 -69) months, and the estimated 3-year overall survival (OS) rate was 51% and the estimated 3-year RFS was 53%. For the AML-M5 and AML-M /M2 patients the CR rate was 74% and 87% and 3 year RFS of CR patients was 75% and 37%, respectively. The CR rate of 100%, 83% and 20% was achieved in patients with favorable, intermediate and unfavorable cytogenetics, respectively. The 3 year OS for favorable and intermediate group was 76% and 50% respectively. The median survival time of unfavorable group was only 6 months.

CONCLUSIONHAA regimen is a safe, efficacious, and well-tolerable induction therapy for newly diagnosed AML.

Aclarubicin ; administration & dosage ; Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; administration & dosage ; Female ; Harringtonines ; administration & dosage ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

This study was purposed to investigate the changes in quantum and function of gammadelta T cell subsets, and to explore its significance in pathogenesis of acquired pure red cell aplastic anemia (A-PRCA). Eleven patients were diagnosed as A-PRCA based on bone marrow smear and biopsy, and were treated with cyclosporine A and glucosidorum tripterygll totorum. The flow cytometry technique was used for analyses of T cells subsets and gammadelta T cells. Furthermore, peripheral mononuclear cells (MNC) isolated from A-PRCA patients were cultured in RPMI 1640 medium (10(5) cells/ml) containing 10% FCS, phytohemagglutinin (PHA, 10 microg/ml), and recombinant human interleukin-2 (rIL-2, 50 U/ml) for two weeks, then gammadelta T cells were isolated with the TCRgammadelta Microbead Kit from cultured cells. The collected gammadelta T cells were incubated with normal control bone marrow MNC in RPMI 1640 medium (37 degrees C, 5% CO2 atmosphere) for CFU-E, CFU-GM, and BFU-E colony assay. The result showed that compared with the control group, CD3(+), CD8(+) cells increased significantly in the patient group (P < 0.05), the CD4(+)/CD8(+) ratio decreased and reversed, and gammadelta T cells were significantly increased in patient group (P < 0.05). After treatment with cyclosporine A, 9 out of 11 patients got good response, and CD3(+), CD8(+) cells in the responding patient decreased, the ratio of CD4(+)/CD8(+) returned to normal, and gammadelta T cells also decreased to normal range. Moreover, in vitro culture, the gammadelta T cells isolated from A-PRCA patients showed an inhibiting action to CFU-E and BFU-E but not to CFU-GM in a dose-dependent manner. It is concluded that gammadelta T cells increase in A-PRCA patients, and decrease in parallel to normal range with significant improvement of anemia symptoms after immune suppressive therapy. The gammadelta T cells isolated from A-PRCA patients showed an inhibiting action to CFU-E and BFU-E but not to CFU-GM in vitro culture, suggesting that gammadelta T cells may bring an impact on the research of A-PRCA pathogenesis. Cyclosporine A demonstrated better therapeutic effect on A-PRCA patients.
Adult ; Aged ; CD4-CD8 Ratio ; Cells, Cultured ; Cyclosporine ; therapeutic use ; Female ; Flow Cytometry ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged ; Receptors, Antigen, T-Cell, gamma-delta ; physiology ; Red-Cell Aplasia, Pure ; drug therapy ; etiology ; immunology ; T-Lymphocyte Subsets ; cytology ; T-Lymphocytes ; cytology ; T-Lymphocytes, Cytotoxic ; immunology

OBJECTIVETo evaluate the diagnostic value of serum galactomannan antigen (GM) and (1→3)-β-D-glucan antigen (BG) assay in invasive fungal infections (IFI) in the patients with hematologic malignancies and the role in monitoring therapeutic response.

METHODSFifty one patients with hematological malignancies met the criteria for inclusion: (1) body temperature above 38°C for 48 hours, (2) failure to respond to broad-spectrum antibiotic treatment, or (3) temperature rose again after the responded drop. Blood samples were collected twice at the first week, then once a week in at least four weeks. The double antibody sandwich enzyme-linked immunosorbent assay (ELISA) and colorimetric assay were used for detecting GM and BG. The positive GM test is defined as two consecutive tests at different time GM value > 0.5 or > 0.8 and the positive G test is defined as BG value > 80 pg/ml. The patients were assigned into four groups as proven, probable, possible, and non-fungal infection respectively, and 21 normal volunteers were as controls.

RESULTSTwo hundred and forty serum samples were collected from 51 patients including 2 of proven IFI, 26 probable IFI, 17 possible IFI and 6 non-fungal infection. The true-positive group including the proven and probable groups, and true negative group was the non-fungal infection group. GM tests were positive in 21 of 28 cases in true positive group, and only one of 6 cases in non-fungal infection. The sensitivity, specificity, positive predictive value and negative predictive value were 75%, 83.3%, 95.5% and 41.7%, respectively. G tests were positive in all 28 cases of the true positive group, and 4 in 6 non-fungal infection cases. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 33.3%, 87.5% and 100%, respectively. G test is more sensitive than GM test (P = 0.015), but there was no significant difference in specificity of the two tests (P = 0.242). In 19 of 21 patients with GM test positive, anti-fungal treatment was effective, and GM value gradually decreased to negative, two invalid patients were persistent with GM test positive. After two weeks treatment, the average GM value was significantly lower in the effective group than in the ineffective group (P < 0.05). BG values in the responded patients showed a gradual decline similar to that of GM values, but not to negative. The changes of BG value in ineffective group varied with a trend upward. The changes in BG value had no relation with treatment effectiveness.

CONCLUSIONSSerum GM and BG antigens detection provides strong evidence for early diagnosis of IFI. Combination of GM and G tests can improve the diagnostic specificity and reduce the false positive GM test seems superior to G test for monitoring GM and BG values during treatment.

Adult ; Aged ; Aged, 80 and over ; Antigens, Fungal ; blood ; immunology ; Female ; Hematologic Neoplasms ; immunology ; microbiology ; Humans ; Male ; Mannans ; immunology ; Middle Aged ; Mycoses ; blood ; immunology ; Young Adult ; beta-Glucans ; immunology

The study was aimed to explore the correlation of expression of pten mRNA and PTEN protein with AKT phosphorylation levels in various types of leukemia and to elucidate its role in the pathogenesis of leukemia so as to provide some evidence for using PI3K/AKT pathway inhibitors in future. 128 de novo leukemia patients were enrolled in this study, including 61 AML cases, 27 ALL cases, 24 CML cases, and 16 CLL cases. 21 volunteers were selected as normal control. The RT-PCR and Western blot were used to assay the expressions of pten mRNA, PTEN protein, and P-AKT protein in Jurkat cells, bone marrow mononuclear cells of patients respectively. The results showed that the expressions of pten mRNA and PTEN protein in Jurkat cells were lower than that in normal control group; the expression of pten mRNA in AML group was lower than that in normal control group, but the difference was not significant (p=0.274); the expressions of pten mRNA in ALL, CML, CLL each group were lower than that in normal control group, and the difference was significant (p<0.05). Compared with normal control group, the expression of PTEN protein was lower and the expression of P-AKT protein was higher in AML, ALL, CML, CLL each group, the difference were significant (p<0.05). It is concluded that the a lower expression of PTEN protein and higher expression of P-AKT protein may play an important role on leukemia pathogenesis, and inactivation of PTEN protein mainly occurs in the level of protein translation.
Bone Marrow Cells ; metabolism ; Case-Control Studies ; Humans ; Jurkat Cells ; Leukemia ; metabolism ; pathology ; PTEN Phosphohydrolase ; metabolism ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; metabolism ; RNA, Messenger ; genetics

OBJECTIVETo evaluate the clinical significance of IgH and TCR gamma gene rearrangement in plasma free DNA in patients with non-Hodgkin Lymphoma (NHL).

METHODSPlasma free DNA in 74 patients with NHL were extracted and identified by Globin gene. IgH (FR3A/VLJH), TCR gamma (TVG/TJX) clonal rearrangements were amplified by PCR and compared with results of mononuclear cell DNA and pathological biopsy sample DNA.

RESULTSPlasma free DNAs were successfully obtained from 58 cases (35 B-NHL and 23 T-NHL) of newly diagnostic, refractory and relapsed NHL out of total 74 patients (78.4%), but not found in the rest 16 patients in remission. Of 35 B-NHL cases, 31 showed IgH rearrangement (88.6%), and none with TCR gamma rearrangement; of 23 T-NHL cases, 8 showed TCR gamma rearrangement (34.8%), and 2 with IgH gene rearrangement synchronously. In comparison with the results of IgH and TCR gamma gene rearrangement in biopsy samples in 30 B-NHL cases, 26 cases in plasma free DNA (86.7%) and 24 in biopsy samples (80%) were positive (P > 0.05). In 20 T-NHL patients, 7 cases in plasma cell-free DNA (35%) and 6 cases in biopsy samples (30%) were positive (P >0.05).

CONCLUSIONSTumor-derived DNA could be detected in plasma from underlying cancer patients. For NHL patients, detecting IgH and TCR gamma gene rearrangement in plasma free DNA has the same clinical significance as in biopsy samples.

Adolescent ; Adult ; Aged ; Child ; DNA ; blood ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Lymphoma, Non-Hodgkin ; blood ; genetics ; Male ; Middle Aged ; Young Adult