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 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

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

This study was aimed to construct a two-dimensional culture system by using osteoblasts induced from human marrow mesenchymal stem cells (MSC) and to investigate its support effect on survival of hematopoietic stem/progenitor cells for umbilical cord blood (UCB) ex vivo. MSCs were isolated from adult human bone marrow and were cultured, the second generation of MSCs were induced into osteoblasts which were irradiated with 20 Gy gamma rays in a Cobalt 60 source and confluenced into a feeder layer. CD34(+) cells were selected from fresh umbilical cord blood samples by using Microbead Kit of MiniMACS and seeded into the two-dimensional culture system to culture ex vivo without exogenous cytokines. By using colony-forming assay, high proliferative potential colony-forming cell assay, and long-term culture initiating cell assay, the ability of the two-dimensional system to culture HSCs/HPCs was observed. The results showed that the osteoblasts induced from bone marrow MSC in constructed two-dimensional culture system displayed more significant support effect on survival of hematopoietic stem/progenitor cells from umbilical cord blood (UCB) ex vivo, compared with other culture systems, especially on long term HSCs survival ex vivo. It is concluded that the two-dimensional culture system constituted by osteoblasts induced from human MSCs has certain ability of supporting maintenance and multipotency of HSCs/HPCs from umbilical cord blood in vitro, especially sustaining survival of HSC in long-term culture. It has also been proved that osteoblasts play a crucial role in regulation of HSC growth.
Bone Marrow Cells ; cytology ; Cell Differentiation ; Coculture Techniques ; Fetal Blood ; cytology ; Hematopoietic Stem Cells ; cytology ; Humans ; Mesenchymal Stromal Cells ; cytology ; Osteoblasts ; cytology ; physiology

To study the expression and significance of pten gene in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), RT-PCR and Western blot were respectively applied to detect pten mRNA and PTEN protein in Jurkat cells (as negative control), in bone marrow nucleated cells of 35 patients with MDS, 45 patients with AML and 20 normal control. The results showed that pten mRNA expression could not be detected in Jurkat cells, and the positive rate in MDS patients (77.1%) was significantly lower than that in normal control group (90.0%) (p > 0.05), while significant difference was found between AML patients and normal control (60.0% vs 90.0%, p < 0.05); the positive rate in MDS-RAEB patients (70.0%) was lower than that in MDS-RCMD (86.7%); positive rate in de novo and relapsed AML patients (53.3%) was lower than that in AML patients in CR (73.3%), but statistics tests did not show significant difference (p > 0.05). The results of relative expression level of pten mRNA in all groups indicated that both relative expression levels in MDS patients and AML patients were definitely lower than that in normal control group (p < 0.005); the relative expression level in MDS-RAEB patients was lower than that in MDS-RCMD patients (p < 0.05); and in de novo and relapsed AML patients was obviously lower than that in AML patients in CR (p < 0.001). However, there was no significant difference between MDS and AML patients (p > 0.05). The positive rate of PTEN protein expression in both MDS (65.7%) and AML (54.8%) patients were lower than that in normal control (90.0%) (p < 0.05), and there was no significant difference when comparing MDS-RCMD patients (80.0%) with MDS-RAEB patients (55.0%) (p > 0.05), but positive rate of PTEN protein expression in de novo and relapsed AML patients (44.4%) was significantly lower than that in AML patients in CR (73.3%) (p < 0.05). It is concluded that the complete loss of pten mRNA in MDS and AML is uncommon, but the relative expression level in both diseases is significantly lower than that in normal people. The positive rates of PTEN protein expression in both MDS and AML patients are lower, compared with normal people, but are not in accordance with the expression of pten mRNA. The abnormalities of pten gene expression may be involved in the pathogenesis of MDS and AML.
Adult ; Aged ; Female ; Gene Expression ; Genes, Suppressor ; Humans ; Jurkat Cells ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; PTEN Phosphohydrolase ; genetics ; metabolism ; Young Adult

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 aim of this study was to investigate whether the single nucleotide polymorphism (SNP) of interferon-gamma (IFN-gamma) +874 T/A correlates with aplastic anemia. Amplification refractory mutation system-polymerase chain reaction was used to amplify the polymorphism gene segment of IFN-gamma +874 A/T from 54 aplastic anemia patients and 51 healthy adults. The results showed that the frequency of IFN-gamma +874 TT genotype and T allele was significantly higher in patients with aplastic anemia than that in the healthy adults (42.6% vs 17.6%, chi2=13.780, p=0.01; 65.7% vs 39.2%; chi2=14.811, p<0.001). In conclusion, IFN-gamma +874 A/T gene polymorphism is correlated with the susceptibility of aplastic anemia, but not significantly correlated with the the severity of aplastic anemia.
Adolescent ; Adult ; Aged ; Alleles ; Anemia, Aplastic ; genetics ; Base Sequence ; Female ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Interferon-gamma ; genetics ; Male ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Single Nucleotide ; Young Adult