OBJECTIVE:To study the clinical efficacy of domestic recombinant human granulocyte colony-stimulating factor (rhG-CSF) on reducing absolute value of white blood cells (WBC) and neutrophil (ANC) in cancer chemotherapy and radiotherapy and its adverse reactions.METHODS:Use of self-crossover,62 patients with malignant tumor were randomly divided into groups AB and BA.period A were treated with domestic rhG-CSF at 48 h after chemotherapy(treatment period) and chemotherapy alone was applied in the period B(control period).Group BA was directly opposite.Routine blood test was performed every other day and the changes of WBC and ANC were observed.RESULTS:Domestic rhG-CSF can improved chemotherapy-induced decline of WBC and ANC,recovery of WBC and ANC patients underwent chemotherapy,reduced duration of WBC and ANC decrease to guarantee progress of chemotherapy.The main adverse reactions represented as pain of injection site,skin rash,fever,muscle pain,weakness.CONCLUSION:The application of domestic rhG-CSF in cancer chemotherapy can effectively reduce the decline of WBC and ANC and shorten the recovery time of WBC and ANC to ensure the smooth progress of chemotherapy.

OBJECTIVE To investigate the reasons and preventive measures of recurrent laryngeal nerve injury during operation in patients with benign thyroid neoplasm. METHODS The clinical data of 2243 cases with benign thyroid neoplasm were reviewed. The relations among different neoplasm regions, different procedures and injury of recurrent laryngeal nerve were analyzed. RESULTS Injury incidence of recurrent laryngeal nerve in this study was 3.0 %. In cases with nodular goiter on the dorsum of thyroid and recurrent laryngeal nerve exposed during operation, injury incidence of recurrent laryngeal nerve was 1.0 %. And there was no recurrent laryngeal nerve injury in cases with nodular goiter on other region of the thyroid. In cases used locality protection during operation, injury incidence of recurrent laryngeal nerve was 7.6 % when benign lesions on the dorsum of thyroid and was 0.17 % when benign lesions on other region of the thyroid. CONCLUSION In cases with nodular goiter or adenoma on the dorsum of thyroid, exposing recurrent laryngeal nerve is necessary during operation and in cases with benign lesions on other region of thyroid, locality protection is useful. There are three major routes for recurrent laryngeal nerve exposure.

BACKGROUND: A middle cerebral artery occlusion and reperfusion(MCAO/R) model in rats with suture has been widely used in the researches of acute focal ischemic cerebral infarction, while the model in rabbits by the same method is relatively rare. Magnetic resonance diffusion weighted imaging (MR DWI) has been paid close attention recently for its sharp sensitivity of cerebral ischemia.OBJECTIVE: To establish rabbit models of MCAO/R by intraluminal thread, and study the characteristics of MR DWI after cerebral ischemia and reperfusion.DESIGN: Random controlled animal experiment.SETTING: Institute of Cerebrovascular Diseases, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was accomplished at the Key Laboratory of Brain Diseases Prevention and Cure of Shandong Province from March to June in 2005. A total of 103 adult healthy New Zealand rabbits of either sex, 10-12 weeks old and 1.8-3.3 kg weight were provided by the Experimental Animal Center of Shandong Agricultural Academy (SCX20040013).They were bred at quiet, sanitary and dry conditions.METHODS: Animal groups: 103 rabbits were divided randomly into group A (n=53) and group B (n=50). The rabbits in group A were treated with suture of 0.51-0.55 mm as the diameter of thread, while group B was reassigned into B1 (0.46-0.50 mm), B2 (0.51-0.55 mm) and B3 (0.56-0.60 mm).The successful MCAO/R models in 57 cases were randomly divided into permanent ischemia group (n=30, ischemia 1, 3, 6, 12, 24 andl 48 hours, 5ones at each time point) and ischemic reperfusion group (n=27, reperfusion 0, 2 and 5 hours, 5 ones at each time point; reperfusion 11, 23 and 47hours, 4 ones at each time point). Another 10 rabbits receiving sham operations were regarded as contrasts for permanent ischemia group and ischemia reperfusion group, with 5 ones in each.MAIN OUTCOME MEASURES: The changes of hyperintensity area on DWI and apparent diffusion coefficient (ADC) were measured in permanent ischemia group and ischemic reperfusion group.RESULTS: The data of 57 successful model rabbits were involved in the result analysis.①The successful rate in group A (26 cases, 49.1%) was significantly lower than that in group B (31 cases, 62.0%).②In ischemia group:The hyperintensity area on DWI with declined ADC appeared at ischemia 1 hour. The hyperintensity areas on DWI at different times increased gradually from ischemia 1 hour and unchanged within 24 hours. The mean ADC at different times declined at first and then gradually increased.③In reperfusion group: Comparing with ischemia 1 hour, the hyperintensity area on DWI reduced while ADC increased at reperfusion 2 hours and 5 hours, and enlarged with ADC high at reperfusion 11 hours, then continued to enlarge with ADC reduced significantly at 23 hours and 47 hours.CONCLUSION: The diameter of thread tip and the inserting distance of thread are main factors for establishing successful MCAO/R models. The hyperintensity area on DWI and the decreasing ADC after acute cerebral ischemia can be improved by early reperfusion, but the secondary decreasing ADC may be induced by continuously reperfusion.

BACKGROUND: It has been recognized that the traditional herbal treatment and daoyin exercises(physical and breathing exercise) can relieve the symptoms such as tiredness of cancer patients and strengthen the tolerance to chemical drugs. But the criterion of quantitative evaluation for the effect should be scientific.OBJECTIVE: To evaluate the influence of Chinese herb for strengthening the body resistance and daoyin exercises on the survival state of lung cancer patients with the evaluation scale of life quality.DESIGN: Non-randomized and concurrent controlled trial.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Clinical Cancer Research Center, Guangzhou Medical College;Zhaoqing First People's Hospital.PARTICIPANTS: Totally 60 inpatients of the Department of Integrated Traditional Chinese and Western Medicine of Clinical Cancer Research Center of Guangzhou Medical College were enrolled from October 1997 to March 2001 in the study. All of them were volunteers. There were 41 males and 19 females, 30 patients in the treatment group and 30 in the control group.METHODS: The treatment group was given chemical therapy, at the same time, the herbal treatment and daoyin exercises. The control group was given chemical therapy only. The same chemical therapy was applied to both groups. The appointed doctor familiar with the evaluation table of quality of life was responsible for evaluating the quality of life of the patients in the two groups before and after treatment and the observation of their accomplishment of chemical therapy. The evaluation table of quality of life of Chinese lung cancer patients was used in the evaluation. The table included 5 factors: the physiological state caused by lung cancer, social/family state, relation of altitude towards doctor and disease, emotional state, and functional state. The statistical analysis was done to see the accomplishment of chemical therapy of two groups.chemical therapy of the two groups.RESULTS: According to the intention-to-treat analysis, 60 patients all completed the whole process of study. The comparison of the score before physiological state after treatment was obviously lower than that before treatment[ (14. 1 ± 3.2), (31.7 ±2.9) scores, P ＜ 0.01] and of control state was obviously higher than that before treatment[(25.2±3.1),(12.2 ±2.3)scores, P ＜0.01] and of control group[(19.1 ±2.2) scores,after treatment was obviously higher than that before treatment[ (37.4 ± 5.2),(24.2 ±3.5) scores, P ＜0. 01 ]and of control group[ (29. 1 ±3.4)scores, P before treatment[ (43.8 ± 5.6), (28.5 ± 4. 7) scores, P ＜ 0. 01 ] and of tional state after treatment was obviously higher than that of before treatment [(26.3±2.3), (17.3±3.3) scores, P ＜ 0.01] and of control group [ (20. 3 ± 1.1) scores, P ＜ 0. 05] . The accomplishment rate of chemical control group, 26 patients accomplished 1 course(87%, 26/30) and 18rate of 2 courses of chemical therapy of treatment group was obviously higher than that of control group ( P ＜ 0.05 ).CONCLUSION: The herbal treatment combined with daoyin exercises can improve the tolerance of lung cancer patients for chemical therapy and relieve the symptoms, thus improving their quality of life.

Objective: To study retrovirus (RV)-mediated transduction of gastric carcinoma cells with the herpes simplex virus thymidine kinase (HSV-tk) gene and the subsequent treatment with ganciclovir(GCV). Methods: The TK gene was transfected into human gastric carcinoma cell line MKN28 using HSV-TK that packed with PA317 cell, the sensitivity of MKN28TK cells to GCV was examined in vitro. Results: The retroviral-mediated HSV-TK gene can be transfected to MKN28 cells. The growth rate of MKN28 cells transfected with HSV-TK gene did not change. MKN28TK cells became significantly sensitive to GCV and had bystander effect. Conclusion: Transfection of gastric carcinoma with HSV-TK has higher transfection efficiency. MKN28TK cells are significantly sensitive to GCV.

Objective:To investigate the effect of gemcitabine on myeloid derived suppressor cells (MDSC) in the spleen of B lymphoma cell-bearing mice, and the therapeutic effect of gemcitabine combined with intratumoral injection of dendritic cells (DCs) in treatment of large B lymphoma. Methods: BALB/c mice were inoculated subcutaneously with B lymphoma A20 cells; large tumors were formed 30 d after inoculation. Gr-1~+ CD11b~+ MDSC proportion in the spleen was analyzed by flow cytometry before and after gemcitabine treatment. Splenic MDSC sorted by immunomagnetic beads was further treated with gemcitabine, and then the apoptosis of MDSC was examined by Annexin-V/PI staining. Tumor growth and survival time of A20 tumor-bearing mice were observed after treatment with gemcitabine and intratumoral injection of DCs. Results: Splenic Gr-1~+ CD11b~+ MDSC ratio in A20 cell-bearing mice was 10 times higher than that in the normal mice. Gemcitabine induced apoptosis and necrosis of purified MDSC in vitro in a time-dependent manner. The percentage of MDSC in the spleen of A20 tumor-bearing mice was decreased after injection of a single dose of gemcitabine. Gemcit-abine or intratumoral injection of DCs alone inhibited growth of tumor to a certain degree, with the mean survival periods of mice in the gemcitabine, DCs, and untreated groups being (48.8±3.6) d, (47.2±7.4) d, and (38.8±2.2) d, respectively. Gemcitabine chemotherapy combined with intratumoral DC injection resulted in continuous shrink of the tumors, and 60% of the mice survived for more than 90 d. Conclusion: Gemcitabine can effectively eliminate splenic MDSC in tumor-bearing mice. Gemcitabine chemotherapy and DCs immunotherapy can work synergistically in the treat-ment of huge lymphoma. These results provide an experimental basis for the comprehensive chemotherapy and immunotber-apy of relapsed or refractory lymphoma.

Objective:To investigate the tumor-specific neoantigen for primary plasma cell leukemia (PCL) using gene sequencing technology combined with bioinformatic analysis. Methods: Peripheral blood samples of one patient with primary PCL during relapse and remission periods were collected. HLA molecular typing was performed using polymerase chain reaction with sequencing-based typing; whole-exome and transcriptome were sequenced by next-generation sequencing method; and bioinformatics software NetMHCpan was used to predict neoantigens. Results: Six tumor-specific missense mutations were found in the patient's peripheral blood during relapse period, located in genes FRG1, MLL3, SVIL, MYOM1, ZDHHC11 and RFPL4A.Considering patient's HLA sub-types, 43 neoantigens were predicted via bioinformatics. Considering that FRG1 and MLL3 had relatively high gene expression levels, 20 neoantigens derived from mutations of the two genes were preferentially selected, among which four neoantigens had high affinity with the patient's HLA molecules and thus had potential clinical application value. Conclusion: The study has completed a tumor neoantigen screen and prediction for primary PCL. This practice demonstrates that predicting neoantigen based on tumor-specific somatic mutation is feasible for primary PCL.

We reviewed the clinical data of 24 patients with postpartum hemorrhage undergoing transcatheter arterial embolism from March 2009 to September 2011.Twenty out of 24 patients underwent uterine artery embolism,while other 4 underwent internal iliac artery embolism.The hemorrhage reduced markedly 2 to 9 min after arterial embolism in all patients,except 2 who underwent secondary embolism due to the intermittent postoperative hemorrhage. The postoperative complications included low fever and discomfort in lower abdomen.Nineteen patients were followed up for a mean period of ( 17.3 ± 1.1 ) months,no recurrent hemorrhage was observed after discharge.The normal menstrual cycle recovered 4 to 6 months after operation.Three patients underwent pregnancy successfully after discharge.The results indicate that transcatheter arterial embolism is safe and effective in the treatment of postpartum hemorrhage and it should be recommended as a feasible choice in clinical practice.

Objective To evaluate bone marrow mesenchymal stem cells combined with VEGF gene in the treatment of limb ischemia in rabbits.Methods The right hind limb ischemia model of New Zealand rabbit was established by superficial femoral artery excision and deep femoral artery ligation.Rabbits then were divided randomly into 4 groups: empty plasmid control group(EP group),bone marrow mesenchymal stem cells group(BMSC group),VEGF gene therapy group(VEGF group),combination bone mesenchymal stem cells and VEGF gene therapy group(BV group).There were 8 rabbits in each group.Angiogenesis was detected by arteriography on day 28 after treatment and expression of VEGF was detected by immunohistochemical staining on day 30 after treatment.Results There were no differences of collateral vessel count between the EP group,BMSC group and VEGF group.The collateral vessel count in BV group was higher than that of the other three groups.Immunohistochemistry of VEGF showed that the integrated optical density(IOD)in BMSC and VEGF groups increased significantly compared with the EP group; the IOD in BV group was the highest compared with the other three groups.Conclusions Combination bone marrow mesenchymal stem cells and VEGF gene in the treatment of limb ischemia in rabbits can obtain stable and effective expression of VEGF along with significant improvement of limb ischemia.

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.