Objective:To observe the effect of ginsenoside Rd pretreatment on the expressions of N-methyl-D-aspartate(NMDA)receptor subunit NR2 B protein and endonuclease G(EndoG)in basal ganglia region after cerebral focal ischemia-reperfusion in rats and to investigate possible mechanism of ginsenoside Rd in the treatment of ischemic stroke.Methods:A rat model of middle cerebral artery occlusion(MCAO)was induced by intraluminal filament method.The expressions of NR2B and EndoG in basal ganglia region for focal cerebral iSChemia 1 hour,and 1,6,24 and 72 hours reperfusion were detected by immunohistochemical staining and image analysis method.The effects of ginsenoside Rd on the expressions of FaxioG and NR2B and the volume of cerebral infarction were evaluated.Results:The positive expression of NR2B in basal ganglia region on the ischemic side in ischemia-reperfusion group was increased significantly.The expression of EndoG in the nucleus was notable;the positive expressions of NR2B and EndoG at different reperfusion time points in ginsenoside Rd pretreatment group were decreased significantly(P<0.05 or P<0.01),and the volume of cerebral infarction was reduced significantly(P<0.01).Conclusions:The expressions of NMDA receptor subunit NR2B protein and apoptosis-inducing factor EndoG were increased significantly after cerebral focal ischemia reperfusion;ginsenoside Rd pretreatment may significantly reduce the expressions of NR2B and EndoG.It reduces the volume of cerebral infarction by inhibiting excitatory neurotoxicity and blocking neuronal apoptosis,and thus plays a role in neuroprotection.

Objective To evaluate the diagnostic and therapeutic role in bladder pain syndrome/interstitial cystitis (BPS/IC) of random bladder biopsy and hydrodistention with cystoscopy under anesthesia.Methods A retrospective review of cases in our BPS/IC center was performed from 2005 to 2010. One hundred and nineteen patients were included who are diagnosed as the bladder pain syndrome/interstitial cystitis (BPS/IC).There were 32 male patients,aged 47 to 64 years,and 56 years on average; 87 female cases,aged 23 to 67 years,49 years on average.Patients with bladder pain symptoms underwent a thorough evaluation which include voiding diary,pelvic pain、urgency and frequency questionnaire,urine culture,cytology,acid fast bacilli and upper tract imaging.Cystoscopy and random bladder biopsy had been undertaken with general anesthesia.Before and after hydrodistention with cystoscopy,the patients daily frequency of urination,the maximum urine volume,pain scores,symptom scores,QOL score were observed to understand whether there are significant improvement. Results One hundred and nineteen BPS/IC cases underwent random bladder biopsy and hydrodistention with cystoscopy under anesthesia,and finally 102 cases were confirmed of IC; 17 cases were not IC. Eight patients who were previously diagnosed as BPS/IC were found bladder transitional cell carcinoma as the cause of bladder pain symptoms( including 4 cases carcinoma in situ,1 case Low grade non-invasive bladder cancer,3 cases High grade invasive bladder cancers),and 4 of whom had no hematuria. Mean time from the occurrence of BPS to diagnosis of transitional cell carcinoma was 10.8 months. Three patients previously diagnosed as BPS/IC were found tuberculous cystitis as the cause of symptoms,and one eosinophilic cystitis,three chemical cystitis,two radiation cystitis were also detected.Before hydrodistention with cystoscopy under anesthesia,the daily frequency of urination in 102 cases diagnosed for IC patients was 42.1 ±5.6; the maximum urine volume was 141.0 ± 8.3 ml; pain score 7.6 ± 3.0; O'Leary-Sant questionnaire symptom score was 27.7 ± 4.2; QOL score was 7.6 ± 2.4.After hydrodistention with cystoscopy under anesthesia,the daily frequency of urination in 102 IC patients was 23.3 ± 3.4,and the maximum urine volume was 352.0 ± 1.7 ml ; pain score was 3.3 ± 4.3 ; O'Leary-Sant questionnaire symptom score was 12.5 ± 7.3 ; QOL score was 3.2 ± 5.1. Before and after hydrodistention with cystoscope under anesthesia,all of the daily frequency of urination,the maximum urine volume,pain scores,symptom scores,QOL score in 102 IC patients were significant improved (P ＜ 0.05 ). Conclusions BPS/IC remains a diagnosis of exclusion.Random bladder biopsy and hydrodistention with cystoscopy under anesthesia play an important diagnostic and therapeutic role in BPS/IC.

adder irritation after intra-vesical sodium hyaluronate therapy. Conclusion Intravesical sodium hyaluronate therapy can effec-tively relieve clinical symptom of IC and improve IC patients' quality of life and is well tolerated.

ct curative effect and prognosis of multiple myeloma.

Objective To evaluate the safety and efficacy of the trieyelic antidepressant amitrip tyline in the treatment of patient with interstitial cystitis (IC). Methods Fifty-four patients diagnosed with IC were recruited in this prospective three-month clinical trial. The average course of patient's history was (40. 75±11.6)months, ranging from 19-72 months. All the 54 patients received oral administration of amitriptyline for 3 months. The initial dosage of amitriptyline was 25 mg per night. After 1 week, the dosage would be increased to 50 mg if the symptom didn't relief. After another 1 week, the dosage would be increased to 75 mg if the symptoms were still exist. The patients were kept on a minimum dosage which could relief patient's IC symptoms. Clinical symptoms, such as frequency per day, maximal voiding volume and odynuria degree score, O'Leary-Sant IC symptom and problem index and quality of life score were recorded and assessed at the beginning of the study and 3 months after the treatment. Results After 3 month treatment, the pre-treatment vs post-treatment parameters of frequency per day was 28.5±8. 4 vs 15.6±3.3, odynuria degree score was 6.4± 1.5 vs 2.2±1.5 and maximal voiding volume was 108.7±62.2 ml vs 171.0±53.9 ml respectively. There was significant improvement in all the above parameters comparing between the baseline and 3 months after the treatment. At the 3 months after treatment, the pre-treatment vs post-treatment O'Leary-Sant IC symptom and problem index and quality of life score was 26.9±4.0 vs 13.7±5.7 and 5.5±0. 5 vs 2.5±0. 6, receptively. There were significant decreases compared with the baseline. There was no serious adverse event after taking amitriptyline. Drowsiness occurred in 45 of the 54 patients at the first month administration. Of the 45 patients, 43 patients relieved and 2 patients quitted from the study. Mild weight increase was noted in 10 patients. Mild constipation was recorded in 11 patients. Mouth dryness was recorded in 9 patients. Three patients quitted because of suffering dysuria. Conclusions Oral administration of amitriptyline can effectively relieve clinical symptoms of IC and improve IC patients" quality of life. The side effects are well tolerated.

AIM: To evaluate the expression of fibroblast growth factor receptor 3 (FGFR3) in acute lymphocytic leukemia (ALL) patients and its contribution to the proliferation of circulating endothelial cells (CECs).METHODS: The mRNA expression levels of FGFR3 in 44 patients with ALL were assayed by RT-PCR.Overall survival (OS) rates of the patients in FGFR3+ group and FGFR3-group were estimated by Kaplan-Meier analysis.The CECs were sorted from peripheral blood by magnetic-activated cell sorting and then counted by 3-color flow cytometry.The cell counts, antigen expression, growth curve and colony forming rate of the CECs in the 2 groups were determined.The FGFR3 expression of CECs was identified by immunofluorescence staining.RESULTS: The positive rate of FGFR3 mRNA expression was 43.2% in 44 ALL patients with normal karyotype.T-ALL expressed higher level of FGFR3 than B-ALL (P<0.05).FGFR3 was over-expressed in ALL patients with bone marrow blast proportion ≥5% (P<0.05).The probability of OS was significantly lower in FGFR3+ group than that in FGFR3-group (P<0.05).The sorted CECs highly expressed CD31, CD144, VEGFR-2 and CD146, and rarely expressed CD45.The counts of CECs and expression level of CD133 significantly increased in FGFR3+ group compared with FGFR3-group.The same result of the amount of colony formation was observed (P<0.05).There was significant difference at 3 time points of cultured CECs count in vitro between FGFR3+ group and FGFR3-group (P<0.05).The positive rate of FGFR3 expression of CECs from 19 ALL-FGFR3+ patients was (29.00±15.71)%.CONCLUSION: The over-expression of FGFR3 gene in ALL may be helpful to evaluate the prolife-ration of CECs, and become a double target with anti-tumor and anti-angiogenesis effects to offer more choice for molecular therapy in the future.

Objective To determine the results of treatment combining all-trans-retinoic acid(ATRA)in childhood acute promyelocytic leukemia(APL).Methods 22 children with newly diagnosed APL received induction therapy with ATRA followed by 3 courses of consolidation chemotherapy:daunorubicin,idarubicin,homoharringtonine or aclacinomycin plus cytosine arabinoside.A maintenance therapy was then administered with ATRA and these reigems for 36 months.Results Early deaths from diffuse intravazcular clotting and intracranial hemorrhage occurred in two patients.The other children achieved a complete remission(CR).By June 2007,the estimated disease-free survival rates at 1,3 and 5 years were 100%,93.3% and 84.7%;respectively.The side effects of ATRA were xerosis eutis and xerocheilia,headaches,nausea and vomiting,hepatic function lesion and ATRA syndrome.Conclusion Remission induction therapy with ATRA is effective and safe for newly diagnosed childhood APL.The maintenance therapy combined chemotherapy with ATRA can improve the long-term effects of APL patients.The main causes of death in APL children is diffuse intravascular clotting and intracranial hemorrhage.The side effects of ATRA can be tolerated.

Objective To observe the clinical effect of sequential therapy with micafungin and reduced -dose voriconazole in prevention of invasive fungal infections in patients received allogeneic hematopoietic stem cell transplantion (Allo -HSCT).Methods 28 patients received the treatments for prevention of fungal infection with micafungin 50 mg per day from pretreatment to 30 days,then oral voriconazole at a dose of 1 00 mg two times per day until 90 days after Allo -HSCT.The occurrence of invasive fungal infection and the side effects of both medicine were observed during 1 80 days after Allo -HSCT.Results 8 patients(28.6%)developed above grade 2 acute graft verse host disease(GVHD),2 patients developed grade 3 GVHD among the 8 patients.Two case with GVHD were cured by voriconazole with the therapeutic dose who occurred probably pulmonary invasive fungal infection at two months after Allo -HSCT.There were no other patients diagnosed fungal infection.No toxic efect were observed during the clinical observation during treatment with micafungin.5 patients appeared mild liver function abnormalities during treatment with voriconazole,and liver dysfunction were improved by symptomatic treatment.2 cases developed transient auditory hallucination and visual impairment induced by voriconazole.Conclusion Micafungin and reduced -dose voricon-azole are effective and safe prophylaxis in prevention early invasive fungal infection after HSCT.

AIM:To determine the biological feature of circulating endothelial cells (CECs) in acute promye-locytic leukemia ( APL) patients before and after treatment , and to analyze the relationship between CECs and the clinical characteristics .METHODS: The CECs were sorted from peripheral blood by magnetic-activated cell sorting and then counted by 3-color flow cytometry.The cells were identified by immunofluorescence staining for the expression of CD 146, CD31, CD144, VEGFR-2, CD45 and CD133.The CECs were cultured in vitro, and the tube formation and colony-forming rate were determined .RESULTS:Increased quantity of CECs was observed in CD 34 positive group and group with WBC >10 ×109/L (P<0.05).The quantity of CECs had a significant difference among low risk , medium risk and high risk groups (P<0.05).The positive rate of CD133 and quantity of CECs significantly reduced in 32 APL patients when they gain complete remission after treatment (P<0.05).The amount of tube formation and colony-forming rate were significant-ly reduced after treatment (P<0.05).The ratio of CECs quantity from APL patients after treatment to that before treatment had a negative correlation with arsenic concentration in urine on day 7 during As2O3 treatment (P<0.05).CONCLU-SION:Accurately counting CECs may be helpful for evaluating prognosis and designing treatment strategy .