OBJECTIVETo analyze the effect of sorafenib as salvage therapy used before and/or after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in refractory relapsed FLT3-positive acute myeloid leukemia (AML).

METHODSA total of 16 patients with refractory relapsed FLT3-positive AML, including 10 refractory relapsed pre-transplantation and 6 relapsed after allo-HSCT, were enrolled in this retrospective study. Sorafenib treatment protocols included sorafenib in combination with chemotherapy inducing remission, and sorafenib monotherapy as mauntenance treatment after complete remission (CR).

RESULTSThirteen of the 16 patients achieved CR after one or two courses of induction therapy, including 7 refractory relapsed pre-transplantation and 6 relapsed after allo-HSCT. With a median follow up of 472 (range, 59-1569) days post-transplantation, 12 patients survived and 4 died. Causes of death included leukemia relapse (n=3) and acute graft-versus-host disease (n=1). The 2-year overall and disease-free survival post-transplantation of the 16 patients were (75.0±10.8) % and (50.5±13.7) % respectively. The main side effect of sorafenib was the skin rash. The incidence of rash was lower in the patients used sorafenib pre-transplantation than those post-transplantation (30.0% vs 75.0%, P=0.043).

CONCLUSIONSorafenib used as salvage therapy befor and/or after transplantation for refractory relapsed FLT3-positive AML could reduce the relapse rate and improve the survival.

Antineoplastic Agents ; therapeutic use ; Disease-Free Survival ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; genetics ; therapy ; Mutation ; Niacinamide ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; therapeutic use ; Recurrence ; Remission Induction ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome ; fms-Like Tyrosine Kinase 3 ; genetics

The complications of injection sclerotherapy for hemorrhoid are always local. Herein, we report a case in which a female patient with abdominal compartment syndrome developed after receiving a local injection of a sclerosing agent for hemorrhoid.
Abdomen ; Aged ; Compartment Syndromes ; etiology ; Female ; Hemorrhoids ; therapy ; Humans ; Sclerotherapy ; adverse effects

In recent years,the CTLA-4 immunoglobulin biologics,a negative regulator in the immune system,have been obtained due attention in autoimmune diseases,transplantation rejection,and antineoplastic agents.CTLA-4 can inhibit T cell activation,reduce the expression of RANKL and other cytokines through regulating immune response,and effectively alleviate the process of bone resorption.According to previous study,CTLA-4 was involved in osteoclast-induced bone destruction and bone remodeling.In this review,the effect of CTLA-4 on the autoimmune diseases,on the osteoclast formation,and on the alveolar bone remodeling in the periodontal tissue was involved,and the related research were also evaluated to look forward to possible future basic research and clinical application direction.

AIM:To observe the influence of erythropoietin (EPO) on eryptosis and production of reactive oxygen species (ROS) in erythrocytes under stimulation of hydrogen peroxide (H2O2),.and to explore its related mecha-nism. METHODS:The erythrocyte suspension (1%) was cultured in vitro and divided into 3 groups:control group (C group,the culture medium was PBS),H2O2group (H group,the culture medium was PBS containing H2O2at final con-centration of 100 μmol/L) and EPO group (E group,the culture medium was PBS containing H2O2at final concentration of 100 μmol/L and EPO at final concentration of 2×104U/L). The erythrocytes were collected at 24 h and 60 h. The eryptosis was detected by flow cytometry with Annexin V staining. The production of ROS and intracellular calcium ion con-centration (Ca2+]i) were also analyzed by flow cytometry. RESULTS:The eryptosis in C group was increased as the in-cubating time extended. The eryptosis in H group was higher than that in C group (P<0.01),while that in E group was lower than that in H group(P<0.01). Meanwhile,ROS production andCa2+]iwere higher in H group than those in C group (P<0.01), but those were lower in E group than those in H group (P<0.05 or P<0.01). CONCLUSION:EPO inhibits eryptosis induced by H2O2and its mechanism may be related to antioxidant effect and change of Ca2+]i.

OBJECTIVETo find out the mechanisms of redifferentiation and reversion of malignant human gastric cancer cells induced by ascorbic acid.

METHODSHuman gastric cancer cells grown in the laboratory were used. The Trypan blue dye exclusion method was used to determine the cell doubling time. The electrophoresis rate and colonogenic potential were the indices used to measure the rate of redifferentiation. The content of malondialdehyde (MDA) was measured using the thiobarbituric acid (TBA) method. The activities of superoxide dismutase (SOD), catalase (CAT) and the content of H202 were evaluated by spectrophotography.

RESULTSSix mmol/L ascorbic acid was used as a positive control. Human gastric cancer cells were treated with 75 microm hydrogen peroxide, which alleviated many of the malignant characteristics. For example, the cell surface charge obviously decreased and the electrophoresis rate dropped from 2.21 to 1.10 microm x s(-1) x V(-1) x cm(-1). The colonogenic potential, a measure of cell differentiation, decreased 90.2%. After treatment with ascorbic acid, there was a concentration- and time-dependent increase in hydrogen peroxide (H202) and the activity of superoxide dismutase (SOD). However, the activity of catalase (CAT) resulted in a concentration- and time-dependent decrease. SOD and 3-amino-1,2,4-triazole (AT) exhibited some effects, but there were statistically significant differences between the SOD and AT group and the H202 group.

CONCLUSIONSAscorbic acid induces growth inhibition and redifferentiation of human gastric cancer cells through the production of hydrogen peroxide.

Antioxidants ; pharmacology ; Ascorbic Acid ; pharmacology ; Cell Differentiation ; drug effects ; Humans ; Hydrogen Peroxide ; metabolism ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology ; Tumor Cells, Cultured

Objective To analyze the efficacy of ponatinib as salvage therapy in relapse chronic myeloid leukemia with T315I mutation (CML-T315D after allogeneic stem cell transplantation (allo-HSCT).Methods Twelve patients with CML-T315I (10 cases of T315I mutation before transplantation and 2 cases of T315I mutation at the time of relapse after transplantation) were included in this retrospective analysis.Ponatinib was used as single agent or combined with chemotherapy and/or donor lymphocyte infusion.The samples obtained for RTQ-PCR were also analyzed for the BCR ABL1 mutation by direct sequencing.Scanning of the ABL KD (amino acids 219-506) for the presence of mutations was sequenced by Sanger.Results In 12 patients with relapse after transplantation,2 patients with molecular relapse were treated with only single-agent ponatinib,and among 10 patients with hematologic relapse,1 patient was treated with single-agent ponatinib and 3 patients were given ponatinib combined with donor lymphocyte infusion (DLI),the remaining 6 patients were treated with ponatinib combined with chemotherapy and DLI.After the treatment with ponatinib,11 patients had a good response,10 patients obtained complete hematologic remission (CHR),1 patient obtained partial hematologic remission (PHR) and 1 patient had no response (NR).For cytogenetic response,10 patients obtained complete cytogenetic response (CCyR),1 patient obtained partial cytogenetic response (PCyR) and one patient had no cytogenetic response.For the molecular biological response,9 patients obtained complete molecular response (CMR),1 patient obtained majore molecular response (MMR) and 2 patients had no molecular biological response.The median time to obtain CHR was 36 days (29-96 days),the median time to obtain CCyR was 63 days (32-127 days),and the median time to obtain CMR was 89 days (27-152 days).The median follow-up time after treatment with ponatinib was 598 (range,93-1470) days,9 patients survived and 3 died.Causes of deaths included leukemia relapse (n =2)and ineffective treatment (n =1).The 2-year overall and disease-free survival rate after relapse in 12 patients was 75.0％ ± 12.5％ and 31.7％ ± 14.9％,respectively.Conclusion This small sample data suggested that ponatinib as salvage therapy had a good response to the relapse CML-T315I after allo-HSCT.

OBJECTIVETo compare the hemodynamic responses to nasotracheal intubation with Glide Scope video-laryngoscope (GSVL), Macintosh direct laryngoscope (MDLS), and fiberoptic bronchoscope (FOB).

METHODSSixty patients, with American Society of Anesthesiologists (ASA) physical status I - II, aged 18- 50 years, and scheduled for elective plastic surgery under general anesthesia requiring nasotracheal intubation, were randomly allocated equally to GSVL group, MDLS group, and FOB group. After the routine anesthesia induction, nasotracheal intubation was performed with the GSVL, MDLS, and FOB, respectively. Noninvasive blood pressure (BP) and heart rate (HR) were recorded before (baseline values) and after anesthesia induction (postinduction values), at intubation, and subsequently at an interval of every 1 minute for a total of five minutes. The maximum and minimum values of BP and HR during the observation period were also noted. The rate pressure product (RPP) at each measuring time point was calculated. The areas under effect-time curve (AUE) of hemodynamics were calculated by time as X-axis and changes of BP and HR during the observation as Y-axis.

RESULTSAll the three groups were similar in the demographic data and intubation time. After anesthesia induction, BP and RPP in all the three groups decreased significantly compared to baseline values (P < 0. 05), while HR had no significant change. After nasotracheal intubation, BP, HR, and RPP in all three groups were significantly higher than the postinduction values (P < 0.05). In the FOB group, BP, HR, and RPP at intubation significantly increased when compared with the baseline values (P < 0.05). In the MDLS group, HR at intubation, and maximum values of diastolic blood pressure (DBP), mean arterial pressure (MAP), HR, and RPP during the observation were significantly higher than the baseline values (P < 0.05). In the GSVL group, all hemodynamic parameters at intubation and after intubation were not significantly different from the baseline values. BP, HR, and RPP at intubation, and the incidences of HR more than 100 bpm during the observation were significantly higher in the FOB group than in the other two groups (P < 0.05). BP was not significantly different during the observation between the MDLS and GSVL groups, but HR and RPP at intubation and after intubation as well as AUE(HR) were significantly higher in the MDLS group than in the GSVL group (P < 0.05). AUE(HR) and AUE(SBP) were significantly lower in the GSVL group than in the FOB group (P < 0.05).

CONCLUSIONThe hemodynamic responses to nasotracheal intubation are most severe with FOB, followed by MDLS, and then GSVL.

Adolescent ; Adult ; Blood Pressure ; physiology ; Bronchoscopy ; Female ; Heart Rate ; physiology ; Hemodynamics ; Humans ; Intubation, Intratracheal ; instrumentation ; methods ; Laryngoscopy ; Male ; Middle Aged ; Young Adult

BACKGROUNDReceptor activator of nuclear factor kappa B (NF-κB) ligand (RANKL) and osteoprotegerin (OPG) have been recently shown to play important roles in bone resorption. The aim of this study was to investigate the possible association between the expression of bone resorption regulators (RANKL and OPG) and inflammatory cell infiltration in chronic apical periodontitis.

METHODSThe samples of chronic periapical lesions (n = 40) and healthy periapical tissues (n = 10) were examined for immunohistochemical analysis of RANKL and OPG. Lesion samples were further analyzed for the inflammatory infiltration condition. The inflammatory cell infiltration was scored in relation to immunohistochemical reactivity for CD3, CD20 and CD68.

RESULTSThe number of RANKL-positive cells and the ratio of RANKL/OPG in chronic apical periodontitis were significantly higher than those in healthy periapical tissues (P < 0.001). The number of RANKL-positive cells was higher in lesions with severe inflammatory infiltration than in those with light inflammatory infiltration (P < 0.05). Significantly increased RANKL expression was found with T lymphocytes (CD3(+)), macrophages (CD68(+)) and B lymphocytes (CD20(+)) infiltration (P < 0.05). No association was found between the ratio of RANKL/OPG and inflammatory cell infiltration.

CONCLUSIONSRANKL expression was increased with T, B lymphocytes and macrophages infiltration, respectively in chronic periapical lesions. RANKL appears to be closely related to periapical inflammatory infiltrates. The relative ratio of RANKL/OPG may be a key determinant of RANKL-mediated bone resorption.

Adolescent ; Adult ; Chronic Periodontitis ; immunology ; pathology ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Inflammation ; metabolism ; Male ; Middle Aged ; Osteoprotegerin ; metabolism ; RANK Ligand ; metabolism ; Young Adult

OBJECTIVETo observe and compare the analgesic effect of electroacupuncture (EA) at "Sanyinjiso" (SP 6), "Hegu" (LI 4) and "Xuehai" (SP 10) in dysmenorrhea rats so as to investigate the functional specificity of acupoint.

METHODSOne hundred SD female rats aged three-month-old in the diestrus examined by the vaginal smear screening were randomly divided into a saline group, a model group, a Sanyinjiao (SF 6) group, a Hegu (LI 4) group and a Xuehai (SF 10) group, 20 rats in each group. The rats in the last four groups were given Estradiol Benzoate combined with Oxytocin to prepare the models of dysmenorrhea and in the saline group were given the same dose of saline. Last three groups were treated with electroacupuncture (EA) at Sanyinjiao" (SF 6), "Hegu" (LI 4) and 'Xuehai" (SF 10) respectively. The writhing behaviors of the rats in each group were observed within 20 min performing electroacupuncture from the start of the pain and the waveforms of uterine contraction were recorded.

RESULTSIn terms of the writhing behaviors, the writhing latency in the Hegu (LI 4) group was extended significantly (P < 0.05, P < 0.01) and the writhing numbers in the Hegu (LI 4) group were decreased significantly (both P < 0.05) as compared with those in the Sanyinjiao (SF 6) group and in the Xuehai (SF 10) group. In terms of the waveforms of uterine contraction, compared with that in the model group, the amplitude and the activity of uterine contraction in both Sanyinjiao (SF 6) group and Hegu (LI 4) group were decreased significantly (all P < 0.05), and with no significant difference between the Xuehai (SF 10) and the model group (P > 0.05).

CONCLUSIONFor comprehensive assessment of the analgesic effect of electroacupuncture at different acupoints by using the writhing behaviors and the waveforms of uterine contraction, "Hegu" (LI 4) is the best, "Sanyinjiao" (SP 6) is the next and "Xuehai" (SP 10) is the third. showing a relatively functional specificity of the acupoint.

Acupuncture Analgesia ; Acupuncture Points ; Animals ; Disease Models, Animal ; Dysmenorrhea ; therapy ; Electroacupuncture ; Female ; Humans ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo measure the feasibility of application of comparative genomic hybridization technique in the prenatal diagnosis of fetus with mandibulofacial dysostosis.

METHODSA pregnant woman having a fetus with mandibulofacial dysostosis diagnosed by prenatal ultrasound test was selected. The amniotic fluid and blood of the pregnant and blood of her husband were collected and conventional cytogenetic analysis was performed. The whole genome was scanned by array comparative genomic hybridization assay (array-CGH). Reverse transcription fluorescence quantitative PCR (RT-qPCR) analysis was used to verify the result of array-CGH.

RESULTSNo abnormality was found in conventional cytogenetic analysis while a duplicated region in 1p36.33 was detected by array-CGH assay. The region spans 722 kb and contains two genes, VWA1 and PYGO2, which play roles in the development of cartilage. The result of array-CGH was confirmed by the RT-qPCR assay. The diagnosis of mandibulofacial dysostosis was confirmed after birth.

CONCLUSIONAuthor diagnosed a fetus with mandibulofacial dysostosis by array-CGH assay and found two candidate genes related to the development of craniofacial bone: VWA1 and PYGO2.

Adult ; Chromosome Aberrations ; Comparative Genomic Hybridization ; methods ; Female ; Fetus ; pathology ; Humans ; Karyotyping ; methods ; Mandibulofacial Dysostosis ; genetics ; Pregnancy ; Prenatal Diagnosis ; methods