Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a highly successful treatment for hematological malignancies,severe congenital immunodeficiencies and some other diseases.Approximate 50 ％ of the disease-free survival patients suffered from long-lasting severe cognitive impairment after allo-HSCT.Pathological evidences showed parenchymal lymphocytic inflammation,microglia activation,and mild cerebral angiitis-like changes in allogeneic transplanted animals and patients' autopsy.Pay much importance attention to the pathological changes of central nervous system and its impact on cognitive function and take suitable measures would help the patients to achieve a state of complete physical mental and social well-being.

The retinoblastoma-protein-interacting zinc finger proteinl (RIZ1),a methyltransferase,contains the characteristic PR zinc finger domain.RIZ1 can methylate H3K9 of the histone,acted as a transcription suppression factor of cancers.Increasing numbers of human cancers are reported to hold decreased or absent RIZ1 expression,which is closely related to the progression of cancer.RIZ1 is defined as a candidate anti-oncogene.The mechanisms of the suppression involved in both oncocytogenetics and epigenetic changes.

Objective To investigate the clinical efficacy of electroacupuncture at specific points in treating different degrees of urgency-frequency syndrome. Methods Sixty patients with urgency-frequency syndrome were randomly allocated, according to the symptom score, to groups A (the symptom score≤ 24) and B (the symptom score>24), 30 cases each. Both groups received electroacupuncture at specific points (four sacral points and four abdominal points). In the two groups, the symptoms were scored before and after treatment and the clinical therapeutic effects were evaluated.Results There was a statistically significant pre-/post-treatment difference in the symptom score in the two groups (P<0.01). The total efficacy rate was 83.3% in group A and 80.0% in group B; there was no statistically significant difference between the two groups (P>0.05).Conclusion Electroacupuncture at specific points is an effective way to treat urgency-frequency syndrome.

Objective To discuss the techniques and efficacy of Ho:YAG laser incision by using uteroscopy for ureterostenosis.Methods From July 2004 to April 2007,52 patients with ureterostenosis received ureteral incision by using Ho:YAG laser under a endoscope.Two double pigtail stents(F5 or F6) were placed in the ureters after the operation and left indwelling for 8 to 12 weeks.Ultrasonography and excretion urography were performed 3 to 6 months after extubation.Results Follow-up was available for 3 to 24 months(mean,17 months) in 46 patients,of which 40(87%) were cured after the treatment.In the cured patients,hydronephrosis,ureteral dilation,and ureterostenosis were improved,and the pain in the kidney region was relieved;none of them showed signs of infection.In the other 6 patients,4 were improved after the treatment(no deterioration of the symptoms of hydronephrosis,ureteral dilation,and pain in the kidney region,and no infection);and 2 failed(the symptoms of hydronephrosis and ureteral dilation deteriorated,and pain in the kidney region and infection were developed).Conclusion Endoscopic ureteral excision using holmium laser combined with indwelling of two double pigtail stents is effective and safe for ureterostenosis.

Objective To investigate the effects of ketamine in relieving postoperative pain after laparoscopic cholecystectomy(LC).Methods Forty patients undergoing selective LC from July to August 2006 were randomly divided into ketamine group and control group,with 20 patients in each group.Incision pain and non-incision pain was assessed at 1,2,4,6,12,24 h and once each day for the first 3 days postoperatively with visual analogue pain scale(VAS)and sedation scale.Adverse effects and analgesic requirements were recorded.Results Patients in ketamine group had significantly lower scores in incision pain and non-incision pain compared with those of control group(F=22.805,P =0.000;F=18.109,P=0.000).Incidence of postoperative nausea and vomiting was not significantly different(P=1.000)between ketamine(55%)and control group(60%).No significant difference was noticed in analgesic requirements between ketamine group(3 cases)and control group(9 cases)(P=0.082).Conclusions Preoperative administration of ketamine significantly improves postoperative analgesia after laparoscopic cholecystectomy,but does not reduce the incidence of postoperative nausea and vomiting.

One hundred and seventy one gastric biopsy specimens from the patients undergoing gastroscopic examination from March to November 2010 were reviewed . HE, sliver and immunohistochemistry stains were performed in the specimens; the correlation of histopatholigy and the density and distribution of Helicobacter pylori in gastric mucosa was analyzed .The results displayed that spiral H.pylori mainly appeared on the surface mucus and in the gland lumen of gastric small concave , some were attached to the epithelial cells; coccoid H.pylori appeared within the apical cytoplasmic part of the epithelial cells and in the mucous membrane stroma .The depth of H.pylori infection was correlated with mucosal erosion , inflammation activities and amount of interstitial lymphocytes .The results suggest that spiral H.pylori infection may facilitate the invasive depth of coccoid H.pylori in gastric mucous membrane and the density of H.pylori infection is correlated with the extent and severity of inflammation .

Objective To analyze antimalarial assosiated retinopathy detected by different methods with of modern ocular fundus examination, and explore screening strategy and the diagnosis of hydroxych-loroquine assosiatedretinopathy according to clinical experience and international guidelines. Methods Full fundus examination was performed in two patients with antimalarial retinopathy. The related literature were reviewed. Results Two patients had bull's eyes maculopathy and abnormal visual fields. Conclusion Clin-icians' alertness to hydroxychloroquine related retinopathy may improve early diagnosis of hydroxychloroquine toxicity. New objective tests are more sensitive than visual fields examination. Visible bull's-eye maculopathy is a late change, and the goal of screening is to recognize toxicity at early stage.

Objective To study the prediction value of C-reactive protein (CRP) level to ankylosing spondylitis disease activity score (ASDAS),the most widely used activity score in ankylosing spondylitis (AS).Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L (n =266) and CRP ＜ 3.5 mg/L(n =120).ASDAS-CRP was evaluated in patients with CRP below the normal range (3.5 mg/L) in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate (ESR).Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L (r =0.899,P =0.000).In the group of CRP ＜ 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L(intra-class correlation coefficient 0.902;kappa coefficient 0.70).By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

A total of 8 099 outpatient prescriptions for treatment of Helicobacter pylori (Hp) infection in 9 community health service centers of Shanghai Jing′an district were collected from the regional health information platform.The prescriptions were reviewed and analyzed according to the criteria of the Forth National Consensus Report on the Treatment of Helicobacter pylori Infection.The results showed that only 195 prescriptions met the criteria (2.4%).For those not meeting the criteria, 611 prescriptions (7.5%) gave the right therapeutic protocol but incorrect treatment course;6 893 prescriptions (85.1%) gave the incorrect protocol.It is uggested that incorrect treatment for Hp eradication is common in community health service centers consist in the Helicobacter pylori herapy prescriptions in the community health service cente in Shanghai, Jing′an District, which should be paid more attention to.

In recent years, the research hot in the field of solid tumor and blood tumor focuses on the myeloid-derived suppressor cells (MDSCs).In tumors, MDSCs not only exert immunosuppression by inhibiting T cell proliferation, destroying the functions of natural killer cells and recruiting regulatory T cells, but also play non-immunosuppression roles in the promotion of angiogenesis and tumor metastasis.All of these hinder the anti-tumor therapy, and particularly affect the curative effect, which are related with a poor clinical prognosis.MDSCs can be used as prognostic markers, which provide new targets for immunotherapy.