Objective To explore the effect of prevention of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) with hyperhydration, forced diuresis and alkalinizing plus infusion mesna. Methods 32 cases of patients receiving HSCT were included in this study. 2 cases of severe aplastic anemia (SAA) received total body irradiation (TBI)+cyclophosphamide(CTX)(TBI-CTX) regimen,and the remaining 30 patients were using the classic busulfan+CTX (BU+CTX) regimen. All patients were treated with mesna combined with hydration, forced diuresis and alkalization to prevent HC. Ganciclovir and acyclovir were used to prevent cytomegalovirus (CMV) and other viral infections and monitor CMV-IgM levels of the blood. Encourage patients to urinate every hour, testing urine pH value and the calculation of urine output, every 6 h review and testing of urine routine,central venous pressure (CVP), each of 8 h of serum electrolytes. Results Only 1 patient at 6 months after transplantation appeared delayed grade Ⅱ HC after hydration, alkalization, diuretic, hemostatic, anti-graft-versus-host disease (GVHD), and ganciclovir antiviral therapy. The HC patients cured at 35 d. The remaining patients did not suffer HC. Adverse effects such as acid-base balance disturbance did not appear clear. Conclusion Mesna joint hydration, forced diuresis and alkalization was effective and safe to prevent HC.

OBJECTIVE: To observe the therapeutic effect of Xincang Decoction on chronic airway inflammation in children with asthma in clinical investigation. METHODS: Xincang Decoction was composed of Flos Magnoliae (Xinyi) and Fructus Xanthii (Cangoerzi), the traditional Chinese herbs for expelling wind. Sixty cases of children with bronchial asthma in remission stage were randomly divided into two groups. Thirty cases in the treatment group were treated with Xincang Decoction and the others in the control group were treated with ketotifen fumarate. The therapeutic effects of the two groups were compared, and the peripheral eosinophil (EOS) count, the levels of immunoglobulin E (IgE), interleukin 4 (IL-4) and interleukin 5 (IL-5), and the pulmonary functions were observed before and three months after the treatment. RESULTS: After three months treatment, the results showed that the total response rates of the treatment and the control group were 83.3% and 80.0%, respectively, without marked difference (P>0.05). The levels of EOS and IL-5 were obviously decreased after the treatment, and the levels of EOS and IL-5 of the patients in the treatment group were lower than those in the control group (P<0.05). Meanwhile the forced expiratory volume in one second (FEV(1)) was improved after the treatment, and the FEV(1) of the patients in the treatment group was higher than that of the patients in the control group (P<0.05). CONCLUSION: Xincang Decoction can decrease the levels of EOS and IL-5 and improve the pulmonary function in treating chronic airway inflammation in children with bronchial asthma in remission stage.

Objective To analyze the clinical features of melioidosis spleen abscess.Methods A retrospective analysis of 26 cases with melioidosis spleen abscess at Hainan People′s Hospital between October 2002 and March 2015 was performed.Data with general conditions, clinical characteristics, imaging features, treatment and outcome were all extracted and analyzed.Results High fever (100.0%) and splenomegaly (73.1%) were the main clinical symptoms and signs.Laboratory examinations showed that white blood cell and neutrophil percentage increased, with a mean value of 12.6×10.9/L and 0.86, respectively.88.5% cases had diabetes mellitus which was the main underlying disease.Apart from spleen abscess, pulmonary infection (73.1%) and liver abscess (38.5%) were the majority.Imaging showed multiple small abscess (92.3%).All patients had at least one positive blood culture of Burkholderia pseudomalleiand were treated with imipenem, ceftazidime and sulfamethoxazole alone or in combination.Hospitalization days ranged between 8 to 65 days with the mean of 29.5 days.Twenty-three cases (88.5%) were cured, the remaining 3 cases (11.5%) abandoned treatment and were all lost for follow-up.Conclusions Melioidosis should be suspected in patients from epidemic areas, who have diabetes and imaging shows spleen abscess and other organ infections including pulmonary infection and liver abscess.Microbiological culture is needed immediately.

Objective To analyze the concentration of epithelial cell derived neutrophil-activating protein 78(CXCL-5) in the sy-(novial) fluid(SF) and peripheral blood in children with rheumatoid arthritis(RA) and evaluate its clinical relevance to the disease development.Methods SF and peripheral sera were taken from 26 children with RA and 16 healthy controls,and CXCL-5 was measured by enzyme linked immunosorbent assay(ELISA).CXCL-5 in SF was also measured in RA children after receiving steroid treatment.Results The levels of CXCL-5 was significantly higher than that in the SF of RA children compared with healthy controls(P0.05).Interestingly,CXCL-5 markedly decreased in RA children after steroid treatment(P

Objective: To observe the changes of heart rate and the contents of angiotensin Ⅱ(AngⅡ) in blood plasma in ventricular tachycardia(VT) rats with electro-acupuncture(EA) on ‘daling’(PC7). Methods: 40 SD rats were randomly divided into normal, model, treatment and control groups with 10 cases in each. VT model was duplicated by inject CsCl in femoral vein. To observe the rats’ electrocardiogram (ECG) and record their heart rates. EA was applied to‘daling’ (PC7) on treatment group and applied to‘Taiyuan’ (LU9) on control group for 5 minutes. Then, we detected the contents of AngⅡ in the rats’blood plasma respectively. Results: The heart rate and contents of AngⅡin rat increased obviously in model group were (547?30) time/min and (353.21?49.12)pg/mL). They restored to the normal state after EA ‘daling’ (PC7) are(474?25)time/min and(268.44?47.49)pg/ mL.But the effect was not obvious in ‘Taiyuan’ (LU9). Conclusion VT rat heart can be prompted to restore to the normal state after EA ‘daling’(PC7); AngⅡ played an important role in VT.

ObjectiveTo explore the efficacy and safety of bone marrow mesenchymal stem cells (BMSC)in treatment of aplastic anemia(AA). MethodsTwenty-two patients with aplastic anemia were enrolled with median age of 31 (12-70) years old,including 11 severe aplastic anemia (SAA),and 3 of whom were cyclosporine and anti-thymocyte globulin-resistant. BMSC were isolated from bone marrow of healthy donors and cultured.The third to fifth generation cells were administered intravenously in 1×106/kg to patients once or twice a week.After infusion,complete blood count,bone marrow aspiration,bone marrow biopsy,flow cytometry analysis of lymphocyte subsets of CD3+ CD4+ and CD3+ CD8+ and clinical symptoms were involved in outcome measurement.ResultsAll patients finished 16-time median (5-83 times) infusions of BMSC with 13-month median (2-33 months) treatment course and 23-month median (2-34 months) follow-up.The total response rate was 72.7 ％(16/22), including one patient with essential cure, 9 with remission, 3 with remarkably improvement and 3 with transfusion interval extension.Two of three front-line immunosuppressiveresistant SAA patients achieved remission. Ten of 14 patients recovered from inverted ratio of CD4+/C8+ cells after BMSC treatment. There were no treatment-related side effects observed in the course of treatment.ConclusionBMSC are effective and safe for the treatment of AA in our preliminary study and they deserve further research with larger-scale and long-term clinical trials.

OBJECTIVETo explore the objective special features and role of various indexes of treadmill exercise test (TET) in patients of coronary heart disease (CHD) caused angina pectoris with Qi-Yin deficiency syndrome (QYD) with or without accompanied phlegm and blood stasis syndrome (PBS), to provide references for preventing and treating CHD in clinical practice.

METHODSOne hundred and one patients, whose diagnosis measured to the diagnostic standard and the inclusion criteria of angina pectoris and CHD, were classified according to their TCM syndrome type to two groups, the QYD without PBS group (49 cases) and the QYD with PBS group (52 cases). TET was conducted on all the patients. The relative parameters were measured and compared.

RESULTSAs compared with the QYD without PBS group, in the QYD with PBS group, (1) the TET positive rate was higher; (2) total exercise time was lesser; (3) the maximal metabolic equivalent (Max MET) was lower; (4) the average depression of ST segment at the exercise endpoint of test (mV) was higher; (5) the time of ST segment depressed for 0.1mV (min) was longer; (6) the metabolic equivalent during ST-segment depressed by 0.1mV was shorter; and (7) the change of QRS wave time-limit before and immediately after TET was more evident. Moreover, in the testing time more patients revealed angina episode after exercise, and less patients had their heart rate reached the requirement in the QYD with PBS group than those in the QYD without PBS group. Comparison between the two groups in all the above-mentioned indices showed significant difference respectively (P < 0.01 or P < 0.05).

CONCLUSIONPatients with CHD caused angina pectoris of QYD with PBS are worse in the tolerance for exercise and severer in pathological change of coronary artery than those in those without PBS, they belong to the severe phase of TCM syndrome.

Angina Pectoris ; physiopathology ; Coronary Artery Disease ; physiopathology ; Diagnosis, Differential ; Exercise Test ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Qi ; Yin Deficiency

Objective To investigate the changes in cytotoxicity of DC-CIK cells to human multiple myeloma RPMI 8226 cells before and after treatment with oridonin. Methods Normal human peripheral blood mononuclear cells were isolated and induced to obtain DC-CIK cells. Cytotoxicity of DC-CIK cells against RPMI 8226 cells which were treated by oridonin was analyzed by LDH releasing assay. The variation for expression of NKG2D ligands on RPMI 8226 cells were measured by flow cytometry. Results DC-CIK cells were successfully induced from the peripheral blood mononuclear cells. At the same effector to target ratio, oridonin obviously enhanced the cytotocixity of DC-CIK cells against RPMI 8226 cells (P<0.01). Flow cytometry showed the expression of NKG2D ligands ULBP1 of RPMI8226 cells was most significantly increased as the cells were treated by oridonin [(9.19 ± 1.85) vs. (15.47 ± 0.67), P<0.01]. Correlation analysis indicated that cytotocixity was positively correlated with changes in ULBP1. Conclusions Oridonin can improve the cytotoxicity of DC-CIK cells against RPMI 8226 cells, which may be related with the increased expressions of NKG2D ligands on the tumor cell surface.

Objective To explore the role of apoptosis-inducing factors (AIF) mediated non-apoptosis classic pathway involved in neuron apoptosis of rats with chronic fluorosis.Methods Sixty Sprague Dawley (SD) rats (body weight 100-120 g) were divided into two groups (30 rats in each group,half male and half female) by random number table according to body weight.Control group was fed with tap water with fluoride content ＜ 0.5 mg/L and fluorine group was fed with water with fluoride content of 50.0 mg/L.Both groups were fed with standard food with fluorine content ＜ 0.5 mg/kg.After 10 months,all the animals were sacrificed though heart perfusion using phosphate buffer,and brain tissue was taken.Immunohistochemical method was employed to detect the distribution of AIF in brain tissue.Western blotting was used to test the protein expression of AIF,cl-caspase-3 and cl-caspase-9.Flow cytometry was used to examine apoptosis rate.Results The AIF positive distribution and degree of staining in the neurons of hippocampal CA1,CA2 and CA3,as well as the parietal cortex (7.50 ± 2.17,9.00 ± 1.63,8.00 ±0.82,10.24 ± 1.80) in rats with chronic fluorosis were significantly higher than those of the control group (5.18 ±1.66,6.27 ± 1.42,6.36 ± 1.96,6.96 ± 2.62,t =2.76,4.09,2.45,5.77,all P ＜ 0.05).The AIF protein expression of neuronal mitochondria in the cerebral tissue of rats with chronic fluorosis [(89.46 ± 8.47)％] was significantly lower than that of the control group [(100.00 ± 7.12)％,t =3.16,P ＜ 0.01],while the AIF protein expression of the neuronal nucleus [(112.80 ± 7.10)％] was significantly higher than that of the control group [(100.00 ± 8.20)％,t =3.75,P ＜ 0.01];cl-caspase-3 and cl-caspase-9 protein expression in the neurons of hippocampus and cortex from the rats with chronic fluorosis [(132.14 ± 18.66)％,(107.31 ± 2.58)％,(121.33 ± 14.86)％,(112.97 ± 7.97)％]were significantly higher than those of the control group [(100.00 ± 11.99)％,(100.00 ± 3.74)％,(100.00 ± 16.87)％,(100.00 ± 8.04)％,t =3.55,3.94,2.32,2.81,P ＜ 0.01 or ＜ 0.05].As compared with those of the control group [(1.28 ± 0.59)％,(1.88 ± 0.25)％],the apoptosis rates in hippocampus and cortex of the rats with chronic fluorosis [(2.55 ± 0.58)％,(3.05 ± 0.65)％] were significantly increased (t =3.08,3.40,all P ＜ 0.05).Conclusion Both of AIF-mediated caspase-independent apoptosis and the classic caspase-dependent apoptosis pathways have participated in neuron apoptosis in rat induced by chronic fluorosis,which may be one of the mechanisms of brain damage of the disease.

Objective To evaluate the effect of topical anesthesia with compound lidocaine cream coated on the tracheal tube on extubation response in patients undergoing Han-uvulopharyngoplasty (H-UPPP).Methods Eighty-four patients,aged 28-48 yr,weighing 91-108 kg,scheduled for elective H-UPPP,requiring tracheal intubation under general anesthesia,were equally and randomly divided into 2 groups:compound lidocaine cream group (group L) and control group (group C).The compound lidocaine cream 2-3 g were coated on the tracheal tube cuff and exterior before induction of anesthesia in group L,while the paraffin oil was coated in group C.Mean arterial pressure (MAP),HR and pulse oxygen saturation were recorded before induction of anesthesia,at the end of infusion of anesthetics,during extubation and 5 min after extubation (T1-4).Blood samples were taken from the forearm veins on the noninfusion side at T1-4 for detection of plasma adrenergic and norepinephrine concentrations.Cardiovascular events during extubation were recorded.Results Compared with group C,MAP and HR were significantly decreased at T3,4,the incidences of hypotension and tachycardia were decreased,the plasma adrenergic and norepinephrine concentrations were significantly decreased at T2-4 in group L (P ＜ 0.05).Conclusion Topical anesthesia with compound lidocaine cream coated on the tracheal tube can effectively reduce the extubation response in the patients undergoing H-UPPP.