Objective To investigate the therapeutic effects and adverse reactions of decitabine combined with IA or CAG regimen in the treatment of elderly patients with acute myeloid leukemia.Methods A retrospective analysis was made to observe the therapeutic effects and adverse reactions of 47 elderly patients with acute myeloid leukemia,who were divided into DAC+IA group (17 cases) and DAC+CAG group (28 cases) according to the different chemotherapy.Results In DAC+IA group,the rate of complete remission was 29.4 ％ (5/17),the rate of partial remission was 35.3 ％ (6/17),the effective rate was 64.7 ％ (11/17).In DAC+CAG group,the rate of complete remission was 26.7 ％ (8/30),the rate of partial remission was 30.0 ％ (9/30),the effective rate was 56.7 ％ (17/30),the difference between the two groups was not statistically significant (x2 =0.227,P =0.716).In DAC+IA group the median remission time and the median suvival time were 4.0 and 8.1 months,respectively.And they were 4.0 and 8.1 months,respectively,in DAC+CAG group.No significant difference was showed between the two groups (P value was 0.835,0.266,respectively).Conclusions Compared with decitabine combined with CAG regimen,decitabine combined with IA regimen has similar effect and can be well tolerated.Accordingly,decitabine combined with IA regimen can be used as first-line treatment for elderly patients with acute myeloid leukemia.

Objective To investigate the value of serum concentration of VEGF-C in the prognosis of advanced pancreatic cancer. Methods Thirty-five patients with advanced pancreatic cancer were selected from Aug. 2006 to Feb. 2008, ELISA method was used to detect the serum level of VEGF-C, CA19-9 and KPS score was calculated, and survival was analyzed by Kaplan Meier method. The survival difference was calculated by log rank. Cox regression model was used to perform univariate and multivariate analysis. Results The mean serum concentration of VEGF-C was ( 1309 ± 542 ) pg/ml in patients with advanced pancreatic cancer, which were significantly higher than that those in normal control [ (278 ±115) pg/ml, P <0.01 ]. In Cox regression, KPS score, serum CA19-9 and VEGF-C were independent factors (x2 =7.208, 6.908, 3.867, P = 0.007, 0.009, 0.049). In multivariate analysis, serum VEGF-C and KPS score were independent factors (x2 =4.873, P=0.027, x2 =5.274, P =0.022). Using serum concentration of VEGF-C at 1280 pg/ml as the cut-off point, the mean survival of patients with VEGF-C ≤1280 pg/ml was 10.0 months, and the median survival was 11.3 months, 1 year cumulative survival was 50.0% ; while they were 6.0 months, 6.3 months and 5.9% in patients with VEGF-C > 1280 pg/ml, and the difference was statistically significant (x2 = 9.400, P= 0.002). Using KPS score 70 as the cut-off point, the mean survival of patients with KPS <70was 6.0 months, and the median survival was 6.6 months, 1 year cumulative survival was 21.4% ; while they were 9.0 months, 10.1 months, 33.3% in patients with KPS score ≥70,and the difference was statistically significant (x2 =4.040, P =0.044). The difference of the median survival, 1 year cumulative survival in patients with CA19-9 ≤200 U/ml or >200 U/ml was not statistically significant (10.0 months vs. 7.8 months, 37.5% vs. 21.1% ; x2 =1910, P=0. 167). Conclusions Serum concentration of VEGF-C can used as an independent factor for predication of prognosis of patients with advanced pancreatic cancer.

Objective To evaluate the relationship between the amount of grafted cells and the incidence of acute graft versus host disease (aGVHD) after haploid hematopoietic stem cell transplantation (haplo-HSCT). Methods Data of 68 patients who underwent haplo-HSCT from Jan 2009 to Dec 2013 were analyzed retrospectively. Influences of different factors on the incidence of Ⅲ-Ⅳ degree of aGVHD after HSCT were evaluated. Results 68 patients including 42 males and 26 females were 5/10-9/10 HLA match with 19 father donors, 24 mother donors, 16 sibling donors and 9 children donors. 51 patients not suffered Ⅲ-Ⅳdegree of aGVHD included 32 males and 19 females with the mean age of 20 years old (5-55 years old). 17 patients sufferedⅢ-Ⅳdegree of aGVHD including 10 males and 7 females with the mean age of 23 years old (5-54 years old). There were no significant differences in the amount of the grafted mononuclear cells (MNC) and CD34+cells, and the white blood cell counts (WBC) and platelet count (Plt) recovered time between two groups (P>0.05). However, MNC number was related to CD34+cell number (P<0.05) and WBC recover time (P<0.05), and the CD34+cells number was related to WBC and Plt recover time (P< 0.05). Conclusion The incidence of Ⅲ-Ⅳ degree of aGVHD is unrelated to the amount of grafted MNC, and CD34+cells.

BACKGROUND:Alogeneic hematopoietic stem cel transplantation (alo-HSCT) is an effective mean to cure severe aplastic anemia, and especialy haplotype transplantation is regarded as a transplantation system with Chinese characteristics, and rank at the international leading level. OBJECTIVE:To explore the patterns of haplotype alo-HSCT as a new immune tolerance method for severe aplastic anemia and to solve the transplantation rejection and graft-versus-host disease. METHODS:Twelve patients with severe aplastic anemia who underwent haplotype alo-HSCT at the Department of Hematology, General Hospital of Beijing Military Area, China from April 2013 to May 2014 were enroled. Al these patients received the new regimen of inducing immune tolerance through the application of high-dose cyclophosphamide (400 mg/m2, consecutively 3 days before transplantation; 50 mg/kg, consecutively 3 days after haplotype transplantation). RESULTS AND CONCLUSION:The median time of neutrophil recovery was 17 (13-21) days, and the median time of platelet recovery was 21 (15-31) days. After transplantation, there were one case of degree II acute graft-versus-host disease and one case of chronic graft-versus-host disease, both of which were controled. The folow-up time was 6 months at least, and the median time was 11 months. During the folow-up, one case died of rejection reaction and one case died of severe lung infection. These findings indicate that the new method of inducing immune tolerance with high-dose cyclophosphamide after transplantation for severe aplastic anemia has significant effects in reducing graft-versus-host disease and transplantation-related mortality rate.

To study the chemical components and the antifungal activity of extraction from conidia of Trichoderma viride LTR-2.The extraction were obtained by distilling with Methylene dichloride from conidia of Trichoderma viride LTR-2 cultured on wheat bran solid matrix.Antifungal activity were determined by mycelium growth method.The chemical components of the extraction were analysed by GC-MS,the relative components in the extraction were determined by area normalization.The extraction not only have broad-spectrum control,showed antibiosis against eleven different plant fungal pathogens in PDA dish,such as Rhizoctonia solani,Alternaria brassica,Verticillium dahliae,Macrophoma kawatsukai,Fusarium moniliforme,Botrytis cinerea,Rhizoctonia cerealis,Fusarium oxysporum f.sp.vasinfectum,Bipolaris sorokinana,Fusarium graminearum,Alternaria.mali,but also have high inhibitory effect,and had 89.3% suppressive rate to Rhizoctonia cerealis.About sixty components were separated and identified by GC-MS,majority components were Hydrocarbon,the number of the Hydrocarbon were fourty-three kinds.Ergosterol was the major chemical components of the extract,and has 41.90% content.Other components comprised:Ketone,Organic acid,Alcohol,Ene,et al.Conclusion:The extraction from conidia of Trichoderma viride LTR-2 have antifungal activity.The extration comprised 2H-Pyran-2-one,5,6-dihydro-6-pentyl,it has 2.35% content.reference others literature,2H-Pyran-2-one,5,6-dihydro-6-pentyl may be the suppressive component of the extration.

OBJECTIVETo explore the role of nuclear factor-kappaB (NF-kappaB) in the protective effects of propofol against liver ischemia-reperfusion (IR) injury.

METHODSForty male rats were randomized into 4 equal groups, namely the sham operation (N) group, IR group with hepatic IR injury (induced by ischemia of the left, right and median hepatic lobes for 1 h followed by reperfusion for 2 h), propofol (P) group with sham operation and propofol perfusion at 10 mg kg(-1) h(-1), and propofol treatment (PIR) group with IR injury and propofol perfusion. RT-PCR was used to detect the transcription level of NF-kappaB, and Western blotting was used for assaying NF-kappaB protein expression in the liver.

RESULTSCompared with either the N or the P group, the IR group showed obvious swelling, fatty degeneration and scatter focal necrosis of the hepatocytes as well as mild congestion in the hepatic sinusoid, with significantly increased plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and NF-kappaB expressions at both mRNA and protein levels (P<0.05). In the PIR group, the histopathological changes of the liver was lessened as compared with the IR group, and ALT and AST elevation was significantly inhibited (P<0.05) as was the protein expression of NF-kappaB (P<0.05), but NF-kappaB transcription level was further enhanced (P<0.05).

CONCLUSIONPropofol can protect the liver from IR injury possibly by inhibiting NF-kappaB expression.

Animals ; Blotting, Western ; Down-Regulation ; drug effects ; Liver ; blood supply ; Male ; NF-kappa B ; biosynthesis ; genetics ; Propofol ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control ; Reverse Transcriptase Polymerase Chain Reaction

Objective To explore the effect and feasibility of haplotype allogeneic hematopoietic stem cell transplantation (allo-HSCT) used in the childhood patients with refractory and relapsed leukemia.Methods Thirty children with refractory and relapsed leukemia received haplotype allo-HSCT from June 2007 to June 2011 in Beijing Military General Hospital,including 14 cases of acute myeloid leukemia (AML) and 16 cases of acute lymphoblastic leukemia (ALL).Of the 30 cases,there were 11 cases of initial recurrence,16 cases of second or more relapse,and 3 cases of primary refractory leukemia.The bone marrow and peripheral blood of donors were used for transplantation.All children were subjected to pretreatment consisting of cytarabine,busulfan,fludarabine and total body irradiation (TBI),etc.Graft-versus-host disease (GVHD) was prevented by combining variety of immunosuppressants including Cyclosporin A (CsA),Methotrexate (MTX),Mycophenolate mofetil (MMF) and anti-thymocyte immunoglobulin (ATG),etc.The regimen-associated side effect incidence of GVHD and disease-free survival probabilities were observed after HSCT.Results The results showed that all of the 30 children acquired hematopoietic reconstitution,and the median time of granulocytes exceeding 0.5 × 109/L and platelets exceeding 20 × 109/L which were transplanted 100％ by donors was 18.5 days and 24.2 days respectively.The mean follow-up period was 22.5 months (3 ～48 months).Twelve children had experience of acute GVHD,and 6 children had experience of chronic GVHD.Four children died of GVHD,3 died of infection and 6 died of relapse,and the rest children were alive in free situation.The 2-year disease-free survival rate was 55％.Conclusion Haplotype allo-HSCT was an safe and feasible therapy for the childhood patients with refractory and relapsed leukemia.

Objective To improve the diagnosis efficiency of patients with angioimmunoblastic T-cell lymphoma (AILT)by analyzing the clinical characteristics and curative effect of AILT. Methods Retrospective studies were used on clinicopathological features,immunophenotypes,treatment and survival of 20 angioimmunoblastic T-cell lymphoma patients,who were collected between January 2005 and January 2010 of Beijing Military General Hospital. Results In the 20 patients receiving chemotherapy,the median age was 55.9 years old.All of the 20 had lymph nodes and 11 of whom were accompanied with B group of symptoms,which were confirmed by lymph node biopsy and T cell antigen CD3, CD45Ro positive expression in all the patients. ALL of the patients received the CHOP regimen and combining with other treatment such as DICE,ESHAP, Hyper-CVAD or autologous hematopoietic stem cell transplantation. A follow-up by 5 to 69 months showed that median survival was 20.2 (5-69) months and 1,2,and 3-year disease free survival (DFS) were 67 ％,33 ％,and 11％ respectively.8 patients of the group (40 ％) with a sustained remission (CCS) respectively survived 63,47,27,24,24,12,5,1 months so far.Conclusion Most patients were older with many complications during chemotherapy, which resulted in easy relapse, and even the symptoms were alleviated at the early stage of the chemotherapy. IPI prognostic index is more important with long-term survival in AITL.Therefore further studies are required to improve the outcome.

Objective To investigate the effect of donor lymphocyte infusion (DLI) for preventing relapse of leukemia after haplotype hematopoietic stem cell transplantation (HSCT), and evaluate the therapeutic effect and the safety of DLI. Methods The 20 haplotype HSCT patients who received DLI were studied for the occurrence of graft-versus-host disease (GVHD) and long-term survival. Results Eleven of twenty patients survived leukemia-free for a median of 25(4-60) months, and leukemia-free survival rate was 55 %. 9 cases died of relapse. 19 patients occurred acute GEHD (aGVHD) after received DLI, 4 of them were severe.Conclusion The prophylactic DLI is effective for preventing from relapse of leukemia. It might be feasible option.

Objective To explore the clinical significance of the relationship between the immune function and the pathogenesis of aplastic anemia in children with aplastic anemia(AA),along with the incidence of graft versus host disease (GVHD)by monitoring the changes of T lymphocyte subsets dynamically in +1 ,+3,+6,+1 2 months for blood disease patients after allogeneic hematopoietic stem cell transplantation.Methods Twelve AA patients re-ceived allogeneic hematopoietic stem cell transplantation in Department of Hematology,the Affiliated General Hospital of Beijing Military Region of Anhui Medical University,from January 201 3 to January 201 4,including 4 male and 8 fe-male,with average age of 7.92 years old(3 -1 4 years old)with 5 cases of human leukocyte antigen(HLA)matched and 7 cases of HLA mismatched.The level of T lymphocyte subsets including CD3 +,CD4 +,CD8 +,CD4 +/CD8 +, CD56 +,CD4 +CD25 high +FOXP3 +were monitored with flow cytometry before transplantation and in +1 ,+3,+6,+1 2 months after transplantation dynamically in the peripheral blood.While in the same period the level of T lymphocyte subsets was monitored in 1 2 cases of healthy children at the same period as the healthy control group.Results Fol-lowed up to March 201 5,1 0 cases had abnormal cellular immunity (CD4 +/CD8 + ratio inversion)in the 1 2 AA pa-tients.Compared with the control group,in the AA group,CD3 + was slightly higher,(66.79 ±7.35)% and (62.74 ± 5.58)% respectively(P =0.043),CD4 + was decreased by (33.73 ±7.26)% and (39.54 ±3.46)% respectively (P =0.037),CD8 + was increased by (35.69 ±6.78)% and (25.34 ±4.36)%,respectively (P =0.000),CD4 +/CD8 + decreased by 1 .23 ±0.56 and 1 .78 ±0.34 respectively(P =0.001 )and CD56 + was decreased by (7.46 ± 2.80)% and (1 6.73 ±3.70)% respectively(P =0.000),CD4 +CD25 high +FOXP3 + was decreased by (3.3 ± 1 .5)% and (8.1 ±1 .3)% respectively (P =0.003),whose difference was statistically significant (P <0.05).The lever of CD3 +,CD4 +,CD8 +,CD4 +/CD8 +,CD56 +,CD4 +CD25 high +FOXP3 + had a different degree of recovery after transplantation for all cases and returned to normal in +1 2 months basically.In +1 ,+3,+6,+1 2 months after transplantation,the levels of CD4 +CD25 high +FOXP3 + in GVHD positive group and negative group were (0.4 ± 0.6)% and (1 .6 ±0.7)% respectively,(0.7 ±0.3)% and (2.7 ±0.4)% respectively,(1 .1 ±0.5 )% and (2.9 ±0.7)% respectively,(1 .4 ±0.3)% and (3.6 ±0.2)% respectively,which had statistical significance (P <0.05).Conclusions There was abnormal cell immune function in some cases with AA.After transplantation,the level of CD4 +CD25 high +FOXP3 + is closely related to the acute GVHD,which can be used to predict the occurrence of GVHD.