Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the major curative treatment for patients with malignant hematologic diseases. However, a number of serious complications limits successful outcomes. Acute graft-versus-host disease(GVHD) is a major cause of death following allo-HSCT.The mortality rate is 50 % in Ⅱ -Ⅳ aGVHD. At present, the major prevention methods conclude inhibiting T cell activation and proliferation, depleting of T cell in graft, and decreasing the dose of preconditioning. And only one quarter of these patients will have a complete response to first-line corticosteroid therapy. Patients with steroid resistant acute GVHD require second-line therapy to which the response rate is only 30 %-50 %.Second-line therapies including monoclone antibody, chemotherapy and cytokine inhibitor were used. Secondline options can impair immune reconstitution and increase the risk for infection. Therefore, novel approaches to prevent and treat GVHD are critically needed. This work will review novel immuno-modulatory therapy currently being employed both for the prevention and treatment of GVHD.

OBJECTIVE:To explore the risk factors for nosocomial infection of multidrug-resistant organism (MDRO) in ICU,and to provide reference for preventing and controlling MDRO in ICU. METHODS:In retrospective study,246 patients with nosocomial infection from ICU of Xi'an Aerospace General Hospital (hereinafter referred to asour hospital) during Jan. 2011-Dec. 2015 were selected and divided into non-MDRO infection group (140 cases) and MDRO infection group (106 cases). The detection and drug resistance of MDRO were analyzed in MDRO group. Univariate analysis and binary Logistic regression anal-ysis were used to explore risk factors for nosocomial infection of MDRO. RESULTS:During 2011-2015,435 strains of MDRO were isolated from 106 MDRO infection patients,in which Gram-negative bacteria accounted for 89.43%,showing severe drug re-sistance. Univariate analysis showed that the following 13 factors were related to nosocomial infection of MDRO,such as ICU ad-mission time,hypoproteinemia,acute cerebrovascular diseases,renal abnormalities,mechanical ventilation time,arterivenous cath-eterization time,urethral catheterization time,indwelling gastric tube time,type and time of using antibiotics,combined use of an-tibiotics,application of carbapenems and the third generation caphalosporins(P<0.05). Binary Logistic regression analysis showed that acute cerebrovascular diseases,type and time of using antibiotics were the independent risk factors for nosocomial infection of MDRO in ICU [odds ratios were 2.816,1.582,1.265,95%CI were (1.540,5.151),(1.085,2.306),(1.131,1.415)]. CONCLU-SIONS:Some prevention and control measures should be taken actively for high-risk MDRO infection patients in ICU to reduce the incidence of nosocomial infection of MDRO and improve the quality of health care.

EphA1,the first member of the Eph receptor tyrosine kinase family,not only plays a pivotal role in embryonic development and angiogenesis,but also expresses in some types of adult human tissues.Its specific characteristics of Eph/ephrin binding and the Eph/ephrin signaling transduction are fundamentally involved in tumor initiation,progression and metastasis.The expression levels of EphA1 vary considerably in different types of normal tissues and tumors,or even in different phases of tumor development,suggestive of its functional pluralism.Intensive studies of EphA1 on angiogenesis,carcinogenesis and metastasis may provide a method for the early diagnosis and a potential target for the treatment of cancers.

Castleman's disease(CD),known as giant lymph node hyperplasia,is a rare lymphoproliferative disorder,whose etiology has not been definitively established.Clinically CD is categorized into unicentric and multicentric,and histologically,subdivided into three subtypes,hyaline vascular variant,plasma cell variant and mixed variant.Different variants usually require inconsistent therapeutic measures and have different prognoses.The present paper gives an overview of the pathogenesis,treatment and prognosis of CD,with emphasis on the stroma-rich variant,a special subtype of CD of the hyaline vascular variant.

Objective To study the correlation of nurse -perceived organizational atmosphere climate and their job involvement. Method About 465 clinical nurses were involved in the investigation by nursing organizational climate scale and work engagement scale. Results The total score on the organizational climate and job involvement were (149.24 ± 21.36) and (52.80 ± 6.31), respectively. The nurse -perceived organizational climate was positively correlated with job involvement ( P <0.01). Conclusions The nurse-perceived organizational climate and job involvement are at a medium level. Nursing managers should create a good organizational climate and promote their positive status into nursing, thereby improving the quality of care.

Objective To observe weight and serum leptin changes in epileptic women who taking valproate or topiramate. Method All 40 epileptic women were treated with valproate or topiramate. Weight and body mass index and serum leptin were measured before and after three months treatment. Result Nine of 20 patients taking valproate gained weight (≥4 kg), and their serum leptin concentration was increased as well [(13.2?3.6) ng/ml vs (7.4?3.0)ng/ml, P

Objective To explore the clinical efficacy and safety of mifepristone combined with misoprostol in the treatment of missed abortion.Methods According to the digital table,184 patients with missed abortion were randomly divided into study group and control group,92 cases in each group.The control group was given oral diethyl-stilbestrol underwent curettage,while the study group was given mifepristone combined with misoprostol therapy under-went curettage.The clinical therapeutic effect and adverse reaction were compared between the two groups.Results The effective rate of the study group after treatment was 95.65%,which was significantly higher than 86.96% of the control group,the difference was statistically significant(χ2 =4.38,P <0.05).Compared with the control group,in the study group,the operative time[(7.22 ±1.11)minute]observed significant relationship,intraoperative hemorrhage volume[(35.68 ±5.62)milliliter]decreased significantly,pregnancy natural rate of discharge(81.52%)was obvi-ously improved,artificial abortion syndrome incidence rate(3.26%)and again the rate of curettage(5.43%)was obviously decreased,and the differences were statistically significant(t =16.10,12.52,χ2 =7.84,8.87,15.93,all P <0.05).The clinical adverse reaction rate in the study group was 16.30%,which was significantly lower than 29.35% in the control group,the difference was statistically significant(χ2 =4.44,P <0.05).Conclusion Mife-pristone combined with misoprostol plays a complementary role,can improve the treatment of missed abortion and has good operation condition.It also can reduce the adverse reactions,complications and pain of patients.It is worth of clinical promotion.

At present,conventional whole brain radiotherapy is the standard treatment for brain metastases and prophylactic cranial irradiation,and it can improve patients' clinical symptoms and survival.However,whole brain radiotherapy may induce cognitive function impairment and affect patients' long-term quality of life.The newest radiotherapy technology can protect the hippocampal gyrus during whole brain radiotherapy and then protect cognitive function and improve quality of life.This article reviews the methods and clinical value of hippocampal gyrus protection in whole brain radiotherapy,as well as related advances.

Objective To summarize the clinical characteristics of Foix-Chavany-Marie syndrome.Methods The clinical,electroencephalography and imaging characteristics,as well as etiology,treatment and prognosis of 4 cases of Foix-Chavany-Marie syndrome were retrospectively evaluated,and relevant literature was reviewed to investigate its pathogenesis.Results All the 4 cases presented with hypersalivation,facial diplegia,dysarthria and dysphagia with autonomic-voluntary dissociation.Brain MRI showed bilateral cortical or subcortical lesions in the opercula and perisylvian areas.Three cases were secondary to encephalitis,and 1 case was related to perinatal hypoxic-ischemic encephalopathy.After administration of antiepileptic drugs,they were free of seizures.But all the other symptoms remained.Conclusions Autonomic-voluntary dissociation is a feature of Foix-Chavany-Marie syndrome.Most patients are due to bilateral structural or functional lesions between motor cortices and brain-stem cranial motor nuclei.The prognosis depends on the heterogeneous etiologies,such as encephalitis and cerebrovascular disease.

Abnormal expression of secreted protein acidic and rich in cysteine like 1 (SPARCL1 )gene is closely related to the development,metastasis and prognosis of a variety of tumors.Recent studies show that SPARCL1 gene is high expressed in glioma.The protein product of SPARCL1 gene encoded can interact with collagen,thus affecting the metastasis ability of tumor,which is positively correlated with tumor malignant de-gree.SPARCL1 gene is low expressed in gastric cancer,colorectal cancer,prostate cancer and breast cancer, which is negatively correlated with the invasion and metastasis abilities of tumors.At present,the role of speci-fic molecular mechanisms of SPARCL1 gene remains controversial. The expressions and functions of SPARCL1 gene in tumor tissues seem to depend on the tumor microenvironment.