Administration, Oral ; Adolescent ; Female ; Histiocytosis, Langerhans-Cell ; complications ; drug therapy ; pathology ; Humans ; Lymph Nodes ; pathology ; Prednisone ; administration & dosage ; therapeutic use ; Retrospective Studies ; Skin Ulcer ; drug therapy ; etiology ; pathology ; Thalidomide ; administration & dosage ; therapeutic use ; Treatment Outcome

Objective To explore the pathological basis and clinical characteristics of children with congenital choledochal cyst(CCC) combined with liver damage.Methods According to the age,38 patients with CCC were divided into 2 groups:group A had 24 cases(ranged 6 months to 3 years old);group B had 14 cases(ranged 4 to 14 years old).A comparative analysis of them was conducted retrospectively in the clinical characteristics,hepatic pathological changes,perioperatively liver function and operation.Results Group A was obvious higher than group B in jaundice,white bole stool and abdominal mass,but group B was more in stomachache.Group A was obvious higher than group B in liver function lesion,alkaline phosphatase,bilirubin increase and blood coagulation disfunction(Pa

Objective To investigate the correlation between dose volume histogram(DVH)of tumor targets and organs at risk(OAR)at CT-image based 192Ir brachytherapy and effects and complications for patients with locally advanced cervical cancer. Methods Ten patients with FIGO stage ⅢB cervical cancer received CT image-based 192Ir intracavitary brachytherapy after 54 Gy of three-dimentional four-field pelvic external beam radiotherapy and concurrent weekly cisplatin chemotherapy. Before each brachytherapy,CT images were acquired with applicators in place. Gross tumor volume(GTV), clinical target volume (CTV)and OAR were contoured and inverse treatment planning was designed and optimized by using PLATO treatment planning system. Conventional two-dimensional plans were also designed for comparison.The total intracavitary brachytherapy dose was 30 -42 Gy in 5 -7 fractions. The patients were followed, and the local control and complications were analyzed. The biologically equivalent dose(BED)and biologically equivalent dose in 2 Gy fractions(BED2)for GTV, CTV and OAR were calculated. The minimum dose in the most irradiated tissue volume 2 cm3(D2 cm3)adjacent to the applicator of the sigmoid colon, rectum,bladder and small bowel was determined from the DVH. Results The 1-year local pelvic control rate was 90% and grade 1-2 late complication of sigmoid colon and rectum was 50%. No grade 3 or more complications developed. On CT-image based planning, the BED and BED2 to 90% of the CTV(D90)were 95.50 Gy ± 7. 81 Gy and 79. 73 Gy ± 6. 57 Gy. The BED and BED2 to 90% of the GTV(D90)were 101.86 Gy ± 7.27 Gy and 84. 95 Gy ± 6. 1 Gy. The volume enclosed by 90% of prescribed dose(V90)for GTV and CTV were 92% ±4% and 87% ±7% respectively. The D2cm3 for rectum and sigmoid colon were 74. 97 Gy ±1.64 Gy and 67. 93 Gy ± 4. 30 Gy(EQD2, α/β = 3). Comparing with 2D brachytherapy plans , CT - image based planning has improved D90 and V90 for GTV and CTV with similar dose at point A and rectum reference point. Conclusions Computer tomography-image based 192Ir brachytherapy has resulted in the better dose distribution to the tumor targets with excellent tumor control and acceptable toxicity.

Objective To retrospectively analyze and compare the curative outcome of hematopoietic stem cell transplantation (HSCT) from HLA identical siblings vs intensive immunosuppression therapy (IST) for severe aplastic anemia (SAA).Methods From January 2008 to December 2010,41 patients with severe aplastic anemia were treated with related HSCT (n =14) or IST (n =27) which combined antithymocyte globulin (ATG) with cyclosporine-A (CsA) therapy.Results All the patients receiving HSCT reached complete response.Among the patients receiving IST,21 patients could be responsive to the therapy,and 2 patients died.There was significant difference in the response rate between HSCT group and IST group (100 ％ vs 77.8 ％,P＜0.01 ).Conclusion With the improvement of HSCT technology,the curative outcome of HSCT from HLA identical siblings for SAA is much better than IST.

Objective To evaluate the outcome of combination of intensive preconditioning regimen allo-HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia (ALL). Methods Between 2009 and 2010, 8 patients diagnosed as Ph+ ALL received allo-HSCT from HLA identical sibling during complete remission. Imatinib was added into the therapies of 5 patients.Seven patients received the intensive preconditioning regimen based on BuCy2, one patient received the regimen of TBI-Cy. A median of 6. 02 × 108/kg mononuclear cells and 3. 14 × 106/kg CD34+ cells were transfused. GVHD prophylaxis included cyclosporine A and methotrexate. Results All patients were well tolerant to the regimen without serious regimen-related toxicity. The median time of ANC≥0. 5 × 109/L was 15. 5 days, and that of PLT≥20 × 109/L was 19 days. Thirty days after allo-HSCT, all patients got donor engraftment successfully. Among 8 cases, 4 cases presented acute GVHD, 2 developed degree Ⅰ , one developed degree Ⅱ , and one developed degree Ⅳ. Seven patients were alive 100 days after allo-HSCT, 3 of whom presented chronic GVHD. At the end of following-up period, 6 patients were alive, among them, 3 patients were alive without relapse; 3 patients relapsed; Two patients died, one from acute GVHD, and one from leukemia relapse. Conclusion Combined intensive preconditioning regimen allo-HSCT with Imatinib was an effective treatment for Ph+ ALL, but the effect of anti-chronic GVHD of imatinib should arouse certain attention.

Objective To optimize the concentration of polyethylene glycol (PEG) for the growth of Chlamydia trachomatis (Ct) reference strains D-UW-5/Cx and E-UW-5/Cx,and to evaluate the effects of PEG on the sensitivity of Ct to 4 common antibiotics.Methods After the inoculation of Ct standard strains (D-UW-5/Cx and E-UW-5/Cx) into McCoy cell monolayer,different concentrations of PEG were added into the culture medium followed by centrifugation.After 2 hours of incubation at 37 ℃,the inoculum was removed and a complete culture medium containing 1 μg/mL cycloheximide was added followed by another 48-hour culture.Subsequently,the culture was fixed and subjected to iodine staining for the calculation of Ct inclusions and optimization of PEG for the growth of Ct.Some Ct standard strains were used to infect McCoy cells,with PEG (0.7％,wt/vol) added to the culture medium after inoculation and before centrifugation process,and when the infection rate reached higher than 90％,a microdilution method was utilized to evaluate the minimal inhibitory concentration (MIC) of 4 antibiotics,including azithromycin,minocyline,moxifloxacin and doxycycline.Thirty-one clinical specimens,which had been confirmed to be positive for Ct serovar D or E strain,were inoculated into McCoy cell monolayer for the passage of Ct with or without the presence of 0.7％ PEG.Results The optimal concentration of PEG was 0.7％ for the growth of Ct,and this concentration of PEG could increase the number of inclusion bodies of Ct serovar E by 3.44 folds,and that of Ct serovar D by 3.56 folds.In vitro,the MICs of the 4 antibiotics were consistent between PEG-treated and untreated Ct reference strains.Moreover,PEG notably increased the quantity of inclusion bodies of Ct serovar E or D from clinical specimens after passages.Conclusions PEG (0.7％) can enhance the growth of Ct serovar D and E,but has no obvious influence on antimicrobial susceptibility of Ct.

ObjectiveTo detect the changes of heat shock protein 60 (HSP60) during the subcultures of standard and clinical strains of Chlamydia trachomatis(Ct),and to determine if the absence of chlamydial inclusions is associated with the persistent infection of Ct.MethodsA total of 40 Ct strains isolated by cell culture from patients were included in this study and classified into 2 groups according to whether inclusions appeared after initial culture.Reverse transcription PCR was conducted to quantify the levels of HSP60 in specimens containing Ct after 1-4 subcuhures.Chi-squared test was performed to analyze the relationship between the levels of HSP60 and treatment outcomes of patients.ResultsThe levels of HSP60 in clinical specimens containing Ct serovar E were significantly higher in subcultures prior to the appearance of inclusions than in subcultures with the appearance of inclusions(P ＜ 0.05).The ratio of HSP60:16S rRNA mRNA expression after the first,second,third,fourth passage was 0.38 ± 0.06,0.39 ± 0.03,0.38 ± 0.04 and 0.39 ±0.03 respectively in 18 specimens with inclusions appearing after the initial culture,1.18 ± 0.10,0.28 ± 0.06,0.30 ± 0.03 and 0.29 ± 0.05 respectively in 12 specimens with inclusions appearing after the second culture,1.20 ± 0.04,1.20 ± 0.04,0.28 ± 0.04 and 0.28 ± 0.05 in 10 specimens with inclusions appearing after the third culture.Whether inclusions appeared after the initial culture was associated with the treatment outcome of patients.Inclusions were undetected after the initial culture in 16 of 20 specimens from patients with poor response to treatment,but observed in 14 of 20 specimens from patients who tested negative for Ct after one course of treatment.Conclusions It is implicated that no inclusions form after the initial culture in 80％ of specimens from patients experiencing treatment failure.The Ct strains whose inclusions do not form after passages may be in a persistent state,and the expression of HSP60 is high in these strains.Specimens should be subjected to at least 3 blind passages to avoid missed diagnosis of Ct infection.

Objective To analyze the outcome of idarubicin-intensified myeloablastive conditioning regimen in allogeneic peripheral blood stem cell transplantation (allo-PBSCT) in patients with myelodysplastic syndromes (MDS). Methods From August 2004 to July 2009, 12 patients with MDS were treated with alIo-PBSCT following the idarubicin-intensified conditioning regimen. The conditioning regimen was idarubicin (15 mg/m~2), continuous intravenous infusion for 20 h, days-12 to-10; busulfan (0.8 mg/kg), intravenous infusion every 6 h, days-6 to-4; cyclophosphamide (1.8 g/m~2), intravenous infusion every 6 h, days-3 to-2; cyclosporine A combined with short-term methotrexate was used for the prophylaxes of acute graft versus host disease (aGVHD). Results All twelve patients achieved Trilineage engraftment, and were well tolerated to this regimen. Eight patients survived, and the overall survival was 66.7%, disease-free survival (DFS) 58.3%. Two patients relapsed. OS for neither WHO subgroups nor IPSS subgroups had statistically significant difference. Conclusion Allo-PBSCT with idarubicin-inteusified conditioning regimen is an effective treatment with reduction of the relapse rate for MDS patients.

Objective To investigate the expression of cyclin kinase inhibitor P21~(WAF1) and P27~(KIP1)in children with acute leukemia and its clinical significance.Methods A total of 32 hospitalized children with acute leukemia(AL) were included in this study.Their bone marrow samples were collected before chemotherapy and individual patient was detected after complete remission(CR).The method of immunocytochemistry was used to estimate the expression of P21~(WAF1) and P27~(KIP1).Both positive percentage and intensity of the cells were counted.Results Findings showed that the positive ratios of P21~(WAF1) and P27~(KIP1) in total samples,ALL samples and AML samples were lower than the control group(P

Objective: To investigate the relationship between P27，P53 and PCNA expression in human gastric carcinoma tissues and clinicopathological parameters. Methods: The expression of P27，P53 and PCNA in 62 human gastric carcinoma tissues was examined with immunohistochemistry SP method. Results: Positive rates of P27，P53 and PCNA expression were 37.1％, 40.4%，83.9％. P27 expression was related with Bormann type, infiltrative depth, lymph node and distant metastasis and clinical stage. P53 expression was related with sex of patients, distant metastasis and clinical stage. PCNA expression was related with age of patients and infiltrative depth of tumor. P27 positive expression group was higher than negative group as to 5-year survival. P27 expression was in reverse relation with PCNA expression. Conclusion: The expression of P27, P53 and PCNA may be regarded as an important marker in judging malignant degree of gastric carcinoma,distant metastasis and prognosis.