Treatment of gastric varices with partial splenic embolization in a patient with portal vein thrombosis and a myeloproliferative disorder

Therapeutic options for gastric variceal bleeding in the presence of extensive portal vein thrombosis associated with a myeloproliferative disorder are limited.We report a case of a young woman who presented with gastric variceal bleeding secondary to extensive splanchnic venous thrombosis due to a Janus kinase 2 mutation associated myeloproliferative disorder that was managed effectively with partial splenic embolization.

Study about bone marrow hematopoiesis cell cycle and cell apoptosis of Buzhong Yiqi-Pill on myelosuppressed mice

This experiment was designed to study about the regulation and mechanisms of Buzhong Yiqi-Pill on bone marrow hema topoietic system.Bone marrow inhibition of mouse model was established to simulate blood deficiency syndrome.Semi-solid agar culture assay of hematopoietic progenitor cells(HPC)in vitro and flow cytometry were used.To study the effect of Buzhong Yiqi-Pill on bone marrow hematopoietic function of myelosuppressed mice,HPC survival,colony forming rate,bone marrow call cycle and cell apoptosis was detected.

Juvenile myelo-monocytic leukemia (JMML): No effect of granulocyte monocyte-colony stimulating factor (GM-CSF) on Wilms Tumor gene (<i>WT</i>1) by nested Polymerase Chain Reaction (nPCR) and flow cytometry

This study was to determine whether GM-CSF induced WT1 gene expression and to establish an association with markers of proliferation CD71+CD34+ using nPCR and flow cytometry respectively, in samples obtained from 5 newly diagnosed JMML patients. Overtime (day 0 to day 14) there was an insignificant difference in WT1 gene expression and CD71+CD34+ in JMML samples when compared to peripheral blood of normal volunteers (n = 3). Our study suggests that there is a correlation between WT1 gene expression and cellular proliferation and that GMCSF in vitro does not create a significant difference in JMML samples.

Decitabine in combination with idarubicin within a modified busulfan/cyclophosphamide conditioning regimen for patients with advanced myelodysplastic syndrome:A prospective multicenter clinical cohort study

To the Editor:Allogeneic hemopoietic stem cell transplantation(allo-HSCT)represents the only long-term survival treatment choice for patients with myelodysplastic syndromes(MDS)and MDS/myeloproliferative neoplasm(MPN).Unfortunately,post-hemopoietic stem cell transplantation(HSCT)relapse remains a cause of treatment failure and the results of salvage treatments are poor.Developing better conditioning regimens is urgently needed.Previous studies have shown synergistic antileukemic effects between decitabine(DEC)and idarubicin(IDA).[1]In an attempt to design a conditioning strategy with very low toxicity but considerable myelosuppressive activity and potential immune-enhancing effects for patients with high-risk MDS and MDS/MPN,we combined DEC and IDA with busulfan,cyclophosphamide,andudarabine for a modied myeloablative regimen in this prospective,multicenter cohort study(hereafter referred to as the“DEC/IDA study”).

Specific myeloprotection via multidrug resistance 1 gene controlled by aminopeptidase N myeloid promoter

In the treatment of tumor patients introduction of multidrug resistance genes into hematopoietic cells has been reported as an approach for reducing myelotoxicity created by antitumor drugs. However, the nonspecific expression of the genes can also increase the chemoresistance of the tumor cells invaded into bone marrow, which influences seriously the effectiveness of chemotherapy. In this study, a new strategy is described for specific myeloprotection. The recombinant retroviral vector containing multidrug resistance 1 (MDR1) gene regulated by aminopeptidase N (APN) myeloid promoter was constructed and then introduced into myeloblastic cells KGla and tumor cell line BEL7402. The specific transcript of MDR1 was detected in KGla cells transduced with MDR1 gene and rhodamine 123 was effectively extruded by Pgp, the protein of MDR1 gene. The resistance elevated markedly by 10.6, 10.4, 11.2, 4.2 and 14.2 folds in MDR1 gene-transduced KGla cells to chemothera-peutic drugs such as cochicine, VP-16,

Curse and blessing:upregulation of oncogenes upon treatment with hypomethylating agents in myelodysplastic syndrome

In a recently published study in The New England Journal of Medicine,Liu and colleagues were able to demonstrate that-apart from the antileukemic effects previously reported for hypomethylating agents(HMAs)-treatment with these drugs can also lead to demethylation and subsequent upregulation of oncogenes resulting in shorter survival in patients with myelo-dysplastic syndrome(MDS).

GDF11 level in patients with myelodysplastic syndrome and is clinical significance

Objective To detect the expression level of growth differentiation factor 11(GDF11)in patients with myelodysplastic syndrome(MDS),and to evaluate the relationship between GDF11 level and erythropoiesis functions.Methods A total of 44 MDS patients(18 low-risk group patients and 26 high-risk group patients)in the Department of Hematology in Tianjin Medical

Decitabine-based conditioning regimen is feasible and effective in the treatment of myelodysplastic syndrome and chronic myelomonocytic leukemia

Objective To assess the efficacy and toxicity of decitabine-based conditioning regimen in patients with myelodysplastic syndrome(MDS),acute myeloid leukemia secondary to MDS(MDS-AML)or chronic myelomonocytic leukemia(CMML).Methods From March 1,2013 to May 25,2015,22 patients who underwent allogenic hematopoietic stem cell transplantation(allo-HSCT)with decitabine-based conditioning regimen were analyzed retrospectively.Results①22 patients,14 males and 8 females with a median age of 42.5(24-56)years old,were diagnosed as MDS(n=14),CMML(n=4),MDS-AML(n=4).②15 patients were treated with the conditioning regimen of decitabine combined with busulfan,cyclophosphamide,fludarabine,and cytarabine,the other 7 cases were treated with decitabine,busulfan,fludarabine,and cytarabine.The dose of decitabine was 20 mg·m^-2·d^-1 for 5 days.Rabbit anti-human anti-thymocyte globulin(2.5 mg·kg^-1·d^-1 for 4 days)was involved in conditioning regimen in patients with unrelated donor or haploidentical transplantation.③Except 1 patient died of infection in 2 months after transplantation,the other patients were engrafted successfully.The median time of granulocyte engraftment was 13(12-18)days,and the median time of platelet engraftment was 16(13-81)days.④The incidence of acute graft versus host disease(aGVHD)was(41.3±10.6)%,and severe aGVHD(grade ofⅢ-Ⅳ)was(18.4±9.7)%.The incidence of chronic graft versus host disease(cGVHD)was(56.4±11.3)%,and extensive cGVHD was(36.4±12.1)%.⑤8 patients were suffered with cytomegalovirus(CMV)viremia.Among the 18 patients with definite infection,6 occurred during myelosuppression and 12 cases occurred after hematopoietic reconstruction.The 2-year and 3-year nonrelapse mortality was(13.9±7.4)%and(24.3±9.5)%,respectively.⑥The 2-year and 3-year overallsurvival(OS)was(77.3±8.9)%and(67.9±10.0)%,respectively.The 2-year and 3-year relapsefreesurvival(RFS)was(72.7±9.5)%and(63.6±10.3)%,respectively.Conclusion allo-HSCT withdecitabine-based conditioning regimen is feasible in thetreatment of MDS,MDS-AML or CMML.

Prognostic factors of cyclosporine A combined with danazol with or without thalidomide in myelodysplastic syndrome treatment with low-percentage bone marrow blasts

Objective To explore the outcome of cyclosporine A(CsA) combined with danazol with or without thalidomide regimen for myelodysplastic syndrome (MDS) with low-percentage bone marrow blasts and predictive factors for treatment response.

Clinical and molecular characteristics of GATA2 related pediatric primary myelodysplastic syndrome

Objective To clarify the prevalence,clinical features and molecular characteristics of germline GATA2 mutations in pediatric primary myelodysplastic syndromes(MDS).Methods Next-generation sequencing technology was used to detect mutations in GATA2 and other myeloid malignancy genes in 129 children with primary MDS from Jan.2007 to Jan.2018.The relationship between genotypes and phenotypes was analyzed.Results Germline GATA2 mutations accounted for 8.5%(11/129)of all primary MDS cases,and 14.0%(11/50)of MDS with excess blasts(MDS-EB)and acute myeloid leukaemia with myelodysplasia-related changes(AMLMRC).Compared with GATA2 wild-type patients,GATA2 mutated patients were older at diagnosis[8(1-16)years old vs 6 years old(range:1 month old-18 years old),P=0.035]and higher risk of monosomy 7(72.7%vs 5.2%,P<0.001)and classified into MDS-EB and AML-MRC compared with refractory cytopenia of childhood(RCC)(63.6%vs 36.4%,P=0.111).The multivariate analysis showed SETBP1 mutation(P=0.041,OR=9.003,95%CI 1.098-73.787)and isolated monosomy 7(P=0.002,OR=24.835,95%CI 3.305-186.620)were significantly associated with germline mutated GATA2.Overall survival(OS)and outcomes of hematopoietic stem cell transplantation(HSCT)were not influenced by GATA2 mutational status.Conclusion Our data identify germline GATA2 mutations have a high prevalence in older pediatric patients with monosomy 7,and high risk of progression into advanced MDS subtypes.GATA2 mutation status does not affect OS in pediatric primary MDS.

Quantitative analysis of myelofibrosis and its prognostic significance in patients with myelodysplastic syndrome

Objective To quantitatively analyze the reticulin fiber intensity density (RFD) in patients with myelodysplastic syndrome (MDS) by using the computer-aided grid point method, and preliminarily explore its correlation with the prognosis of MDS patients.

脑血肿周围细胞间黏附分子-1 mRNA表达及白细胞浸润的实验研究

目的 探讨大鼠脑血肿周围细胞间黏附分子 1(ICAM 1)mRNA表达及白细胞浸润情况 ,明确脑血肿周围是否存在急性炎性反应。方法 胶原酶Ⅶ型脑立体定向注射制作脑出血模型 ,应用逆转录聚合酶链(RT PCR)技术检测ICAM 1mRNA表达 ;通过测定髓过氧化物酶 (MPO)活性来检测中性粒细胞的浸润情况。结果 脑出血后 6hICAM 1mRNA表达开始增加 (P <0 0 5 ) ,2 4h达高峰 (P <0 0 1) ,然后逐渐减退。脑出血后 2 4hMPO活性明显增加 (P <0 0 5 ) ,4 8h达高峰 (P <0 0 1) ,然后逐渐减退。结论 脑血肿周围存在明显的炎性反应 。

人血清骨钙素ELISA测定法及临床应用

采用酶联免疫学方法(ELISA)测定人血清完整骨钙素(BGP)水平,观察全年龄组BGP的正常人参考值范围,提出其在某些疾病中的临床意义。研究对象选取正常人254例,内科疾患79例,妇科妊高征8例。结果表明:BGP水平随年龄和性别变化,5～15岁青少组的BGP水平出现一明显峰值。与同年龄正常对照组相比,肾功能不全患者、佝偻病患儿、多发性骨髓瘤患者和骨质疏松患者BGP水平均升高(P<0.001,P<0.05,P<0.02及P<0.05);妊高征患者则低于对照组(P<0.05)。本研究结论:BGP作为骨代谢研究的灵敏指标,对某些与骨代谢有关的内科疾病的诊断及其严重程度的判别有参考意义。

电化学免疫传感器超灵敏检测髓过氧化物酶的研究

目的本研究拟建立一种电化学免疫传感器用于超灵敏检测人血清中髓过氧化物酶（MPO）水平的方法。方法通过石墨化多孔碳-金复合纳米材料（AuNPs@GMCs）将MPO抗体固定到玻碳电极表面,研制出一种新型MPO电化学免疫传感器,探讨了实验条件对传感器性能的影响,并与酶联免疫吸附试验（ELISA）进行方法学比较。结果在最优条件下该传感器对MPO反应灵敏,其线性范围为2.000-300.000ng/mL,相关系数为0.999,检出限为0.5ng/mL,与ELISA法检测结果的相关系数为0.983。结论该电化学免疫传感器可实现对MPO的超灵敏检测。

脊髓型颈椎病的MRI改变及其临床意义

目的探讨脊髓型颈椎病的MRI改变及其临床意义。方法回顾分析经手术和临床证实的脊髓型颈椎病23例的MRI改变。结果在全部患者的MRI上主要影像学改变为椎间隙变窄、椎间盘信号减弱、受累节段椎体后缘有信号减弱的致压物,受压颈髓弯曲、变形、向后移位等异常信号。结论MRI对脊髓型颈椎病的诊断、治疗方法选择和预后判断有重要价值。

氨肽酶N启动子调控的MnSOD基因对骨髓细胞的特异性辐射防护作用

背景与目的:骨髓造血细胞中导入耐辐射基因是克服放疗对造血系统抑制作用的有效手段,但这也增加了肿瘤细胞的辐射耐受性。本实验旨在探索不明显增加肿瘤细胞对辐射抗拒性的同时,能特异性保护骨髓细胞免受辐射导致的损伤的方法。方法:构建以氨肽酶N(aminopeptidaseN,APN)基因骨髓特异性启动子调控的锰超氧化物歧化酶(manganesesuperoxidedismutase,MnSOD)基因逆转录病毒载体,并导入成骨髓细胞KG1a和肝癌细胞BEL7402中。用RT-PCR分析MnSODmRNA水平,测定细胞中MnSOD活性,以细胞存活实验检测骨髓细胞和肝癌细胞对X射线的敏感性,并用流式细胞术和断裂DNA电泳方法对辐射诱导的细胞凋亡进行分析。结果:导入基因的KG1a细胞中MnSODmRNA水平和酶活性明显升高。APN骨髓特异性启动子调控的MnSOD基因表达能有效抑制辐射引起的KG1a细胞凋亡。导入基因的KG1a细胞对辐射的耐受性提高,在用10Gy剂量照射时,KG1a细胞存活率比原来增加3.7倍。而导入MnSOD基因并未使BEL7402细胞中MnSODmRNA水平和酶活性提高,其放射敏感性未发生明显变化。结论:APN骨髓特异性启动子能控制MnSOD基因在骨髓细胞中高表达,而在癌细胞中低表达。在用X射线杀伤癌细胞的过程中,APN骨髓特异性启动子调控的MnSOD基因能特异性保护骨髓细胞。

拓扑替康治疗晚期复发妇科恶性肿瘤的临床观察

目的 评价拓扑替康在晚期复发妇科恶性肿瘤治疗中的近期疗效及血液学毒性.方法 选择中国医学科学院肿瘤医院妇瘤科2011年11月至2014年2月收治的20例晚期妇科恶性肿瘤患者,完全随机分配11例应用拓扑替康周疗方案：3.5 mg/（m2·d）,第1、8、15天,每28天重复.另外9例为拓扑替康月疗方案（单药或联合）：1.25 mg/（m2·d）,第1～5天,每21天重复.中位疗程数为3个.从给药方式、复发类型、无铂间期、既往化疗方案数的不同观察拓扑替康用于晚期复发妇科恶性肿瘤的近期疗效和血液学毒性.结果 20例患者中,0例完全缓解,2例部分缓解,10例疾病稳定,8例疾病进展.拓扑替康周疗临床有效5例;月疗临床有效7例,其中联合治疗临床有效3例.铂敏感型复发5例,临床有效4例,铂耐药型复发15例,临床有效8例.3例月疗（3/9）和1例周疗（1/11）患者在疗程中或治疗后出现3或4级骨髓抑制,周疗方案的血液学毒性低于月疗方案.结论 拓扑替康用于铂敏感型或铂耐药型晚期妇科恶性肿瘤复发后的二线治疗效果较满意,周疗方案血液学毒性较低,耐受性较好.

双重滤过血浆分离置换法的应用及疗效

应用双重滤过血浆分离置换法（ＤＦＰＰ）治疗为数尚少的系统性红斑狼疮（ＳＬＥ）、多发性骨髓瘤（ＭＭ）和高脂血症（ＨＬ）。结果显示：ＤＦＰＰ对清除血液中大分子量蛋白形成的病因物质如与ＳＬＥ发病有关的抗体、ＨＬ患者的胆固醇（ＣＨＯ）、甘油三酯（ＴＧ）和载脂蛋白Ｂ（ＡＰＯＢ）等有较好的作用，同时可使ＭＭ患者的血尿酸下降和骨痛等症状明显减轻。而且ＤＦＰＰ的补液量少，减少了副作用，表明ＤＦＰＰ比标准血浆置换（ＰＥ）有较大的优点。

白血病化疗及造血干细胞移植对卵巢功能的影响

目的研究造血干细胞移植对卵巢功能的影响。方法观察45例因急性非淋巴细胞白血病分别接受同种异体造血干细胞移植(Allogeneicstemcelltransplantation,Allo-SCT)和自体造血干细胞移植(Autologousstemcelltransplantation,Auto-SCT)患者的月经恢复情况和性激素变化,同时抽取45名同年龄段健康妇女作为对照。结果Allo-SCT组有2例患者月经恢复,Auto-SCT组有4例恢复;移植时年龄越小,卵巢功能越易恢复。Allo-SCT和Au-to-SCT后促性腺激素较对照组显著升高,而雌激素显著降低,Allo-SCT患者雄激素也显著降低。结论造血干细胞移植后引起的卵巢功能降低主要是因为移植前化疗对卵巢的损害,但Allo-SCT引起的免疫调节障碍可进一步使卵巢功能减退。

Physical method of diagnosis

970208 MRI of aortic dissections: evaluation andcomparison of MRI, cine MRI and MRA. CHENZuwang(陈祖望), et al. Dept Radiol, ZhongshanHosp, Shanghai Med Univ, Shanghai, 200032. Chin JRadiol 1997; 31(1): 15-19. Objective: To evaluate and compare the value of spinecho(SE), cine MRI and MRA in diagnosing