[A group of occupational acute methyl bromide poisoning incident]

Objective: To investigate a mass of occupational acute methyl bromide poisoning incident and analyzed their clinical data. Methods: To investigate an incident a mass of occupational acute methyl bromide poisoning in occurred in Shandong province in November 2016, and the clinical datas of 3 cases of severe patients with methyl bromide poisoning were analysed. Results: This event was a sudden occupational poisoning incident. Lack of vocational training and irregularities is the main reason for the accident 3 patients with nervous system, respiratory system, circulatory system, urinary system damage is given priority to, after comprehensive rescue treatment, 2 cases died and 1 case survived. Conclusions: Methyl bromide can cause severe poisoning, has high mortality in patients with acute severe poisoning.

[Changes and the impact on immune function of opioid-dependent subjects by Jitai tabelets during the withdrawal stage]

Objective: To detect the changes in the immune function of opioid-dependent subjects during the withdrawal stage through the administration of Jitai tablet. Methods: Subjects were treated as Jitai tablet alone, Jitai tablet plus buprenorphine and placebo, in a randomized,double-blind, placebo-controlled trial. Before and after the 14(th) day of withdrawal, levels of immunoglobulin (IgM, IgA, IgG), T cell subsets (CD(3)(+), CD(4)(+), CD(8)(+), CD(4)(+)/CD(8)(+)) and cytokines (IL-2, IFN-γ, IL-4, IFN-γ/IL-4) were detected. Results: Compared with healthy people, immunity function before withdrawal among the opioid abusers showed higher levels of IgM, IL-2, IFN-γ, IL-4 and lower level of CD(3)(+)T, as (1.67±0.87) g/L, (14.44±13.50)%, (20.23±15.10)%, (1.97±1.59)%, (47.01±13.62)%, respectively, with difference statistically significant (P<0.05). There was no big difference of other immunity indicators between the two groups (P>0.05). At the 14(th) day of withdrawal in placebo group, levels of IL-4 returned to normal while IFN-γ/IL-4 ratio increased by 3.43 times (P<0.05). Levels of IgA, IgG, CD(4)(+) and CD(4)(+)/CD(8)(+) ratio fluctuated within normal range. There were no significant changes in other immunity indicators (P>0.05). Compared with placebo group, fluctuation of IgG and IgM decreased in Jitai group during withdrawal period, together with a normal level of IgM at the 14(th) day. Level of IL-4 abnormally rose up by 0.54 times in Jitai tablet plus buprenorphine group, while IFN-γ/IL-4 ratio been switched back at the 14(th) day of withdrawal. Other immune indicators were not affected by medical interventions. Conclusion: We noticed that certain impairment of the immune function might be restored by Jitai tablet during the withdrawal period.

[Post-marketing surveillance of Tanreqing injection in children: a real world study]

Objective: To evaluate the safety of Tanreqing injection among children in the real world. Methods: A multicenter, large sample, ambispective cohort study, with registration-type clinical safety monitoring. A total of 6 188 inpatients and patients from the emergency units, aged ≤ 14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China, were recruited between January, 2014 and May, 2015. The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection. Univariate analysis was used to explain the risk factors of ADR. Results: The overall incidence of ADE was 4.20‰ (26 cases), including 4 serious ones. The incidence of ADR was 3.07‰ (19 cases), including 17 cases of general ADR and 2 cases of new ADR. All the ADR cases were mild or moderate, mostly showing damages in skin and appendages. The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured. Having histories of allergies to drugs or foods would increase the incidence of ADR. Conclusion:Tanreqing injection caused low incidence of ADR in children. Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.

[Determination of relative elements of hard metal in workplace air and urine by inductive coupled plama]

Objective: To establish a rapid detection method regarding the air conditions of workplace and the workers' urine included Tungsten, Cobalt, Nickel, Titanium, Cadmium, Manganese, Lead and its compounds based on inductively coupled plasma mass spectrometry (ICP-MS) . Methods: The experiment adopts ICP-MS to deter-mine those metals in workshop air and workers urine, evaluate the detection's limitation, the precision and accuracy of the method. Using the membrane filter and urine freeze - dried metal standard material to verify this method. Results: Each element of correlation coefficient was greater than 0.999. The recovery rate of air samples was 91.6%~104.6%, within-batch RSD precision was 1.41%~3.50%, between-run precision was 1.28%~4.31%, urine samples recovery rate was 93.0%~102.6%, within - batch RSD precision was 1.25%~3.56%, between - run precision was 1.58%~4.67%, According to the method every element was within the scope of the standard reference, it was also showed that the established method is accurate and reliable. Conclusion: ICP-MS is an effective and feasible method to detect the workshop air and the workers' urine which included Tungsten, Cobalt, Nickel, Titanium, Cadmium, Manganese, Lead and its compounds.

[Primary central nervous system diffuse large B cell lymphoma: a clinicopathologic and molecular study]

Objective: To investigate clinicopathologic characteristics, immunophenotype and EB virus-related molecular genetic alterations in primary central nervous system diffuse large B cell lymphoma (DLBCL) along with correlation with clinical prognosis. Methods: A total of 30 cases of primary central nervous system DLBCL were retrospectively studied by retrieving clinical data, histological evaluation and immunophenotyping by EnVision two steps methods. The expression of EBER mRNA was detected by in situ hybridization and bcl-2, bcl-6 and C-MYC gene abnormalities were analyzed by interphase fluorescence in situ hybridization. Results: The cases included 18 males and 12 females (sex ratio of 1.5∶1.0) with an age ranging from 24 to 78 years (average age of 52 years, the median age of 53 years). The single primary clinical presentation was focal neurologic deficits. Tumor locations were supratentorial (21 cases), subtentorial (7 cases), involving both locations in 2 cases. Diffuse growth pattern was observed with large lymphoid cells mostly resembling centroblasts with abundant basophilic cytoplasm with oval to round, vesicular nuclei containing fine chromatin. An angiocentric and angiodestructive growth pattern was also present. Other features included perivascular space invasion. Immunohistochemical staining using a panel of CD10, bcl-6 and MUM1, six cases were germinal center-like (GCB) and 24 cases were non-germinal central-like (non-GCB). The positive rates of bcl-2, bcl-6 and C-MYC were 53.3% (16/30), 80.0% (24/30) and 20.0% (6/30), respectively. Genetic alterations were detected by FISH and the gene arrangement rates of bcl-2, bcl-6 and C-MYC were 3.3% (1/30), 16.7% (5/30) and 3.3% (1/30), respectively. There were 19 cases in stage 0-1 disease and 11 cases had stage 2-3 disease. Postoperative follow-up for average 13.6 months showed the median survival of 10 months, one-year survival of 46.7% and 16 patients died within a year. Conclusions: The clinical prognosis of primary central nerve system DLBCL depends on age, clinical performence status score, IPI score, immune classification and treatment. Patients typically progress rapidly with the high mortality within one year of diagnosis. Surgical resection combined with high-dose methotrexate or cytarabine chemotherapy offer the best treatment option.

[The efficacy of large spot indirect ophthalmoscopy laser alone or combined with systemic chemotherapy in retinoblastoma therapy]

Objective: To evaluate the efficacy of large spot indirect ophthalmoscopy laser alone or combined with systemic chemotherapy in the treatment of early and middle stage retinoblastoma. Methods: Retrospective series case study. Clinical data of 21 patients (22 eyes) who were diagnosed as retinoblastoma (RB) in Peking University People's Hospital from March 2009 to August 2014 were collected. Medical and family history, ocular ultrasound, orbital and cranial MRI or CT examination of RB Children were detailed recorded. Ocular examination and laser treatment were performed under general anesthesia, once every 3-4 weeks until the tumor was under control. The observation period was at least 3 months after the last treatment. The ocular examination included intraocular pressure measurement, anterior segment and fundus examination and the fundus photography with Retcam. Laser therapeutic instrument was large spot indirect ophthalmoscopy laser of 810nm wavelength. Results: Of the 21 children, 16 were male and 5 were female. The range of age was 3 to 82 months averaged 17.3 months. Among 22 eyes, four with small tumor, eight with medium tumor, and ten with large tumor. Two eyes underwent laser treatment only and 20 eyes underwent laser treatment combined with systemic chemotherapy. During the average observation period of 33.9 months, 15 tumors were treated successfully, but 7 failed. The total success rate was 68.2%. The number and success rate of small, medium and large tumor eyes were 4 (100%), 5 (62.5%) and 5 (50%), respectively. There was one case of tumor brain metastases, and the classification of contralateral eye of the child was E phase.

COMPLICATIONS

Iris burns happened in one eye, obvious vitreous proliferation in one eye and mild vitreous hemorrhage occurred in two eyes, which did not affect the treatment of laser. However, obvious tumor hemorrhage happened in two eyes and affected laser therapy. There was no complicated cataract, iatrogenic retinal hole and tumor intravitreal implant caused by laser blasting effect. Conclusions: Indirect ophthalmoscope laser in 810-nm diode laser with large-spot alone or combined with systemic chemotherapy may be effective treatment for retinoblastoma in earlier than stage C of international classification. It is suitable for large and multiple retinoblastoma.(Chin J Ophthalmol, 2016, 52: 745-748).

[The clinical feature and outcomes of severe aplastic anemia patients suffered from bacteremia following antithymocyte globulin]

Objective: To assess the clinical feature and outcomes of severe aplastic anemia (SAA) patients suffered from bacteremia following antithymocyte globulin (ATG). Methods: A total of 264 cases hospitalized in our hospital between Jan 2000 and July 2011 were enrolled into this study. We evaluated the associated pathogens of bacteremia, analyzed the risk factors by Logistic regression and estimated the overall survival (OS) by Kaplan-Meier method for the cohort of patients. Results: Bloodstream infections occurred in 49 patients, with a median age of 20 (4-62) years, including 38 cases with very SAA (VSAA) and 11 SAA patients. The median time of bacteremia was 13 (2-233) days following ATG administration. The most common microbiologically were Enterobacteriaceae (28.4% ), Pseudomonas aeruginosa (20.9% ) and Klebsiella pneumonia (14.9% ). Almost half (46.9% ) of these bacteria were resistant to most or all available antibacterial classes. Univariate and multivariate analyses demonstrated that VSAA, infections during previous week before ATG treatment were risk factors for bacteremia. The 3 and 6 months response rates (10.6% and 17.0% ) were poor in the patients with bloodstream infections, which were significantly lower than those patients without infections (35.6% and 55.6%, respectively, both P<0.001). The estimated 5-year OS were 36.4% (95%CI 21.3% to 51.5%) and 74.5% (95%CI 68.4% to 80.7%) in the two groups, respectively (P<0.001). Conclusions: ①VSAA has higher risk of bacteremia than SAA; ②Infections during previous week before ATG administration was a risk factor for bacteremia; ③ The outcomes of SAA or VSAA patients suffered from bacteremia following ATG was poor.

[Spatial-temporal analysis of pulmonary tuberculosis in Shandong province, 2015]

Objective: To analyze the spatial-temporal epidemiological characteristics of active pulmonary tuberculosis (PTB) and sputum smear positive (SS+) PTB in Shandong province, China, 2015. Methods: The surveillance data of active PTB and SS+PTB in Shandong in 2015 were collected and analyzed by using the global and local indicators of spatial association (Moran's I) for the spatial autocorrelation of PTB, and by using SaTScan forspatial-temporal clustering characteristics of PTB based on geographic information system. Results: Totally, 31 776 active PTB cases and 8 631 SS+PTB cases were reported in Shandong in 2015, and the reported incidence rates of active PTB and SS+PTB were 33.09/100 000 and 8.99/100 000, respectively. Active PTB had positive spatial autocorrelation at county level, and the value of Moran's I value was 0.219 (P<0.001), indicating that the high-high (HH) aggregation areas with high incidence were in the northwestern, southeastern and central southern Shandong; SS+PTB also had positive spatial autocorrelation at county level, and the value of the Moran's I was 1.178 (P<0.001), indicating that the HH aggregation areas with high incidence were in the southeastern and northwestern Shandong. The results of spatial-temporal scanning indicated that there was incidence clustering of active PTB in the second quarter and the third quarter in 2015, and the clustering areas were in the central southern, southeastern and northwestern Shandong; there also was incidence clustering of SS+PTB in the second quarter and the third quarter in 2015, and the clustering areas were in the southeastern and northwestern Shandong. Conclusions: The incidence of active PTB and SS+PTB showed spatial and temporal clustering in Shandong in 2015. The areas with high PTB burden and high PTB transmission risks were in the northwestern and southeastern Shandong. The areas with high PTB burden but without high PTB transmission risks were in the central southern Shandong.

Identification of protease m1 zinc metalloprotease conferring resistance to deltamethrin by characterization of an AFLP marker in Culex pipiens pallens

BACKGROUND

Continuous and excessive application of deltamethrin (DM) has resulted in the rapid development of insecticide resistance in Culex pipiens pallens. The quantitative trait loci (QTL) responsible for resistance to DM had previously been detected in Cx. pipiens pallens. But locating the QTLs on the chromosomes remained difficult. An available approach is to first characterize DNA molecular markers linked with the phenotype, and then identify candidate genes.

METHODS

In this study, the amplified fragment length polymorphism (AFLP) marker L3A8.177 associated with the QTL, was characterized. We searched for potential candidate genes in the flank region of L3A8.177 in the genome sequence of the closely related Cx. pipiens quinquefasciatus and conducted mRNA expression analysis of the candidate gene via quantitative real-time PCR. Then the relationship between DM resistance and the candidate gene was identified using RNAi and American CDC Bottle Bioassay in vivo. We also cloned the ORF sequences of the candidate gene from both susceptible and resistant mosquitoes.

RESULTS

The genes CYP6CP1 and protease m1 zinc metalloprotease were in the flank region of L3A8.177 and had significantly different expression levels between susceptible and resistant strains. Protease m1 zinc metalloprotease was significantly up-regulated in the susceptible strains compared with the resistant and remained over-expressed in the susceptible field-collected strains. For deduced amino acid sequences of protease m1 zinc metalloprotease, there was no difference between susceptible and resistant mosquitoes. Knockdown of protease m1 zinc metalloprotease not only decreased the sensitivity of mosquitoes to DM in the susceptible strain but also increased the expression of CYP6CP1, suggesting the role of protease m1 zinc metalloprotease in resistance may be involved in the regulation of the P450 gene expression.

CONCLUSION

Our study represents an example of candidate genes derived from the AFLP marker associated with the QTL and provides the first evidence that protease m1 zinc metalloprotease may play a role in the regulation of DM resistance in Cx. pipiens pallens.

Clinical Analysis of 70 Adult Patients with Paroxysmal Nocturnal Hemoglobinuria

OBJECTIVE

To investigate the clinical characteristics of Chinese patients with paroxysmal nocturnal hemoglobinuria (PNH).

METHODS

The clinical data of 70 adult PNH cases in our hospital from January 2000 to December 2009 were analyzed retrospectively, and the clinical manifestation, laboratory examination, treatment, complications and prognostic factors influencing survival rate were assessed.

RESULTS

The nosopoietic median age of 70 cases(41 male cases and 29 female cases) was 37 (18-73) years old. The clinical manifestation included fatigue (87.1%), hemogolobinuria (44.3%), infection (22.9%), bleeding (37.1%), and abdominal pain (2.9%). FHb (free hemoglobin) in 56 patients (80%) was <50 mg/L. Hp (haptoglobin) in 54 patients (77.1%) was <0.5 g/L, and LDH in 49 patients (70.0%) was <220 U/L. The overall 10 year-survival rate after diagnosis was 72.2% estimated by Kaplan-Meier. The complications in this study were as follow: recurrent abdominal pain crisis (2.9%), infections (30.0%), thrombotic events (8.6%), evolution to MDS/AML (5.7%), calculus (11.4%) and death (17.1%). Both univariate and multivariate analyses identified risk factors affecting survival, including development of thrombotic events, progression to myelodysplastic syndrome or acute myelogenous leukemia (MDS/AML) and recurrent infections.

CONCLUSION

This larger number of cases for the first time allowed us to carry out a detailed analysis of prognostic factors for this rare disease. Evaluation of PNH prognostic factors may provide a basis to assess the current and future therapies of this disease.

Label-free aptasensor for adenosine deaminase sensing based on fluorescence turn-on

A label-free and fluorescence turn-on aptamer biosensor has been developed for the detection of adenosine deaminase (ADA) activity with simplicity and selectivity. Adenosine aptamer will form a tight stem-loop structure upon binding with adenosine. In the absence of ADA, only a small quantity of picagreen intercalates into the stem section of aptamer, resulting in a low fluorescence of picagreen when excited at 490 nm. Interestingly, after the addition of ADA, adenosine is hydrolyzed to inosine, and the released aptamer forms double-stranded DNA (dsDNA) with its complementary single-stranded DNAc, followed by the intercalation of picagreen to dsDNA. When the solution is excited, picagreen emits strong green fluorescence. The increased fluorescence intensity of picagreen is dependent on the concentration of ADA. The detection limit of the ADA is determined to be 2 U L(-1), which is lower than ADA cutoff value (4 U L(-1)) in the clinical requirement and more sensitive than most of the reported methods. Compared to other previous ADA sensors, the assay is not only label-free but also a turn-on signal, and possesses properties of lower cost and simpler detection system. Furthermore, this label-free strategy is also applicable to the assay of other enzymes and screening of corresponding inhibitors.

Curative effect and safety of intrathecal transplantation of neural stem cells for the treatment of cerebral hemorrhage

In this study, we aimed to explore the curative effect and safety of neural stem cell intrathecal transplantation for the treatment of cerebral hemorrhage. We transplanted 4.0 x 10(8) neural stem cells per procedure into the subarachnoid space by lumbar puncture 7 days after cerebral hemorrhage, twice a week, a total of 4 times. NIHSS scores and brain CT scans were conducted to assess neural functions and the volume of perihematoma lesions in patients on days 1, 7, 14, 21, and 28. We found that the NIHSS scores and the volume of the perihematoma lesions were significantly reduced after day 14. The differences before and after treatment were highly significant in intra- and between-group comparisons (P < 0.05). There were no adverse reactions, except for transient fever and shivering in a few patients. Our data suggest that the use of neural stem cells in intrathecal transplantation for the treatment of cerebral hemorrhage is safe and effective.

Catheter-directed thrombolysis in the treatment of acute deep venous thrombosis: a meta-analysis

We performed a meta-analysis for systematic evaluation of the status quo of catheter thrombolysis for the treatment of acute lower limb deep vein thrombosis in China. We searched the China Biomedical bibliographic database (CBM), China National Knowledge Infrastructure (CNKI), Weipu full-text electronic journals, Wanfang full-text database, and Medline (1990 through June 2011) for clinical randomized controlled trials of catheter-directed thrombolysis and superficial venous thrombolysis to compare their efficacies for the treatment of acute deep vein thrombosis. The results were analyzed by using the Cochrane-recommended RevMan 4.2 software package, and the odds ratio (OR) was used as the combined measure of efficacy. The search retrieved 8 randomized controlled trials, and meta-analysis using the total rate of effective treatment as the clinical observation index found that the combined OR for the catheter thrombolysis group versus the superficial venous thrombolysis group was significant (P < 0.01; OR = 11.78; 95% confidence interval = 6.99-19.87). In conclusion, the meta-analysis indicated that catheter thrombolysis was more effective than superficial venous thrombolysis for the treatment of acute deep vein thrombosis in the lower limb in Chinese individuals. However, the included trials were only of medium quality, so more rational and scientific clinical trials are needed to validate this conclusion.

Preparation and malachite green adsorption behavior of polyurethane/chitosan composite foam

A series of Polyurethane/Chitosan composite foam with different chitosan content of 5–25 wt% was prepared, and their adsorption performance of malachite green (MG) in aqueous solutions was investigated by pH values, contact time, temperatures and chitosan content. It was observed that Polyurethane/Chitosan composite foam exhibited well-developed open cell structures. Malachite green adsorption capacities of the composite foam increased with the increment of chitosan content in composite foam. Polyurethane/Chitosan composite foam with 20% chitosan content exhibited a maximum removal capacity of 16.67 mg/g and 95.60% MG removal efficiency. In addition, MG adsorption capacities of composite foam increased with pH value increase, 30℃ was the optimum temperature, which affects the adsorption process, and the adsorption maximum was attained within 12 hours. The result of SEM showed the prepared composite foam possess well-developed open cell structures. The MG adsorption kinetics and equilibrium isotherm of the composite foam were well described with the pseudo-second order kinetic model and Langmuir isotherm model, respectively. This work provided an attractive adsorbent for removing of the hazardous materials from water.

Study on a negative hydrogen ion source with hot cathode arc discharge

A negative hydrogen (H(-)) ion source with hot cathode arc discharge was designed and fabricated as a primary injector for a 10 MeV PET cyclotron at IMP. 1 mA dc H(-) beam with ɛ N, RMS = 0.08 π mm mrad was extracted at 25 kV. Halbach hexapole was adopted to confine the plasma. The state of arc discharge, the parameters including filament current, arc current, gas pressure, plasma electrode bias, and the ratio of I(e(-))/I(H(-)) were experimentally studied. The discussion on the result, and opinions to improve the source were given.

Toll-like receptor 3 polymorphism is not associated with neovascular age-related macular degeneration and polypoidal choroidal vasculopathy in the Chinese

Toll-like receptor 3 (TLR3) variants in mainland northern Chinese patients with polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (nAMD) were investigated. The complete genes of TLR3, including all exons and the promoter region, were assessed using direct sequencing technology of 284 unrelated mainland northern Chinese individuals: 96 nAMD patients, 92 PCV patients, and 96 controls. Six single nucleotide polymorphisms were identified: rs5743303, rs5743305, rs5743312, rs3775291, rs3775290, and rs6830345. The distribution of TLR3 genotypes for nAMD and PCV was not significantly different compared with normal controls. This study indicates that the TLR3 gene polymorphism is not associated with nAMD and PCV in northern Chinese patients.

Quantifying climate and management effects on regional crop yield and nitrogen leaching in the north china plain

Better water and nitrogen (N) management requires better understanding of soil water and N balances and their effects on crop yield under various climate and soil conditions. In this study, the calibrated Root Zone Water Quality Model (RZWQM2) was used to assess crop yield and N leaching under current and alternative management practices in a double-cropped wheat ( L.) and maize ( L.) system under long-term weather conditions (1970-2009) for dominant soil types at 15 locations in the North China Plain. The results provided quantitative long-term variation of deep seepage and N leaching at these locations, which strengthened the existing qualitative knowledge for site-specific management of water and N. In general, the current management practices showed high residual soil N and N leaching in the region, with the amounts varying between crops and from location to location and from year to year. Seasonal rainfall explained 39 to 84% of the variability in N leaching (1970-2009) in maize across locations, while for wheat, its relationship with N leaching was significant ( < 0.01) only at five locations. When N and/or irrigation inputs were reduced to 40 to 80% of their current levels, N leaching generally responded more to N rate than to irrigation, while the reverse was true for crop yield at most locations. Matching N input with crop requirements under limited water conditions helped achieve lower N leaching without considerable soil N accumulation. Based on the long-term simulation results and water resources availability in the region, it is recommended to irrigate at 60 to 80% of the current water levels and fertilize only at 40 to 60% of the current N rate to minimizing N leaching without compromising crop yield.

Down-regulation of TCF21 is associated with poor survival in clear cell renal cell carcinoma

Transcription factor 21 (TCF21) has been identified as a candidate tumor suppressor at 6q23-q24 that is epigenetically inactivated in many types of human cancers. We recently found that TCF21 methylation level was significantly increased in clear cell renal cell carcinoma (ccRCC). The purpose of this study was to investigate the prognostic impact of TCF21 expression in ccRCC and analyze the relationship between TCF21 expression and methylation level. We used real-time PCR and immunohistochemical staining to detect the expression of TCF21, and used methylation specific-PCR (MS-PCR) to determine the methylation status of TCF21 in ccRCC samples and cell line 786-O. The results showed that TCF21 expression level in ccRCC samples was significantly lower than in normal adjacent tissue samples (NAT samples). The Kaplan-Meier survival analysis demonstrated that TCF21 was a significant prognosticator of cancer-specific survival (p=0.001). Furthermore, the DNA demethylating agent 5'-azacytidine restored part of TCF21 expression by suppressing TCF21 methylation in 786-O. The methylation level of TCF21 in ccRCC samples was much higher than in NAT samples. These results suggest that the expression of TCF21 was an independent prognostic factor for poor survival in patients with ccRCC. Aberrant methylation was an important reason for the down-regulation the expression of TCF21, and may be associated with tumorigenesis in ccRCC.

Development of DRAGON electron cyclotron resonance ion source at Institute of Modern Physics

A new room temperature electron cyclotron resonance (ECR) ion source, DRAGON, is under construction at IMP. DRAGON is designed to operate at microwaves of frequencies of 14.5-18 GHz. Its axial solenoid coils are cooled with evaporative medium to provide an axial magnetic mirror field of 2.5 T at the injection and 1.4 T at the extraction, respectively. In comparison to other conventional room temperature ECR ion sources, DRAGON has so far the largest bore plasma chamber of inner diameter of 126 mm with maximum radial fields of 1.4-1.5 T produced by a non-Halbach permanent sextupole magnet.

Status of the laser ion source at IMP

A laser (Nd:YAG laser, 3 J, 1064 nm, 8-10 ns) ion source has been built and under development at IMP to provide pulsed high-charge-state heavy ion beams to a radio frequency quadrupole (RFQ) for upgrading the IMP accelerators with a new low-energy beam injector. The laser ion source currently operates in a direct plasma injection scheme to inject the high charge state ions produced from a solid target into the RFQ. The maximum power density on the target was about 8.4 × 10(12) W∕cm(2). The preliminary experimental results will be presented and discussed in this paper.

[The clinical significance of evolution of paroxysmal nocturnal haemoglobinuria clones in aplastic anemia patients]

OBJECTIVE

To explore the clinical significance of evolution of paroxysmal nocturnal hemoglobinuria (PNH) clones in aplastic anemia (AA) patients.

METHODS

The positive rate of PNH clones in 678 AA cases at first diagnosis from January 2002 to December 2009 were analyzed, and to compare the response rate and overall survival (OS) between AA patients with or without PNH clones. All patients were sequentially followed-up to assess the incidence rate and risk factors for AA evolving to overt PNH.

RESULTS

(1) Of 119/678 (17.6%) AA patients at initial diagnosis presented with PNH clones,the positive rates of PNH clones among non-severe AA (NSAA), severe AA (SAA) and very severe AA (VSAA) were 16.7% (37/ 222), 17.3% (45/260) and 18.9% (37/196), respectively. There was no statistical difference among the three groups. (Chi2 = 0.369; P = 0.832); (2) 678 newly diagnosed AA cases were divided into 5 subgroups according to PNH clones, severity of disease and treatment regimens. There was no statistical difference among the five subgroups regarding 6m-response rate (RR) and OS. (3) Serial follow-up revealed that persistent PNH negative clones were found in 516 (76.1%) cases, and evolved to PNH positive clones after therapy in 43 (6.3%) cases. Persistent PNH positive clones were found in 72 (10.6%) cases, and disappeared the clones after treatment in 47 (6.9%) cases. There was no statistical difference among the four subgroups in terms of the 6m RR (Chi2 = 2.489,P = 0.426) and OS (P = 0.477); (4) 17 out of 678 AA cases (2.5%) evolved to overt PNH and the estimated incidence of evolution to overt PNH was (3.7 +/- 0.9)% at 10 years. The incidences of AA patients with or without PNH clones at initial diagnosis evolved to overt PNH were 3.4% and 2.3%, respectively. There was no statistical difference between the two groups, (Chi2 = 0.111; P = 0.739); and so was found in OS by Kaplan-Meier analysis (P = 0.868). Cox regression model analysis showed that none of the severity of AA, with or without PNH clone at initial diagnosis, treatment regimen and 6m RR was the risk factor for evolution to overt PNH.

CONCLUSION

There is no difference between AA patients presented with or without PNH clones at initial diagnosis regarding the RR and prognosis. The appearance of PNH clones in AA is not identified as a risk factor for developing into overt PNH.

A 2.45 GHz electron cyclotron resonance proton ion source and a dual-lens low energy beam transport

The structure and preliminary commissioning results of a new 2.45 GHz ECR proton ion source and a dual-lens low energy beam transport (LEBT) system are presented in this paper. The main magnetic field of the ion source is provided by a set of permanent magnets with two small electro-solenoid magnets at the injection and the extraction to fine tune the magnetic field for better microwave coupling. A 50 keV pulsed proton beam extracted by a three-electrode mechanism passes through the LEBT system of length of 1183 mm. This LEBT consists of a diagnosis chamber, two Glaser lenses, two steering magnets, and a final beam defining cone. A set of inner permanent magnetic rings is embedded in each of the two Glaser lenses to produce a flatter axial-field to reduce the lens aberrations.