[Diagnosis and treatment of 26 cases of adenovirus infection after allogeneic hematopoietic stem cell transplantation]

Objective: To analyze the clinical characteristics and prognosis of adenovirus infection after allogeneic hematopoietic stem cell transplantation. Methods: A total of 26 patients with adenovirus infection admitted to the posttransplant ward of the First Affiliated Hospital of Soochow University from 2018 to 2022 were enrolled. Their data on baseline and clinical characteristics, treatment, and follow-up were analyzed. Results: The median patient age was 30 (22, 44) years. Twenty-two patients received related haploid stem cell transplantation, three received unrelated stem cell transplantation, and one received umbilical cord stem cell transplantation. Antithymocyte globulin was included in the conditioning regimen in 25 patients. The median time of adenovirus infection was +95 (+44, +152) days. The median peripheral blood lymphocyte count was 0.30 (0.11, 0.69) × 10(9)/L. Twelve patients had acute graft-versus-host disease. Twenty-four patients received antirejection therapies at diagnosis. Sixteen cases had combined infection with other pathogens with adenovirus infection. Eight cases were diagnosed as asymptomatic infection, and 18 were diagnosed as adenovirus disease, including pneumonia (38.89% ) , gastrointestinal disease (38.89% ) , encephalitis (33.33% ) , hepatitis (5.56% ) , and urinary tract inflammation (5.56% ) . The age of >30 years was a risk factor for adenovirus disease (P=0.03) . Eighteen patients received tapering of immunosuppression, and all 26 patients received at least one antiviral drug. Other treatments included high-dose gamma globulin and donor lymphocyte infusion. Adenovirus infection improved in 10 cases and progressed in 16 cases. The median follow-up time was 30 (7, 237) days. Twenty-two patients died. The all-cause mortality rate was (88.5±7.1) % , and the attributable mortality rate was 45.5% . There was no significant difference in the 100 d survival rate between asymptomatic infected patients and patients diagnosed with adenovirus disease (37.5% vs 22.2% , HR=1.83, 95% CI 0.66-5.04, P=0.24) . Conclusion: The age of >30 years was a risk factor for adenovirus disease. Mortality was high in patients with adenovirus infection after allogeneic hematopoietic stem cell transplantation.

Discovery of an Imine Reductase for Reductive Amination of Carbonyl Compounds with Sterically Challenging Amines

The synthesis of structurally diverse amines is of fundamental significance in the pharmaceutical industry due to the ubiquitous presence of amine motifs in biologically active molecules. Biocatalytic reductive amination for amine production has attracted great interest owing to its synthetic advantages. Herein, we report the direct synthesis of a wide range of sterically demanding secondary amines, including several important active pharmaceutical ingredients and pharmaceutical intermediates, via reductive amination of carbonyl substrates and bulky amine nucleophiles employing imine reductases. Key to success for this route is the identification of an imine reductase from Penicillium camemberti with unusual substrate specificity and its further engineering, which empowered the accommodation of a broad range of sterically demanding amine nucleophiles encompassing linear alkyl and (hetero)aromatic (oxy)alkyl substituents and the formation of final amine products with up to >99% conversion. The practical utility of the biocatalytic route has been demonstrated by its application in the preparative synthesis of the anti-hyperparathyroidism drug cinacalcet.

[The Role and Mechanism of Tfh and B Cell in Human Chronic Graft-Versus-Host-Disease]

AbstractObjective: To investigate the role and mechanism of circulating follicular helper T cells (cTfh), extrafollicular helper T cells, B cells and their subsets in chronic graft-versus-host disease (cGVHD) after transplantation.

METHODS

Peripheral blood of cGVHD 64 patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the First Affiliated Hospital of Soochow University from 2016 to 2019 were collected. The percentage of cTfh cells, extrafollicular helper T cells, B cells and subsets were detected by flow cytometry. The healthy donors were detected as control. Percentage of each cell subpopulation between the two groups were compared by the two-tailed Students' T test.

RESULTS

The percentage of circulating follicular helper T cells (cTfh, CD4⁺CXCR5⁺) was markedly decreased in patients with cGVHD as compared with that in the healthy donors (0.53%±0.10% vs 3.91%±0.60%, P<0.001). The percentage of extrafollicular helper T cells (CD44^hiCD62L^loPSGL-1^loCD4⁺T) of the patients in cGVHD and the healthy donors were 8.86%±0.45% and 5.38%±0.79% (P=0.003). A significant change in B cell subsets was found in the patients with cGVHD. The two types of antigen-stimulate CD27⁺ B cell: the percentages of pre-GC B cells (CD19⁺IgD⁺CD38^hiCD27⁺) and plasmablast/plasma cells (PB/PC, CD19⁺IgD^-CD38^hiCD27⁺) of patients with cGVHD were 20.91%±2.70% and 41.05%±5.00%, respectively, which were significantly higher than those in healthy donors (P=0.005, P=0.014). Meanwhile, the percentage of unstimulated CD27^- B cells in patients with cGVHD was significantly reduced, especially the naive B cells (CD19⁺IgD⁺CD38^loCD27^-, 12.59%±2.63%, P=0.025). There was a positive correlation between the percentage of extrafollicular helper T cells and plasmablast/ plasma cells (PB/PC) in cGVHD patients (r=0.43).

CONCLUSION

Compared with healthy donor, cTfh cells, extrafollicular helper T cells and B cell subsets in the peripheral blood of patients with cGVHD after transplantation changed in varying degress.

[Clinical and prognostic values of TP53 mutation in patients with B-lineage acute lymphoblastic leukemia]

Objective: To investigate the survival and prognosis of B-lineage acute lymphoblastic leukemia (B-ALL) patients with TP53 mutation. Methods: The clinical data of 479 newly diagnosed B-ALL patients treated in the First Affiliated Hospital of Soochow University from January 2016 to December 2019 were retrospectively analyzed. Results: Among 479 B-ALL patients, 34 cases (7.1%) were positive for TP53 gene mutation, and a total of 36 TP53 mutations were detected, including 10 frameshift gene mutations (27.8%) , 23 missense mutations (63.9%) and 3 nonsense mutations (8.3%) . A total of 34 (94.4%) mutations were located in the DNA binding domain (exons 5-8) .The average number of mutated genes in patients with TP53 gene mutation (2.3) and the group without TP53 gene mutation (1.1) were statistically different (P<0.001) . The proportion of Ph positive and Ph-like positive patients in the TP53 gene mutation negative group was significantly higher than that of the TP53 mutation positive group, and the difference was statistically significant (P<0.001) . The 3-year OS and EFS rates of the TP53 gene mutation negative group were significantly higher than those of the TP53 gene mutation positive group. The differences in OS and EFS rates between the two groups were statistically significant (χ(2)= 4.694, P = 0.030; χ(2)= 5.080, P= 0.024) . In the multivariate analysis, failure to achieve remission (CR) after one course of induction chemotherapy was an independent adverse prognostic factor affecting OS.Of the 34 patients with TP53 mutation, 16 underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the CR(1) state, and 2 patients with recurrence after transplantation obtained CR(2) after infusion of donor-derived anti-CD19 chimeric antigen receptor T (CAR-T) cells. Among the 11 patients with TP53 gene mutation who relapsed during consolidation chemotherapy, 6 received anti-CD19 CAR T cell therapy, 4 patients achieved remission and minimal residual disease (MRD) turned negative, followed by bridging allo-HSCT, and 2 of them sustained CR. Conclusion: Missense mutations are the most common in B-ALL patients with TP53 gene mutation, and the majority of mutations were located in the DNA binding domain. B-ALL patients with TP53 gene mutation should undergo allo-HSCT as soon as possible after CAR-T cell therapy has cleared the MRD after recurrence. B-ALL patients with TP53 gene mutation still have a higher recurrence rate after allo-HSCT, and the infusion of donor-derived CAR-T cells can achieve better sustained remission.

Visible wide-angle view imaging system for the first plasma on the HL-2M tokamak

The wide-angle view imaging system, in terms of a tangential view diagnostic with field of view (FOV) of 56.8° and a downward-looking diagnostic from the top of the machine with FOV of 94.7°, has been newly constructed for the first plasma of the HL-2M tokamak achieved in December 2020. Its mission in this stage is to monitor the plasma evolution during its startup, sustainment, and disruption in the visible spectral range as well as the plasma-wall interaction. For the latter ultrawide view diagnostic, nearly three-quarters of the divertor region and half the area of the inner wall are in the view range. Both the diagnostics are characterized by a similar optical structure, i.e., the light emission from the plasma is collected by a front-end lens and transferred through an imaging fiber bundle to the camera. This optical structure is suitable for application in the complex tokamak environment mainly because the fiber bundle is flexible. Photos of glow discharges are acquired prior to the first plasma for testing the FOVs in the vacuum vessel. The spatial resolution is ∼4mm for the tangential view diagnostic and ∼10mm for the downward-looking diagnostic. The temporal resolutions, ranging from 90 to 360 Hz by changing the region of interest or binning acquisition mode of the color camera, are applied to record the plasma evolutions and/or dust creation events during the first plasma campaign.

Muscleblind-like 1 antisense RNA 1 inhibits cell proliferation, invasion, and migration of prostate cancer by sponging miR-181a-5p and regulating PTEN/PI3K/AKT/mTOR signaling

The present study aimed to investigate the role and underlying mechanisms of long non-coding RNA (lncRNA) muscleblind-like 1 antisense RNA 1 (MBNL1-AS1) in the progression of Prostate cancer (PCa). MBNL1-AS1 and microRNA (miR)-181a-5p expression in PCa tissues and several human PCa cell lines were analyzed, respectively, using StarBasev3.0 project and RT-qPCR assay. After MBNL1-AS1 overexpression, cell proliferation, invasion and migration were, respectively, evaluated using CCK-8, colony formation, transwell and wound healing assays. Dual luciferase assay were used for analysis of the interactions among MBNL1-AS1, miR-181a-5p, and phosphatase and tensin homolog (PTEN). Subsequently, the expression of PTEN and proteins in PI3K/AKT/mTOR signaling was examined using western blot analysis after transfection with miR-181a-5p mimic. The rescue assays were performed to investigate the effects of MBNL1-AS1 and miR-181a-5p on the functions of PCa cells and the expression of PTEN/PI3K/AKT/mTOR signaling by co-transfection with MBNL1-AS1 plasmid and miR-181a-5p mimic. Results indicated that MBNL1-AS1 was conspicuously downregulated while miR-181a-5p upregulating in PCa tissues and cell lines. MBNL1-AS1 overexpression decreased the abilities of cell proliferation, invasion, and migration. Further study revealed that MBNL1-AS1 acted as a sponge for miR-181a-5p and positively regulated PTEN by a sponge effect. Additionally, rescue assays proved that the effect of MBNL1-AS1-upregulation on the proliferation, invasion, and migration of PCa cells was dependent on miR-181a-5p. Furthermore, miR-181a-5p overexpression counteracted the expression of PTEN and proteins in PI3K/AKT/mTOR signaling exerted by MBNL1-AS1-upregulation in PCa cells. This study suggests that MBNL1-AS1 inhibits the progression of PCa via sponging miR-181a-5p and regulating PTEN/PI3K/AKT/mTOR pathway.

Hybrid Molecular Dynamics for Elucidating Cooperativity Between Halogen Bond and Water Molecules During the Interaction of p53-Y220C and the PhiKan5196 Complex

The cooperativity between hydrogen and halogen bonds plays an important role in rational drug design. However, mimicking the dynamic cooperation between these bonds is a challenging issue, which has impeded the development of the halogen bond force field. In this study, the Y220C–PhiKan5196 complex of p53 protein was adopted as a model, and the functions of three water molecules that formed hydrogen bonds with halogen atoms were analyzed by the simulation method governed by the hybrid quantum mechanical/molecular mechanical molecular dynamics. A comparison with the water-free model revealed that the strength of the halogen bond in the complex was consistently stronger. This confirmed that the water molecules formed weak hydrogen bonds with the halogen atom and cooperated with the halogen atom to enhance the halogen bond. Further, it was discovered that the roles of the three water molecules were not the same. Therefore, the results obtained herein can facilitate a rational drug design. Further, this work emphasizes on the fact that, in addition to protein pockets and ligands, the role of voids should also be considered with regard to the water molecules surrounding them.

Fast charge exchange recombination spectroscopy on HuanLiu-2A tokamak

A Fast Charge eXchange Recombination Spectroscopy (CXRS) diagnostic with eight radial channels has been implemented on a HuanLiu-2A (HL-2A) tokamak with a time resolution of up to 10 kHz monitoring helium II spectra or 1 kHz monitoring carbon VI spectra. The crucial aspects of the fast CXRS are to improve the spectral intensity and the acquisition frequency. The spectral intensity has been greatly enhanced by customized fiber bundles. The main boost in optimizing the acquisition frequency is achieved by binning more pixel rows of the charge coupled device (CCD) representing one radial channel and by reducing the effective image area of the CCD. Consequently, the sawtooth oscillations of ion temperature and rotation velocity are continuously observed for the first time in the HL-2A tokamak.

Increased fat synthesis and limited apolipoprotein B cause lipid accumulation in the liver of broiler chickens exposed to chronic heat stress

Chronic heat stress can enhance fat synthesis in broilers, and excessive triglyceride (TG) synthesized by the liver needs to be transported to extrahepatic tissues by very low density lipoprotein (VLDL) otherwise will accumulate in the liver, which may even result in hepatic steatosis. To investigate the molecular mechanisms by which chronic heat stress enhances fat synthesis and results in lipid accumulation in the liver of chickens, 144 broilers (Arbor Acres, 28-day-old) were randomly allocated to the normal control (NC, 22°C), heat stress (HS, consistent 32°C), or pair-fed (PF, 22°C) groups for a 14-D trial. The 7 D of heat exposure significantly increased the respiratory rate, relative weight of abdominal fat, the levels of glucose, TG, corticosterone, insulin, and VLDL in plasma, as well as the levels of TG, total cholesterol, acyl-CoA carboxylase (ACC), and fatty acid synthase (FAS) in the liver, and mRNA expression levels of carbohydrate response element-binding protein (ChREBP), ACC, FAS, and microsomal triglyceride transfer protein (MTTP) in comparison with the other 2 groups. After 14 D of heat exposure, the relative weights of abdominal fat and liver and levels of TG and FAS in the liver were significantly higher in the HS group than in the other 2 groups, and there were no significant differences in the respiratory rate, plasma corticosterone concentration, apolipoprotein B (ApoB) level in the liver, and mRNA expression levels of key genes of fat synthesis among the 3 groups. In conclusion, chronic heat exposure activated LXRα pathway and enhanced fat synthesis in the liver after 7 D of heat exposure. After 14 D of heat exposure, heat-stressed broilers exhibited an adaptation to the high temperature in parameters of stress and fat synthesis gene expression levels. Moreover, chronic heat stress resulted in lipid accumulation in the liver of broilers, which is probably because the limited ApoB was not enough to transport the excessive TG synthesized by the liver in chronic heat-stressed broilers.

[New progress in the diagnosis and treatment of natal teeth and neonatal teeth]

There were great individual differences in eruption time of the teeth. Generally speaking, the deciduous teeth begin to erupt at 6 months after birth, but some babies are born with erupted teeth, which are called natal teeth; in addition, teeth erupted within 30 days after the baby is born are called neonatal teeth. Natal teeth and neonatal teeth may cause ulceration, aspiration, and nipple pain or trauma in the mother's breast during the time of breastfeeding. Extraction of the teeth may cause complications such as neonatal osteomyelitis. To avoid the complications caused by these diseases, and to alleviate the suffering of patients and their families, this article will introduce the clinical manifestations, etiology and related complications of natal teeth and neonatal teeth, and then give some treatment methods and nursing methods, especially to help clinical work.

The alleviative effects and related mechanisms of taurine supplementation on growth performance and carcass characteristics in broilers exposed to chronic heat stress

To investigate the alleviative effects and molecular mechanisms of taurine supplementation on growth performance and carcass characteristics in broilers exposed to chronic heat stress, 144 male Arbor Acres broilers (28 d old) were randomly distributed to positive control (PC, 22°C, basal diet), heat stress (HS, consistent 32°C, basal diet), or heat stress + taurine (HS + T, consistent 32°C, basal diet + 5.00 g/kg taurine) groups, with 6 cages per group and 8 birds per cage. Chronic heat stress significantly decreased body weight, average daily gain, and average daily feed intake, and increased cloacal temperature and feed conversion ratio (FCR, P < 0.05). Though taurine supplementation tended to decrease the FCR in the HS + T group compared with the HS group after 14 d of heat exposure (P = 0.071), there were no significant alleviative effects of taurine supplementation on the increased cloacal temperature and decreased growth performance in chronic heat-stressed broilers (P > 0.05). After 7 and 14 d of heat exposure, taurine supplementation significantly increased the proportion of breast muscle and hormone-sensitive lipase activity in the abdominal fat (P < 0.05), and decreased the mRNA expressions of muscle atrophy F-box protein (MAFbx) and muscle ring-finger protein-1 (MuRF1) in breast muscle compared with the HS group (P < 0.05). After 7 d of heat exposure, taurine supplementation significantly increased serum non-esterified fatty acid concentration (P < 0.05), and decreased the mRNA expressions of acetyl-CoA carboxylase 1c (ACC) and muscular isoform of carnitine palmitoyl transferase 1 (M-CPT1) compared with the HS group (P < 0.05). In addition, the mRNA expressions of M-CPT1 and ribosomal protein S6 kinase, 70 kDa (p70S6K) in the HS + T group were significantly higher than those of the other two groups after 14 d of heat exposure (P < 0.05). In conclusion, taurine supplementation can improve carcass characteristics of chronic heat-stressed broilers by facilitating lipolysis for energy, enhancing protein synthesis, and suppressing protein degradation of the breast muscles.

[Effect of Additional Chromosomal Abnormalities on the Outcome of CML-CP Patients Receiving TKI Therapy]

OBJECTIVES

To explore the effect of additional chromosomal abnormalities on the prognosis and outcome of CML-CP patients receiving imatinib therapy.

METHODS

The clinical and genetic data of 589 CML-CP patients receiving imatinib treatment between May 2009 and October 2014 in the 1st Affiliated Hospital of Soochow University were analyzed, the 589 patients were divided into 5 groups according to the karyotypes at the initial diagnosis. The OS(overall survival), PFS (progression-free survival), EFS (event-free survival), Cumulative MMR (major molecular remission) and Cumulative CCyR (complete cytogenetic remission) were calculated by using the Kaplan-Meier method and compared by using the log-rank text by Graphpad 6.0. The χ² test was used to compare the frequency of optimal molecular response at 3, 6, 12 months among the 5 groups.

RESULTS

There was significant difference about the frequency of optimal molecular response at 3 and 6 months between CML-CP patients with additional chromosomal abnormalities and those with classic t(9;22) ［50%（12/24） vs. 73.94%(261 /353), P<0.05; 50%(10 /20) vs. 72.05%(232 /322) (P<0.05)］, and the same significant difference was found at 6 months between the group with variant translocations and that with classic t(9;22) ［53.3% (16 /30) vs. 72.05%(232 /322) (P<0.05)］. The P values of cumulative CCyR (P<0.05) and EFS (P<0.01) for 4 years were statistically significant between CML-CP patients with additional chromosomal abnormalities and the other 4 groups. Compared one to another, there was the significant difference in cumulative CCyR and EFS for 4 years between CML-CP patients with additional chromosomal.abnormalities and those with classic t(9;22) (47.25% vs. 84.01%)(P<0.05); (75.03% vs. 90.01%)(P<0.01).

CONCLUSION

The additional chromosomal abnormalities influence the outcome of CML-CP patients receiving imatinib treatment, which make poor prognosis.

[An experimental study of CD4 targeted chimeric antigen receptor modified T cell with anti-lymphoma activity]

目的

探讨针对CD4膜蛋白的CAR-T细胞对CD4⁺T细胞淋巴瘤细胞的靶向特异性杀伤作用。

方法

采用重组DNA技术构建含4-1BB共刺激分子的第二代针对CD4的CAR慢病毒载体，应用293T细胞包装慢病毒，采用流式细胞术检测T细胞的转染效率及T细胞亚群动态变化，采用流式细胞术微球法检测培养上清中IFN-γ浓度。

结果

①构建的慢病毒载体转染激活的T细胞后CAR膜蛋白阳性率达到50.0%~70.0%。T细胞激活后部分CD8⁺T细胞弱表达（dim）CD4膜蛋白。T细胞转染针对CD4的CAR慢病毒后CD4⁺ T细胞、CD8⁺ CD4^dim T细胞逐渐被清除。②CAR-T细胞、对照组T细胞（空载体转染的T细胞）以8∶1效靶比分别与CD4⁺人T细胞淋巴瘤细胞株KARPAS 299细胞共培养24 h，杀伤效率分别为（96.9±2.1）%和（11.2±3.1）%，前者明显高于后者（t=7.137，P=0.028）。③CAR-T细胞单独培养，与转染慢病毒载体表达人CD4的K562细胞（K562-CD4细胞）、K562细胞共培养后上清中IFN-γ浓度分别为（1 785±268）、（15 648±2 168）、（1 978±354）pg/ml，CAR-T细胞与K562-CD4细胞共培养上清IFN-γ浓度明显高于其他两组，差异有统计学意义（P<0.01）。

结论

CD4特异性CAR-T细胞效应细胞免疫表型为CD8⁺ CD4⁺ T细胞，在体外具有杀伤正常CD4⁺ T细胞和CD4⁺ T细胞淋巴瘤细胞的活性，对于CD4^dim T细胞也有较好的清除活性。

[Clinical analysis of 7 patients with Epstein-Barr virus encephalitis after allogeneic hematopoietic stem cell transplantation]

Objective: To summarize the clinical features, treatment and prognosis of patients with Epstein Barr virus (EBV) encephalitis after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The clinical data of 7 patients with EBV encephalitis who had undergone allo-HSCT in the First Affiliated Hospital of Soochow University from January 2012 to December 2015 were reviewed. Results: The incidence of EBV encephalitis was 0.70% (7/998) , and the median time was 63 (10-136) d after allo-HSCT. Seven patients had fever and mental disorder, of whom 4 cases of brain MRI were positive. Two patients received HLA-matched unrelated transplantation, while other 5 ones received haploidentical allo-HSCT. In conditioning regimen process, 7 patients were combined with anti-thymocyte globulin (ATG) to prevent graft versus host disease (GVHD) , of whom 6 patients had grade Ⅱ-Ⅳ acute GVHD. All patients of EBV-DNA were negative in CSF after taking anti-virus agent Rituximab. Until the last follow-up, a total of 3 patients died, 2 died of leukemia recurrence, 1 EBV encephalitis progression. Conclusion: Once suspected EBV encephalitis after allo-HSCT, brain MRI and EBV-DNA in CSF should be detected, which could improve early diagnosis of EBV encephalitis. The usage of Rituximab was effective and well tolerated.

[Clinical application of CT-guided radiofrequency ablation combined with biopsy synchronously to multiple small nodules of lung metastatic tumors]

Objective: To investigate the therapeutic efficacy and safety of CT-guided radiofrequency ablation(RFA)combined with biopsy synchronously to multiple small nodules of metastatic tumors in lung. Method: From January 2016 to December 2016, a total of 86 patients in the General Hospital of People's Liberation Army with 144 lesions were divide into two groups(all the lesions were less than 1 cm). Group A with 51 cases located in the lung periphery underwent biopsy prior to RFA.Group B with 35 cases located in the middle and inner side of lung adjacent to the vasculatures contrarily underwent RFA first.The changes of these lesions during the 1 to 12-month were followed up. Results: All the procedures were completed successfully.The intra operative CT scanning showed the ablation zones were completely covered by the indicative "halo sign" respectively.The P value was 0.818, 0.155 and 0.452 respectively, in the number of nodules, pathological results positive rate and complications in the rank and inspection for A, B two groups, which were all higher than 0.05.Though different strategies according to different location of the nodes, the two groups can achieve safe and effective treatments.All patients in two groups had high density ablation zones on their 1-month post operative CT without enhancement.3-and 6-post operative CT illustrated a decrease of lesions, 12-month post operative CT showed the lesions turned to fibrous stripes. Conclusion: The CT-guided RFA combined with biopsy synchronously to multiple small nodules of metastatic tumors in lung is safe and effective, for the lesions located in the middle or inner side of lung, RFA prior to the biopsy can avoid the massive hemoptysis.

[Risk Factors of Leukemia-free Survival in Ph+ ALL Patients with Allogeneic Hematopoietic Stem Cell Transplantation]

OBJECTIVE

To explore the effect of BCR-ABL gene transcripts on Leukemia-free survival (LFS) and prognosis of patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph⁺ ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS

The clinical data of 107 cases of Ph⁺ B-ALL patients received allo-HSCT from July 2006 to November 2014 in the First Affiliated Hospital of Soochow University were collected and the relationship between the clinical characteristics and LFS after transplantation was analyzed.

RESULTS

Out of 107 Ph⁺ ALL patients (64 males and 43 females) with a median age of 30(7 to 54)years old, 35.5% (38/107) cases relapsed after transplantation within a median time of 6.9 (1.5 to 40.7) months. A total of 39 (36.4%) cases died within a median time of 19.8 (3.6 to 83.7) months after HSCT, of which 51.3% (20/39) due to disease relapse and 25.6% (10/39) due to infection. BCR-ABL gene transcripts of 49 cases turn into negative before transplantation, of which the expected 5-year cumulative incidence of relapse (CIR), non-relapse mortality (NRM) and overall survival (OS) were 26.5%, 29.5% and 41.6%, respectively. Another 49 cases still had a positive BCR-ABL gene transcripts before transplantation, of which the life expectancy of 5 year CIR, NRM and OS were 64.4%,8.9% and 48.9%, respectively. Compared with BCR-ABL positive patients, BCR-ABL negative patients showed a lower CIR (P<0.001), a higher NRM (P=0.030) and a similar OS (41.6% versus 48.9%, P=0.497). Multivariate analysis showed that BCR-ABL positive (P=0.016) and a disease statusphase ≥CR2 (P<0.001) before HSCT were independent risk factors for LFS, while the age underwent HSCT was the principal element affecting prognosis (P<0.001).

CONCLUSION

Both the relapse and infection are the main causes of death in the patients after transplantation. A disease status ≥CR2 and the BCR-ABL positive before transplantation are 2 independent risk factors of LFS in the patients with Ph⁺ ALL after allo-HSCT.

[Clinical efficacy of tonsillectomy in renal transplant patients with recurrent IgA nephropathy]

Objective: To investigate the therapeutic efficacy of tonsillectomy for patients with recurrence of IgA nephropathy (IgAN) after kidney transplantation. Methods: From May 2014, tonsillectomy was performed in 11 renal transplant patients with biopsy-proved recurrent IgAN. In a median follow-up of 14 (4-38) months, data of proteinuria, hematuria, estimated glomerular filtration rate (eGFR), and serum levels of IgA in these patients were compared before and after tonsillectomy.Patient's survival and renal graft survival were also summarized. Results: A remission of proteinuria was observed in 8 patients after tonsillectomy, and this status maintained well in the subsequent follow-up.Three patients had no or minimal reduction of proteinuria after tonsillectomy and returned to dialysis within 1 year after tonsillectomy.Possible causes could be severe primary IgAN of crescentric glomerulonephritis, IgAN recurrence in kidney retransplantation, and late tonsillectomy after IgAN recurrence.Serum levels of IgA significant decreased and no patients developed acute rejection or infection after tonsillectomy.In the 1-year follow-up, no patients died and grafts survived well in 8 out of 11 patients. Conclusions: Tonsillectomy may represent an effective and reliable way to treat recurrence IgAN after kidney transplantation, and may be applied widely in the future clinical management. However, early intervention is critical and effects may depend on the pathological features of primary IgAN.

[The value of plasma EBV-DNA testing in high-risk group of nasopharyngeal carcinoma in the nasal endoscopy]

Objective:The aim of this study is to evaluate the level of plasma EBV DNA and nasal endoscopy in high risk population of nasopharyngeal carcinoma, and to explore the value of EBV DNA testing in nasal endoscopy. Method:The nasopharyngeal carcinoma was screened in High-incidence Area of Zhongshan City. EBV antibody was detected by ELISA, and 427 patients with high risk of nasopharyngeal carcinoma were identified. In the high risk population the plasma EBV-DNA was measured using Fluorescent quantitative PCR, and all patients were used nasal endoscopy in the first two years. The application value of EBV DNA and nasopharyngeal endoscopic biopsy were analyzed. Result:There were 427 NPC high risk population in first screening. The rates of nasopharyngeal biopsy in EBV DNA positive and EBV DNA negative population were 90.2% (55/61) and 13.9% (51/366), respectively. The rate of NPC nasopharyngeal biopsy in EBV DNA positive population was higher than that in EBV DNA negative population (P<0.01). The rate of NPC detection in EBV DNA positive group (60.7%) was higher than that (3.3%) in EBV DNA negative population (P<0.01). In first year follow up, there were 286 NPC high risk population. The rates of nasopharyngeal biopsy in EBV DNA positive and EBV DNA negative population were 91.2% (31/34) and 11.9% (30/252), respectively. The rate of NPC nasopharyngeal biopsy in EBV DNA positive population was higher than that in EBV DNA negative population (P<0.01). The rate of NPC detection in EBV DNA positive group (17.6%) was higher than that (1.6%) in EBV DNA negative population (P<0.01). The positive predicative value of serological risk assessment was 8.3% (59/713), but for NPC high risk group, adding quantitative analysis of plasma EBV DNA, the positive predicative value was 45.3% (43/95). The early diagnosis rates in EBV DNA positive and EBV DNA negative population were 79.1% (34/43) and 93.8% (15/16), respectively. There was no significant difference in early diagnosis rates in two groups (P>0.05). Conclusion:The positive rate of plasma EBV DNA in high risk group of nasopharyngeal carcinoma may be helpful for nasal endoscopic nasopharyngeal biopsy, which can greatly improve the positive predictive value of high risk population of nasopharyngeal carcinoma. For NPC high risk population, Therefore, EBV DNA positive population are the focus for NPC screening.

[Clinical effect of polyvinyl alcohol particles combined with chemoembolization in treatment of hepatocellular carcinoma complicated by hepatic arteriovenous shunt and related and prognostic factors]

Objective: To investigate the clinical effect of polyvinyl alcohol (PVA) particles combined with chemoembolization using chemotherapeutic agents or chemotherapeutic agents lipiodol emulsion (CALE) in the treatment of hepatocellular carcinoma (HCC) complicated by hepatic arteriovenous shunt (HAVS) and related prognostic factors. Methods: A retrospective analysis was performed for the clinical data of 133 patients with HCC complicated by HAVS. HAVS was classified into slow-flow HAVS, intermediate-flow HAVS, and high-flow HAVS, which were treated with 300-500μm, 500-710μm, and 710-1000μm PVA particles, respectively. The patients with slow-flow and intermediate-flow HAVS underwent embolization with PVA combined with chemotherapeutic agents followed by CALE, while those with high-flow HAVS underwent the treatment with PVA combined with chemotherapeutic agents alone. The survival time, progression-free survival time, and postoperative complications were followed up and analyzed. The Kaplan-Meier method was used to calculate cumulative survival rate and the Cox proportional hazards model was used to determine prognostic factors. Results: The median overall survival (OS) of 133 patients was 9.1 months, and the 6-, 12-, and 24-month survival rates were 73.7%, 36.2%, and 10.2%, respectively. The median OS of slow-flow group (36 patients), intermediate-flow group (58 patients), and high-flow group (39 patients) were 7.3, 9.1, and 10.8 months, respectively. And the 6- and 12-month survival rates were 69.2%/19.0%, 72.4%/39.2%, and 77.8%/42.7%, respectively. There was no significant difference in survival time between the patients with different types of HAVS (χ²= 2.865,P= 0.239). The incidence rates of postoperative gastroesophageal variceal bleeding and acute liver failure were 1.1% and 0.4%, respectively. The results of Cox regression analysis showed that preoperative alpha-fetoprotein level≥400 ng/ml (HR= 2.105,P= 0.006) was an independent risk factor, while multiple embolizations (HR= 0.482,P= 0.011), tumor remission (HR= 0.431,P= 0.041), and multimodality therapy (HR= 0.416,P= 0.004) were independent protective factors. Conclusion: PVA particles combined with chemotherapeutic agents or CALE is safe and effective in the treatment of HCC complicated by HAVS. Patients with multiple embolizations, tumor remission, and multimodality therapy tend to have good prognosis, while those with a high level of alpha-fetoprotein before embolization often have poor prognosis.

[EVI1 expression, clinical and cytogenetical characteristics in 447 patients with acute myeloid leukemia]

Objective: To investigate EVI1 expression and its associated clinical and cytogenetic characteristics in 447 acute myeloid leukemia (AML) patients. Methods: EVI1 expressions were measured in 447 AML cases from Jan. 2007 to Apr. 2015 to couple with clinical, cytogenetic and mutations' characteristics to summarize the features of AMLs with high EVI1 expression. Results: 17.9% of AML were high EVI1 expression (EVI1 +), and the remainder low EVI1 expression (EVI1-). No significant differences between the two groups in terms of age, sex, hemoglobin level, white blood cell count and platelet count were observed. More M0, M5 and M6 subtypes were observed in EVI1+ group (P= 0.027, 0.004 and 0.011, respectively). Cytogenetic abnormalities of 11q15, 11q23/MLL, 3q26, -7/7q- and t (9;11) were observed more frequently in EVI1 + group (P<0.001, <0.001, <0.001, <0.001, =0.014, respectively). Normal karyotype, inv (16), t (8;21) were observed more frequent in EVI1- group (P=0.001, 0.009, 0.002, respectively). EVI1 + was more observed in high risk cytogenetics. Mutation of NPM1 was more observed in EVI1- group (P <0.001). Remission rate in EVI1 + group was significantly lower than EVI1- group (P<0.001). Leukemia-free survival was improved in EVI1 + AML patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Conclusions: High EVI1 expression was more observed in FAB subgroup M5, harbored more cytogenetic abnormalities of 11p15, 11q23/MLL, 3q26 rearrangement, -7/7q- and t (9;11). Remission rate of high EVI1 expression AML was lower, which could be improved by allo-HSCT.

Overexpression of microRna-200c in CD44+CD133+ CSCS inhibits the cellular migratory and invasion as well as tumorigenicity in mice

Cancer stem cells (CSCs) are believed to be responsible for drug resistance, metastasis of tumors. To investigate the biological characteristics of CD44+CD133+CSCs with over- expressing microRNA-200c (miR-200c), and to provide evidences for miR-200c as a tumor suppressor to treat melanoma. CD44+CD133+CSCs were isolated from the mouse melanoma B16F10 cell line by using immune magnetic activated cell sorting. The lentivirus miR-200c was transduced into the cells, and the effect of miR-200c overexpression on the biological characteristics of B16F10 CD44+ CD133+CSCs was analyzed by a series assays. The stable overexpression of miR-200c in B16F10 CD44+CD133+CSCs obviously resulted in downregulation of zinc-finger E-box binding homeobox 1 expression, reduction of the cell proliferation, colony forming, cell migratory and invasion ability in vitro as well as tumorigenicity in vivo compared with those of the B16F10 cells and B16F10 non-CD44+ CD133+CSCs. These findings suggest that the miR-200c overexpression as a novel strategy to target therapy of melanoma CSCs.

[The prognosis analysis of novel influenza A (H1N1) in patients with hematologic disease]

OBJECTIVE

To explore disease progression and prognosis factors of novel influenza A (H1N1) in immunocompromised patients with or without hematologic disease.

METHOD

A total of 76 confirmed novel influenza A (H1N1) infection patients from November 2009 to March 2010 included in the study, their clinical feature was analyzed, and the relationship between clinical feature and outcome was explored retrospectively by multivariate analysis method.

RESULTS

The whole 76 patients were administrated of oseltamivir. Among the 76 patients, 46 were severe and 23 were critical. Of the 6 patients with immunocompromised hematologic disease, 2 were severe and 4 were critical, case-fatality rate was 66.67% (4/6). The case-fatality rate of patients with non-hematologic disease was 10.42% (5/48). Multivariable logistic-regression analysis showed that immunocompromised hematologic disease (P = 0.0008, odds ratio:75.368; 95% CI, 5.980 to 949.853) and age (P = 0.0380) were independent risk factors for death. And other variables such as chronical lung disease, interval time from the onset of illness and lymphocyte count had no statistical significance (P > 0.05).

CONCLUSIONS

The novel influenza A (H1N1) patients with immunocompromised hematologic disease has a poor prognosis, they can deteriorate quickly and have high mortality, it may aid clinicians to pay high attention to these people.

First Report of the Cyst Nematode (Heterodera elachista) on Rice in Hunan Province, China

During a survey for the cyst nematodes (Heterodera elachista) from May to June of 2011, cyst nematodes were detected in hilly rice fields in five counties (Changsha, Pingjiang, Hengdong, Shaoyang, and Xiangxiang) of Hunan Province, China. Cyst nematodes obtained from soil samples and harvested rice root samples at these five locations had uniform morphological and molecular characteristics. Cysts (n = 20) had the following characteristics: spherical to lemon shaped, vulval cone ambifenestrate, vulval bridge narrow, medium sized underbridge, with a few dark brown bullae, body length (not including the neck) ranging from 354 to 586 μm (mean = 438.9 μm, st. dev. = 63.7); body width ranged from 283 to 495 μm (354.5, 60.1); fenestrate length of 30 to 50 μm (37.4, 5.0) and width of 25 to 47.5 μm (35.1, 7.1); underbridge length from 70 to 95 μm (83.4, 8.2); and vulval slit length from 30.3 to 55.5 μm (40.3, 9.1). J2 (n = 20) had the following characteristics: body length ranging from 404 to 525 μm (mean of 461.6 μm, st. dev. = 34.5); stylet length from 20 to 25 μm (22.5, 1.1) with rounded knob; tail length of 60 to 87.5 μm (67.3, 6.9); and hyaline terminal tail ranged from 30 to 50 μm (37.5, 6.4); lateral field with three lines. The mean and range of J2 were longer than those reported for H. elachista by Nobbs et al. (1) and Tanha et al. (4), but other morphological character values were within the range of those reported (4). DNA from a single cyst was extracted, the rDNA-internal transcribed spacer (ITS) and D2/D3 fragments of the 28S RNA were amplified with universal primers TW81 and AB28, D2A and D3B, respectively. Five ITS sequences (JN202913, JN202914, JN202915, JN202916, and JN202917) and five D2/D3 sequences (JN202918, JN202919, JN202920, JN202921, and JN202922) from nematode samples collected in Changsha, Hengdong, Shaoyang, Pingjiang, and Xiangxiang, respectively, were submitted to GenBank. These ITS sequences were remarkably similar to each other and exhibited 98.6 to 99.3% similarity with that of H. elachista isolate from Iran (AF498391), and 98.8 to 99.4% similarity with that of H. elachista isolates from Ningxia Province, China (HM560778 and HM560779). The D2/D3 sequences exhibited 99.7 to 100% similarity with that of H. elachista isolates from Ningxia Province, China (HM560842 and HM560843). These characteristics indicated that the five populations were H. elachista belonging to the 'cyperi' group (1,2). In glasshouse evaluations of the pathogenicity of these isolates, 500 second-stage juveniles were inoculated onto five 20-day-old seedlings of rice (Weiyou No.227) in 4.5-cm diameter 30-cm high tubes with six replicates. After 8 weeks, stunting and reduction of leaf length were observed and cysts were extracted from dried soil of each tube using sieves. Brown cysts (92 to 204) and white females (14 to 40) were obtained from inoculated rice from each tube. H. elachista can decrease yield by 7 to 19% and has the most severe impact during the later stages of plant growth (3). H. elachista has been previously identified from rice fields in Japan and Iran (3). To our knowledge, this is the first report of H. elachista on rice in Hunan Province, China. References: (1) J. M. Nobbs et al. Fundam. Appl. Nematol. 15:551, 1992. (2) S. A. Subbotin et al. Mol. Phylogenet. Evol. 21:1, 2001. (3) S. A. Subbotin et al. Systematics of Cyst Nematodes (Nematoda: Heteroderinae). Volume 8 Part B. Brill, Leiden, the Netherlands, 2010. (4) M. Z. Tanha et al. Nematology 5:99, 2003.

[Expressions of survivin and the splice variants survivin-2B and survivin-DeltaEx3 in bladder cancer and their clinical significance]

BACKGROUND AND OBJECTIVE

Studies on survivin over the past 5 years have shown that survivin participates in the genesis of several human cancers, including bladder cancer. Recent studies have indicated that survivin splice variants appeared to have unique subcellular localizations and functions as well. This study was to explore the roles of survivin and its two splice variants survivin-2B and survivin-DeltaEx3 in transitional cell carcinoma of bladder (BTCC).

METHODS

The relative amount of survivin, survivin-2B, and survivin-DeltaEx3 mRNA of fresh carcinoma tissues from 60 patients with BTCC and 12 non-cancerous bladder tissues were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR), and the relationships of their expression levels in different pathologic grades to clinical stages of bladder cancer were analyzed. The time of follow-up was 4-24 months.

RESULTS

Survivin, survivin-2B, and survivin-DeltaEx3 mRNA were detected in all BTCC tissues, and their relative expressions were 0.333+/-0.163, 0.056+/-0.017, and 0.124+/-0.096, respectively. In the control group,three and four samples expressed survivin and survivin-DeltaEx3 mRNA respectively, and all samples expressed survivin-2B mRNA. The expressions of survivin and survivin-DeltaEx3 mRNA were positively correlated with the pathologic grades and clinical stages (0 < r 's < 1,P < 0.05), however, survivin-2B mRNA was negatively correlated with those (-1 < r 's < 0, P < 0.05).

CONCLUSION

Detecting the expression levels of survivin and its two splice variants survivin-2B and survivin-DeltaEx3 mRNA in BTCC by real-time PCR could have potential values to evaluate tumor progression and recurrence rate.

Immunotherapy of melanoma by GPI-anchored IL-21 tumour vaccine involves down-regulating regulatory T cells in mouse model

In this study, we developed a tumour cell vaccine expressing a glycosylphosphatidylinositol (GPI)-anchored IL-21 to test the effect of immunotherapy of melanoma in mouse model. The results indicated that the tumour vaccine was functional, exhibiting delayed tumour growth and prolonging longevity of tumour bearing mice. The immunotherapeutic effect was associated with decreasing the numbers of CD4(+) CD25(+) Foxp3(+) Treg (Tregs) cells, increasing IFN-γ level and promoting lymphocyte-infiltration in tumour tissues. Overall, our data demonstrate that the GPI-anchored IL-21 tumour vaccine regulates immune responses at least in part by down-regulating Tregs and reveals enhanced efficacy of tumour vaccine therapy of melanoma.

[Analysis of the chemical constituents of essential oil from Magnolia biondii by GC-MS]

OBJECTIVE

The chemical components of essential oil from Magnolia biondii were analyzed by GC-MS.

METHODS

Essential oil was extracted by steam distillation (SD). The chemical components of essential oil were analyzed by GC-MS.

RESULTS

The chemical components in the oil were qualitatively and quantitatively analyzed by GC-MS. 63 components were separated and 50 components were identified. The main components were Eucalyptol (28.92%), P-pinene (12.39%), alpha-Terpineol (8.28%).

CONCLUSION

This is the first time to adopt GC-MS to analyze the chemical components of volatile oil of Magnolia biondii, and this study can provide science basis for further research development of Magnolia biondii.

[Effects and mechanism of thrombin on the expression of tissue factor activity in cultured bovine aortic endothelial cells]

OBJECTIVE

To explore the effects and mechanism of thrombin on the expression of tissue factor (TF) activity in cultured bovine aortic endothelial cells(BAECs).

METHODS

BAECs were cultured according to Schwartz's method, and one stage clotting time assay was used to measure TF activity.

RESULTS

1. Thrombin enhanced the expression of TF activity in cultured BAECs. 2. A23187, a calcium ionophore, induced slightly the expression of TF activity, but markedly promoted the thrombin-induced TF activity in BAECs(P < 0.05). 3. TFP, a Ca2+/CaM inhibitor, inhibited the inductive effects of thrombin. 4. Pentoxifylline, a phosphodiesterase inhibitor, inhibited thrombin-induced TF activity in BAECs.

CONCLUSION

Thrombin can induce the expression of TF activity in cultured BAECs, and the processes of signal transduction may be associated with Ca2+/CaM-dependent pathway and cAMP.

[Levels of plasma TF and TFPI activities in patients with acute leukemia]

OBJECTIVE

To investigate the changes of plasma tissue factor(TF) and tissue factor pathway inhibitor(TFPI) activities in the patients with acute leukemia.

METHODS

TF and TFPI activities were measured by using chromogenic assays.

RESULTS

Plasma TF activity in the patients with acute leukemia was higher and TFPI activity was lower than those in normal(P < 0.01). In 7 patients who underwent the first chemotherapy, the plasma TF activity was decreased after chemotherapy(P < 0.01), while TFPI activity increased(P < 0.05).

CONCLUSION

The unbalance between plasma TF and TFPI activities contributes to the coagulant disorders in acute leukemia.

[Expression of tissue factor of astrocytes and its signal transductional pathways]

The aim of this study was to observe the expression of tissue factor (TF) of astrocytes in basic culture medium and under the condition stimulated by thrombin and to explore the relevant signal transduction pathways. The results showed that 4-bromo calcium ionophore (A23187) and phorbol 12-myristate 13-acetate (PMA) enhanced significantly the TF expression of astrocytes, but the expression was decreased markedly by trifluoperazine (TFP) and 1-(5-isoquinolinyl sulfonyl)-3-methyl-piperazine (H7) in the basic medium. Thrombin increased significantly the TF expression of astrocytes, which was obviously inhibited by TFP and H7. The results above indicate that astrocytes can express TF activity in the basic medium, which is promoted by thrombin, probably through some pathways involving Ca2+/CaM and protein kinase C (PKC).

[HPLC determination of five constituents in plants of genus Ligusticum]

A RP-HPLC method was established to separate and determine five constituents in plants of genus Ligusticum by using an ODS column (Hypersil-C18, 5 microns) and acetonitrile (containing 1.25% CHCl3)--water (saturated with CHCl3) as mobile phase for gradient elution. The five constituents were ferulic acid, scopoletin, 3-butyl-phthalide, ligustilide, and diligustide. They were detected at 284 nm. Peak purity was monitored by photodiode array detector. Benzthiazide was used as the internal standard. The method is simple, fast, sensitive and reproducible.

[HPLC determination of six flavonoid constituents in Ginkgo biloba leaves]

Six flavonoid constituents (quercetin, isorhamnetin, kaempferol, bilobetin, ginkgetin and sciadopitysin) were isolated from Ginkgo biloba leaves and determined by reversed phase HPLC using salvianolic acid B as internal standard. The column employed was Zorbax ODS (150 mm x 4 mm ID, 5 microns). The mobile phase consisted of solvent A (methanol) and solvent B [tetrahydrofuran--water--formic acid (34:65:1)] for gradient elution. The flow rate was 1 ml.min-1 and detection was effected at 350 nm. This method is accurate, rapid and reproducible. Analytical data for various samples were given.

HLA-DMA and HLA-DMB gene expression functions through the conserved S-X-Y region

The MHC class II homologous proteins HLA-DMA and HLA-DMB function in the loading of peptides onto class II molecules. Like the class II genes, the HLA-DM genes contain upstream regulatory sequences similar to the S-X-Y regulatory region as well as additional putative regulatory sites. To determine whether the DM genes are regulated in a similar manner as class II genes, a series of in vivo and in vitro analyses was performed. Deletion analysis showed that expression from the DM promoters is dependent on the conserved S-X-Y region. The class II-specific transcription factors RFX and CIITA are also required for expression, as cell lines deficient in these factors failed to allow transcription from the DM promoters. In addition, in vivo footprint analysis showed the putative X and Y boxes to be occupied by transcription factors in wild-type B cells, but not in RFX-deficient B cells. In astrocytes, IFN-gamma treatment induced increased occupancy of these sites. None of the other putative regulatory sites was occupied in vivo, indicating that they may not be functional. Finally, gel shift analysis showed synergistic complex formation between proteins that bind to the putative X boxes of the DM genes, as is found for the DRA gene. Therefore, the DM genes share a common mechanism of regulation with the class II genes.

HLA-DMA and HLA-DMB gene expression functions through the conserved S-X-Y region

The MHC class II homologous proteins HLA-DMA and HLA-DMB function in the loading of peptides onto class II molecules. Like the class II genes, the HLA-DM genes contain upstream regulatory sequences similar to the S-X-Y regulatory region as well as additional putative regulatory sites. To determine whether the DM genes are regulated in a similar manner as class II genes, a series of in vivo and in vitro analyses was performed. Deletion analysis showed that expression from the DM promoters is dependent on the conserved S-X-Y region. The class II-specific transcription factors RFX and CIITA are also required for expression, as cell lines deficient in these factors failed to allow transcription from the DM promoters. In addition, in vivo footprint analysis showed the putative X and Y boxes to be occupied by transcription factors in wild-type B cells, but not in RFX-deficient B cells. In astrocytes, IFN-gamma treatment induced increased occupancy of these sites. None of the other putative regulatory sites was occupied in vivo, indicating that they may not be functional. Finally, gel shift analysis showed synergistic complex formation between proteins that bind to the putative X boxes of the DM genes, as is found for the DRA gene. Therefore, the DM genes share a common mechanism of regulation with the class II genes.

[Clinical study on the piweiping capsule in treating patients with metaplasia of gastric mucosa]

One hundred and forty-three patients were diagnosed as chronic superficial atrophic gastritis of gastric antrum or with metaplasia by means of gastroscopic observation with pathological biopsy examination. They were divided into 4 types (the Spleen-Stomach Cold-Deficiency type, Disharmonious of Liver and Stomach type, Spleen-Stomach Yin Deficiency type and Spleen Deficiency with Qi-Stagnation type) and subdivided according to treatment into two groups, 75 patients of treatment group of above-mentioned 4 types were treated with Piweiping capsule (PWPC) I, II, III, IV respectively, 68 patients of control group were all treated with Sanjiu Weitai (SJWT). After 3-6 months of treatment, the improvement of gastric mucosa cyclic adenosine monophosphate, deoxyribonucleic acid, 3H-thymopyrimidine nucleoside and lymphocyte transformation of treatment group were all superior to that of control group, P < 0.05-0.001. The curative rate and total effective rate of symptomatic effect of treatment group were 49.3% and 92.0%, while at intestinal metaplasia of treatment group were 45.3% and 62.7%. As in control group, they were 29.4%, 67.6%, 10.3% and 29.4% respectively. The difference between two groups was significant, P < 0.001. These results suggested that the PWPC could reverse the intestinal metaplasia through improving the gastric cAMP, DNA and strengthening the cellular immunity and the effect would be enhanced when the treatment was based on syndrome differentiation.

[Study on mitochondrial ultrastructure, trace elements and correlative factors of gastric mucosa in patients with spleen deficiency syndrome]

Eighty-eight gastropathic patients with Spleen deficiency syndrome by using transmission electron microscope (TEM), X-ray energy disperse analysis system (EDAX), histochemical staining and radioimmuno methods were examined. The authors found that the gastric mucosa cAMP, SOD level, the quantity of mitochondria and its crista, the ratio of diameter between ventricle and cavity of mitochondria and the content of Zn, Cu of mitochondria were reduced in the trend of healthy control group, Spleen Qi deficiency group, Spleen deficiency with Qi stagnation group; chronic superficial gastritis group, chronic atrophic gastritis group, gastric cancer group: complete small intestinal metaplasia group, incomplete small intestinal metaplasia group, complete colonic intestinal metaplasia group, incomplete colonic intestinal metaplasia group (P < 0.05-0.001). While the degeneration rate of mitochondria, the Cu/Zn ratio of mitochondria, the metaplasia rate of gastric, the rate of incomplete colonic intestinal metaplasia and the content of serum LPO were increased in the above turn. It is suggested that the comprehensive effect of the degeneration of mitochondria and the quantitative changes of its correlative factors is the physiopathologic base for inducing Spleen deficiency disease, gastric mucosa metaplasia and canceration. Much attention must be paid in clinic to the cancerization trend of gastric disease with Spleen deficiency syndrome.

[Effect of zhuchun pill on immunity and endocrine function of elderly with kidney-yang deficiency]

After randomly dividing 45 elderly males with Kidney-Yang Deficiency into Zhuchun Pill (ZCP) group and placebo (starch capsule) group by single blind method, and treating them for 3 months, we found that ZCP could greatly improve the main symptoms of Kidney-Yang Deficiency, P < 0.01 by comparison with control group: the 3H-TdR lymphocyte transformation (3H-TdR LCT) rate, level of serum C3, IgA, IgD, IgG & IgM went up (P < 0.01); contents of plasma adrenocortical hormone (ACTH), testosterone (T) and cyclic adenosine monophosphate (cAMP) increased (P < 0.01-0.001): the level of superoxide dismutase (SOD) in serum also increased while lipid peroxide (LPO) in plasma decreased (P < 0.01). But for control group, there were no remarkable changes after treatment, so it revealed that the improvement of Kidney-Yang Deficiency by ZCP is realized through regulating the organism's immunity and endocrine function as well as through scavenging the free radical agents.

Raman heterodyne detected electron-nuclear-double-resonance measurements of the nitrogen-vacancy center in diamond

We report two new applications of the Raman heterodyne detection technique. Raman heterodyne detected electron-nuclear double resonance and a double rf resonance technique are used to obtain the hyperfine structure of the nitrogen-vacancy center in diamond.

Raman heterodyne detection of electron paramagnetic resonance

We report the detection of an electron paramagnetic resonance signal using Raman heterodyne spectroscopy, a rf -optical double-resonance technique. The signals are associated with the nitrogen-vacancy center in diamond, which has a spin-triplet ground state. A three-line spectrum associated with the nitrogen hyperfine structure is observed for various magnetic field strengths and crystal orientations.