Objective To ana1yze the therapeutic effect of p1asma exchange(PE)in the treatment of hyperbi1irubi-nemia after a11o-HSCT.Method From October 2009 to October 2016,nine patients(16 events a1together)received PE due to hyperbi1irubinemia after a11o-HSCT.The 1iver function,bi1irubin and prothrombin time activity were com-pared before and after the treatment.Adverse effects were observed in the same time.Result A11 9 patients were trea-ted with p1asma exchange tota11y 16 times;After the treatment,serum tota1 bi1irubin(TB)and direct bi1irubin(DB) decreased.The decreased 1eve1s in b1ood ce11s,a1bumin and prothrombin time activity were not statistica11y signifi-cant.Conclusion P1asma exchange therapy may reduce the serum bi1irubin 1eve1 in a certain extent.But the effect of p1asma exchange on prognosis remains to be further studied.

Angiogenesis is important in pathophysiological processes, including the pathogenesis of acute monocytic leukemia (AML). MicroRNA‑21 (miR‑21) is overexpressed and exhibits oncogenic activity in cancer. However, the biological mechanism underlying the effect of miR‑21 in AML remains to be fully elucidated. In the present study, the expression levels of miR‑21 and vascular endothelial growth factor (VEGF) were determined in 26 patients with AML and 28 healthy individuals. The secretion of VEGF was also measured following the transfection of THP‑1 cells with miR‑21 mimic or inhibitor. The supernatants of the THP‑1 cells, which were transfected with miR‑21 mimic, inhibitor or small interfering RNA (si)VEGF, respectively, were used to incubate human umbilical vein endothelial cells (HUVECs), following which tube formation of the HUVECs was measured. miR‑21 targets were predicted using a biological target prediction website and confirmed using a luciferase assay. The effects of interleukin (IL)‑12 were investigated by examining the tube formation of HUVECs and the secretion of VEGF following recombinant human (rh) IL‑12 pretreatment. The results revealed that miR‑21 and VEGF expression was significantly increased in the peripheral blood monocytes of the patients, compared with the healthy controls. There was negative correlation between the expression of IL‑12 and miR‑21 in the serum of patients with AML. Furthermore, supernatant VEGF levels from the miR‑21 mimic‑transfected THP‑1 cells were increased, whereas a decreasing trend was observed in the miR‑21 inhibitor group. The angiogenic ability of the HUVECs pretreated with supernatant from the THP‑1 cells transfected with miR‑21 mimic was higher, and was lower in THP‑1 cells co‑transfected with miR‑21 mimic and siVEGF, compared with the miR‑21 mimic only group. A luciferase assay demonstrated that IL‑12 was the direct target of miR‑21, and the level of IL‑12 in the supernatant of THP‑1 cells transfected with miR‑21 mimic was increased. IL‑12 pretreatment increased VEGF expression and angiogenic ability in HUVECs. The inactivation of miR‑21 or activation of its target gene may be a potential therapeutic strategy in human AML.

Acute leukemia (AL) is the most popular malignant tumor in children. Currently little has been known about the relationship between childhood AL pathogenesis and whole-genome methylation level. As the polymorphism of DNA methyltransferase (DNMT) gene can affect DNA methylation level, we investigated the whole genome methylation level in childhood AL patients. Meanwhile, the relationship between DNMT1 gene polymorphism and susceptibility of childhood AL was also been investigated. A case-control study was performed recruiting childhood AL patients and age-matched healthy children (N=168 each). PCR-ligase detective response (PCR-LDR) typing method was used to study the genotype distribution of human DNMT1 gene at rs2228611 and rs10854076 loci. Pyrophosphate sequencing was used to measure LINE-1 methylation level. Allele frequency of two loci fits HardyWeinberg equilibrium (P>0.05). Significant difference of genotype and allele frequency existed at locus rs10854076 but not locus rs2228611 between patients and healthy people. Allele C was found to be a risk factor for AL. A significant difference of LINE-1 methylation level existed between the two groups, as AL patients had lower methylation level (P<0.05). Specifically, LINE-1 methylation level at locus rs10854076 but not at rs2228611 had significant difference between patients and controls. Polymorphism of DNMT1 gene at locus rs10854076 is related with children AL susceptibility, possibly via affecting LINE-1 methylation level.

AIMS:To investigate the association of several single nucleotide polymorphisms (SNPs) within vascular endothelial growth factor (VEGF) and vitamin D receptor (VDR) gene polymorphisms and additional gene- gene and gene- smoking interaction with multiple myeloma (MM) risk in Chinese population. METHODS:Generalized multifactor dimensionality reduction (GMDR) was used to screen the best interaction combination among SNPs and smoking. Logistic regression was performed to investigate association between 6 SNPs within VEGF and VDR gene, additional gene- gene and gene- smoking interaction on MM risk. RESULTS:MM risk is significantly higher in carriers with the rs699947- A allele within VEGF gene than those with CC genotype (CA+ AA versus CC), adjusted OR (95%CI) =1.72 (1.19-2.33), and higher in carriers with rs2228570- T allele within VDR gene than those with CC genotype (CT+ TT versus CC), adjusted OR (95%CI) = 1.68 (1.26-2.17). We also found a significant two-locus model (p=0.0010) involving rs699947 and rs2228570, and a significant two-locus model (p=0.0107) involving rs2228570 andsmoking. Participants with rs699947- CA+AA and rs2228570- CT+TT genotype had the highest MM risk, compared to participants with rs699947- CC and rs2228570- CC genotype, OR (95%CI) = 3.12 (1.82 -4.61). Smokers with rs2228570- CT+TT genotype had the highest MM risk, compared to never- smokers with rs2228570- CC genotype, OR (95%CI) = 3.27 (1.74-4.86). CONCLUSIONS:We found that the A allele of rs699947 within VEGF and T allele of rs2228570 within VDR gene, interaction between rs699947 and rs2228570, rs2228570 andsmoking were all associated with increased MM risk.

Objective To evaluate the efficacy of post-transplantation cyclophosphamide for tolerance induction in post-transplantation for severe aplastic anemia(SAA)and to observe the effects of cyclophosphamide on hematopoietic stem cells in animal experiments. Method 16 patients with severe aplastic anemia who underwent allo-HSCT were enrolled. All patients received fludarabine, CY, busulfan, and ATG as conditioning before allo-HSCT. On days 3 and 4 after transplantation combined with 50 mg/(kg·d) of cyclophosphamide. Animal experiments with three doses of 100,200,380 mg/kg respectively by intraperitoneal injection of cyclophosphamide BALB/c mice, and dynamic observe of the formation of CFU-GM and BFU-E between groups of mice.Result All patients, one case died of engraftment failure, the rest of the 15 patients all engraftment success. All mice survived in animal experiments, the experimental group and control group of BFU -E and CFU-GM colony formation of no significant difference (P>0.05), and had no obvious difference between the experimental group (P>0.05).Conclusion Use of cyclophosphamide induction of immune tolerance for SAA after transplantation is a feasible method, animal experiments cyclophosphamide has no damage effect on bone marrow hematopoietic stem cells in mice SAA cyclophosphamide induction of immune tolerance for clinical treatment.

The study was aimed to explore the efficacy and safety of allo-HSCT with high-dose cyclophosphamide-induced immune tolerance for SAA. In the present study, 20 cases (12 male, 8 female; average age = 17.8 years) received reduced-intensity conditioning allo-HSCT from August 2012 to August 2014 in the Beijing Military Region General Hospital. All were HLA mismatched and received CSA; 11 received ATG-intensive immune therapy. Donors underwent mobilization with cell colony-stimulating factor. The modified preconditioning regimen included reduced-strength fludarabine combined with Busulfex and cytarabine, cyclophosphamide. Cyclophosphamide (50 mg/kg/d) induced immune tolerance 3 days after transplantation and was combined with immunosuppressive agents, including CSA, MTX, and FK506, for GVHD prophylaxis and the management of observed toxicity, GVHD and DFS. Hematopoietic reconstitution was achieved in 17 cases and engraftment after a second transplantation in an additional three cases. The average times to engraftment were 17.4 and 21.3 days, respectively, with neutrophils ≥0.5 × 109/L and platelets ≥20 × 109/L. Engraftment was confirmed by the evidence of 100 % donor hematopoiesis; T lymphocyte subset counts also increased significantly after transplantation. During follow-up monitoring to April 2015 (median duration = 17.7 months), three patients died of complications, while the other 17 showed disease-free survival (DFS rate = 85 %; longest DFS period = 32 months). Reduced-intensity allo-HSCT with high-dose cyclophosphamide-induced immune tolerance treatment is effective for SAA and can be the key technology extensively used in clinic, but its efficacy needs to be confirmed further with prospective randomized study with increased sample size.

ObjectiveTo explore the clinical effect of hemodialysis combined with hemoperfusion in the treatment of acute severe organophosphorus pesticide poisoning.Method100 cases of acute severe organophosphorus pesticide poisoning patients admitted in our hospital from June 2011 to June 2015 were divided into combined group and conventional group according to the random number table method, 50 cases in each group. Conventional group patients were treated with gastric lavage and catharsis, cleaning skin, protecting gastric mucosa and other conventional treatment. In addition to the routine treatments, combined group patients were treated with hemodialysis combined with hemoperfusion. Compared the dosage of atropine, recovery time, hospitalization time, the incidence of multiple organ failure and cholinesterase activity of the two groups before and after treatment.ResultThe differences of cure rate and mortality rate between the two groups were significant (P<0.05). Combined group patients with atropine dosage were less than control group, the recovery time, hospitalization time weres shorter than control group, multiple organ failure rate were lower than conventional group (P<0.05). Two groups of patients before treatment of cholinesterase activity had no obvious difference (P>0.05), and the cholinesterase activity of combined group was significantly higher than conventional group after treatment (P<0.05).Conclusion Hemoperfusion combined with hemodialysis can effectively improve the prognosis of patients with severe acute organophosphorus pesticide poisoning, reduce the dosage of atropine, accelerate the recovery of the patients, avoid multiple organ failure, worthy of clinical application.

OBJECTIVE:To evaluate the relationship between T lymphocyte subsets and the incidence of graft-versus-host disease (GVHD) and its clinical significance of monitoring the changes of T lymphocyte subsets dynamicly on 1, 3, 6, 12 month after allogeneic hematopoietic stem cell transplantation (allo-HSCT).METHODS:Twenty cases received allo-HSCT in Department of Hematology of General Hospital of Beijing Military Command from January 2013 to January 2014, including 10 males and 10 females with average age of 20.3 years (3-46 years old), among them 4 cases rectived HLA matched transplantation and 16 cases rectived HLA mismatched transplantation. The levels of T lymphocyte subsets including CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD4(+)CD25(high) FOXP3(+) in the peripheral blood were manitored with flow cytometry (FCM) on +1, +3, +6, +12 month after transplantation dynamicly.RESULTS:(1) Follow up to March 2015, the levers of CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD4(+) CD25(high) FOXP3(+) showed a different degree of recovery after transplantation for all cases and returned to the lever of pre-transplantation on 12 month basically, and CD8(+) T cells recovered earlier than CD4(+) T cells, while the decrease of CD4(+) T cells lasted more than 1 year; The proportion inversion of CD4(+)/CD8(+) also lasted for more than 1 year;(2) The level of CD4(+) CD25(high) FOXP3(+) in patients with acute GVHD was lower than that in patients without acute GVHD.CONCLUSION:The dynamic monitoring of the T lymphocyte subsets, especially CD4(+) CD25(high) FOXP3(+) after transplantation has importent clinical significance, it can forecast the incidence of acute GVHD before symptoms appeared; the dynamic monitoring of the T-lymphocyte subsets also can be used as reference indicator for prediction of GVHD, theraby it can reduce mortality of patients after transplantation.

OBJECTIVE:To investigate the efficacy and safety of haploidentical allo-HSCT in combination of reduced intensity preconditioning combined with cyclophosphamid (CTX)-induced immune tolerance after transplanitation for treatment of severe aplastic anemia (SAA).METHODS:A total of 15 patients with SAA received the haploidentical allo-HSCT of reduced intensity preconditioning combined with CTX-induced immune tolerance after transplartation in the General hospital of Beijing military command of chinese PLA from June 2012 to December 2014. The reduced intensity preconditioning regimen consisted of CTX, fludarabine, busulfex and amti-lymphocyte immunoglobin; the immune tolerance was induced with CTX (50 mg/kg·d) on day 3 after transplantation; the HSC donors were father and mother of patients. The GVHD was prevented by inmunosuppression consisted of cyclosporine A(CsA), methotrexate and tacrolimus. The aduvese reaction and disease-free survival (DFS) were observed in all the patients.RESULTS:All the SAA patients achieved hematopoietic reconstitution with 100% donor hematopoiesis, and all the T lymphocyte subsets increased. Out of 15 patients, 3 cases died of complication, and the DFS rate was 80% with a median follow-up of 19.8 month (6-36 months).CONCLUSION:The haploidentical allo-HSCT of reduced intensity preconditioning combined with CTX-induced immune tolerance after transplantation is safet and effective for SAA patients, that may be applied to clinical therapy.

Objective To compare the efficacy of first-line treatment of EPOCH regimen and CHOP regimen for periph-eral T cell lymphoma .Methods 32 cases with peripheral T cell lymphoma were divided into 2 groups ,16 cases received chemo-therapy with EPOCH regimen:VP-16 50 mg/m2 d1~4、ADM 10 mg/m2 d1~4、VDS 1 mg/d d1~4、CTX 750 mg/m2 d5、Pred 60 mg/m2 d1~5,16 cases received chemotherapy with CHOP regimen:CTX 750 mg/m2 d1、ADM 45 mg/m2 d1、VDS 4 mg/d d1、Pred 60 mg/m2 d1~5.3 weeks was a cycle for 6~8 cycles,and the clinical efficacy of the 2 programs were compared.Results The total remission rates of the 2 groups were 56.3%and 31.3%,the total efficiency were 81.3%and 62.5%,and the median survival time was 28.5 months and 21.8 months.Conclusion EPOCH regimen is superior to CHOP regimen in the first-line treatment for Peripheral T cell lymphoma .

目的 观察DVD（脂质体多柔比星+长春新碱＋地塞米松）方案治疗复发难治性多发性骨髓瘤（MM）的临床疗效和安全性。 方法 选取北京军区总医院血液科2013年1月至2015年1月收治的20例复发难治性MM患者，其中男11例，女9例，平均年龄55岁（38~ 77岁），按患者治疗意愿分为治疗组（DVD组）10例，对照组10例（VTD组，硼替佐米+沙利度胺+地塞米松），化疗4个疗程以上，比较两组患者治疗效果及不良反应。 结果 治疗组总有效率90 %（9/10），对照组总有效率80 %（8/10），两组差异无统计学意义（P=0.682）。随访至2015年3月，DVD组因疾病进展死亡1例，其余9例均生存，VTD组因并发症、疾病进展死亡2例，其余8例均生存，两组的总生存率分别为90％和80 %；DVD组周围神经毒性发生率低于VTD组，差异有统计学意义（P 0.05）。 结论 DVD方案治疗复发难治性MM疗效与VTD方案相当，是一种安全、可靠、有效的治疗方法，且患者不良反应小，同时价格相对便宜，适合临床推广应用。

Objective To explore the clinical significance of the relationship between the immune function and the pathogenesis of aplastic anemia in children with aplastic anemia(AA),along with the incidence of graft versus host disease (GVHD)by monitoring the changes of T lymphocyte subsets dynamically in +1 ,+3,+6,+1 2 months for blood disease patients after allogeneic hematopoietic stem cell transplantation.Methods Twelve AA patients re-ceived allogeneic hematopoietic stem cell transplantation in Department of Hematology,the Affiliated General Hospital of Beijing Military Region of Anhui Medical University,from January 201 3 to January 201 4,including 4 male and 8 fe-male,with average age of 7.92 years old(3 -1 4 years old)with 5 cases of human leukocyte antigen(HLA)matched and 7 cases of HLA mismatched.The level of T lymphocyte subsets including CD3 +,CD4 +,CD8 +,CD4 +/CD8 +, CD56 +,CD4 +CD25 high +FOXP3 +were monitored with flow cytometry before transplantation and in +1 ,+3,+6,+1 2 months after transplantation dynamically in the peripheral blood.While in the same period the level of T lymphocyte subsets was monitored in 1 2 cases of healthy children at the same period as the healthy control group.Results Fol-lowed up to March 201 5,1 0 cases had abnormal cellular immunity (CD4 +/CD8 + ratio inversion)in the 1 2 AA pa-tients.Compared with the control group,in the AA group,CD3 + was slightly higher,(66.79 ±7.35)% and (62.74 ± 5.58)% respectively(P =0.043),CD4 + was decreased by (33.73 ±7.26)% and (39.54 ±3.46)% respectively (P =0.037),CD8 + was increased by (35.69 ±6.78)% and (25.34 ±4.36)%,respectively (P =0.000),CD4 +/CD8 + decreased by 1 .23 ±0.56 and 1 .78 ±0.34 respectively(P =0.001 )and CD56 + was decreased by (7.46 ± 2.80)% and (1 6.73 ±3.70)% respectively(P =0.000),CD4 +CD25 high +FOXP3 + was decreased by (3.3 ± 1 .5)% and (8.1 ±1 .3)% respectively (P =0.003),whose difference was statistically significant (P <0.05).The lever of CD3 +,CD4 +,CD8 +,CD4 +/CD8 +,CD56 +,CD4 +CD25 high +FOXP3 + had a different degree of recovery after transplantation for all cases and returned to normal in +1 2 months basically.In +1 ,+3,+6,+1 2 months after transplantation,the levels of CD4 +CD25 high +FOXP3 + in GVHD positive group and negative group were (0.4 ± 0.6)% and (1 .6 ±0.7)% respectively,(0.7 ±0.3)% and (2.7 ±0.4)% respectively,(1 .1 ±0.5 )% and (2.9 ±0.7)% respectively,(1 .4 ±0.3)% and (3.6 ±0.2)% respectively,which had statistical significance (P <0.05).Conclusions There was abnormal cell immune function in some cases with AA.After transplantation,the level of CD4 +CD25 high +FOXP3 + is closely related to the acute GVHD,which can be used to predict the occurrence of GVHD.

The aim of the present study was to construct a chimeric adenovirus (Ad) 5/F35 co-expressing human CD4O ligand (CD4OL) and interleukin (IL)-2 (Ad5/F35 CD40L-IL-2). The infection efficiency to human monocyte-derived dendritic cells (Mo-DCs), expression of genes, phenotype changes and IL-12 production of Mo-DC by Ad5/F35 CD40L-IL-2 were investigated. CD40L and IL-2 from total RNA extracted from human peripheral blood mononuclear cells (PBMCs) were cloned by reverse transcription-polymerase chain reaction and used to construct Ad5/F35 CD40L-IL-2. The infection efficiency, expression of CD40L, and phenotype changes of Mo-DC infected with Ad5/F35 CD40L-IL-2 were analyzed using flow cytometry. The quantities of IL-2 and IL-12 in the supernatants of Mo-DC following infection of Ad5/F35 CD40L-IL-2 were measured by enzyme-linked immunosorbent assay. The CD40L and IL-2 genes were successfully cloned and the Ad5/F35 CD40L-IL-2 was constructed. Ad5/F35 CD40L-IL-2 efficiently infected Mo-DCs with an infection efficiency of >75%, and the infected Mo-DCs expressed CD40L and secreted IL-2. The expression levels of cluster of differentiation (CD) 80, CD86, CD40, and human leukocyte antigen-antigen D related on Mo-DC were moderate; however, CD83 was low prior to infection of Ad5/F35 CD40L-IL-2. Those molecules, particularly CD83, were markedly upregulated 24 h after the infection. Increasing quantities of IL-12 in the supernatants were detected subsequent to infection at different time points in a time-dependent manner. Thus, Ad5/F35 CD40L-IL-2 efficiently infected human Mo-DCs and its products, CD40L and IL-2, were subsequently expressed. In addition, infection with Ad5/F35 CD40L-IL-2 stimulated the maturation of Mo-DC and high levels of IL-12 production.

Objective To explore the efficacy and feasibility of idarubicin combined with medium-dose arabinoside in intensive chemotherapy for acute myeloid leukemia (AML). Methods Fifty remittent patients with induced chemotherapy who underwent the intensive consolidation therapy with medium-dose arabinoside from January 2010 to January 2015 in hematology department of General Hospital of Beijing Military Area were considered as the treatment group. The single arabinoside (2 g/m 2, 1/12 h, d1-3) treatment for 50 cases in the same period were considered as the control group. Two groups were performed with 6 courses sequential. There were 28 males, 22 females in the treatment group, and average age was 27.6 years (18-52 years), with 3 cases of M 1, 27 cases of M2, 8 cases of M4, 12 cases of M5. In the control group, there were 30 males, 20 females, and average age was 26.8 years (16-50 years), with 2 cases of M1, 30 cases of M2, 8 cases of M4, 10 cases of M5. Then the complications and disease-free survival of two groups were observed respectively. Results Follow-up was done until June 2015. In the treatment group, 1 case died of pulmonary infection, 2 cases died of septic shock and 3 cases died of pulmonary infection, 1 case died of septic shock in the control group. The treatment related mortality of both groups were 6 % (3/50), 8 % (4/50), the related relapse rates were 32 % (16/50), 52 % (26/50), the disease-free survival rates were 62 % (31/50), 40 % (20/50) respectively in two groups. Conclusion Compared with the single arabinoside, the intensive consolidation therapy with medium-dose arabinoside and idarubicin for the treatment of AML has gained lower relapse rate and the related mortality, and the DFS rate has been improved significantly, which need further clinical application.

目的 观察DCAG方案治疗初次诱导失败的急性髓系白血病的临床疗效.方法 30例初次诱导失败的急性髓系白血病患者,采用DCAG方案治疗:地西他滨15 mg/m2,第1～5天;阿克拉霉素6 mg/m2,第1～8天;阿糖胞苷10mg/m2,q12 h,第1～8天;粒细胞集落刺激因子300 mg/d,第1～14天.结果 全部患者中,18例获得完全缓解,7例获得部分患者,完全缓解率和总有效率分别为60.0％、83.3％.临床不良反应主要为骨髓抑制,其中粒细胞缺乏(中性粒细胞＜ 0.5×109/L)和血小板减少(PLT ＜20×109/L)的中位持续时间分别为8.5d、10.8 d.结论 DCAG方案治疗初次诱导失败的急性髓系白血病安全有效、不良反应轻.

Objective To observe the effect and adverse reactions of interleukin-11 (IL-11) for platelet recovery of patients with relapsed and refractory lymphoma by haploidentical hematopoietic stem cell transplantation. Methods A total of 16 patients with relapsed and refractory lymphoma undergoing haploidentical allogeneic hematopoietic stem cell transplantation during January 2011 and January 2014, were recruited in this study. The patients were randomly divided into IL-11 treatment group (n=8) and symptomatic treatment group (n=8). The symptomatic treatment group received symptomatic supporting treatments such as platelet transfusion, while the IL-11 treatment group was given additional IL-11 2400 million U/d for 14 d on the 7 th d after the transplantation based on the symptomatic supporting treatments. The mod-ified Busulfan/Cyclophosphamide ( BU/CY) was used as preparative regimen. The times of platelet ( PLT) count equal to or over 20 × 109/L and 50 × 109/L, the condition of disease free survival after the transplantation and platelet infusion times were observed. Results All the patients acquired hematopoietic reconstruction. The times of PLT count equal to or over 20 × 109/L and 50 × 109/L and irradiated platelet infusion times in the IL-11 group were less than those in the control group (P<0. 05). In IL-11 group, 2 patients had transient adverse reactions such as nausea, vomiting and head-ache. With follow-up to January 2015, the disease free survival rates were 50% in IL-11 group and 62. 5% in control group respectively, but the difference was not statistically significant (P>0. 05). Conclusion IL-11 in application of patients with relapsed and refractory lymphoma by haploidentical hematopoietic stem cell transplantation can accelerate platelet recovery with mild adverse reactions and good tolerance.

目的:分析益气活血中药血液透析液对慢性肾功能衰竭（Chronic renal failure,CRF）患者血小板膜糖蛋白CD62P表达的影响。方法:选取我科2012年1月~2014年1月长期接受血液透析的CRF患者92例,随机分为实验组和对照组。对照组采用碳酸氢盐血液透析液,实验组在对照组基础上,加用益气活血中药。对比两组患者透析3个月后中医症候评分、血生化、血常规指标、尿白蛋白/肌酐比（ACR）、尿渗透压和血清CD62P水平。结果:治疗3个月后,两组患者的中医症候评分较治疗前显著降低,P＜0.05;实验组治疗3个月后中医症候评分较对照组显著降低,P＜0.05。治疗3个月后,两组患者的血肌酐、尿素氮、血钾、血磷和免疫反应性甲状旁腺激素（immunoreactive parathyroid hormone,i PTH）较治疗前显著降低,血钙较治疗前显著上升,P＜0.05;治疗3个月后,实验组的血肌酐、尿素氮、血钾、血磷和i PTH较对照组显著降低,血钙较对照组显著上升,P＜0.05。治疗3个月后,两组患者的红细胞、血红蛋白和尿渗透压较治疗前显著升高,尿ACR较治疗前显著降低,P＜0.05;治疗3个月后,实验组的红细胞、血红蛋白和尿渗透压较对照组显著升高,尿ACR较对照组显著降低,P＜0.05。治疗3个月后,两组患者的血清CD62P水平较治疗前显著降低,P＜0.05;治疗3个月后,实验组血清CD62P水平较对照组显著降低,P＜0.05。结论:益气活血中药血液透析液用于CRF患者透析可降低其CD62P水平,改善肾功能,具有一定的应用价值。

Objective To observe the effectiveness and safety of infliximab on acute intestinal graftversus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation.Methods Fifteen patients were diagnosed with grade Ⅲ to Ⅳ acute intestinal GVHD after transplantation in the Department of Hematology,Military General Hospital of Beijing PLA from January 2012 to January 2015,9 males and 6 females,average age was 28.8 years (8～ 45 years).Among them,5 cases with HLA matching identical,and 10 cases with HLA mismatched.The median time of intestinal GVHD was 66.7 (35 ～ 90) days after transplantation.The method of infliximab treatment was 5 mg/kg,once per week,then applicated 1 to 4 times according to the situation of intestinal GVHD control.Effectiveness and the related toxicity were observed.Results The overall adverse reactions were relatively light with infliximab.Seven cases obtained complete remission,3 cases with partial remission,other 5 cases were ineffective,and the total efficiency of 66.7％.Follow up to January 2015,the median follow-up was 11.1 months (2 to 32 months).Five cases died of intestinal GVHD,3 patients died of recurrence,1 cases died of infection,other patients are still in complete remission,and the disease free survival rate was 40％,of which the longest disease-free survival was 32 months.Conclusion Infliximab shows significant efficacy and small adverse side effects for acute intestinal GVHD.

Objective: In this study, we performed an updated meta-analysis by summarizing all available relevant association studies to evaluate whether the murine double minute-2 (MDM2) T309G polymorphism is associated with risk of leukemia and to determine its prognostic effect. Material and Methods: Studies published in PubMed, Embase and the Cochrane Controlled Trial Register were searched till June 2014 using the search terms ‘MDM2', ‘polymorphism' and ‘leukemia'. Results: Eleven studies were included in this meta-analysis, with a total of 2,478 patients accrued. There were 8 studies providing data on single nucleotide polymorphism at position 309 (SNP309) and risk of leukemia and 7 studies providing data on SNP309 and overall survival. Our analysis showed that patients having G/G mutations had a significantly higher risk of developing leukemia (HR 1.90, 95% CI 1.56-2.31, p < 0.00001), while the association between G/T and leukemia was not significant (HR 1.18, 95% CI 0.96-1.45, p = 0.11). In addition, SNP309 was not significantly associated with patient survival (HR 1.29, 95% CI 0.79-2.13, p = 0.31). Conclusions: Our meta-analysis showed that the MDM2 T309G variation, especially homozygous G/G, might be associated with an increased risk of leukemia. Additional studies are needed to confirm the findings as well as to understand the underlying mechanisms.