米非司酮合并米索前列醇房事后避孕临床多中心研究

在黄体早、中、晚期应用米非司酮合并米索前列醇与单用米非司酮进行房事后避孕临床多中心比较性研究。５４１名自愿接随机序号参加本研究的健康、月经规律妇女，组Ⅰ口服米非司酮２５ｍｇ，ｑ１２ｈ共４次，第三天上午加服米索前列醇０．４ｍｇ，妊娠率为０．４％。组Ⅱ单服米非司酮２５ｍｇ，ｑ１２ｈ，共４～６次，妊娠率为３％。二者差异有显著性（Ｐ＜０．０５）。两者引起出血类型和时间均与正常月经相似，且无明显副反应发生，错过了服用传统房事后避孕药时，采用本研究的方法可不考虑性生活时间、次数。这种方法提供了一种新型有效避孕方法。     

The Fourth Nagoya International Blood and Marrow Transplantation Symposium: New Horizons in Allogeneic Hematopoietic Cell Transplantation— 2001 Revolution

In this symposium, we saw new horizons in allogeneic transplantation. Are these truly revolutionary? We do not yet know the answer. However, there is no question about the importance of allogeneic T cells. T cells are much more powerful than any pharmacological drug man has ever generated. The question is, how do we take the most advantage of their potential. Every participant was encouraged to search for good answers to this question until the next meeting.     

Posttreatment M-protein nadir level is a significant prognostic factor associated with survival in multiple myeloma. Nagoya Myeloma Cooperative Study Group.

In the present study 142 patients with myeloma (102 with IgG M-protein and 40 with IgA) treated with either VMCP (65 patients) or MMCP (77 patients) as remission induction therapy were retrospectively analyzed. Response to treatment was evaluated in terms of a more-than-50% fall of pretreatment M-protein and the posttreatment M-protein nadir. Though significantly more patients treated with MMCP achieved partial response (PR) as compared with those treated with VMCP (P=0.019) and though patients achieving PR showed a significantly longer survival than those with less responsiveness (P=0.0091), the difference in survival curves between the two treatment groups was not significant (P=0.1871). The difference in response between the treatment groups evaluated in terms of posttreatment nadir was not significant (P=0.507). Multivariate analysis identified posttreatment M-protein nadir as a significant prognostic factor associated with survival, along with 3 other factors: sex, performance status, and hemoglobin. The lack of difference between the survival curves for patients treated with the 2 regimens despite the significantly different response rates evaluated in terms of percent fall of pretreatment M-protein levels was considered to be due to the lack of a difference in the ability to induce a deep posttreatment nadir between the regimens. Posttreatment M-protein nadir is an important prognostic factor associated with survival and should be included in the evaluation of the efficacy of chemotherapy.     

Acute myeloid leukemia in the elderly:--159 Nagoya case studies--Nagoya Cooperative Study Group for Elderly Leukemia

To obtain background information on elderly acute myeloid leukemia (AML), unselected data covering 159 patients aged 60 years or over with AML from 14 hospitals in Nagoya, Japan was analyzed retrospectively. Among these patients, 119 had de novo acute AML, 32 had AML which evolved from myelodysplastic syndrome (MDS-AML), and 8 had other types of leukemia. The survey showed that MDS-AML tended to be more prevalent in patients aged 70 years and older and that MDS-AML showed a significantly more severe degree of leukopenia and anemia than de novo AML. MDS-AML also showed a significantly lower complete remission (CR) rate than that of de novo AML [6.9% (2/29) vs 58.3% (67/11), P < 0.01] and significantly shorter survival times than those of de novo AML [median: 3.6 months vs 9.6 months, P < 0.01 (generalized Wilcoxon test; GW]. In de novo AML, the proportion of patients treated with conventional therapy (CT group) decreased significantly, and that of those with attenuated therapy (AT group) increased significantly as age elevated (P < 0.01). The CT group showed a significantly higher CR rate (65.4% vs 41.2%, P < 0.05) and a significantly longer survival period than those of the AT group [median: 11.6 months vs 4.8 months, P < 0.05 (GW)]. Overall survival rates of the older age groups became significantly shorter with aging [P < 0.01 (GW)].     

H12单克隆抗体荧光标记活体脑胶质瘤的实验研究

目的 :识别肿瘤边界 ,确保正常神经组织不受损伤的前题下更完全地切除脑胶质瘤。方法 :FITC标记的单克隆抗体 40 0 μg/只 ,腹腔注射或局部点染脑胶质瘤C6细胞颅内肿瘤裸鼠模型 ,共聚焦激光扫描显微镜观察。结果 :C6胶质瘤本身和肿瘤瘤周水肿区被染成绿色 ;正常脑组织未被染色 ;镜下可以辨别经FITC标记单克隆抗体特异结合的肿瘤组织与正常脑组织之间的界限 ,瘤周水肿区存在一个显著的荧光辉度渐变带。结论 :该显像技术可用于肿瘤边界的确定 ,为脑胶质瘤显微外科手术的彻底性提供了理论和实践基础     

Bifidobacterium as an oral delivery carrier of interleukin-12 for the treatment of Coxsackie virus B3-induced myocarditis in the Balb/c mice

IL-12 plays an important role in the treatment of many infectious diseases by being administered intravenously or intramuscularly. However, intravenous or intramuscular administration is difficult and inconvenient and may cause side effects. The aim of this study is to develop a novel oral delivery system for IL-12 using genetically engineered Bifidobacterium longum as the carrier and further investigate the efficacy of IL-12-expressed B. longum on the coxsackie virus B3 (CVB3)-induced myocarditis in mice. A mIL-12 gene expression vector pBBADs-IL-12 for B. longum was constructed and transformed into Bifidobacterium. Subsequently, the expression of mIL-12 in the engineered B. longum was identified in vitro by western blot and enzyme-linked immunosorbent assay (ELISA) after l-arabinose induction. Moreover, our data indicated that oral administration of IL-12-expressed B. longum for two weeks after CVB3 infection in the Balb/c mice could downregulate the severity of virus-induced myocarditis, markedly reduce the virus titers in the heart and induce a Th1 pattern in the spleen and heart compared with the controls. In conclusion, a novel oral delivery system of Bifidobacterium for murine IL-12 has been successfully established. Oral administration of mIL-12-transformed B. longum may play a therapeutic role in the treatment of CVB3-induced myocarditis in the mice.     

Challenges to early childhood education in rural China: lessons from the Hebei province

This research study examined the challenges faced by early childhood education (ECE) in rural China based on a qualitative study of 217 kindergarten classrooms in a large agricultural, rural province. This study utilised onsite teacher surveys, interviews, and observational field notes. This investigation's findings revealed important information in regard to (a) enrollment, class size, and student–teacher ratios; (b) facilities, basic furnishings, and materials; (c) teacher qualifications; and (d) curriculum and pedagogy. Kindergartens in the rural province of Hebei, typical of Chinese provinces with economically disadvantaged students and inadequate ECE funding, were found to be of poor quality across every ECE indicator measured. For the future improvement and well-being of children and their families in rural China, the authors recommend reform policy to increase ECE quality by affiliating quality kindergartens with existing elementary public school structures and to improve teacher quality by advancing teacher benefits, professional status, and professional development opportunities.     

Study of chronic graft-vs-host disease, infection and immune reconstitution in patients surviving more than one year after bone marrow transplantation from unrelated donors]

We studied the immune reconstitution and incidence of chronic graft-vs-host disease (GVHD) and infection in 25 patients who survived more than 1 year after bone marrow transplantation (BMT) from unrelated donors for treatment of leukemia. Of the 25 patients, 4 died after 1 year post-transplantation. The causes of death were relapse of leukemia (2 patients), obstructive bronchiolitis (1 patient), and hepatic failure (1 patient). Only 2 of 14 patients who were under 30 years of age at the time of their BMT developed chronic GVHD, however, 7 of 11 patients 30 years of age or older developed chronic GVHD. Lower karnofsky scores were displayed by 6 of the older patients with chronic GVHD but by none of the younger patients with chronic GVHD. These results underscored the importance of care for older patients with chronic GVHD.CD4-positive T cells, and especially CD4 * CD45RA-positive T cells, had not recovered to a normal range even 2 years after BMT. Longer follow-up will be necessary.     

Successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis

A case of successful endoscopic therapy of superficial esophageal cancer on varices in a patient with alcoholic liver cirrhosis is reported. A slightly depressed superficial cancer (type 0‐IIc) occupied half the inner surface of the middle esophagus. Endoscopic ultrasonography revealed esophageal varices and periesophageal collaterals, but no perforating veins connecting the varices and collaterals were observed where the cancer was located. The esophageal cancer could not be detected even with a 20 MHz microprobe. The tortuous esophageal varices in the lower esophagus were endoscopically ligated to reduce blood flow just below the cancer and 10 mL polidocanol solution was endoscopically injected to induce sclerosis of the varices. After these procedures, the mucosal cancer was endoscopically resected without any severe complications and residual cancer was eliminated by cauterization using a heater probe. Histopathological examination revealed that poorly differentiated squamous cell carcinoma invaded into the lamina propria mucosae but not into the vessels or the lymphatic system. Three years after treatment, the patient showed no signs of local recurrence of cancer. It is considered that the endoscopic techniques used in this patient constitute a valuable and minimally invasive treatment for superficial esophageal cancer on varices.