Objective To compare the effect of pedicles screw fixation through entry point of the “人" shape crest and traditional entry point (Weinstein method). Methods Ninety-two patients of lumbar spine disorders were treated by pedicles screw fixation combined with bone grafting through posterior approach. The screws were placed through the traditional entry point among 45 patients (group A, transverse process method, 186 screws), the others were through entry point of the “人" shape crest (group B, “人" shape crest method, 196 screws). The condition of accuracy of screw placement, operation time, bleeding amount and injury were compared. Results All patients accepted the examination of X-ray and CT scan after operation. The rate of screw bad placement was 6.5% in group A and 2.0% in group B, the incidence of injury of nerve and blood vessel was 8.9% in group A and 2.1% in group B. The accuracy of screw placement, operational time and bleeding amount in group B were significantly better than those in group A (P

Objective To investigate the effects of prostatitis on secretory alterations of urethral glands in rats.Methods Twenty adult Sprague-Dawley rats were randomly divided into prostatitis group and control group.The prostatitis group(n=10) was injected with 0.1 ml Freund's complete adjuvant at each lateral lobe while the control group(n=10) with 0.1 ml 0.9% physiological saline.Two weeks later the rats were killed and the urethral glands were harvested for pathologic examination and immunohistochemical staining.Results ① There was a great quantity of lymphcells and mononuclear cells infiltrating the prostate gland in prostatitis group while there was no inflammatory cells in control group.② AB-PAS pathologic examination results in urethral glands showed that the grume area,diameter,optical density in control group were significantly less than those of the prostatitis group(P

Objective To compare the efficacy and safety between flumatinib and imatinib in patients with newly diagnosed chronic myeloid leukemia (CML). Methods A multi-center, randomized and parallel comparison clinical trial was conducted in 24 newly diagnosed patients with Philadelphia chromosome-positive CML-chronic phase (Ph+ CML-CP) who were treated by flumatinib 400 mg/d, 600 mg/d or imatinib for 6 cycles (24 weeks). The hematology was evaluated at pre-medication and the 2nd, 4th, 6th, 8th, 10th, 12th, 16th, 20th, 24th week of post-medication. The morphology, cytogenetics and molecular biology were evaluated at pre-medication and 12th, 24th week of post-medication. Results In terms of efficacy, the main molecular remission (MMR) rate of flumatinib 600 mg/d group was higher than that of imatinib group after 24 weeks [44.44 % (4/9) vs. 14.29 % (1/7), P=0.017]. The rate of bcr-ablIS≤10 % in flumatinib 600 mg/d group was significantly higher than that in imatinib group (P=0.002). PK/PD analysis also hinted that patients treated by flumatinib 600 mg/d was more likely to get molecular reaction in the early stage compared with those treated by flumatinib 400 mg/d. In terms of safety, there was no significant difference in grade Ⅲ-Ⅳ of adverse events among flumatinib 400 mg/d group, flumatinib 600 mg/d group and imatinib group (P >0.05). The common adverse events in flumatinib group included skin toxicity, gastrointestinal reactions and diarrhea.There was no heart and cardiovascular toxicity in flumatinib group, and incidence of edema in flumatinib group was lower than that in imatinib group. Conclusions Flumatinib is a safe and effective drug for newly diagnosed patients with Ph+ CML-CP, and 600 mg/d is the appropriate clinical starting dose. Flumatinib and imatinib have similar safety in clinic.

Objective To investigate the clinical and laboratorial characteristics of patients with myelodysplastic syndrome ( MDS) and erythroid hyperplasia.Methods MDS patients whose bone marrow was hypercellular with erythroid lineage more than 50% and blasts account for less than 20% of non-erythroid cells were enrolled in this study.The ratio of mature erythrocytes to nucleated erythrocytes was no more than 20, namely MDS patients with erythroid hyperplasia ( MDS-E ).The retrospective analysis comprised 102 patients with MDS-E from the First Affiliated Hospital of Suzhou University.Clinical characteristics , karyotype , and the prognostic significance of erythroid hyperplasia were evaluated.Results A total of 48 MDS-E patients (47.1%) presented a variety of cytogenetic abnormalities.The most frequently involved chromosomes were chromosome 8 (39.5%of all abnormal karyotypes ), chromosome 7 (22.9%), followed by chromosome 5 ( 18.8%) , chromosome 1 ( 16.7%) and chromosome 20 ( 16.7%) .Hemoglobin ( Hb) level affected the prognosis by survival analysis.The overall survival ( OS) of MDS-E patients with Hb equal or more than 70 g/L was longer than that of patients less than 70 g/L ( P<0.001).Allogeneic hematopoietic stem cell transplantation (HSCT) significantly improved the OS compared with best supportive care (P<0.001) and chemotherapy (P<0.001).The extent of erythroid hyperplasia in bone marrow did not impact on prognosis ( P=0.187 ).Conclusions Compared with previous reports of MDS patients, MDS-E patients have higher level of erythroid hyperplasia , more common erythroid dyshematopoiesis , more frequent 8 and 1 chromosome abnormalities .The degree of erythroid hyperplasia is not correlated with prognosis.Allogeneic hematopoietic stem cell transplantation improves the prognosis.

Objective To explore the efficacy of non-T cell depletion haploidentical hematopoietic stem-cell transplantation for T lymphoblastic lymphoma (T-LL). Methods 3 T-LL patients achieving complete remission received haploidentical bone marrow stem cell transplantation with granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow grafts from related donor without T-cell depletion. Two of them received a myeloablative conditioning regimen consisting of high-doses of cyclophosphamide and cytarabine with total body irradiation, whereas the other was preconditioned with busulfan, cyclophosphamide and cytarabine. All patients received strengthened phophylaxis regimen including rabbit anti-thymocyte globulin against acute graft-versus-host disease. Results All patients had rapid hematopoietic engraftment with the median time for neutrophil and platelet recovery being 12 days and 13 days, respectively. They are still alive without relapse at a median follow-up of 24 months (range: 9-75 months). Conclusion Treatment related toxicity can be acceptable in non-T cell depletion haploidenfical hematopoietic stem-cell transplantation for T-LL and the patients may achieve long term survival.

Objective To investigate the expression of human beta defensin 1 (HBD-1) in peripheral blood of children with community acquired pneumonia (CAP) and its clinical implication.Methods A total of 122 CAP children were included in this study from February 2015 to October 2015.The patients were stratified in terms of age,etiology,and disease severity.Additional 52 patients were included as control in the same period.All patients were classified according to the clinical feature after admission.Serum HBD-1 level was determined by ELISA method.Results Serum HBD-1 level was significantly higher in CAP group than in control group (P＜0.001).HBD-1 level did not vary significantly with pathogen or sex in CAP group.HBD-1 level did not show significant difference between severe pneumonia and mild pneumonia.The HBD-1 level in 6-12 months age group was significantly higher than that in other age groups.HBD-1 level was not correlated to CRP or neutrophils in CAP children.Conclusions HBD-1 plays a role in anti-infective process as part of body innate immunity.It boasts non-specific and broad-spectrum anti-infective immunity against various pathogens.

Objective:To evaluate the role of c-Abl in myocardial ischemia-reperfusion (I/R) injury in diabetic rats.Methods:Sixty male SPF-grade healthy Sprague-Dawley rats, aged 7-9 weeks, weighing 210-230 g, were divided into 6 groups by a random number table method: sham operation group (S group, n=6), myocardial I/R group (IR group, n=12), diabetic sham operation group (DS group, n=6), diabetic myocardial I/R group (DIR group, n=12), diabetic myocardial I/R plus AVV9-siRNA-c-Abl group (DIR+ c-Abl group, n=12), and diabetic myocardial I/R plus AVV9-GFP group (DIR+ GFP group, n=12). One percent streptozotocin 60 mg/kg was intraperitoneally injected to induce type 1 diabetes mellitus.AVV9-siRNA-c-Abl and AVV9-GFP 1×10 12 mg/kg were slowly injected at 4 weeks after establishing the model in DIR+ c-Abl and DIR+ GFP groups.Myocardial ischemia was induced by 30 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 2 h reperfusion at 8 weeks after establishing the model.At the end of reperfusion, left ventricular systolic pressure (LVSP) and the maximum rate of increase and decrease of left ventricular systolic pressure (±dp/dt max) were monitored, and blood samples were collected for determination of the concentrations of serum lactic dehydrogenase (LDH) and creatine kinase-MB (CK-MB) (by enzyme-linked immunosorbent assay)and myocardial infarct size (except group S and group DS). Myocardial tissues were obtained for determination of the apoptosis index of cardiomyocytes(by TUNEL staining), expression of c-Abl, p53 and activated caspase-3 (by Western blot), and binding of c-Abl and p53 (c-Abl/p53) (by co-immunoprecipitation method). Results:LVSP and ±dp/dt max were significantly decreased, serum LDH and CK-MB concentrations were increased, apoptosis index and c-Abl/p53 were increased, and the expression of c-Abl, p53 and activated caspase-3 was up-regulated in group IR when compared with group S and in group DIR as compared with group DS ( P<0.05). Compared with group DIR, the LVSP and ± dp/dt max were significantly increased, serum LDH and CK-MB concentrations were decreased, myocardial infarct size was decreased, apoptosis index and c-Abl/p53 were decreased, and the expression of c-Abl, p53 and activated caspase-3 was down-regulated in group DIR+ c-Abl ( P<0.05), and no significant change was found in the parameters mentioned above in group DIR+ GFP ( P>0.05). Conclusion:c-Abl is involved in the pathophysiological process of myocardial I/R injury probably by activating p53 signaling pathway in diabetic rats.

Objective:To evaluate the relationship between silence information regulator 1 (SIRT1) and signal transducers and activators of transcription 3 (STAT3) acetylation during high glucose-induced cardiac microvascular endothelial cell injury.Methods:Cardiac microvascular endothelial cells of Sprague-Dawley rats were cultured.The cells at the logarithmic growth phase were selected and divided into 3 groups ( n=24 each) using a random number table method: control group (C group), high glucose group (HG group) and high glucose+ SIRT1 agonist SRT1720 group (HG+ SRT group). The cardiac microvascular endothelial cells were seeded in a 6- or 96-well cell culture plate at a density of 2×10 5 cells/ml.When the cell density reached 50%, the culture medium was then replaced with high-glucose (glucose 33 mmol/L) DMEM culture medium containing with 10% fetal bovine serum and 1% double antibody in HG and HG+ SRT groups.In group HG+ SRT, 20 μmol/L SRT1720 was added simultaneously, and the cells were cultured at 37 ℃ in an incubator with 5% CO 2 for 24 h. The cell viability was determined by CCK-8 assay, the activity of superoxide dismutase (SOD) was detected using a spectrophotometer, the levels of lactic dehydrogenase (LDH), interleukin-6 (IL-6) and tumor necrosis factor-β (TNF-β) in the supernatant were detected by enzyme-linked immunosorbent assay, and the expression of SIRT1, acetylated STAT3 (ac-STAT3) and phosphorylated STAT3 (p-STAT3) was determined by Western blot. Results:Compared with C group, the cell viability and SOD activity were significantly decreased, levels of LDH, IL-6 and TNF-β in the supernatant were increased, expression of SIRT1 was down-regulated, and expression of ac-STAT3 and p-STAT3 was up-regulated in group HG and group HG+ SRT ( P<0.05). Compared with group HG, the cell viability and SOD activity were significantly increased, levels of LDH, IL-6 and TNF-β in the supernatant were decreased, expression of SIRT1 was up-regulated, and expression of ac-STAT3 and p-STAT3 was down-regulated in group HG+ SRT ( P<0.05). Conclusion:SIRT1 can alleviate high glucose-induced cardiac microvascular endothelial cell injury by promoting STAT3 deacetylation.

Objective:To evaluate the relationship between protein kinase RNA-like endoplasmic reticulum kinase (PERK) pathway-mediated endoplasmic reticulum stress and the reduction of cerebral ischemia-reperfusion (I/R) injury by dexmedetomidine in mice by the in vivo experiment and the cell experiment. Methods:In the in vivo experiment, 20 healthy clean-grade male mice, aged 6-8 weeks, weighing 20-30 g, were divided into 4 groups ( n=5 each) using a random number table method: sham operation group (group S), sham operation+ dexmedetomidine group (group SD), cerebral I/R group (group IR) and cerebral I/R+ dexmedetomidine group (group IRD). Cerebral I/R was established by two-vessel occlusion plus hypotension.Dexmedetomidine 25 μg/kg was intraperitoneally injected at 10 min of ischemia in group IRD and at the corresponding time point in group SD.Neurological function was assessed using modified neurological severity score at 1 h of reperfusion.The animals were then sacrificed and brain tissues were taken for determination of the expression of endoplasmic reticulum stress-related proteins such as immunoglobulin heavy chain-binding protein (BIP), eukaryotic translation initiation factor 2α (EIF-2α), phosphorylated EIF-2α (p-EIF-2α), PERK and phosphorylated PERK (p-PERK) (by Wester blot). In the cell experiment, a mouse hippocampal neuronal cell line was selected and divided into 4 groups ( n=12 each) using a random number table method: control group (group C), oxygen-glucose deprivation/restoration (OGD/R) group (group OGD/R), OGD/R+ dexmedetomidine group (group OGD/R+ D) and OGD/R+ ISRIB (PERK pathway inhibitor) group (group OGD/R+ ISRIB). Cells were exposed to 94%N 2-5%CO 2-1%O 2 and incubated in a low-glucose DMEM medium for 6 h followed by restoration to establish OGD/R model.At 30 min before OGD, dexmedetomidine (final concentration 5 mmol/L) was added in group OGD/R+ D, and ISRIB (final concentration 10 mmol/L) was added in group OGD/R+ ISRIB.After 12-h restoration was completed, the cell survival rate was detected by CCK-8 assay.At 24 of restoration, the expression of endoplasmic reticulum stress-related proteins was determined by Wester blot. Results:In the in vivo experiment, compared with group S, neurobehavioral score was significantly increased and the expression of BIP, p-EIF-2α and p-PERK in brain tissues was up-regulated in group IR ( P<0.05). Compared with group IR, neurobehavioral score was significantly decreased and the expression of BIP, p-EIF-2α and p-PERK in brain tissues was down-regulated in group IRD ( P<0.05). In the cell experiment, compared with group C, the expression of BIP, p-EIF-2α, PERK and p-PERK was significantly up-regulated, and the cell survival rate was decreased in group OGD/R ( P<0.05). Compared with group OGD/R, the expression of BIP, p-EIF-2α, PERK and p-PERK was significantly down-regulated, and the cell survival rate was increased in OGD/R+ D, OGD/R+ ISRIB groups ( P<0.05). Compared with group OGD/R+ ISRIB, the expression of PERK was significantly down-regulated ( P<0.05) and no significant change was found in the other parameters in group OGD/R+ D ( P>0.05). Conclusion:The mechanism by which dexmedetomidine reduces cerebral I/R injury may be related to inhibiting PERK pathway-mediated endoplasmic reticulum stress in mice.

Objective To examine the value ofprocalcitonin (PCT) in differential diagnosis of bloodstream infections (BSI) caused by coagulase-negative Staphylococcus (CNS) from contamination in Department of Hematology.Methods One hundred and fifty-six patients with bloodstream or intravenous catheter-related CNS infection were included in this study.The patients were treated in Department of Hematology,the First Affiliated Hospital of Soochow University during the period from January 2013 to December 2015.The patients were divided into CNS bloodstream infection group (n=66) and blood culture contamination group (n=90).The two groups were compared in terms of sex,age,diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count,peak fever,C-reactive protein (CRP) and PCT.The receiver operating characteristic (ROC) curve was plotted with SPSS 21.0 software to analyze the value of PCT in differential diagnosis.Results Age,sex,clinical diagnosis,length of hospital stay,duration of neutropenia,neutrophil count and lymphocyte count did not show significant difference between bloodstream infection group and contamination group (P＞0.05),while peak fever (P＜0.001),CRP (P=0.002) and PCT (P=0.018) were significantly higher in bloodstream infection group than in contamination group.ROC analysis indicated that PCT provided optimal discrimination between these two groups at cnt-offvalue of 0.374 μg/L,with sensitivity of 54.5％ and specificity of 94.4％.The area under the curve (AUC) was 0.830±0.032 (95％ CI:0.767-0.893,P＜0.001).Conclusions PCT may be a good marker for differentiating CNS bloodstream infection from contamination with higher specificity than the commonly used marker CRP.This finding may help clinicians reduce the overuse of antibiotics.