Objective To explore the efficacy and side effect of CAG (G-CSF, aclarubicin and cytarabine) priming chemotherapy for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Methods 54 patients with AML at diagnosis and relapse or MDS were'enrolled for the initial treatment with CAG regimen. Patients who have achieved complete remission (CR) were treated with various regimens. Results The total effective rate was 72.2 %, complete remission rate was 48.1% and partial remission rate was 24.1%. The incidence of granulocyte deficiency was 40.7 %(22/54). The severe infection rate was 24.1%(13/54). One case died of function damage in liver. The study includes 36 patients below 60 years, 18 patients above 60 years, and overall effective cases are 28 (77.8 %), 11 (61.1%),respectively. There was significant difference (P ＜0.05). Conclusion CAG regimen is effective and well tolerated in remission for AML and MDS-RAEB.

BACKGROUND:Cannulated screw tension band combined with wire fixation is most commonly used for treatment of patel a fractures.
OBJECTIVE:To evaluate the clinical outcomes of combination of cannulated screw tension band and wire fixation in the treatment of patel a fractures.
METHODS:A literature search method was employed to retrieve relevant articles addressing cannulated screw tension band and wire fixation of patel a fractures. In-depth analysis of literatures meeting the study criteria was carried out. Patients with patel a fractures who received cannulated screw tension band and wire fixation were fol owed up to evaluate the postoperative fracture healing, complications and functional recovery of the knee joint at the injury side. Then, the clinical efficacy of cannulated screw tension band combined with wire fixation was analyzed.
RESULTS AND CONCLUSION:After treatment with cannulated screw tension band and wire fixation, patients with patel a fractures exhibited good fracture healing and low probability of complications, including screw or wire loosening, broken, and shedding. Functional recovery of the affected knee was up to 90%. Clinical case analysis showed that cannulated screw tension band combined with wire fixation achieved good outcomes in the treatment of patel a fracture, with over 90%functional recovery of the affected knee, which is consistent with the reported results. It indicates that the cannulated screw tension band combined with wire fixation is one of the ideal and reliable methods in use for internal fixation of patel a fractures.

After investigating conditions of 210 seven-year system medical students' extracurricular reading,we discovered that most medical students were rather interested in extracurricular reading,but there existed certain problems in the aspects of the arrangement of time and choice of books etc,which not only lowered the quantity of the student' extracurricular reading,but was disadvantageous to the effective display of the humanities education.Therefore,it was necessary to enhance the seven-year system medical students' extracurricular reading.

Objective To investigate the clinical therapeutic effectiveness of laparoscopic high ligation of spermatic vein method, modified Palomo procedure and ligating of spermatic vein via inguinal canal for varicocele. Methods All 135 patients with varicocele who underwent varicocele were divided into three groups by random number table method: laparoscopic high ligation of spermatic vein method group (group A, 50 cases), modified Palomo procedure group(group B, 70 cases) and ligating of spermatic vein via inguinal canal group (group C, 15 cases). The surgery time,the length of stay,the hospital expenses,and the quality of their semen were collected at different time points (preoperation, 1,6,12 months after operation) and assessed,the recurrence rate,the pregnant outcomes of their spouses and the testicle atrophy rate 18 months postoperation were followed-up. Results There was no significant difference in the surgery time and the length of stay among three groups (P> 0.05). But the hospital expenses in group A was significantly higher than that in group B and group C (P <0.05). The quality of their semen were all significantly increased after operation in three groups compared with that before operation (P<0.05). There was no significant difference in the key parameters of the quality of their after operation among three groups (P> 0.05). During the follow-up of 18 months, the recurrence rate in semen group C (13.3% ,2/15) was significantly higher than that in group A (0) and group B (1.4%, l/70)(P< 0.05). There was no significant difference in their spouses who were found to have clinical pregnant outcomes during follow-up [group A: 68.0%(34/50),group B:68.6%(48/70),group C:66.7%(10/15)](P> 0.05). No testicle atrophy happened during follow-up. Conclusions Laparoscopic surgery and modified Palomo procedure are safe,convenient and effective surgical techniques. Modified Palomo procedure is recommended for unilateral varicocele. Laparoscopic surgery has advantages for recurrent and bilateral varicocele.

Chronic insomnia is a severe disease that seriously influence the human health,and about 10%-15% of the adults suffer from it.No definite conclusion has been made about its etiology up to now,possibly associated with heredity,hormone secretion and living habits.Insomnia not only decreases the patients' quality of life,but also adds burden to society,families and individuals.The diagnosis of chronic insomnia should be based on the patients' sleep history,medication history,psychiatric history and necessary examinations.International diagnosis criteria should be combined if possible.Presently the treatments for chronic insomnia mainly include the OTC medicine,prescription drugs,self-medication with alcoholic beverage,cognitive behavior therapy,melatonin and some traditional herbal therapies.Limited information is available presently about insomnia and a large amount of laboratory and clinical research need to be done to further understand and solve this public problem.

Objective To study the expression of tight junction factors in human placental tissues derived from assisted reproductive technology (ART) and natural pregnancy and its role in placental barrier.Methods Ten placental samples were collected from the women who had undergone ART treatment and 11 placenta were collected from control group.Transmission electron microscope (TEM) examination was utilized to detect the morphology of placental tight junctions.The mRNA of claudin (CLDN) 1,CLDN4,CLDN5,CLDN8,zonula occudens (ZO) 1 was detected by real-time PCR and the protein of CLDN4,CLDN8 and occludin (OCLN) were measured by western blot.Results TEM microscopy results showed that placenta samples derived both ART and control placenta had normal microscopic histological features of tight junctions,localized in the apical part of the syncytium and also between the cell-cell contacts of fetal blood vessel endothelial.The expression level of CLDN4 mRNA were 0.87 ±0.17 in ART group and 1.18 ± 0.30 in control group,respectively.The expression level of CLDN8 mRNA were 3.25 ± 2.32 in ART group and 1.08±0.41 in control group,respectively.The mRNA level of CLDN4 and CLDN8 were significantly differentially expressed in ART derived placenta when compared with control groups.The expression level of CLDN1,CLDN5,OCLN and ZO1 mRNA were 0.49 ± 0.44,0.80 ± 0.20,0.92 ± 0.18 in ART group and 1.09±0.82,1.21 ±0.78,0.80± 0.27 in control group,respectively,in which there were no significant differences between two groups.Western Blot analysis showed the protein levels of tight junctions CLDN4,CLDN8 and OCLN did not differ between groups.Conclusions Tight junction factors were expressed in human placental tissues.Tight junction derived from ATR platenta might have mild dysfunction.

OBJECTIVE:To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoper-ative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS:A total of 70 patients undergoing simultane-ous bilateral TKA in our hospital were randomly divided into control group and observation group,with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg,30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraopera-tive blood loss,postoperative drainage as well as the levels of FIB,PT,APTT before trectment and 3 d after surgery,the occur-rence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS:There was no statistical significance in operation duration,intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in coagulation indexes(FIB,PT and APTT)be-tween 2 groups before treatment and 3 d after surgery,with statistical significance(P>0.05). CONCLUSIONS:The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.

Nowadays more and more medical study fields need mathematics knowledge.The mathematics abilities of medical students include the ability of basic logic thought,changing medical problems into mathematics ones,understanding and applying mathematics knowledge as well as solving mathematics problems with computers.

Objective To investigate the relationship between the clinical onset of cerebral infarction in anterior cycle and properties of carotid atheromatous plaque.Methods A retrospective analysis was carried out on clinical data of 624 cases of cerebral infarction in anterior cycle from December 2010 to December 2013 in our hospital.The carotid artery plaque Crouse score,index,and intima-media thickness (IMT) were used to evaluate carotid atherosclerosis and plaque lesions.The National Institute of Health stroke scale (NIHSS) questionnaire was used to evaluate neural function defect.Results Compared to the non-lesion side,the lesion side carotid artery plaque Crouse score was decreased and IMT was increased (P ＜ 0.05) ; the lesion carotid artery plaque Crouse was lower,the higher NIHSS scores (r =-0.546,P =0.004) ; IMT score was higher,higher NIHSS score; carotid artery atheromatous plaque Crouse was negatively related to NIHSS score; IMT score was positively related to NIHSS score (r =0.672,P =0.003).Conclusions The clinical onset of cerebral infarction in anterior cycle was correlated with the carotid sclerosis degree.The Crouse score and IMT of the lesion have certain significance in predicting prognosis of cerebral infarction in anterior cycle.

Objective To investigate the relationship between gastrin expression and the development of coloreetal neoplasm and cell proliferation.Methods 15 samples of normal coloreetal mucosal tissue,21 samples of coloreetal adenomas and 70 samples of colorectal cancer were selected for evaluation of the expression of gastrin and Ki67 with immunohistochemieal method.Results In normal colorectal mucosal tissues.colorectal adenomas and coloreetal cancer,the positive rates of gastrin expression were 0.28.6%and 25.7%,respectively-which were signff-ieantly hisher in coloreetal cancer and adenomas groups than in the normal colorectal mucosal tissues(P<0.05).But there was no significance between colorectal cancer and adenomas(P>0.05).The positive expression rate of Ki67 with the obove samples were 40.0%,76.2%and 82.8%-respectively,with statistical results identical with results of gastrin(P<0.05).There was significant correlation between gastrin and Ki67[P<0.05).Conclusion Gastrin and Ki67 are highly expressed in eolorectal neoplasm.Gastrin miight play an important role in the carcinogen-esis and development of colorectal neoplasm,and might promote tumor cell proliferation.