Objective To study the effect of oxigenated leukodepletion filter(OLF), in order to evaluate its potential value in battlefield trauma application.Methods 12 bags of whole blood were filtered by OLFs, while the other 12 by normal filters,some indexes including ,partial pressure of oxygen(PO 2),O 2 saturation of oxygen(SO 2),HbO 2 WBC,RBC counter and volume of RBC supernatant were measured before and after leukocyte filtration.Results PO 2,SO 2 and HbO 2 increased 57%,51% and 53% respectively after filtration by OLFs, the residual leukocyte count decreased to (3 37?0 54)?10 7 each bag,and the leukocyte clearance rate was (97 52?0 74)%.Conclusions OLF can improve the effect of blood transfusion and reduce some acute transfusion adverse reactions.Thereby,application of the OLF has binefits significantly to heal the wounded patients in battlefield trauma.

Objective To retrospectively analyse the impact of imatinib mesylate(Gleevec)on HSCT outcome in patients with Ph(+)leukemias.Methods From June 2001 to June 2005,31 CML-BC/AP patients and 8 refractory Ph(+)ALL patients were treated with imatinib mesylate to induce remission,followed by allogeneic transplantation,and we evaluated its influence on engraftment,graft versus host disease(GVHD),overall survival(OS),disease free survival(DFS),relapse rate(RR)and transplant-related mortality(TRM).Results Eighteen of 39 patients achieved complete hematologic remission(CHR),9 patients bone marrow remission(BMR)and 4 patients partial response(PR),the overall response rate being 70.96%.After HSCT,all patients achieved complete allogeneic engraftment with a median of 14 and 13.5 days for neutrophil and platelet recovery,respectively.The cumulative incidence rates of Ⅱ~Ⅳ? and Ⅲ~Ⅳ? aGVHD were 61.53% and 15.38%.The probability of OS and DFS was(73.51?9.61)% and(61.28?12.37)%,when HSCT was performed in CR,compared with(36.36?14.50)% and(31.25?13.98)% in NR.The 3-year cumulative relapse rate(RR)was 20.41% vs 75.00%.Four cases died of transplant-related complications.Conclusion Pre-transplant imatinib mesylate seems effective and safe for refractory Ph(+)leukemias;it allows transplantation to be in a more favorable status,and leads to better outcome.

Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; Neovascularization, Physiologic ; Osteogenesis

Objective To explore the value of dynamic contrast-enhanced MRI (DCE-MRI)and diffusion tensor imaging(DTI)in grading of glioma.Methods 3.0T DCE-MRI and DTI scans were performed in 31 patients with glioma confirmed by pathology.Capacity volume transfer constant (Ktrans ),extravascular extracellular volume fraction (Ve ),exchange rate constant (Kep ),initial area under the gadolinium concentration-time curve (iAUC),and relative fractional anisotropy (rFA)were measured in the low grade glioma (LGG)and the high grade glioma (HGG).The correlation between parameters of DCE-MRI and rFA with microvessel denisity (MVD)and microvessel structure (MVS)were performed by Spearman rank correlation analysis.Results The MVD and MVS were positive correlation with the grading of glioma.Ktrans ,Kep ,Ve ,iAUC and rFA values of the LGG were (0.02±0.01)min-1 ,1.82 (0.18-8.54)min-1 ,0.05±0.03, 2.47±1.66 and 0.55±0.22,respectively.Ktrans ,Kep ,Ve ,iAUC and rFA values of the HGG were (0.1 1±0.02)min-1 ,1.31 (0.12-7.58)min-1 ,0.28±0.10,10.84 ±6.46 and 0.28 ±0.08,respectively.The differences of all parameters between the LGG and the HGG were statistically significant,except for Kep (P <0.05 ).Ktrans ,Ve and iAUC values were positive correlation with MVD and MVS (P <0.05),and rFA values were negative correlation with MVD and MVS (P <0.01).Conclusion The quantitative parameters of DCE-MRI and DTI have important values in grading of glioma and evaluating tumor angiogenesis and microvessel structure.

Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.

OBJECTIVE: To investigate the anti-tumor effect of bufalin and its regulation on Bcl-2 and Bax proteins in orthotopically transplanted tumor of human hepatocellular carcinoma in nude mice. METHODS: Orthotopically transplanted tumor of human hepatocellular carcinoma was established in nude mice. The mice were randomly divided into five groups: high-dose bufalin-treated group (1.5 mg/kg), medium-dose bufalin-treated group (1 mg/kg), low-dose bufalin-treated group (0.5 mg/kg), adriamycin-treated group (8.0 mg/kg), and normal saline-treated group. After 25 days, mice were sacrificed. The tumor volume was measured, and the pathological changes of tumor tissues were detected by HE staining to observe the tumor necrosis degree. Cell morphological changes were also observed by an electron microscopy. Label index of tumor cell apoptosis was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), and the expressions of Bcl-2 and Bax proteins were determined by immunohistochemical method. RESULTS: The tumor volume in the bufalin-treated groups was shrunk significantly compared with that in the normal saline-treated group (P<0.01). The survival time of the bufalin-treated groups was prolonged compared with that of the adriamycin-treated group and the normal saline-treated group P<0.05. Apoptotic characteristics could be seen in tumor tissues of the bufalin-treated groups. The label index of tumor cell apoptosis in the bufalin-treated groups (5.87+/-2.13, 8.86+/-2.96 and 10.60+/-3.42 in low-, medium- and high-dose groups respectively) was higher than that in the adriamycin-treated group (3.28+/-0.98) (P<0.05, P<0.01). The expression of Bax was up-regulated, while no changes were detected as to Bcl-2 protein in tumors of the bufalin-treated groups. CONCLUSION: Bufalin has significant anti-tumor effect on the orthotopically transplanted tumor of human hepatocellular carcinoma in nude mice. Its effect might be related to up-regulation of Bax protein and inducement of the tumor cell apoptosis.

Objective: To investigate the clinical efficacy and safety of Shure granule combined with estradiol valerate in the prevention of intrauterine adhesions in induced abortion.Methods: Selected 240 cases of artificial abortion were divided into observation group and control group according to the order of admission, 120 cases each.Patients in the control group were treated with estradiol valerate.The observation group was treated with Shure granules on the basis of the control group;The treatment time was 3 weeks.The time of vaginal bleeding and the amount of bleeding, menstruation, retidal and adverse drug reactions of the two groups were observed;The levels of serum fibronectin (FN), human laminin (LN) and vascular endothelial growth factor (VEGF) were compared between the two groups before and after the operation.The adhesion of the 12 cases in the two cases was compared.Results: The time of vaginal bleeding and the amount of bleeding in the observation group were significantly better than those in the control group (P＜0.05), and the normal rate of menstrual volume was higher than that of the control group (P＜0.05).The serum levels of FN, LN and VEGF in the observation group were significantly lower than those in the control group 2 weeks after the operation (P＜0.05).After 12 months, the incidence of intrauterine adhesions in the observation group was significantly lower than that in the control group (P＜0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups (P＞0.05).Conclusion: The efficacy of Shure granule combined with estradiol valerate in preventing intrauterine adhesions in induced abortion is superior to estradiol valerate alone.

Holistic education is an important philosophy of medical education.Medical graduate students can show their skills of medical specialties,improve their abilities of communication and cooperation,and promote their sense of social responsibility through social practice.Through conducting questionnaire among medical graduate students of Peking University Third Hospital who major in internal medicine,we have got to know the effect of social practice on holistic education philosophy.Meanwhile,social practice is a crucial approach to implementing holistic education.

Objective To investigate the efficacy of botulinum toxin type A injection with ankle-foot orthosis (AFO) for the treatment of post-stroke lower limb spasticity.Methods One hundred and three stroke patients with lower limb spasticity were randomly divided into control group,observation group and treatment group.The patients in control group were given routine treatment,those in observation group were given botulinum toxin type A injection in addition to routine treatment,and those in treatment group were treated with AFO on the basis of the interventions of observation group.Before treatment and at 1,3 and 6 months after treatment,clinic spasticity index (CSI) and Fugl-Meyer assessment (FMA),Berg balance scale (BBS) and functional independence measure (FIM) were used to evaluate the efficacy of all groups.Results When compare the assessment results at 1 month after treatment with those before treatment,statistically significant difference in terms of scores of CSI,FMA and FIM were revealed in treatment group and observation group (P ＜ 0.05),but not in the control group (P ＞ 0.05).Within-group comparison with the results at 1 month after treatment,the scores of CSI at 3 and 6 months increased in control group and observation group,while decreased in treatment group(P ＜ 0.05),although the scores of FMA and FIM increased in all groups and the increase was statistically significant only in treatment group(P ＜ 0.05).Between-group comparison of the scores in CSI,FMA and FIM showed no significant difference between the observation and control groups(P ＞ 0.05).It was shown that the scores of BBS at 1,3,and 6 months improved continuously in all groups(P ＜0.05),the improvements in treatment group were significantly greater than that of observation group and control group (P ＜ 0.05).Conclusion Ultrasound-guided botulinum toxin type A injection with AFO could further improve lower limb muscle spasticity,and enhance motor,balance and activities of daily life for stroke patients.

Objective To investigate the clinical features of moyamoya disease complicated with Graves′disease and the efficacy of extra-and intra-cranial revascularization. Methods The clinical data of 4 patients with moyamoya disease complicated with Graves′disease were analyzed retrospectively. Among them,three were females and one was a male. Their mean age was 32 ± 7 years. After medical treatment, their thyroid function was normal. The patients were treated with superficial temporal artery-middle cerebral artery bypass grafting. Results (1) Three patients showed cerebral infarction and one showed frequent transient ischemic attack. DSA confirmed that 2 patients had unilateral moyamoya disease and 2 had bilateral moyamoya disease. Head MRI revealed brain infarcts. (2) The thyroid function was normal after drug treat-ment,the symptoms of moyamoya disease were stable in 3 cases. One patient had high metabolic symptoms, such as high fever and accelerated heart rate within one week after procedure. The patients were followedup for 6 to 18 months,one was good,3 were excellent,and there was no recurrence of Graves′disease. Postoperative head MRI revealed that the 4 patients did not have new brain infarcts. MRA showed that the arterial filling in cerebral sulci in the ischemic lesion areas was obviously improved compared with that before procedure. Retrograde filling of the ipsilateral middle cerebral artery M2-M3 segment was observed in 2 patients. Postoperative single photon emission computed tomography perfusion imaging revealed that the ischemic perfusion lesions on the operated sides were obviously improved compared with those before procedure. Conclusion When complicated with Graves′ disease,the symptoms of moyamoya disease will aggravate. It manifests as acute and chronic cerebral ischemia. After controlling the symptoms of hyperthyroidism,most cerebral ischemic symptoms can be alleviated. Superficial temporal artery-middle cerebral artery bypass grafting may establish an effective collateral circulation and improve the clinical symptoms.