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.

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 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 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.

Objective To investigate the impact of different kinds of laparoscopic surgery including conventional blunt elimination and modified acute elimination on sex hormone, antral follicle count and ovarian volume of patients with endometriosis (EMs). Methods 100 patients with EMs were chosen from January 2013 to April 2016 and randomly divided into control group (50 patients) with conventional blunt elimination and observation group (50 patients) with modified acute elimination; and the thickness of elimination lesion, the removal rate of ovary cortex, the thickness of ovarian cortex, the level of serum sex hormones, the AFC number of affected side and the volume of ovary before and after operation of the two groups were compared. Results There was no significant difference in the thickness of lesion elimination, the removal rate and removed thickness of ovarian cortical between the two groups (P > 0.05). The thickness of lesion elimination and the thickness of ovarian cortex in middle position of observation group were significantly lower than that in control group (P < 0.05). The thickness of lesion elimination, removed thickness of ovarian cortical and the removal rate of ovary cortex in hilus ovarii in observation group were significantly lower than that in control group (P < 0.05). There was no significant difference in the levels of serum sex hormones before and after treatment between the two groups (P > 0.05). There was no significant difference in the levels of AFC number of affected side before and after treatment (P > 0.05). The levels of AFC number of affected side in hilus ovarii of control group after treatment were significantly lower than that before treatment (P < 0.05). The volume of ovary of both groups after treatment were significantly lower than that before treatment (P < 0.05). The volume of ovary of observation group after treatment were significantly higher than that in control group (P < 0.05). Conclusion Compared with conventional blunt elimination, modified acute elimination in the treatment of patients with EMs can efficiently shorten the operation time, reduce the surgical trauma degree, speed up the recovery process after operation, regulate the level of FSH and AMH and be helpful to protect the ovarian reserve function.

OBJECTIVE:To provide reference for rational use of anti-tumor essential medicine in the clinic. METHODS:The application of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in re-spects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 increased from 10 083.65 ten thousand yuan to 15 186.65 ten thousand yuan,with annual increase rate of 22.72%. 3-year total consumption sum was 37 952.45 ten thousand yuan,and the sum of consumption sum of top 10 medicines was 36 742.24 ten thousand yuan,accounting for 96.81%;top 3 medicines were paclitaxel,oxaliplatin and flu-orouracil. During 2012-2014,DDDs had changed to certain extent,and the front medicines contained tegafur,paclitaxel and cyclo-phosphamide,etc;the most increment medicine was paclitaxel (oral),whose annual growth rate was 59.63%;that of tamoxifen decreased year by year,with annual decrease rate of 5.14%. DDC of paclitaxel,oxaliplatin and etoposide were the higher others. Annual B/A of oxaliplatin,fluorouracil and cytosine arabinoside were all lower than 1.00. CONCLUSIONS:The lonsumption sum and DDDs of anti-tumor essential medicine had increased reasonably in 39 hospitals from Chongqing area during 2012-2014,while their DDC had kept stable. Main medicines used in the clinic are suitable for numerous indications,and are expensive.

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

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.