The recently published papers about donor cell-derived leukemia after umbilical cord blood transplantation and related data were reviewed, while the mechanism of leukemia and related problems of umbilical blood conservation were discussed. In view of the possibility of prenatal origin of leukemia, it is necessary to more systematically check the leukemia relapse cases after umbilical cord blood transplantation for exactly identifying the frequency of donor cell derived leukemia and to determine whether the transfer of pre-leukemic clones is indeed present.
Adult ; Cord Blood Stem Cell Transplantation ; adverse effects ; Female ; Histiocytosis, Langerhans-Cell ; therapy ; Humans ; Infant ; Leukemia, Myeloid, Acute ; etiology ; pathology ; Lymphoma, T-Cell ; therapy ; Male ; Middle Aged ; Tissue Donors

China ; Health Status ; Humans ; Occupational Health ; Shoes

[Objective]To complete comparison between anterior cervical surgery by microendoscopic and open operation,explore feasibility and efficacy of anterior cervical decompression,interbody fusion and fixation by microendoscopic surgery,and give preliminary clinical evaluation of mieroendoscopic surgery.[Method]In a retrospective study,46 patients underwent one level cervical surgery by anterior approach.23 patients(23~64 years,41.5 years in average)were treated with microendoscopic surgery as microendoscopic group.Under general anesthesia,a transverse incision(1.6 cm)was made at right side of neck.A tubular retractor was then inserted and fixed,and a specially designed endoscope was placed inside the tubular retractor.Discectomy and interbody fusion with insertion of Cage or/and plate fixation was performed by endoscope.At fracture and dislocation patient group,titanium Cage was used in 1 case,CBK in 1 case,plate in 5 cases.At cervical disc herniation patient group,titanium Cage was used in 2 cases,CBK in 12 cases,plate in 2 cases.During the same period,23 patients(25~68 years,46.5 years in average)were treated with open surgery as open group.A transverse incision(4～5 cm)was made by right route approach.Discectomy and interbody fusion with Cage or/and plate fixation was performed by general procedure.[Result]At microendoscopic group,23 cases were followed up from 10 to 22 months(16.5 months in average),and mean operative time were 95 minutes,mean blood loss 90 ml.For fracture and dislocation patients,by Frankels classification,2 cases with complete tetraplegia showed no improvement,2 cases with incomplete tetraplegia improved from grade C to grade D postoperatively,1 case upgraded from C to E.For cervical spondylotic myelopathy patients with disc herniation,according to Odoms scoring system,10 cases had excellent outcome,5 good,1 fair.At open group,23 cases were followed up from 8~21 months(15.2 months as average),and mean operative time was 95 minutes,mean blood loss 90 ml.By Frankels classification,2 cases with complete tetraplegia had no improvement,3 cases with incomplete tetraplegia improved from C to D,1 case from D to E.According to Odoms scoring system,8 patients suffering from cervical spondylotic myelopathy with disc herniation had excellent result,6 good,2 fair.[Conclusion]Compared with open surgery,microendoscopic surgery with endoscopic instrument and technique can be used for one level discectomy,interbody fusion and internal fixation,and offer a similar short-term good clinical outcome with minimal incision,less traumatic reaction and postoperative discomfort.

[Objective]To explore the feasibility and efficiency of treatment of lumbar degenerative disease with unilateral decompression,interbody fusion and percutaneous pedicle screw fixation under endoscopic system.[Method]From June 2004 to March 2007,20 patients underwent minimally invasive transforaminal lumbar interbody fusion(TLIF) or posterior lumbar interbody interbody fusion(PLIF),which consisted of 11 male and 9 female patients.The mean age was 46.2 years(range,31～70),and the preoperative diagnosis consisted of postoperative recurrent lumbar disc herniation(n =8),far lateral lumbar disc herniation(n =4),spinal stenosis(n = 3),lumbar instability(n = 3),and discogenic lumbar pain(n =2).One-level decompression and intebody fusion with unilateral pedicle screw fixation under endoscopic system was performed in all of cases(12 at L4、5,and 8 at L5S1).A paramedian,muscle-sparing approach was performed through a tubular retractor docked unilaterally on the facet joint.A total facetectomy was then conducted,exposing and removing the disc(TLIF),or microendoscopic discectomy(MED) was performed(PLIF).The intervertebral space preparation were completed through the X-tube or METRx system.Interbody fusion was achieved with autograft bone and interbody cages.Unilateral pedicle screw-rod placement was accomplished.[Result]There was no conversions to open surgery.Operative time averaged 115 minutes(range,100～165 min).Blood loss averaged 130 ml(range,50～180 ml).Mean length of postoperative hospital stay was 11 days(range,7～15 days).All patients presenting with preoperative low back pain and /or lower extremity radicular pain(n= 20) had resolution of symptoms postoperatively.Complications included two cases of new radiculopathy postoperatively(one from graft dislodgement,the other from hematoma formation).Twenty patients were followed up 10～39 months(average 21.6 months).The preoperative,1 month postoperative and last follow-up Oswestry Disability Index(ODI scores were 42.05+8.36,21.33?6.37 and 12.31?3.75 separately(P

Objective To study the surgical techniques,indications and clinical effects of microendoscopic lumbar discectomy with the preservation of the ligamentum flavum.Methods A total of 65 patients with lumbar disc herniation were enclosed in the study.All the patients suffered from low back pain and radicular syndrome.The diagnosis was confirmed with CT scanning and/or MRI examination.The Microscope Endoscopic Tubular Retractor System(METRx) was used to access the interlaminar space.The superior,inferior and lateral edges of the ligamentum flavum were released using a micro-scalpel.The nerve root was retracted medially with a nerve root retractor to expose the herniated lumbar disc for performing the discectomy.The dissociative ligament was restored anatomically after disc removal and the decompression of the nerve root.Results The operation was completed smoothly in all the 65 patients without conversions to open surgery.The operation time was 136?21 min(range,110~170 min).The wound healed by first intention in all the patients.No nerve root injuries,intervertebral infection,or cerebrospinal fluid leakage were observed.A follow-up was carried out for 6~24 months(mean,14.5 months).According to the Nakai classification,excellent results were achieved in 42 patients,good in 18 patients,fair in 3,and poor in 2,the rate of excellent or good outcomes being 92.3%(60/65).Conclusions Microendoscopic lumbar discectomy with the preservation of the ligamentum flavum using the METRx is feasible.The preserved ligamentum flavum,as a good natural barrier,is helpful to prevent epidural fibrosis.

Objective To summarize the perioperative complications of microendoscopic discectomy(MED)for lumbar disc herniation,and to discuss the therapeutic strategies for these complications.Methods From October 1999 to Decmeber 2006,1852 patients with lumbar disc herniation were treated by MED in our hospital,140 of them developed perioperative complications.The clinical data of these patients were analyzed.Results Hemorrhage from the vertebral venous plexus was found in 48 cases,among which,MED was completed after controlling the bleeding under an endoscope in 42 cases,open discectomy was carried out in the other 6.In 47 cases,the herniated disc was incorrectly localized,and the MED was completed after correcting the location and direction of the endoscope.Twenty-one cases developed rupture of the dura mater during the MED,2 of them were converted to open surgery.Thirteen patients had leakage of the nucleus pulpous,and received a second-stage MED to remove the spinal nucleus.Six patients developed nerve injury and recovered completely one month later.Intraspinal infection was found in 5 patients after the MED;one of them was cured by conservative therapy,and the other 4 recovered after receiving the evacuation of the intraspinal lesions.Conclusion Complications of MED for lumbar disc herniation can be prevented or reduced effectively by proper therapeutic strategies.

Objective To study the curative effect of Bairui capsule combined with azithromycin in treatment of children with mycoplasmal pneumonia and its effect on serum high sensitive C-reactive protein, eosinophil, soluble interleukin-2.Methods 86 patients with mycoplasma pneumonia were enrolled from August 2015 to July 2016 in our hospital.According to the order of admission, the patients were divided into observation group and control group.The control group was treated with azithromycin , and the observation group was treated with Bairui capsule and azithromycin.Clinical efficacy,symptoms and signs of disappearance of time, CRP, EC, SIL-2R and adverse reaction rate were compared between the two groups.Results The total effective rate in the observation group was significantly higher than the control group [90.70% (39/43) vs 67.44% (29/43)](P<0.05).The time of disappearance of lung rales, the disappearance time of cough, the time of fever and the recovery time of X -ray in the observation group were significantly shorter than the control group (P<0.05).The levels of serum hs-CRP, EC and SIL-2R in the observation group were lower than the control group (P<0.05) .There was no significant difference in adverse reaction rate between observation group and control group.Conclusion Bai Rui capsule combined with azithromycin in children with mycoplasma pneumonia can effectively reduce the serum hs-CRP, EC, SIL-2R levels, clinical efficacy is good, low adverse reaction rate.

Amartya Sen's capabilities approach was deeply favored by academic comnmunity since developed.Martha Nussbaum had made great contribution on the implementation of capabilities approach.The capabilities approach was emphasized and analyzed by many foreign health econometrists,which had great value of application in health field.It briefly discussed the development of capabilities theories and described the application of capabilities approach in health economics.

● AIM: To explore the role that hepatocyte growth factor plays in proliferative vitreoretinopathy (PVR) after retinal detachment.● METHODS: The contents of hepatocyte growth factor in subretinal fluid (SRF) in 49 cases with retinal detachment were measured with enzyme-linked immunosorbent assay.● RESULTS: With the worsening of PVR and vitreous opacity and prolonging of disease course, the content of hepatocyte growth factor increased (P＜0.05), the difference being statistically significant.● CONCLUSION: The change of hepatocyte growth factor in SRF had a close relation ship with the occurrence and development of PVR after retinal detachment.

Objective To evaluate and analyze the postoperative complications induced from the procedure for prolapse and hemorrhoids(PPH).Methods The data of the third or fourth degree hemorrhoids operated by pro- cedure for prolapse and hemorrhoids were analyzed.Results Total 224 patients with hemorrhoids were operated on by PPH,and the mean operative time was 25 minutes and mean postoperative hospital stay were 3.5 days.Postoper- ative bleeding requiring haemostatic procedures occurred in two patients.Urine retention rate was 30.36%,there were 56 eases pain scores＞5,there of re-prolapse,16 cases of residual skin tags.One case of mucocele.Conclusion The rule of PPH is individual management.