Objective To explore the efficacy of allogeneic hematopoietic stem cell transplantation using reduced-intensity Bu/Cy conditioning for patients with hematologic malignancies.Methods Five patients with hematologic malignancies were treated by allogeneic hematopoietic stem cell transplantation using reduced-intensity Bu/Cy conditioning,which consisted of busufan3~4 mg/(kg?d) for 3 days,cyclophosphamide50 mg/(kg?d) for 2 days, Ara-C 2 g/(m~2?d) for 1 or 2 days,and CsA 3 mg/(kg?d) and mycophenolate mofetil 1 g/d 7 days before the transplantation.Results Five patients established successful engraftment and no severe complications occured.After a follow-up of median 10.5(3-22)months,five patients still survived without diseases.Conclusion Reduced-intensity Bu/Cy conditioning may reduce transplantation-related toxicities.Allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning is a safe and effective option for the patients with hematologic malignancies.

To investigate the effect of the basic knowledge of chemistry teaching for preparatory international students,bilingual teaching based on Chinese-English languages and multimedia teaching,such flexible applications are carried out,which increases the students' listening,speaking,reading and writing skills in Chinese and helps them to adapt to the academic environment in China,and to master basic chemistry knowledge efficiently so that students can lay a good foundation for undergraduate program.

Objective To investigate the effects of trichostatin A (TSA) on Th1 and Th17 cells in the mice model of collagen induced arthritis (CIA).Methods Mice model of rheumatoid arthritis (RA) was induced in DBA/1 mice with type Ⅱ collagen.Paws were scored for histological severity of arthritis.The severity of inflammation of mice joints was evaluated by histological examination.Real time polymerase chain reaction (PCR) was used to determine mRNA of cytokines and transcriptional factors.Serum cytokine production was measured by enzyme linked immunosorbent assay (ELISA).T cell proliferation was examined by MTT method.One-way ANOVA and Student-Newman-Keuls were conducted in this study.Results The expressions of IFN-γand IL-17 mRNA of the CIA group were higher than that of the control group (8.27±0.64 vs 2.97±0.25,5.80±0.23 vs 0.70±0.26,all P＜0.01),but were inhibited significantly by TSA introduced at the onset of arthritis(6.60±0.52,2.50±0.41,all P＜0.01).Collagen specific T cell proliferation was significantly suppressed by the introduction of TSA.Increased level of IL-4 was observed in TSA treated group compared to that of CIA group(2.10±0.17 vs 1.01±0.08,P＜0.01).Conclusion Th1 and Th17 cells play crucial roles in the lesions of RA.TSA can suppress the progress of CIA by decreasing the percentage of Th1 and Th17.

Objective To study the relationship between the clinic-pathological features and pain symptoms in patients with endometriotic cyst(EM).Methods The medical data of symptoms,laparoscopy and pathology examination in 416 patients with endometriosis were studied retrospectively.All cases were divided into two groups on the existence of ovarian endometrioma,including 338 patients in cyst group and 78 cases in non-cyst group.The relationship between clinical symptoms and location and type of endometrioma was studied.Results(1)Serum CA125 level:the level of CA125 were(61 ± 39)kU/L in cyst group(28 ± 24)kU/L in non-cyst group,which reached statistical difference(P ＜ 0.01).(2)Pathological features:among 338 cases,34.0％ of cyst were on left side(115/338),26.3％ were right side(89/338),and 39.6％ were on both side(134/338).And 95.8％(324/338)of cases were combined with the other type of endometriosis,which were 48.5％(164/338)with peritoneal endometriosis,47.3％(160/338)with deep infiltrating endometriosis(DIE).In cystic patients,the incidences of endometriosis lesion were 13.9％(47/338)on the uterine surface,38.5％(130/338)on obstruction of cul-de sac,40.5％ (137/338)on utero-sacral ligament of DIE,which were significantly higher than 5.1％,(4/78),9.0％ (7/78)and 28.2％(22/78)in noncyst group.(3)Pain symptom:the incidence and degree of dysmenorrhea and dyschezia had no statistical difference between two groups(P ＞ 0.05),and the incidence of chronic pelvic pain(CPP)of 24.6％(83/338)and dyspareunia of 29.9％(101/338)in the cyst group were significantly lower than 35.9％(28/78)and 44.9％(35/78)in non-cyst group(P ＜ 0.05).The incidence of dysmenorrheal was 85.1％(114/134)in cases with bilateral cyst,which was higher than 74.0％(151/204)in cases with single cyst.The incidence of dysmenorrheal and dyschezia in moderatesevere adhesion was 89.0％(138/155)and 18.7％(29/155),which was significantly higher than 68.8％ (126/183)and 8.2％(15/183)in mild adhesion.In the patients cyst existed with DIE,the risk of dysmenorrheal,CPP,dyspareunia,and dyschezia were obviously raised(OR respectively was 5.17,3.01,3.05,2.75).Conclusions The endometriotic cyst often co-exists with other type of endometriotic lesions.Ovarian endometrioma was associated with lesion localized on uterine surface,cul-de-sac,sacrum ligament.The risk of all the pain symptoms would be raised when the endometriotic cyst co-exit with the DIE lesions.So the treatment for DIE lesions was as same important as the endometriotic lesions in order to relieve pain symptoms and delay the relapse.

The data collected from 34 type 2 diabetic patients receiving intensive insulin therapy for six years showed that the yearly mean HbA1C was less than 7.0％,and none of the patients showed severe hypoglycemia,occurrence or evident progression of retinopathy or nephropathy,and the islet β cell function gained improvement.The DQOL score,used to evaluate the quality of patients' life had no significant change during the observation ( P ＞0.05 ).It is satisfactory and safe to maintain long-term glycemic control with prolonged intensive insulin therapy in patients with type 2 diabetes,and that such therapy does not induce untoward influence on the quality of diabetic patients life.

Objective To utilize service quality difference model to analyze the gap between expectation of emergency patients and recognition of nursing service, in order to improve the quality of emergency nursing service by making out the management strategy. Methods A total of 114 emergency observed patients were transversely selected by cluster sampling method and investigated by self-designed current status of emergency nursing quality scale which based on service quality difference model in Taiyuan one class A grade three hospital from March to October 2013. We assessed at time of admitted emergency and discharged from emergency, analyzed the gap of nursing service′s source and types between expectation and recognition and reordered. At the same time, we applied multiple factors analysis method to ensure attribute of nursing service requirement for emergency observed patients. Results The average scores of patients to emergency nursing service was 6. 23 including 5 dimensions and 22 items, and the average score of expectation was 6. 72 (P <0. 05); the SQ average score of 5 dimensions sequenced from large to small: reactive mode, guarantee, stylish, reliability and empathetic; the age, annual times of seeking medical advice and ability of self-care all were the influencing factor of nursing service recognition. Conclusions Service quality difference model is one service quality assessment method from patients′ perspective, and we utilize this model to analyze the expectation and real feeling of service object, help administrators to find out the source caused quality issues and suitable measures targeted to minimize gap.

Objective To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system (LNG-IUS) for symptomatic adenomyosis in a prospective cohort study. Methods From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients′ parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results Totally 1 100 cases met inclusion criteria, with median age 36 years (range 20-44 years), median follow-up 35 months (range 1-108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383) and 29.6%(82/277) patients achieved amenorrhea respectively (P<0.01). Total and subclassification of adverse effects decreased significantly (P<0.01). Within 12 months and >12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status (all P>0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened-menstruation being the most common manifestations, while adverse effects decrease significantly. Changes of menstruation patterns or adverse effects neither have any risk factor nor have impact on treatment effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with severe dysmenorrhea in a prospective cohort study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, carrying status of LNG-IUS, menstruation patterns and adverse effects. Changes of scores and patterns of pain during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 640 cases (58.18%, 640/1 100) had severe dysmeorrhea, with median follow-up period of 35 months (range 1-60 months), and accumulative carrying rate of 65% at 60 months follow-up. After placement of LNG-IUS, scores of pain and ratio of severe dysmenorrhea had decreased significantly compared with baselines (all P<0.01), the scroes of visual analog scale (VAS) were 8.1 ± 0.9, 5.5 ± 2.4, 4.6 ± 2.4, 3.3 ± 2.2, 2.2 ± 2.1, 2.2 ± 1.8, 1.4 ± 1.6 and 1.3 ± 1.3 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 36 months after placement of LNG-IUS, scores of pain had improved significantly compared with preceding period (all P<0.01). We found no universal dependent factors predicting improvement of pain, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusion LNG-IUS is effective for adenomyosis of severe dysmenorrhea. Improvement of pain is independent on patients characters, menstruation patterns or adverse effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with menorrhea in a prospective study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including scores of menstruation blood loss, carrying status of IUS, symptoms and scores of dysmenorrhea, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Changes of pictorial chart scores of menstruation and distribution of anemia during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 618 cases (56.18%, 618/1 100) had severe menorrhea, with median follow-up period of 28 months (range 1-60 months), and accumulative carrying rate of 66% at 60 months follow-up. After placement of LNG-IUS, compared with baselines, pictorial chart scores and ratio of menorrhea had decreased significantly (all P<0.01), the scroes of menstruation were 157±34, 94±35, 70±33,67 ± 18, 67 ± 20, 65 ± 19, 66 ± 19, 65 ± 21 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 24 months after placement of LNG-IUS, pictorial chart scores and distribution of anemia had improved significantly compared with preceding period (all P<0.01). We found no dependent factors predicting improvement of pictorial chart scores of menorrhea, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusions LNG-IUS is effective for adenomyosis of menorrhea. Improvement of menstruation blood loss is independent on patients characters, menstruation patterns or adverse effects.

Objective:To explore the effect of comprehensive intraoperative physical intervention to prevent deep vein thrombosis (DVT) of lower extremity in patients with gynecological tumor surgery.Methods:From January 2020 to January 2021, 80 gynecological tumor patients undergoing surgery in Shanxi Provincial People 's Hospital were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the control group and the intervention group, each with 40 cases. The intervention group used intermittent pneumatic compression device (IPC) combined with graduated compression stockings (GCS) during the operation. In the control group, IPC was used alone for intervention. This study compared the blood flow rate and tube diameter of the lower extremity veins (common femoral vein, deep femoral vein, popliteal vein, and intermuscular vein) , blood coagulation indexes [prothrombin time (PT) , thrombin time (TT) , activated partial thromboplastin time (APTT) , fibrinogen (FIB) and D-dimer]before and after operation and the incidence of lower extremity DVT on the third day after operation between the two groups. Pearson correlation analysis was used to analyze the correlation between postoperative D-dimer and lower extremity venous blood flow rate. Results:There was no significant difference between the two groups of patients in the preoperative lower extremity venous blood flow velocity and diameter ( P>0.05) . The comparison of postoperative lower extremity venous blood flow rate between the two groups were statistically significant ( t=2.217, 4.863, 2.946, 2.397; P<0.05) . The diameters of common femoral vein, deep femoral vein and intermuscular vein between the two groups were statistically different ( t=2.117, 2.756, 2.274; P<0.05) , and there was no significant difference in the diameter of popliteal vein ( P>0.05) . There was no significant difference in PT, TT, APTT, FIB, D-dimer between the two groups of patients before operation ( P>0.05) . The differences in FIB and D-dimer between the two groups of patients were statistically significant ( t=-2.338, -3.554; P<0.05) . The incidence of lower extremity DVT in the intervention group was 2.5% (1/40) on the third day after operation, and the incidence of lower extremity DVT in the control group was 20.0% (8/40) , and the difference was statistically significant (χ 2=6.135, P<0.05) . Pearson correlation analysis showed that postoperative D-dimer and lower extremity venous blood flow rate were negatively correlated ( r=-0.484, -0.442, -0.358, -0.308; P<0.01) . Conclusions:The application of comprehensive intraoperative physical intervention of IPC combined with GCS can reduce the incidence of DVT in the lower extremities of patients with gynecological tumors, and it is worthy of clinical application.