Objective To observe the therapeutic efficacy of all-trans retinoic acid(ATRA) combined with arsenic trioxide(As2O3) on acute promyelocytic leukemia(APL).Methods 9 patients of APL underwent ATRA with As2O3 therapy.The patients in combination group were treated with ATRA 25mg/(m2?d) and As2O3 10mg intravenously for 3 to 4 hours per day until complete remission(CR) or for 50 days.According to the white blood cell(WBC) counts,anthracycline and cytosine arabinoside(Ara-C) were added on third day.Results 6 newly-diagnosed and 2 relapse patients of the combination group were CR after first treat.The medium time to CR was 30.12?4.89 days.Conclusion ATRA + As2O3 with anthracycline regiment is superior to either regiment given alone to patients with APL.It is an efficient therapeutic approach to APL patients using a combination of ATRA with As2O3.

Islet transplantation is effective in treating diabetes, however, its clinical use is highly restricted by a series of influencing factors. This review elucidates the non-immune factors including islet purification, instant blood-mediated inflammatory response and revascularization deficit on the development of islet transplantation, and also highlights the application and perspective of islet xenotrasplantation in the treatment of diabetes.

Objective To study the expression of macrophage inflammatory protein-1α(MIP-1α),inter-feron gamma inducible protein 10(IP -10)and angiopoietin -1 (Ang -1)in primary acute myelogenous leukemia (AML),and clarify their clinical significance.Methods ELISA was used to detect the expressions of MIP -1α,IP-10 and Ang -1 in serum samples from 54 AML patients(observation group),and twenty volunteers(normal control group).Results The expression levels of MIP -1α,IP -10 and Ang -1 in the observation group[(198.813 ± 53.923)pg/mL,(2.332 ±0.745)ng/mL,(1.593 ±0.447)ng/mL]were significantly higher than the normal control group[(153.309 ±44.475)pg/mL,(1.569 ±0.485)ng/mL,(0.838 ±0.333)ng/mL](t =3.369,5.133,6.856, all P <0.05).Subgroup analysis,during the groups of better -risk,intermediate -risk and poor -risk,the contents of MIP -1αwere (141.524 ±27.510)pg/mL,(196.370 ±31.966)pg/mL,(269.892 ±54.795)pg/mL;the contents of IP -10 were (2.085 ±0.332)ng/mL,(2.307 ±0.696)ng/mL,(2.685 ±0.348)ng/mL;the contents of Ang -1 were (1.248 ±0.454)ng/mL,(1.599 ±0.386)ng/mL,(1.951 ±0.359)ng/mL.The levels of MIP -1αand Ang -1 in the better -risk group were significantly lower than those in the intermediate -risk group and poor -risk group (q =6.100,11.438,3.603,5.742,all P <0.05).While the levels of IP -10 had no closely correlation with NCCN risk status(q =1.225,2.643,2.016,all P >0.05).There were remarkable correlation between the serum expression levels of MIP -1αand Ang -1 (r =0.324,P <0.05).Conclusion There are differences of serum MIP -1α, IP -10 and Ang -1 in the different NCCN prognosis groups,which reflect they may have certain guiding significance in the choice of clinical treatment and the prognosis for newly diagnosed AML.

Objective To study the short-and long-term results for Cockett syndrome caused acute deep vein thrombosis (DVT) of the lower extremity by surgical thrombectomy or catheter-directed thrombolysis.Methods One hundred and two Cockett syndrome caused acute DVT cases were treated by surgical thrombectomy or catheter-directed thrombolysis (CDT) from Jan 2006 to Dec 2011.There were 52 patients treated by CDT (group A),and 50 cases by surgical thrombectomy (group B).All patients received warfarin treatment after operation.Results There were no significant differences in general clinical characteristics between the two groups.The limb edema reduction rates between the two groups were of no significant difference(83％ ± 6％ vs.82％ ± 8％ P ＞ 0.05).The venous patency were basically the same (64.6％ ± 6.7％ vs.65.3％ ± 7.2％,P ＞ 0.05).The mean time required was shorter in group A than in group B[(30.5 ±6.7) min vs.(97.5 ±23.6) min,P ＜0.01].The average hospital stay was shorter [(9.8±5.4) d vs.(17.7 ±8.2) d,P＜0.01],and morbidity was less[13.4％ vs.42％,P＜0.01].Eighty six patients were followed up.The circunference difference of thigh,the score of vein patency between the two groups were of no significant difference (P ＞ 0.05).Conclusions Compared with surgical group,patients in CDT group have shorter hospital stay,less complication and similar long and shortterm results.

Objective To evaluate the surgical and interventional therapy in patients with acute superior mesenteric vein thrombosis.Methods In this series,31 acute superior mesenteric vein thrombosis(SMVT) cases were reviewed from Oct 2006 to Feb 2012.According to varied clinical presence,patients received superior mesenteric vein thrombectomy with necrotic bowel resection or indirected catheter thrombolysis through superior mesenteric artery.Results 6 of 9 cases undergoing surgery were cured and other 3 still complained abdominal distension when discharged for not being able to bear anticoagulation and thrombolysis after operation due to alimentary tract hemorrhage,and residual thrombus was shown in superior veins by venography.17 of 22 treated by interventional therapy gained obvious relief within 72 hours after intervention,others gained symptomatic relief in 5-7 days.Indirected catheter thrombolysis were interrupted in 2 due to alimentary tract hemorrhage.One patient was shifted to surgery 48 hours after catheter thrombolysis due to deterioration.Mean duration of follow-up after hospital discharge was (19 ± 5) months in 25 cases,20 had no abdominal distension and pain,3 with postcibal abdominal distension.Conclusions Indirected thrombolytic therapy by way of the superior mesenteric artery is a technically simple,safe and effective therapy for patients with acute SMVT.

Objective To investigate the value of multi-slice spiral CT image texture analysis in differentiating metastatic (MLN) from non-metastatic lymph nodes (NLN) in patients with rectal cancer.Methods Thirty five patiets with rectal cancer who were pathologically confirmed by total mesorectum excision were included retrospectively,with regional lymph nodes (short-axis diameter of larger than 3 mm)found in preoperative CT images.All the patients underwent preoperative abdominal and pelvic dynamic contrast-enhanced CT scan.Regional lymph nodes were identified according to pathological findings,and were divided into MLN and NLN groups.The short-axis diameter,short-to long-axis diameter ratio of lymph nodes were manually measured and calculated,and the texture features,including skewness,kurtosis,variance,entropy and inverse difference moment,were analyzed.The above parameters between MLN and NLN groups were compared using independent sample t test or Mann-Whitney U test.ROC curve analysis was performed regarding the statistically significant parameters and the areas under curve (AUC) were calculated.Multivariate Logistic regression analysis was accomplished to obtain the independent predictive factor of diagnosing regional lymph nodes.Results A total of 68 regional lymph nodes were obtained and consisted of 31 MLNs and 37 NLNs.The short-axis diameter,kurtosis,and entropy of the MLN group were significantly higher than those of the NLN group (all P＜0.05).Whereas,the short-to long-axis diameter ratio,skewness,variance,and inverse difference moment did not differ significantly between the two groups (all P＞0.05).The AUC for distinguishing MLN from NLN of the short-axis diameter,kurtosis and entropy were 0.79,0.67,and 0.85,respectively.Multivariate logistic regression analysis showed that only entropy (odds ratio=8.48,95％ confidence interval was 3.01 to 23.92,P＜0.01) was screened out as the independent variable,which suggested that the entropy was the unique predictor for characterizing regional lymph nodes of rectal cancer.Conclusion Multi-slice spiral CT images texture analysis can facilitate the accurate differentiation between MLN and NLN in patients with rectal cancer,and especially the entropy has the optimal reference significance.

Objective To develop the personalized 3D printing scaffolds for bone grafts,to meet the needs of the patients with the bone defect.Methods The model of three-dimensional woodpile structure was designed by the software of computer-aided design (CAD).The β-tricalcium phosphate (β-TCP),hydroxyapatite (HA),and polylactic acid (PLA) composite scaffolds with three-dimensional woodpile structure was simulated using 3D printing method by three-dimensional air floating platform.The three-dimensional bone graft scaffolds was then vacuum heat-treated,and the residual chloroform was detected by energy dispersive X-ray spectrometer.The morphology of the β-TCP/HMPLA scaffolds was characterized by scanning electron microscope,and in vitro cytotoxicity against osteoblasts hFOB 1.19 was assessed by thiazolyl blue tetrazolium bromide (MTT) assay.Results When the extrusion pressure of printing slurry was 137.9-413.7 kPa,the three-dimensional bone graft scaffolds could be printed out.Then the scaffolds was vacuum treated at 90 ℃ and preheated at 150 ℃,which could eliminate the solvent CHC13.The three-dimensional bone graft scaffolds,with a through-hole and rough surface,was co-cultured with osteoblasts hFOB1.19 for 7 d,and it's cytotoxicity grade was grade 0.Conclusions The three-dimensional bone graft scaffolds have a through-hole and rough surface,which is favorable to the osteoblasts culture and bone induction,indicating the advantage and development prospects of 3D printing in the preparation of porous materials for bone grafts.

Objective To evaluate the prevention and management for the complications in interventional therapy for the lower extremity arteriosclerosis obliterans (ASO). Methods In this study 207 ASO cases received interventional therapy. The relationship between complication rates and different TASC type and the influence of diabetes mellitus (DM) with coronary heart disease (CHD) on critical organs complication rates was analyzed. Results The intervention succeeded in 190 cases. There was 17 failures, including 13 procedure failures and 4 deaths due to postoperative critical organ complications. Among the complications there were puncture site hemorrhage in 12, pseudoaneurysm in 4, alimentary tract hemorrhage in 2, arteriorrhexis in 6, cerebral infarction in 8, acute heart failure in 9, respiratory failure in 13, renal failure in 6, thrombosis in 5 and blue-toe syndrome in 1. The intraoperative complication rate of femoral-political type (39.84%, 51/128) was high than that of aorta-iliac type (18.99%, 15/79) (P< 0.05). Those critical organ complication rates of patients with DM and patients with DM&CHD were 27.66% (13/47)and 24.49% (12/49)respectively, they were higher than that of patients without (5%, 2/40) (P<0.05). Conclusions The high complication rates during interventional therapy of ASO were because of misoperation and complicated pathological type and together with DM and CHD. These rates could be decreased when we treated DM and CHD before operation and chosen a reasonable method and shorten the duration of operation.

Objective To evaluate the methods and efficacy of interventional treatment for subclavian arterial stenosis or occlusion retrospectively. Methods From Oct 2003 to Sop 2009,25 patients with subclavian arterial lesions , including stenosis in 13 cases and occlusion in 12 cases, underwent interventional treatment. Four patients received percutaneous transluminal angioplasty (PTA) alone, and concurrent 22 stents placement were performed in 20 cases. Results The technical success rate in stenotic lesions was 100% and in occluded lesions was 91.6% with a interventional failure in 1 case. Blood pressure increased significantly after interventional treatment. The diseased side/healthy side blood pressure index increased from 0.60 ±0.11 mm Hg preoperatively to (0.95 ±0.12) mm Hg postoperatively( t = 10.53 ,P ＜0.01 ). Clinical symptoms improved, and there were no complications with strokes and embolism. 20 cases were followed up for 30 months ( from 2 months to 69 months ). Restenosis was found in 2 cases and the restenosis rate was 8.3%. The cumulative primary patency rate was 92.5% and 81.3% at 1 and 3 years,respectively. Conclusions Intervention was a less invasive and safe, effective treatment for subclavian arterial lesions.

Objective To evaluate the feasibility of the diagnosis of the early immunologic rejection after xeno-islet transplantation by MR imaging enhanced with superparamagnetic iron oxide(SPIO)marking CD4+T cell antibody.Methods Two thousand neonatal porcine islets(NPI)were transplanted under the left renal capsule of BALB/C nude mice.When the grafts could be observed bv MRI.107 human PBMC was intraperitoneal injected to nude mouse models to reconstitute the human immunologic system,20 mice were reconstituted.Before and 3,7,14 days after reconstitution of human immunologic system on BALB/C nude mice,MRI imaging Was performed half an hour after intravenous injection of nano-immunomagnetic beads via vena caudalis to observe the grafts'MRI signal.BALB/C nude mice were sacrificed after MRI scanning immediately,the histopathologic examination was assessed on grafts,the results were compared with MRI results.And calculate the sensitivity,specificity,Youden index number and coincidence of the MRI for immunologic rejection.Results Grafts can be observed bv MRI 3 weeks after islet cell transplantation (before immunologic rejection modeling),there is no abnormal MRI signal detected in nude mice'graft region after mierobeads injected.Seven days after building of immunologic rejection model,MRI hypo-signal in graft site is shown in the T2 WI sequence after nano-bioprober injected.Histopathologic assessments were employed on grafts in nude mice immediately(HE and immunohistochemistry staining),the results shown that there are a lot of T lymphocyts infiltrated in graft region.implying the occurrence of immunologic rejection.And the sensitivity,specificity,Youden index number and coincidence is:(72.96±0.24)%,100%,0.73±0.24,(88.46±0.13)%respectively.The correct Kappa between the MRI and the imunohistochemistry staining was 0.76.Conclusion The cellular immunological rejection to xeno-islet grarts can be assessed with nano-bioprobe with anti-CD4+ antibody MR imaging,real time,and noninvasively.