ObjectiveTo investigate the clinical efficacy of focused ultrasound for treating non-neoplastic epithelial disorders of vulvar. Methods212 patients with non-neoplastic epithelial disorders of vulvar were treated with focused ultrasound. The patients were followed up after the treatment,and symptom was observed and the efficacy was evaluated. ResultsThe efficacy of non - neoplastic epithelial disorders of vulvar of squamous hyperplasia,lichen sclerosus and mixed dystrophy was 99.2％, 100. 0％, 88.9％ respectively, the difference was not significat (P ＞ 0.05 ). The efficacy in different courses of patients was 100.0％ ( ＜ 2 years), 100.0％ (2 ～10 years) ,91.3％( ＞ 10 years) respectively,the difference was not significat( P ＞ 0.05). ConclusionFocused ultrasound was obviously effective in the treatment of patients with non-neoplastic epithelial disorders of vulvar.

Objective To investigate the efficacy of imatinib combining with allogeneic hematopioetic stem cell transplantation or chemotherapy for bcr-abl positive acute lymphoblastic leukemia (ALL). Methods 12 cases were diagnosed on morphology, cytochemistry, immunophenotype and bcr-abl fusion gene. The induction is imatinib (400 mg/d) combining chemotherapy. 8 cases accepted allogeneic hematopoietic stem cell transplantation after complete remission (CR). If bcr-abl became positive, the patient was treated with imatinib (400～600 mg/d). 3 cases were tested with imatinib alternating chemotherapy after cr. Results 11 patients gained CR, CR rate 91.7 %; 5 patients (41.7 %) became bcr-abl negative through 2 courses induction. 3 cases relapsed after transplantation. 2 cases relapsed in imatinib combining chemotherapy group. The median remission interval is 16 months (imatinib combining transplantation group) and 10 months (imatinib combining chemotherapy group) (P <0.01) respectively. The median survival time is 18 months (imatinib combining transplantation group), and the other group (imatinib combining chemotherapy) is 12 months (P <0.01). Conclusion Imatinib combining chemotherapy achieved high CR rate for the bcr-abl positive ALL. Imatinib combining allogeneic hematopoietic stem cell transplantation is superior to imatinib combining chemotherapy for CR patients.

Objective To explore the relationship between the expression of P53 protein and the radiosensitivity in patients with advanced maxillary squamous cell carcinoma.Methods An immunohistochomical method wag used to detect the expression of P53 protein in patients with advanced maxillary squamous cell carcinoma.The follow up time was 2 years.The local recurrence of the patients having been treated with radical surgery and affiliated radiotheraphy were analyzed.Results The overexpression of P53 protein in 26 cages was 65.4% (17/26).In the P53 overexpression group,the local recurrence after systiem therapy wag occurred in one case within 6 months,6 cages between 7～12 months.3 cages between 13～18 months and 2 cases between 19～24 months.In the P53 low expression group,there were no recurrence within 6 and 12 months and one case ocurred within 18 months.5 cages between 19～24 months.The difference of recurrence within 18 months after system therapy between the expression of P53 Wag statistically significant(P＜0.05),but it Wag not significant for those within 24 months(P＞0.05).Conclusions The expression of P53 protein Wag correlated with the radiosensitivity in patient with advaneed maxillary squamous cell carciaoma,especially for the resid.rod cells in mitosis phase.The affiliated radiotherapy after radical surgery Wag limited effect.

Objective To compare the efficiency and safety of regimens of empiric antibiotic therapy in neutropenic hematological maligence patients.Methods The clinical data of empiric antibiotic therapy for 260 febrile episodes in 125 neutropenic hematological maligence patients were analyzed retrospectively.Results A total of 45 febrile episodes were treated with tazocin plus amikacin(regimen TA).80 episodes were treated with ceftazidime plus amikacin(regimen CA),75 episodes with imipenem plus amikacin(regimen IA) and 60 episodes with maxipime plus amikacin(regimen MA).The medians of initial therapy in each regimen were 7～8 days.Percentage of satisfactory response had no significant difference in episodes treated with regimens TA,IA and MA(65%,70% and 79% respectively),and it was better than regimen CA(P

ObjectiveTo explore the clinical significance of fms-like tyrosine kinase3(FLT3) expression in evaluation prognosis of acute myeloid leukemia(AML) prognosis.Methods50 patients with AML were selected.AML patients with normal karyotype were 20 cases,the abnormal karyotype were 30 cases.3ml bone marrow before themotherapy was aspirated respectively,and the FLT3 gene expression in leukemia cells was detected with polyenzyme chain react(PCR).ResultsThe FLT3 expression rate in AML patients with normal karyotype was 5.0％,and was 26.7％ in AML patients with abnormal karyotype,33.3％ in AML patients with refractory-relapse,and 4.5％ in AML patients with continue remission.The FLT3 expression rate was related with high leukemia cells percentage in bone marrow and high blood cells count in peripheral blood,and was not related with Franch America British(FAB) classification.The free-disease survival(FDS) and overall survived(OS) was shorter in FLT3 expression AML patients than that in no FLT3 expression AML patients.There was a statistical significance between the former and the latter( x2 =4.17,P ＜0.05 ).Conclusion FLT3 was a kind of worse factor in AML patients prognosis,and could guide clinical individual treatment in AML.

Objective To explore the high-risk factors,clinical characteristics,therapy and prognosis of invasive fungal infection (IFI)in patients underwent allogeneic haemopoietic stem cell transplantation (AlloHSCT). Methods One hundred patients underwent Allo-HSCT at our department from March 2002 to July 2010 were analyzed retrospectively,among whom 26 patients had invasive fungal infection(IFI). Seven patients had pulmonary IFI before allo-HSCT, 14 patients had pulmonary IFI after allo-HSCT,3 patients had respiratory tract system IFI, and 2 patients had intestinal IFI. We observed the occurrence of Graft-versus-host disease (GVHD) ,cytomegalovirus( CMV )infection, Lymphocyte subsets and chronic basic diseases in patients with IFI. The twenty six cases were divided into two groups: experience therapy group with 12 cases and preemption therapy group with 14 cases. Results Among 26 patients with IFI,20 cases suffered from GVHD,6 cases had CMV infection,19 cases had low cellular immune function simultaneously. 1 case had diabetes,3 patients had pulmonary tuberculosis and 1 case had bronchiectasis as complications. In experience therapy groupe: 8 cases (67%)recovered completely but 1 case(8% )suffered from progressive infection. In preemption therapy groupe:3 cases ( 21% ) recovered completely but 5 cases ( 36% ) suffered from progressive infection. Conclusion Clinician should pay close attention to the patients with high-risk factors of IFI after allo-HSCT.

Objective To quantify sjTREC using a modified method in patients who underwent allogeneic hematopoietic stem transplantation (all-HSCT),and determine the level of thymic output function and analyse the influencing factors in post-allo-HSCT patients.Methods Real time quantitative PCR was used to detect sjTREC levels from the peripheral blood DNA of pre-transplantation,14 d,28 d,3 m,6 m,9 m,1 y,1.5 y,2 y,2.5 y,and above 2.5 y after HSCT,and analyse thymic output function and related factors after HSCT.sjTREC levels in 24 normal individuals were also determined to use as the normal range.Results The mean of Log (sjTREC copies/ml) in normal individuals was 3.74±0.26.Negative correlation existed between thte Log sjTREC and the age (r =-0.65,P ＜ 0.01).There was no clear association between the TREC and the gender.Log sjTREC in pre-transplantation patients was 3.09±0.52,and the levels of sjTREC in 14 d,28 d,6 m,1 y after HSCT were 1.18±0.22,2.16±0.31,1.31±0.2,1.83±0.31,respectively.There was no significant difference between normal individuals and patients 1.5 years after HSCT.The post-transplantation level of sjTREC was not related to the age,but was negatively correlated to the acute graft versus host disease (aGVHD) 1 year after HSCT.There was no difference between patients with or without aGVHD 1.5 years post-HSCT.Conclusion The modified method for detecting sjTREC is applicable to allo-HSCT.The recovery of thymic output function after allo-HSCT is slow,in which aGVHD may have a negative effect.

Objective To investigate the cytogenetic and immunological phenotypes of acute myeloid leukemia (AML) with t(8;21),and explore the risk stratification and risk-adapted treatments.Methods The chromosomal karyotype of bone marrow was detected and analyzed in 22 newly diagnosed patients with t(8;21) AML by direct culture and G banding technique.Patients were divided into two groups according to the chromosomal karyotypes.Clinical characteristics and immunological phenotypes were compared between patients with isolated t(8;21) and those with additional aberrations.A follow-up study with median time 30 months (4-68 months) was conducted to analyze prognostic factors.Results 13 cases (59.1％) were isolated t(8;21) AML,while 9 (40.9 ％) had additional aberrations.Loss of sex chromosome was found in 3 cases and complex variant translocation in 2.The 10q-,9q-,-18 and +10 were found in single cases.Overall survival of patients with additional aberrations was significantly poorer than those with isolated t (8;21) (P =0.0176).Analysis of prognostic factors showed that t(8;21) chromosomal karyotype,initial white blood cells at diagnosis,and treatment regimen (chemotherapy alone or plus hematopoietic stem cell transplantation) had effects on overall survival.Conclusion Patients with t (8;21) AML are frequently associated with additional chromosomal aberrations.The latter indicates a poorer outcome and can be one of the bases of risk stratification.Hematopoietic stem cell transplantation might help to improve the overall survival.

Objective To investigate the effectiveness of intratympanic dexamethasone injection as a protec-tion agent against cisplatin ototoxicity.Methods Fifty five healthy guinea pigs were randomly divided into four groups.The guinea pigs groups received (group I)0.9% NaCl solution(16 ml/kg)intraperitoneally (IP),(group II)dexamethasone (10 mg/ml)intratympanically(IT),(group III)cisplatin (16 mg/kg)only intraperitoneally(IP) and (group IV)dexamethasone (10 mg/ml)IT followed after 1h by 16 mg/kg cisplatin.Before and 7 days following injections,the ototoxic effect was measured with auditory brainstem response(ABR).The contents of malondiade-hyde(MDA)and activities of superoxide dismutase(SOD)were also measured.Results ABR thresholds before and after dosing were 28.50±4.74,29.00±3.94 dB nHL and 28.67±5.82,31.33±5.81 dB nHL in group I and group II,respectively,with no significant differences (P>0.05).The contents of MDA and activities of SOD were 2.01 ±0.07 mmol/L ,234.10±13.09 U/ml and 2.06±0.09 mmol/L,233.20±13.24 U/ml in the group I and group II, respectively,with no significant differences (P>0.05).ABR thresholds after dosing were 55.33±4.81,and 40.67 ±3.72 dB nHL in the group III and group IV,which were significantly increased,but ABR thresholds in the group IV were significantly lower than that in the group III (P<0.05).The contents of MDA were 5.74±0.17,3.51± 0.18 mmol/L in the group III and group IV,which were significantly increased.SOD activities were 107.90 ± 14.21,and 162.70±11.25 U/ml,which significantly decreased.Nevertheless,in the group IV dexamethasone rela-tively reduced the contents of MDA(P<0.001)while increased the activities of SOD(P<0.001)compared with group III.Conclusion Intratympanic dexamethasone injection presents as an effective treatment modality to prevent cisplatin ototoxicity without any ototoxic effect.

OBJECTIVE To investigate the feas-ibility of preserving parotid duct in regional excision of pleomorphic adenoma. METHODS 32 patients with parotid pleomorphic adenoma were treated by regional excision with the preservation of the parotid duct. RESULTS No relapse occurred during 3-6-year follow-up period. Transient facial nerve palsy occurred in only 3.1%(1/32) of patients and the drainage of the parotid duct on the surgical side was preserved. CONCLUSION Remaining function of the parotid gland function was preserved and the facial nerve was well-protected in the regional excision of pleomorphic adenomas, especially for patients with small pleomorphic adenomas.