Objective To improve the recognition of diagnosis, treatment and leukemia transformation of primary myelofibrosis (PMF). Methods One case with PMF which transformed into acute myeloid leukemia (AML) was reported and the literatures on this topic were reviewed. Results The patient was diagnosed according to the 2008 version of the WHO classification of PMF leukemia transformation was diagnosed after 2.5 years. The JAK2 V617F gene mutation was detectable both before and after leukemia transformation. The outcome of low dose chemotherapy could keep a short time. Conclusion JAK2 V617F gene could remain detectable after leukemia transformation in PMF patients. It is difficult to control the disease progress by low dose chemotherapy.

Objective To investigate the correlation between serum tumor necrosis factor (TNF)-α,neuron-specific enolase (NSE)and the degree of hypoxic-ischemic encephalopathy (HIE).Methods Forty-six HIE patients in acute and convalescent stage and 30 full-term newborn infant were enrolled in this study.The level of serum of TNF-α and NSE were detected.The relationship between TNF-α,NSE level and severity of HIE was analyzed.Results The level of serum TNF-α and NSE in acute stage of HIE group were (156.3 ± 28.8) ng/L and (21.5 ± 3.6) μg/L,in convalescent stage of HIE group were (80.7 ± 26.1) ng/L and (10.6 ± 1.7) μ g/L,and in control group were (76.3 ± 24.4) ng/L and (9.4 ± 1.6) μ g/L.The level of serum TNF-α and NSE in acute stage of HIE group were significantly higher than those in convalescent stage of HIE group and control group (P ＜ 0.05).The level of serum TNF-α and NSE in convalescent stage of HIE group had no significant difference compared with those in control group (P ＞ 0.05).The level of serum TNF-α and NSE in mild HIE group were (88.5 ± 25.6) ng/L and (9.7 ± 2.4) μ g/L,in moderate HIE group were (150.1 ± 16.5) ng/L and (17.8 ± 3.6) μ g/L,and in severe HIE group were (197.3 ± 30.2) ng/L and (23.6 ±4.3) μg/L.The level of TNF-αand NSE were increased with the aggravation of HIE and there had significant difference among different degree of HIE(P ＜ 0.05).The level of serum TNF-α and NSE in mild HIE group and control group had no significant difference (P ＞ 0.05),and there had significant difference between moderate HIE group,severe HIE group and control group (P ＜ 0.05).Spearman rank correlation analysis showed that the level of TNF-α and NSE had positive correlation with the degree of HIE (r =0.54,0.57,P ＜ 0.01 or ＜ 0.05).Pearson correlation analysis showed that the level of TNF-α had positive correlation with the level of NSE (r =0.46,P ＜ 0.05).Conclusions The variation of TNF-α and NSE level in HIE newborn infant is parallel to the severity of the disease,which can sensitively reflect the severity of HIE.Therefore,TNF-α and NSE may be used as vital indexes for the evaluation of the severity of HIE.

Objective To evaluate the usefulness of magnetic resonance spectroscopic imaging in detecting local recurrence in patients with T3N0M0 prostate cancer after cryotherapy.Methods Sixty-five patients with T3N0M0 prostate cancer underwent cryotherapy.The preoperative data of conventional MRI,MRS,transrectal ultrasound (TRUS)-guided prostate biopsy were collected.After cryotherapy,the prostate specific antigen (PSA) of all patients was detected monthly.If PSA ＞5 μg/L,MRI,MRS,and TRUS-guided prostate biopsy were planned within a week.If PSA was unremarkable,MRI,MRS,and TRUS-guided prostate biopsy were planned 12 months after cryotherapy.The prostate was divided 6 regions and the cancerous and noncancerous were marked.The signal-to-noise ratio(S/N) of choline (Cho),citrate (Cit)and the ratios of Cho + creatine ( Cre)/Cit of each regions were measured in pre-operation and postoperation.The patients were divided into non-recurrence and recurrence group according to TRUS-guided biopsy.The S/N of Cho,Cit,and the ratio of Cho + Cre/Cit were compared between the groups before and after cryotherapy by using independent samples t-test.Results ( 1) Fifteen patients were confirmed local recurrence 12 months after cryotherapy,including 11patients with an evaluate PSA level and 4 patients with PSA umemarkable.(2) The S/N of Cho,Cit and the ratios of Cho + Cre/Cit in the cancerous and noncancerous regions before cryotherapy in the sixty-five patients were 25 + 9,11+ 5,and 18 + 5,and 39 ±12,2.33 +0.60,and 0.53 ± 0.19.There had significant difference between that of two groups ( t values were 11.36,9.81,and 13.39,respectively,P =0.00).(3) In the patients with non-recurrence,The S/N of Cho,Cit in the cancerous and noncancerous regions were 4 ± 2 and 3 ± 2 ( t =1.024,P =0.305 ),and 2 +2 and 4 ±3 (t =1.147,P =0.178) and no difference was found.In necrotic area,the ratios of Cho + Cre/Cit could not be calculated because of low level of the S/N of Cho and Cit.(4)In the patients with local recurrence after cryotherapy,the S/N of Cho and Cit in the cancerous and noncancerous regions were 17 ±3 and 3 ± 2 ( t =17.24,p =0.00 ),9 ± 2 and 3 ± 3 ( t =23.66,P =0.00 ) and a significant difference was found.The ratio of Cho + Cre/Cit in the recurrent area was no significant different compared with that of preoperation(t =1.214,P =0.256 ).In necrotic area,the ratios of Cho + Cre/Cit could not be calculated because of low level of the S/N of Cho and Cit.Conclusions MRS is a useful tool to evaluate the changes of the S/N of Cho and Cit,the ratios of the Cho + Cre/Cit and help diagnosis of local recurrence.

Objective To analyze the 2015 IAAF World Athletics Championships victim of disease type and composition,investigate medical emergency services for major international sporting events.Methods The 2015 IAAF World Athletics Championships in Medical Encounter Forms records in 737 cases during the game (2015-8-21 to 2015-8-30) were retrospectively reviewed and analyzed.Results Total of 737 patients during the match,trauma 259 cases (35.1％),respiratory diseases 196 cases (26.6％),digestive diseases 77 cases (10.4％),heat-related illnesses 41 cases (5.6％).Athletes 170 cases (23.1％),174 cases of staff (23.6％),139 cases of the IAAF family members (18.9％),136 cases of spectators (18.4％),members of the media 56 cases (7.6％).Conclusions 2015 IAAF World Athletics Championships type of disease the treatment of patients with the most common sports injury,followed by respiratory diseases and common diseases in summer heat-related illnesses.Clinic staff personnel structure the most common,followed by extended family members as well as the IAAF athletes and spectators.Major sports events should develop reasonable security programs for priority diseases and key customer base,and to ensure a smooth operation.

Objective To analyze clinical and radiological characteristics of intracranial hemorrhage in hematological diseases to improve the recognition of them. Methods Thirty-one clinical data of intracranial hemorrhage cases with hematological diseases were reviewed. The basic diseases, clinical and radiological manifestations, and risk factors of mortality were analyzed. Results Intracranial hemorrhage usually occurred in patients with acute myeloid leukemia (AML) or idiopathic thrombocytopenic purpura (ITP),and 13 and 6 cases, respectively, in this group. Most patients presented with headache, restlessness, nausea,vomiting, conscious disturbance and no localization sign by physical examination. CT or MRI images often revealed focus of errlysis. Compared with CT scan, a higher detection rate of ICH could be realized by MRI scan. The total mortality in this group of ICH patients was 71% (22/31). Fever, white blood cell ＞5×109/L,platelet ＜50×109/L, hyperimmunoglobulinemia and disturbance of blood coagulation were risk factors for ICH of this group of patients. The mortality was higher in patients with no less than 2 risk factors[86.4 % (19/22)vs 33.3 % (3/9)] (x2 = 8.718, P = 0.003). Conclusion ICH is a serious complication for hematological patients. MRI scan is good at improving the diagnosis of ICH. It is of high risk of death in patients with no less than 2 risk factors such as fever, white blood cell higher than 5×109/L, platelet less than 50×109/L,hyperimmunoglobulinemia and disturbance of blood coagulation.

Objective To explore the influence of tranexamic acid used in different modes in total hip arthroplasty (T HA ) blood loss by control experiment .Methods 60 patients accepted total hip arthroplasty from orthopaedics in our hospital were se‐lected between March 2010 to August 2013 ,among them femoral neck fracture were 47 cases and 13 cases were osteonecrosis .aged between 45‐82 years old ,and 62 in average .All gave unilateral total hip arthroplasty .All patients were divided into three groups ,A group(contradistinction group) ,B ,C group(experiment group) .each groups include 6 men and 14 women ,no revision surgery pa‐tients .For group A ,100 mL normal saline was dripped both in half on hour before surgery and 3 hours after surgery ;For group B , tranexamic acid diluted in 100 mL normal saline according to 10 mg/kg was dripped half on hour before surgery ,100 mL normal sa‐line was dripped 3 hour after surgery ;For group C ,tranexamic acid diluted in 100 mL normal saline according to 10 mg/kg was dripped both half on hour before surgery and 3 hour after surgery .Compute and record the visible blood cell loss and hidden blood loss ,the comparative analysis was conducted to discuss the effectiveness and safety of tranexamic acid used in the two methods .Re‐sults The visible blood cell loss in each group were (196 .20 ± 44 .45)mL ,(114 .84 ± 35 .21)mL and (104 .47 ± 30 .01)mL ;hidden blood loss in each group were:(614 .50 ± 98 .41)mL ,(425 .74 ± 70 .01)mL and (337 .12 ± 52 .23)mL .Conclusion In the unilateral total hip arthroplasty ,the use of tranexamic acid can significantly reduce a significant amount of visible and hidden blood loss .Com‐pared with tranexamic acid dripped just half one hour before surgery ,dripping tranexamic acid both half one hour before surgery and 3 hour after surgery reduced more hidden blood loss ,decreased transfusion requirement ,and this does not significantly increase the risk of deep venous thrombosis .

Symptomatic venous thromboembolism (VTE) has a six-to seven-fold risk of occurring in cancer patients compared with non-cancer patients. VTE is the second most common cause of death among patients with cancer, and cancer-associated VTE is be-coming increasingly prevalent. Therefore, early diagnosis and treatment of cancer-associated VTE is particularly important. This study presents a pancreatic cancer-associated deep vein thrombosis (DVT) patient who engaged in a multidisciplinary comprehensive discus-sion in the Interventional Therapy Department, Tianjin Medical University Cancer Hospital to enhance concern, interdisciplinary com-munication, and cooperation in terms of cancer-associated VTE diagnosis and treatment strategies.

OBJECTIVETo observe the developing changes of adventitia in restenosis after precutaneous transluminal angioplasty(PTA), and investigate the effect of androgen on restenosis through contrasting the castrated male rat models and its mechanism.

METHODSModels were constructed of castrated male rats and restenosis of the common carotid artery, and specimens were collected at the 3rd, 7th, 14th and 28th day respectively after modeling. Hematoxylin and eosin staining, immunohistochemical staining, and electronic microscopy were performed to observe the condition of restenosis.

RESULTSProliferating cells occurred in adventitia first and phenotype of adventitial cells was changed at the 3rd day after PTA. The adventitial proliferating index was the highest at the 7th day after PTA, and proliferating migration towards intimal was observed. The proliferating cells mostly occurred in the middle layer and neointima at the 14th day after PTA. The areas of adventitia and neointima were larger and the degrees of restenosis were higher in the castrated rats than in the non-castrated ones at different time points. Take the 14 d group, the adventitial area was[(3,566 +/- 337) micron2 vs (2,751 +/- 401) micron2, P = 0.008], the neointimal area[(3,553 +/- 477) micron2 vs (2,757 +/- 435) micron2, P = 0.025], the restenosis rate[(76 +/- 2)% vs (60 +/- 8)%, P = 0.005], and the proliferating index [(29 +/- 2)% vs (13 +/- 1)%, P < 0.001].

CONCLUSIONAdventitial proliferation and migration contribute to restenosis after PTA; Androgen in rats can physiologically relieve restenosis, probably through intervening in the activation of adventitia.

Actins ; analysis ; Androgens ; physiology ; Angioplasty, Balloon, Coronary ; Animals ; Bromodeoxyuridine ; metabolism ; Coronary Restenosis ; etiology ; pathology ; Coronary Vessels ; pathology ; ultrastructure ; Immunohistochemistry ; Male ; Orchiectomy ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the efficacy and safety of CT-guided percutaneous argon-helium cryoablation in treating hepatic metastases from nasopharyngeal carcinoma. Methods The clinical data of 16 patients with hepatic metastases from nasopharyngeal carcinoma, who had received percutaneous argonhelium cryoablation therapy, were retrospectively analyzed. The quality of life before and after therapy, and the postoperative complications were recorded. After argon-helium cryoablation therapy, the progression-free survival (PFS), the overall survival (OS), and the one-month, 3-month, 6-month, 12-month postoperative tumor local control rates were calculated. Results In all 16 patients, no severe complications occurred and the quality of life was significantly improved after argon-helium cryoablation therapy. The one-month, 3-month, 6-month, 12-month postoperative tumor local control rates were 100％, 87.5％, 80.0％ and 58.3％respectively. The median PFS was 11 months (95％CI: 8.4-13.6 months), and the median survival time was19 months (95％CI: 9.2-28.8 months) . After argon-helium cryoablation therapy, the half-year, one-year and2-year survival rates were 93.8％, 75％ and 43.8％ respectively. Conclusion For the treatment of hepatic metastases from nasopharyngeal carcinoma, CT-guided percutaneous argon-helium cryoablation is minimally-invasive, safe and effective with reliable curative effect.

Objective: To explore the dialectical relationship between immunosuppressed cell expression and TCM inpatients with liver cancer. Methods: The clinical data of 237 HBV-related primary liver cancer patients were collectedand the differences of MDSC expression and clinical BCLC stage and intrahepatic metastasis were analyzed. Peripheralvenous blood was taken for the detection of MDSC (CD33/CDl4/HLA-DR-/low/CDllb) expression in mononuclear cells, helper T cells (Th1, Th2) and interleukin (IL-12, IL-4) ) detection. Results: There was a significant difference betweenliver stagnation and spleen deficiency syndrome (24.21％) and qi stagnation and blood stasis syndrome (5.54％) (Χ2=11.544, P ＜ 0.05) . The expression of MDSC (21.03％) was higher than that of liver-kidney yin deficiency (5.10％) in advanced hepatocellular carcinoma (＞ 5 cm) (Χ2= 8.223, P ＜ 0.005); the expression of Th2 in liver stagnation and spleendeficiency was higher than that of qi stagnation. There was a significant difference between groups in blood stasis group (t = 10.341, P ＜ 0.05) . The expression of Th2 in wet sputum was higher than that in liver and kidney yin deficiency group.There was significant difference between groups (t = 16.307, P ＜ 0.01) . The IL-4 in liver stagnation and spleendeficiency group (76.57 ± 5.01) was higher than that in qi stagnation and blood stasis group (121.70 ± 6.22); There was asignificant difference between groups (t = 21.414, P ＜ 0.05) . There was a significant difference in IL-4 (375.12 ± 5.31) inthe liver-kidney yin deficiency group compared with the group with wet phlegm (115.46 ± 4.15) (t = 12.455, P ＜ 0.05) .Conclusion: MDSC participates in tumor proliferation, invasion and metastasis by regulating Th2 and IL-4, which isclosely related to the dialectical classification of TCM.