Objective This research summarized the nursing experience of critically ill patients infected by H7N9 avian influenza who were treated with extracorporeal membrane oxygenation (ECMO) and artificial liver device.Methods 10 critically ill patients infected by H7N9 avian influenza were selected,during treatment of ECMO combined with artificial liver device,nursing care such as careful observation of the changes of symptoms,strict disinfection and protection,contact isolation,symptomatic treatment to fever,correct management of airway and ventilator circle,pipeline nursing of ECMO and artificial liver device,mental nursing,symptomatic and support therapy which included antivirus,anti-hypoxia and anti multiple organ failure,anti-shock,anti-infection,microecological balance maintenance and water-electrolyte balance maintenance.Results 4 critically ill patients infected by H7N9 avian influenza improved and removed ECMO and artificial liver device,among whom one patient rehabilitated and was discharged.Another 6 patients were in a steady state.Conclusions For critically ill patients infected by H7N9 avian influenza,comprehensive and elaborate care can facilitate early recovery of patients.

Objective To determine the diagnosis and the prognosis of acute bilineal leukemia(aBLL).Methods The cases who had been morphologicaUy diagnosed as acute leukemia were retrospectively screened.The characteristics of aBLL blasts and the patients'responses to chemotherapy and the survival rate were identified based on the analysis of both their clinical and laboratory data.Results From total of 352 cases screened,11 cases of aBLL were identified.The incidence of aBLL was 3.1%.Among them 4 were male and 7 female.The median age was 38 years old.The median counts of white blood cell at the onset of the disease was 56.3×109/L.There were more My/B aBLL subtype cases than My/T aBLL (8 cases vs.3 cases). Cytogenefie analysis data were available for 7 cages. All were standard karyotypes except 1 who had complex karyotypie change.The complete remission(CR)rate of chemotherapy was 45.5%(5/11)and the response rate(CR+PR)Wag 54.5%(6/11).Only 2 patients achieved CR after the first course of induction chemotherapy.The median of remission duration was 11 months,ranged from 3 to 14 months.The median of survival time was 10 month. ranged from 1 to 23 months. 1 patient died during the induction course.Conclusion aBLL is a rare subtype of acute leukemia.The diagnosis of the disease could be based on the combinational analysis of morphology and immunophenotype study.The patients'responses to the conventional chemotherapy regimens were not satisfied.Therefore,the prognosis of the disease was poor.

0.05).(4) The subtypes of 4 cases of B-cell lymphoma diagnosed by cytology originally were determined by analyzing immunophenotype of their bone marrow involvement.Conclusions:Flow cytometry is an effective method for detecting bone marrow involvement in B-cell lymphoma and is superior to cytomorphology;Bone marrow involvement detected by FCM can be useful for helping diagnosis.The relevance of bone marrow involvement in different types of untreated B-cell lymphoma patients with clinical presentations and response to treatment should be further studied in more patients.

AIMTo investigate the effects of prostaglandin E 1 on apoptosis induced by hypoxia/reoxygenation in cultured neonatal rat cardiomyocy tes. METHODSThe models of hypoxia/reoxygenation were made with t he first generation of cultured cardiomyocytes. Hypoxia/reoxygenation apoptosis in cultured neonatal rat cardiomyocytes was studied by agarose gel electrophores is and Tdt-mediated dUTP nick end labeling(TUNEL). Bcl-2 and bax mRNA were det ected by in situ hybridization. RESULTSThe results of DNA electr ophoresis in the H/R group showed the typical DNA ladder. And the DNA ladder decreased gradually corresponding to the increased dose of PGE 1. The TUNEL staining showed that the total number of apo ptotic cells in the H/R group was much biger than that in PGE 1(0 127 ?mol?L -1 ) group. The results of in situ hybridization showed that the conten t of bcl-2 mRNA in H/R group was lower than control. And the content of bax mRN A showed a reverse result as bcl-2 mRNA. Compared with H/R group, the content o f bcl-2 mRNA was significantly higher after treatment with PGE 1(0 014 ?mol ?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 ). But the content of bax mRNA in PGE 1(0 014 ?mol?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 )groups was significantly lower than H/R group. CONCLUSI ONH/R injury can induce cardiomyocyte apoptosis. PGE 1 has obvious an ti-apoptotic effects on cardiomyocyte and the mechanisms are possibly by inhibi ting the expression of bax and increasing the expression of bcl-2.hein creaseddoseofPGE1 .TheTUNELstainingshowedthatthetotalnumberofapoptoticcellsintheH

Objective To evaluate the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in combination with flow cytometry (FCM) in lymphoma.Methods From January 2011 to December 2011,the cases of suspicious lymphoma with EUS-FNA examination at Shanghai Ruijin Hospital were retrospectively analyzed.The final diagnosis was according to pathological diagnosis of specimen from the surgery and follow up results.The sensitivity,specificity and accuracy of EUS-FNA combined with FCM in lymphoma diagnosis were initially analyzed.Results A total of 14 suspicious lymphoma patients were collected,eight cases were diagnosed as lymphoma by pathological examination of specimen from the surgery or.tissue from aspiration,four cases were non-lymphoma lesions and two cases still had no final diagnosis.The sensitivity and specificity of FCM alone in lymphoma diagnosis were 4/8 and 4/4 respectively.Six cases of lymphoma were detected by EUS-FNA with FCM.The sensitivity,specificity and accuracy of EUS FNA combined with FCM were 6/8,6/6 and 10/12 respectively.Conclusion EUS-FNA combined with FCM has better diagnostic value in lymphoma,especially for gastrointestinal lymphoma and those surrounding deep lesions.

Collaboration of c-KIT mutations with AML1-ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.