It is difficult for the patients of refractory leukemia to complete remission (CR) and long-term disease-free survival (DFS), and it was always been the hot spots of research in the field of hematologic malignancies. The diagnostic criteria of refractory leukemia were adjusted constantly at domestic and foreign, the high-risk factors about refractory leukemia were found constantly too. New molecular markers that represent mutations or gene overexpression have been identified such as FMS-like tyrosine kinase-3 and nucleophosmin,which will enhance the ability to more accurately prognosticate for patients with acute myeloid leukemia. The treatment of patients with refractory or relapsed acute myeloid leukemia remains challenging. Multiple new agents with tremendous potential were in development and clinical trials. Such as applying resistance reversal agents,enhancing molecular targeted therapy, improving the technology of hematopoietic stem cell transplantation,empoldering the new drugs, and forming a new chemotherapy program etc. Monoclonal antibodies and peptide vaccination with leukemia-associated antigens also brought the hopes of increasing the remission and cure rates for patients with acute myeloid leukemia.

Objective To evaluate the clinical features,diagnosis and treatment of metastatic adrenal carcinoma. Methods The data of 11 cases of metastatic adrenal carcinoma who were admitted from December 1993 to March 2003 were reviewed,including 4 cases of lung carcinoma,5 cases of hepatocellular carcinoma,1 case of bile duct carcinoma and 1 case of renal cell carcinoma.The main clinical manifestations were waist pain in 3,fatigue and weight loss in 3,hematuria in 1 and no symptom in 4.All the 11 cases underwent B-ultrasonography and CT scan,of whom 2 underwent positron emission tomography (PET).All patients were treated by surgical operation,including 9 cases by total adrenalectomy,1 case by palliative adrenalectomy and 1 bilateral metastatic case by left-adrenalectomy alone. Results In 5 cases by total adrenalectomy the survival time was 6 to 63 months with a mean of 34 months.Two cases were followed up for 2 to 16 months and 2 cases were lost with follow-up.One case by palliative adrenalectomy survived for 3 months.One bilateral metastatic case by left-adrenalectomy survived for 4 months. Conclusions Ultrasonography and CT are important in the diagnosis of metastatic adrenal carcinoma,and PET is of greater value in clinical practice.Complete adrenalectomy may be the best treatment choice to prolong the survival time.

Objective To establish an orthotopic animal model of human prostate carcinoma (PC),and to provide a useful tool for the research of PC. Methods A total of 30 male BALB/c nude mice were included.First,2?10 6 human PC-3 cells were injected subcutaneously in 10 nude mice.Then 8 weeks later,the tumor on mice backs were took out and smashed into pieces.The tissue was implanted on the ventral lateral lobe of prostate gland by surgical orthotopic implantation in the other 20 nude mice.Twelve weeks later, the mice were autopsied,and histopathological examination of orthotopic tumors and relevant organs was done to identify and quantitate micrometastasis. Results Of the 20 mice,18 (90%) had tumor growth.The tumors were greater than 1.5 cm in diameter in 17 mice.Dilatation of bladder and hydronephrosis because of obstruction occurred in 12 mice.A high frequency of lymph node and organ metastasis was noted upon histological examination (10 with retroperitoneal para-aortic lymph node metastasis,4 with lung metastasis,1 with liver metastasis).But no bone metastasis was found. Pathological sections showed that most parts of the prostate were occupied by tumor cells. The nuclei looked polymorphic and hyperchromatic.Abnormal nucleus division could be seen.The cortices and medullae of metastatic lymph nodes were occupied by tumor cells. Conclusions The model set up by surgical orthotopic implantation can show the biological features of prostate carcinoma cells well.It expresses the metastatic potential of PC cell line significantly and can be considered an ideal heterotransplant animal model.

Objective To study the mechanism of occurrence of the multifocal bladder cancers. Methods The expressions of p21,p53 and EMA in twenty specimens from 5 cases of multifocal bladder cancers were studied by means of immunohistochemistry. Results In 4 of 5 cases, the expressions of p21 and p53 were correspondent in scattering specimens from the same patient. In all the 5 cases, the expressions of EMA were correspondent in scattering specimens from the same patient. Conclusions Multifocal bladder cancer may originate from the same monocolone.

Objective To evaluate the use of spiral Double J stent in the treatment of complica ted ureteral calculi with extracorporeal shockwave lithotripsy (ESWL). Methods Spiral Double J stent was inserted in 52 patients with complicated ureteral calculi before ESWL,and the conventional Double J stent was inserted in 45 patients as control. Results In the control group,the number of ESWLprocedures was 4.2,while in spiral Double J stent group,it was 3.8( P

Objective To investigate the expression level of MMP 1 and MMP 2 in the bladder transitional cell carcinoma (BTCC) and to analyse the location feature of expression and to provide a useful marker for judging the invasion. Methods From March 1998 to December 1999,62 cases of BTCC specimens were collected.The expression level of MMP 1 and MMP 2 of the specimens was detected by in situ hybridization technique. Results MMP 1 and MMP 2 were expressed in a small amount in the normal bladder walls.They were expressed mainly in cytoplasm of tumor cells and stromal cells. The positive rate of MMP 1 mRNA was 43.5%,and had no association with cell grade and TNM stage.The positive rate of MMP 2 mRNA was 59.6%.The expression level closely correlated with the cell grade and TNM stage ( P

Objective To evaluate the clinical effect of Ho:YAG laser with flexible ureteroscope on the treatment of renal calculi. Methods Fifty one cases of renal stone burdens were treated with Versa Pulse Select Ho:YAG lithotriptor through flexible ureteroscope. Results The successful rate of stone fragmentation after single session was 90%(45/51).Mean operation duration was 45 min (30～78 min).Mean duration of post operation in hospital was 2.4 days (1～6 days).Stone free time was 3～6 weeks,with a mean of 4 weeks.No ureteral perforations or pyonephrosis occurred. Conclusions Ho:YAG laser lithotripsy through flexible ureteroscope is a safe, effective treatment for renal calculi.

OBJECTIVE:To investigate the effects of erythropoietin (EPO) combined with hyperbaric oxygen on neurologic function recovery and cerebral tissue metabolism of hypoxic-ischemic encephalopathy (HIE). METHODS:A total of 47 HIE neo-nates in our hospital during Sept. 2012-Apr. 2015 were selected and divided into observation group (25 cases) and control group (22 cases)according to random number table. Both groups received routine symptomatic supportive treatment as reducing intracrani-al pressure,correcting acidosis,maintaining electrolyte balance and controlling seizures. Control group was given hyperbaric oxy-gen therapy,compressing 15 min,inhaling 30 min,decompressing 15 min,qd. Observation group was additionally given rhEPO injection(CHO cell)200 U/kg,subcutaneously at the first time,intravenous injection from the second time,qd. Both groups were treated for consecutive 10 d. NBNA score,neural reflex recovery time,consciousness recovery time,the serum levels of NSE, MBP and S100B protein were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in NBNA score,serum levels of NSE,MBP and S100B protein between 2 groups (P>0.05). Five and ten days after treatment,NBNA scores of 2 groups were increased significantly compared to before treatment,and the observation group was significantly higher than the control group at corresponding period,with statistical signifi-cance (P<0.05). The serum levels of NSE and S100B protein in 2 groups were decreased significantly compared to before treat-ment,and the observation group was significantly lower than control group at corresponding period,with statistical significance (P<0.05). After 5 days of treatment,serum levels of MBP in 2 groups were increased significantly compared to before treatment, with statistical significance(P<0.05),but there was no statistical significance between 2 groups(P>0.05). After 10 days of treat-ment,serum levels of MBP in 2 groups were decreased significantly,and the observation group was significantly lower than con-trol group,with statistical significance (P<0.05). After treat-ment,neural reflex recovery time and consciousness recovery time of observation group were significantly shorter than con-trol group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (8.00%) and control group (9.09%)(P>0.05). CONCLUSIONS:For HIE neonates,EPO combined with hyperbaric oxygen can effectively promote neurologic function recovery and cerebral tissue metabolism with good safety.

Objective To evaluate the clinical effect o f Ho:YAG laser on the treatment of urinary calculi. Methods 155 cases of urolithiasis were treated via ureteroscope or cystoscope with V ersa Pulse Select Ho:YAG lithotriptor. Results 8 cases with kidney stones and 7 bladder stones were fragmented after a single s ession. The overall successful stone fragmentation rate of ureteral calculi was 95.7%(134/140). The mean stone expectoration time stone-free was 2.5 weeks. The mean operation time and post-operation hospital stay were 25 minutes and 2.5 da ys. No major complications such as perforation were encountered. Co nclusions Ho:YAG lithotripsy is an excellent treatment modality for urolithiasis.

Objective To study the feasibility of renal hypothermia achieved by retrograde icecold saline infusion with perfusion pump. Methods Twenty-one patients who received the open radical nephreetomy were divided into three groups,A group with ice-slush renal hypothermia,B group with gravitational retrograde ice-cold infusion,C group with retrograde ice-cold infusion by perfusion pump.After the kidney was dissected and the ureter was divided,the renal vasculars were clamped.The kidney was cooled by three methods respectively.The temperature of renal parenchyma was monitored for 15 min. Results Fifteen minutes later,the temperature of renal parenchyma of A group declined from 34.4℃ to 5.4℃,B group from 34.8℃ tO 23.8℃,C group from 35.1℃ to 22.3℃.Coneiusions Renal hypothermia can be achieved by retrograde cold saline infusion and the perfusion pump may accelerate the speed of cooling.