Objective To observe the efficacy and main complications of allogeneic hematopoietic stem cell transplantation(allo-HSCT)for 76 patients with hematopoietic malignancies.Methods From September 2001 to March 2007,76 patients received allo-HSCT in Department of Hematology,Xijing Hospital,Fourth Military Medical University.All cases included 24 acute myeloid leukemia(AML),15 acute lymphocytic leukemia(ALL)and 34 chronic myelogenous leukemia(CML)and 3 T cell lymphoma/leukemia.Donors were HLA-identical sibling(n=57),1 locus mismatched sibling(n=3),HLA-matched unrelated volunteer(n=9)and haplo-identical sibling(n=7).Conditioning regimen consisted of busulphan-cyclophosphamide or cyclophosphamide and total body irradiation plus Ara-c/VP-16.Graft versus-host disease prophylaxis was the standard methotrexate and cyclosporine combination.Anti-human thymocyte immunoglobulin(ATG)and CD25 monoclonal antibody was given in unrelated donor and haplo-identical HSCT.Results Totally 73 patients got sustained engraftment.Acute GVHD and chronic GVHD were found in 18/73(24.7%)and 24/73(32.9%)patients,respectively.Severe veno-occlusive disease occurred in 2 cases.Pure red cell aplasia was found in 5 patients with major ABO mismatched HSCT.With a follow-up of 3 to 76 months,43/76(56.6%))patients were still alive and 33/76(43.4%)died from leukemia relapse or transplantation-related complications.Conclusion Allogeneic heamatopoietic stem cell transplantation is an effective therapy for leukemia,especially in CML-chronic period and acute leukemia in complete remission,but there is high rate of relapse in patients with high-risk and refractory status before transplantation.

Specimens of 50 adult brain with meninges were examined under magnificationof 5?.The number of the superior cerebral veins(SCV)varies considerably on bothsides.Cases with 7 branches on one side are most commonly seen. SCV perforate the arachnoid either at the superior border of the cerebral hemi-sphere or far beyond it.More branches perforate the arachnoid beyond the superiorborder of the cerebral hemisphere.The length of SCV between the superior borderof the cerebral hemisphere and the point where the veins perforate the arachnoid ismeasured and in average,the length of the frontal veins and veins of central gyriis longer than that of the parieto-occipital veins.The outer caliber of the frontopolar veins and occipital veins is the smallest andthat of the combined trunk veins is the largest.Bridge veins usually occur in the branches of SCV except the left central vein.The incidence of the bridge vein in the left and right frontopolar veins is thehighest(50～60%).There is an adherent segment occurring in all branches of SCV.The incidenceof the adherent segment in different branches is almost over 50%.Therefore it maybe considered that the presence of the adherent segment in SCV is a normal pheno-menon.The frontal veins and the veins of the central gyri usually adhere to thedura,and the parieto-occipital veins to the lateral wall of the superior sagittal sinusand the cerebral falx.Very few perforated segments can be seen in frontal veins,yet the percentageof its presence in the both sides of the veins of central gyri and parieto-occipitalveins are 9% and 11.22% respectively.Any vein with a perforated segment per-forates the lateral wall of the superior sagittal sinus predominantly.The application of the bridging vein,or adherent segment and perforated seg-ment of the SCV in neurosurgery has been discussed.

The morphology of the extraglandular and intraglandular portions of the adrenal veins and other veins concerned with the catheterization in adrenal venography was observed on 53 adult cadavers.The extraglandnlar portion of both adrenal veins is of single trunk type on all the specimens. The left adrenal vein consistently ends into the left renal vein while the right adrenal vein ends into the inferior vena cava in 83.02% of cases and into the right accessory hepatic vein in 9.43%.The length and diameter of the extraglandular portion of the left adrenal vein are 23.05?5.96 mm and 4.99?0.82 mm and those of the right adrenal vein are 8.73?5.13 mm and 2.93 ? 0.87 mm. The angle formed by the left adrenal and left renal veins is 117.35?11.95? and that formed by right adrenal vein and inferior vena cava is 47.5?14.58?.The distances from the femoral vein(lower margin of inguinal ligment)through the external and common iliac veins and inferior vena cava to the hila of both adrenal glands were measured. They may be used as references in performing adrenal venography.The intraglandular portion of the adrenal veins is of three types: single, double and triple trunk types. The single trunk type is the most common occurring in 86% of the left adrenal veins and 50% of the right veins. The triple trunk type exists only on the right side.In addition, the feasibilities and difficulties of the catheterization of the both adrenal veins were discussed according to the anatomy studied.

Objective To examine the expression of autoantibodies against angiotensin Ⅱ type 1 receptor (AT1-AAs),monocyte chemoattractant protein-1 (MCP-1) and high-sensitivity C-reactive protein (hs-CRP) in patients of acute coronary syndrome (ACS),and study the role of AT1-AAs in plaque stability and pathogenesis of ACS.Methods Sixty patients with ACS were selected as ACS group,60 patients with stable angina pectoris (SAP) were selected as SAP group,and 60 healthy people were selected as control groups.The epitopes of the second extracellular loop of angiotensin Ⅱ type 1 receptor (165-191) were synthesized and used as antigen to screen the serum autoantibodies by enzyme-linked immunosorbent assay (ELISA).The peripheral blood levels of MCP-1 and hs-CRP were also evaluated.Results The positive rates of AT1-AAs in ACS group,SAP group and control group were 45.0％(27/60),21.7％(13/60) and 5.0％(3/60),respectively.The positive rates of AT1-AAs in ACS group and SAP group were significantly higher than those in control group,the positive rate of AT1-AAs in ACS group was significantly higher than that in SAP group,and there were statistical differences (P ＜ 0.01).The MCP-1 and hs-CRP levels in ACS group and SAP group were significantly higher than those in control group,the MCP-1 and hs-CRP levels in ACS group were significantly higher than those in SAP group,and there were statistical differences (P ＜ 0.01).The MCP-1 and hs-CRP levels in AT1-AAs positive patients in ACS group and SAP group were significantly higher than those in AT1-AAs negative patients,and there were statistical differences (P ＜0.01).Conclusions AT1-AAs may play an important role in the pathogenesis of ACS.Inducing the expression of inflammatory factor through AT1-AAs maybe an important mechanism for plaque instability.

Key healthcare resources are doubtlessly critical in emergency management. How to balance the supply and demand, use limited resources scientifically and rationally, and maintain a healthy public service system, have emerged an important challenge in emergency command. Based on the theory of supply-demand balance of public goods, the article took Wuhan as an example to analyze and establish a model on key healthcare resources allocation, in order to provide reference and evidence for global health governance and other similar public health emergencies.

Cadre assessment is an important part of cadre management and should have scientific and credible characteristics. " who assesses" " what to assess" " how to assess" and " how to use the results" have become urgent practical issues that need to be resolved in cadre assessments. By combining analysis of relevant policies and the actual annual assessment work of cadres from 2016 to 2019 at a certain hospital, and using expert consultation and in-depth interviews, a hierarchical and classified annual comprehensive evaluation system for middle-level cadres has been established. This system included both daily assessments and annual assessments, with weights of 10% and 90% respectively; moreover, in the annual assessment, different weights were assigned to the indicators at various levels for middle-level cadres in different positions, highlighting the organizational assessment orientation, emphasizing the performance orientation in medical practice, teaching, research, and management, and focusing on objective achievements. Since 2021, a certain hospital has been using this comprehensive evaluation system, which has further improved the methods for examining and identifying cadres, enhanced the targeting and effectiveness of cadre education and training, strengthened positive incentives for cadres, tightened supervision and management of cadres, and improved the assessment and evaluation mechanisms. This has led to an increase in the quality, capacity, and implementation of job responsibilities within the cadre team, and can provide decision-making reference and work guidance for health administrative departments and other medical institutions.

Objective:To investigate the clinical value of digital technology in repair of soft tissue defect in hand by anterior tibial artery perforator flap.Methods:From January 2015 to February 2021, 9 patients with soft tissue defects in hand were repaired with anterior tibial artery perforator flap assisted by digital technology in flap design, including 6 males and 3 females aged from 19 to 63 years with a mean age of 33 years. The size of defects varied from 2.0 cm×1.5 cm to 4.0 cm×3.0 cm, with exposed bones or tendons. Preoperative CTA scan of lower limb was performed and three-dimensional image was reconstructed with Mimics 20.0. The anterior tibial artery perforator flap was designed according to the shape and size of the defect, then the resection of flap was digitally simulated. The flap based on the digital design was harvested and the defect was repaired in the operation. The size of flap was 2.5 cm×2.0 cm~4.5 cm×3.5 cm. Outpatient clinic follow-up was performed to evaluate the survival of flaps. Disability of Arm, Shoulder and Hand(DASH) was used for function evaluation.Results:All flaps were harvested successfully and all donor sites were closed directly. After surgery, 8 flaps survived completely. One flap developed venous occlusion that showed partial necrosis of the flap, and it was rescued after exploration and re-anastomosis. The follow-up period ranged from 6 to 21 months, with an average of 13 months. The DASH scores of the affected limb were 2 to 15 points at the last follow-up, with an average of 6.4 points. Mild scar hyperplasia occurred at donor site in 1 case without sensory abnormality.Conclusion:The digital technology is able to accurately locate the perforators by allowing an individualised design of the anterior tibial artery perforator flap. The flap is suitable for repair of small and medium-sized soft tissue defect in hand, and the digital technology has certain value in clinical application.