To study the efficacy of CAG regimen used in 35 cases of newly diagnosed acute myeloid leukemia in elder-ly patients. Methods:Totally 35 cases of elderly patients with acute myeloid leukemia were randomly divided into two groups. The pa-tients in the control group (15 cases) were treated with standard chemotherapy treatment, while the CAG regimen group (20 cases) was treated with CAG regimen (cytarabine, aclarubicin and granulocyte colony-stimulating factor). After one treatment course, the chemotherapy efficacy was observed, and the neutrophil and platelet recovery time and the incidence of adverse reactions in the two groups were compared. Results:The treatment efficacy of the CAG regimen group was 90%, which was higher than that of the control group (60%, P<0. 05). The neutrophil and platelet recovery time of the CAG regimen group was significantly shorter than that of the control group (P<0. 05). The incidence of adverse reactions in CAG regimen group was much lower than that of the control group(P<0. 05). Conclusion:The efficacy of CAG regimen used in the 35 cases of newly diagnosed acute myeloid leukemia in elderly pa-tients is promising, which can effectively control the progression of the disease and accelerate blood cell recovery with high safety.

50% was in 72.1% of patients and

A 37-year-old male patient presented with persistent generalized itching erythema and papules for more than 1 month.The patient had received surgical treatment for type B3 thymoma in stage Ⅳ.Five months prior to the presentation,he developed myasthenia gravis.He also complained of chronic diarrhea for two years.Physical examination revealed white patches in the oral mucosa as well as scaly erythema of varying size on the face,trunk and extremities.Lamellar scales could be seen after scratching,while removal of scales could not result in the appearance of bleeding points.There was scaly hyperkeratotic erythema of palms and soles.Histopathological examination revealed psoriasis-like epidermal hyperplasia and parakeratosis with multiple dyskeratocytes,and some of the dyskeratocytes were surrounded by lymphocytes.There was a perivascular infiltration with a small number of lymphocytes.Immunohistochemical study showed positive staining for CD3,CD4 (dermis),CD8 (epidermis) and CD45RO,but negative staining for CD20,CD68 and CD30.The patient was diagnosed as thymoma-associated graftversus-host-like disease,myasthenia gravis and mucosal candidiasis.After treatment with tacrolimus and prednisone,the condition was gradually relieved.

Objective To assess the clinical value of high-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus. Methods The clinical data of 8 patients with presacral venous hemorrhage treated with high-frequency electrocautery from February 2005 to March 2008 were analyzed. Once the presacral venous hemorrhage happened, the bleeding site was pressed with a gauze or finger and the accumulated blood was aspirated. Then, while simultaneously withdrawing the gauze or finger over the bleeding sites, high-frequency electrocautery was applied with a power of 80-100 W to coagulate all the bleeding sites. Results High-frequency electrocautery was used to stop bleeding in the 8 patients, and no electrocautery related complica-tions occurred postoperatively. Conclusions High-frequency electrocautery for massive hemorrhage of presacral venous plexus is simple, efficient and safe.

Objective To analyze the clinical manifestations of early cerebral ischemic lesions after stenting with WingSpan system for symptomatic intracranial artery stenosis, and to evaluate the early effects and safety of the stenting therapy. Methods Twenty-nine consecutive patients with symptomatic intracranial stenosis underwent diffusion weighted imaging (DWI) before and after stenting (within 72 hours). The clinical data, including patients' general condition, stenting procedures and newly-developed cerebral ischemic lesions, were recorded. Neurological defect was estimated with NIHSS, the safety and early outcome of stenting were evaluated. Results The degree of stenosis was reduced from a mean baseline of (72.3 ± 10.7)% to (31.9 ± 13.6)% immediately after stenting. The technical success rate was 100%. The total eomplicatiom nate was 17.2%. And among them, z were symptomatic (6.9%). Sixty-three ischemic lesions were demonstrated on DWI in 13 patients (44.8%). Among them, 11 (84.6%) were asymptomatic. Fifty-five newly-developed lesions on DWI (87.3%) were located in the region of stented vessels and 3.2% were situated in the region of branch vessels of stented artery. Conclusion DWI is of great value in assessing the safety of intracranial stenting procedures. The treatment of symptomatic intracranial artery stenosis by using WingSpan system is safe and effective. Newly-developed ischemic lesions can be well detected on DWI and should receive physician's attention, although most ischemic lesions are asymptomatic. Long-term outcome of this treatment needs to be further observed.

Objective To detect the related genes with rifampin and isoniazid in Mycobacterium tuberculosis in sputums using the DNA chip technique and evaluate the fensibility of the clinical application of the DNA chip technique.Methods 586 sputum smear specimen was detected using the L-J cultivation to determine their drug resistance.Simultaneously.DNA chip was employed to detect the mutation of the frequent mutable points rpoB,katG/inhA in mycobaeterium tuberculosis isolates.These two assays were compared and samples showing discrepancy were chosen for additional sequencing to evaluate the accuracy of the detection.Results(1)There were 584 culture positive sputum smear specimens including 3(+)163 specimens,2(+)204 specimens,and 1(+)217 specimens.The drug fast results displayed that 361 strains were sensitive to INH,223 strains tolerated INH in which 93 strains tolerated it in low concentration while sensitive to it in high concentration.and 130 strains tolerated it in both low and high concentration.While 327 strains were sensitive to RFP.247 strains tolerated RFP in which 59 strains tolemted it in low concentration while sensitive to it in high concentration,and 188 strains tolerated it in both low and high concentration.(2)There were 367 positive strains(62.8%)and 217 negative strains(37.2%)identified by PCR amplification of the specific resistance gene fragments.The detection rate of the katG/inhA was 28.4%,and the mutation sites were mainly focused on the katG315(89.8%).The detection rate of the rpoB was 55.9%(137/247),and the mutation sites were mainly focused on rpoB531(68.6%)and rpoB 526(16.1%).(3)The sequencing of sample,which showed discrepancy with L-J cultivation and the DNA chip confirm a certain omission ratio.Conclusions It is feasible to detect the related resistant genes in Mycobacterium tuberculosis isolates using the DNA chip technique.The key factor is to raise the efficiency of the DNA extraction,the effciency of the PCR and the quality control of the experiment to facilitate its clinical application.

Objective To reduce the misdiagnosis of the inpatients admitted to digest department with abdominal pain through analyzing the consultation undertaken by surgeon.Method The causes and the constituent ratio according to the case records of those inpatients admitted to digest department because of abdominal pain were analyzed.Results The obstruction of hollow viscus was the first cauge(51.07%),and the tumor of digestive tract(17.78%)was the second cause for invitation for consultation to surgeon of the inpatients with abdominal pain in digest department wards.The ultrasound 32.78%,CT 26.67% and gastroenterological endoscope 13.89% were definite diagnosis,and should shorten the time of consultation.Conclusion Whether inpatient or outpatient with abdominal pain should be planned to be examined by ultrasound,CT or gastroenterological endoscope,obgerve the changes of the symptom and sign so that the misdiagnosis can be avoided.

Objective To study the effect of Xuebijing injection on the change of intestinal tract mucosa barriers and the expression of macrophage antihody in rats with sepsis. Method Totally 150 Wistar rats were ran-domly divided into three groups: sham group, sepsis group, and Xuebijing group. Sepsis models were estabhshed in rats by cecal ligation and puncture. The success standards of sepsis included fever, the increase of respiration rate,increased heart rate and change in leukocyte count. At 12 hours before operation, and after operation the rats in the Xuebijing group were injected with 4 mL/kg Xuebijing (once every 12 hours for 3 days), and the rats in the others two groups were injected with the same volume of saline, the image analytical system were used to detect the pathological change of intestinal tract mucosa harriers and the expression of macrophage antibody in three groups. All the data were analyzed by rank-sum test and variance analysis(F test). Results Almost all the mucous mem-brahe of small intestine in sham groups were normal. The mucous membrane lesions of small intestine developed in sepsis and Xuebijing groups after 12,24,48,72 hours, and the lesion was severer in sepsis group than that in the Xuebijing group (H=19.732, P<0.01). There were no significant differences on the expression of macrophage antibody in mucous membrane of small intestine between three groups at 3 hours. But at 12, 24, 48 and 72 hours, the expression of macmphage antibody of sepsis and Xnebijing groups increased with time (F=560.13, P< 0.05). Conclusions At the early period of sepsis, intestinal tract mucosa barriers develops varying degrees of damage, and Xnebijing can partly protect intestinal tract mucosa barriers.

Objeclive To analyze the occurrence characteristics of stenosis or occlu-sion in guilty artery in patients with ischemic cerebrovascular disease. Methods The data of digital subtraction angiography (DSA) of 304 patients with ischemic cerebrovascular disease were analyzed retrospectively, in which there were 188 patients with transient ischemic attack (TIA) and 116 patients with cerebral infarction. Guilty arteries were identified, and the length of stenotic segment and severity of stenosis were measured. Results Of the 304 patients, 227 (74. 7%) had cerebral artery stenosis or occlusion. 193 (85.0%) identified guilty arteries, in which 104 (53.9%) were in extracranial artery only, 70 (36. 3%) were in intracranial artery only, and 19 (9. 8%) were in both intra- and extracranial arteries, The incidence of cerebral artery stenosis or occlusion (97/116, 82.9%) in the cerebral infarction group was significantly higher than that in the TIA group (130/188, 68.8%) (P <0. 01); the incidence of extracranial vascular lesions in posterior circulation in the TIA group was significantly higher than that in the cerebral infarction group (24.3% vs. 7.0%, P < 0. 01); and the incidence of intracranial vascular lesions in anterior circulation in the cerebral infarction group was significantly higher than that in the TIA group (32.6% vs. 20.6%, P <0. 01). However, there yeas no significant difference bergen the TIA group and the cerebral infarction group in the length of stenosis and severity of guilty artery. Conclusions Cerebral artery stenosis or occlusion in the in the cerebral infarction group is more common than that in the TIA group. The extracranial artery lesions in posterior circulation is more common in the TIA group, and the intracranial artery lesions in anterior circulation is more common in the cerelral infarction group, while the severity of cerebral ischemia is not associated with the stenosis degree and length of guilty artery.

Objective To analyze the effects of quality supervision and continuous improvement system on optimizing in-hospital diagnosis and treatment process in patients with acute ischemic stroke (AIS).Methods From September 2013 to May 2016,424 consecutive patients with AIS treated with intravenous thrombolysis and/or endovascular therapy in Changhai Hospital,the Second Military Medical University were enrolled retrospectively.They were analyzed according to the annual running process (the first year[from September 2013 to August 2014],the second year[from September 2014 to August 2015],and the third year[from September 2015 to May 2016]).The spend time and delay (DTN>60 min,DTP>90 min) rate of each treatment process in the first,second,and third year (time from door-to-imaging[DTI],door-to-needle[DTN],imaging-to-needle (ITN),door-to-groin puncture (DTP) and imaging-to-groin puncture (ITP) were compared.Taking the time periods (>median) of having significant differences of the spend time of the treatment processes as the dependent variables in the first,second,and third year,the influence of the years and treatment modalities on delay was observed.The difference of constituent ratio of the reasons for delay in intravenous thrombolysis and endovascular therapy (objective reasons/other reasons) in different years were analyzed.Results (1) DTIs were 23.0 (11.0,42.0) min,22.0 (10.1,39.0) min,and 13.0 (6.0,27.0) min,respectively,and DTNs were 50.0 (30.0,77.1) min,45.0 (30.0,70.2) min,and 36.0 (24.0,57.0) min,respectively in the first,second,and third year.The spending time was shortened year by year.There were significant differences among the different years (all P<0.01).The spending time of DTP had a tendency to be shortened,but there were significant differences among different years (P=0.06).There were no significant differences between the spending time of ITN and ITP (all P>0.05).(2) The DTN delay rates were 33.3% (40/120),20.7% (29/140),and 8.1% (9/111),respectively in the first,second,and third year.There were significant differences among the 3 years (x2=22.111,P<0.01).There were no significant differences among the DTP delay rates (P=0.08).(3) Multivariate Logistic regression analysis showed that taking the first years as a reference,the risk of DTI delay was reduced in the third year (OR,0.174,95%CI 0.101-0.298,P<0.01),the risks of DTN delay were reduced in the second and third year (OR,0.564,95%CI 0.338-0.941;OR,0.180,95%CI 0.101-0.320,all P<0.05).For simple intravenous thrombolysis,bridging therapy was a protective factor for the improvement of treatment efficiency in the DTI process (OR,0.530,95%CI 0.297-0.943,P=0.031).Compared with the bridging therapy,the direct endovascular therapy was a protective factor for DTP treatment (OR,0.427,95%CI 0.202-0.901,P=0.025).The remaining independent variables were not associated with the occurrence of DTN and DTP delay (all P>0.05).(4) During the three years,the delay of intravenous thrombolysis was mainly due to objective reasons.The constituent ratio of other reasons caused delay of intravenous thrombolysis was decreased year by year.There was no other reasons for delay in the third year).There was no significant difference in the constituent ratio of the delay reasons in endovascular treatment (x2=3.622,P=0.164).Conclusion Under the existing process and resource allocation,setting the DTN target time and implementing continuous quality improvement are conducive to the effective implementation of brain CT scan and continuous optimization of intravenous thrombolysis in the processes in AIS patients with the first diagnosis.