A total of 120 patients with Ⅲ/Ⅳ degree hemorrhoids were randomly divided into 3 groups.Self-made drainage(A group),traditional device(B group)and stuffing(C group) were used at the end of operation.The patient postoperative complications and satisfaction were observed and compared.The results showed that postoperative abdominal distension,pain,medical dressing dampness and satisfaction were better in A group than those in B and C groups(all P ＜0.01).Postoperative abdominal distention in B group was lighter than that in C group and medical dressing dampness less in C group than that in B group (all P ＜ 0.01).Thus the self-made drainage device may reduce the levels of postoperative abdominal distension,pain and medical dressing dampness and increase postoperative patient satisfaction.

Objective To observe the changes of serum potassium concentration in rectal cancer patients from the admission to before the operation,to provide clinical evidence for preventing serum potassium disorder during and after their operation.Methods Monitoring of the changes of serum potassium concentration of 40 cases of rectal cancer patients according to three time points including the first day of admission,before taking of cathartics and the morning before operation.They were divided into different groups according to their age(young,middle age and elderly group),gender(male and female group),diet(normal,decreased slightly and serious decline group) and course(long,middle and short course group) of disease.The serum potassium concentration was observed between each time point of each group and SPSS13.0 statistical software was used to analyze the changes above.Results The mean of all patients' serum potassium concentration was (4.09 ± 0.62) mmol/L on the first day of admission,was (3.83 ± 0.46) mmoL/L before taking of cathartics that was decreased compared to the former and there was significant difference (P ＜ 0.01),it was (3.36 ±0.40) mmol/L on the morning of operation and had significant difference with the above two groups (P ＜ 0.01).It hadn't significant difference between different gender and age groups at different time points (P ＞ 0.05) except between the young group and the elderly group in the morning of the operation (P ＜ 0.05).There were statistically significant differences between the different diet condition and different course at anytime point (P ＜ 0.01).Conclusions The rectal cancer patients were possiblely in hypokalemia before operation,the causes might be relative to the long course of disease,the decreased diet,the aged and infirm,the diet structure change after admission and taking cathartics cleaning intestinal tract.

Objective In order to provide clinical evidence of reducing postoperative complications of procedure for prolapse and hemorrhoids and observe the effects of constipation on postoperative complications of procedure for prolapse and hemorrhoids.Methods One hundred and sixty cases of hemorrhoid were divided into two groups according to whether suffering from constipation:there were eihgty cases who were suffered from constipation in the experimental group and eighty cases who were not suffered from constipation in the control group.All patients' postoperative bleeding,anal edema,stool impaction and satisfaction were observed within 30 days and these data were compared and analysed by using SPSS 13.0 software.Results In the experimental group,the postoperative bleeding incidence was 37.5 ％ (30/80),the anal edema incidence was 31.3 ％ (25/80),the stool impaction inci dence was 8.6％ (7/80),and the patients' satisfaction rate was 88.6％ (71/80).In the control group,the postoperative bleeding incidence was 18.6％ (15/80),the anal edema's incidence was 15.0％ (12/80),the stool impaction incidence was 1.3％ (1/80),and the patients' satisfaction rate was 97.5％ (78/80).All the indexes above were different statistically in the two groups (P ＜ 0.05).Conclusion constipation could increase complications and reduce the degree of satisfaction after procedure for prolapse and hemorrhoids.

Objective To investigate the relationship between prothrombin fragment 1+2 (F1+2) and peripherally inserted central catheter (PICC) associated thrombosis in cervical cancer patients, and provide certain clinical basis of early prevention in peripherally inserted central catheter associated thrombosis in cervical cancer patients. Methods One hundred and forty cervical patients with PICC were enrolled in this study, and they were divided into thrombosis group (35 patients) and non-thrombosis group (105 patients). The level of F1+2 was examined using enzyme-linked immunoassay, and was analyzed according to the clinic features. Results The level of F1+2 was correlated with clinical stage (r = 0.640, P = 0.004);but was not correlated with age, type of tumor and concurrent radiochemotherapy (P>0.05). The level of F1+2 in thrombosis group was (520.343 ± 121.759) pmol/L, in non- thrombosis group was (388.361 ± 104.873) pmol/L, and there was significant difference (P =0.001). The multi-factors Logistic analysis showed that the level of F1+2 (OR=1.011, P=0.001) and age (OR = 21.025, P = 0.031) were independent risk factors for the PICC associated with thrombosis in cervical cancer. Conclusions The level of F1+2 is closely related with clinical stage and PICC associated thrombosis, and it is an independent risk factor for the PICC associated with thrombosis in cervical cancer.

Objective To observe the Lactulose Oral Solution's influence in PPH postoperative complications and patients′ satisfactory rate for constipation and to find more intervention measures for reducing the complications. Methods A hundred and twenty cases of hemorrhoids with constipation were randomly divided into the two groups: the experimental group, the control group in 60 cases in each group. All patients’ postoperative bleeding, anal edema, stool impaction and satisfaction were observed and compared within 30 days. Results In the control group, the postoperative bleeding’ cases were of 23, anal edema’s were of 20 and stool impaction‘s were of 8. The incidence was 38.3%, 33.3% and 13.3% severally. The satisfactory patients were of 49 and the degree of satisfaction was of 81.7%. In the experimental group, the postoperative bleeding’ cases were of 12, anal edema’s were of 8 and stool impaction's was of 1. The incidence was 20%, 13.3% and 1.7% respectively. The cases who were satisfactory were of 58 and the degree of satisfaction was 96.7%. The postoperative bleeding , anal edema , stool impaction and satisfaction were different statistically in the two groups above (P < 0.05). Conclusion It can reduce PPH postoperative complications and increase patients′satisfaction by using Lactulose Oral Solution in patients with constipation and it will have a certain clinical value if these patients take this oral solution routinely.

Objective To observe the clinical effect of thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids(PPH) in the treatment of circumferential mixed hemorrhoid with incarceration.Methods A total of 118 cases of circumferential mixed hemorrhoid with incarceration were divided into two groups:experimental group of 60 cases was treated by thrombus removal combined with PPH;control group of 58 cases was treated by Milligan-Morgan.We observed the differences of postoperative visual analogue scale (VAS)score,edema,bleeding,residual skin tag,wound healing time,anal stenosis,fecal incontinence,anorectal manometry and satisfaction in the two groups.Results There was significant difference between the experimental group and the control group in postoperative edema,bleeding and residual skin tag(χ2=6.63,4.19,6.64,P<0.05),but postoperative anal stenosis and fecal incontinence weren′t statistically significant different(χ2=0.38,1.11,P>0.05).Postoperative VAS score,wound healing time,satisfaction,anal resting and anal maximal squeeze pressure between the two groups were all statistically different(P<0.01).Conclusion The operation of thrombus removal of external hemorrhoid combined with PPH can effectively reduce the postoperative complications and promote recovery.

Objective To observe the clinical effects and safety of sodium valproate combined with decitabine for treatment of myelodysplastic syndrome (MDS). Methods Forty-two patients with MDS were enrolled in department of hematology in Shanxi Dayi Hospital from February 2012 to February 2017. According to random number table, the patients were divided into the control group (21 cases) and the experimental group (21 cases). The patients in the control group received decitabine at the dose of 20 mg·m-2·d-1, and intravenous infusion was completed in 2 hours, continuous therapy up to 5 days, 4 weeks as a course; the patients in the experimental group received combined medication, orally given sodium valproate 0.2 g once, 3 times per day. One week later, the dosage was added to 0.4 g once, 3 times per day. Both groups received at least 4 courses of treatment. The treatment was stopped when serious adverse reactions or obvious disease progression occurred. The bone marrow smear was rechecked every 4 weeks after treatment to evaluate the efficacy. The expressions of ASXL1, DNMT3A and TET2 in bone marrow cells were detected by fluorescence quantitative PCR before and after treatment. Results The total treatment response rate of the experimental group and the control group were 76.2 % (16/21) and 57.1 % (12/21) respectively, and there was statistically significant difference (P< 0.05); the total remission rate of the two groups was 47.6 % (10/21) and 38.1 %(8/21) respectively, and there was no significant difference (P> 0.05). All patients had slight adverse reactions, and the adverse reaction rate was 42.9 % (9/21) and 38.1 % (8/21), and there was no significant difference (P>0.05). The content of TET2 mRNA and DNMT3A mRNA after treatment in both groups were decreased compared with the expressions before treatment, and there were significant differences (P<0.05). However, there was no significant difference between the two groups after treatment (P> 0.05); the content of ASXL1 mRNA had no obvious change in the control group and a dramatic decrease in the experimental group compared with that before treatment (P<0.05). Conclusion Sodium valproate combined with decitabine has favorable effects and mild adverse reactions for treatment of MDS, besides, it can influence the expressions of TET2, DNMT3A and ASXL1.

Objective:To compare the effects of two pretreatment schemes on the efficacy, gonad and reproductive function of haploid hematopoietic stem cell transplantation recipients with severe aplastic anemia(SAA).Methods:The data of 73 patients with SAA who underwent haploid hematopoietic stem cell transplantation were analyzed retrospectively.The pretreatment scheme was divided into Fludarabine+ Cyclophosphamide+ Antithymocyte globulin group(FC lowATG group, 45 cases)and Busulfan+ Cyclophosphamide+ Antithymocyte globulin group(Bucy/ATG group, 28 cases). The changes of blood cell implantation time, follicle stimulating hormone(FSH), luteinizing hormone (LH), estradiol and testosterone were compared between the two groups. Results:there was no significant difference in blood cell implantation time between the two groups( P=0.096; P=0.133). The levels of FSH and LH in female recipients in Bucy/ATG group were higher than those in FC lowATG group, and the level of estradiol was lower than that in FC lowATG group.There were significant differences between the groups(all P<0.05). The pregnancy or fertility rate of female recipients in Bucy/ATG group was lower than that in FC lowATG group(all P<0.05). There was no significant difference in FSH, LH, testosterone and fertility between the two groups(all P>0.05). There was no significant difference in 2-year overall survival rate and failure free survival rate between the two groups( P=0.091; P=0.084). Conclusions:FC lowATG may be an effective pretreatment scheme for haploid hematopoietic stem cell transplantation in SAA with less damage to gonad and reproductive function.

Objective: To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation. Method: The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR₂) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR₂ rate was analyzed. Results: 68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR₂. All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR₂ compared with non-KIT D816 group (23.1% vs 57.1%, χ²=7.559, P=0.006), and patients with longer CR₁ duration achieved significantly higher CR₂ than those with CR₁ duration less than 12 months (74.1% vs 31.9%, χ²=9.192, P=0.002). KIT D816 mutation was tightly related to shorter CR₁ duration. No significant difference of 2 years post relapse survival was observed between KIT D816 mutation and non-KIT D816 mutation group. Conclusion KIT D816 mutation at diagnosis was an adverse factor on the salvage therapy in relapsed AML with t(8;21) translocation, significantly related to shorter CR1 duration, and can be used for prediction of salvage therapy response. KIT D816 mutation could guide the decision-making of salvage therapy in relapsed AML with t(8;21) translocation.

OBJECTIVETo investigate the efficacy and toxicity of modified FLAG and CAG on relapsed or refractory acute myeloid leukemia (AML).

METHODSSixty-one patients with relapsed or refractory AML were divided into modified FLAG or CAG group. In modified FLAG group: G-CSF 200 μg·m⁻²·d⁻¹ on days 0-5; fludarabine 30 mg·m⁻²·d⁻¹ on days 1-5; Ara-C 1.0 g·m⁻²·d⁻¹ on days 1-5. In CAG group: Ara-C 10 mg·m⁻²·12 h⁻¹ on days 1-14, aclarubicin 20 mg/d on days 1-4, G-CSF 200 μg·m⁻²·d⁻¹ on days 0 1-14.

RESULTSThe complete response (CR) rate was 43% (12/28) and the partial response (PR) rate 18% (5/28) with the overall response (OR) rate of 61% in modified FLAG group. CR rate was 21% (7/33) and PR rate 15% (5/33) with OR rate of 36% in CAG group. There was significant statistical difference between two groups (P<0.05). The main toxicities of these groups were myelosupression and infection. The infection rate was 68% (19/28) in modified FLAG group (twenty-two patients were treated in the sterile laminar flow ward duing neutropenic period), treatment related mortality (TRM) in modified FLAG group was 7%; The infection rate was 55% (18/33) in CAG group (no patient was treated in the sterile laminar flow ward), TRM in CAG group was 3%. There was no significant statistical difference in two groups (P>0.05).

CONCLUSIONModified FLAG was effective for relapsed or refractory AML. The supportive cares to strengthen infection-controlled measures and shorten the period of bone marrow suppression produced the additional effect. CAG regimen has low adverse reactions and could be individualized to elder or weak patients.