Objective To explore the influence of hospital- based transitional care on the rehabilita-tion of patients with enterostomy, and provide evidence- based reference for specialist care of the enterostomy patients. Methods The randomized controlled trials on the hospital- based transitional care in enterostomy patients were collected by computer using China National Knowledge Infrastructure Database, Chinese Science Technology Periodical Database, Wanfang Periodical Database, Foreign Medical Information Resources Database and PubMed from the building of the database till December 2014, and analyzed by RevMan 5.2 software. Results Sixteen articles were included in the study, involving 1 263 patients with enterostomy. The results of Meta- analysis revealed that the incidence of complications in transitional care patients was lower than that in conventional discharge guidance patients, odds ratio(95% confidence interval) was 0.31 (0.21-0.45), the difference was significant (Z=6.02, P<0.01), and the quality of life was raised (including the physical function, cognitive function, role function, emotional functions, social function and the total quality of life), weighted mean differences (95% confidence interval) were 13.81 (8.23-19.39), 22.00 (17.21-26.79), 15.22(11.71-18.73), 16.68(13.01-20.35), 22.60(16.58-28.62), 17.46(13.53-21.38),the differences were significant(P<0.01). Conclusions The transitional care model giving priority to hospital service resources can provide a higher level professional care for patients after enterostomy, and avoid or reduce the complications, promote the recovery earlier as well as constantly improve the quality of life.

Objective To explore the immunophenotype of children with acute myeloid leukemia(AML) and its clinical significance.Methods Statistics was used to analyze the relationship between the immunophenotype of AML and their French-American-Britain(FAB) classification,complete remission (CR) in one month and 3-years event-free survival(EFS).Results CR rate was 71.6% and 3-years EFS rate was 50.8%. HLA-DR and CD34 absent mainly in M3, associated with higher CR and EFS rate. So did CD33 negative cases, especially in M2. CD13 positive was significantly predictive factor for achieving CR.Co-expression of lymphoid antigens and NK cell antigens(CD56) with M2 which correlated with lower CR and EFS rate.Conclusions The negative of HLA-DR, CD34, CD33,as well as CD13 positive, have relationship with good prognosis. Lymphoid antigens and CD56 are poor prognostic factors.

Objective To investigate the stability of immunophenotyping in the course of relapse or at treatment failure of patients with acute lymphoblastic leukemia(ALL) and that of immunophenotyping of positive minimal residual disease(MRD).Methods From Aug.2000 to Dec.2007,33 children with ALL who relapsed or treated failure were enrolled. These children were detected MRD by flow cytometry. The immunophenotyping of children who relapsed or treated failure were compared with that of initial therapy;the immunophenotyping of MRD relapsed was compared with that of initial therapy.Results 1.In 23 out of 27 cases (85.18%) with B-ALL,changed at least 1 antigen between diagnosis and relapse.Six children with CD45 down-modulation and 2 children with CD45 up-modulation.Two children with CD19 down-modulation and 1 child with CD19 up-modulation.Six children with CD34 down-modulation and 4 children with CD34 up-modulation. Five children with CD10 down-modulation and 7 children with CD10 up-modulation.2.Six children with T-ALL had the same expression in CD45 between relapse and treatment failure. 3.These were 15 children had the least 1 case MRD,25 cases MRD were detected,these was 1 case up-modulation in CD45,1 case down-modulation in CD19,2 cases up-modulation and 8 cases down-modulation in CD34,3 cases up-modulation and 6 cases down-modulation in CD10.Conclusions Immunophenotyping of children with ALL may change at relapse and treatment failure. The frequency of change in B-ALL is higher than that of in T-ALL,but the change can not impact the detection of MRD.

Objective To investigate the value of diffusion weighted imaging (DWI) in detecting acute intracerebral hemorrhage with 3.0T MR. Methods A total of 105 patients with acute strokes underwent MR examination within 3 days after on set. The detectability and reliability of intracerebral hemorrhage with the DWI b0 sequence was assessed. The results were compared with the gradient-echo (GRE) sequence. The results of the GRE sequence were used as the standard. Results DWI b0 images of 47 cases displayed clearly in 48 acute intracerebral hemorrhage patients. For the detection of acute intracerebral hemorrhage, DWI b0 images had a sensitivity of 97.92%, specificity of 100%, the positive predictive value of 100%, and the negative predictive value of 98.25%. Deoxyhemoglobin-induced hypointense rim was characteristic on DWI b0 images, the next was GRE. Conclusion In the setting of acute stroke, DWI can clearly distinct intracerebral hemorrhage and non-intracerebral hemorrhage with 3.0T MR scanner. With a more rapid and accurate MRI strategy to evaluate acute stroke including DWI, T1WI and T2WI sequences without GRE is helpful in clinical decision making.

Objective To evaluate the value of three-dimensional contrast-enhanced angiography (3D CE MRA) and MRI in the diagnosis and delineation of cerebral arteriovenous malformation(AVM). Methods Twenty-two cases of cerebral AVM examined by MRI and 3D CE,MRA.DSA was performed in 17 cases.A three-dimensional fast low angle shot (3D FLASH) was used for 3D CE MRA with Gd-DTPA dosage of 0.2 mmol per kilogram for body weight.The source images were subtracted from mask images and transferred to computer workstation using three-dimensional reconstruction.Results Among 22 cases, 19 showed typical AVM“flow void”signal on MR images.3D CE MRA clearly displayed the nidus,feeding artery and draining vein.All of the foci were above the cerebellum tentorium.13 located within one lobe, 3 exceeded one lobe and 3 situated in the deep of cerebrum.Feeding arteries were derived from single artery in 9 cases,and mixed supply in 10 cases.Draining veins diverted to sagittal sinus and/or sigmoid sinus in 6,deep cerebral veins in 8 and mixed in 5.In the 14 cases examined by both DSA and 3D CE MRA,3D CE MRA was superior to DSA in three-dimensional demonstration of the nidus,but inferior to DSA in demonstration of some details.3D CE MRA depicted 78.4% feeding arteries and 84.0% draining veins in addition,tiny pathologic blood vessels smaller than 1 centimeter were detected by DSA,but could not be found by 3D CE MRA and were only shown as hemorrhage lesions on MR images in 3 cases.Conclusion As a non-invasive technique,3D CE MRA combined with MRI is accurate in diagnosis and localization of cerebral AVM,and should be used as the first choice for those clinically suspected of AVM.But DSA remains needed for demonstration of details and tiny AVM.

OBJECTIVE To understand the distribution and epidemiology of ESBLs in ceftazidime or cefotaxime-(resistant) clinical Enterobacter cloacae isolates.METHODS Twenty seven ceftazidime or cefotaxime-resistant(nonrepetitive) E.cloacae were collected from 27 patients hospitalized at the Huashan Hospital,Shanghai.PCR and(sequencing) were performed to understand the distribution of ESBLs in E.cloacae;rep-PCR was(performed) to(understand) the epidemiology of ESBLs in E.cloacae.RESULTS CTX-M-3 like(ESBLs) were the most prevalent in our study(48%);this was the first report of VEB-1-like ESBLs in the member of(Enterobacteriaceae) in China,and the first report of the ESBLs VEB-1-like and CTX-M-3-like in an isolate simultaneously;the majority of(ESBLs) producers exhibited the same rep-PCR pattern,but harbored different ESBLs gene.(CONCLUSIONS) In our study,ESBLs have become prevalent in clinical E.cloacae isolates,and become an important factor of E.cloacae isolates resistant to extended-spectrum beta(-lactams).

Objective To analyze the clinical value of minimal residual disease(MRD) of acute myeloblastic leukemia(AML) with AML 1-ETO by using the real-time quantitative reverse transcriptase polymerase chain reaction(RQ-RT-PCR).Methods From Jan.2001 to Jan.2007,the MRD of 32 AML1-ETO-positive AML patients were analyzed by using PQ-RT-PCR.The detection of the AML1-ETO was taken after the induced chemotherapy every 1.5-2.0 months during the consolidation therapy.The survival of different stages in children with AML was analyzed by SPSS 10.0 software and calculated by using Kaplan-Meier analysis.Results Thirty-two patients received the induced chemotherapy and 29 patients with complete remission morphologically,3 patients had no complete remission morphologically and then gave up.Patients with molecular remission were associated with a high probability of survival(P=0.001 8).Patients with high transcript levels at diagnosis had no difference in event free survival with patients with low transcript levels.The quality of molecular response after induction,6 months in the chemotherapy as well as consolidation period,has significant impact on the event free survival(P=0.023,0.000 1,0.004 9).Conclusion The current study demonstrate that quantitative evaluation of AML1-ETO transcript levels is important and may be helpful for therapeutic decisions in future.

OBJECTIVETo retrospectively analyze the treatment outcomes and side effects of childhood acute promyelocytic leukemia (APL) treated with all-trans retinoic acid (ATRA) or ATRA + arsenic trioxide (As2O3).

METHODSFrom 1992 to 2006, 45 patients with newly diagnosed APL were enrolled. All of them were PML-RAR alpha positive. 24 patients were induced with ATRA (group A) and 21 with ATRA + As2O3 (group B). The remission rate and side effects were observed.

RESULTS1) 19 (79.2%) patients in group A achieved CR, while 21(100%) patients in group B achieved CR. The CR rate in group A was lower than that in group B (P=0.027). 2) The recovery time of coagulation parameters and PLT count in group B was shorter than that in group A. 3) The overall survival (OS) and event-free survival(EFS) in group A were 77.8% and 66.9% at 41 months of follow-up, and in group B were 100% and 100% respectively at 34 months of followup. Group A had a significant lower EFS (P=0.0357)than group B. 4) The time of PML-RAR alpha fusion gene converting to negative in group A was longer (P=0.026) than that in group B.

CONCLUSIONSATRA + As2O3 for patients with newly diagnosed childhood APL is a feasible treatment with higher CR rate, less side effects and longer long-term survival.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Arsenicals ; administration & dosage ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; genetics ; Male ; Oncogene Proteins, Fusion ; genetics ; Oxides ; administration & dosage ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Tretinoin ; administration & dosage

OBJECTIVETo screen the FANCA gene mutation and explore the FANCA protein function in Fanconi anemia (FA) patients.

METHODSFANCA protein expression and its interaction with FANCF were analyzed using Western blot and immunoprecipitation in 3 cases of FA-A. Genomic DNA was used for MLPA analysis followed by sequencing.

RESULTSFANCA protein was undetectable and FANCA and FANCF protein interaction was impaired in these 3 cases of FA-A. Each case of FA-A contained biallelic pathogenic mutations in FANCA gene.

CONCLUSIONSNo functional FANCA protein was found in these 3 cases of FA-A, and intragenic deletion, frame shift and splice site mutation were the major pathogenic mutations found in FANCA gene.

Cell Line ; DNA Mutational Analysis ; Fanconi Anemia ; genetics ; metabolism ; Fanconi Anemia Complementation Group A Protein ; genetics ; metabolism ; Humans ; Mutation

This study was purposed to investigate the diagnosis, typing and influencing factors of the antibody (inhibitor) to coagulation factors in hemophilia. 500 hemophilia patients were enrolled in this study. The activities of coagulation factor FVIII and FIX were tested by one stage assay. The antibodies of FVIII and FIX were detected by Bethesda assay. All data were analyzed by statistical soft SPSS 10.0. The results indicated that there were 411 cases of hemophilia A, out of which 151 cases (30.2%) showed FVIII antibody positive, the titer was 3.50 ± 2.84 Bu/ml; there were 79 cases of hemophilia B, out of which 18 cases (3.6%) showed FIX antibody positive, the titer was 2.92 ± 2.19 Bu/ml. The other 10 cases were acquired autogeneic hemophilia (2.0%). The antibody was divided into three types: high-response (3 cases), intermediate-response (47 cases), and low-response (119 cases). Among the 169 cases with antibody positive, 157 cases (92.9%) were younger than 30 years old; among 151 (89.35%) cases of hemophilia A; 138 cases (81.66%) were moderate or severe hemophilia; 166 case (98.22%) showed intermediate or low-response antibody. There were 158 cases with allogeneic antibody positive, all of which received blood transfusion. It is concluded that the moderate and low responsive antibodies are the dominant in hemophilia patients, the age of patients and transfusion frequency of blood preparation are the influencing factors. The results of this study provide the basis for the hemophilia diagnosis, antibody typing and evaluation of factors influencing hemophilia, and also suggest that the repeated transfusion of blood preparation may influence the production of antibodies.
Adolescent ; Adult ; Aged ; Autoantibodies ; blood ; Child ; Child, Preschool ; Factor VIII ; immunology ; Female ; Hemophilia A ; blood ; diagnosis ; immunology ; Humans ; Infant ; Male ; Middle Aged ; Young Adult