Objective To explore the risk factors of schistosomiasis cirrhosis esophageal varices hemorrhage. Methods A total of 113 cases of schistosomiasis cirrhosis esophageal varices hemorrhage and 128 schistosomiasis cirrhosis esophageal varices patients without hemorrhage were selected and their relevant factors were analyzed statistically. Results There were significant differences between the two groups in the prothrombin time,portal vein diameter,degree of esophageal varices,and varicose vein tumor-like lesions(P<0.01). Conclusion The risk factors of schistosomiasis cirrhosis esophageal varices hemorrhage are the prothrombin time,portal vein diameter,degree of esophageal varices,and varicose vein tumor-like lesions.

Objective To investigate the clinical data and laboratory features of acute megakaryocytic leukemia transformed from idiopathic myelofibrosis after 26 years in one case and the prognostic factors of myelofibrosis.Methods A case of acute megakaryocytic leukemia (M7) transformed from idiopathic myelofibrosis after 26 years was reported,and the clinical data was analyzed.Bone marrow cytology,cytogenetic and mutation detection in JAK2V617F were detected before and after transformation.Standard chemotherapeutic protocols including idarubicin plus cytarabine (IDA),homoharringtonine and cytarabine (HA),mitoxantrone and cytarabine (MA),pirarubicin plus cytarabine (TA) sequential therapies were performed.Results JAK2V617F mutation and normal karyotype were found before and after the transformation.This patient was treated with standard chemotherapeutic protocols of IDA,HA,MA and TA sequential therapies until getting complete remission,and he lived well till now.Conclusions Chromosome karyotype is related to the prognosis of IMF.Acute megakaryocytic leukemia (M7) with the normal karyotype transformed from the IMF can achieve complete remission by rational consecutive chemotherapy.

Objective To propose a practical method for moderate-to-server cup-ear correction.Methods Auricular reconstruction was performed in a manner of two-stage approach with mastoid flap and costal cartilage support.In the first stage,the autogenous costal cartilage framework was inserted under the retroauricular mastoid skin flap.The corrected ear was raised in the second operation and wound was closed with grafting skin.Results Satisfaction of appearance was achieved for totally 18 cases except one case of partly necrosis of cartilage.They were followed-up for 3-26 months.Conclusions This integrative two-stage approach of mastoid flap combining three dimensional costal cartilage is safe and effctive for moderate to severe cup-ear correction,which brings about good appearances and symmetry.The complications are in control.

@@

Objective: To explore the method and result of repairing segmental ear defect with postauricular skin flap according to different region. Methods: 25 partial ear defects were divided into 5 regions.The cases with defect in 1 and 2nd regions were treated by postauricular flap combined with ipsilateral conchal cartilage graft in one stage; Cases in the 3rd regions were repaired with the posterior pedicled flap combined with conchal or rib cartilage graft in two stages; According to the defect in 4th region, post-auricular skin flap was transplanted anteriorly to repair; The temporal fascial flap and skin graft were used for the 3 cases with post-operative cartilage exposure. Results: All flaps survived with good shape except one case with partial epidermal necrosis and 3 cases deep color after the temporal fascial flap and skin graft. 9 cases that needed second operation. Conclusions The postauricular flap is a preferred alternative method in case periauricular skin is in fact, which yields closer tissue match, color, and texture. It is safe and effective for the correction of segmental ear defect with satisfied shape. The temporal fascial flap can be regarded as the last alternatives.

Objective To analyze the efficacy and safety of tetrandrine in the adjuvant treatment of relapsed/refractory acute leukemia (except M3).Methods A total of 58 patients with relapsed/refractory acute leukemia (except M3) admitted to six tertiary hospitals in Jiangsu Province from January 2015 to December 2017 were included in this study.The tetrandrine-adjuvant standard chemotherapy regimen and standard chemotherapy regimen were given to treatment and control groups respectively.There were 17 and 41 patients in treatment and control groups.The treatment group was given tetrandrine for 5 days before the use of standard chemotherapy.The dose of tetrandrine was 4 mg ·kg-1 ·d-1,and patients had continuous oral administration of 5 days.After that,the patients in the treatment group started chemotherapy immediately.On the other side,the control group received standard chemotherapy without any other multidrug reversal medicine.Then the clinical efficacy and safety outcomes in both groups were analyzed.Results In the treatment group,5,3,and 9 cases achieved complete remission (CR),partial remission (PR),and nonremission (NR) respectively,and the total effective (CR+PR) rate was 47.06 ％ (8/17);in the control group,14,10,and 17 cases achieved CR,PR,and NR,and the total effective rate was 58.54 ％ (24/41).There was no significant difference in the total effective rate between the two groups (x2 =0.64,P =0.424).There was no significant difference in the efficacy between the two groups of patients with different genders (P ＞ 0.05).When the disease duration was 6-11 months,the difference of efficacy between the two groups was statistically significant (P =0.041).There was no significant difference in the proportion of myeloid leukemia cells,white blood cell count,platelet count,red blood cell count,and hemoglobin between the two groups before and after treatment (all P ＞ 0.05).There was no significant difference in clinical safety indicators (urine,faecal routine,liver and kidney function,and electrocardiogram) between the two groups (all P ＞ 0.05).Conclusions Tetrandrine is more effective in patients with relapsed/refractory acute leukemia (except M3) with shorter duration of disease.Compared with chemotherapy alone,the clinical efficacy of adding tetrandrine in chemotherapy cannot be considered superior to the former.

Objective To evaluate the efficacy and safety of tigecycline-based treatment approach on severe infection of patients with hematological diseases. Methods The clinical data of 64 patients who were treated with tigecycline-based treatment approach for severe infection were retrospectively reviewed. The curative effect was evaluated, meanwhile the drug side effects were observed. Results A total of 51 strains of bacteria were isolated from 64 patients, including 12 extended-spectrum β-lactamase(ESBL)and 15 multi-drug resistant strains and the total effective rate was 59.4%(38/64). Five patients diagnosed as carbapenem resistant infection and were treated with the addition dose of tigecycline and 3 patients relieved. Main adverse events were nausea, vomiting, diarrhea and hepatic dysfunction, but all events were slight. Conclusions Tigecycline-based treatment approach has a good clinical efficacy in treating severe infection of patients with hematological diseases, and the side effect is few.Tigecycline-based treatment approach could be used as a new choice for patients non-responding favorably to conventional anti-infective treatment or multiple resistant bacteria.