There is no radical cure for essential thrombocythemia currently. Professor SUN Xue-mei has extensive clinical experience in treating it by combined therapy of Chinese and Western medicine. In this paper, authors tried to summarize her experience from guiding ideology and therapeutic points. Authors insisted on the direction of integrative medicine on the basis of syndrome differentiation, paying attention to psychological counseling,and applied individual treatment in clinics.
Acupuncture Therapy ; Female ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Objective: To evaluate the effects of enteral nutrition(EN) containing dietary fiber and parenteral nutrition(PN) on nutritional status and immune function of patients following surgery for carcinoma of stomach.Methods: 60 patients who underwent surgery for carcinoma of stomach were randomized to PN group(n=20),Pepti-2000(elemental diet) group(n=20) or Nutrison Multi Fibre(EN containing dietary fiber) group(n=20) for 7 days.Isocaloric and isonitrogenous nutritional supports began at the first day after operation and were maintained for a week.Nutritional variables such as body weight,serum albumin,transferin and accumulated nitrogen balance were measured preoperatively and on the 8th day after operation.Meanwhile,immune variables such as peripheral lymphocytes counts,subsets of lymphocytes(CD3,CD4,CD8,CD25),NK cells,serum immunoglobulins(IgG,IgM,IgA),complement system(C3,C4,CH50) and C-reactive protein(CRP) were also determined.Results: No serious complications occurred in all groups after surgery.Body weight decreased significantly in all groups(P

Objective To explore the clinical significance of the coagulation and fibrolysis parameters changes for the knowledge of complicated thrombosis after chemotherapy in malignant lymphomas. Methods Morning fasting anti-coagulation blood samples were taken to detect plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) with automatic coagulation analyzer in 71 hospitalized malignant lymphomas and 20 normal controls. The plasma D-dimer levels of the two groups were detected with immunoturbidimetry. Results The levels of plasma APTT, Fib and D-dimer in 71 malignant lynphomas were (30.44±1.43) s, (3.28±0.20) g/L, (297.05±56.59) μg/L respectively, which were significantly higher than those in normal controls at the levels of (23.72±0.76) s, (2.57±0.22) g/L, (94.50±26.07) μg/L respectively (P ＜0.05). The coagulation and fibrolysis parameters were of no statistic differences between the normal controls and lymphomas of stage Ⅰ and Ⅱ (P ＞0.05). The APTT and Fib levels in lymphomas of stage Ⅲ and Ⅳ were higher than those in normal controls and lymphomas of stage Ⅰ and Ⅱ (P ＜0.05). There are 7 malignant lymphomas complicated venous thrombosis . Of the 7 cases, the FIB and D-dimer levels were higher than those of stage Ⅰ and Ⅱ, furthermore the D-dimer levels were higher than those of stage Ⅲ and Ⅳ. Conclusion The abnormalities of coagulation and fibrolysis parameters occurred in malignant lymphomas with requirement of periodic monitoring. After chemotherapy, the lymphoma patients had a high incidence of venous thrombosis, which need early prevention for prolongation of the survival.

The study intended to evaluate the effect of high-dese atorvastafin on serum high sensitive C-reactive protein (hs-CRP) and renal function in patients with acute myocardial infarction undergoing elective pereutancous coronary intervention ( PCI ). One hundred and sixty seven patients were randomly divided into two groups: in test group (n =84) patients received oral atorvastatin 80 mg/d and in control group (n = 83) patients received atorvastatin 20 mg/d, the medication in both groups was lasted for 7 days before PCL Compared to levels at 24 h before PCI, serum hs-CRP and creatinine levels at 48 h after PCI were increased in both groups ( both P < 0. 05), and glomerular filtration rate was decreased ( P < 0. 05 ). Compared to control group, serum hs-CRP and creatinine levels 24 h before PCI and 48 h after PCI in test group were significantly lower, and glomerular filtration rate was significantly higher (P <0. 05, respectively). The incidence of contrast-induced nephropathy was lower in test group than that in control group[7% (6/84) vs.18% (15/83), P <0.05]. The results indicate that high-dose atorvastatin might be effective in protecting patients with acute myocardial infarction undergoing elective PCI from contrast-induced nephropathy via inflammatory response inhibition.

Objective To evaluate the effect of three diamension-digital subtraction angiography (3D-DSA) or computed tomography angiography (CTA) on the patients with ruptured multiple intmcranial aneurysm (MIA). Methods A retrospective study on 21 patients with MIA was performed.After scanning with 3D-DSA or 3D-CTA, three-dimensional reconstruction of MIA was carried out by 3D workstation,then the diagnosis was decided and the treatment plan (endovascular treatment or microsurgery) was selected according to stereoscopic image of MIA. Results (1) 3D-DSA or CTA was performed in 21 patients with subarachnoid hemorrhage (SAH),it was revealed these patients carried with 48 aneurysms,including 35 small aneurysms (25 mm).Not only miero-aneurysms and small aneurysms could be precisely showed,also the size of aneurysmal neck,the relationship of the aneurysm and the parent vessel and contiguous branches by stereoscopic image.(2) According to the standard of classification,9 patients with MIA for gradeⅠ(42.9%),10 for gradeⅡ(47.6%),2 for gradeⅢ(9.5%),0 for gradeⅣ.Endovascular treatment was selected prior to microsargery for those high grade patients.In this group,17 patients with 40 aneurysms underwent endovascular embolotherapy with GDC coils.Twenty four anemysms were completely occlusioned,12 beyond 90%,4 were left without treatment because of their small size.In microsurgery group,3 aneurysrus were totally clipped,1 could not be found during operation.No any treatment was accepted in 2 patients with 4 aneurysms. Conclusions 3D-DSA or CTA,which is very useful for the diagnosis and treatment of MIA,could improve the accuracy of diagnosis of MIA and clearly show the stereoscopic image of MIA,also the relation of sac and parent artery.For those patients with high grade MIA,endovascular treatment was selected prior to microsurgery,pro re nata,used to combine with mierosurgery.

ObjectiveTo evaluate the clinical efficacy and toxicity of reduced dose idarubicin and cytarabine,semustine(IAS) regimen as induction therapy in patients with acute myeloid leukemia.MethodsA total of fifty-eight newly acute myeloid leukemia(AML) patients were randomly divided into 2 groups,including 30 cases with IAS regimen,28 cases with DA regimen The IAS regimen was treated with reduced dose idarubicin (8 ～ 10 mg/m2,days 1 to 3) and cytarabine( 100 ～ 150 mg/m2,days 1 to 7),semustine(200mg,d0).The DA regimen was treated with daunorubicin(40 ～60 mg/m2,days 1 to 3) and cytarabine ( 100 ～ 150 mg/m2,days 1 to 7).The responses ( CR and overall response rate ) were compared between the 2 groups.Results Complete remission(CR) rate in IAS and DA groups were 24 of 30( 80.0％ ) and 16 of 28 (57.1％ ) respectively,while the overall response rate were 26 of 30 ( 86.7％ ) and 18 of 28 ( 64.3％ ) respectively.There was significant difference in CR rate and overall response rate between IAS group and DA group( P ＜ 0.05 ).Myelosuppression and infections due to neutropenia were the most frequent adverse effects,severe nonhematologic toxicity was not observed.The incidence rates of toxicities in the 2 groups were not significantly different ( P ＞ 0.05 ).Conclusion The effect of reduced dose idarubicin and cytarabine,semustine regimen in the treatment for acute myeloid leukemia is superior to that of DA regimen,and the toxicities are tolerable.IAS regimen can be as the optional induction therapy in newly patients with acute myeloid leukemia.

AIM:To investigate the effect of dihydroartemisinin ( DHA) adjuvant treatment on enhancing the antitumor effect of 5-fluorouracil (5-FU) against gastric cancer .METHODS:The gastric cancer BGC-823 cells were di-vided into control group , DHA group, 5-FU group, 5-FU+DHA group and 5-FU+DHA+SIRT1 plasmid group.The via-bility of BGC-823 cells treated with DHA and 5-FU was measured by MTT assay .The expression of SIRT1 and NADPH ox-idase, activation of caspase-9 and caspase-3, and phosphorylation of ASK1 and JNK in the BGC-823 cells treated with DHA and 5-FU were determined by Western blot .The production of ROS and the apoptosis of the BGC-823 cells treated with DHA and 5-FU were analyzed by flow cytometry .RESULTS:Dihydroartemisinin significantly inhibited the expression of SIRT1 and increased NADPH oxidase protein level (P<0.05).DHA increased the sensitivity of BGC-823 cells to 5-FU, thus decreasing the IC50 of 5-FU to the gastric cancer cells.However, transfection with SIRT1 plasmid decreased the cytotoxicity of DHA and 5-FU co-treatment to the BGC-823 cells.DHA promoted the production of ROS and phosphoryla-tion of ASK1 and JNK induced by 5-FU in the BGC-823 cells ( P<0.05 ) .However , ROS scavenger N-acetylcysteine ( NAC) or JNK specific inhibitor SP600125 inhibited the cell death and activation of caspase-9 and caspase-3 induced by DHA and 5-FU co-treatment (P<0.05).In addition, NAC significantly inhibited the phosphorylation of JNK in the BGC-823 cells co-treated with DHA and 5-FU.However, treatment with SP600125 did not influence the ROS production in the BGC-823 cells, indicating that JNK was the downstream target of ROS pathway .CONCLUSION: Combination of DHA with 5-FU induces caspase-dependent apoptosis in gastric cancer cells through the SIRT 1/NADPH oxidase/ROS/JNK sig-naling pathway .

Humans ; Lung Neoplasms ; diagnosis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; Pacemaker, Artificial ; Syncope ; diagnosis

OBJECTIVEChildren with nephrotic syndrome are always associated with retardation of growth. Growth hormone (GH) administration to these children can stimulate their growth, but it plays an important role in glomerulosclerosis. Thus these children would take a risk to use it to improve their growth. This study was designed to investigate the effect of GH on the kidney of rats with adriamycin-induced nephropathy (AN) and its mechanism, and to observe the renoprotective effect of angiotensin II (AngII) receptor antagonist, irbesartan, in GH-treated AN rats.

METHODSRats were divided into the following groups: normal control rats, AN rats, GH-treated AN rats and GH plus irbesartan-treated AN rats. There were 8 developing male SD rats (120-130 g) in each group. Urinary protein was measured at weeks 3, 6 and 9. Blood pressure, serum creatinine, BUN, albumin, cholesterol, triglyceride, as well as ACE activity and AngII concentration of the kidney were detected at the end of the study. Renal pathological changes were evaluated also. Immunohistochemistry was used to examine the protein expressions of TGF beta(1), collagen IV and fibronectin in glomeruli.

RESULTSGlomerular sclerosis score of GH-treated AN rats (49.4 +/- 9.8) was significantly higher than that of AN rats (12.8 +/- 5.5, P < 0.01), and this score of GH-treated AN rats plus irbesartan (26.2 +/- 7.5) was significantly lower than the score of GH-treated AN rats (P < 0.01). The changes of urinary protein, hyperlipidemia and hypoalbuminemia in rats of each group consisted with the degree of glomerular injury in rats of each group. There was azotemia in GH-treated AN rats, but rats in the other groups did not have azotemia. ACE activity of kidney was significantly (P < 0.01) increased in GH-treated AN rats [(28.1 +/- 4.1) U/mg pro] and GH-treated AN rats plus irbesartan [(27.6 +/- 3.4) U/mg pro] compared with that in AN rats [(14.6 +/- 4.4) U/mg pro]. AngII concentrations in the kidney of GH-treated AN rats [(17.8 +/- 3.3) pg/mg pro] and GH-treated AN rats plus irbesartan [(27.3 +/- 5.1) pg/mg pro] were significantly higher than that in AN rats [(8.3 +/- 1.9) pg/mg pro] (P < 0.01). The protein expressions of TGF-beta(1), collagen IV and fibronectin in GH-treated AN rats were the most distinct in all groups. These expressions were significantly (P < 0.05) reduced in GH-treated AN rats plus irbesartan.

CONCLUSIONGH is able to exacerbate adriamycin-induced nephropathy in rats, which was partly through activating renal tissue RAS and initiating the function of the AngII-TGF beta(1)-ECM axis. Angiotensin II receptor antagonist, irbesartan, has some renal protective effects on AN rats treated with GH.

Angiotensin II ; analysis ; Angiotensin Receptor Antagonists ; Animals ; Antibiotics, Antineoplastic ; toxicity ; Biphenyl Compounds ; pharmacology ; therapeutic use ; Blood Urea Nitrogen ; Collagen Type IV ; analysis ; Creatinine ; blood ; Disease Models, Animal ; Doxorubicin ; toxicity ; Fibronectins ; analysis ; Growth Hormone ; pharmacology ; Immunohistochemistry ; Kidney Diseases ; chemically induced ; drug therapy ; Kidney Glomerulus ; chemistry ; drug effects ; pathology ; Male ; Peptidyl-Dipeptidase A ; analysis ; Proteinuria ; urine ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Serum Albumin ; metabolism ; Tetrazoles ; pharmacology ; therapeutic use ; Transforming Growth Factor beta ; analysis ; Triglycerides ; blood

OBJECTIVETo investigate the monitoring and therapeutic methods of nonoperative management of blunt splenic injury.

METHODSEighty-two cases with nonoperative management of 95 patients of blunt splenic injury from September 2005 to April 2008 were analyzed retrospectively. Percutaneous peritoneal drainage was applied to 75 cases, and auto-blood transfusion was applied to 38 cases. Eighty-two cases were followed up from 3 weeks to 8 months.

RESULTSEighty-two patients with nonoperative management were treated successfully, including 34 cases classified as grade III to IV, 6 cases over 55-years-old, 14 cases with severe multiple injury (ISS > or = 16) and 37 cases whose drained peritoneal blood volume were over 500 ml. The drained peritoneal blood volume was 30 to 2400 ml. The total volume of auto-blood transfusion was 22 300 ml and the average volume was 613 ml. All cases were followed up without delayed hematocele or peritoneal infection.

CONCLUSIONSMost hemodynamically stable patients with blunt splenic injury can be healed with nonoperative management. The treatments including percutaneous peritoneal drainage and transfusion of auto-blood can significantly increase the performance rate and the achievement ratio of nonoperative management of blunt splenic injury.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spleen ; injuries ; Wounds, Nonpenetrating ; therapy ; Young Adult