ObjectiveTo relieve the nausea and vomiting caused by chemotherapy in patients with hematologic diseases, and to secure the completion of chemotherapy.Methods320 cases of hematologic patients were divided randomly into 2 groups: the treatment group (160 cases): ondanseton 4 mg and dexamethone 10 mg I.V.; ondanseton group (160 cases): ondanseton 4 mg I.V.ResultsThe effective rate of the treatment group was 98.75%, and that of the ondansetron group was 43.13%. There was a singificantly difference between two groups (P<0.001).ConclusionOndanseton combined with dexamethone has a good effect on the vomiting and nausea induced by chemotherapy.

Objective To evaluate the clinical features and efficiency of surgical treatment in elderly patients with parathyroid tumor.Methods Clinical data of 12 cases (aged 60-83 years) was retrospectively analyzed.Their main complaints varies individually,including bone and muscle trouble in 9 patients,abdominal problem in 7 ones,and kidney stone in 6 ones.PTH level ranged from 78 to 2850 μg/L,and calcium level 2.6-4.5 mmol/L.Parathyroidectomy was carried out in 8 patients,while extended excision of suspected tissues in 6 ones.Intraoperative PTH determination was routinely performed.Results A drop by at least 50％ in PTH level was achieved in all cases after 10 minutes of tumor-bearing tissues excision.A much improvement of main complaints was shown in all cases about 1 week postoperatively.During the follow-up period from 18 to 48 months,both PTH and calcium levels were still in normal range in 9 patients,relapse was noticed in two cases 1 or 2 years after operation respectively.One patient died even after successful excision of parathyroid tumor.Conclusions PTH and calcium level determination is advised in elderly patients with suspected parathyroid tumor,and surgical treatment is generally safe and effective.

OBJECTIVE We designed the overall layout,formulated the functional demand,and optimized the key design and operating parameters of a new-style asepsis clean ward.The new-style ward intends to provide a higher quality environment for patient infection control and all-around protection during treatment.METHODS We applied computational fluid dynamics(CFD)simulation to optimize the design scheme according to Chinese and international hospital design specifications.RESULTS The new-style asepsis ward reflected a new idea,new technology,high standards and created a comfortable and safe,high-quality environment for the treatment of patient.The Satisfaction of patients was more than 95% and workload of nurses was alleviated obviously.CONCLUSIONS The new-style asepsis ward can significantly control the endogenous infection of patients.

OBJECTIVE To compare the computational fluid dynamics(CFD) simulated results and field test data of the new-style asepsis ward.METHODS We used various equipments to test the asepsis ward and CFD software to simulate airflow of asepsis ward.RESULTS After calculating and comparing,we found the CFD simulation results agreed well with the tested data.Key design and operating parameters were up to the standard.The new-style of asepsis ward could improve the air quality and provide a comfortable environment for patient treatment and it was of great help to decrease the infection rate of patient.CONCLUSIONS The new-style asepsis ward can significantly control the endogenous infection of patients.

Objective　To research the direct electrophysiological evidence of discomplete spinal cord injury (SCI) and the effect of 4-aminopyridine on it. Methods　Motor evoked potentials (MEPs), both spinal cord recorded MEPs (scMEPs) and extracellularly recorded MEPs (exMEPs) were recorded and characterized on a T13 epidural electrode (scMEPs) and an extracellular microelectrode (exMEPs) for 10 normal rats and 40 rats with lesions of various severity (sham, 35?g*cm force (gcf), 70?gcf, 100?gcf impact injury) at the T8-T9 cord using the Allen's drop model. The incline plane and Tarlov techniques were used to assess clinical neurological function. Results　MEPs in the normal rats were elicited by applying transcortical suprathreshold stimulation consisting of 3-4 early negative peaks (N1, N2, N3 and N4) followed by several late waves. The N1 and N2 peaks were largest in the anterior and ventrolateral funiculus, respectively, which was indicative of extrapyramidal pathways. The 100?gcf impact injuries and the cord transection abolished the MEP distal to the lesion, whereas the 35?gcf injuries resulted in a latency shift and amplitude decrement of the MEP peaks. Eighteen of the 20 rats with 70?gcf injuries showed clinical paraplegia. Among them, 7 rats had neurophysiological evidence of residual conduction pathways through the lesioned cord segment, such as the presence of N1 and N2 peaks in the scMEPs or exMEPs. After 4-aminopyridine (4-AP) administrations (1?mg/kg), the amplitude of the spared exMEP increased significantly and spread more widely. Conclusions　MEPs evoked by transcortical stimulation travel mostly in the extrapyramidal tract. MEP monitoring could provide an excellent method of detecting the functional integrity of the motor tracts after SCI, and could even detect spared motor fibers after discomplete SCI. Furthermore, the use of 4-AP or other K+ channel blocking agents may be a potential treatment for patients with chronic moderate to severe SCI.

OBJECTIVE: To study on relationship between diverse handling time following onset and clinical prognosis of cases with Bell palsy. METHOD: Two hundred and sixteen cases with Bell palsy, who were admitted in our department between Jun. 2006 and Dec. 2009, were collected and divided into 6 groups according to disease time: 1-2 months, > 2 - 3 months, > 3 - 4 months, > 4 - 5 months, > 5 - 6 months, and > 6 months. Cases in all groups received subtotal course decompression of facial nerve and other compound treatment, and the relationship between handling timing and clinical prognosis were compared. RESULT: It was found that the difference of prognosis and handling timing was statistically significant, after comparison between all groups with Facial Grading Standards (H-B) as the standard to assess prognosis. CONCLUSION Clinical prognosis of cases with Bell palsy was related to alternative handling time, and subtotal course decompression of facial nerve was recommended to be performed as early as possible for those cases who were irresponsive after conservative treatment for one month.
Adolescent ; Adult ; Bell Palsy ; surgery ; Decompression, Surgical ; methods ; Facial Nerve ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Treatment Outcome ; Young Adult

Objective To evaluated the results of surgical treatment for primary hyperparathyroidism coexistent with thyroid cancer.Methods From March 2007 to May 2014,27 patients suffered thyroid carcinoma coexistent with primary hyperparathyroidism with pathological and laboratory confirmation were studied retrospectively.In 8 of 27 cases thyroidectomy and parathyroidectomy were performed separately,with interval time of 3 to 26 months,and in the remaining cases both procedures were done simultaneously.During surgery quick PTH evaluation and calcium measure were routinely performed.Results Postoperative temporary hypoparathyroidism was found in 26 of 27 cases,and postoperative permanent hypoparathyroidism developed in 4 cases that underwent separate operation.Limited movement of vocal cord was showed in 4 cases after parathyroidectomy,but it lasted no more than 2 months.No permanent paralysis of recurrent laryngeal nerve was found.No thyroid cancer or hyperparathyroidism was found with follows-up of 11 to 43 months.Conclusions Thyroidectomy and parathyroidectomy performed separately have higher risk to develop hypoparathyroidism than they are done simultaneously.PTH and calcium should be evaluated in patients with thyroid carcinoma whenever available.

BACKGROUNDAllogeneic peripheral blood stem cell transplantation from unrelated donors (UR-PBSCT) is an alternative treatment for many hematologic diseases due to lack of human leukocyte antigen (HLA)-identical sibling donors. This study aimed to evaluate the impact of the degree of the HLA match on the clinical efficacy of UR-PBSCT.

METHODSPatients who underwent UR-PBSCT from September 2003 to September 2012 were retrospectively investigated. They were divided into three groups according to high-resolution molecular typing. SPSS version 17.0 was used to analysis and compare the statistics of engraftment, incidence of GVHD, other complications and survival among the groups.

RESULTSOne hundred and eleven patients received UR-PBSCT, 60 of them with an HLA matched donor (10/10), 36 of them with a one locus mismatched donor (9/10), and 15 of them with a two loci mismatched donor (8/10). Similar basic characteristics were found in the three groups. No differences were found in engraftment of myeloid cells or platelets in the three groups (P > 0.05). Two-year cumulative incidence of relapse, overall survival (OS) and disease-free survival (DFS) among those three groups were similar (P > 0.05). The cumulative incidence of 100-day III-IV aGVHD in the HLA matched group and the one HLA locus mismatched group were significantly lower than that in the two HLA loci mismatched group (3.3%, 8.6%, and 26.7%, P = 0.009). The occurrence rate of new pulmonary infections in the HLA matched group was lower than in the two HLA mismatched groups (26.67%, 52.78%, and 41.18%, P = 0.035). The cumulative incidence of 100-day and 2-year transplantation related mortality (TRM) in two HLA loci mismatched group was higher than in the HLA matched group and in the one HLA locus mismatched group, (8.4%, 11.8% and 33.3%, P = 0.016) and (12.3%, 18.7% and 47.5%, P = 0.002).

CONCLUSIONSHLA mismatch will not significantly impact the engraftment or 2-year survival after UR-PBSCT, but two mismatched HLA loci may increase the cumulative incidence of severe aGVHD and TRM.

Adolescent ; Adult ; Child ; Female ; HLA Antigens ; immunology ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; standards ; Unrelated Donors ; Young Adult