Objective To investigate the clinical guiding significance of lymphoscintigraphy with 99mTc-DX for radical lateral lymph node dissection with pelvic autonomic nerve preservation(PANP) in lower rectal cancer.Methods In 67 patients with pathologically proven lower rectal cancer,37MBq/0.8ml 99mTc-DX was injected into submucosa of the rectum through rectal endoscopy.At 0.5h,1h,2h,3h,4h,6h,12h,and 24h after the injection,the patients underwent pelvic and lower abdominal lymphoscintigraphy. The operative method was determined according to the imaging results,and the results of lymphoscintigrams were correlated with postoperative lateral node histologic examination.Results The scintigrams were postive in 37 cases,and all were unilateral.The positive patients underwent PANP.The image results were compared with histological lymph node examination in all patients operated upon for rectal cancer.Histologically,the cases in conformity were 26(70.3 %),false positive in 11 cases(29.7 %),and 2 of 30 false positive patients who demonstrated metastases to lateral node were operated by PANP,while the others underwent only PANP(type Ⅰ) without lateral lymph nodes dissection.The percentage of good sexual function of the two groups of cases after operation was 74.4 % and 71.4 % respentively.The percentages of mild dysuria and good function of urination were both 100 %.Conclusions Lymphoscintigraphy with 99mTC-DX has particular guiding significance in selection of PANP for lower rectal cancer.

Objective To evaluate the two-stage repair in hypospadias cripples.Methods 35 patients with hypospadias cripples underwent two-stage repair.At the first stage,a full-thickness graft of skin or buccal mucosa was used for urethral plate reconstruction after the release of chordee.The second stage was performed 6 months after completion of the first stage.Tubularization of the replaced urethral plate was the preferred technique.Results There was no urethra stricture or “preplaced urethral plate ” atrophy.Fistula developed in 2 of 35 cases.Conclusion The twostaged technique was a useful strategy to deal with the myriad abnormalities encountered in crippled hypospadias.This technique could not only create a neourethra successfully,but also give the penis a near-normal shape and appearance.

OBJECTIVETo explore the feasibility and safety of conditioning regimen containing fludarabine (Flud) for haploidentical hematopoietic stem cell transplantation (HSCT).

METHODSPreparative regimen containing Flud 40 mgxm(-2)xd(-1) on day -7 to -3 in place of cyclophosphamide (CTX) for haploidentical HSCT was given to 35 patients with hematologic malignancies (4 standard risk, 16 high risk, 15 relapse with no remission). All donors received rhG-CSF followed by HSC harvest. One patient received peripheral blood HSCT (PBSCT), one bone marrow transplantation (BMT), and the others BM combination with PBSCT. The regimen-associated side effect, engraftment, incidence of graft-versus-host disease (GVHD) and disease-free survival (DFS) probabilities were observed.

RESULTSAll patients achieved sustained, full donor-type engraftment. Thirty-four patients obtained primary durable engraftment, and 1 who rejected graft from his mother obtained successful durable engraftment after the second graft from his father. The cumulative incidence of grade III-IV acute GVHD and chronic GVHD was 12.1% and 31.7%, respectively. With a follow-up duration of 8-25 months, 6 patients were dead, in which 3 died of relapse, 2 of acute GVHD, 1 of fungal infection, none died of regimen-associated side effect. The other 29 patients remained alive and DFS probability was 79.7%.

CONCLUSIONFlud based conditioning regimens for haploidentical HSCT is safe and feasible, which reduces regimen-associated side effect, with no increasing the rate of relapse and infection, and decreases the incidence of aGVHD.

Adolescent ; Adult ; Child ; Child, Preschool ; Cyclophosphamide ; Feasibility Studies ; Female ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Transplantation Conditioning ; adverse effects ; methods ; Transplantation, Homologous ; Vidarabine ; adverse effects ; analogs & derivatives ; therapeutic use ; Young Adult

Objective of this study was to evaluate the efficacy and safety of haploidentical or unrelated donor hematopoietic stem cell transplantation (HSCT) for patients with severe aplastic anemia (SAA). Twenty patients with SAA received allogeneic HSCT from haploidentical or unrelated donors (14 from haploidentical donors and 6 from unrelated donors) from November 2005 to May 2011. Conditioning regimen consisted of fludarabine (FLU), cyclophosphamide (Cy) and anti-thymocyte immunoglobulin (ATG). The patients were administrated with G-CSF-primed bone marrow and mobilized peripheral blood as grafts from haploidentical donor or only mobilized peripheral blood from the unrelated donor. The results showed that the median time of neutrophil and platelet engraftment were 14 (11 - 20) d and 17 (13 - 31) d respectively. All patients who achieved engraftment had complete hematologic recovery with complete donor chimerism, except for two patients who developed graft failure in 2 months after transplantation. Four cases developed acute grade IIGVHD. The chronic GVHD occurred in 7 of the 16 evaluable cases (6 limited, 1 extensive). 14 patients got disease-free survival with follow-up to January 2012. The disease-free survival rate was 68.9%. It is concluded that the haploidentical or unrelated donor hematopoietic stem cell transplantation may become a viable therapeutic option for severe aplastic anemia patients who lack suitable human leukocyte antigen-matched donors and fail immunosuppressive therapy.
Adolescent ; Adult ; Anemia, Aplastic ; surgery ; Child ; Child, Preschool ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors

To compare gait parameters during single-task and dual-task walking in older adults, and to examine differences in dual-task costs between individuals with high versus low balance abilities under different task conditions.

From November to December 2024, community-dwelling older adults were recruited through Hebei Province's national physical fitness monitoring network across multiple communities in Shijiazhuang and Xiong'an New Area. An inertial sensor-based gait analysis system was used to collect spatiotemporal gait parameters during three conditions: single-task walking, motor dual-task walking (simultaneous carrying task), and cognitive dual-task walking (serial subtraction task). Participants were stratified into high-balance and low-balance groups based on median eyes-closed single-leg stance duration (cut-off: 18.40 seconds). Dual-task costs (DTC) were calculated and compared between groups.

The study included 133 eligible participants[30 male, 103 female; mean age (66.95±4.75) years]. The low-balance group 66 participants, and the high-balance group 67 participants. Compared to single-task walking, motor dual-task conditions significantly increased stride time and double support phase duration (all P < 0.05), while decreasing stride length, gait velocity, and cadence (all P < 0.05). Cognitive dual-task conditions prolonged all temporal parameters (stride time, single/double support, swing time; all P < 0.05) and reduced spatial parameters (stride length, velocity, cadence; all P < 0.05). Under the dual-task intervention condition, compared to the low-balance group, the high-balance group exhibited an increase in single support time cost (0.35% vs. -1.51%, P=0.019) and swing time cost (0.33% vs. -1.20%, P=0.044), along with a reduction in stride frequency cost (-0.85% vs. 0.14%, P=0.042).

While dual-task conditions generally impair gait parameters in older adults, individuals with higher balance abilities maintain more stable gait patterns during motor dual-tasks, demonstrating greater resilience to interference. These findings highlight the importance of balance capacity in preserving functional mobility during daily multitasking activities.

To explore the dose-response correlation between appendicular skeletal muscle index (ASMI) and muscle strength in older adults.

This study included adults aged 60-79 years from the 2024 National Routine Physical Fitness Surveillance database. ASMI was used to assess muscle mass, while handgrip strength and 30-second chair stand test (30-s CST) repetitions were employed to evaluate muscle strength. Linear regression analyses, adjusted for age and body mass index (BMI), were performed to examine the associations between ASMI and handgrip strength/30-s CST. Additionally, restricted cubic spline (RCS) models were applied for dose-response analysis.

A total of 68 038 older adults (56.3% female, mean age 68.0±5.4 years) were included. Males exhibited significantly higher handgrip strength(33.6± 7.8 kg vs. 23.4±5.6 kg, P < 0.001) and ASMI (13.6±1.3 kg/m² vs. 11.4±1.2 kg/m², P < 0.001) than females. Linear regression revealed significant positive associations between ASMI and both handgrip strength(β=0.940, 95% CI: 0.930-0.950, P < 0.001) and 30-s CST repetitions(β=0.008, 95% CI: 0.005-0.011, P < 0.001), with consistent trends across genders. RCS analysis identified a threshold effect of ASMI on handgrip strength in older men (cut-off: 13.55 kg/m², P < 0.001), but not on 30-s CST(P=0.090). In women, significant thresholds were observed for both handgrip strength and 30-s CST(cut-off: 11.25 kg/m², P < 0.001). Below these thresholds, muscle strength declined rapidly with decreasing ASMI.

s Muscle mass and strength are significantly positively correlated in older adults. Personalized muscle health interventions should be considered to reduce the rate of decline in muscle strength, when ASMI falls below 13.55 kg/m² in men or 11.25 kg/m² in women.

This study was aimed to explore the effect and feasibility of reduced conditioning intensity allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of relapsed ETO positive acute myeloid leukemia (AML) patients. Fifteen cases of relapsed AML received the reducing conditioning intensity allo-HSCT from January 2011 to January 2013 in Beijing Military Command General Hospital. All patients were high-risk type of relapsed or refractory AML, including 10 males and 5 females, aged from 16 to 48 years old with mean age of 32.5 years. Ten cases are HLA-identical matching and other 5 cases are HLA-haploidentical.donors received granulocyte colony-stimulating factor (G-CSF) to mobilize the peripheral blood stem cell for transplantation. Conditioning regimen was fludarabine combined with busulfex, cytarabine and cyclophosphamide. The preventive donor's peripheral blood stem cell infusion were performed after 3 months of transplantation, and the toxicity, GVHD and disease-free survival were observed in patients after transplantation. The results showed that all patients achieved hematopoietic reconstitution, the average time of neutrophils ≥ 0.5 × 10⁹/L and platelets ≥ 20 × 10⁹/L were 15.5 d and 16.8 d respectively. Implantation was confirmed by the evidence of 100% donor hematopoiesis. Follow-up to June 2014, with a median follow-up duration of 27.5 months (18-54 months), GVHD occurred in 8 cases of all patients, one died of complication, the other 4 cases died of relapse and the other three patients remained in disease-free survival. The disease-free survival rate of 2-year was 66.7%,the longest disease-free survival time was up to 54 months. It is concluded that the reduced conditioning intensity allo-HSCT is the effective and safe method for relapsed AML with ETO-positive, and it may be chosen as a treatment method for relapsed ETO positive AML patients.
Adolescent ; Adult ; Allografts ; Cytarabine ; Disease-Free Survival ; Erythropoietin ; analysis ; Female ; Granulocyte Colony-Stimulating Factor ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; therapy ; Male ; Middle Aged ; Transplantation Conditioning ; Vidarabine ; analogs & derivatives ; Young Adult

This study was purposed to investigate the therapeutic efficacy of haploidentical allogeneic hemopoietic stem cell transplantation (allo-HSCT) for severe aplastic anemia (SAA), and evaluate the safety of this treatment by retrospective analysis. A total of 21 patients with SAA (13 cases of SAA-I, 8 cases of SAA-II) were treated with haploidentical allo-HSCT. Donors were the relatives of the patients (12 were the parents, 9 were the siblings). The conditioning regimen contained cyclophosphamide, fludarabine and antithymocyte globulin. Methylaminopterin, mycophenolate mofetil and cyclosporin A were used for preventing graft versus host disease (GVHD). The chimerism rate was monitored periodically after successful graft. The long survival rate, incidence and severity of complication, such as GVHD, infection, and so on were analyzed. The results showed that 15 out of 21 patients were survived for 16 (3-46) months, survival rate was 71.4%. Graft tailure happened in one case who died of mycetes septicemia at 43 days after allo-HSCT. Two patients died of pulmonary infection at 6 days and 10 days respectively after transplantation. Rejection happened in one case at 3 months who died of pulmonary infection at 17 days after the second transplantation with the same donor. Two patients died of IV grade intestinal GVHD at 35 days and 52 days. GVHD occurred in 14 of 21 patients, the accumulative incidence was 66.7%, 5 cases of them were severe. It is concluded that the therapeutic efficacy of haploidentical allo-HSCT is effective for SAA and with slighter complications.
Adolescent ; Allografts ; Anemia, Aplastic ; diagnosis ; therapy ; Antilymphocyte Serum ; Cyclosporine ; Graft vs Host Disease ; Haploidy ; Hematopoietic Stem Cell Transplantation ; Humans ; Retrospective Studies ; Siblings ; Survival Rate ; Tissue Donors ; Transplantation Conditioning ; Vidarabine ; analogs & derivatives

OBJECTIVETo evaluate the relationship between T lymphocyte subsets and the incidence of graft-versus-host disease (GVHD) and its clinical significance of monitoring the changes of T lymphocyte subsets dynamicly on 1, 3, 6, 12 month after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSTwenty cases received allo-HSCT in Department of Hematology of General Hospital of Beijing Military Command from January 2013 to January 2014, including 10 males and 10 females with average age of 20.3 years (3-46 years old), among them 4 cases rectived HLA matched transplantation and 16 cases rectived HLA mismatched transplantation. The levels of T lymphocyte subsets including CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD4(+)CD25(high) FOXP3(+) in the peripheral blood were manitored with flow cytometry (FCM) on +1, +3, +6, +12 month after transplantation dynamicly.

RESULTS(1) Follow up to March 2015, the levers of CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD4(+) CD25(high) FOXP3(+) showed a different degree of recovery after transplantation for all cases and returned to the lever of pre-transplantation on 12 month basically, and CD8(+) T cells recovered earlier than CD4(+) T cells, while the decrease of CD4(+) T cells lasted more than 1 year; The proportion inversion of CD4(+)/CD8(+) also lasted for more than 1 year;(2) The level of CD4(+) CD25(high) FOXP3(+) in patients with acute GVHD was lower than that in patients without acute GVHD.

CONCLUSIONThe dynamic monitoring of the T lymphocyte subsets, especially CD4(+) CD25(high) FOXP3(+) after transplantation has importent clinical significance, it can forecast the incidence of acute GVHD before symptoms appeared; the dynamic monitoring of the T-lymphocyte subsets also can be used as reference indicator for prediction of GVHD, theraby it can reduce mortality of patients after transplantation.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; T-Lymphocyte Subsets ; cytology ; Young Adult

This study was purposed to evaluate the curative efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) after failure of the first allo-HSCT in aplastic anemia patients, the cause of implant failure after allo-HSCT and clinical data of 10 severe aplastic anemia (SAA) patients in the second allo-HSCT were retrospectively analyszed. The second HSCT conditioning programs include: cyclophosphamide (CTX) + fludarabine (FLU)+ anti-thymocyte globulin (ATG) combination chemotherapy for 3 cases; CTX + FLU + white busulfan (Bu) + ATG combination chemotherapy for 7 cases. The prevention regimen of graft-versus-host disease (GVHD) include cyclosporine (CsA), mycophenolate mofetil (MMF) and methotrexate (MTX). The median count of mononuclear cell infusion was 12.17 (5.99-18.12)×10(8)/kg. The CD34(+) cell count was 5.2 (3.8-10.9)×10(6)/kg. The results showed that 10 evaluable patients achieved hematopoietic reconstitution with absolute neutrophil >0.5×10(9)/L, platelets >20×10(9)/L at 15d (8-21d) and 17d (11-27d) after transplantation. The grade I aGVHD occurred in 2 case, grade II in 1 case, chronic GVHD in 3 cases. Transplant-related deaths occurred in 4 cases. The disease-free survival rate, transplant-related mortality, GVHD after transplantation were 60%, 40% and 50% respectively. It is concluded that the second allo-HSCT is an effective therapy for aplastic anemia after allo-HSCT implant failure.
Allografts ; Anemia, Aplastic ; therapy ; Antilymphocyte Serum ; Cyclosporine ; Disease-Free Survival ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Methotrexate ; Mycophenolic Acid ; analogs & derivatives ; Retrospective Studies