OBJECTIVETo evaluate the efficacy and safety of thrombopoietin (TPO) on platelet engraftment in hematological malignancies patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT).

METHODSOne hundred and twenty patients were enrolled in a multicenter, open-label, randomized, controlled clinical trial, and were randomized into 4 treatment groups following allo-HSCT. Group A was the control arm without TPO, while group B, C and D were trial arms with received 300 U×kg(-1)×d(-1) of TPO starting from day +1, +4 and +7, respectively. A total of 89 cases were evaluated, of which 22 cases in group A, 23 in group B, 20 in group C and 24 in group D. Efficacy evaluation (the time of platelet engraftment, the number of platelet transfusion) and safety evaluation \[adverse events, routine blood tests, liver and renal function, coagulation function and occurrence of graft-versus-host disease (GVHD)\] were observed.

RESULTSThe median platelet engraftment time in experimental groups (groups B, C and D) were on day (13.17 ± 2.89), day (12.15 ± 2.08), day (12.33 ± 1.76), respectively, and that in control group was on day (14.82 ± 5.05). There was statistically significant difference between two groups (P = 0.029), There were no statistically significant difference in the average amount of platelet transfusion, platelet engraftment time, and platelet nadir value among the 3 experimental groups. No significant adverse events were observed in experimental groups.

CONCLUSIONSTPO administration following allo-HSCT for patients with hematologic malignancies appears to shorten platelet engraftment time. TPO given starting from day +7 is effective and safe.

Adolescent ; Adult ; Blood Platelets ; Child ; Female ; Hematologic Neoplasms ; surgery ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Platelet Transfusion ; methods ; Thrombopoietin ; therapeutic use ; Transplantation, Homologous ; Young Adult

OBJECTIVETo analyze effects of different thread helix angles and densities on the primary stability of immediately loaded implants using the three-dimensional finite element model analysis.

METHODSFive models of three-dimensional finite element (0.8 mm, 1.6 mm, 2.4 mm, double-threaded, and triple-threaded) were created using the commercial codes of Pro/E software, Hypermesh software, and ABAQUS software. In conditions of horizontal and vertical loading, the micro-motion of the finite element models with different thread helix angles and densities were computed with ABAQUS software.

RESULTSConcerning different thread helix angles, the micro-motion of single-threaded implant was the minimum and that of the triple-threaded was the maximum with vertical and horizontal loading. The micro-motion of doubled-threaded implant was the minimum compared with thread pitch 1.6 mm and the micro-motion of triple-threaded implant was the minimum compared with thread pitch 2.4 mm with vertical and horizontal loading.

CONCLUSIONSThe thread helix angle and density of implants can greatly affect the vertical interfacial micro-motion. With increasing thread pitchs, the resistance of implant to vertical load is weakened; with increasing thread helix angle, the resistance of implant to vertical load is weakened; with increasing thread density, the resistance of implant to the vertical load is weakened.

Dental Implants ; Dental Prosthesis Design ; Dental Stress Analysis ; Denture Retention ; Finite Element Analysis

Objective To assess the laparoscopic technique combined with open surgical technique in pyeloplasty.Methods Overall,45 patients with ureteropelvic junction obstruction underwent laparo- scopic dissection of the renal pelvis and upper ureter transperitoneally,and pyeloplasty was performed through a expanded trocar-incision(extension of 1-2 cm)as open surgery was performed.Results The opera- tion was successful in all 45 patients.The mean operative time was 58 min(range,40-85 min),and the mean blood loss was 22 ml(range,15-30 ml).No complication was observed during and after operation. Follow-up for 3-36 months was available in 34 patients.Intravenous urography(IVU)showed no obstruc- tion of the anastomotic stoma,and B-ultrasound indicated relief of hydronephrosis.Conclusions Laparo- scopic approach combined with open surgery in pyeloplasty is an effective way to treat ureteropelvic junction obstruction.This technique can simplify the operative manipulation and shorten the operative time without more trauma to the patients.It is worth general application in clinical practice.

Objective To explore the effects of dichloromethane(DCM)exposure on serum biochemical indexes among furniture manufacturing workers. Methods A total of 65 workers who engaged in adhesive operations in furniture manufactory and 56 workers who would be recruited into another factory as new employees were investigated. Twenty two pairs of workers were selected as occupationally exposure group and control group,respectively. The concentration of DCM in workplace of adhesive operations in furniture manufactory was determined. Serum levels of TP,ALB,GloB,A/ G, ALT,AST,GGT,AFU,GPDA,ADA,ALP,CHE,CHOL,TG,TBA,TBIL,DBIL and IBIL were tested by automatic biochemical analyzer in all groups. Results The mean levels of serum TP,ALB,GloB in exposure group( the concentrations of DCM in workplace were 1 300 - 7 760 mg/ m3 )were 73. 7 ± 3. 6,47. 5 ± 2. 3 and 26. 2 ± 2. 8 g/ L,which were significantly lower than that of control group(P < 0. 05). Compared to the control group,the mean levels of CHE, ADA,AST and ALT activity in exposure group(7 477. 8 ± 1 240. 8,7. 3 ± 1. 7,21. 6 ± 5. 6 and 13. 0 ± 5. 6 U/ L)were significantly lower(P < 0. 05). The mean levels of TBIL,DBIL and IBIL were 13. 9 ± 7. 6,6. 4 ± 4. 3 and 7. 5 ± 3. 4μmol/ L,respectively,which were significantly higher than that of control group(P < 0. 05). No significant difference in the mean levels of the other biochemical indexes in serum was observed between exposure and control group. However,no correlation was found between the levels of ALB and TBIL,ALB and DBIL,or ALB and IBIL. Conclusion Occupational exposure to DCM is associated with the decrease of TP,ALB,GloB and CHE levels in serum. Meanwhile,DCM occupational exposure is correlated with the increase of TBIL,DBIL and IBIL levels in serum. Our data suggest that occupational exposure to DCM may be related to inhibition of synthetic function in live,damage of blood cells and declined metabolism of bilirubin.

Objective To explore the effect of family-centered nursing on family function and family burden of schizophrenic patients.Methods A total of 108 schizophrenic patients with the whole course less than 5 years were randomly divided into study group(n =53)and control group(n =55).The two groups received the routine antipsychotic drugs maintenance therapy and the general psychological education.In addition,the study group received the family-centered nursing intervention,and the total following-up course was 1 year.To evaluate the family situation and psychotic symptoms of patients,all the participants were assessed by using Family Assessment Device (FAD),Family Burden Scale of Disease (FBS) and Brief Psychiatric Rating Scale (BPRS) at entry and 1 year after discharged.Results There was no statistically significant difference between the two groups in scores of BPRS,FAD and FBS at baseline (P ＞ 0.05).After 1 year,the scores of BPRS (24.60 ± 7.87),total function of FAD (26.8 ± 3.7) and FBS (20.60 ± 9.91) in the study group were lower than those in the control group:BPRS (28.91 ± 8.72),FAD (30.1 ± 3.4) and FBS (30.76 ± 12.27),and the difference was statistically significant (t =2.61,4.67,4.57,respectively; P ＜0.05).The scores of each factor of FAD and four domains of FBS (such as family economic burden,family daily activities,familyent ertainment and mental health of family member) of the study group were lower than those of the control group (P ＜ 0.05).Conclusions The family-centered nursing model is helpful to improve family function,the prognosis of the disease and to decrease family burden of schizophrenia.

Objective： To study the application of DSA in the diagnosis and treatment of ENT diseases. Methods： The diagnostic and therapeutic roles of DSA in ENT patients admitted from November 1995 to December 1999 were retrospectively studied. Results： Therapeutic vascular embolization using DSA was performed in 9/10 patients with severe epistaxis. The treatment was successful in 8/9 patients with a successful rate of 88.89%; embolization of tumor supplying vessels using DSA as a preoperative measure for reducing operative blood loss in 3 patients with nasopharyngeal fibrohemangioma obtained a total success; diagnosis was clarified in 2 patients using DSA. No patients were with severe complications. Conclusion： DSA is not only a safe and effective measure for diagnosis and therapy, but also effective in differential diagnosis of space occupying lesions. Preoperative selective embolization of tumor supplying arteries can reduce operative blood loss.

Objective：This study was designed to investigate the outcome of double autologous hematopoietic stem cell transplantation(Double AHSCT) in hematological malignancies. Methods: The clinical data of 12 patients who underwent Double AHSCT between January 1995 and January 1999 were analyzed retrospectively and the outcome were compared with that of 17 patients who received single autologous hematopoietic stem cell transplantation (Single AHSCT) in the same period. Results: The duration of continuous remission in 12 patients undergoing Double AHSCT ranged from 6 to 68 months(mean 27 months). Among them, eight patients (66.7％ ) were still alive without relapse up to now. While one patient had relapsed 6 months after second grafting. Three patients died from diseases related to graft. The patients who received Single AHSCT had a continuous remission of 1－ 36 months after graft (mean 12 months). Six of the 17 patients were still alive in good condition. Eight patients relapsed and 3 patients died from diseases related to graft. Conclusion: Good outcome were showed in Double AHSCT for the treatment of hematological malignancies. The 18 month survival rate in Double AHSCT tended to be better than that in Single AHSCT.

This study was purposed to constructe the three-plasmid system of the lentiviral vector carrying the green fluorescent protein (GFP) gene and to investigate the expression of GFP in T lymphocytes of the mouse. The polypurine tract (PPT) element, ubiquinone promoter (PUB) and GFP were ligated to plasmid pLO134 using subcloning technology to construct plasmid pTK153. Human kidney 293T cells were co-transfected with the three-plasmid system containing packaging plasmid DeltaNRF, plasmid pTK153 and envelope plasmid VSV-G by using calcium phosphate DNA precipation and the expression of GFP was observed under fluorescence microscope after 12 hours. The viral particles were collected after transfection 72 hours, were frozen at -80 degrees C and were used to infect mouse T lymphocytes at multiplicity of infection (m.o.i.) of 3. The expression of GFP in mouse T lymphocytes was observed by fluorescence microscopy and fluorescence-activated cell sorting (FACS). The results showed that the transfection efficacy was 63.04 +/- 7.24% in 293T cells analysed by FACS and the viral titer was (3.09 +/- 0.61) x 10(6) U/ml. The expression of GFP was also evident in mouse T lymphocytes and the transduction efficacy was (37.98 +/- 6.26)%. It is concluded that the three-plasmid system of lentiviral vector containing GFP gene is successfully constructed and the transduction efficacy is high in mouse T lymphocytes.
Animals ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; biosynthesis ; genetics ; Lentivirus ; genetics ; Mice ; Mice, Inbred BALB C ; RNA, Viral ; analysis ; T-Lymphocytes ; metabolism ; Transduction, Genetic

OBJECTIVETo evaluate the clinical effectiveness of three localization methods, including methylene blue, metal clips and intraoperative colonoscopy in laparoscopic colorectal surgery.

METHODSA retrospective analysis was performed to review the clinical data of 64 patients who underwent the laparoscopic colorectal operations in Cancer Hospital of Fudan University from December 2009 to June 2012. Three methods of tumor localization were used perioperatively, including 23 cases of methylene blue, 20 of metal clips and 21 of colonoscopy.

RESULTSOperations were successfully performed in this cohort and there were no deaths or complications. In methylene blue group, intraoperative colonoscopy was performed in two cases because of the inability to visualize blue dye on the serosal surface of the intestinal wall, another 2 cases were converted to open operation because of methylene blue diffusion and inability to identify resection margin. Intraoperative colonoscopic localization was required for 3 cases of sigmoid colon or upper rectal tumor because of inaccurate tumor localization by metal clips. Poor operative exposure due to obvious bowel distension prompted the conversion to open surgery in 2 cases of colonoscopy localization group, and the accurate position of the lesion was not found in another 2 cases due to long pedunculated adenoma.

CONCLUSIONSColorectal tumor can be localized effectively by endoscopic methylene blue tattooing at a maximum of 2 tumors before operation and the method of 4-point positioning can significantly improve the accuracy of colorectal tumor localization. Tumor localization preoperatively on the day of surgery by metal clip is accurate for the right or left colon cancer. Intraoperative colonoscopy can localize tumor accurately and rapidly for rectosigmoid or descending tumor, and the incidence of bowel distension can be significantly reduced. Localization method should be considered according to the tumor location and surgical procedure.

Adult ; Aged ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

BACKGROUNDLaparoscopic dismembered pyeloplasty with less trauma than open surgery is commonly performed for ureteropelvic junction obstruction despite a longer operating time and a long learning curve. We describe in this paper a new technique, which combines laparoscopic and open procedure in dismembered pyeloplasty, that we have developed in 51 patients and achieved excellent results.

METHODSThe surgical procedure can be divided into two steps: laparoscopic dissection of the renal pelvis and proximal ureter transperitoneally; then accomplishing the pyeloplasty through the extended port incision above the ureteropelvic junction as in open surgery.

RESULTSAll 51 operations were successful without conversion to open surgery. No intraoperative complications were observed. The operating time was 40 minutes to 90 minutes with an average of 57.5 minutes. The estimated blood loss was 15 ml to 30 ml with an average of 21.2 ml. Aberrant artery vessel and primary stricture as the cause of ureteropelvic junction obstruction was noted in 2 and 49 patients, respectively. Thirty-nine patients had fever to differing extents in the 4 days postoperation and no severe infection was observed. Four patients had urinary leakage with their drains being retained for 6 days, 6 days, 5 days or 8 days after the operation. The mean followup was 10.8 months (range 3 months to 36 months). The followup showed good results with symptom resolution in all the patients. Renal ultrasonography demonstrated that the average separation of the collecting systems decreased from preoperative 2.7 cm (range 2.0 cm to 4.7 cm) to postoperative 1.5 cm (range 1.0 cm to 2.3 cm). Excretory urography at 3 months postoperatively showed improved drainage. Of the 51 patients, 35 underwent two or more excretory urograms, demonstrating stable renal function, improved drainage and no evidence of recurrent obstruction. At the last followup visit, each patient was doing well.

CONCLUSIONSCombination of laparoscopic and open procedure in dismembered pyeloplasty offers a simpler, timesaving method in a minimally invasive fashion with low morbidity for patients with ureteropelvic junction obstruction. Ensuring quality of repair, the method provides a minimally invasive alternative with good results. It is worth future clinical application.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Kidney Pelvis ; surgery ; Laparoscopy ; methods ; Male ; Middle Aged ; Ureteral Obstruction ; surgery ; Urologic Surgical Procedures ; methods