BACKGROUND:Over the years, muscle, skin, skeletal muscle flaps and luminal tissues, such as stomach and intestines, are used as an artificial esophagus to repair esophagus defects, but the results are not good.
OBJECTIVE:To investigate the feasibility of chitosan tube stent combined with muscle flaps to repair partial defects of the cervical esophagus.
METHODS:Thirty white rabbits were used to make animal models of partial cervical esophageal defects, and randomly divided into experimental group (n=20) and control group (n=10). Esophagus defect in rabbits of experimental group was repaired using autologous muscle flap with a chitosan tube stent, and esophagus defect in the control group was repaired only with muscle flap. Gross and histological appearance was observed at weeks 2, 4 and 8 after operation, and barium sulphate X-ray screen was performed at week 10 after operation.
RESULTS AND CONCLUSION:After 2 weeks, muscle tissue structure, cellswel ing, and inflammatory cellinfiltration could be seen in the experiment and control groups, exhibiting an acute inflammatory reaction. After 4 weeks, the experimental group showed clear muscle flaps, reduced inflammatory reaction, and no obvious fibrosis;while in the control group, muscle tissue could be seen at defect site, with growth of fibrous tissue cells and a few of inflammatory cells. After 8 weeks, in the experimental group, squamous metaplasia could be seen on the gross surface of the muscle flaps,esophageal mucosa could be seen, accompanied by chronic inflammatory reaction under the mucosas that had a clear abate than that at 4 weeks after implantation;in the control group, chronic inflammatory reaction could be found, accompanied by clear fibrosis but no squamous metaplasia and mucosal regeneration. Barium sulphate examination found that the esophagus was smooth with a slight motility in the experimental group, but there was a part of stricture in the esophagus without motility. These findings suggest that the chitosan tube stent combined with muscle flaps could better repair partial defects of the cervical esophagus.

Objective To investigate the effecacy of open reduction internal fixation in cases with rib fracture. Methods The pain scores,respiratory related clinical indicators change of 81 rib fractuure cases underwent open reduction internal fixation surgery were ob-served. A comparison was made between the surgical group and the non-surgical group of 37 cases on pain scores trend and hospital stay. Re-sults All operations were successfully completed and postoperative recovery was good. Postoperative pain scores and respiratory rate was sig-nificantly lower(P=0. 000),Oxygen saturation was significantly higher(P=0. 002),the proportion of expectoration difficult,dyspnea and ac-tivities inconvenience were significantly lower(P<0. 05). Pain scores of surgical group significantly decreased after surgery peak hours that was the fourth day hospitalized,but the overall decline of pain scores in non-surgical group was slow. The hospital stay between the surgical group and the non-surgical group was not significantly different(P=0. 084). Conclusion The efficacy of open reduction internal fixation is significant to rib fracture with exact surgery indications,and appropriate timing of surgery is the fourth day after admission.

Objective To observe the effect of health education on the mental health and life quality of people at high risk of stroke.Methods Totally 3092 residents of Wuhan aged over 40 were screened for stroke risk.Of those,392 cases were assessed as at high risk of stroke and were chosen as the study's subjects.They were given a 1-year course of standard health education.Before and after the intervention,their diet,exercise,compliance with medication and smoking habits were recorded.They were also assessed using the self-rating depression scale (SDS),the self-rating anxiety scale (SAS) and the Spitzer quality of life index (QLI).Results Significant improvement in healthy behavior was observed after the intervention.The average SDS score and SAS score had decreased significantly,and the average QLI score was significantly higher than before the intervention.Conclusion Health education can improve the healthy behavior,mental state and life quality of people at high risk of stroke.

BACKGROUND:Recent studies have found that stem cellpluripotency and differentiation is regulated by many long non-coding RNAs (LncRNAs). The expression and effect of LncRNA AK089560 during differentiation of stem cells is unclear. OBJECTIVE:To investigate the expression of LncRNA AK089560 in mesenchymal stem cells C3H10T1/2 undergoing osteogenic and adipogenic differentiation. METHODS:Osteogenic differentiation of mesenchymal stem cells C3H10T1/2 was induced by recombinant human bone morphogenetic protein-2 and evaluated using alkaline phosphatase staining. The adipogenic differentiation of mesenchymal stem cells C3H10T1/2 was induced by three factors (dexamethasone, indomethacin and insulin) and evaluated by oil red O staining. The dynamical expression of LncRNA AK089560 was detected by qRT-PCR assay. The AK089560 secondary structure was predicted using RNAfold software. The relationship between AK089560 and neighboring protein-coding genes was analyzed using UCSC genome browser and visualized by fancyGENE online software. RESULTS AND CONCLUSION:Over 70%of C3H10T1/2 cells were positive for alkaline phosphatase after osteogenic induction and more than 80%of the cells positive for oil red O staining after adipogenic induction. qRT-PCR results showed that the expression of LncRNA AK089560 at days 2, 4, 6 of both osteogenic and adipogenic differentiation was significantly decreased compared with the control group (P<0.05). Bioinformatics analysis showed that there was a stem-loop structure for AK089560 and sense overlap relationship between AK089560 and protein-encoding gene Sema3a. These findings indicate that LncRNA AK089560 expression is reduced during osteogenic differentiation and adipogenic differentiation, showing that AK089560 may be involved in regulating the multi-directional differentiation of stem cells.

OBJECTIVETo investigate the application of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) in the treatment of hematologic malignancies.

METHODSBetween October 1995 and August 2001, fifty-one patients with hematologic malignancies (median age 34 years, range 5.5 approximately 52 years) received allo-PBSCT from HLA-identical (50) or 1-antigen mismatched sibling donors with conditioning regimens of TBI + CY or modified BU/CY2. Thirty-one patients were acute leukemia (AL) (15 in CR(1), 7 in CR(2) or greater, 10 in relapse including 2 relapse after allo-BMT and the other one never achieved remission); 12 chronic myeloid leukemia (CML) (CP 5, AP 2, BC 4 and relapse after allo-BMT 1); 7 MDS (RAEB 1, RAEB-T 1, AL secondary to MDS 5); Burkitt's lymphoma 1. A combination of cyclosporine and methotrexate was administered for GVHD prophylaxis.

RESULTAll patients were engrafted. The median time (range) to neutrophil >/= 0.5 x 10(9)/L and platelet >/= 20 x 10(9)/L was 14 (10 approximately 20) and 11 (7 approximately 45) days post-transplant, respectively. Grade II approximately IV acute GVHD occurred in 20/51 (39%) and grade III approximately IV aGVHD in 2 patients. Clinical chronic GVHD was diagnosed in 23 of 44 (52%) evaluable patients. Fourteen patients died: 8 died of transplant related complications, 6 of relapse. Thirty-seven patients are alive with a median follow-up of 399 (75 approximately 2 176) days, and among them 34 are in continuous complete remission, the other 3 relapsed. The 2-year probability of overall survival, disease-free survival (DFS) and relapse is 64%, 61% and 24%, respectively.

CONCLUSIONAllogeneic PBSCT is safe for both donors and recipients, and results in a rapid and stable engraftment without increase in incidence or severity of acute GVHD.

Acute Disease ; Adolescent ; Adult ; Child ; Female ; Follow-Up Studies ; Graft vs Host Disease ; etiology ; Hematologic Neoplasms ; mortality ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Survival Analysis ; Survival Rate ; Transplantation, Homologous ; Treatment Outcome

Objective: To investigate the feasibility of molecular diagnostic techniques to guide individualized treatment of lung cancer. Methods:A total of 360 patients with lung cancer confirmed by pathological diagnosis received clinical chemotherapy from Jan 2011 to Dec 2013 were selected as the experimental group who chose chemotherapy drugs for drug?sensitive individualized treat?ment based on molecular diagnostic technology test results. Another 180 patients with lung cancer were selected as the control group who did not carry out individual testing only chose conventional chemotherapy. The efficacy and side effects of drugs were assessed. The progression?free survival and median survival time were followed and recorded, and the survival curve was drawn by the Kaplan?Meier method. Results: There was significant difference in the efficacy between the two groups ( P<0?05) , and there was no signifi?cant difference in side effects of drugs. The progression?free survival time and median survival time were significantly different ( P<0?01) . Conclusions: Molecular diagnostic techniques to guide individual treatment of lung cancer have some clinical significance, it will help to improve the efficacy and worthy of further study.

Transposition of simple or composite forearm island flaps with a radial vascular pedicle was performed in repairing tissue defects of the hand and reconstruction of the thumb in 16 patients. It was found to be easy to operate and no suturing of blood vessels was necessary. The postoperative swelling was less marked. The flap was good in texture and sensation after the operation. The overall result wassatisfactory. Anatomic-physiological situdy was also carried out. 16 patients have been operated on, including 2 thumb reconstructions, with satisfactoryresults.

Objective: To investigate the therapeutic effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FLAG sequential busulfan/cyclophosphamide(Bu/Cy) conditioning regimen for refractory/relapsed acute myeloid leukemia. Methods: From February 2012 to June 2017, 21 patients with refractory/relapsed acute myeloid leukemia underwent allo-HSCT with FLAG sequential Bu/Cy conditioning regimen. Transplantation-related complications and clinical outcome were retrospectively analyzed. Results: After conditioning, no hepatic veno-occlusive disease (VOD) and grade Ⅲ hemorrhagic cystitis occurred. 76.2% (16/21) patients had fever with 4 septicemia. One patient died of septic shock before engraftment. Twenty patients achieved neutrophil engraftment with a median time of 13 days (range, 10 to 21 days). Seventeen patients achieved platelet engraftment with a median time of 18 days (range, 9 to 25 days). The cumulative incidence of acute graft-versus-host disease (aGVHD) was 39.5%, and 3 patients developed grade Ⅲ-Ⅳ aGVHD. Of 19 patients who survived more than 100 days after transplantation, 4 had local chronic graft-versus-host disease (cGVHD). Of 21 patients, the median survival time was 15 months (range, 0.5 to 67 months) post-transplantation. Transplantation-related mortality rate was 28.7%. Leukemia relapse occurred in 4 patients with a median time of 4 months (range, 3 to 8 months) after transplantation. The cumulative relapse rate at 1 year was 21.4%. The 1-year and 3-year overall survival (OS) rates were 60.7% and 54.9% respectively. Log-rank analysis revealed that bone marrow blasts ≥ 20% or extramedullary leukemia before transplantation, poor platelet engraftment and grade Ⅲ-Ⅳ aGVHD were significantly related to shortened OS (P<0.05). Conclusions Allo-HSCT with FLAG sequential Bu/Cy conditioning regimen in patients with refractory/relapsed myeloid leukemia has acceptable transplantation-related risk and relapse rate. The 1-year and 3-year OS rates are comparable with those in remission patients.

Objective:To investigate the clinical features,therapeutic methods,therapeutic efficacy,and prognostic characteristics of older patients with acute myeloid leukemia(AML).Methods:We collected data from 134 older patients with AML treated at Peking University International Hospital between January 2015 and February 2023.White blood cell count,bone marrow primitive cell count,cytogen-etic and molecular characteristics,and European LeukemiaNet(ELN)risk stratification at initial diagnosis were retrospectively ana-lyzed.Patients were assigned into two groups according to treatment plan―high-intensity chemotherapy and low-dose treatment―to determine whether intensive chemotherapy would yield survival benefits during treatment and the factors affecting survival.Results:Among 36 patients treated with high-intensity chemotherapy,22(61.1%)achieved complete response(CR);among 90 treated with low-intensity therapy,46(51.1%)achieved CR;and among 19 treated with azacitidine(AZA)+ venecra(VEN),14(73.7%)achieved CR.Medi-an overall survival(OS)was 15 months for high-intensity chemotherapy and 14.5 months for low-intensity treatment(P=0.226).According to ELN risk stratification,patients in the low,medium,and high risk groups exhibited OS of 18,14,and 9 months,respectively(P=0.009).OS for high-intensity chemotherapy and low-dose therapy was 22 and 15 months in the low-risk group(P=0.745),9 and 15 months in the medium-risk group(P=0.783),and 9 and 8 months in the high-risk group(P=0.739),respectively.Patients in the intensive chemotherapy group(n=36)had an OS of 15 and 17 months(P=0.689)compared with AZA+VEN treatment(n=19).The prognosis of six patients with TP53 mutation was significantly worse than those without the mutation,and the median OS was 2 months and 14 months,respectively(P=0.004).One-and 3-year survival rates for the low-,medium-and high-risk groups were 79%,53%,and 44%,and 41%,20%,and 3%,respectively.Multivariate analysis revealed that high peripheral blood white blood cell count(P=0.034),ELN risk stratification(P=0.002),and complications(P=0.017)were correlated with OS,while treatment intensity,age,sex,and bone marrow primitive cell count were not significantly correlated with OS.Conclusions:High-intensity chemotherapy did not yield a significant survival benefit in older patients with AML;however,this result needs to be confirmed in patients at low risk.Patients with TP53 mutations had a poor prognosis.Multivariate analyses revealed that baseline mo-lecular characteristics,leukocyte count,and comorbidities were more important than treatment intensity in predicting survival among older patients with AML.