Objective To discuss the efficacy and safety of decitabine plus aclacinomycin/cytarabine/ G-CSF (CAG) regimen in the treatment of patients with relapsed refractory acute myeloid leukemia (AML).Methods 17 cases with relapsed refractory AML were collected.They were given decitabine (25 mg/d,d1-5) plus CAG regimen (aclacinomycin 20 mg/d,d3-6; cytarabine 10 mg/m2,d3-9; G-CSF 400 μg/d,d0-9).Results After one course treatment by decitabine plus CAG regimen,10 patients (58.8 ％) achieved complete response (CR),1 patient (5.9 ％) achieved partial response (PR) and 6 patients (35.3 ％) displayed no response (NR),the overall response rate was 64.7 ％ (11/17).For karyotyping of chromosomal abnormalities,only 1 case (100 ％) in CR showed normal karyotype.8 cases (66.7 ％) in CR,1 case (8.3 ％) in PR showed medium karyotype.1 case (25.0 ％) in CR showed bad karyotype.Statistical analysis revealed that there were significant differences among different groups (P ＜ 0.05).Follow-up to January 31,2013,15 patients survived,2 patients died early.The median overall survival was 67 d (14-307 d),and the median relapse-free survival was 47 d (14-152 d).Conclusions The combined regimen of decitabine and CAG in the treatment of patients with relapsed refractory AML has a high response rate,little non-hematologic side effects and good tolerance.

Objective To compare the effect of sevoflurane and propofol in elderly surgery patients towards cardiac damage.Methods 45 elderly patients with hypertension were divided into Sevoflurane group and Propofol group,which were observed changes of their ECG ST-segment,Mb,CK-MB,cTnI.Results 24 hours after induction of anesthesia,cardiac damage could be observed;Compared with Sevoflurane group,levels of CK-MB,Mb and cTnI increased significantly 24 hours after induction of anesthesia(t =2.771,0.681,0.557,all P ＜ 0.05),ST-segment significantly depressed at the same time[(-1.96±0.06)mV,(-1.45±0.04)mV](P ＜0.05).Conclusion Elderly patients with hypertension show cardiac damage during pevi-operative stage;Compared with propofol,sevoflurane shows lighter damage to cardiac muscle.

Objective To explore the effects of dignity therapy on self-esteem status and negative emotions of lung cancer patients.Methods A total of 62 lung cancer patients were recruited and divided into experimental and control groups (n =31 each).The control group received routine care while the experimental group additional individualized dignity therapy.And the state self-esteem scale,self-rating anxiety and self-rating depression were used to evaluate the intervention outcomes.Results For both groups,the self-esteem status and negative emotions of the intervention group were significantly better than that those of the control group (self-esteem:61.2 ±4.6 vs.52.6 ±4.1,anxiety:52.2 ±6.8 vs.64.6 ±9.3,depression:51.1 ±7.9 vs.66.2 ±8.7,all P ＜0.05).Conclusion Dignity therapy can improve selfesteem status,decrease the levels of anxiety and depression level and boost quality of life for lung cancer patients.

Objective To summarize the nursing of infants with cavernous transformation of the portal vein (CTPV) and gastrointestinal bleeding undergoing distal splenorenal shunt.Methods 3 cases of infants with CTPV and gastrointestinal bleeding were given with preoperative nursing for upper gastrointestinal bleeding,strengthening nutritional support; strengthening prevention measures of thrombosis and bleeding complications,monitoring of urine and urine gravity,completing the artery piezometer tube care,paying attention to the discharge guidance and follow-up work.Results The platelet increased in 3 cases post-operation.1 cases occurred abdominal bleeding,but improved after symptomatic treatment.1 case occurred leakage on the site of venous indwelling needle during intravenous infusion of high nutrient solution.3 cases of children received 3 months to 3 years follow-up after discharge,no complications such as liver,kidney and blood clots occurred.Conclusions Infants with CTPV and gastrointestinal bleeding undergoing distal splenorenal shunt is very rare in clinic.Good perioperative care and strengthening the observation of the postoperative complications,attaching great importance to the discharge guidance and follow-up work,are the assurances of successful treatment.

Objective To observe the anaesthetic effect of sulfentanil combined with bupivacaine for subarachnoid block on cesarean section patients and the influence on the patient and fetus.Methods Eighty patients who were scheduled for elective cesarean section under subarachnoid block,were distributed into two groups:bupivacaine with no sulfenlanil(group B)and bupivacaine with sulfentanil(group BS).Detected SBP,DBP,MAP,HR,SpO2 before and after anesthesia.The time of drug onset,motor recovery and pain recovery were recorded,the effect of muscle relaxation was evaluated,and the drag reaction,neonatal Apgar score and anesthesia complication were recorded.Results There was no significant difference in the time of drug onset and motor recovery,muscle relaxation,neonatal Apgar score between the two groups.MAP was lower after 3-10 min of anesthesia than before anesthesia,but there was no significant difference after 30-120 min of anesthesia in the two groups.The rate of drag reaction was 27.5% in group B,but no case in group BS.The time of pain recovery was longer in group BS than that in group B(P＜0.01).The rate of temporary itch of skin after operation was 17.5% in group BS.Conclusion The addition of sulfentanil to hyperbaric bupivacaine provides adequate anesthesia for cesarean section and good postoperative analgesia.

Due to a great amount of data in clinical trials, the data cleansing needs to adopt a variety of measures, including the latest developed visual check approach. According to the different types of clinical data and the different stages in the course of clinical data management, this study reviews 8 types of visual graphics that show the relevance and trend among the data. The series of graphics can rapidly detect abnormal data, monitor clinical research in real-time, make the data management process much easier and improve the clinical trial efficiency and data quality.

Electronic case report forms (eCRFs) instead of the traditional paper case report forms (pCRFs) are increasingly used by investigators and sponsors of clinical research. We include a total of 14 phase III studies (8 pCRF, 6 eCRF) to compare paper and electronic data documentation both quantitatively and qualitatively in clinical studies. The result suggests that adaptions of electronic data capture (EDC) in clinical trials have the advantages in optimization of data capture process, improvement of data quality and earlier clinical decision compared to paper-based methods. Furthermore, the successful implementation of EDC requires accouplements with corresponding data management processes and reallocation of resources.

Objective To explore the clinical effect and prognosis of plasma N -terminal probrain natriuret-ic peptide (NT -proBNP)and 6 min walk test performance (6 -MWT)in patients with chronic heart failure (CHF).Methods 100 patients with CHF were selected as observation group,and 50 healthy people were selected as control group.They were grouped by NYHA degree,28 cases were NYHA Ⅱ,56 cases were NYHA Ⅲ and 16 cases were NYHA Ⅳ.The plasma level of NT -proBNP,6 -MWT,left ventricular ejection fraction (LVEF),early diastolic peak mitral flow velocity to late diastolic peak mitral flow velocity (E /A)were measured.Results The plasma NT -proBNP level of CHF patients was positively correlated with NYHA degree (r =0.683,P <0.01);6 -MWT was neg-atively correlated with NYHA degree(r =-0.518,P <0.01).For CHF patients,significant correlation was observed between NT -proBNP and 6 -MWT (r =-0.789,P <0.05).Plasma NT -proBNP level was correlated with dias-tolic HF,systolic HF and mixed type heart failure (r =-0.678,P <0.01;r =-0.845,P <0.01;r =-0.759,P <0.01).Conclusion Plasma NT -proBNP,6 -MWT can serve as a marker for the detection and evaluation of heart failure.Meanwhile,the higher the NT -proBNP level,the shorter the 6 -MWT,the more serious the heart failure,the poorer the prognosis.

Objective To evaluate the relationship between the expression of cyclooxygenase-2(Cox-2) and inducible nitric oxide synthase (iNOS) and the angiogenesis in gastric carcinoma. Methods Immunohistochemical stain was used to detect the expression of Cox-2, iNOS and MVD in 45 resected specimens of gastric carcinoma. The monoclonal antibody against CD34 was used for displaying vascular endothelial cells, and MVD was detected by counting the CD34-positive vascular endothelia cells. Paracancerous tissues were examined as the control. Results The expression rates of Cox-2, iNOS and MVD in gastric cancer were significantly increased, compared with those in the paracancerous tissues (77.78% vs. 33.33%, 68.89% vs. 17.78%, 58.13?19.99 vs. 24.02?10.28, P

Objective To investigate whether there is a correlation between the esophageal length of the adult Chinese people and their height, sitting height, sex or age. Methods The length from the upper end of esophagus to the dentate line of the cardia was measured by watching esophageal cavity with endoscope. A total of 613 cases (378 males and 235 females) were studied. Results ① The average length of esophagus was (24.8?2.1)cm for male and (22.8?1.9)cm for female. The difference between male and female was statistically significant (P