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 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 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 evaluate the serum 25-hydroxyvitamin D [25 (OH)D3] levels in non-diabetic people in Taiyuan community,and its relationship with obesity and abdominal obesity.Methods This crosssectional study enrolled 417 non-diabetic people in Tainyuan community from July to September in 2011 [225 males and 192 females,mean age (47.6 ±7.8) years].For all the enrolled subjects,we collected data about anthropometric indexes,medical history,blood glucose,lipid profile,25 (OH) D3,fasting insulin (Fins) level,homeostasis model assessement for insulin resistance (HOMA-IR),body fat content (％) measured with dualenergy X-ray absorptiometry (DEXA),and intra-abdominal adipose tissue (IAAT) and abdominal subcutaneous adipose tissue (SCAT) calculated based on magnetic resonance imaging at the 4th to 5th lumbar disc level (IAAT≥80 cm2 was considered abdominal obesity).Correlation analysis was performed to assess the relationships of serum 25 (OH) D3 levels with biochemical and body fat indexes.Results The average serum level of 25 (OH) D3 was 44.5 nmol/L in the 417 people,with vitamin D deficiency in 261 cases (62.6％) and vitamin D insufficiency in 109 cases (26.1％).Of the vitamin D deficient and insufficient people,77.6％ had abdominal obesity according to IAAT (IAAT ≥ 80 cm2).According to Pearson analysis result,lg 25 (OH)D3 was negatively correlated with lg Fins,lg HOMA-IR,waist circumference,systolic blood pressure,diastolic blood pressure,total abdominal adipose tissue (TAAT),IAAT (all P ＜0.05).It was also negatively correlated with waist-to-hip-ratio,body mass index (BMI),and body fat content (％),but without statistical significance (all P ＞0.05).In stepwise multiple linear regression model,lg HOMA-IR (t =-4.278,P =0.001) and TAAT (t =-5.146,P =0.002) were independently correlated with lg 25 (OH) D3.Conclusions About 90％ of all non-diabetic population in Taiyuan community have vitamin D deficiency or insufficiency,of whom 4/5 have abdominal obesity.Serum 25 (OH)D3 level is negatively correlated with abdominal adipose tissue,but not significantly associated with BMI.HOMA-IR and TAAT are independent risk factors for vitamin D deficiency.

Objective To observe the therapeutic effect of electroacupuncture (EA) on acupoints located along anterior and posterior thigh muscles plus isokinetic muscle strength training for poststroke lower limb dysfunction. Methods Fifty-two qualified mild hemiplegia cases were randomized into control group A ( N=17) , control group B (N=17), and observation group (N=18 ). Control group A was given conventional rehabilitation training, control group B was given conventional rehabilitation training and task-targeting knee strength-coordination isokinetic muscle strength training based on visual feedback, and observation group was given EA on acupoints located along anterior and posterior thigh muscles plus the treatment for control group B. The treatment for the three groups was performed once a day, five days a week, lasting 3 weeks. Before and after treatment, the lower limb motor function, peak torque ( PT) of knee flexion and extension muscles, and gait speed and gait symmetry were monitored. Results After treatment for 3 weeks, the lower limb motor function, PT and gait symmetry were much improved in the three groups (P<0.05 compared with those before treatment) . Except that the gait speed and lower limb muscle tension of observation group did not differ from those of control group B ( P>0.05) , the improvement of observation indexes of control group B was superior to that of control group A, and the improvement of observation indexes of observation group was more obvious than that of the two control groups ( P<0.05) . Conclusion EA on acupoints located along anterior and posterior thigh muscles plus isokinetic muscle strength training is more effective for improving lower limb motor function of poststroke lower limb dysfunction patients than conventional isokinetic training.