OBJECTIVETo summarize the risk stratification and current treatment strategies for acute myeloid leukemia (AML) and discuss the role of emerging novel agents that might be applied in future clinical trials.

DATA SOURCESThe data in this article were collected from PubMed database with relevant English articles published from 1991 to 2009.

STUDY SELECTIONArticles regarding the risk stratification and therapeutic options of AML, as well as the characteristics of leukemic stem cells were selected.

RESULTSAML is a heterogeneous disease with variable clinical outcome dependent on several prognostic factors, including age, cytogenetics and molecular markers. The advances in the understanding of AML pathogenesis and development will generate potential novel agents that might improve the treatment results of standard chemotherapy.

CONCLUSIONDeeper insight into the multiple transforming events of AML may aid us in designing combinations of small molecule inhibitors based on the individual patient characteristics.

Antineoplastic Agents ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; therapy

Objective To analyze injury characteristics and treatment of hospitalized patients wounded in Wenehuan earthquake so as to provide references for medical rescue in disasters. Methods The study involved data of seismic patients from Trauma Database System Version 3.0 that collected clini-cal data of seismic patients admitted into West China Hospital of Sichuan University, Chengdu, and First and Second Hospitals of Deyang City. Trauma Database System Version 3.0 was developed by Research Institute for Traffic Medicine of PLA, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing. A comparative analysis was done on patient distribution, injury severity and medical treatment. Results There were 826 qualified patients including 410 males and 416 females ( at age range of 1-102 years, mean 45.8 years). Of all, the patients at age of 31-60 years accounted for 50. 2%. The patients were mainly peasants (43.8%, 208/477), workers (15.7%, 75/477) and students (14.1%, 67/477). Blunt injury (53.2%), crush/bury injury (22.5%) and slip/fall injury were three main causes for injury. The patients for 92.1% were admitted into two hospitals of the City of Deyang within four days after earthquake, while 81.7% of patients were admitted into West China Hospital in Chengdu at days 3-9 after earthquake. Patients with bone injuries accounted for 75.3%. The patients had abbreviated injury score (AIS) for mainly 1-3 points, with incidence rate of se-vere multiple trauma ( ISS > 16 points) of 8.2%. Internal fixation was done in 120 patients ( 34. 1% ), debridement and suturing in 103 (29.3%), external fixation in 55 ( 15.6% ), extremity amputation in 22 (6.3%) and intracerebral surgery in 2 (0.6%). Conclusions The injuries are mainly induced by collapse of buildings during earthquake. Bone injuries are predominant injury type, with AIS of mainly 1-3 points and few severe multiple trauma. The results show that the patients receive late special treat-ment and slow evacuation, indieating necessity of strengthening capacity of early medical treatment and ef-fective evacuation during destructive natural disasters.

Regenerative surgery is an emerging multidisciplinary field that has the potential to transform the surgical treatment for diseases and injuries. This article provides a brief overview of the history of surgery and regenerative medicine, introduces the new concept of regenerative surgery, describes the surgical procedures, and discusses the role of surgeons in developing and implementing these technologies. Insights gained from recent clinical research of regenerative medicine are beginning to yield three strategies for regenerative therapies for surgical diseases, and this review also provides the challenges and translational perspectives of these different strategies.
Biomedical Research ; General Surgery ; trends ; Humans ; Regenerative Medicine

OBJECTIVETo prepare morphine-loaded chitosan microspheres by emulsion ionic cross-linking and investigate the effect of initial morphine quantity and different cross-linking degrees on drug loading, encapsulation efficiency and in vitro drug release.

METHODSChitosan (with a relative molecular mass of 50,000 and deacetylation degree no less than 90%) at 100 mg and morphine at 20, 30, 40, or 50 mg were dissolved by 2% acetate and dripped slowly into 15 ml soy-bean oil containing 0.75 ml Span80. After full emulsification at 35 degrees C; for 1.5 h, the mixture was dripped slowly into sodium tripolyphosphate (10 mg/ml) at the mass ratio of 5:1, 7:1, or 9:1 to allow cross-linking for 2 h. The drug loading, encapsulation efficiency and in vitro drug release of the preparations were measured.

RESULTSThe drug loading in the microsphere increased while the encapsulation efficiency reduced with the increment of the initial morphine quantity. High cross-linking degree resulted in prolonged release time of the drug loaded in the preparations.

CONCLUSIONThe microspheres loaded with morphine allows sustained release of morphine.

Chitosan ; administration & dosage ; Delayed-Action Preparations ; chemical synthesis ; Drug Carriers ; administration & dosage ; Microspheres ; Morphine ; administration & dosage

OBJECTIVETo summarize clinical outcomes of using medial transposition of the radial nerve in humeral shaft fracture fixation.

METHODSFrom January 2005 to December 2009, 16 patients with humeral shaft fractures were treated with medial transposition of the radial nerve during open reduction and anterolateral plate fixation, included 12 males and 4 females ranging in age from 26 to 49 years, with a mean of 36 years. There were 7 fractures in the right and 9 in the left. According to AO classification, 6 fractures were type A3.2, 5 fractures were type A2.2, 2 fractures were type A1.2 and 3 fractures were type B2.2. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS), where 0 indicates normal upper extremity function, and 1 to 100 indicate varying degrees of damage to the function of the upper extremities.

RESULTSThere was no neurologic complication or postoperative would infection in this series. The followed-up period ranged from 20 to 46 (means 29) months postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, indicating that all patients reached a normal value (value of 0). The function of the upper extremities recovered satisfactorily. There was no surgery-related complication.

CONCLUSIONMedial transposition of the radial nerve is safe and does not cause iatrogenic nerve injury. It protects the radial nerve during open reduction and anterolateral plate fixation of humeral shaft fractures.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Radial Nerve ; surgery

OBJECTIVESTo assess the clinic efficacy of treating chronic prostatitis by Neisseria gonorrhoeae with azithromycin aspartic-acid injection.

METHODSNineteen cases were treated with monotherapy and once-daily intravenous dosing of azithromycin injection. The effects and side-effects after treatment were observed.

RESULTSTwelve of nineteen cases were cured.

CONCLUSIONSA short term therapy with azithromycin injection for chronic prostatitis caused by Neisseria gonorrhoeae is very effective and easy to used and thus eliminate any problem of compliance.

Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Azithromycin ; therapeutic use ; Gonorrhea ; drug therapy ; microbiology ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Neisseria gonorrhoeae ; Prostatitis ; drug therapy ; microbiology ; Treatment Outcome

OBJECTIVETo report the clinical application results of free deep inferior epigastric perforator flap in the repair of soft tissue defect.

METHODSFrom January 2006 to January 2012,13 patients with soft tissue defect (7 cases in leg and 6 cases in forearm) underwent reconstruction with a free deep inferior epigastric perforator flap. There were 9 males and 4 females, aged from 21 to 45 years old with an average of 33 years. Soft tissue defect in the extremities were from 7 cm x 17 cm to 8 cm x 26 cm. The medial branch and lateral brangh flaps were 7 cases and 6 cases respectively. The donor site was closed directly.

RESULTSOne patient developed small wound dehiscence, which spontaneous healed at one month after surgery. All the flaps had survived completely. Follow-up period ranged from 1.8 to 4.0 years with the mean of 2.8 years postoperatively. Satisfactory clinical results were obtained in 12 cases. A good contour was confirmed at the recipient area.

CONCLUSIONThe free deep inferior epigastric perforator flap for the extremities defects of soft tissue is a good option. This technique is safe and reliable, and can decrease the injury of donor site.

Adult ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Perforator Flap ; Soft Tissue Injuries ; surgery

OBJECTIVETo summarize clinical application results of repair soft tissue defect in forefoot with a reversed lateral soleus muscle flap on peroneal artery pedicle.

METHODSFrom January 2005 to January 2013, 8 patients with soft-tissue defect on forefoot were underwent reconstruction with a reversed lateral soleus muscle flap on peroneal artery pedicle. There were 6 males and 2 female, aged from 16 to 48 years with an average of 26.8 years old. The reversed lateral soleus muscle flap was transposed to the forefoot defect area, then immediate coverage of the muscle flaps were performed by a meshed split-thickness free skin graft. The donor site was closed directly. The muscle flap survey was observed after the repair of the forefoot.

RESULTSAll muscle flaps had survived completely. No clinical vascular deficiency was found on muscle flaps postoperatively. One case occurred recipient area sustained insignificant superficial infection, one patient developed distal muscle flap small skin graft necrosis, and spontaneous heal by 2 weeks' change dressing. Follow-up period was ranged form 2.5 to 5.5 years with an average of 3.5 years postoperatively. A good contour was confirmed at the recipient area. According to Cedell questionnaire, 6 patients obtained good results and 2 fair.

CONCLUSIONSWhen the local skin flap or muscle flap application is limited, lateral soleus muscle flap survey is satisfactory after repair and very suitable for repair of soft tissue defect of forefoot.

Objective To summarize the risk stratification and current treatment strategies for acute myeloid leukemia (AML) and discuss the role of emerging novel agents that might be applied in future clinical trials.Data sources The data in this article were collected from PubMed database with relevant English articles published from 1991 to 2009.Study selection Articles regarding the risk stratification and therapeutic options of AML, as well as the characteristics of leukemic stem cells were selected.Results AML is a heterogeneous disease with variable clinical outcome dependent on several prognostic factors,including age, cytogenetics and molecular markers. The advances in the understanding of AML pathogenesis and development will generate potential novel agents that might improve the treatment results of standard chemotherapy.Conclusion Deeper insight into the multiple transforming events of AML may aid us in designing combinations of small molecule inhibitors based on the individual patient characteristics.

Background/Aims: Interstitial cells of Cajal (ICC) are specialized gastrointestinal (GI) pacemaker cells required for normal GI motility. Dysfunctions in ICC have been reported in patients with GI motility disorders, such as gastroparesis, who exhibit debilitating symptoms and greatly reduced quality of life. While the proteins, calcium-activated chloride channel anoctamin-1 (ANO1) and the receptor tyrosine kinase (KIT), are known to be expressed by human ICC, relatively little is known about the broad molecular circuitry underpinning human ICC functions. The present study therefore investigates the transcriptome and proteome of ANO1-expressing, KIT low /CD45- /CD11B- ICC obtained from primary human gastric tissue. Methods: Excess human gastric tissue resections were obtained from sleeve gastrectomy patients. ICC were purified using fluorescence-activated cell sorting (FACSorting). Then, ICC were characterized by using immunofluorescence, real-time polymerase chain reaction, RNAsequencing and mass spectrometry. Results: Compared to unsorted cells, real-time polymerase chain reaction showed the KIT low /CD45- /CD11B- ICC had: a 9-fold (P < 0.05) increase in ANO1 expression; unchanged KIT expression; and reduced expression for genes associated with hematopoietic cells (CD68, > 10-fold, P < 0.001) and smooth muscle cells (DES, > 4-fold, P < 0.05). RNA-sequencing and gene ontology analyses of the KIT low / CD45- /CD11B- cells revealed a transcriptional profile consistent with ICC function. Similarly, mass spectrometry analyses of the KIT low / CD45- /CD11B - cells presented a proteomic profile consistent with ICC activities. STRING-based protein interaction analyses using the RNA-sequencing and proteomic datasets predicted protein networks consistent with ICC-associated pacemaker activity and ion transport. Conclusion These new and complementary datasets provide a valuable molecular framework for further understanding how ICC pacemaker activity regulates smooth muscle contraction in both normal GI tissue and GI motility disorders.