Objective To investigate the diagnostic significance of argyrophilic nuclear organizer regions(AgNORs) of peripheral T lymphocytes in elderly cancer patients. Methods AgNORs was examined using KL tumor image analysis system in 45 cases of health control,36 cases of elderly inflammatory patients,97 cases of elderly cancer patients and 30 cases of elderly tumor-cured patients. CD3,CD4,CD8,CD4/8 and NK were detected by flow cytometer in cancer patients. Results Compared with normal controls,inflammation and tumor-cured patients,AgNORs was decreased extremely in elderly patients with cancer. Moreover,AgNORs was decreased in tumor metastasis status. Conclusions In analyzed elderly cancer patient cases,the expression of AgNORs is significantly decreased. The AgNORs may serve as a marker for judgment of clinical treatment and supervisor.

OBJECTIVE:To analyze the application of drugs in the treatment of pediatric bronchial pneumonia,and to provide reference for rational use of drugs in the clinic.METHODS:150 Pediatric cases of bronchial pneumonia in our hospital from Jul.2005 to Mar.2006 were randomly divided to 5 groups(n=30).Each group were given different antibacterial therpy.The hospitalization duration and medical costs were processed and analyzed using PEMS software under cured and discharge condition.RESULTS:Bactericide penicillin or cephalosporin combined with antibacterial drugs erythromycin or clindamycin would lower the antibacterial effect and aggravated economic burden of patients.Penicillin combined with cephalosporin is optimal,the cheapest and time-saving therapy for pediatric bronchial pneumonia.CONCLUSION:The application of drugs for pediatric bronchial pneumonia is reasonable basically.

Objective To summarize the experience of nursing the patients with liver transplantation complicated with early portal vein thrombosis treated with post-embolectomic anticoagulation. Method The clinical data of 5 cases of liver transplantation-induced portal vein thrombosis treated with post-embolectomic anticoagulation was reviewed to summarize the curative effect , key points for disease conditions and anticoagulative nursing. Results The anticoagulative effect was not good in only one case. 4 other cases were recovered by embolectomy and postoperative anticoagulation therapy as well as related nursing measures. Conclusion The nursing measures such as close observation of the disease processing, early reasonable anticoagulation, accurate medication, prevention of patent complication are critical for preventing the recurrence of portal vein thrombosis after liver transplantation.

Objective To review the important points in the preoperative assessment and the surgical technique in precise hepatic pedicle dissection in anatomical hepatic segmentectomy.Methods 104 patients who underwent anatomical hepatic segmentectomy were divided into two groups according to the different surgical approaches adopted in a prospective and non-randomized manner:the precise hepatic pedicle dissection group (the precise group,n=44) and the conventional hepatectomy group (the conventional group,n=60).The perioperative and follow-up data were analyzed.Patients who had primary liver cancer,including hepatocellular carcinoma and intrahepatic cholangiocellular carcinoma,were analyzed separately.Results (1) There was no perioperative death in the two groups.There was no significant differences in blood loss and transfusion between the 2 groups of patients (P=0.069,0.208; t=1.844,1.266).There was a significantly higher rate of vascular inflow occlusion (P=0.001).There were significantly longer periods of vascular inflow occlusion and operative time (P=0.001,0.001; t=3.849,3.574) in the precise group.There was no significant difference in postoperative complications (P=0.988) and the duration of postoperative hospital stay (P=0.509;t=0.662) between the two groups.(2) In patients with primary liver cancer,there were no significant differences between the precise group (n=29) and the conventional group (n=41) in tumor margin positivity,vascular invasion and pathological staging (P=0.985,0.630,0.769).(3) All patients were followed up for two years.When compared with the conventional group,the disease-free survival (P=0.012),overall survival (P =0.006),and median survival (16.5 ± 4.5mo vs.7.8 ± 3.8mo)were significantly longer in the precise group.Conclusion Precise hepatic pedicle dissection had the same safety and efficacy as conventional method in partial hepatectomy.For primary liver cancer,precise hepatic pedicle dissection had better survival compared to the conventional method when the surgical margin was negative.

Objective To assess the efficacy of combination therapy with all-trans-retinoic acid (ATRA ) and arsenic trioxide (ATO) in treating patients with acute promyelocytic leukemia (APL) .Methods A retrospective study was conducted to evaluate the efficacy of combining ATO with ATRA based induction therapy ,followed by 3 courses of consolidation chemotherapy and 2-year sequential ATO/ATRA maintenance therapy in newly diagnosed APL ,and the efficacy between high risk group and low/inter-mediate risk group ,also between different PML-RARa isoform sub-group were compared .Results In high risk group and low/in-termediate risk group ,the complete remission(CR)rates were 70 .0% and 96 .9% (P=0 .04) ,respectively ;the 3 years overall sur-vival rates(OS) and disease free survival rates (DFS) were(70 .0 ± 14 .5)% ,(96 .9 ± 3 .1)% ,P= 0 .01 and(66 .7% ± 19 .2)% , (93 .8 ± 6 .1)% ,P=0 .08 ,respectively .In BCR1 group and BCR3 group ,the CR were 78 .6% and 95 .6% (P=0 .14) ,respectively ;the rates of 3 years OS and DFS were(95 .7 ± 4 .3)% ,(78 .6 ± 11 .0)% ,P=0 .18 ,and(92 .9 ± 6 .9)% ,(87 .5 ± 11 .7)% ,P=0 .24 , respectively .Conclusion The results indicate that ATO based first-line protocol is highly effective for treatment of newly diagnosed APL ,especially for the PML-RARa BCR3 isoform APL .

ObjectiveTo evaluate the clinical and functional outcome of traumatic segmental defects of the tibia treated by internal bone transport using the the adjustable mono-lateral external fixation.Methods12 patients who underwent internal bone transport using the the adjustable mono-lateral external fixation for traumatic segmental defects in the tibia were reviewed, the length of bone defect was 6～10 cm.ResultsMean follow-up was 14 months. All the cases got primary bone union. The length of time in healing was 9～14 months.ConclusionTraumatic segmental defects of the tibia treated by internal bone transport using the adjustable mono-lateral external fixation is a simple, less traumatic, non-bone graft and effective way.

Objective To evaluate the efficacy and safety of prucalopride two mg once daily in the treatment of chronic constipation (CC) in China.Methods In this multicentre,randomised,placebo controlled,parallel-group,phase Ⅲ study,patients with CC received either two mg prucalopride or placebo,once daily,for 12 weeks.The primary efficacy endpoint was the proportion of patients reaching an average of three or more spontaneous complete bowel movements (SCBM) per week during the 12 week treatment.The key secondary efficacy endpoint was the percentage of patients reaching three or more SCBM/week during the first four weeks of treatment.Other efficacy assessments included the average number of SCBM/week; the median time to onset of first SCBM after intake of the first dose of trial medication and the average number of bisacodyl tablets or enemas used per week.Furthermore,the symptoms of constipation were assessed by patient assessment of constipation symptom (PAC-SYM) questionnaire.The quality of life was evaluated by patient assessment of constipation-quality of life (PAC-QOL) questionnaire.Safety assessments included adverse events,laboratory values and cardiovascular events.Results Four hundred and forty-six patients from China were screened,313 were treated and 295 completed 12-week study treatment.Averaged over 12 weeks,significantly higher proportion of patients on prucalopride two mg (39.4％,P＜0.01) had three or more SCBM/week compared with placebo (12.7％,x2 =29.50,P＜0.01).Over four weeks,significantly higher proportion of responders was also found in patients on prucalopride (40.0 ％vs 13.3 ％,x2 =28.58,P＜0.01).Prucalopride also significantly improved associated symptoms and quality of life (QOL).The most frequent treatment emergent adverse events were diarrhoea,nausea,abdominal pain,and headache,which were mild to moderate and transient,spontaneously resolved in a few days.Conclusion Prucalopride two mg once daily significantly improved bowel function,associated symptoms and satisfaction in CC over a 12-week treatment period,and was safe and well tolerated in Chinese patients.

BACKGROUND: Three kinds of donor meniscus are commonly used at present, namely cryopreserved, fresh and deep-frozen meniscus, which,however, almost invariably give rise to degenerative changes of various degrees after transplantation.OBJECTIVE: To compare the outcome of transplantation of allograft deep-frozen meniscus and meniscal acellular matrix to determine the most preferable means of allograft meniscus preservation.DESIGN: Randomized controlled experiment with rabbits.SETTING: Department of Orthopedics, Second Hospital Affiliated to Harbin Medical University.MATERIALS: Sixty-four male Japanese white rabbits with body mass of 3.0 - 3.5 kg.METHODS: This experiment was carried out in the Animal Experimental Center, Second Hospital Affiliated to Harbin Medical University between September 2002 and September 2003. Totally 64 adult rabbits were assigned into 32 pairs according to the body weight to served as the donor and the recipient animals, respectively. The medial menisci was obtained from the bilateral knees of the donor animals with the right one cryopreserved at -80 ℃ and the left prepared into acellular matrix for deep-frozen preservation. The donor menisci were respectively transplanted into the corresponding knee joints of the recipient animal's hindlimbs, with the left side taken as the experimental side and right as control. Gross observation,X-ray examination, and histological examination of the tissues were carried out at postoperative 4, 8, 12 and 16 weeks, respectively.MAIN OUTCOME MEASURES: Findings in X-ray, gross observation and histological observation of the grafted meniscus with meniscal measurement and findings in abdominal aorta perfusion.RFSULTS: All the 64 rabbits were observed for result analysis. X-ray examination of the grafted meniscus revealed no obvious changes in either the experimental and control side at 4 and 8 weeks postoperatively, but mild changes occurred on the control side at 12 weeks, which became obvious at 16 weeks, presented by joint space narrowing, hyperostosis and osteosclerosis below the cartilage of varied severities (with scores of 1.3 and 0.6, respectively, P ＜ 0.05). By gross observation, meniscal atrophy on the experimental side was milder and slower than the control side, with al so lower atrophy rate [(15.14±4.62) % vs (20.97±4.72) % at week 4, P ＜ 0.001, and (19.23±11.27) % vs (32.74±10.43) % at week 16, P ＜ 0.05].Perfusion of the abdominal aorta revealed no revascularization in the surrounding tissues of the meniscus by gross observation in either groups, but histologically, the experimental side showed more favorable structure than the control side at postoperative weeks 4, 8, 12 and 16.CONCLUSION: Meniscal acellular matrix may produce better outcome than deep-frozen meniscus after transplantation and can be a more practical means for preservation of the meniscus.

ABSTRACT:Objective To investigate the distributional characteristics of anaphylactogens in prurigo nodularis (PN)patients so as to provide clinical basis for selecting the method of allergy test.Methods We divided 262 PN patients into four groups and then used skin-prick (5 4 patients ),skin-patch (5 0 patients ),serum IgE allergen detection (56 patients)and serum IgG allergen detection (102 patients)to analyze anaphylactogen positive rate and their distribution differences in PN.Results For skin-prick test in 54 PN patients,the detection rates of platanus orientalis,artemisia argyi,poplar,dust mite,dirt mite,cod,peanut and tomato were higher than those in the control group (P<0.05 ).For skin-patch test in 50 PN patients,the detection rates of nickel sulfate,flavor compounds,black rubber,and carba mix were higher than those in the control group (P<0.05).For serum IgE test in 5 6 PN patients,the detection rates of house dust,scandent hop,cat/dog hair,bug,penicillium/neurospora and mutton were higher than those in the control group (P<0.05).For serum IgG test in 102 PN ones,the detection rates of crab,shrimp,beef and cod were higher than those in the control group (P<0.05).Conclusion Skin-prick test and serum IgE detection have high application values in PN patients.Serum IgG detection is of certain importance in adjusting PN patients’diet structure while skin-patch test applied in PN needs further exploration.

Objective To evaluate the feasibility and clinical efficacy of amputation in situ secondary braches of splenic pedicle for laparoscopic splenectomy(LS)in patients of idiopathic thrombocytopenic purpura(ITP).Methods LS was performed in 41 ITP patients hospitalized in our department from January 2007 to November 2008 by dissecting secondary braches of splenic pedicle.The serosa on the spleen pedicle was opened by using a harmonic scalpel.Then secondary structures of the splenic arteries and veins,one by one,were disconnected from downward to upward,and then double ligated with the Hem-O-lok clips.The ligated section was cut off with the harmonic scalpe1,and then the spleen was resected.Results LS was successfully completed with no conversion to open surgery in all the 41 cases.The operative time was 75 to 180 min,and the estimated intra-operative blood loss was 50 to 800 ml.There were 3 cases of vice spleen and the vice spleen removed.Two cases were converted to traditional LS with Endo-GIA.The period of hospitalization was 4 to 9 d after operation.There was no severe postoperative complication.Platelet counts began to increase significantly after operation,reached to the peak in 5 to 7 d after operation.During the follow-up of 3 to 20 months to all 41 ITP patients,the total effective rate was 85.4%(35/41,including 22 cases of complete response and 13 cases of partial response).Conclusion LS with amputation in situ secondary braches of splenic pedicle is a safe,effective,minimally invasive and low complication in treatment of ITP.It is worth be recommended because of its lower costs in comparison with common LS.