We retrospectively reviewed clinical data of 150 elderly patients with serious chronic congestive heart failure who admitted in 1986, 1996 or 2006, including medication treatment, hospital stay,and admission interval. The results indicated that before 1990s, digitalis, diuretics, and blood vessel dilating agents were more often used in the treatment of chronic congestive heart failure(digitalis=100%,diuretics≥95%, blood vessel dilating agents>50%, β-blocker<10%, ACEI/ARB = 0% ). Since 1990s,the use of β-blocker, ACEI and ARB increased, which resulted in reduced hospital stay and increased admission interval(P<0.01). Our investigation suggests that evidence-based medication could be necessary in the treatment of elderly patients with chronic congestive heart failure.

Objective To compare the clinical effects of needle buried suture and the posterior wall of vagina mucosa excision vaginal tightening surgery for the treatment of mild to moderate vaginal relaxation.Methods A total of 71 patients with mild to moderate vaginal relaxation were randomly divided into observation group (39 cases) and control group (32 cases).The patients in the observation group were given buried lead needle suture,and the control group were treated with posterior wall of vagina mucosa resection.Analysis of two groups was conducted in patients with operation time,intraoperative bleeding,vaginal secretion color,postoperative wound healing and complications;sexual satisfaction was evaluated after 6,12 and 24 months in two groups of patients.Results There was no significant difference between two groups in operation time and vaginal secretion color (P＞ 0.05).Intraoperative blood loss was much more in the observation group than those in the control group,with statistically significant differences between the two groups [(6.23±2.43) ml vs (15.79 ± 7.31) ml,P＜0.05)].The follow-up for a number of months showed that sexual satisfaction had significant difference between the two groups (P＜0.05).None of the patients had rectal or urethral injury,no fistula,incision infection or other complications occurred,and the incision healed in stage Ⅰ.Conclusions For patients with mild to moderate vaginal relaxation,buried lead needle suture vaginal tightening surgery does not damage the vaginal mucosa,no scar,and fewer complications,which is a more simple and effective method to improve the quality of life in patients with vaginal relaxation.

Abdominal Pain ; etiology ; Acute Disease ; Adult ; Atropine ; therapeutic use ; Chemical and Drug Induced Liver Injury ; etiology ; therapy ; Diarrhea ; etiology ; Fatal Outcome ; Female ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; etiology ; Muscarinic Antagonists ; therapeutic use ; Mushroom Poisoning ; complications ; therapy

To investigate the leukemia relapse of AL patients after HLA haploidentical bone marrow transplantation (HLA HBMT), 2 relapsed leukemia patients received HLA HBMT were studied, peripheral blood simples and bone marrow smear were examined, morphologic change of bone marrow cells was observed, while the HLA genotype and chromosome karyotye were analyzed by PCR and routine G-banding methods, respectively. The results indicated that the two cases were diagnosed primarily as acute lymphocytic leukemia (common cell subtype) and acute megakaryocytic leukemia, in which chromosome abnormalities or activation of protooncogene in leukemic cells were observed. The complete hematopuietie reconstitution of donor origin was obtained in these 2 cases after HLA HBMT, but the leukemic cells in these 2 leukemia patients were confirmed to be donor origin after relapse, their blood groups and HLA genotype were found to be originated from donor. These 2 relapsed leukemia patients were diagnosed as acute lymphocytic leukemia (B cell subtype) and acute megakaryocytic leukemia. It is suggested that high-dose of immunosuppressive agents used in transplantation may contribute to leukemia relapse of donor origin in these patients. Abnormalities in hematopoietic microenvironment may be also involved in the leukemia development. Donor-cell leukemia after allogeneic hematopoietic stem cell transplantation can be an ideal model to investigate the related events in human leukemogenesis.
Cell Transformation, Neoplastic ; Child ; HLA Antigens ; immunology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Histocompatibility ; Humans ; Infant ; Leukemia, Megakaryoblastic, Acute ; blood ; therapy ; Male ; Neoplasms, Second Primary ; etiology ; pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; therapy ; Recurrence ; Transplantation, Homologous

The purpose of this study was to compare the efficacy of CEP plus G-CSF and CVP plus G-CSF regimens in the mobilization and collection of peripheral blood hematopoietic stem cells (PBHSC), and in the hematopoietic recovery. 57 patients with non-Hodgkin's lymphoma (NHL) underwent autologous PBHSC transplantation were analyzed retrospectively. The PBHSC were mobilized and collected by using CEP plus G-CSF and CVP plus G-CSF respectively, and were retransfused into these NHL patients after preconditioning, then the mobilization efficacy, adverse reactions and hematopoietic recovery were analyzed. The results showed that the WBC count decreased to ≤ 1.0 × 10(9)/L, platelet amount dropped to ≤ 40 × 10(9)/L during peripheral blood stem cell mobilization of all patients, which indicated successful collection of PBHSC. The mean value of (4.38 ± 3.40) × 10(8)/kg mononuclear cells (MNC) containing (2.79 ± 2.53) × 10(6)/kg CD34(+) cells were collected in CEP plus G-CSF group, while the mean value of (3.31 ± 1.23) × 10(8)/kg MNC containing (2.02 ± 0.87) × 10(6)/kg CD34(+) cells were collected in CVP plus G-CSF group. The efficacy of mobilization in CEP plus G-CSF group was significantly higher than that in CVP plus G-CSF group (p < 0.05). After preconditioning, bone marrow was suppressed in all patients. The average time of WBC count recovery to ≥ 1.0 × 10(9)/L was 11.4 days in CEP plus G-CSF group and 12.3 days in CVP plus G-CSF group; the average time of platelet amount recovery to ≥ 50 × 10(9)/L was 18.6 days in CEP plus G-CSF group and 19.3 days in CVP plus G-CSF group. The statistical analysis showed no significant difference in the average time of hematopoietic recovery between 2 groups. It is concluded that autologous PBHSC transplantation shows significant effect for treatment of patients with NHL. Either modified CEP or CVP plus G-CSF regimen is safe and effective in PBHSC mobilization. The CEP plus G-CSF regimen is better than CVP plus G-CSF regimen.
Adolescent ; Adult ; Child ; Female ; Hematopoietic Stem Cell Mobilization ; methods ; Humans ; Lymphoma, Non-Hodgkin ; therapy ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Transplantation, Autologous ; Young Adult

BACKGROUNDInflammation and coagulation are two intimately cross-linked defense mechanisms of most, if not all organisms to injuries. During cardiopulmonary bypass (CPB), these two processes are activated and interact with each other through several common pathways, which may result in subsequent organ dysfunction. In the present study, we hypothesized that the addition of nitric oxide, prostaglandin E1 (PGE1), and aprotinin to the systemic circulation, hereby referred to as blood hibernation, would attenuate the inflammation and coagulation induced by CPB.

METHODSThirty adult mongrel dogs were equally divided into five groups, anesthetized and placed on hypothermic CPB (32 degrees C). Each group received respectively the following treatments: (1) inhalation of 40 ppm nitric oxide; (2) intravenous infusion of 20 ng x kg(-1) x min(-1) of PGE1; (3) 80,000 kallikrein inhibitor units (KIU)/kg of aprotinin; (4) the combination of all three agents (blood hibernation group); and (5) no treatment (control group) during CPB. Activation of leukocyte, platelet, endothelial cell, and formation of thrombin were assessed after CPB.

RESULTSAs compared with the other four groups, leukocyte counts were higher, while plasma elastase, interleukin-8, CD11b mRNA expression, myeloperoxidase activities and lung tissue leukocyte counts were lower in the blood hibernation group (P < 0.05 versus other four groups after CPB). Plasma prothrombin fragment (PTF)1+2, and platelet activation factors were lower, while platelet counts were higher in the blood hibernation group (P < 0.05 versus other four groups at 6 and 12 hours after CPB). Electron microscopy showed endothelial pseudopods protrusion, with cell adherence in all four groups except the blood hibernation group where endothelial cells remained intact.

CONCLUSIONBlood hibernation, effected by the addition of nitric oxide, PGE1 and aprotinin to the circulating blood during extra-corporeal circulation, was observed to attenuate the inflammation and coagulation induced by cardiopulmonary bypass, most likely by inhibiting the important common intermediates between the two cross-linked processes.

Alprostadil ; pharmacology ; therapeutic use ; Animals ; Aprotinin ; pharmacology ; therapeutic use ; Blood Coagulation ; drug effects ; CD11b Antigen ; genetics ; Cardiopulmonary Bypass ; adverse effects ; Dogs ; Inflammation ; drug therapy ; etiology ; Male ; Nitric Oxide ; pharmacology ; therapeutic use ; Reverse Transcriptase Polymerase Chain Reaction