Objective To observe and compare the analgesic effects of electro-acupuncture(EA)of “Tsusanli point” (St. 36) with various stimulation parameters. Methods Single wide dynamic range (WDR) and nociceptive specific (NS) neurons were recorded extracellularly in the dorsal horn of the rat lumbar spinal cord. The late train discharges (C-response) of the neurons evoked by intense electrical stimulation of the skin were used as a nocicepive response. The inhibitory effects of EA stimulation of the “Tsusanli point” (St. 36) with various intensities (1 and 6 mA) and frequencies (5, 20, 50 and 100 Hz) on the C-response were observed, respectively. Results A lower frequency (5 Hz) was appropriate to the high-intensity EA, while a higher frequency (50 Hz) was proper for the low-intensity EA. Conclusion The effect of EA on the spinal nociceptive transmission is both intensity- and frequency-dependent.

Objective To discuss the complications of the bilateral uterine artery superselective embolization for uterine fibroids. Methods Fourty one cases(mean 42 years old) with uterine fibroids were approached by right femoral artery puncture; including thirty six cases of single hysteromyoma(33 cases with diameter 10 cm), and 5 cases of multi hysteromyoma. Bilateral uterine artery super selective 5F catheterization embolization were done along uterine descending artery(neck of uterus to vagina)with PVA particles. Rdsults Embolization succeeded with 100% and effective ratio was 92.3%. Sixteen of these cases showed post embolization syndrome, with something outflowed from vagina and 10 cases showed changes of emmenia but with no serious complications in all 41 cases. Conclusion Using bilateral uterine artery superselective embolization for uterine fibroids with PVP grains can decrease the incidence of complications. (J Intervent Radiol, 2006, 15: 280-282)

Objective To investigate the expression of serum thrombopoietin (TPO) in patients with hemophagocytic syndrome (HPS) and to evaluate its clinical significance. Methods The clinical data of HPS patients from Beijing Friendship Hospital,Capital Medical University during the period from September 2008 to July 2010 were collected. They were divided into infection-associated HPS,tumor-associated HPS and rheumatological disease associated HPS according to different causes. The serum concentration of TPO in HPS patients and 26 healthy controls was measured with enzyme-linked immunosorbent assay (ELISA). Then the correlations between TPO and laboratory indicators was analyzed. Results The level of serum TPO in 26 cases of HPS was significantly lower than that of control group (P =0.001) and the variance was not statistically significant in different causes of HPS groups using ANOVA (P =0.183). The TPO levels in HPS patients showed positive correlations with serum creatinine,after we detected their TPO levels and platelets,red blood cells,hemoglobin,serum creatinine,urea nitrogen,triglyceride,fibrinogen,ferritin,NK cell activity and sCD25 levels on the same day. Conclusion TPO together with various cytokines may affect the formation of blood cells in HPS patients,and its reduction may be associated with impaired liver function. The underlying mechanism remains to be further explored.

Compressed sensing (CS) is a novel theoretical framework for information acquisition and processing. Taking advantages of the sparsity or compressibility of the signals inherent in the real world, compressed sensing can collect compressed data at the sampling rate much lower than that needed in Shannon's theorem based on random measurement matrix. This technique is used in medical imaging to accelerate MRI's scanning speed, reduce radiation dosage and alleviate patients' suffering. The whole process of the proposed algorithm was as follows: firstly, the wavelet transform was applied to achieve sparse representation of medical images and reserve certain parts with maximal coefficients; secondly, the reconstruction based on CS theory were achieved according to the improved optimized orthogonal matching pursuit (OOMP) algorithm;finally, maximum intensity projection algorithm was used to achieve three-dimensional volume reconstruction. The experimental results demonstrated that our proposed two-dimensional reconstruction method was accurate and effective, which was verified qualitatively by the local detail magnification of images and quantitatively by peak signal-to-noise ratio and sectional comparison. Therefore, the three-dimensional reconstruction can be rather helpful in clinic diagnosis and treatment.

Febrile infection -related epilepsy syndrome(FIRES)is a newly named entity of epileptic encepha-lopathy in recent years.As one of the hot spots studied by domestic and foreign scholars,the etiology and pathogenesis of FIRES,which has a poor treatment and outcome,are undefined.It manifests with refractory seizures and status epilep-ticus in previously healthy school -aged children after banal febrile illness.In addition,with the negative response to currently available treatments,there are a poor prognosis and a high mortality rate in FIRES.Survivors are typically left with refractory partial epilepsy and severe cognitive impairment.Through domestic and foreign literature,this article re-views the potential pathogenesis,clinical features,treatment and prognosis of the syndrome,and provides theoretical ba-sis and new ideas for clinical diagnosis and treatment.

Objective To explore the use of antithymocyte globulin in peripheral blood stem cell transplantation from HLA-identical sibling donors. Methods Fifty-seven adults with hematological malignancy were treated with a first myeloablative matched related donor peripheral blood stem cell transplantation with pretransplantation of ATG. All patients received modified Bu/cy conditioning regimen or Cy/TBI conditioning regimen. GVHD prophylaxis protocol included Rabbit ATG (thymoglobulin, genzyme),Cyclosporin A, methotrexate and mycophenolate mofetil. Results All patients underwent engraftment with neutrophils and platelets. Incidence of aGVHD was 36.8 %. Gades Ⅰ - Ⅱ was observed in 31.6 %. Grade Ⅲ was 5.2 %. Grade Ⅳ was not seen. Incidence of cGVHD was 33.3 %, including two extensive cGVHD cases.Infection had occurred in twenty-two patients during transplantation. Twenty-nine (50.9 %) patients occurred CMV reactivation. The 5-year estimated OS is 71.35 %. The 5-year estimated DFS is 68.61%. Conclusion Pretransplantation with low dose ATG given to recipients undergoing MRD PBCT may result in less aGVHD and cGVHD. No cases of posttransplantation lymphoproliferative disease was observed. Significant morbidity and mortality from opportunistic infection were not seen. Relapse remains a problem among high-risk patients.

Objective To analyze the clinical characteristics of adult patients with hemophagocytic lymphohistiocytosis (HLH) receiving haploidentical donor hematopoietic stem cell transplantation (HID HSCT).Method We retrospectively reviewed 20 adult patients with HLH from August 2009 to August 2014.The clinical features and outcome were analyzed.Results Conditioning regimens consisted of total body irradiation/etoposide/cyclophosphamide (TBI/VP-16/CTX) and busulfan (Bu)/VP-16/CTX in HLH with anti-thymocyte globulin (ATG) 8 mg/kg.The stem cells were mobilized from donors' peripheral blood.Median time to white blood cell engraftment was 13 (9-27) days.Median time to platelet engraftment was 14 (10-28) days.Mixed chimerism after transplantation developed in 4 patients and no patient presented graft failure.Eight patients developed grade Ⅱ to Ⅲ acute graft-versus-host disease (GVHD),while as chronic GVHD occurred in 9 patients.Among 12 patients with EB virus (EBV) reactivation,2 patients developed post-transplant lymphoproliferative disorder (PTLD),7 were suspected as PTLD and 3 were considered as relapse of primary disease.With a median follow-up of 20 months (range:0.5-108 months) after transplantation,the estimated 2-year overall survival (OS) rate was (60.0 ± 11.0) ％ in all patients.During the follow-up,12 patients survived,8 died including 5 within 100 days after HSCT.Among 5 non-remission patients before HSCT,4 patients died within 100 days after HCT.Conclusions HID HSCT is an effective treatment for adult patients with HLH to achieve remission and long-term survival.High proportion of mixed chimerism has been seen at early stage after transplantation.EBV reactivation and early transplant-related mortality are common.

Objective To investigate the clinical and pathological characteristics,treatment response and clinical follow-up for patients with mantle cell lymphoma (MCL).Methods Clinical data,treatment efficacy and outcomes of 25 cases of MCL enrolled from Beijing Friendship Hospital were retrospectively analyzed.Results Median age of onset was 65 years old.Male to female ratio was 3.4:1,15 cases (60 ％) had bone marrow invasion,Ann Arbor clinical stage Ⅲ were 6 cases (24 ％),stage Ⅳ were 17 cases (68 ％).10 cases (40 ％) of patients had symptoms B.5 cases (20 ％) patients had elevation of lactate dehydrogenase (LDH).17 cases (64 ％) had elevation of β2 microglobulin (β2-MG).11 eases (64.71％) had complete remission (CR) after rituximab combined chemotherapy in 17 patients,2 years overall survival (OS) rate was 69.6 ％,2 years progression-free suvival (PFS) rate was 45.1％,significantly higher than those in traditional chemotherapy group (P ＜ 0.005).Outcomes analyses showed that variants of plasma cells,bone marrow invasion,LDH elevation,Ki-67 level,sMIPI ＞ 5 scores and increased leukocyte number were negative prognostic factors.IPI score,splenomeagly,age,symptoms B and elevation of [β2-MG had no predicative value.Conclusion MCL has higher invasion and poor prognosis.Rituximab combined chemotherapy could significantly improve CR,PFS and OS rates.

Objective To evaluate the pancreaticojejunostomy procedures selection strategy in pancreaticoduodenectomy.Methods The clinical data of 455 patients who received pancreaticoduodenectomy at the Xijing Hospital from June 2007 to June 2012 were retrospectively analyzed.For patients with pancreatic duct diameter≥4 mm,duct-to-mucosa pancreaticojejunostomy(DMPJ)was applied(DMPJ group,210 cases).For patients with pancreatic duct diameter ＜ 4 mm,modified Child pancreaticojejunostomy was applied to 140 patients(modified Child group)whose jejunal end was smaller than the pancreatic stump,and binding pancreaticojejunostomy was applied to 105 patients(binding group)whose jejunal end was bigger than or equal to the pancreatic stump.The clinical efficacy and incidence of postoperative complications were compared among the 3 groups.The count data and measurement data were analyzed by chi-square test and t test,respectively.Results The pancreatic duct diameter of the DMPJ group was(4.4 ± 0.7)mm,which was significantly bigger than(2.8 ± 0.6)mm of the modified Child group and(2.3 ± 0.7)mm of the binding group(t =2.25,2.48,P ＜ 0.05).The diameter of the pancreatic stump of the modified Child group was(36 ± 5)mm,which was significantly bigger than(21 ± 6)mm of the binding group(t =21.65,P ＜ 0.05).The overall incidence of pancreatic leakage was 8.4％(38/455).There were no significant differences in the incidences of pancreatic leakage,peritoneal bleeding,abdominal infection,digestive dysfunction rate and the mean duration of hospital stay among the 3 groups(x2 =0.53,0.88,1.63,5.34,F =2.53,P ＞ 0.05).Conclusion Pancreaticojejunostomy procedure selection strategy based on the diameters of pancreatic duct and pancreatic stump could obtain good clinical efficacy and is appropriate.

Objective To evaluate musical therapy combined with sufentanil postoperative intravenous analgesia on hemodynamic changes in patient accepted lung cancer operation.Methods Sixty lung cancer surgery patients (ASA Ⅰ-Ⅱ grade) were selected and divided randomly into musical therapy (group M; n =30) and control (group C; n =30).In group M,patients accepted music relaxation training for fifteen minutes before surgery,and music intervention for one hour at 3,7,15,19 hour after surgery.Whereas,in Group C,patients did not listen to any music during the same period.In the intensive care unit,patients were connected to a patient controlled analgesia (PCA) device.The PCA device (sufentanil 2 μg/kg,100 ml saline) was set to deliver a bolus of 2 ml,with a lockout interval of 10 min and background infusion volume of 0.5 ml/h.Hemodynamic changes,the visual analog scale (VAS) and consumption of sufentanil were recorded at the 4th,8th,12th,16th,20th and 24th hour after operation.Results SBP,DBP,HR and VAS of group M were significantly decreased compared to the group C,respectively (P ＜0.05),and significant difference was found in the PCA delivery frequency [group C (30.96 ± 4.00),group M (19.06 ± 3.49),t =12.39,P ＜ 0.01] and postoperative sufentanil consumption[group C (82.65±6.19)μg,group M (52.68 ±7.07)μg,t =20.00,P ＜0.01].Conclusions Musical therapy combined with sufentanil postoperative intravenous analgesia was able to produce better analgesic effect in the treatment of patient accepted lung cancer operation,which decreased postoperative sufentanil consumption and effectively reduced SBP,DBP and HR,and relieved the patient's anxiety.