Objective To compare the subjective satisfaction of the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) of the donor site after surgical reconstruction for tongue cancer. Methods A total of 121 consecutive patients underwent FRFF or ALTF reconstruction after ablative surgery for untreated, primary tongue squamous cell carcinoma at Tianjin Stomatological Hospital and Peking University School and Hospital of Stomatology from August 2011 to October 2014 were enrolled in this study. The subjective satisfaction of the donor site, including sensibility, movement disabilities, cosmetics, social activities and general impacts on the quality of life (QOL), was assessed by a self-established donor site morbidity questionnaire from October 2016 to January 2017. Results Of the 121 patients, 34 died because of cancer or other diseases, 2 were excluded because of recurrence after reconstruction surgery, 11 lost to contact, and 74 (61.2％) completed the questionnaires finally, which included 39 patients in FRFF group and 35 patients in ALTF group. The scores for sensibility, cosmetics, general impacts on the QOL and composite score were significantly higher in ALTF group than those of FRFF group (P<0.05). No significant differences were found in the movement disabilities and social activities between the two groups (P > 0.05). Conclusion ALTF has the advantage of better results of donor site morbidity, less adverse effect on the general QOL, and higher subjective satisfaction.

OBJECTIVETo compare the differences in clinical therapeutic effect and safety between amphotericin B and its liposome form in treating invasive fungal infection (IFI) in hematological disorder with neutrocytopenia.

METHODSOf 111 patients with IFI, 82 were treated with amphotericin B and 29 with amphotericin B liposome. The mean cumulative dose of amphotericin B was 617 (60-1895) mg and the mean course was 18 (7-60) d, and those for amphotericin B liposome was 925 (140-3420) mg and 13 (7-50) d, respectively.

RESULTSThe total effective rates of amphotericin B and its liposome groups were 69% and 58%, respectively (P>0.05). The adverse effect rates of chill and fever in amphotericin B and its liposome groups were 21% and 10% (P>0.05), hypopotassemia 34% and 14% (P=0.03), hepatic impairment 22% and 17% (P>0.05), and renal impairment 9% and 3%, respectively (P>0.05).

CONCLUSIONThe therapeutic effect for IFI of amphotericin B and its liposome was similar. The severe adverse reaction of amphotericin B liposome was slightly lower than that of amphotericin B.

Agranulocytosis ; complications ; Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Hematologic Diseases ; complications ; Humans ; Liposomes ; administration & dosage ; therapeutic use ; Mycoses ; complications ; drug therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo analyse the outcome of newly diagnosed adult acute myeloid leukemia (AML) patients treated with HAA (homoharringtonine, cytarabine and aclarubicin) regimen and explore the efficacy and safety of this regimen.

METHODSEighty patients were treated with HAA regimen. The complete remission (CR) rate was observed. Kaplan-Meier method was used to estimate relapse free survival (RFS) rate and the differences were compared with 2-sided log-rank test.

RESULTSOf the 80 patients, 65 (81%) attained CR and the CR rate after the first course of induction was 75%. For the CR patients, the median follow-up was 26 (2 -69) months, and the estimated 3-year overall survival (OS) rate was 51% and the estimated 3-year RFS was 53%. For the AML-M5 and AML-M /M2 patients the CR rate was 74% and 87% and 3 year RFS of CR patients was 75% and 37%, respectively. The CR rate of 100%, 83% and 20% was achieved in patients with favorable, intermediate and unfavorable cytogenetics, respectively. The 3 year OS for favorable and intermediate group was 76% and 50% respectively. The median survival time of unfavorable group was only 6 months.

CONCLUSIONHAA regimen is a safe, efficacious, and well-tolerable induction therapy for newly diagnosed AML.

Aclarubicin ; administration & dosage ; Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; administration & dosage ; Female ; Harringtonines ; administration & dosage ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUND AND OBJECTIVERadiotherapy (RT) is a major non-surgical modality in the comprehensive treatment for colorectal adenocarcinoma. The radioresistance of cancer stem cells (CSCs) is a key factor that influences therapeutic effectiveness. This study was to investigate the effects of specific chromosome structure and histone modification in CSCs in colorectal adenocarcinoma radioresistance.

METHODSSamples were collected from resected human colorectal adenocarcinomas. Subcutaneous colorectal cancer model was established in nude mice. Immunohistochemistry showed that xenografts generated from bulk colorectal cancer cells resembled the original tumor specimen. Flow cytometry was performed to sort CSCs (CD133+) and non-CSCs (CD133-) from both resected samples of colorectal adenocarcinoma and xenograft before and after high single-dose radiation. The markers labeling heterochromatin (H3K9me3, HP1-alpha and H3K4me1) and euchromatin (H3K4me3) in CD133+ and CD133- nucleus were detected by immunofluorescence.

RESULTSThere was distinct difference in chromatin structure between colorectal CSCs (CD133+) and non-CSCs (CD133-). The chromatin displayed compact patches in CD133+ nucleus, but loosely latticed structure in CD133- nucleus; immunofluorescence verified that the compact patches existing in CSCs was generated from heterochromatin construction. In addition, the vacuole-like defect in heterochromatin regions of CSCs was observed within 24 h after exposure to 10 gray (Gy) single-dose RT. Interestingly, this phenomenon was repaired from 96 h, and recovered to dense plaque structure in heterochromatin regions of CSCs after 144 h. However, no significant difference in non-CSCs was observed after RT exception for a loose chromatin structure.

CONCLUSIONSCSCs play a role in radiosensitivity in colorectal cancer. The mechanism may be related to heterochromatin formation and histone methylation.

AC133 Antigen ; Adenocarcinoma ; pathology ; radiotherapy ; Adult ; Aged ; Aged, 80 and over ; Animals ; Antigens, CD ; metabolism ; Cell Nucleus ; genetics ; pathology ; Colorectal Neoplasms ; pathology ; radiotherapy ; Female ; Glycoproteins ; metabolism ; Heterochromatin ; metabolism ; Histones ; metabolism ; Humans ; Male ; Methylation ; Mice ; Mice, Nude ; Middle Aged ; Neoplasm Transplantation ; Neoplastic Stem Cells ; pathology ; radiation effects ; Particle Accelerators ; Peptides ; metabolism ; Radiation Dosage ; Radiation Tolerance

OBJECTIVETo investigate the selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fracture.

METHODSTwenty-two consecutive procedures were performed in 17 aged patients with osteoporotic spinal compression fractures from April 2002 to June 2004. The signal changes in different sequences were confirmed by magnetic resonance imaging before the procedures. This operation involved the percutaneous insertion of two inflatable bone tamps into a fractured vertebral body transpedicularly under fluoroscopic guidance. Every patient was treated individually, according to the results of radiography and CT scan before operation. Preoperative and postoperative complications, visual analogue scale, and radiographic findings such as vertebral height and Cobb angle were recorded and analyzed.

RESULTSAll patients tolerated the procedure well with immediate relief of their back pain in 24 hours. There was no leakage of cement into the epidura. The mean loss percent of the anterior and middle vertebral heights were (35.32 +/- 13.15)% and (27.53 +/- 12.61)% before operation, and (14.21 +/- 12.43)% and (16.2 +/- 7.5)% after operation. The height restoration of vertebra was confirmed by X-ray after the procedure (P < 0.01). The mean kyphosis was improved from (25.3 +/- 4.2) degrees to (8.6 +/- 5.1) degrees. No complications occurred. No patient had nerve injury. The patients were allowed to walk next day after the procedure.

CONCLUSIONThe selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fractures has satisfactory short-term clinical efficacy. It is also an effective way to prevent complications.

Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Spontaneous ; etiology ; surgery ; Humans ; Kyphosis ; etiology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Osteoporosis ; complications ; Osteoporosis, Postmenopausal ; complications ; Spinal Fractures ; surgery

OBJECTIVETo study the clinical characteristics, risk factors and therapeutic outcome of Philadelphia chromosome-positive adult acute lymphoblastic leukemia (Ph(+)aALL).

METHODSThe clinical data of 117 newly diagnosed adults with Ph(+)ALL in our hospital between January 1995 and December 2009 were retrospectively analyzed. And their prognoses were followed up.

RESULTSThere were 117(16.1%) of 727 aALL patients diagnosed as Ph(+)aALL. Among the 117 cases, 64.1% patients were classified as pre-B immunophenotype and 31.3% as common B immunophenotype, 37.5% patients with co-expression of myeloid antigens (CD13 or CD33), and 98.4% patients with positive CD34. The complete remission (CR) rate after 1 or 2 cycles of induction chemotherapy was 62.2% in Ph(+)aALL group versus 82% in Ph(-)aALL group (P = 0.000). The median disease-free survival time of Ph(+) group was 6 months and the median survival time was 9 months. Sole karyotype abnormality subgroup t(9;22) accounted for 53% of all Ph(+)aALL patients and additional karyotype abnormality subgroup, t(9;22) plus other chromosome variation, accounted for 47%. Patients in sole karyotype abnormality subgroup had slightly lower CR rate (59.6% vs 62.5%, P = 0.768), longer median survival time (7 months vs 4 months, P = 0.158), and higher 3-year overall survival rate (27.3% vs 14.4%, P = 0.271). For the myeloid antigen co-expressed patients and the only lymphocytic antigen expressed ones, CR rate was 56.0% and 61.5% (P = 0.750), the median survival time was 5 months and 4 months (P = 0.182), and the 3-year overall survival rate was 16.0% and 15.0% (P = 0.354), respectively. In the imatinib plus combination chemotherapy treatment group, 81.3% patients achieved CR, compared with that of 58.3% in patients treated with only traditional combination chemotherapy (P = 0.083). The median survival time was 9.5 months and 6 months (P = 0.003) in these two subgroup, and 3-year overall survival rate was 52.2% and 10.3% (P = 0.029), respectively. For the patients receiving allo-HSCT after CR and that receiving traditional consolidation chemotherapy, the median survival time was 15 months and 6 months (P = 0.000), and the 3-year overall survival rate was 62.0% and 10.3% (P = 0.000), respectively. For the patients receiving imatinib as consolidation-maintenance treatment and that receiving allo-HSCT, the median survival time was 12 months and 15 months (P = 0.300), and the 3-year overall survival rate was 64.7% and 62% (P = 0.505), respectively.

CONCLUSIONOf all adult ALL patients, the Ph(+) subgroup accounted for about 16.1%, which have unfavorable prognosis such as lower CR rate and shorter survival duration under traditional chemotherapy. Neither additional chromosome abnormalities to t(9;22) nor co-expression of myeloid antigen had negative effect on CR rate and survival duration. Addition of imatinib to the therapy was beneficial to improve the CR rate and survival duration. Either receiving imatinib as consolidation-maintenance treatment or allo-HSCT after complete remission can improve long-term survival rate of Ph(+) adult ALL group significantly.

Adult ; Benzamides ; Female ; Humans ; Imatinib Mesylate ; Male ; Philadelphia Chromosome ; Piperazines ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; drug therapy ; genetics ; Prognosis ; Pyrimidines ; therapeutic use ; Retrospective Studies

Objective To store and use the military electronic health record ( EHR) data effectively , and to improve the flexibility, scalability, and statistical query performance of data storage .Methods The military EHR data access patterns were analyzed,a military EHR storage model using MongoDB document database was designed ,and the storage model was optimized by storing the whole document and the reduced summary document separately .Results The storage model was used in the military EHR system , which can meet the demands of document query and statistical query at the same time . The optimized model improves the statistical query performance without losing scalability .Conclusion This model can meet the daily needs of the EHR system and is of practical application value.

Objective To improve the analysis efficiency and interactive experience of the Military Electronic Health Records System(MEHRS)and to realize quick response of ad-hoc queries and statistics in the MEHRS with big data columnar storage and processing technologies.Methods We carried out requirement analysis and functional design of the ad-hoc queries and statistics subsystem of the MEHRS,proposed a three-tier architecture which included the archive storage layer,statistical pretreatment layer and statistical application layer.After the selection and evaluation of big data processing technologies,CarbonData columnar storage was used to store preprocessed data and executed statistics with Spark SQL on the basis of medical business data modeling and preprocessing.Results Five testing tasks were executed on two million archives in the following two subsystems:one with modeless and non-preprocessed MongoDB storage,the other with modeled and preprocessed CarbonData storage.The latter could finish these tasks within seconds and was dozens of times more efficient than the former statistically.Conclusion This study designs and implements a big data technology proposal that satisfies the quick response of ad-hoc queries and statistics in the MEHRS, providing powerful and flexible technical support for big data statistical analysis.

Objective To study the prevalence and the main risk factors of neonatal asphyxia in southern Gansu province high-altitude area.Method From October 2016 to December 2016,clinical data of neonates born in eight hospitals of the region were analyzed.A uniform questionnaire was used to survey the maternal condition and family background.Univariate and multivariate Logistic regression analysis were used to determine the risk factors of neonatal asphyxia.Result A total of 183 newborns were born with asphyxia (mild 157 cases,severe 26 cases),and the incidence of neonatal asphyxia was 15.3％ (183/1 197).The multivariate Logistic regression analysis indicated that the risk factors included altitude less than 3 000 meters (OR =2.693,95％ CI 1.275 ～5.689),maternal fever (OR =2.986,95％ CI 1.163 ～7.666),prolonged labor (OR =2.925,95％ CI 1.112 ～ 7.691),fetal distress (OR =7.000,95％ CI 3.254 ～ 15.056),uterine inertia (OR =2.737,95％ CI 1.484 ～ 5.047),umbilical cord abnormality (OR =3.094,95％ CI 2.051 ～4.668),amniotic fluid abnormality (OR =2.033,95％ CI 1.230 ～3.361)and placental abnormality (OR =2.753,95％ CI 1.016 ～ 7.464).Annual household income more than 30 000 yuan (OR =0.452,95％ CI 0.297 ～0.687) was protective factor of neonatal asphyxia.Conclusion The incidence of neonatal asphyxia was high in the region,which was related to intrauterine and intrapartum factors.Antepartum monitoring and timely treatment should be strengthened to reduce the incidence of newborn asphyxia.

Objective To investigate cancer high - risk rate,screening rate,detection rate in Zhejiang urban area and to provide the further evidence for cancer screening,early detection and treatment programs. Methods Epidemiological investigation and cancer risk evaluation were launched among 40 - 69 years old residents in Hangzhou and Ningbo city. People who were at high risk of lung cancer,liver cancer,upper digestive tract cancer,female breast cancer and colorectal cancer could receive clinical screening for free. Cancer high risk rates,screening rate and clinical detection rates were calculated. Results A total of 41 547 residents finished questionnaires and cancer risk evaluation. Cancer high risk rates of lung,liver,upper digestive,female breast and colorectal were 14. 05% ,12. 58% ,23. 28% ,11. 50% and 11. 82% , respectively. The rates of people who encountered single,couple,three,four and five types of cancer high risk were 29. 64% ,10. 97% ,3. 41% ,1. 16% ,0. 38% ,respectively. Screening rates for the five types of cancer were 50. 91% for lung cancer,49. 16% for liver cancer,19. 55% for upper digestive tract cancer,56. 25% for female breast cancer and 21. 75% for colorectal cancer. Lung cancer/ suspected lung cancer detection rate was 2. 42% . Breast cancer screening BI- RADS Grade 4 - 5 detection rate was 6. 71% . Upper digestive tract cancer detection rate was 0. 32% . Liver cancer detection rate was 0. 04% . Colorectal cancer detection rate was 0. 75% . Conclusion Technical solutions and program management should be improved to enhance the effect of cancer screening,early detection and treatment programs.