Objective To investigate the different pathogeneses of asymptomatic lacunar infaction and symptomatic nonlacunar infaction by investigating their risk factors.Methods A total of 1989 people more than 50 years old,performed physical examination were chosen with the results showing 48 patients with asymptomatic lacunar infaction (group A) and 51 patients with symptomatic nonlacunar infaction (group B).Another 1862 controls without cerebrovascular disease were also chosen.Single factor analysis and logistic regression analysis were used to analyze the risk factors.Each risk factor and amount of risk factors for the two diseases was compared between group A and group B.Results Age,hypertension and smoking were the independent predictors of asymptomatic lacunar infaction (P＜0.05).Age,sex,diabetes mellitus,drinking,family history of stroke and stenosis of intracrianial artery were the independent predictors of the symptomatic nonlacunar infaction (P＜0.05).Both rates of diabetes mellitus and stenosis of intracrianial artery in group B were higher than those in group A (diabetes mellitus:x2=17.603,P=0.008; stenosis of intracrianial artery:x2=19.319,P=0.005).The amount of risk factors in patients from group B was significantly more than that in patients from group A (Z=2598,P=0.009).Conclusion The risk factors and vascular mechanism in patients with symptomatic nonlacunar infaction and asymptomatic lacunar infaction are different.Diabetes mellitus and stenosis of intracrianial artery are more often noted in patients with symptomatic nonlacunar infarction.

OBJECTIVETo evaluate the value of real time quantitative RT-PCR (Q-PCR) for monitoring bcr-abl mRNA levels in chronic myeloid leukemia (CML) patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSQuantification of bcr-abl mRNA was performed on 316 bone marrow samples from 112 patients with CML after HSCT by Q-PCR using the TaqMan probe system. The bcr-abl mRNA level was normalized by control gene abl. Cytogenetic response was evaluated with fluorescent in-situ hybridization (FISH).

RESULTSThe reproducible sensitivity of Q-PCR was 5 copies. The coefficients C(T) of interassay and intraassay variation for abl and bcr-abl were all below 2.0%. 289 bone marrow samples were collected from 101 CML patients who achieved a sustained complete cytogenetic response (CCyR) one month post allo-HSCT in a period of 6 - 60 months (median 12 months) at different intervals. In general, the median bcr-abl levels gradually decreased with the prolongation of time after HSCT: the median bcr-abl levels were 0.035% (0 - 0.406%) at 1 month post allo-HSCT (+ 1 month), 0.006% (0 - 0.683%) at +3 month, 0% (0 - 0.225%) at +6 month and remained 0% till +24 months. The highest level in CCyR patients detected at + 6 month was 0.068%. The bcr-abl mRNA level was decreased by 3 log in sustained CCyR patients at + 1 month compared with the newly diagnosed CML-CP patients (33.0%, data unpublished). On the contrary, Q-PCR results ranged from 0.12% to 13.45% in 8 cytogenetic non-responders or relapsed patients post allo-HSCT. Among them, 5 patients' samples were collected 1 - 2 months before cytogenetic relapse, the results were ranged from 0.09% to 3.42%. If 0.09% was assumed 0.09% as a threshold, 9 sustained CCyR patients (8.9%) were tested once higher than that within 6 month after HSCT but decreased to 0% eventually. 2 blast crisis patients achieved CCyR within 1.6 and 3 months after HSCT, but hematological relapse occurred after 1 and 1.5 months, and their bcr-abl mRNA levels increased dramatically from 0% and 0.14% to 46.9% and 75.9% respectively.

CONCLUSIONSQ- PCR is a sensitive, precise and reliable technique, and can be used to monitor CML patients post allo-HSCT regularly. Patients in blast phase of CML should be monitored more frequently.

Adolescent ; Adult ; Bone Marrow Cells ; metabolism ; Child ; Female ; Fusion Proteins, bcr-abl ; biosynthesis ; genetics ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; metabolism ; surgery ; Male ; Middle Aged ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; methods

Objective To explore clinical effect of vancomycin calcium sulfate combined with internal fixation on cal-caneal beak-like fracture secondary to calcaneal osteomyelitis caused by diabetic foot.Methods From April 2018 to October 2021,a retrospective analysis was performed on 5 patients with calcaneal bone osteomyelitis secondary to diabetic foot,includ-ing 2 males and 3 females,aged from 48 to 60 years old;diabetes course ranged from 5 to 13 years;the courses of diabetic foot disease ranged from 18 to 52 days;5 patients were grade Ⅲ according to Wagner classification.All patients were treated with debridement,vancomycin bone cement implantation,negative pressure aspiration at stage Ⅰ,vancomycin calcium sulfate and internal fixation at stage Ⅱ for calcaneal beak-like fracture.Surgical incision and fracture healing time were recorded,and the recurrence of osteomyelitis was observed.American Orthopedic Foot Andankle Society(AOFAS)score and exudation at 12 months after operation were evaluated.Results Five patients were successfully completed operation without lower extremity vascular occlusion,and were followed up for 16 to 36 months.The wound healing time after internal fixation ranged from 16 to 26 days,and healing time of fractures ranged from 16 to 27 weeks.AOFAS score ranged from 65 to 91 at 12 months after oper-ation,and 2 patients got excellent result,2 good and 1 fair.Among them,1 patient with skin ulcer on the back of foot caused by scalding at 5 months after operation(non-complication),was recovered after treatment;the wound leakage complication oc-curred in 2 patients,and were recovered after dressing change.No osteomyelitis or fracture occurred in all patients.Conclusion Vancomycin calcium sulfate with internal fixation in treating calcaneal osteomyelitis secondary to calcaneal osteomyelitis caused by diabetic foot could not only control infection,but also promote fracture healing,and obtain good clinical results.

OBJECTIVETo observe the hemodynamic changes in patients undergoing pericardiectomy at different operational stages.

METHODSTotally 16 consecutive patients receiving radical pericardiectomy were enrolled in this observational study. Hemodynamic variables were monitored continuously by pulse-indicated continuous cardiac output(PiCCO)system. Totally,three sets of intraoperative hemodynamic parameters were obtained at three different stages of pericardiectomy.

RESULTSDuring the pericardiectomy,the cardiac index[CI,(1.9±0.6),(2.7±0.6),(3.0±0.5)L·min(-1)·m(-2);P<0.05]and stroke volume index[SI,(22.5±8.7),(29.9±8.5),(30.1±8.5)dyn·s·cm(-5)·m(2);P<0.05]showed significant improvement,whereas central venous pressure[CVP,(17.1±5.0),(13.3±3.9),(12.3±3.0)mmHg;P<0.05]decreased significantly. Global end-diastolic volume index[GEDVi,(533±156),(580±153),(559±144)ml·m(-2);P<0.05]increased and stroke volume variation[SVV,(15.6±6.1)%,(10.8±4.2)%,(9.4±5.4)%;P<0.05]decreased intra-operatively. The majority of the above-mentioned hemodynamic improvements occurred after the resection of pericardium over the left ventricular outflow tract(LVOT).

CONCLUSIONSPiCCO system can serve as a reliable,less invasive hemodynamic monitoring method during pericardiectomy. Resection of the pericardium over the LVOT is the most important step of the pericardiectomy.

Cardiac Output ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Pericardiectomy ; Stroke Volume

Objective::To establish the evaluation method of Pinelliae Rhizoma (PR) resources by the analytic hierarchy process (AHP) and grey correlation degree (GCD) method, so as to explore the differences in quality components, production efficiency and appearance traits of different germplasm resources cultivated in the same environment. Method::The quality component index, efficiency index, and appearance traits index of 15 germplasm resources were measured, including moisture, total ash, extractives, total acid content, harvest index, yield, drying rate, commodity rate, decay rate and deformability of tubers. Based on AHP and grey correlation method, each indicator data was processed in a comprehensive way, its comprehensive correlation value was calculated, and different PR germplasm resources were comprehensively evaluated. Result::Based on three factors-quality composition, production efficiency and appearance traits, the comprehensive correlation value of A6 was the highest, reaching 0.749 4, which was followed by A14, A15, A7, and their comprehensive correlation values were 0.736 6, 0.726 2, 0.718 2, respectively. Therefore, the source of A6 could be used as an excellent provenance introduced to the cultivation of PR, and the provenance of A14, A15, and A7 could be used as a useful supplement. Conclusion::The method of AHP and GCD-based multi-index comprehensive evaluation is simple and comprehensive to evaluate the diversity of different PR germplasm resources, and could provide a reference for the development and utilization of resources and the screening of high-quality provenances.