Objective To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. Methods 975 elderly over 60 years from 41counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. Results In the last year, rates of common physical abuse, serious physical abuse,emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it, Low ability in managing daily activity of living was the risk factor causing serions physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. Conclusion High prevalence on abuse and negligence against the elderly was seen in the rural areas of China. Different forms on elderly abuse and negligence were affected by different factors that called for more attention to be paid to those elderly with lower ability in managing their daily life.

The aim of study was to select the best scheme of G-CSF to mobilize peripheral stem/progenitor cells in healthy donors. The clinical data of 60 cases received nonmyeloablative allogenic hematopoietic stem cell transplantation was analyzed retrospectively. The results indicated that the counts of MNC and CD34(+) cells were significantly higher in the 10 microg/(kg.d) group than that in the 5 microg/(kg.d) group (P < 0.05). The counts of MNC and CD34(+) cells which were collected after day 4 or 5 in the 10 microg/(kg.d) groups were not significantly different. The percentage of CD3(+) cells, CD4(+) cells and CD8(+) cells were not different in different groups. It is concluded that the scheme using 10 microg/(kg.d) G-CSF is more efficient than that in the 5 microg/(kg.d) group in mobilizing stem cells. It may reduce days for mobilization and decrease expense for collection of cells after 4 days of mobilization. Scheme using 10 microg/(kg.d) G-CSF for cells collecting after 4 days is more efficient.
Adult ; Blood Cell Count ; Drug Administration Schedule ; Female ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; Hematopoietic Stem Cell Mobilization ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; methods ; Retrospective Studies ; Time Factors

This study was purposed to investigate the reconstitution of immune system in patients with acute lymphocyte leukemia (ALL) or acute myeloid leukemia (AML) after HLA-mismatched nonmyeloablative hematopoietic stem cell transplantation (NHSCT) and its relation with infection and GVHD. 6 ALL and 4 AML patients having HLA-mismatched related donors received the nonmyeloablative precondition regimen composed of fludarabine (Fln), ATG, Ara-C, CTX and total body irradiation (TBI) in dose 2 Gy. The GVHD was prevented and treated by CsA, anti-CD25 antibody and mycophenolic mofetil (MMF) before and after transplantation. The flow cytometry was used to detect the changes of total T cells, help/inducer T cells, suppressor/killer T cells, gamma/delta T cells, B cells, NK cells, NKT cells, regulatory T cells, activated T cells, naive T cells, memory T cells and ratio of CD4/CD8 in patients with remission resulting from chemotherapy before transplantation, and analyse the relation of immunofunctional cells to infection and GVHD after transplantation, compare the difference in recovery of immune system of ALL and AML patients. The results showed that the recovery of total lymphocytes and lymphocyte subsets displayed one's own regular pattern. As compared with patients without GVHD, the counts of lymphocyte subsets in patients with GVHD was higher, while the counts of gamma/delta T cells, regulatory T cells, NK cells, the counts of B cells, NK cells, naive cells and CD4/CD8 ratio as well as the counts of B cells, naive T cells and NK cells were lower at 1 month, 2 - 3 months and 6 - 8 months after transplantation respectively. The total T cells and subsets recovered slowly, but NK cells and NKT cells recovered rapidly in patients with infection at early period after transplantation, the B cells and naive B cells recovered rapidly at 3 months after transplantation. There was no difference in lymphocyte recovery between ALL and AML patients. It is concluded that the analysis of each lymphocyte subsets may indirectly show the recovery of thymus function in patients, the changes of NK cells, B cells and naive T cells have an important significance for identifying and forecasting the GVHD and infection.
Adolescent ; Adult ; Child ; Female ; Graft vs Host Disease ; etiology ; HLA Antigens ; immunology ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; immunology ; Lymphocyte Subsets ; immunology ; Male ; Middle Aged ; Postoperative Period ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; immunology ; Young Adult

OBJECTIVETo compare the short-term clinical outcome of non-fusion techniques using interspinous implantation Coflex(TM) and Wallis treatment in patients with lumbar spine degenerative diseases.

METHODSForty-one cases of lumbar stenosis, 18 of lumbar disc herniation, and 34 of lumbar stenosis with lumbar disc herniation were evaluated. Among the 43 cases receiving Coflex(TM) implantation, 41 had operations in one segment and 2 in 2 segments. In the other 50 cases with Wallis implantation, 47 had fixation of 1 segment and 3 had 2 segments fixed. JOA Score, Oswestry Disable Index (ODI) and VAS were used to evaluate the short-term clinical results.

RESULTSThe average operating time was 64.55 min in Coflex(TM) implantation with an average blood loss of 81.82 ml. The average operating time was 82.71 min in Wallis implantation, which caused an average blood loss of 89.66 ml. Significant improvements in the JOA Score, ODI and VAS were noted after the operations.

CONCLUSIONThe two interspinous non-fusion techniques, Coflex and Wallis, produce good short-term clinical outcome in the treatment of lumbar spine degenerative diseases.

Adult ; Aged ; Aged, 80 and over ; Female ; Fracture Fixation ; methods ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Stenosis ; surgery ; Young Adult

The objective of this study was to explore the occurrence and clinical features of acute graft versus host disease (aGVHD) in non-myeloablative stem cell transplantation (NAST). 19 cases developed aGVHD out of 71 cases with NAST in recent years were analyzed retrospectively. Out of 19 cases, 9 males and 10 females at the median age of 38 (18-59), 16 cases with grade I-II aGVHD, 3 cases with grade III-IV aGVHD. The results indicated that the incidence of aGVHD in NAST was 26.7% (19/71), and severe aGVHD was 4.2%, the median onset time was 58 days (17-240 days) after transplantation. Skin and especially the intestine were the main target organs of aGVHD, while diarrhea occurred as the first symptom in 7 cases, 3 cases showed mixed acute and chronic GVHD involving more locations at the same time. aGVHD occurrence was 38.2% in those patients with full donor chimerism (FDC) and 16% in patients with the mixed chimerism (MC). It is concluded that aGVHD in NAST is less in occurrence, lighter in severity and later in time, but higher occurrence in those with early FDC, which intestine and skin are the main target organs. The clinical course is prolonged and easily complicated with severe infection in the later phase. Early combined therapy with powerful supportive treatment is necessary.
Adolescent ; Adult ; Bone Marrow Purging ; China ; epidemiology ; Female ; Graft vs Host Disease ; epidemiology ; etiology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Incidence ; Leukemia ; therapy ; Male ; Middle Aged ; Young Adult

OBJECTIVETo explore the significance of nonmyeloablative allogeneic peripheral blood hematopoietic stem cell transplantation in the treatment of hematological diseases.

METHODSA nonmyeloablative conditioning regimen consisted of CD(3) monoclonal antibody, cyclosporine A, cyclophosphamide and cytarabine was used for allogeneic stem cell transplantation in 33 patients with hematological diseases. Of them, 11 were acute leukemia (AL) in first complete remission (CR(1)), 4 AL-CR(2) approximately 3, 3 refractory AL, 4 severe aplastic anemia (SAA), 7 chronic myeloid leukemia (CML), 2 myelodysplastic syndrome, 1 each of chronic lymphocytic leukemia (CLL) and myelofibrosis.

RESULTSAll 33 patients passed the hematopoietic suppression stage smoothly and achieved engraftment of the donor cells. There were 24 cases of full donor chimerism (13 cases converted from mixed chimerism), 4 mixed chimerism (MC) and 5 developed graft rejection. Of the 33 cases, 7 (21.2%) developed acute GVHD and chronic GVHD, 25 (75.8%) still live and 8 (24.2%) died.

CONCLUSIONSNonmyeloablative allogeneic peripheral blood stem cells transplantation is a safe, less toxic and curative approach for patients with hematological disease.

Acute Disease ; Adolescent ; Adult ; Chronic Disease ; Female ; Follow-Up Studies ; Graft vs Host Disease ; etiology ; Hematologic Diseases ; mortality ; therapy ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Platelet Count ; Survival Analysis ; Survival Rate ; Transplantation Chimera ; blood ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Treatment Outcome

This study was aimed to explore the prognostic significance of telomere length in patients with chronic lymphocytic leukemia (CLL) and to analyze relation of telomere length with Binet stage, IgVH mutation status, CD38, ZAP-70 expression as well as other clinical features. 35 CLL patients who contained 80% or more tumor cells in the peripheral blood or bone marrow samples were selected as objects studied, while 13 healthy donors were served as normal controls. The telomere relative length was detected by using a real-time fluorescent quantitative polymerase chain reaction method (qPCR); the expression of CD38 and ZAP-70 protein were detected by flow cytometry, the IgVH mutation was detected by multiplex PCR. The results showed that the mean telomere relative length in CLL patients and normal controls were 0.384 and 0.443 respectively, but the difference between them was not significant (p > 0.05). The telomere length was significantly correlated with Binet stages and IgVH mutation status. Patients in Binet stage B and C showed significantly shorter telomeres than those in Binet stage A (p = 0.001). Mean telomere relative lengths in patients without IgVH mutation were shorter than those in patients with IgVH mutation (p = 0.015). No relation of telomere length with sex, age, ZAP-70 protein and CD38 were found (p > 0.05). It is concluded that telomere length may have a prognostic significance for CLL patients. Combining telomere length and IgVH mutation status may achieve a better prognostic subclassification for CLL patients.
ADP-ribosyl Cyclase 1 ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; genetics ; metabolism ; Male ; Middle Aged ; Mutation ; Prognosis ; Telomere ; chemistry ; genetics ; metabolism ; ZAP-70 Protein-Tyrosine Kinase ; metabolism

OBJECTIVETo investigate the relationship between the patient-based questionnaires and the computed tomography (CT) staging in patients with chronic rhinosinusitis (CRS).

METHODSQuantitative data of 121 preoperative recruits with CRS were collected by using the Lund-Mackay CT staging system, a visual analogue scale (VAS), sino-nasal outcome test-20 (SNOT-20), and the medical outcome study short-form 36 items (SF-36). The patients were classified into several subgroups according to whether CRS was associated with nasal polyps (NP) or not, sex, duration of disease, and educational background. Correlation between the patient-based questionnaires and the CT staging were analyzed in the total cohort patients and subgroups.

RESULTSIn the total cohort patients, there were significant correlations between SNOT-20 and SF-36 (r = -0.561, P < 0.01), SNOT-20 and VAS (r = 0.743, P < 0.01), and SF-36 and VAS (r = -0.504, P < 0.01), however, the CT staging did not correlate with the patient-based questionnaires (P > 0.05). Significant but weak correlations were found between the CT staging and the patient-based questionnaires in the CRS with NP subgroup (CT vs SNOT-20, r = 0.318, P = 0.005; CT vs SF-36, r = -0.358, P = 0.002; CT vs VAS, r = 0.358, P = 0.002). Compared between CRS with NP and without NP subgroup, there were statistic differences on the Lund-Mackay CT stage and the SNOT-20 and VAS scores (t value was 3.249, -2.409, -2.957, respectively, all P < 0.05).

CONCLUSIONSThe patient-based questionnaires correlate well with each other, but CT staging correlated significantly but weakly with the patient-based questionnaires only in the CRS with NP subgroup. Nasal polyps do not appear to be responsible for the adverse effects of CRS on quality of life.

Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; diagnostic imaging ; psychology ; Pain Measurement ; Quality of Life ; Sinusitis ; diagnostic imaging ; psychology ; Surveys and Questionnaires ; Tomography, X-Ray Computed ; Young Adult

To explore the effects of ABO incompatibility between recipient and donor on HLA-matched nonmyeloablative allogeneic peripheral blood stem cell transplantation (NAST), a retrospective, cohort study was performed. Among 24 HLA-matched NAST, 15 were major ABO-incompatible and 9 minor. Control group included 24 HLA-matched NAST with ABO-compatible grafts. Nonmyeloablative conditioning regimens consisted of CTX, Ara-C and ATG. The patients were given cyclosporine A and mycophenolate mofetile for prophylaxis of acute GVHD. The ABO-incompatible patients received grafts depleted erythrocytes by hydroxyethyl starch (HES) sedimentation. The results showed that successful and stable engraftment was established in 23 patients. No recipient developed clinically immediate hemolysis during graft infusion, but 2 recipients experienced delayed hemolysis attributable to the ABO incompatibility. The median time of granulocyte counts >0.5 x 10(9)/L and platelet >30 x 10(9)/L was 11 and 14.9 days, respectively. In ABO major incompatible group, the onset of erythropoiesis after NAST was delayed. One out of 10 recipients with blood group "O" in this group developed pure red cell aplasia (PRCA), lasting 5 months. The acute GVHD occurred in 7 out of the 24 patients. The chronic GVHD occurred in 5 of 21 cases. Relapse was observed in 2 patients with acute leukemia. The actuarial probability of disease-free survival at 2 years was 63.3%. In conclusion, ABO-incompatible grafts for NAST have no adverse effect on engraftment, recovery of platelets, incidence of GVHD, relapse rate or survival. ABO-incompatible NAST is fairly safe if there is indication, however, the onset of erythropoiesis is delayed when major ABO mismatched.
ABO Blood-Group System ; immunology ; Blood Group Incompatibility ; Cohort Studies ; Graft Survival ; immunology ; Graft vs Host Disease ; etiology ; immunology ; prevention & control ; Humans ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; methods ; Retrospective Studies ; Transplantation Conditioning ; methods ; Transplantation, Homologous

OBJECTIVETo investigate the therapeutic effect of conditioning regimen containing fludarabine in nonmyeloablative allogeneic peripheral blood stem cells transplantation (NAST) in the treatment of hematological diseases.

METHODSThirty-six patients with acute leukaemia, severe aplastic anaemia, MDS and myelofibrosis received NAST from HLA matched donors' G-CSF mobilized peripheral blood stem cells after nonmyeloabalative conditioning. The conditioning regimen consisted of CTX, Ara-C, CsA, anti-CD(3) antibody or anti-thymocyte globulin and with or without fludarabine. GVHD prophylaxis was performed with cyclosporine combined methotrexate (no MMF group, n = 5) or mycophenolate mofetil (MMF group, n = 31).

RESULTSAll of the treatment was generally well tolerated and all cases achieved engrafted of the donor cells. In fludarabine group, engraftment was observed in 87.5% (14/16) patients with complete donor chimerism, graft failure was 12.5% (2/16) and in no fludarabine group, 80% (16/20) and 20% (4/20), respectively. The incidence of acute GVHD (grade I - IV) was 27.8% (10/36) and chronic GVHD 22.2% (8/36). In fludarabine group, grade I - II aGVHD was 37.5%, in no fludarabine group, 20%. cGVHD was 12.5% in fludarabine group and in no fludarabine group 30%, respectively. Interstitial pneumonia (IP) was observed in 16.7% (6/36) of the patients, being 18.7% (3/16) and 15% (3/20) in fludarabine and no fludarabine group, respectively. Overall survival rate was 80.5% (29/36) with a median follow-up of 13 months.

CONCLUSIONSThere was no significant difference between fludarabine based (n = 16) and non-fludarabine based conditioning regimen (n = 20) in NAST for the treatment of hematological diseases, regarding for incidence of GVHD, IP, engraftment and survival.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Hematologic Diseases ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Myeloablative Agonists ; administration & dosage ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Treatment Outcome ; Vidarabine ; administration & dosage ; analogs & derivatives