ObjectiveTo investigate the clinical efficacy of focused ultrasound for treating non-neoplastic epithelial disorders of vulvar. Methods212 patients with non-neoplastic epithelial disorders of vulvar were treated with focused ultrasound. The patients were followed up after the treatment,and symptom was observed and the efficacy was evaluated. ResultsThe efficacy of non - neoplastic epithelial disorders of vulvar of squamous hyperplasia,lichen sclerosus and mixed dystrophy was 99.2％, 100. 0％, 88.9％ respectively, the difference was not significat (P ＞ 0.05 ). The efficacy in different courses of patients was 100.0％ ( ＜ 2 years), 100.0％ (2 ～10 years) ,91.3％( ＞ 10 years) respectively,the difference was not significat( P ＞ 0.05). ConclusionFocused ultrasound was obviously effective in the treatment of patients with non-neoplastic epithelial disorders of vulvar.

Objective To investigate the efficacy of imatinib combining with allogeneic hematopioetic stem cell transplantation or chemotherapy for bcr-abl positive acute lymphoblastic leukemia (ALL). Methods 12 cases were diagnosed on morphology, cytochemistry, immunophenotype and bcr-abl fusion gene. The induction is imatinib (400 mg/d) combining chemotherapy. 8 cases accepted allogeneic hematopoietic stem cell transplantation after complete remission (CR). If bcr-abl became positive, the patient was treated with imatinib (400～600 mg/d). 3 cases were tested with imatinib alternating chemotherapy after cr. Results 11 patients gained CR, CR rate 91.7 %; 5 patients (41.7 %) became bcr-abl negative through 2 courses induction. 3 cases relapsed after transplantation. 2 cases relapsed in imatinib combining chemotherapy group. The median remission interval is 16 months (imatinib combining transplantation group) and 10 months (imatinib combining chemotherapy group) (P <0.01) respectively. The median survival time is 18 months (imatinib combining transplantation group), and the other group (imatinib combining chemotherapy) is 12 months (P <0.01). Conclusion Imatinib combining chemotherapy achieved high CR rate for the bcr-abl positive ALL. Imatinib combining allogeneic hematopoietic stem cell transplantation is superior to imatinib combining chemotherapy for CR patients.

Objective To explore the relationship between the expression of P53 protein and the radiosensitivity in patients with advanced maxillary squamous cell carcinoma.Methods An immunohistochomical method wag used to detect the expression of P53 protein in patients with advanced maxillary squamous cell carcinoma.The follow up time was 2 years.The local recurrence of the patients having been treated with radical surgery and affiliated radiotheraphy were analyzed.Results The overexpression of P53 protein in 26 cages was 65.4% (17/26).In the P53 overexpression group,the local recurrence after systiem therapy wag occurred in one case within 6 months,6 cages between 7～12 months.3 cages between 13～18 months and 2 cases between 19～24 months.In the P53 low expression group,there were no recurrence within 6 and 12 months and one case ocurred within 18 months.5 cages between 19～24 months.The difference of recurrence within 18 months after system therapy between the expression of P53 Wag statistically significant(P＜0.05),but it Wag not significant for those within 24 months(P＞0.05).Conclusions The expression of P53 protein Wag correlated with the radiosensitivity in patient with advaneed maxillary squamous cell carciaoma,especially for the resid.rod cells in mitosis phase.The affiliated radiotherapy after radical surgery Wag limited effect.

Objective To compare the efficiency and safety of regimens of empiric antibiotic therapy in neutropenic hematological maligence patients.Methods The clinical data of empiric antibiotic therapy for 260 febrile episodes in 125 neutropenic hematological maligence patients were analyzed retrospectively.Results A total of 45 febrile episodes were treated with tazocin plus amikacin(regimen TA).80 episodes were treated with ceftazidime plus amikacin(regimen CA),75 episodes with imipenem plus amikacin(regimen IA) and 60 episodes with maxipime plus amikacin(regimen MA).The medians of initial therapy in each regimen were 7～8 days.Percentage of satisfactory response had no significant difference in episodes treated with regimens TA,IA and MA(65%,70% and 79% respectively),and it was better than regimen CA(P

ObjectiveTo explore the clinical significance of fms-like tyrosine kinase3(FLT3) expression in evaluation prognosis of acute myeloid leukemia(AML) prognosis.Methods50 patients with AML were selected.AML patients with normal karyotype were 20 cases,the abnormal karyotype were 30 cases.3ml bone marrow before themotherapy was aspirated respectively,and the FLT3 gene expression in leukemia cells was detected with polyenzyme chain react(PCR).ResultsThe FLT3 expression rate in AML patients with normal karyotype was 5.0％,and was 26.7％ in AML patients with abnormal karyotype,33.3％ in AML patients with refractory-relapse,and 4.5％ in AML patients with continue remission.The FLT3 expression rate was related with high leukemia cells percentage in bone marrow and high blood cells count in peripheral blood,and was not related with Franch America British(FAB) classification.The free-disease survival(FDS) and overall survived(OS) was shorter in FLT3 expression AML patients than that in no FLT3 expression AML patients.There was a statistical significance between the former and the latter( x2 =4.17,P ＜0.05 ).Conclusion FLT3 was a kind of worse factor in AML patients prognosis,and could guide clinical individual treatment in AML.

OBJECTIVE: To analyze the long-term efficacy of nasal endoscopic opticnerve decompression for traumatic optic neuropathy(TON) and to explore its possible influencing factors. METHOD: To summarize the clinical data of 39 cases underwent transnasal decompression, which were followed-up for more than 1 year. The data, including optic canal CT scanning, flashed-elicited visual-evoked potential (FVEP), preoperational vision and visual field examination were reviewed. Nasal endoscopic optic nerve decompression was preformed. Whether or not optic nerve sheath incision decided to perform was according to preoperative CT and situations in operation. Postoperative follow-up including vision, visual field, funduscopy, nasal endoscopy were performed. RESULT: Total efficacy rate was 30. 77% (12/39), inefficacy rate was 69. 23%(27/39). The efficacy rate was 85. 71% with better than nolight perception, and the efficacy rate was 18. 75% with nolight perception, the clinical effect in the group of preoperative better than nolight perception was better than that of nolight perception, the difference was statistically significant (P<0. 05). The efficacy rate was 34. 38% with duration of less than 7 days from the traumatic point to the operation point, and the efficacy rate was 14. 29% for more than 7 days, but the difference was not statistically significant (P> 0. 05). The efficacy rate was 26. 32% with optic nerve sheathincision, while the efficacy rate was 35. 00% without optic nerve sheath incision, and there was no statistically significant difference (P>0. 05); Postoperative vision tended to stabilize until about 6 months post-operation, without complications. CONCLUSION The long-term efficacy of nasal endoscopic opticnerve decompression for TON was certain; The efficacy with preoperative residual vision was better than that of nolight perception, the factor of long or short duration from the trauma point to the operation point and the factor of optic nerve sheath incision didn't influence long curative effect. To avoid the secondary damage to the optic nerve after trauma was the key to increase long curative effect in TON.
Decompression, Surgical ; Endoscopy ; Humans ; Neurosurgical Procedures ; Nose ; surgery ; Optic Nerve ; surgery ; Optic Nerve Injuries ; surgery ; Postoperative Period ; Tomography, X-Ray Computed ; Treatment Outcome ; Visual Acuity

OBJECTIVE: To evaluate effectiveness of endoscopic tragus cartilage-perichondrium in the treatment of large tympanic membrane perforations. METHOD: Patients with large tympanic membrane perfortations who had underwent cartilage-perichondrium myringoplasty were retrospectively retrieved from our department. Those with a follow-up of equal to or greater than 12 months after surgery were included in the study. Hearing test results were reported using a four-frequency air conduction and bone-air conduction gap. Patients were labeled as treatment success if the tympanic membrane was intact without lateralization or anterior blunting after surgery. RESULT: Of the 35 patients with large tympanic membrane perforations treated by endoscopic tragus cartilage-perichondrium, 33 (94.3%) were treatment success. There was no graft lateralization, anterior blunting, neocholesteatoma, and sensorineural hearing loss in these patients after surgery. The air conduction and bone-air conduction gap before surgery in the study cohort were (43.8 ± 5.7) dB and (28.5 ± 3.1) dB, respectively. Postoperative air conduction and bone-air conduction gap of the cohort were (31.4 ± 6.4) dB HL and (16.2 ± 4.1) dB, respectively. The postoperative air conduction and bone-air conduction gap decreased significantly after surgery (P < 0.01). Overall postoperative air-bone gap in 27 of the 35 patients (77%) were less than 20 dB after surgery. CONCLUSION Endoscopic cartilage-perichondrium myringoplasty is an effective procedure in the treatment of large tympanic membrane perforations.
Bone Conduction ; Cartilage ; Cohort Studies ; Ear Auricle ; Endoscopy ; Hearing ; Hearing Tests ; Humans ; Myringoplasty ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; Tympanic Membrane Perforation ; surgery ; Tympanoplasty

OBJECTIVE: To explore the influence of sublingual immunotherapy on Th2 type immunoreaction in patients with allergic rhinitis within 12 months' treatment. METHOD: Forty three patients with allergic rhinitis were followed-up within 12 months after receiving sublingual immunotherapy. The changes of clinic symptoms and immunoreaction were analyzed. VAS score was applied to evaluate the efficacy of clinic treatment. TIgE and sIgE in serum were tested to evaluate the systemic immunoreaction. Eosinophil counting in nasal discharge was applied to evaluate the local nasal mucosa immunoreaction. RESULT: VAS scores were decreased significantly one month after the starting point of treatment, companied by the decrease of EOS count in nasal discharge (P < 0.05). The changes of TIgE and sIgE in serum within 12 months of sublingual immunotherapy were not significant (P < 0.05). The levels of IL-4 and IL-13 in nasal lavage were decreased significantly after 12 months' treatment. CONCLUSION The bias of Th2 type immunoreaction existed in nasal mucosa immune system in patients with allergic rhinitis could been rectified partially after receiving sublingual immunotherapy for 12 months, but the significant changes were not observed in systemic immune system.
Adolescent ; Adult ; Animals ; Child ; Eosinophils ; immunology ; Female ; Humans ; Immunoglobulin E ; blood ; Interleukin-13 ; immunology ; Interleukin-4 ; immunology ; Male ; Middle Aged ; Mites ; immunology ; Rhinitis, Allergic ; immunology ; therapy ; Sublingual Immunotherapy ; Th2 Cells ; immunology ; Young Adult

Objective To quantify sjTREC using a modified method in patients who underwent allogeneic hematopoietic stem transplantation (all-HSCT),and determine the level of thymic output function and analyse the influencing factors in post-allo-HSCT patients.Methods Real time quantitative PCR was used to detect sjTREC levels from the peripheral blood DNA of pre-transplantation,14 d,28 d,3 m,6 m,9 m,1 y,1.5 y,2 y,2.5 y,and above 2.5 y after HSCT,and analyse thymic output function and related factors after HSCT.sjTREC levels in 24 normal individuals were also determined to use as the normal range.Results The mean of Log (sjTREC copies/ml) in normal individuals was 3.74±0.26.Negative correlation existed between thte Log sjTREC and the age (r =-0.65,P ＜ 0.01).There was no clear association between the TREC and the gender.Log sjTREC in pre-transplantation patients was 3.09±0.52,and the levels of sjTREC in 14 d,28 d,6 m,1 y after HSCT were 1.18±0.22,2.16±0.31,1.31±0.2,1.83±0.31,respectively.There was no significant difference between normal individuals and patients 1.5 years after HSCT.The post-transplantation level of sjTREC was not related to the age,but was negatively correlated to the acute graft versus host disease (aGVHD) 1 year after HSCT.There was no difference between patients with or without aGVHD 1.5 years post-HSCT.Conclusion The modified method for detecting sjTREC is applicable to allo-HSCT.The recovery of thymic output function after allo-HSCT is slow,in which aGVHD may have a negative effect.

Objective To investigate the cytogenetic and immunological phenotypes of acute myeloid leukemia (AML) with t(8;21),and explore the risk stratification and risk-adapted treatments.Methods The chromosomal karyotype of bone marrow was detected and analyzed in 22 newly diagnosed patients with t(8;21) AML by direct culture and G banding technique.Patients were divided into two groups according to the chromosomal karyotypes.Clinical characteristics and immunological phenotypes were compared between patients with isolated t(8;21) and those with additional aberrations.A follow-up study with median time 30 months (4-68 months) was conducted to analyze prognostic factors.Results 13 cases (59.1％) were isolated t(8;21) AML,while 9 (40.9 ％) had additional aberrations.Loss of sex chromosome was found in 3 cases and complex variant translocation in 2.The 10q-,9q-,-18 and +10 were found in single cases.Overall survival of patients with additional aberrations was significantly poorer than those with isolated t (8;21) (P =0.0176).Analysis of prognostic factors showed that t(8;21) chromosomal karyotype,initial white blood cells at diagnosis,and treatment regimen (chemotherapy alone or plus hematopoietic stem cell transplantation) had effects on overall survival.Conclusion Patients with t (8;21) AML are frequently associated with additional chromosomal aberrations.The latter indicates a poorer outcome and can be one of the bases of risk stratification.Hematopoietic stem cell transplantation might help to improve the overall survival.