Using chemotherapy (DA or HA and ATRA) to treat 22 cases of acute promyelocytic leukemia following to give PSS (100mg/d X 7d) ,the patients complicated with DIC were treated then were given the chemotherapy,combined with PSS to end. The results showed that the complete remission rate of the therapy of APL with PSS was increased to

[Summary] The article reported 107 cases of bile duct residual stones treated by plasma shock wave lithotripsy with inverse flush under fiber choledochoscope via T-tube fistula.Of the 107 patients, stones were completely removed in 98 patients, and residual stones remained in 9.Intraoperative biliary hemorrhage occurred in 5 cases, which were stopped after spraying the norepinephrine . There were 4 cases of arhythmia , 13 cases of subcostal or upper abdominal pain , and 11 cases of abdominal distention and diarrhea , all of which were cured by symptomatic treatment .Postoperative biliary infection occurred in 7 cases, which were cured by anti-infection and biliary drainage.Except for 1 patient of lost of follow-up, 106 patients were followed for 6 months.Ultrasound and CT examinations showed free of calculus in 101 cases, and intrahepatic bile duct residual stones in 5 cases.We deem that plasma shock wave lithotripsy combined with reverse flushing under fiber choledochoscope is a minimally invasive , safe, and effective treatment for difficult biliary residual stones .

BACKGROUND:Interstitial fluid flow around the osteocytes caused by a series of physiological activities plays an important role in the osteocyte metabolism and signal transduction.
OBJECTIVE:To review and summarize the research progress of bone structures and physiological functions, then further il ustrate how the mechanical loads make an impact on bone tissue.
METHODS:A computer-based search was conducted in PubMed database for articles related to the bone microstructure, metabolism and osteocyte signal transduction published from January 2009 to December 2015. The keywords were“osteocyte, mechanical load, permeability, lacunar-canalicular system, interstitial fluid flow, mechanotransduction, signaling pathways”in English. Data were screened firstly, dated articles or literatures with wrong research methods were excluded, and total y 40 eligible articles were enrol ed.
RESULTS AND CONCLUSION:Bone tissue can quickly adapt to the change of mechanical environment to guarantee enough osteocytes in the functional bone area indicating that osteocytes regulate the bone absorption and formation by responding to stress, which is closely related to osteocyte physiological characters. Osteocytes exist in mineralized matrix, and the special microstructures make it possible to receive mechanical loads and transform the mechanical signals into chemical signals aimed at regulating the bone absorption or formation.So the interstitial fluid flow in the lacuna-canalicular system occures, namely load-induced fluid flow, when the mechanical load is distributed on the bone. This fluid flow affects the bone tissue through two mechanisms:regulating osteocyte metabolism and participating in the mechanotransduction. In conclusion, the mechanical load plays a vital role in maintaining health bone and regulating bone adaptation.

[Objective]To explore the correlation between anticardiolipin antibodies and post-SARS patients with osteonecrosis,investigate the etiology of post-SARS osteonecrosis,and select the sensitive molecular symbols for early diagnosis and distinguish the high risk population.[Method]The studied subjects were divided into two groups.Sixty-two post-SARS patients with osteonecrosis was one group,and 52 matched healthy people was as normal controlled group.Empty stomach blood samples from cubital veins were collected from both groups.IgA,IgG and IgM of anticardiolipin antibodies types were examined by ELISA.[Result]Twenty-one of 62 post-SARS osteonecrosis patients were tested at least one type of anticardiolipin antibodies positive,among them,with IgA(11.33?11.209)APL,IgG(5.127?5.927)GPL,IGM(17.821?10.606)MPL.Four of 52 control group persons were detected positive,with IGA(10.702?3.126)APL,IgG(5.184?4.780)GPL,IgM(14.684?5.516)MPL.There were significant differences between two groups,while,there were no difference in prothrombin time(PT),thrombin time(TT),prothrombin activity(PTA)and international normalized ratio(INR).[Conclusion]The study indicates an increased positive incidence of anticardiolipin antibodies in post-SARS patients with osteonecrosis.This has reflected that anticardiolipin antibodies may play a role in osteonecrosis.

Objective To summarize the clinical results of combined procedure of resections and constructions of bronchus,great vessels and heart in the treatment of 79 patients with central lung cancer.Methods From Jun,1988 to Jun,2005,the combined procedure of resections and constructions of bronchus,great vessels and heart were carried out in 74 patients with central lung cancer.The operations included ring of bronchus or sleeve lobectomy in 57 cases,double sleeve lobectomy in 15 cases,carinal resection and reconstruction in 4 cases.Results There was no operative deaths and 7(8.86 %) patients had operative complications.The survival rates of 12,36,60 months and 10 years were 78.5%,59.5%,35.4% and 17.7% respectively.Conclusion With the treatment of sleeve lobectomy or combined with resection and reconstruction of pulmonary artery,great vessels or heart,the pulmonary function can be protected significantly,and the cure rate and the long term survival rate can be improved in patients with central lung cancer.

Objective To evaluate the clinical application of transendoscopic Doppler ultrasonogra-phy in various gastrointestinal diseases. Methods Transendoscopic Doppler ultrasonography was performed in 59 patients with various gastrointestinal diseases. Results The Doppler signals were detected beneath the peptic ulcer base in 29 of 39 patients (74. 4% ) . For acute ulcer bleeding and non - bleeding, the Doppler - positive rates were 87. 5% and 65. 2% , respectively, and the measured depth of vessels were 0. 49 mm and 0. 65mm (P

BACKGROUND: Neuroprotective role of hypothermia on cerebral ischemic-reperfusional impairment has been long acknowledged. Since general hypothermia is complicated and unfit for observing postoperative consciousness and neurological function, it is of important significance to explore novel methods of focal cerebral hypothermia.OBJECTIVE: To study the neuroprotective effect of lateral ventricle infusion of low-temperature fluid on ischemic neurons of middle cerebral artery (MAC) occlusion models established on New Zealand rabbits.DESIGN: A randomized case-control study based on experimental animal models.SETTING: Neurosurgical department and pathological department of a general military hospital of Chinese PLA.MATERIALS: This study was carried out at Neurosurgical Laboratory of Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Altogether 18 healthy New Zealand male rabbits, weighing from 2. 8 to 3.2 kg, were selected 4 - 6 months after birth, and randomly divided into occlusion group, hypothermia group and control group.INTERVENTIONS: Cerebral focal ischemic-reperfusional model was established on the New Zealand rabbits through MCA occlusion for 2 hours followed by reperfusion for 24 hours.MAIN OUTCOME MEASURES: Scores for neurological function, water content in the left and right brain, pathological changes of nerve cells in the left MCA supplying region.pothermia group, significantly higher than that in occlusion group(7.58 ± 0.58 )( P ＜ 0.01 ), but no significant difference could be observed in contrast with brain was(81.64 ± 0.82)% and (79.26 ± 1.30)% in occlusion and hypothermia groups with significant difference between them( P ＜ 0.05), and it was significantly different between the left side [ (81.64 ± 0. 82 )% ] and opyknosis and deep staining could be observed in nerve ganglion cells in occlusion group under optical microscope, but no obvious pathological changes were observed in MCA supplying brain regions in hypothermia group.CONCLUSION: Permanent infusion of low-temperature fluid into the lateral ventricle plays an important neuroprotective role by attenuating cerebral ischemic-reperfusional impairment and improving post-ischemic neurological functions.

Objective To investigate haemodynamic change during hemodialysis and analyze effects of cardiac index (CI) on hemodynamic parameters and associated influencing factors in maintenance hemodialysis (MHD) patients.Methods Seventy-five patients bearing an arteriovenous fistula (AVF) entered the study.Cardiac output (CO),cardiac index (CI),central blood volume (CBV) and peripheral vascular resistance (PR) were determined by ultrasound dilution technique at the end of 1 hour,2 hours and 3 hours of dialysis.AVF blood flow (Qa) was also measured with the same device before haemodynamic parameters investigation.Results Mean age of patients was (55.84 ±12.39) years old (range 21-81 years) and 43 patients (57.3％) were female.Systolic arterial pressure,SV,CO,CI and CBV were significantly declined and no significant change for diastolic arterial pressure and heart rates at the end of 2 hour and 3 hour hemodialysis,whereas PR was increased gradually during hemodialysis.Patients were divided into there groups with CI less than 2.5 L·min 1·(m2)-1,2.5-4.2 L·min-1·(m2)-1 and more than 4.2 L·min-1 ·(m2)-1 at the end of 1 hour dialysis.Statistically significant decreasing SV,CO and increasing PR were detected in patients with CI＜2.5 L·min-1· (m2)-1 and 2.5-4.2 L· min-1· (m2)-1,compared with CI＞4.2 L·min-1· (m2)-1 group (P＜0.01).The hemodynamic change was the most obvious in the group of CI less than 2.5 L· min-1· (m2) 1,and no significant changes happened in CI＞4.2 L·min-1 ·(m2)-1 group.Some factors were found to be associated to CI values.Qa and systolic arterial pressure had positive relationship with CI,while age and diabetes had negative relationship with CI.Conclusions Systolic arterial pressure,CO,CI and CBV decrease and PR increases during hemodialysis.Obvious change occurs when CI is less than 2.5 L·min-1· (m2)-1.CI is associated with Qa,systolic arterial pressure,age and diabetes.

Objectives To study the expression patterns of steroid receptor coactivators (SRC) and steroid-induced stromal cell-derived factor-1 (SDF-1) in endometriosis,and to explore the roles of SRC in the steroid-induced SDF-1 expression endometriosis.Methods From May 2010 to October 2012,16 endometriosis cases at stages Ⅲ or Ⅳ according to the revised American Society for Reproductive Medicine classification undergoing surgery in the First Affiliated Hospital to Nanjing Medical University were enrolled in this study.Their ectopic endometrium were from ovarian endometriomata which were identified pathologically with 9 cases at proliferative phase and 7 cases at secretory phase.The normal endometrium were acquired from the healthy women with normal menstrual cycle (n =10,proliferative phase =5,secretory phase =5).The mnRNA levels of SRC and SDF-1α during the menstrual cycle were detected by quantitative real-time polymerase chain reaction.Ectopic endometrium stromal cells were purified and cultured in medium containing 17β-estradiol (10-8mol/L) or 17β-estradiol (10-8 mol/L) + progesterone (10-6 mol/L).At 24,48,72 and 96 hours,the supernatants were collected to measure SDF-1α expression by ELISA.Ectopic endometrium stromal cells were transfected respectively with siRNA of SRC-1 and SRC-2 using lipofectamine.Two days after transfection,17β-estradiol (10-8 moL/L) or 17β-estradiol (10-8 mol/L) + progesterone (10-6 mol/L) were added into the media.On the third day after the steroid hormones treatment,the media were collected to quantify SDF-1α expression with ELISA.Results (1) Cyclical changes: the SRC-1,SRC-2 and SDF-1 α showed marked cyclic differences in normal endometrium (P ＜ 0.05).In proliferative phase and secretory phase,the SRC-1,SRC-2 and SDF-1 α were 5.6 ± 1.2,3.8 ± 1.1,2.7 ± 0.5 and 2.6 ± 1.0,2.1 ± 1.0,1.6-± 0.5,respectively.There was no periodic variation in the expression of SRC-1,SRC-2 and SDF-1α in ectopic endometrium throughout the menstrual cycle.(2) Steroid-induced SDF-1α expression in ectopic endometrium stromal cells: the 17β-estradiol-induced SDF-1α expression was (1 803 ± 196),(2 272 ± 261) and (2 162 ± 258) ng/L at 48,72 and 96 hours.At the same time points,the SDF-1α expression induced by 17β-estradiol and progesterone was (1 307 ± 150),(1 518 ± 301) and (1 550 ± 144) ng/L,respectively.There was significant difference between two groups (P ＜0.05).(3) The effects of SRC silencing on steroid hormones-induced SDF-1 α expression in ectopic endometrium stromal cells: the expression of 17β-estradiol-induced SDF-1α at 72 hours was significantly decreased from (2 313 ± 357) ng/L to (1 155 ± 244) ng/L after the silencing of SRC-1 (P ＜ 0.05).After the silencing of SRC-2,the 17β-estradiol-induced SDF-1 α at 72 hours was (1 958 ±324) ng/L.There was no significant difference compared with the before the silencing (P ＞ 0.05).The expression of SDF-1 α at 72 hours induced by 17β-estradiol + progesterone was (1 534 ± 449) ng/L and (2 051 ± 380) ng/L respectively before and after the silencing of SRC-2 and showed the significant difference (P ＜ 0.05).Conclusion During the expression of SDF-1 α regulated by steroids in ectopic endometrium cells,SRC-1 is the major coactivator of 17β-estradiol and SRC-2 is the major coactivator of progesterone.

When we did compatibility testing, we found a case of leukemia with irregular antibody. The antibody specificity was identified as anti-Ce using panel-cell, and was IgG antibody. The anti-Ce antibody had both anti-C and anti-e activity. It is very difficult to find a Ce antigen negative blood for transfusion. The compatible donors rate is very low, only 2%-3%.