Anemia, Aplastic ; mortality ; pathology ; therapy ; Child ; Disease-Free Survival ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Risk Factors ; Severity of Illness Index ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors

Osteoarthritis ( OA) is a chronic joint disease characterized by degeneration of articular cartilage and changes of subchondral bone play an important role in the occurrence and development of OA .Recent studies have found that change in the struc-ture and mechanical properties of subchondral bone is one of the main pathological processes in OA .To confirm the role of subchondral bone in OA process can provide not only more details about the pathogenesis of OA , but also new targets for treatment .Early diagnosis and treatment of OA may be possible by detecting radiographic and genomics of subchondral bone .We review subchondral bone chan-ges andits role in OA process in aspects of biomechanics , biology, radiological and genomics .

Objective To observe the efficacy and safety of intravitreal injection of conbercept for wet age-related macular degeneration.Methods Retrospective clinical study.Sixty eyes of 60 cases diagnosed as wet age-related macular degeneration (AMD) definitely were intravitreally injected conbercept 0.5 mg from March 2014 to March 2016.Follow-up time was 6 months to 12 months,averaged (8.5 ± 2.4) months.Visual acuity (ETDRS charts letter),central macular thickness (CMT),leakage of choroidal neovasculaxization (CNV) and area of CNV and complications before and after the treatment were analyzed.Results Conbercept injection therapeutic times were 1-5,the average therapeutic times were 2.80 ± 0.89.At 1 month,2 months,3 months and 6 months after treatment and the last follow up,the mean letter of ETDRS charts increased (14.76 ± 5.89) letters,(19.88 ± 7.13) letters,(24.75 ± 6.74) letters,(23.94 ±6.15) letters,(22.89 ± 8.53) letters compared with pre-operation,respectively (all P ＜0.05).CMT decreased (70.19 ± 60.56) μm,(82.07 ± 57.97) μm,(95.40 ± 87.92) μm,(97.57 ± 46.68) μm,(107.46 ± 56.82) μm compared with pre-operation,respectively (all P ＜ 0.05).Before treatment,the area of CNV leakage was (12.32 ± 5.67) mm2,and at postoperative 3 months,6months the area were statistically significant different (all P ＜ 0.05).Four cases had subconjunctival flake bleeding,intraocular pressure increased slightly in 3 cases and they all recovered at 1 week after treatment.There was no serious ocular and system complication.Conclusion Intravitreal injection of conbercept for wet AMD can improve the visual acuity,decrease CMT and inhibit the CNV regression without serious complication.

Objective: To establish an HPLC method for the determination of kaempferitrin in Celastri Orbiculati Fructus and to compare the quality of samples from different habitats in northeast China. Methods: The extracts were obtained by methanol ultrasonic method and kaempferitrin was determinated by HPLC. Chromatographic separation was achieved on an Agilent Zorbax Eclipse Plus C18 column (250 mm × 4.6 mm, 5 μm) at 30℃ and the mobile phase was a mixture of methanol- 0.01 mol/L solution of potassium dihydrogenphosphate -glacial acetic acid (40:60:15). The flow rate was 1.0 mL/min and the detection wavelength was 254 nm. Results: The linearity range was 0.092 7-0.926 7 μg (r = 0.999 8), average recovery was 100.8%, and RSD = 1.1% (n = 6). Conclusion: This method is validated in terms of selectivity, linearity, precision, and accuracy. It can be used as the effective method for quality control. The determination results show that the longer the fruit sits followed by picking, the less contents it has.

Objective To evaluate the clinical diagnostic contribution of 18 F-FDG PET/CT in giant cell arteritis with initial presentation as fever of unknown origin (FUO).Methods Eight cases with initial presentation as FUO diagnosed with the contribution of PET/CT were retrospectively studied in Peking Union Medical College Hospital.The radiologic manifestations of PET/CT were analyzed.Results Eight patients (4 men and 4 women) with average (63 ± 7) years (range from 55-75 years) were included in our study based on the criteria.Non-specific clinical symptoms were common in these patients,including fatigue,night sweat and weight loss.They all suffered from anemia of chronic disease.Not surprisingly,the inflammatory parameters were elevated significantly in all patients.The medical history,physical examination and routine lab and radiologic examinations couldn't reveal the causes of fever.PET/CT was performed in all of them,which demonstrated intense 18F-FDG uptake in the area of aorta and its major branches with maximal standard uptake value (SUVmax) 2.1-4.6 (3.6 ± 0.9).Immunosuppressive agents were effective to control the inflammation activity.The SUV decreased significantly after treatment in the follow-up PET/CT.Conclusions PET/CT has demonstrated high yield of diagnostic contribution in giant cell arteritis with initial presentation as fever of unknown origin.As to elderly FUO patients presenting with prominent inflammatory reaction,PET/CT may provide potential value to differentiate diagnosis from maligancies.

Objective To assess the function of motor nerve fiber in patients with diabetic peripheral neuropathy (DPN) by single-fiber conduction studies.Methods According to the diagnostic standard of DPN issued in Toronto meeting in 2009,on the basis of the result of peroneal nerve conventional conduction study,a total of 65 patients with DPN in the Department of Endocrinology and the Department of Neurology of Tianjin Third Central Hospital from October 2012 to October 2013 were enrolled into the study,from whom 33 had abnormal sensory conduction (sensory-diabetic peripheral neuropathy group,S-DPN group),32 had abnormal sensory motor conduction (sensory motor-diabetic peripheral neuropathy group,SM-DPN group).Single-fiber conduction velocity (SF-CV) and single-fiber distal motor latency (SF-DML)were detected in all subjects.The obtained results were compared with the data from 34 healthy volunteers (control group).The relationship of SF-CV,SF-DML and the duration of diabetes mellitus,fasting glucose,HbA1 c was also studied in DPN patients.Results The SF-CV ((43.1 ± 3.6) m/s) was decreased in S-DPN group compared with control group ((47.5 ± 3.3) m/s,t =5.077,P ＜ 0.01).There were no significant differences in SF-DML ((3.6 ± 0.7) ms),motor nerve conduction velocity (MCV (49.5 ± 2.6)m/s) and DML ((3.4 ± 0.6) ms) in S-DPN group compared with that of control group ((3.4 ± 0.5) ms,(50.9 ± 3.5) m/s,(3.2 ± 0.5) ms,respectively).SM-DPN group had lower SF-CV ((35.2 ± 3.6)m/s,t =9.119,14.219),MCV ((40.9 ± 3.2) m/s,t =11.131,13.025) and increased SF-DML ((4.5±0.7) ms,t=5.692,7.231),DML ((4.2 ±0.7) ms,t=5.561,6.975) compared with the other two groups (P ＜0.01).SF-CV in DPN patients was negatively related to the diabetic duration (r =-0.340,P =0.006),while SF-DML had no correlation with duration of DM,fasting blood glucose and HbAlc.Conclusions Detection of SF-CV is easy to find early motor nerve dysfunction in DPN patients.SF-CV is decreased with the increasing duration of diabetes.

Clinical characteristics were retrospectively analyzed in a patient with parathyroid crisis as the main symptoms of parathyroid adenoma and asymptomatic pheochromocytoma.This analysis was aimed to implement specific diagnosis and treatment and to accumulate experience in managing these diseases.

Objective To explore the clinical characteristics for patients with hemorrhagic transformation(HT) after acute cere‐bral infarction .Methods In this study ,retrospective analysis was performed for 48 patients HT ,which were classified as HI(n=45 ,93 .8% ) ,HI‐1(n=27) ,HI‐2(n=18);PH(n=3 ,6 .3% ) ,PH‐1(n=2) ,PH‐2(n=1) .PH‐2 admission NIHSS score was signifi‐cantly higher than other types of HT .CT scans and MRT were carried out ,infarction area were defined so that we could choose dif‐ferent treatments .Results The total cases with hemorrhage time within 1 -2 weeks after infarction was 28(58 .3% ) ,while 14 (29 .2% )occured within 1 week .The relationship between HT location and infarction area:25 cases(52 .1% ) occurred cerebral lobe infarction ,for which hemorrhage lesion was located in cortex and(or) subcortical;11 cases (22 .9% ) occurred deep brain parenchy‐ma infarction ,for which hemorrhagic lesion was located inside or on the edge of infarcts;8 cases were lobes and deep infarction ,3 cases were cerebellar infarction ,1 case was brain stem infarction ,all of the hemorrhagic lesion was inside the infarcts .The relation‐ship between HT and infarct size:31 cases(64 .6% ) occured secondary to large area acute cerebral infarction ,14 cases(29 .2% ) oc‐cured secondary to small area of cerebral infarction ,3 cases(6 .3% ) occured secondary to lacunar infarction .Hemorrhage of the HI patients was in the cortex and the subcortical white matter ,with shapes of deep brain dot ,patchy ,funicular or gyrus .Hematoma was formed in cerebral infarction for PH patients ,which mainly located in basal ganglia .Conclusion The HT occurrence is closely relat‐ed to the infarction area and size .Patients with Large area and cerebral lobe infarction have high opportunity for complication of HT .HT usually occurs within 1-2 weeks after cerebral infarction ,during which brain CT or MRI should be routinely reexamined .

Objective To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations.Methods PubMed,Ovid,EMbase,and the Cochrane Library were searched to identify clinical trials published up to December 2012.The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2;the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95％ confidence intervals (CI).Results Twenty-two studies involving 10106 patients were included in the meta-analysis.The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR =2.72,95％ CI=1.06-6.99,P=0.038),hypertension (OR=1.84,95％ CI=1.38-2.44,P=0.000),body mass index (OR =1.68,95％ CI=1.22-2.32,P =0.001),and radiotherapy (OR =1.65,95％ CI =1.20-2.25,P =0.002),while no significant associations were found for such factors as chemotherapy,age,number of positive lymph nodes,and number of dissected lymph nodes.Conclusions The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment,and axillary lymph node dissection,hypertension,body mass index,and radiotherapy are the main risk factors for lymphedema after breast cancer treatment.

Objective To investigate the nursing of replantation methods of sea-water soaked rotated avulsion amputated fingers.Methods There were 8 cases (16 fingers) with sea-water soaked rotated avulsion amputated fingers.5 cases were replanted by synchronic replantation method,the other 3 cases were replanted by traditional replantation method.We adopted complete debridement and high quality vascular anastomosis during the operation,and give hyperbaric oxygen therapy and anticoagulant treatment post-operation.Results There were 15 survival fingers in 16 replanted fingers.The survival rate was 93.75％.After follow-up for three months to two years,the total good rate was 87.5％.No wound infection and nonunion of fracture occurred.The outline of the fingers was satisfying and patients felt well.The twopoint discrimination was 3～6 mm after 3～24 months follow-up.Conclusions The injury of sea-water soaked rotated avulsion amputated fingers is complicated and the replantation operation is difficult.but if we can adopt individual measure according to the actual circumstance,it is possible that the sea-water soaked rotated avulsion amputated fingers can survive.