Objectives To explore the clinical effect of external fixator combined antibiotic-calcium sulfate packing medullary cavity, VSD continuous drain with negative pressure and local skin flap transposition for the treatment of postoperative infected nonunion after initial debridement. Methods 20 cases of traumatic osteomyelitis from August 2012 to August 2014 were selected and taken antibiotic-calcium sulfate to focal zone. The patients were taken first-stage bone grafting for small bone defects and osteotomy for lengthening for big bone defects. For patients with cutaneous injury, local skin flap transposition was taken. For other patients with partial flap necrosis and non healing wounds, VSD continuous drain with negative pressure was taken. Results Operative incisions of 12 cases were primary healing, two cases were healing by second intention, four cases of flap were survived after local skin flap transposition, and two cases of flap were partial necrosis and healed by second intention. 11 cases of immobilization with external fixator, bone healing was satisfactory in seven cases after osteotomy for lengthening and two cases of bone delayed union in osteotomy for lengthening and recovered after bone transplantation. All patients were followed up for average 19(6-32) months with permatoplasty survived; all the infection of wounds was controlled and relapse-free. The fracture healing period was eight(4-12) month without pin site infection, osteoporosis and deformed healing. But there were 1 cases of knee stiffness and two cases stiffness of ankle joint. Conclusion After initial debridement, taken external fixator and taken antibiotic-calcium sulfate to medullary cavity and fracture ends. The patients were taken first-stage bone grafting for small bone defects and osteotomy for lengthening for big bone defects. For the skin defect after local flap grafting, taken VSD continuous drain with negative pressure for partial necrosis of flap occurred and non healing wounds cases. The method obtained prominent curative effect, reduces the treatment cycle and reduce the complications in the treatment of postoperative infected nonunion.

Sulforaphane (SFN) is an isothiocyanate rich in cruciferous vegetables, and is one of the plant active substances with strong anticancer activity. SFN can protect cells from environmental carcinogens and induce growth arrest and apoptosis of various cancer cells. This article reviews the research progress of SFN in tumor prevention, treatment, and its role in tumor stem cells, explores the feasibility of SFN in clinical application for cancer prevention, and provides new strategies to reduce the development and recurrence of malignant tumors and improve patient survival.

Objective: To explore the efficacies of regimens of three-drug induction therapy (ATRA+ATO+anthracyclines) versus two-drug induction therapy (ATRA+ATO) in patients with acute promyelocytic leukemia (APL). Methods: Of 184 patients diagnosed with APL from January 2009 to March 2016, 58 patients underwent three-drug induction therapy, while the rest were treated with two-drug induction therapy. Three-drug induction therapy was of ATRA (20 mg·m^-2·d^-1, d_1-28) + ATO (0.16 mg·kg^-1·d^-1, d_1-28) + Idarubicin (8 mg·m^-2·d^-1, d_3-5) /daunorubicin (40 mg·m^-2·d^-1, d_3-5) , while two-drug induction therapy ATRA+ATO with the same doses and methods as above. Of 184 cases, 69 cases accompanied with WBC counts>10×10⁹/L, 115 cases with WBC counts≤10×10⁹/L at onset. Results: ①Short-term efficacy: After one cycle induction therapy, the rates of hematologic remission, genetic remission, molecular remission and induced differentiation syndrome (DS) in three-drug regimen group were 98.3%, 87.9%, 72.4% and 0 respectively, while those in two-drug regimen group were 87.3%, 65.9%, 51.6% and 12.7% respectively. In patients with WBC >10×10⁹/L, DS rate and early mortality in three-drug regimen group were lower than in two-drug regimen group (0 vs 15.6%, 4.2% vs 15.6%, respectively). In patients with WBC≤10×10⁹/L, DS rate in three-drug regimen group was also lower than in two-drug regimen group (0 vs 12.3%) , but there were no statistical differences in terms of relapse and early mortality. ② Long-term efficacy: The relapse rate, overall survival (OS) and disease free survival (DFS) in three-drug regimen group were 0, 98.5%, 96.6% respectively, while those in two-drug regimen group were 8.6%, 86.5% and 84.1% respectively; the advantages of three-drug over two-drug regimen, especially in cases of WBC >10×10⁹/L were observed. ③ Side effects: the incidences of gastrointestinal reaction, liver dysfunction, myocardial damage and headache in three-drug regimen group hardly increased. Conclusion The efficacies of three-drug induction therapy were superior to two-drug one.