Bendamustine is a kind of nitrogen mustard derivatives consisting of a 2-chloroethylamine alkylating group and a benzimidazole ring.This special structure grants its anti-cancer mechanism different from other common alkylating agents with double function.Since approved,bendanustine has been widely used to treat henatologic malignancies and solid tumors such as breast cancer.In 2008,the FDA approved bendamustine injection for the treatment of chronic lymphocytic leukemia and indolent B cell non-Hodgkin's lymphoma.In recent years,scholars in China and abroad have carried out a series of clinical researches on single bendamustine and bendamsutine combinational chemotherapy,especially in hematologic malignancies,which obtained certain clinical efficacy.In this paper,the pharmacological actions,pharmacokinetics and clinical progress of bendamustine in lymphoma and leukemia are reviewed.

152 patients with pseudobulbar paralysis resulting from ischemic cerebral infarction were treated with polysaccharide sulphate (PSS) or Troxerutin (TR) and their clinical curative effect and laboratory parameters were studied. 76 patients (M46,F30,mean ages 62+6 y),were treated with PSS:PSS 150 mg in 5% Glocose Solution 500 mL iv. drip. qd,for 14 days as a course. The other 76 patients (M46,F30,mean age 63 + 7 y) were treated with (TR);TR 600 mg in hydroxyethyi-starch 500 mL iv. drip ,qd .for 14 days as a course. The results showed that the total effective rates of the two groups were 94. 74% and 77. 63% .respectively. Moreover the plasma levels of cholesteral and triglyceride were decreased significantly ( P

Objective To evaluate the clinical value of minimally invasive methods for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation during recent 10 years in Liver Transplantation Center at General Hospital of Guangzhou Military Commanmol were analyzed retrospectively,and 13 patients with NABS were selected.The outcomes of 3 types of NABS patients treated by endoscopic retrograde cholangiopancreatography(ERCP) or percutaneous transhepatic cholangial drainage(PTCD) were compared and the indication for re-transplantation was identified.Results PTCD treatments of 4 patients were proved ineffective.The shortterm curative rate of minimally invasive treatments was 8/13.Five patients eventually required surgical treatments (re-transplantation in 4,Roux-en-Y anastomosis in 1).According to cholangiography results,NABS were divided into 3 types,namely hepatic bile duct strictures (n =4,type Ⅰ),multiple extra-hepatic and intrahepatic biliary strictures (n =7,type Ⅱ),intrahepatic biliary strictures (n =2,type Ⅲ).The success rates of minimally invasive treatment in 3 types of NABS were 3/4,4/7 and 1/2,respectively.Nearly half of type Ⅱ and type Ⅲ patients needed re-transplantation,which was more likely for those patients with hepatic artery stenosis (2/3).Conclusion NABS treated with minimally invasive methods are preferred.Based on the appearance of biliary stricture,type Ⅰ patients had the best prognosis.For those type Ⅱ and type Ⅲ patients who failed minimally invasive treatment,especially combined with hepatic arterial stenosis,surgical treatment should be timely,so as not to lose a chance for re-transplantation.

Objective To investigate the diagnosis and treatment of latent perforation of peptic ulcer (LPPU) during laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 13 cases of LPPU diagnosed during LC from January 1994 to November 2005. Results All the 13 cases were misdiagnosed before the LC and clarified as having LPPU during the LC. Three cases of anterior duodenal bulbar perforation (0.4~0.5 cm in size) were laparoscopically repaired, whereas conversions to open repair were performed in 5 cases of duodenal perforation (0.5~1 cm in size) and 5 cases of gastric perforation (0.6~1 cm in size) because of severe adhesion or difficult performance. No surgical complications occurred. Twelve cases were followed for 6~36 months (mean, 27 months). The symptoms disappeared and gastroscopy showed healed ulcer. No recurrence of perforation was found. Conclusions Underestimation of LPPU leads to misdiagnosis, and preoperative gastrosopy can prevent it. For small perforation, laparoscopic repair and abdominal drainage can be employed. But in most cases, a conversion to open surgery is required. It is necessary to give regular internal medicine for peptic ulcer after operation.

Objective To investigate laparoscopic treatment of hepatic cysts in the right posterior lobe.Methods A four-port laparoscopic fenestration and drainage was performed in 35 patients with symptomatic hepatic cysts in the right posterior lobe(the lesion was located at the segment Ⅳ in 21 patients and at the segment Ⅶ in 14 patients) from January 1998 to December 2005.For cysts located at the superior segment of the right posterior lobe,the operation was performed through the suprahepatic approach. The liver was pressed along the anterior and inferior direction by using a pair of traction tongs for the exposure of hepatic cysts.Then the cyst was fenestrated and filled with pedicled greater omentum.For cysts located at the inferior segment of the right posterior lobe,the operation was conducted through the infrahepatic approach.The hepatocolic ligament,right triangular ligament,and connective tissues between the liver and the kidney were opened by using a harmonic scalpel.The liver was lifted with the traction tongs,and the cyst was fenestrated and filled with greater omentum.Results Laparoscopic fenestration and drainage was accomplished in all the 35 patients,without conversions to open surgery.The suprahepatic approach was adopted in 15 patients and the infrahepatic approach,in 20 patients.The operation time was 30～95 min(mean,46 min).No surgery related complications occurred.Pathological examinations in the 35 patients showed congenital cysts of liver.After operation,patients' symptoms all disappeared.The postoperative hospitalization time was 2～5 days (mean,3.8 days).All the 35 patients were followed for 6～36 months(mean,34 months).The cyst did not completely disappeared but significantly subsided in 2 patients(suprahepatic approach),without remarkable symptoms.The cysts were not obviously enlarged within 6 months.Conclusions Laparoscopic fenestration and drainage via suprahepatic or infrahepatic approach is an effective treatment for hepatic cysts in the right posterior lobe.

Objective To study the feasibility of ultrasound-guided interventional therapy for parovarian cysts. Methods Diagnostic characteristics of 82 patients preoperatively diagnosed as having parovarian cysts were analyzed, and their clinical parameters were compared between 27 patients receiving ultrasound-guided interventional therapy and 55 patients receiving open or laparoscopic operations. Results Ultrasound examination was the principal means of diagnosis of parovarian cysts. The diagnostic accordance rate was 95.3% (82/86). The operative time, intraoperative blood loss and hospitalization costs in patients receiving ultrasound-guided intervention significantly decreased as compared with those receiving open or laparoscopic operation ( t =-20 798, 65 356, -184 533 , respectively; P =0 000). There were no significant differences in the postoperative recurrence rate and pyrexia rate between the two groups ( ? 2 =0 000, P =1 000; ? 2 =0 373, P =1 000). Conclusions Ultrasound-guided interventional therapy for parovarian cysts is feasible and offers satisfactory effects.

Objective To investigate the clinical features of intrahepatic arteriovenous shunt(AVS) in patients with hepatic carcinoma. Method The clinical data including results of therapy of 538 hepatic carcinoma patients admitted between 1996 and 2001 were retrospectively reviewed. Results There were 71 cases of AVS altogether with 61 cases of arterio-portal shunt and 8 cases of hepatic arterio-venous shunt. Thirty out of 39 AVS cases with fistula formed between hepatic artery and main portal branch developed portal hypertension. The patients received a total of 84 sessions of transarterial chemotherapy and embolization(TACE) with a success rate of 61%(51 sessions).After TACE liver failure ensued in 3 cases. The mean survival time of these patients was 5.77 months. Conclusion Arterio-portal/venous fistula is a common complication among hepatic carcinoma patients which often predicts poor prognosis. A high percentage of AVS patients will not tolerate TACE and in which the portal hypertension will be exacerbated.

Objective To study the value of HEART scores in predicting the risk of getting acute coronary syndrome in patients with chest pain and assessing the prognosis in order to elucidate the validity of the HEART scores.Methods A total of 1 200 patients with chest pain were continuously observed and followed up,and their HEART scores were calculated.The survival rates were calculated with Kaplan-Meier method and AUROC (area under ROC curve) was used to determine the accuracy of this methods.The HEART scores were compared with TIMI and GRACE scores.Results Low HEART scores (0-3) were found in 34.5％ of the patients and MACE (major adverse cardiac event) occurred in 1.4％ of them.The patients with intermediate HEART scores (4-6) accounted for 50.7％ patients,and MACE was diagnosed in 22.2％ of them.High HEART scores (7-10) were found in 14.85％ patients,and MACE occurred in 60.7％ of them.There was significant difference among these three groups (Log rank P ＜ 0.01).The AUROC of HEART score was 0.83 (95％ CI:0.80-0.85,P ＜0.01),being significantly higher than the GRACE scores (0.76) and TIMI scores (0.72).Conclusions The HEART score is applicable for predicting the risk of getting acute coronary syndrome of chest pain patients in emergency department and the prognosis.

The donated organ after cardiac death would undergo warn ischemia injury inevitably,and the incidences of primary non-function of donated organs,transplanted organ loss and ischemic-type biliary lesions were increased.It is a paramount research dilemma to devise how to avert,lessen and recover the warm ischemia organs after donation of cardiac death (DCD).Since February 2009,the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation (ECMO) to protect the organs of DCD.The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation,and it is an important method to solve the problem of donor shortage in China.Spreading the application range of ECMO in DCD and establishing the standard procedures and techniques in China is of great importance.

AIM: To compare the clinical effect of Tianshu Capsule(Rhizoma Chuanxiong,Rhizoma Gastrodiae,efc) on migraine with Flunarizine. METHODS: 82 cases of patients with migraine were divided randomly into the treatment group(40 cases),which were treated with oral Tianshu Capsule,4 capsules(1.36 g),3 times daily after meals,and the control group(42 cases),which were treated with Flunarizine(Sibelium) 5 mg quaque nocte,for 2 months.One year follow-up was carried out.The frquency and duration of migraine were analyged before and after treatment,and duration of positive results after withdraw of drugs were also recorded.The body weight,blood and urine routine,liver and kidney function as well as electrocardiograph were compared before and after treatment. RESULTS: In the treatment group the frequency and duration of migraine decreased more than that of control group.The positive results remained longer in the Tianshu Capsule group(P