Objective To explore the role of the change of the CD11b expression in hyperleukocytosis and acute promyelocytic leukemia(APL) differentiation syndrome, we observed the effects of all-trans retinoie acid(ATRA) and trioxide arsenic(ATO) alone or the combination together with daunorubicin (DNR) on CD11b expression of human APL cell line NB4 cells. Methods By using the mono-antibody of CD11b FITC-conjugated, we monitored the level of CD11b expression of NB4 cells by flow cytometry. Results With the length of the 1 μmol/L ATRA exposure,the CD11b expression was increased. Exposed to ATRA for 24 h, 48 h, 72 h and 168 h;the CD11b expression of NB4 cell was (33.34±3.15)%, (55.59±5.13)%, (86.08±5.12)% and (90.69±2.69)%, respectively which were higher than control group and the difference was statistically significant (P<0.01). With the length of the 1 μmol/L ATO exposure, the CD11b expression showed no significant difference with control group(P>0.05), but was significantly lower than that in ATRA exposure(P<0.01). Exposed to 1 μmol/L ATRA combined with 1 μmol/L ATO for 72 h and 168 h, the CD11b expression were (18.81±1.40)% and (25.61±4.54)%, which were significantly higher than that in control group (P<0.05, P<0.01), but significantly lower than ATRA exposure (P<0.01). With the exposure to 1 μmol/L ATRA combined with 1 μmol/L ATO and 1 μmol/L DNR, the CD11b expression was also significantly lower than ATRA exposure (P<0.01) and showed no difference with control group (P>0.05). Conclusion By avoiding the increase of CD11b expression of promyelocytic leukemia cells, ATRA combined with ATO or two drugs together with DNR could play a role in eliminating incidence of hyperleukocytosis and retinoic acid syndrome.

Objective:To evaluate the value of adjuvant radiotherapy for stage Ⅱ endometrial cancer after surgery.Methods:40 patients with stage Ⅱ endometrial cancer with over five years follow up were analyzed vetrosectively.27 cases received subradical hysterectomy,and additional pelvic lymph node dissection in 13 cases.6 cases were treated with surgery alone.34 cases were treated with postoperative pelvic irradiation and additional vaginal brachytherapy in 12 cases.Results:The 5 year survival rate,pelvic failure rate and extrapelvic recurrence rate were 65%(26/40),17.5%(7/40),25%(10/40) repectively.The 5 year disease free survival rate,pelvic failure rate and extrapelvic recurrence rate were 70.5%(24/34),5.9%(2/34),29%(10/34) respectively in 34 patients with postoperative radiotherapy.5 cases with surgery alone recurrenced at the vaginal residual within two years.The late complications were 44%(15/34),including proctitis,cystitis and intestinal obstruction.Conclusion:Postoperative radiotherapy for stage Ⅱ endometrial cancer can improve the tumor local control and increase the late complications.

Adolescent ; Altitude ; Anaerobic Threshold ; physiology ; Drugs, Chinese Herbal ; therapeutic use ; Emigrants and Immigrants ; Humans ; Hypoxia ; physiopathology ; prevention & control ; Male ; Oxygen Consumption ; physiology ; Physical Endurance ; physiology ; Phytotherapy ; Young Adult

Chromatography, Gas ; methods ; Dimethoate ; blood ; Humans ; Insecticides ; blood ; Methyl Parathion ; blood

Objective:To introduce the Australian Life Saving Drugs Program ( LSDP) and provide references for medical assistance system for the rare diseases in China. Methods:The main content and characteristics of LSDP were analyzed and compared with the Chinese status quo valuation. Results:Through the orphan drug designation and cost-effectiveness evaluation, eligible drugs are included in LSDP and funded to the rare disease patients. LSDP stip-ulated the strict funding criteria and conditions, established the Guidelines and Disease Advisory Committees, and processed the post-market reviews program in order to guarantee the medication requirements of the patients. Conclu-sions:The Australian experience is worth learning and China should implement a country-led management system for the rare disease and orphan drugs, and explore a medical assisstance system in line with the Chinese national condi-tion based on the catastrophic medical insurances.

In top-quality course construction of medical ethics,it is necessary to attach importance to practical operation as well as the consistency of theoretical logic.To well adapt to the current medical practice and medical technical advances,the idea of medical ethics should include virtue,harmony and value.Virtue is the prominent concept in top-quality course construction of medical ethics.Harmony is the core idea of medical ethics,and value is the innovative idea to solve the questions caused by life technologies.Therefore,in the top-quality course construction of medical ethics,coordination and unification of the above three ideas must be maintained in order to defend the demonstration significance of top-quality course of medical ethics.

Objective To determine and compare the minimum local analgesic concentration(MLAC) of ropivacaine and bupivacaine in continuous block of axillary brachial plexus for postoperative active mobilization of flexor tendon. Methods Seventy ASA Ⅰ or Ⅱ patients undergoing relaxation of flexor tendon were randomly allocated into 2 groups (n = 35 each): ropivacaine group (group R) and bupivacaine group (group B). A catheter was inserted into axillary sheath using B. Braun stimulating intraducer, 24-48 h after operation. 30 min before functional exercise 20 ml of ropivacaine or bupivacaine was injected through catheter. The minimum local analgesic concentration of both local anesthetics was determined by up-and-down sequential test. The first concentration of both local anesthetics was 0.1%. The next concentration of local anesthetic was determined by response of the previous patient. The analgesia efficacy was assessed using 100 mm VAS score (0 = no pain, 100 mm = worst possible pain) . Increase/decrease in VAS by 10 mm was defined as effective. An effective result resulted in increase/decrease by 0.01% in the next patient. The motor block was also recorded.Results The two groups were comparable with regard to age, sex, body weight and baseline VAS score. The MLAC of ropivacaine was 0.133% [95% confidence interval (CI), 0.128%-0.138%] and MLAC of bupivacaine was0.121% (95%CI, 0.116%-0.126%). The analgesic potency of ropivacaine was 10% less than that of bupivacaine. The potency ratio of ropivacaine to bupivacaine was 0.91. The degree of motor block is higher with bupivacaine than with ropivacaine. Conclusion The results of our study show that the analgesic potency of ropivacaine is 10% less than that of bupivacaine. The degree of motor block is higher with bupivacaine than with ropivacaine.

Objective To study the value of adrenal venous sampling (AVS) in the differential diagnosis of primary aldosteronism (PA).Methods Fourteen patients (11 adenoma and 3 adrenal hyperplasia) clinically diagnosed as PA were examined with AVS for measurement of plasma aldosterone and cortisol levels.Selectivity of AVS was assessed by the aldosterone level in each adrenal vein and in the infrarenal inferior vena cava plasma.The data were compared with CT and postoperative pathologic result.Results The diagnosis of adenoma by AVS in 9 (9/11) cases was in accordance with the postoperative pathologic findings.The diagnosis of hyperplasia by AVS in all 3 cases was in accordance with CT scanning result.Conclusion AVS should be selected to distinguish the PA without overt occupational lesion in CT scanning.

Objective To discuss the difference of myopia prevalence and spherical equivalent among normal,exophoria and intermittent exotropia children.Methods The children aged between 6 years old to14 years old were divided into 3 groups of orthophoria (n =151),exophoria (n =180) and intermittent exotropia (n =168) based on the result of cover-uncover test.Intermittent exotropia group was divided into three types of basic,convergence insufficiency and divergence excess.Diopter values were retrospectively reviewed,and results were recorded with the average data after the objective optometry of cycloplegia.Results Myopia prevalence of intermittent exotropia of different ages was higher than normal and exophoria (all P ＜ 0.05),but no difference between exophoria and normal (all P ＞ 0.05).There were statistical significant differences in overall prevalence among three groups (intermittent exotropia and orthophoria:P =0.000,intermittent exotropia and exophoria:P =0.000,orthophoria and exophoria:P =0.034).Average spherical equivalent was (0.08 ± 0.99) D in orthophoric group,(-0.16 ± 1.16)D in exophoric group and (-1.23 ± 1.57)D in intermittent exotropic group,there was statistical difference among three groups (P =0.000).The differences were also statistical significant between orthophoria group and exophoria group (P =0.015),intermittent exotropia group and orthophoria group (P =0.000),exophoria group and intermittent exotropia group (P =0.000).In the group of intermittent exotropia,average spherical equivalent was (-1.68 ± 1.61) D in convergence insufficient group,(-1.14 ± 1.44) D in basic group and (-0.85 ± 1.50) D in divergence excessive group,there was statistical difference among three groups (P =0.000).The spherical equivalent in convergence insufficient group was lower than the basic group (P =0.000)and divergence excessive group (P =0.041).Conclusion The myopia prevalence and degree of intermittent exotropia are all higher than normal and exophoria in children.