Objective To investigate the long-term efficacy of nonmyeloablative autologous peripheral blood stem cell transplantation(NAST) to cure refractory autoimmune disease(AD).MethodLong-term follow up of four cases of AD patients with NAST were summarized.The pretreatment regimen was intravenous injection of cytarabin (200 mg· kg-1· d-1 ) and cyclophosphamide (40 mg· kg-1· d-1).The therapeutic effect was evaluated by the change of symptoms and signs and long term complications.Changes of immune function were detected by flow-cytometry.ResultsFive cases of patients had been successfully engrafted.The average time for peripheral leucocytes count to reach 4.0×109/L was 12 days.It needed 10 days for platelets to return to 100×109/L and 22 days for hemoglobin to 120 g/L.Apparent remission of symptoms and signs was observed after transplantation.Lymphocyte subtypes analysis pre- and post- NAST showed that count of CD4+ and the ratio of CD4 +/CD8 + was returned to normal.One patient gave birth to a healthy baby four years after transplantation.Three female patients returned tonormal life. Conclusions Compared with classical myeloablative stem cell transplantation,NAST has a rapid hematopoietic recovery and good long-term therapeutic effect in AD.The quality of life in AD patients treated with NAST is higher than those treated with myeloablative hematopoietic stem cell transplantation.

Objective To investigate the feasibility and potential advantages of RapidArc applied to the radiotherapy of the postoperative rectal cancer.Methods 8 postoperative patients with rectal cancer were selected to be treated with a dose of 50Gy in fraction of 2Gy every time and 5 times a week.IMRT and RapidArc were used respectively to compare different target conformities,homogeneity index,dose-volume histogram data,treatment times and monitor units.Results The conformal index by RapidArc was 0.89±0.02 which was better than those by 5F-IMRT,0.87±0.02 (t =3.286,P ＜ 0.05),while the homogeneity index of target volume (1.060±0.005) and average dose [(52.55±0.76) Gy] by RapidArc were a little less than the homogeneity index of target volume (1.064±0.007) and average dose [(52.90±0.82) Gy] by 5F-IMRT (t =-1.459,-1.000,P ＞ 0.05).The exposure dose and mean dose of bladder and small bowel in high dose region by RapidArc were lower than those by 5F-IMRT,as well as bone marrow.The differences were statistical significant (P ＜ 0.05).The monitor units by RapidArc and by 5F-IMRT were (631±68) MU and (1046±146) MU,respectively (t =-5.830,P ＜ 0.05),while the mean treatment times were (78±5) s and (348±29) s,respectively (t =-26.358,P ＜ 0.05).Conclusion Compared with 5F-IMRT,RapidArc improves the target conformities and lowers the exposure dose for the organs at risk in high dose region while using fewer monitor units and less treatment time,which helps comforting patients and improving the efficiency.

Objective To compare the clinical efficacy and safety of two different conditioning regimens in nonmyeloablative autologous peripheral blood stem cell transplantation (NAST) for the treatment of systemic lupus erythematosus (SLE).Methods Different conditioning regimens were used in two groups:cytarabin combined cyclophosphamide in group 1 and ATG combined cyclophosphamide in group 2.Different recovery time of leucocytes,neutrophils and platelets in the two groups were compared.Statistical analysis were carried out by paired t-test.Results The mean time for peripheral leucocytes reaching 1.0×109/L,neutrophils getting up to 0.5×109/L,platelet raising to 100×l09/L and hemoglobin rising to 120 g/L in group 1 were [(7.2±1.3),(8.0±1.5),(10.5±1.4),(22.1±2.3)days] and [(10.4±2.1),(12.0±1.9),(19.3±2.1),(28.1± 2.4)] days in group 2.The difference was statistically significant (P＜0.01).CD4+ cell count and the ratio of CD4+/CD8+ of pre- and pro-NAST was changed.No significant differences were observed in the two groups.Conclusion For the sake of safety and hematopoietic reconstitution,we recommend cytarabin combined cyclophosphamide as the preferred conditioning regimen.

Objective To explore the diagnostic value of endoscopic ultrasonography(EUS)for the minimal submucosal invasion of early gastrointestinal tumor. Methods A total of 242 patients with early gastrointestinal tumor,who underwent endoscopic submucosal dissection,were retrospectively analyzed. The accuracy of EUS diagnosis was calculated based on postoperative histopathological findings as the golden standard,and influencing factors were also analyzed. Results Overall diagnostic accuracy of EUS for sub-mucosal invasion of early gastrointestinal tumors was 72. 3%(175/ 242),with an overstaging rate of 21. 5%(52/ 242)and an understaging rate of 6. 2%(15/ 242).Tumor size(P = 0. 018)and location(P = 0. 005) had significant effects on the diagnostic accuracy of the minimal submucosal invasion of early gastrointestinal tumor by EUS. The overstaging rate in the lesion length of diameter>3 cm was higher than those of 3 cm or less[27. 0%(33/ 122)VS 15. 8%(19/ 120),P = 0. 807],the overstaging rates of early colonrectal and gastric cancer were also significantly higher than the understaging rate[ Colonrectum:12. 2%(9/ 74)VS 2. 7%(2/ 74),P= 0. 028;Stomach:26. 9%(28/ 104)VS 2. 9%(3/ 104),P = 0. 000]. Conclusion Endoscopic ultrasonography is of diagnostic value for the invasion depth of early cancer in gastrointestinal tract. However,precaution should be taken in large lesions and the tendency of overstaging in gastrointestinal tract.

Objective To analyse the efficacy of microvascular decompression for hemifacial spasm (HFS) caused by vertebral basilar artery compression. Methods A total of 141 patients with HFS treated by microvascular decompression in our hospital were collected in this study. The improvement of the symptoms after operation was compared between patients with HFS caused by vertebral basilar artery compression (28 cases) and patients with HFS caused by non-vertebral basilar artery compression (113 cases). Results There was no significant difference in the effective rate between the two groups of HFS (96.43%vs. 98.23%,P=0.49) with mean following-up 13.81 ± 1.57 months. And there was no significant difference in the delayed cure rate after surgery between two groups (37.04%vs. 20.72%,χ2=1.38, P>0.05). Conclusion Microvascular decompression is a safe and effective method for the treatment of HFS caused by compressed vertebral basilar artery.

Objective:To evaluate the value of conventional ultrasound, shear wave elastic parameters and immunohistochemistry in predicting axillary lymph node metastasis of breast cancer.Methods:The ultrasonographic features and pathological results of 172 masses in 152 breast cancer patients who underwent surgery in the First Affiliated Hospital of Shihezi University Medical College from May to October 2020 were analyzed retrospectively. The patients were divided into metastatic group and non-metastatic group according to the status of axillary lymph nodes. The conventional ultrasound characteristics, shear wave velocity (SWV) and immunohistochemical indexes (ER, PR, HER-2, Ki-67) of 2 groups of breast cancer masses were analyzed. Finally, the parameters with statistically significant difference between groups were selected and the Logistic regression model was established.Results:There were significant differences in the aspect ratio, calcification, SWVmean and HER-2 expression between metastatic group and non-metastatic group (all P<0.05). A prediction model was constructed with aspect ratio >1, calcification, high SWVmean and HER-2(+ ). The area under receiver operating characteristic curve (AUC) of the subjects was 0.891, which was larger than the single parameter (all P<0.05), and was in good agreement with pathological results (Kappa=0.731). Conclusions:The joint prediction model can be used to predict the status of lymph nodes, and the axillary lymph node metastasis is more likely to occur in breast cancer with the aspect ratio >1, calcification, high SWVmean and HER-2(+ ).

Objective:To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) after pancreaticoduodenectomy and endoscopic selection strategies.Methods:Clinical data of 34 patients treated with ERCP after pancreaticoduodenectomy at the Endoscopic Center of the First Affiliated Hospital of Air Force Medical University from January 2013 to December 2021 were retrospectively analyzed. The success rates of endoscopic insertion, diagnosis, treatment and ERCP, and the incidence of adverse events were analyzed.Results:Fifty ERCP treatments were performed in 34 patients. The success rates of endoscopic insertion, diagnosis, treatment, and ERCP after pancreaticoduodenectomy were 92.0% (46/50), 93.5% (43/46), 88.4% (38/43) and 76.0% (38/50), respectively. The success rates of ERCP assisted with colonoscope and balloon-assisted enterosocpe were 76.0% (19/25) and 75.0% (18/24), respectively. There were 3 adverse events, including 1 case of anastomotic mucosa tear during surgery, 1 case of cardiopulmonary arrest and 1 case of postoperative cholangitis.Conclusion:ERCP is effective and safe after pancreaticoduodenectomy in general. ERCP assisted with colonoscope and balloon-assisted colonoscope shows similar success rate after pancreaticoduodenectomy.