Objective To observe the influences of different analgesic methods on blood sugar, stress hormones and cytokinesMethods According to different postoperative analgesic methods, 30 patients immediately after elective cholecystectomy, were randomly divided into four groups: normal saline was infused epidurally in group C as control; analgesia via epidural infusion of morphine 2 mg in group EM; patient-controlled analgesia via epidural or intravenous fentanyl in group PCEFA or group PCIFABlood sugar, cortisol, insulin, interlukin-2 (IL-2), interlukin-6 (IL-6) and tumor necrosis factor-?(TNF-?) levels were determined during the perioperative periodResults Postoperative visual analog score was higher in group C than that in group EM, group PCEFA or group PCIFA (P005)Conclusions Postoperative application of PCEFA can much more help to maintain the stability of neuroimmunoendocrinal system

Objective To explore the clinical efficacy of low-dose cytarabine and harringtonine (LD-HA) regimen in the induction therapy of acute myeloid leukemia (AML) except M3. Methods 52 AML patients who received LD-HA were analyzed retrospectively. The patients were graded according to molecular biological and cytogenetic risk degree. The clinical efficacy, toxicity of LD-HA and long-term survival followed-up were compared with those of idarubicin and cytarabine (IA) regimen in 49 patients. Results After one cycle, the overall remission (OR) rates of LD-HA group and IA group were 71.2%(37/52) [CR rate 50.0%(26/52), PR rate 21.2%(11/52)] and 53.1%(26/49) [CR rate 44.9%(22/49), PR rate 8.2%(4/49)], respectively, with no statistical significance of OR between the two groups (P= 0.068). OR rates were not statistically significant in either low-risk group or intermediate-risk group between LD-HA group and IA group (P> 0.05), but OR of high-risk group in LD-HA was much higher than that in IA group [100 % (11/11) vs 66.7 % (12/18), P<0.05]. Cardiac toxicity and bone marrow suppression in LD-HA group were much milder than those in IA group. The patients unfit for standard chemotherapy could tolerate to LD-HA regimen. Conclusions LD-HA regimen as induction for high risk AML patients can improve the OR rate, and reduce the side effects, which is beneficial for high-risk AML patients.

Objective To investigate the influence of C arm X- ray perspective computer auxiliary surgery navigation system on lumbar vertebral pedicle screw fixation in the elderly.Methods 286 patients(aged≥65 years) treated by lumbar spine post decompress and pedicle screw fixation for lumbar vertebral degeneration were divided into navigation (n=153) or non-navigation (n=133) groups.The amount of blood loss,surgery duration and time of beginning to walk after surgery were measured and compared, the improvement grading was determined by Oswestry disability index (ODI) before surgery and at the last follow-up. Results The surgery duration [(27.6+6.3)ain vs.(33.8±9.9)min],the volume of blood loss[(135.7±21.1)ml vs.(165.4±32.1)ml] and the time of beginning to walk after surgery[(134.6± 12.3)h vs.(169.0±23.9)h] were obviously reduced in navigation group as compared with non-navigation group (P ＜ 0.05). The grading improvement rate by ODI[(76.6±±3.7)％vs.(69.8+6.6)％] was higher in navigation group than in non navigation group (P＜0.05). Conclusions Using C arm X-ray perspective computer auxiliary surgery navigation system to lumbar pedicle screws fixation is helpful in the elderly for improving clinical efficacy.

Objective To investigate the influence of the two-dimension computer-aided surgery navigation system to the concordance of lumbar spine pedicle screw fixation on both sides.Methods 1355 patients were undergone lumbar spinal pedicle screw fixation during January 2004 to December 2009.All patients were divided into tow groups:the navigation group (743cases) and the fluoroscopy assistant group (612 cases).All patients got standard A-P and lateral X-ray plate of lumbar spine within seven days after surgery.The X-ray images were analyzed by the software of Image-pro plus 5.0 to evaluate the concordance of lumbar spine pedicle screw fixation on both sides.The angle between axial line of pedicle screw and superior lamina terminals (α angle) and the angle between axial lines of pedicle screw on both sides (γangle) were measured.The position of the pedicle screw was checked weather it was in the lumbar pedicle partially.Results There were no significant differences (P＞0.05) between the α angle on both sides of L1-S5 vertebral body in navigation assistant group (L:3.89°±0.47°,R:3.94°±0.37°).The differences of the α angle on both sides of L2 (L:4.55°±1.27°,R:5.12°±1.87°) and L4 (L:4.22°±1.89°,R:6.62°±1.97°) vertebral body in the fluoroscopy assistant group had statistical significance (P＜0.05).There were no significant differences between the α angle on both sides of other bodies (L:4.32°±1.47°,R:4.37°±1.59°,P＞0.05).The γangle in navigation assistant group (2.32°± 0.27°) was obviously smaller than fluoroscopy assistant group (3.32°±1.51°),the differences had statistical significance (P＜0.05).Accuracy of pedicle screw in navigation assistant group was 91.5％ (3604/3938).Accuracy of pedicle screw in fluoroscopy assistant group was 87.6％ (2426/2768).The difference in accuracy of pedicle screw in both groups had statistical significance (x2=26.913,P＜0.0001).Conclusion The accuracy of pedicle screw and the concordance of pedicle screw on both sides can be significantly improved using the two-dimension perspective computer-aided surgery navigation system.

OBJECTIVE To investigate the epidemiological conditions of bacterial colonization in respiratory tract,and antibiotic resistance under the antibiotic pretreatment in liver transplanted patients. METHODS From Oct 2002 to Jan 2005,121 liver transplanted patients were admitted to ICU.Among them,45 patients who were intubated more than 48 hours were included in this study.All of the patients received antibiotic pretreatment after operation.Sputum specimens were collected after 24 hours and 48 hours in ICU via the intubated tube with bronchoscopy. RESULTS Thirty nine pathogens were isolated from 36 patients during 48 hours.Pseudomonas aeruginosa was the predominant pathogen.Only 8 bacilli were susceptible to the antibiotics. CONCLUSIONS Although antibiotic pretreatment performed,bacterial colonization in respiratory tract emerges early in liver transplanted intubated patients.Antibiotic pretreatment may make the susceptible bacteria escape.

Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; therapy ; Protein-Tyrosine Kinases ; antagonists & inhibitors

Objective To study the calculational method for the radiotherapy facilities of the medical linear accelerator' s useful beam towars its maze.Methods The shielding calculation was made under the relevant national standards for a radiotherapy treatment room and compared with the test results.Results The dose rates at the maze entrance as calculated and measured were 89 and 86 μSv/h inside the maze door,as well as 5.7 and 6.2 μSv/h outside the maze door,respectively.The calculated results were consistent with measured results.Conclusions By comparison of calculated results with measured results,the accuracy of the theoretical calculation method could be verified.

Aim To explore the method of transfering oncoprotein bcr/abl, mediated by protein transduction domain (PTD), in order to provide the experimental basis for immune therapy. Methods DNA fragment encoding PTD was synthesized and fused with PCR-amplified bcr/abl gene fragment. The fusion protein was expressed in E.coli as His-tagged protein. The purified fusion protein was loaded to cultured HL-60 cells. Whether the fusion protein entered into HL-60 cells was determined by Western blot. Results It is shown that PTD could mediate transportation of bcr/abl protein to enter into cells. Conclusion These results may provide a new approach for loading exogenous proteins to antigen presenting cells.

Objective To investigate the outcome of high-risk acute non-lymphocytic leukemia treated with sequential low-dose cytarabine and harringtonine(LD-HA) and standard induction. Methods 50 high-risk ANLL. patients (LD-HA group) who were regarded as unfit for intensive chemotherapy were chosen to receive LD-HA. Reinductive treatments with standard regimens would be given for those who did not achieve complete remission. 23 patients DA/HA group given two cycles of standard inductive regimens were taken as the control. Results In LD-HA group 80.0 %. (40/50) reached CR, 2 patients died shortly after inductive therapy. The median leukemia-free survival(LFS) was 19.6 months, and the median overall survival (OS) was 12.2 months. Overall survival was 57.0 % at 1 year, 24.1% at 3 years, and 18.8 % at 5 years. While the CR rate was 73.9 % for DA/HA group, and none died during the inductive therapy. LFS and OS was 19.8 months and 12.1 months, respectively. OS rate was 56.58 % at 1 year, 27.1% at 3 years, and 27.1% at 5 years.There were no difference on OS rates between 2 groups (x2 were 0.009, 0.237 and 1.807, respectively,P ＞0.05). Conclusion In patients who were unfit for intensive chemotherapy, sequential therapy with LD-HA and standard induction improved the rate of complete remission and the duration of survival.

Objective: To evaluate the effects of endothelial cell-targeted soluble Notch ligand hD1R protein on the proliferation of acute myeloid leukemia (AML) cells. Methods: The expression levels of Notch1, Notch2, Notch3, Notch4, Hes1 in bone marrow CD34⁺ cells from 24 cases of untreated AML (AML group) and 9 healthy controls (control group) were determined by real time quantitative polymerase chain reaction (PCR) . Recombinant hD1R protein was first induced and purified. Bone marrow CD34⁺ cells were co-cultured on human umbilical vein endothelial cells (HUVEC) supplemented with a cocktail containing 5 types of human cytokines (5GF) and soluble hD1R. The cultured cells were tested under different culture conditions including PBS group (PBS replaces HUVEC) , hD1R group, 5GF group, GSI group (hD1R plus GSI) . Proliferation and apoptosis of cultured cells were also analyzed. Real time quantitative PCR was used to test the expression levels of Hes1 and Bcl-2 in cultured cells. Results: The expression levels of Notch1 and Hes1 in primary AML patients were significantly lower, and Notch4 expression was higher compared to the control group (P<0.05) . Cell counting showed a remarkable decrease of AML cells number in the culture with hD1R compared with that in the PBS group[ (0.74±0.13) ×10⁵ vs (2.16±0.21) ×10⁵, P<0.01]. FACS analysis showed that the percentage of AML cells was (18.48±2.51) % in apoptosis, which was higher than that of control cells (3.19±0.58) % after co-culture with hD1R. AML cells in the hD1R group underwent significantly increased apoptosis compared with those in the PBS one (P<0.05) . Moreover, apoptosis of AML cells in the GSI group was lower than that in the hD1R one (P<0.05) . Apoptosis in the PBS group also decreased compared with that in the 5GF one (P<0.05) . Finally, hD1R up-regulated Hes1 expression and inhibited Bcl-2 one in the AML cells. Conclusion hD1R effectively activated Notch signaling and down-regulated Bcl-2 mRNA in AML cells, which lead to cell apoptosis.