Objective To investigate the technical outline and clinical value of percutaneons transhepatic portal vein port-catheter system implantation in preventing small hepatocellular carcinoma recurrence after curative treatments. Methods Fifteen patients with small hepatocellular carcinoma after curative treatment were included in this study. Guided by ultrasound and fluoroscopy, left branch of the portal vein were punctured and port-catheter system were implanted. Then drugs infusion into portal vein system was done for preventing recurrence of hepatic carcinoma. Results Interventional operations were succeed in all 15 cases. Drugs could drop into portal vein smoothly. No operating complications occurred. Conclusion Percutaneous transhepatic portal vein port-catheter system implantation was an easy operating and micro traumatic method. This technique could play an important role in preventing recurrence.

Objective To evaluate the outcome of combination of intensive preconditioning regimen allo-HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia (ALL). Methods Between 2009 and 2010, 8 patients diagnosed as Ph+ ALL received allo-HSCT from HLA identical sibling during complete remission. Imatinib was added into the therapies of 5 patients.Seven patients received the intensive preconditioning regimen based on BuCy2, one patient received the regimen of TBI-Cy. A median of 6. 02 × 108/kg mononuclear cells and 3. 14 × 106/kg CD34+ cells were transfused. GVHD prophylaxis included cyclosporine A and methotrexate. Results All patients were well tolerant to the regimen without serious regimen-related toxicity. The median time of ANC≥0. 5 × 109/L was 15. 5 days, and that of PLT≥20 × 109/L was 19 days. Thirty days after allo-HSCT, all patients got donor engraftment successfully. Among 8 cases, 4 cases presented acute GVHD, 2 developed degree Ⅰ , one developed degree Ⅱ , and one developed degree Ⅳ. Seven patients were alive 100 days after allo-HSCT, 3 of whom presented chronic GVHD. At the end of following-up period, 6 patients were alive, among them, 3 patients were alive without relapse; 3 patients relapsed; Two patients died, one from acute GVHD, and one from leukemia relapse. Conclusion Combined intensive preconditioning regimen allo-HSCT with Imatinib was an effective treatment for Ph+ ALL, but the effect of anti-chronic GVHD of imatinib should arouse certain attention.

ObjectiveTo study the different clinical effects of using 5 kinds of hemostatic surgeries to manage the intractable postpartum hemorrhage and analyse the risk factors of failed hemostasis.Methods From Jan.2007 to Jul.2011,96 patients with intractable postpartum hemorrhage were studied retrospectively and grouped by the first step surgical treatment.The hemostatic surgeries included uterine tamponade (tamponadegroup ), pelvicbloodvessels ligation(ligationgroup), pelvical arterial embolization (embolization group), uterine compression sutures (sutures group)and uterine compression sutures combining tamponade (combined group).The intraoperative and postoperation datum were compared among groups,so dose the treatment outcomes.Multivariate analysis were used for failed hemostasis.Results( 1 ) The blood loss of 96 patients ranged from 1200 to 9100 ml,and 71 patients had a succeed hemoatasis after employing these surgeries and 25 failed.(2) The blood loss before hemostasis surgeries in tamponade group and embolization group was statisically greater than in sutures group ( P ＜ 0.05 ).Blood loss during the hemostasis surgeries in ligation group was statistically greater than in embolization and sutures groups ( P ＜0.05).The operating time of embolization group was statistically shorter than ligation group,sutures group and the combined group (P ＜ 0.05 ).(3) Fine of 96 patients had uterine atony and 43 had a successful hemostasis with the success rate about 78％.Forty-six had placenta previa and 39 success with success rate 85％.Thirty-three had placenta accrete and 13 of which succeed in hemostasis with success rate about 39％.In patients with uterine atony and placenta previa,the difference of hemostasis rate in groups had no statistically significant ( P ＞ 0.05 ).In patients with placenta accrete,the hemostasis rate in embolization group was higher than in others groups (P ＜ 0.01 ). (4) The multivariate analysis found that scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemotasis.The OR value respectively was 2.9 (95 ％ CI:1.1 - 7.6 ),17.9 ( 95 ％ CI:5.6 - 56.3 ) and 16.2 ( 95 ％ CI:3.2 - 83.5 ).Embolization had some extent of protective effection ( OR =0.9,95 ％ CI:0.8 - 0.9 ).Conclusions ( 1 ) Five kinds of hemostatic surgeries were all effective.Though the success rate among groups did show statistical difference,pelvical arterial embolization has the comparative advantage of shorter operating time,less operating blood loss and higher success rate in placenta accrete.(2) Since scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemostasis,sufficient preparation should be made for patients with these risk factors and the hemostatic surgeries should be choosed individually.

To know the characteristics of Shuxuening injection used on cerebral infarction patients in clinical practice, 6 053 cases of Hospital information system (HIS) data from 20 hospitals were analyzed. Using the basic description method and association rules to analysis the data. By analysis the data we found that the average age of cerebral infarction patients who used Shuxuening injection is 67.96, 83.94% of patients were aged 46-80. The injection is administered intravenously,with most patients receiving a dosage of 15-20 mL per dose for between 1 and 14 days. It is always combined with aspirin (48.508%), cinepazide maleate injection (22.073%), atorvastatin calcium tablets (18.873%) in clinical practice. When it comes to two drug combinations, it always combined with cinepazide maleate injection and aspirin (8.178%), nicergoline capsules and aspirin (7.63%). Therefore, based on existing data, we give the conclusion that for the treatment of cerebral infarction Shuxuening injection is mainly used for older patients, and is often combination with similar pharmacological effects chemical drugs, which is complied with the guidelines. However, the wrong dose is still exist, doctors should realize the hiding risk.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants ; therapeutic use ; Aspirin ; therapeutic use ; Atorvastatin Calcium ; Cerebral Infarction ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pyrroles ; therapeutic use ; Young Adult

Objective To master the prevalence trend of Kaschin-Beck disease in Xinghai county (Shanglujuan and X.ialujuan village of Tangnaihai township) from 2003 to 2008 in order to understand changes of selenium level of internal and external environments. Methods According to monitoring method on national Kaschin-Beck disease,we carried out epidemical investigation,clinical examination and X-ray photograph on school children aged 7-12 in Xinghai county,a monitoring region,and collected samples of hair and grain. The content of selenium was detected by 2,3-naphthalene fluorescence. Results From 2003 to 2008,in Shanglujuan village,the prevalence rate of clinic examination was fluctuating between 0(0/34)-17.14%(6/35); the detectable rate of X-ray examination was fluctuating between 11.11% (3/27)-20.59% (7/34),the prevalence rates of metaphysis and extremities were fluctuating between 0 (0/27)-13.21%(7/53) and 2.63% (1/38)-11.43% (4/35). In Xialujuan village,the prevalence rate of clinic examination was fluctuating between 2.94% (1/34)-13.33% (6/45); the detectable rate of X-ray examination was fluctuating between 26.67% (12/45)-43.63%(24/55),the prevalence rate of metaphysis and extremities were fluctuating between 8.33% (6/72)-26.47% (9/34) and 13.33% (6/45)-38.18% (21/55). The selenium contents in hair samples were (139.92±92.27),(134.98±63.77)μg/kg respectively in Shanglujuan and Xialujuan village in 2003; the selenium contents in grain samples were (12.90± 7.18),(14.58±9.90)μg/kg respectively in Shanglujuan and Xialujuan village in 2005. Conclusions The prevalence state of Kaschin-Beck disease in national monitoring region is rigid and pathogenetic factors of Kaschin-Beck disease are active. Selenium levels of internal and external environments are low in this region.

Relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a main question on treatment failure.Current strategies for management that usually include salvage chemotherapy,donor lymphocytic infusion and second transplantation.Our study assessed the efficacy of decitabine (DAC) for treating patients with acute lymphoblastic leukemia (ALL) who relapsed after allogeneic hematopoietic stem cell transplantation (allo-HSCT).We retrospectively analyzed the outcomes of 12 patients with relapsed ALL after allo-HSCT who received DAC therapy.Nine patients received DAC combined with chemotherapy and donor stem cell infusion,and 3 patients received single-agent DAC.Ten of the 12 patients achieved complete remission (CR),1 achieved a partial remission (PR),and 1 had no response (NR) after treatment at the latest follow-up (LFU),the median survival was 11.2 months (range,3.8-34,7 months).The 1-and 2-year overall survival (OS) rates were 50％ (6/12) and 25％ (3/12),respectively.Five patients were still alive;4 had maintained CR and 1 was alive with disease.Patients with Philadelphia chromosome-positive ALL had higher survival rate than patients with Philadelphia chromosome-negative ALL (57.1％ vs.20％).No aggravated flares of graft-versus-host disease (GVHD) were observed during DAC treatment.Therefore,DAC may be a promising therapeutic agent for ALL recurrence after allo-HSCT.

Objective To retrospectively evaluate the safety ,technical success rate and long‐term efficacy of the hepatic mul‐tiple cavernous hemangioma with super selective arterial cheoembolization .Methods 6 cases multiple hepatic cavernous hemangio‐ma by clinical diagnosed between 2004-2011 years in our hospital ,Through arterial super selective and completely filling cheoem‐bolization by Pingyang mycin lipiodol emulsion(PYM‐Lip) ,To assess the long‐term efficacy .by multi slice spiral CT enhanced scan‐ning and carry on relevant statistics processing in postoperative 6 ,12 ,36months .Results 26 lesions were embolismed in 6 cases multiple hepatic cavernous hemangioma ,Among the number of successful embolization were 15 of 1 cases ,2 of 4 cases ,3 of 1 cases , respectively .26 lesions was decreased with different degrees ,which the diameter of lesions were reduced with embolismed by CT enhanced scanning in postoperative 6 ,12 ,36months and diameter reduced> 50% ,diameter reduced≤50% ,lesions disappear was 38% (10/26) ,54% (14/26) ,8% (2/26) ,62% (16/26) ,23% (6/26) ,15% (4/26) ,69% (18/26) ,12% (3/26) ,19% (5/26) .Technical operation success rate 100% ,not serious complications occurred .There are statistically significant differences in the size of lesions before and after operation(P<0 .01) .Conclusion The technique success rate was high ,minimally invasive ,the complications was less ,the curative efficacy was obvious by transcatheter arterial super selective cheoembolizaton with hepatic multiple cavernous he ‐mangioma .

OBJECTIVETo study the clinical application and the safety of electronic gastroscopy in infants at ages of 0-3 months.

METHODSAn Olympus electronic gastroscope GIF 260 or GIF 230 was applied in 177 infants at ages of 0-3 months with upper gastrointestinal symptoms. An ECG Monitor II was used for monitoring heart rate, cardiac rhythm and pulse transcutaneous oxygen saturation in 65 infants during the whole process of gastroscopy. Some related treatments were performed under the electronic gastroscope, such as removal of foreign body, topical administration of antihemorrhagic drugs, reduction of volvulus of stomach and bougienage of oesophagus.

RESULTSAll 177 infants were examined successfully and they all well tolerated. Forty-two cases demonstrated positive findings in 68 cases of upper gastrointestinal bleeding. Ninety-two cases demonstrated positive findings in 104 cases of recurrent vomiting. Under the electronic gastroscope, removal of foreign body in the upper gastrointestinal tract was performed in 5 cases; topical administration of antihemorrhagic drugs or electrocoagulation for stopping bleeding in 22 cases; reduction of volvulus of stomach in 3 cases.

CONCLUSIONSAs a safe and visual means for diagnosis of digestive tract diseases, the electronic gastroscopy may be recommended for wide application in infants at ages of 0-3 months.

Female ; Foreign Bodies ; surgery ; Gastrointestinal Hemorrhage ; diagnosis ; Gastroscopy ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Male ; Oxygen ; blood ; Vomiting ; diagnosis

Adolescent ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Tongue, Hairy ; etiology ; Transplantation, Homologous ; adverse effects

OBJECTIVETo observe the changes in the activity of dendritic cells (DCs) after carcino-embryonic antigen (CEA) gene transfection mediated by recombinant adeno-associated virus type2 (rAAV) and tumor cell lysate.

METHODSImmature DCs isolated from peripheral blood monocytes of HLA-A11-positive healthy volunteers were infected with the rAAV carrying CEA gene or loaded with tumor cell lysate. The surface markers of the DCs such as CD40, CD 1alpha, and CD86 were analyzed by flow cytometry. Interleukin-12 (IL-12) in the supernatants of DCs and interferon-gamma (IFN-gamma) released by the cytotoxic T lymphocytes (CTLs) were determined by ELISA detection kit. The specific killing activity of CTL against LoVo cells was assessed by MTT assay.

RESULTSThe DCs following antigen loading with the two methods both highly expressed CD40, CD86 and IL-12, and induced specific CTL that specifically recognized and killed LoVo cells, but the killing effect resulting from rAAV infection of the DCs was much better than that induced by tumor cell lysate loading.

CONCLUSIONBoth methods of antigen loading can induce mature DCs from peripheral blood monocyte cells, but rAAV infection of the DCs can be more effective than tumor cells lysate loading. DCs infected with rAAV may have the potential to serve as an adjuvant immunotherapy for patients with colorectal carcinoma.

B7-2 Antigen ; metabolism ; CD40 Antigens ; metabolism ; Cancer Vaccines ; biosynthesis ; immunology ; Carcinoembryonic Antigen ; genetics ; Cell Line, Tumor ; Colorectal Neoplasms ; therapy ; Dendritic Cells ; immunology ; metabolism ; Dependovirus ; genetics ; Genetic Vectors ; Humans ; Interleukin-12 ; metabolism ; Transfection