To study the efficacy of CAG regimen used in 35 cases of newly diagnosed acute myeloid leukemia in elder-ly patients. Methods:Totally 35 cases of elderly patients with acute myeloid leukemia were randomly divided into two groups. The pa-tients in the control group (15 cases) were treated with standard chemotherapy treatment, while the CAG regimen group (20 cases) was treated with CAG regimen (cytarabine, aclarubicin and granulocyte colony-stimulating factor). After one treatment course, the chemotherapy efficacy was observed, and the neutrophil and platelet recovery time and the incidence of adverse reactions in the two groups were compared. Results:The treatment efficacy of the CAG regimen group was 90%, which was higher than that of the control group (60%, P<0. 05). The neutrophil and platelet recovery time of the CAG regimen group was significantly shorter than that of the control group (P<0. 05). The incidence of adverse reactions in CAG regimen group was much lower than that of the control group(P<0. 05). Conclusion:The efficacy of CAG regimen used in the 35 cases of newly diagnosed acute myeloid leukemia in elderly pa-tients is promising, which can effectively control the progression of the disease and accelerate blood cell recovery with high safety.

50% was in 72.1% of patients and

A 37-year-old male patient presented with persistent generalized itching erythema and papules for more than 1 month.The patient had received surgical treatment for type B3 thymoma in stage Ⅳ.Five months prior to the presentation,he developed myasthenia gravis.He also complained of chronic diarrhea for two years.Physical examination revealed white patches in the oral mucosa as well as scaly erythema of varying size on the face,trunk and extremities.Lamellar scales could be seen after scratching,while removal of scales could not result in the appearance of bleeding points.There was scaly hyperkeratotic erythema of palms and soles.Histopathological examination revealed psoriasis-like epidermal hyperplasia and parakeratosis with multiple dyskeratocytes,and some of the dyskeratocytes were surrounded by lymphocytes.There was a perivascular infiltration with a small number of lymphocytes.Immunohistochemical study showed positive staining for CD3,CD4 (dermis),CD8 (epidermis) and CD45RO,but negative staining for CD20,CD68 and CD30.The patient was diagnosed as thymoma-associated graftversus-host-like disease,myasthenia gravis and mucosal candidiasis.After treatment with tacrolimus and prednisone,the condition was gradually relieved.

Objective To detect the related genes with rifampin and isoniazid in Mycobacterium tuberculosis in sputums using the DNA chip technique and evaluate the fensibility of the clinical application of the DNA chip technique.Methods 586 sputum smear specimen was detected using the L-J cultivation to determine their drug resistance.Simultaneously.DNA chip was employed to detect the mutation of the frequent mutable points rpoB,katG/inhA in mycobaeterium tuberculosis isolates.These two assays were compared and samples showing discrepancy were chosen for additional sequencing to evaluate the accuracy of the detection.Results(1)There were 584 culture positive sputum smear specimens including 3(+)163 specimens,2(+)204 specimens,and 1(+)217 specimens.The drug fast results displayed that 361 strains were sensitive to INH,223 strains tolerated INH in which 93 strains tolerated it in low concentration while sensitive to it in high concentration.and 130 strains tolerated it in both low and high concentration.While 327 strains were sensitive to RFP.247 strains tolerated RFP in which 59 strains tolemted it in low concentration while sensitive to it in high concentration,and 188 strains tolerated it in both low and high concentration.(2)There were 367 positive strains(62.8%)and 217 negative strains(37.2%)identified by PCR amplification of the specific resistance gene fragments.The detection rate of the katG/inhA was 28.4%,and the mutation sites were mainly focused on the katG315(89.8%).The detection rate of the rpoB was 55.9%(137/247),and the mutation sites were mainly focused on rpoB531(68.6%)and rpoB 526(16.1%).(3)The sequencing of sample,which showed discrepancy with L-J cultivation and the DNA chip confirm a certain omission ratio.Conclusions It is feasible to detect the related resistant genes in Mycobacterium tuberculosis isolates using the DNA chip technique.The key factor is to raise the efficiency of the DNA extraction,the effciency of the PCR and the quality control of the experiment to facilitate its clinical application.

Objective To study the effect of Xuebijing injection on the change of intestinal tract mucosa barriers and the expression of macrophage antihody in rats with sepsis. Method Totally 150 Wistar rats were ran-domly divided into three groups: sham group, sepsis group, and Xuebijing group. Sepsis models were estabhshed in rats by cecal ligation and puncture. The success standards of sepsis included fever, the increase of respiration rate,increased heart rate and change in leukocyte count. At 12 hours before operation, and after operation the rats in the Xuebijing group were injected with 4 mL/kg Xuebijing (once every 12 hours for 3 days), and the rats in the others two groups were injected with the same volume of saline, the image analytical system were used to detect the pathological change of intestinal tract mucosa harriers and the expression of macrophage antibody in three groups. All the data were analyzed by rank-sum test and variance analysis(F test). Results Almost all the mucous mem-brahe of small intestine in sham groups were normal. The mucous membrane lesions of small intestine developed in sepsis and Xuebijing groups after 12,24,48,72 hours, and the lesion was severer in sepsis group than that in the Xuebijing group (H=19.732, P<0.01). There were no significant differences on the expression of macrophage antibody in mucous membrane of small intestine between three groups at 3 hours. But at 12, 24, 48 and 72 hours, the expression of macmphage antibody of sepsis and Xnebijing groups increased with time (F=560.13, P< 0.05). Conclusions At the early period of sepsis, intestinal tract mucosa barriers develops varying degrees of damage, and Xnebijing can partly protect intestinal tract mucosa barriers.

Objeclive To analyze the occurrence characteristics of stenosis or occlu-sion in guilty artery in patients with ischemic cerebrovascular disease. Methods The data of digital subtraction angiography (DSA) of 304 patients with ischemic cerebrovascular disease were analyzed retrospectively, in which there were 188 patients with transient ischemic attack (TIA) and 116 patients with cerebral infarction. Guilty arteries were identified, and the length of stenotic segment and severity of stenosis were measured. Results Of the 304 patients, 227 (74. 7%) had cerebral artery stenosis or occlusion. 193 (85.0%) identified guilty arteries, in which 104 (53.9%) were in extracranial artery only, 70 (36. 3%) were in intracranial artery only, and 19 (9. 8%) were in both intra- and extracranial arteries, The incidence of cerebral artery stenosis or occlusion (97/116, 82.9%) in the cerebral infarction group was significantly higher than that in the TIA group (130/188, 68.8%) (P <0. 01); the incidence of extracranial vascular lesions in posterior circulation in the TIA group was significantly higher than that in the cerebral infarction group (24.3% vs. 7.0%, P < 0. 01); and the incidence of intracranial vascular lesions in anterior circulation in the cerebral infarction group was significantly higher than that in the TIA group (32.6% vs. 20.6%, P <0. 01). However, there yeas no significant difference bergen the TIA group and the cerebral infarction group in the length of stenosis and severity of guilty artery. Conclusions Cerebral artery stenosis or occlusion in the in the cerebral infarction group is more common than that in the TIA group. The extracranial artery lesions in posterior circulation is more common in the TIA group, and the intracranial artery lesions in anterior circulation is more common in the cerelral infarction group, while the severity of cerebral ischemia is not associated with the stenosis degree and length of guilty artery.

Objective To analyze the clinical manifestations of early cerebral ischemic lesions after stenting with WingSpan system for symptomatic intracranial artery stenosis, and to evaluate the early effects and safety of the stenting therapy. Methods Twenty-nine consecutive patients with symptomatic intracranial stenosis underwent diffusion weighted imaging (DWI) before and after stenting (within 72 hours). The clinical data, including patients' general condition, stenting procedures and newly-developed cerebral ischemic lesions, were recorded. Neurological defect was estimated with NIHSS, the safety and early outcome of stenting were evaluated. Results The degree of stenosis was reduced from a mean baseline of (72.3 ± 10.7)% to (31.9 ± 13.6)% immediately after stenting. The technical success rate was 100%. The total eomplicatiom nate was 17.2%. And among them, z were symptomatic (6.9%). Sixty-three ischemic lesions were demonstrated on DWI in 13 patients (44.8%). Among them, 11 (84.6%) were asymptomatic. Fifty-five newly-developed lesions on DWI (87.3%) were located in the region of stented vessels and 3.2% were situated in the region of branch vessels of stented artery. Conclusion DWI is of great value in assessing the safety of intracranial stenting procedures. The treatment of symptomatic intracranial artery stenosis by using WingSpan system is safe and effective. Newly-developed ischemic lesions can be well detected on DWI and should receive physician's attention, although most ischemic lesions are asymptomatic. Long-term outcome of this treatment needs to be further observed.

Objective To reduce the misdiagnosis of the inpatients admitted to digest department with abdominal pain through analyzing the consultation undertaken by surgeon.Method The causes and the constituent ratio according to the case records of those inpatients admitted to digest department because of abdominal pain were analyzed.Results The obstruction of hollow viscus was the first cauge(51.07%),and the tumor of digestive tract(17.78%)was the second cause for invitation for consultation to surgeon of the inpatients with abdominal pain in digest department wards.The ultrasound 32.78%,CT 26.67% and gastroenterological endoscope 13.89% were definite diagnosis,and should shorten the time of consultation.Conclusion Whether inpatient or outpatient with abdominal pain should be planned to be examined by ultrasound,CT or gastroenterological endoscope,obgerve the changes of the symptom and sign so that the misdiagnosis can be avoided.

Objective To assess the clinical value of high-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus. Methods The clinical data of 8 patients with presacral venous hemorrhage treated with high-frequency electrocautery from February 2005 to March 2008 were analyzed. Once the presacral venous hemorrhage happened, the bleeding site was pressed with a gauze or finger and the accumulated blood was aspirated. Then, while simultaneously withdrawing the gauze or finger over the bleeding sites, high-frequency electrocautery was applied with a power of 80-100 W to coagulate all the bleeding sites. Results High-frequency electrocautery was used to stop bleeding in the 8 patients, and no electrocautery related complica-tions occurred postoperatively. Conclusions High-frequency electrocautery for massive hemorrhage of presacral venous plexus is simple, efficient and safe.

Objective:To investigate the efficacy of peritoneal perfusion combined with intravenous and oral chemotherapy in the treatment of gastric cancer with peritoneal metastasis and its correlation with prognosis.Methods:The clinical data of 142 patients with peritoneal metastasis of gastric cancer admitted to the Affiliated Hospital of Xuzhou Medical University from March 2012 to June 2019 were retrospectively analyzed.According to different treatment schemes, the patients were divided into observation group (47 cases treated with tegafur capsule orally+ docetaxel+ cisplatin combined with recombinant human tumor necrosis factor intraperitoneal perfusion) and control group (oral administration of tegafur capsule+ oxaliplatin). The clinical efficacy and prognostic factors were compared between the two groups.Results:The short-term efficacy after two courses of chemotherapy: the effective rate was 44.7% (21/47) in the observation group and 8.4% (8/95) in the control group, the difference was statistically significant (χ 2=25.438, P<0.001); the disease control rate was 97.9% (46/47) in the observation group and 60.0% (57/95) in the control group, the difference was statistically significant (χ 2=22.639, P<0.001). Long term efficacy: the progression free survival time of the observation group was higher than that of the control group (6.50 months vs.3.83 months, χ 2=16.399, P<0.001); the total survival time of the observation group was higher than that of the control group (15.60 months vs.10.83 months, χ 2=9.219, P=0.002). Univariate analysis showed that ascites volume, chemotherapy, palliative surgery, liver metastasis, Lauren classification and Her-2 expression were related to prognosis (all P<0.05); there was no significant difference in cumulative survival rate of different gender, age and ECOG score (all P>0.05). Multivariate analysis showed that liver metastasis ( HR=1.996, 95% CI=1.194-3.338, P=0.008 ), Lauren type ( HR=1.979, 95% CI=1.265-3.094, P=0.003 ), Her-2 expression ( HR=3.872, 95% CI=2.202-6.808, P<0.001 ), chemotherapy regimens(whether combined with intraperitoneal chemotherapy) ( HR=1.826, 95% CI=1.046-3.188, P=0.034 ) and abdomina volume ( HR=2.785, 95% CI=1.644-4.718, P<0.001 ) were independent risk factor for the prognosis of patients. Conclusion:Intraperitoneal perfusion combined with intravenous and oral administration has a good clinical effect in the treatment of peritoneal metastasis of gastric cancer, which can effectively improve the clinical symptoms and improve the survival rate of patients.The presence or absence of liver metastasis, Lauren classification, Her-2 expression, chemotherapy method (combined with intraperitoneal perfusion or not) and ascites volume are independent risk factors for the prognosis of peritoneal metastasis of gastric cancer.