Objective To compare the clinical outcome among white blood cell, platelet and red blood cell hemapheresis. Methods Thirty-seven patients with high blood cell count received hemapheresis for forty times by CS-3000 plus. Results After white blood cell hemapheresis, the peripheral white blood cell counts decreased from (231 52?355 56)?10 9/L to(140 64?230 85)?10 9/L(P

Objective To discuss the efficacy and safety of different second-line chemotherapies in small cell lung cancer chemotherapy.Methods 170 patients with small cell lung cancer who were failure to first -line treatment were chosen,they were randomly divided into observation group and control group.The control group was given paclitaxel plus cisplatin second-line chemotherapy,the observation group used the irinotecan joint cisplatin second-line chemotherapy.The effect of the two groups was recorded.Results The effective rate of the observation group was 45.88%,which of the control group was 25.88%,the difference between the two groups was statistically significant (χ2 =7.389,P<0.05).The median survival time,total survival time,median disease-free survival time, Karnofsky score,pain score of the observation group were (10.32 ±2.41)months,(7.89 ±1.88)months,(7.54 ± 1.78)months,(83.23 ±6.89)points,(2.37 ±1.07)points,which of the control group were (7.45 ±1.03)months, (3.16 ±0.79)months,(3.89 ±0.68)months,(69.97 ±2.33)points,(4.81 ±2.13)points,the differences between the two groups were statistically significant (t =10.095,21.384,17.660,21.384,17.660,all P<0.05).In the observation group,nausea and vomiting occurred in 5 cases,thrombocytopenia in 3 cases,anemia in 1 case,leukopenia in 7 cases,hypodynamia in 12 cases.In the control group,nausea and vomiting occurred in 16 cases,thrombocytopenia in 11 cases,6 cases of anemia,leukopenia in 18 patients,hypodynamia in 26 cases,the differences between the two groups were statistically significant(χ2 =6.574,4.981,4.722,4.981,4.722,all P <0.05).Conclusion The second-line chemotherapy regimens with irinotecan used in small cell lung cancer patients can improve the treatment effect,adverse reaction mild,prolong patients'survival,it is worth popularizing in clinical.

Objective To explore and analyze the curative effect of capecitabine in the treatment of advanced breast cancer and its influcing factors. Methods 100 cases of advanced breast cancer were selected,all patients were treated with combined or individual therapy, one period was 21-28 days, and the course of treatment was more than two cycles. Before and after treatment, the Eastern Cooperative Oncology Group (ECGO) score, receptor status, chemotherapy cycles, tumor metastasis and other factors of the data were collected and recorded. Results The short-term efficacy of the patients was: stable disease (SD) 39 cases, progressive disease (PD) 8 cases, complete remission (CR) 1 cases, partial remission (PR) 52 cases. 53.0%(53/100) for objective response rate (ORR), 92.0%(92/100) for disease control rate (DCR). All patients who received treatment from the end of the follow-up period were: 1 to 24 months, the median survival period was 6.5 months. The independent influencing factors of progress free survival (PFS) were the number of cycles of combination chemotherapy (P<0.05). During chemotherapy, the adverse reactions of patients was not much, respectively: 4 cases of hand foot syndrome, 2 cases of grade Ⅰ, 1 case of grade Ⅱ, 1 case of grade Ⅲ; 7 cases of gastrointestinal reaction, 4 cases of grade Ⅰ, 3 cases of grade Ⅱ; 3 cases of hematologic toxicity, 1 case of grade Ⅰ, 2 cases of grade Ⅱ. The lower ECGO score, ≥4 times of cycles of treatment, ER/PR+ improved the short-term efficacy(P<0.05), while the tumor metastasis and HER-2 receptor could not effect the short-term efficacy. Conclusion The short-term efficacy of capecitabine is related to ECGO score, receptor status and chemotherapy cycles, while has no relation with tumor metastasis and HER-2 receptor.

OBJECTIVETo dicuss the clinical efficacy of Timolol Maleate Eye Drops in the treatment of superficial infantile hemangiomas. Methods From April 2012 to May 2014, 210 patients with superficial infantile hemangiomas were included. According to the parents' choice, a total of 176 cases were treated with Timolol Maleate Eye Drops as the treatment group, and the 34 cases who received the treatment of "wait and see" was included in the control group. In the treatment group, the gauzes were dipped into the eye drops and putted evenly on the surface of the hemangioma, 3-4 times daily and lasted for more than 20 minutes. The gauze should completely cover the surface of the tumor. The follow-up periods were 3 weeks and 6 months after treatment with the pictures to record the treatment effect. The therapeutic effect was graded as: grade I (unable to control the growth of the hemangioma), II (the growth of the hemangioma stagnated), III (hemangioma significantly subsided), IV (the hemangioma completely disappeared). The effective rate included the cases with grade II and above grade II . The cure cases included the cases with grade IV. The data was analyzed with the statistical software SPSS 17.0 and the Chi-square test (P < 0.05).

RESULTS3 cases in the treatment group showed eczema action. Tumor ulcer happened in 1 case in treatment group. The side effect rate was 2.3% . The results at 3 weeks following in the treatment group showed that the growth of the hemangioma were stagnated in 154 cases. The color of hemangioma became darker in different degrees than before, and the texture of the hemangioma became soft in majority of children, and the thickness of hemangioma became thinner in some cases. However, only 4 cases showed the hemangiomas were subsided, 18 cases showed the color of the part of the hemangiomas were brighter than before, and 12 cases of the hemangiomas remained original state in the control group. The results of 6 weeks following the treatment showed that 18 patients in the treatment group reached the standard of the grade IV, 84 patients reached the standard of the grade III, 60 patients achieved in the standard of grade II, and only 14 patients showed the volume of hemangiomas were increased as grade I. The effective rate was 58. 0% , and the cure rate was 10. 2% in treatment group. In control group, no children reached the standard of the grade IV, 4 cases reached the standard of grade III, 13 cases who remained original state reached the standard of grade II, and 17 cases showed the volume of hemangiomas continued to increase as grade I . The effective rate was 11. 8% , and the cure rate was 0. By comparison, the effective rate and the cure rate in the control group were relatively lower than those in the treatment group (P < 0.05).

CONCLUSIONSThe efficacy of Timolol Maleate Eye Drops in the treatment of superficial infantile hemangioma is exact, especially in the proliferative phase of the infantile hemangioma. It is safe and easy to perform with mild side effect. It should be selected as first-line treatment.

Administration, Topical ; Adrenergic beta-Antagonists ; administration & dosage ; Child ; Hemangioma ; drug therapy ; Humans ; Ophthalmic Solutions ; administration & dosage ; Skin Neoplasms ; drug therapy ; Timolol ; administration & dosage ; adverse effects ; Treatment Outcome ; Watchful Waiting

Objective Toexploretheclinicalefficacyandtoxicityofintensitymodulatedradiationtherapy(IMRT)combined with high intensity focused ultrasound(HIFU) for inoperatable recurrent hepatic carcinoma after operation and TACE .Methods Total 60 patients with inoperatable recurrent hepatic carcinoma after operation and TACE were randomly divided into two group ,30 patients in observation group received IMRT and HIFU ,while 30 patients in control group received only IMRT .For both groups , the same radiotherapy technic was given with IMRT in 6 MV X‐ray ,the total dose was 54 -70 Gy/6 -7 weeks .In observation group ,HIFU was carried out concurrently with IMRT (5 days/week ,6-7 weeks) .Results The difference of the short‐term effi‐cacy between the observation group and the control group was statistically significant (P<0 .05) ,there was no significant difference in acute radioactive toxicity between the two groups (P>0 .05) .The one and two year overall survival rate 89 .9% ,78 .9% in obser‐vation group ,while 72 .8% ,36 .2% in control group ,the differnces were statistically significant (P<0 .05);the one and two year progression‐free survival rate were 85 .9% and 50 .9% in observation group ,while 64 .3% and 28 .1% in control group ,the differ‐ences between two groups were statistically significant (P<0 .05) .The medium survival time was 36 months in observation group , and 24 months in control group;the medium progression‐free survival was 27 months in observation group ,and 17 months in control group .Conclusion For recurrent unresectable or reject surgery after TACE in patients with primary hepatic carcinoma ,the efficacy of IMRT combined with HIFU treatment is effective ,the toxicity can be tolerated ,and has certain application value .

Objective: To investigate the safety and efficacy of pingyangmycin (bleomycin A5) sclerotherapy for early peripheral arteriovenous malformations (AVM). Methods: Thirteen cases of early-stage [Schobinger clinical stage (Ⅰ/Ⅱ)] peripheral AVM patients (11 stage Ⅰ and 2 stage Ⅱ patients) aged between 3 months and 51 years were selected between January 2012 and May 2015. Pingyangmycin sclerotherapy injections were administered with B-scan ultrasonography or digital subtraction angiography positioning. All patients underwent relevant supplementary examinations before and after the procedure, and clinical evaluation was performed based on the improvement of the clinical symptoms of the patient and re-examination of lesion by imaging. Results: A total of 88 injections were administered to the 13 patients with an average of 6.7 injections per patient, 3-6 years of follow-up. Based on clinical evaluation, 7 patients were generally cured, 3 patients had significant improvement, 2 patients had partial improvement, and 1 patient had no improvement. Seven patients had different levels of postoperative swelling that resolved on its own. No serious complications occurred. Conclusions Pingyangmycin sclerotherapy for treatment of early peripheral AVM was effective and had few complications. It can control further progression of pathological changes.

Objective To investigate high risk factors of intensive care unit-acquired weakness (ICUAW) in patients with sepsis. Methods A retrospective study was conducted. 164 patients with mechanical ventilation (MV) who were diagnosed sepsis and multiple organ dysfunction syndrome (MODS), admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January 1st, 2015 to September 30th, 2017 were enrolled. The general situation, the basic diseases (hypertension, diabetes), body mass index (BMI), protopathy diseases, the level of albumin before ICU admission, the MV time, whether to use glucocorticoid and continuous renal replacement therapy (CRRT) or not, nutrition supply (nutritional way, nutrition initiation time, amino acid/protein supply, nutritional status on ICU 3 days and 7 days), myoglobin, the length of ICU stay, the length of hospital stay, and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score were collected. The high risk factors of ICUAW in patients with sepsis complicated with MODS were analyzed further using multi-factor Logistic regression analysis. Multiple linear regression analysis was used to analyze the myoglobin related factors in sepsis patients. Results The ICUAW incidence was 25.6% (42/164). The risk factors with differences in univariate analysis were included in the multivariate Logistic regression analysis, and it was shown that the level of albumin before ICU [odds ratio (OR) = 0.232, 95% confidence interval (95%CI) = 0.061-0.885, P = 0.032], the MV time (OR = 0.380,95%CI = 0.154-0.935, P = 0.035), nutrition initiation time (OR = 2.642, 95%CI = 1.100-6.346, P = 0.030), myoglobin (OR = 4.129, 95%CI = 1.681-10.142, P =0.002) were the independent risk factors for ICUAW in sepsis patients with MODS. The linear regression showed that the level of myoglobin was positively correlated with APACHE Ⅱ score (β= 38.297, P = 0.000), negatively correlated with the length of hospital stay (β= -7.071, P = 0.048), and it had nothing to do with the MV time and the length of ICU stay. Conclusions Evaluation of muscle function should be a routine part of ICU examination. The levels of albumin,MV time, hemoglobin and nutritional start-up time were independent risk factors for ICUAW in sepsis patients with MODS. Myoglobin levels can be used as an indicator of severity.

Objective Total thyroidectomy of C57BL/6 and KM mice was performed by two different surgical methods to verify the success of mouse hypothyroidism model modeling,and compared the success rate of different surgical methods.Methods C57BL/6 and KM mice underwent total thyroidectomy by ligation(operation method Ⅰ)or hemostasis(operation method Ⅱ),and the detailed operation processes were recorded.Serum TT3,TT4 and TSH levels detected by enzyme-linked immunosorbent assay,body weight,and hematoxylin-eosin(HE)-stained neck tissue were compared before and after surgery to verify the model.Results Serum TT3 and TT4 levels were decreased(P＜0.05)and TSH was increased(P＜0.001)in both model groups.The 28-day postoperative survival rates were 40％and 60％in groups Ⅰ and Ⅱ,respectively,and 50％and 40％in KM mice.Body weights were significantly higher in both model groups compared with the sham control group.HE staining and microscopic observation showed that the cervical tissue in both strains was thyroid tissue,and the back membrane of the thyroid remained intact after isolation.Conclusions Both surgical method can induce hypothyroidism in C57BL/6 and KM mice;however,it is necessary to consider the anatomical relationship of the thyroid gland to the surrounding tissue,improve the proficiency of the surgical operation,prevent the occurrence of postoperative hypocalcemia and infection,and thus improve the survival rate of the model mice.

Objective:To analyze the predictive value of von Willebrand factor (vWF) for venous thromboembolism (VTE) of patients in intensive care unit (ICU) by using propensity score matching (PSM).Methods:Patients admitted to ICU of the Second Affiliated Hospital of Kunming Medical University from December 2020 to June 2022 who stayed in ICU for ≥72 hours and underwent daily bedside vascular ultrasound screening were included. Baseline data such as age, gender, primary disease, and chronic comorbidities were collected. Coagulation indexes before admission to ICU and 24 hours and 48 hours after ICU admission were collected, including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), international normalized ratio (INR), fibrinogen (Fib), fibrin monomer (FM), vWF, D-dimer, antithrombin Ⅲ (ATⅢ), etc. Patients were divided into VTE group and non-VTE group according to whether they had VTE or not [diagnosis of VTE: patients underwent daily ultrasound screening of bedside blood vessels (both upper and lower limbs, visceral veins), and those suspected of having thrombosis were confirmed by ultrasonographer or pulmonary angiography]. Using PSM analysis method, the VTE group was used as the benchmark to conduct 1 : 1 matching of age, whether there was malignant tumor, whether there was infection, whether there was diabetes, and coagulation indicators before admission to ICU. Finally, the cases with balanced covariates between the two groups were obtained. The risk factors of VTE were analyzed by multivariate Logistic regression analysis. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of vWF in the occurrence of VTE in critically ill patients.Results:A total of 120 patients were enrolled, of which 18 (15.0%) were diagnosed with VTE within 72 hours after admission to ICU, and 102 (85.0%) were not found to have thrombus in ICU. Before PSM, there were significant differences in age, gender, proportion of malignant tumor and infection, and coagulation indexes between VTE group and non-VTE group. After PSM, 14 pairs were successfully matched, and the unbalanced covariables between the two groups reached equilibrium. Multivariate Logistic regression analysis showed that vWF was an independent risk factor for VTE at 48 hours after ICU admission in critically ill patients [odds ratio ( OR) = 1.165, 95% confidence interval (95% CI) was 1.000-1.025, P = 0.004]. ROC curve analysis showed that the area under the ROC curve (AUC) of vWF at 48 hours after ICU admission for predicting VTE was 0.782, 95% CI was 0.618-0.945, P = 0.007. When the optimal cut-off value was 312.12%, the sensitivity was 67.7% and the specificity was 93.0%. Conclusion:Dynamic monitoring of vWF is helpful to predict the occurrence of VTE in ICU patients, and vWF at 48 hours after ICU admission has certain value in predicting the occurrence of VTE.