Objective To evaluate the effect of stage health education on living-relative donor kidney transplantationrecipients.Methods Forty-eightliving-relativedonorkidneytransplantation recipients were randomly assigned to receive stage ( study group,n =24 ) or conventional health education (control group,n =24 ).ResultsIn comparison with the control group,the study group showed better awareness of kidney transplantation and improved satisfaction with nursing ( x2 =8.83,x2 =10.32,P ＜0.05).Conclusions Stage health education improves the awareness of renal transplantation and promotes mental and physical recovery,thus resulting in better quality of life of living-relative donor kidney transplantation recipients.

Objective To compare the clinical efficacy of laparoscopic radical resection of cervical cancer and laparotomy in the treatment of early cervical cancer.Methods From March 2015 to March 2017,102 patients with early cervical cancer in Taizhou Hospital were selected and randomly divided into control group and study group according to the digital table,with 51 cases in each group.The control group received traditional open surgery,the study group received laparoscopic surgery for cervical cancer.The operation time,intraoperative blood loss,postoperative first exhaust time,postoperative hospital stay,pelvic lymph node dissection and complication occurred in both two groups were observed and recorded in hysteroscopic cervical cancer.Results The operation time of the study group was significantly longer than that of the control group [(239.3 ±66.7)min vs.(156.9 ±41.5)min,t=5.65,P<0.01],the amount of intraoperative blood loss,the time of first postoperative exhaust and postoperative hospital stay of the study group were significantly less/shorter than those of the control group [(299.8 ±49.2)mL vs.(361.4 ± 60.3)mL,(44.6 ±6.7)min vs.(62.5 ±7.0)min,(6.5 ±2.3)d vs.(10.9 ±4.4)d,t=7.49,13.19,6.33,all P<0.01].And the number of pelvic lymph node dissection of the study group was significantly higher than that of the control group[(28.2 ±3.9)vs.(18.8 ±4.1),t=11.86,P<0.01].The incidence rate of postoperative complications in the study group was 9.8％,which in the control group was 25.5％,the difference was statistically significant(χ2 =0.092,P=0.035).Conclusion Laparoscopic radical resection of cervical cancer is superior to traditional laparotomy in the treatment of early cervical cancer.It has advantages of good clinical efficacy and less complication.It is worthy of clinical application.

Objective To analyze the therapeutic effect and tolerability of decitabine monotherapy or combined with arsenic trioxide for the treatment of patients with myelodysplastic syndromes (MDS). Methods Clinical characteristics of 32 patients with primary MDS in North Hospital of Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2014 to April 2017 were retrospectively analyzed. The clinical data of these patients were collected, and the patients were followed up. Decitabine combined with arsenic trioxide was used in 23 cases, decitabine (20 mg·m-·2d-1) and arsenic trioxide (0.16 mg/kg) were administrated from day 1 to day 5 and was repeated every 4-6 weeks. For the remaining 9 cases, only decitabine was applied, decitabine(20 mg·m-2·d-1) was administrated from day 1 to day 5 and was repeated every 4-6 weeks. The clinicopathological characteristics and the effect of genetic mutations on the efficacy of treatment were investigated. Results Of the 32 patients with primary MDS, 18 were male and 14 were female. The patients were 17-72 years old with a median age of 56 years old. Genetic analysis revealed 10 cases with TP53 mutations, 8 cases with TET2 mutations, 4 cases with U2AF1 mutations, 3 cases with RUNX1 mutations, 3 cases with ASXL1 mutations, 2 cases with NRAS mutations, 2 cases with DNMT3A mutations and 1 case with JAK2 V617 mutation. The follow﹣up time was 2-23 months with a median follow﹣up time of 8 months. A total of 21 cases (65.6%) attained treatment response. Among them, there were 10 cases (31.3%) with complete remission (CR), 5 cases (15.6%) with bone marrow complete remission (MCR), and 6 cases (18.7%) with hematological improvement. There was no significant difference in the efficiency and CR rate between the combination group and the monotherapy group (P＝0.441, P＝0.681). Ten cases were found to have TP53 mutations, of which 7 cases had CR. Multivariate analysis demonstrated that TP53 mutation was an independent risk factor for CR (P＝ 0.037). All patients developed myelosuppression after treatment, of which 16 cases developed pulmonary infection. Conclusions Decitabine combined with arsenic trioxide in the treatment of MDS is effective and well tolerated. The therapeutic effects of decitabine monotherapy or decitabine combined with arsenic trioxide for treatment of patients with TP53 mutations are better than the average levels.

Objective To quantify the setup errors for the different anatomical sites of patients who received intensity-modulated radiotherapy (IMRT) with linear accelerator on-board kilovolt fan beam CT(kV-FBCT) as non-isocenter IGRT and megavolt cone beam CT (MV-CBCT) as isocenter IGRT. Methods A retrospective analysis was performedon 70 patients who underwent radiotherapy, kV-FBCT, and/or MV-CBCT scans after each routine setup prior to IMRT. The average displacement (M), systematic error (Σ), and random error (б) at different treatment sites in the left-right, anterior-posterior, and cranial-caudal directions were calculated according to the individual displacements. The formula 2.5Σ+0.7б was used to estimate the PTV margin in respective direction. For each single patient, the root mean square in three directions was used as 3D displacement. Results A total of 1130 displacements were recorded in the 70 patients. The PTV margin was estimated to be 1.9-3.1 mm in head and neck cancer, 2.8-5.1 mm in thoracic cancer, 4.6-5.1 mm in breast cancer, 3.0-5.5 mm in upper abdominal cancer, and 3.5-6.8 mm in pelvic tumor. For the 3D mean displacements, the head and neck, thoracic, breast, upper abdominal, and pelvic cancer were 2.4±1.0, 4.0±1.6, 4.1±2.0, 4.6±2.1, and 4.6±2.1 mm, respectively. The average 3D displacement obtained by kV-FBCT and MV-CBCT were 4.1 and 3.4 mm, respectively (P=0.212). Conclusion The quantitative setup-error data can be obtained using linear accelerator on-board FBCT, and the non-isocenter IGRT induced set-up error cannot be negligible.

Objective:To investigate clinical efficacy and safety of venetoclax (VEN)-based regimens in the treatment of acute myeloid leukemia (AML).Methods:The clinical data of 41 AML patients treated with venetoclax-based regimens from January 2021 to December 2021 in Ruijin Hospital North of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The treatment regimens included VEN+demethylating drugs ± gene mutation inhibitors or VEN+chemotherapy with a median number of 2 courses (1- 5 courses).Results:The median age of all patients was 60 years (18-73 years), and there were 24 males and 17 females. After 1 course of VEN-based therapy, 22 (53.7%) patients achieved complete remission (CR) or morphological complete remission without complete blood count recovery (CRi), including 5 patients achieving minimal residual disease (MRD) negative. After 2 courses of treatment, of 17 patients available for efficacy evaluation, 7 patients achieved MRD negative. Among 20 relapsed/refractory AML patients, 9 cases achieved CR/CRi after 1 course of treatment, of which 1 patient had MRD negative. Among 21 patients initially treated and re-treated, 13 cases achieved CR/CRi and 1 case achieved partial remission after 1 course of treatment, of which 4 cases had MRD negative.Conclusions:VEN-based treatment regimens for AML have a high remission rate and tolerable adverse effects.