Objective To investigate the security and efficacy in the elderly patients with acute myeloid leukemia (AML) treated by decitabine based regimen. Methods A retrospective analysis was carried out on 12 elderly patients with AML who were treated by decitabine alone or with low-dose chemotherapy in Beijing Luhe Hospital, Capital Medical University from June 2014 to December 2015. Results There were 6 patients of complete remission (CR), 5 patients of partial remission (PR), 1 patient of none remission (NR) after one course of chemotherapy. 1 case of 6 CR patients relapsed after 6 cycles of chemotherapy , others remained CR during the follow-up . Among 5 PR patients , 2 cases achieved CR , 1 patient relapsed after 2 cycles of chemotherapy and 2 patients relapsed after 3 cycles of chemotherapy. 1 patient remained NR after 2 cycles of chemotherapy and died of severe pulmonary infection. 3 of 4 complex karyotype patients had poor efficiency, and only 1 patient achieved CR but relapsed eventually. 7 patients achieved CR in patients with +8, -X or normal karyotype in the near future. The main adverse effects were bone marrow suppression and infection. All patients could tolerate. Conclusion Elderly patients with primary AML treated by decitabine alone or with low-dose chemotherapy show good effects, well tolerance and high safety, which could serve as the front-line treatment.

Objective To investigate the effect of chuan kezhi injection atomizing inhalation in the prevention of respiratory infection after general anesthesia postoperative.MethodsA total of 74 cases with fractures and brain surgery postoperative with intubation anesthesia from Jiaxing First Hospital were collected and randomly divided into two groups with 37 cases in each group.Patients in the control group were treated by routine atomizing inhalation, patients in the experiment group were treated by chuan kezhi injection atomizing inhalation, before and after treatment empty stomach sampled venous blood 5 mL, determined T cell subgroup, observed cough and expectoration eased and throat discomfort alleviated situations of the patients after operation 1 to 4 days, and compared the clinical efficacy.ResultsAfter treatment the effective rate of the experiment group 94.59% was higher than the control group 81.08%, with no statistical significance;the cough and expectoration symptoms eased of the experiment group were significant better than the control group after treatment 1, 2, 3d (P<0.05), the throat discomfort symptoms eased of the experiment group was significant better than the control group at treatment 3 d (P<0.05), after treatment the CD3+, CD4+/CD8+ and NK cell levels of the experiment group were higher than the control group(P<0.05).ConclusionChuan kezhi injection atomizing inhalation can effectively ease throat symptoms after general anesthesia, improve immune status, the effect is remarkable.

Objective To explore the clinical characteristics and risk factors of healthcare-associated infection (HAI)in patients with severe viral hepatitis,so as to provide basis for clinical prevention and treatment of HAI. Methods Clinical data of 193 patients with severe viral hepatitis and admitted to a hospital from January 2012 to November 2015 were analyzed retrospectively,clinical characteristics and risk factors for HAI in patients were evaluated,all data were statistically analyzed.Results Among 193 patients,75 developed 112 times of HAI, incidence and case incidence of HAI were 38.86% and 58.03% respectively.The main infection sites were abdomi-nal cavity,lower respiratory tract,and gastrointestinal tract,infection rates were 33.93%,25.00% and 16.96%respectively.A total of 58 strains of pathogens were isolated,including fungi,gram-negative bacteria,and gram-positive bacteria,accounting for 53.45%,36.21%,and 10.34% respectively.Mulvariate logistic regression analy-sis showed that underlying diseases,use of glucocorticoid,invasive procedure,and white blood cell count<4.0×109/L were independent risk factors for HAI in patients with severe viral hepatitis (P<0.05).Conclusion Incidence of HAI in patients with severe viral hepatitis is high,risk factors are multiple.It is necessary to take targeted prevention measures during the treatment,so as to reduce the incidence of HAI.

Objective To compare the changes of serum hepcidin,hemoglobin and other indexes of pure hemodialysis and hemodialysis combined with hemodiafiltration in treatment of maintenance hemodialysis patients,and to investigate the effect of hemodialysis combined with hemodiafiltration therapy on serum hepcidin clearance,the improvement of anemia and the relationship between them of maintenance hemodialysis patients.Methods Twenty-two patients with maintenance hemodialysis patients were collected from Shengjing Hosphal Affiliated to China Medical University from January 2015 to February 2017.This study was self-controlled study,before enrollment all patients were given only regular hemodialysis,after enrollment all patients were given hemodialysis combined with hemodiafiltration therapy for 3 months,compared the changes of serum hepcidin,hemoglobin,reticulocyte percentage,ferritin,serum iron,transferrin saturation and EPO of pure hemodialysis(before treatment) and hemodialysis combined with hemodiafiltration treatment for 3 months of patients,and analyzed the correlationship between serum hepcidin and other indexes.Results After hemodialysis combined with hemodiafiltration therapy for 3 months,compared with pure hemodialysis serum hepcidin levels were significantly lower((77.61±3.31) μg/L vs.(89.49±7.87) μg/L,t=9.660,P<0.01),hemoglobin levels were increased((112.73±11.02) g/L vs.(88.32±11.83) g/L,t=-11.957,P<0.01).The correlations between serum hepcidin and other indexes show that serum hepcidin and hemoglobin and ferritin were related,serum hepcidin was negatively correlated with hemoglobin(r=-0.851,P<0.01)and positively correlated with ferritin(r=0.385,P<0.05),and found no correlations between hepcidin and reticulocyte percentage(r=-0.151,P=0.328),serum iron(r=0.123,P=0.427),transferrin saturation(r=0.211,P=0.170) and EPO(r=-0.173,P=0.261).Conclusion To compare with pure hemodialysis,hemodialysis combined with hemodiafiltration therapy can more effectively remove hepcidin and improve anemia,and they are related.

Objective To investigate the clinical value of 64 slice spiral CT low dose chest scan in the diagnosis of pulmonary tuberculosis.Methods From January 2015 to January 2016,45 patients with suspected pulmonary tuberculosis were studied.All patients underwent routine chest CT scan and low dose chest CT scan.To compare the difference of radiation dose related parameters between normal dose chest CT scanning and low dose chest CT scan.To observe the display of the characteristics of lung disease by routine dose chest CT scanning and low dose chest CT scan.Results In 45 patients,there were a total of 30 patients were diagnosed with tuberculosis.The diagnostic sensitivity,specificity and diagnostic coincidence rate of conventional CT scan and spiral CT low-dose scan were 93.3% and 86.7% respectively.In low dose CT scanning radiation dose related parameters,the effective dose [(1.36±0.22)mSv vs.(5.24±0.68) mSv],CT dose index[(31.8±3.7) vs.(51.2±6.3)] and dose length product[(35.4±5.4)mGycm vs.(137.9±26.1) mGycm]were significantly lower than those of the conventional dose CT scan,the differences were statistically significant (all P<0.05).Conventional dose and low dose CT scan could show the lung lesions of pulmonary tuberculosis.Comparison between the two groups,low dose CT scanning on the burr sign and grinding glass shadow display rate was low.Compared with the conventional dose CT scanning,the difference was statistically significant (P<0.05).Conclusion In the diagnosis of pulmonary tuberculosis,the radiation dose of 64 slice spiral CT is significantly decreased,be able to clear most of the lung lesions.However,the effect is poor in the display of the grinding glass and the thin and short burr.

MicroRNAs(miRNAs) are a type of highly conserved,small non-coding RNAs,which powerfully regulate gene expression at the posttranscriptional level.In humans,it modulates about 30％ of protein coding genes.Ocular neovascularization is one of the most important clinical problems in ophthalmology and a common cause of blindness.Recent studieshavedemonstrated that miRNAs play a crucial rolein the development of ocular neovascularization.The use of miRNAs provides novel therapeutic approaches for ocular neovascularization.Here,we describe our understanding of the functions and expressions of miRNAs in eyes,the relationship among miRNAs,ocular neovascularization and angiogenic factors,and the current research of miRNAs in diabetic retinopathy.

The all-in-one femtosecond laser corneal refractive surgery,especially small incision lenticule extraction (SMILE),has gained more and more attention in clinic,because of its small incision,“no flap” and corneal biomechanical stability advantages.However,like any other kind of corneal refractive surgery,the all-in-one femtosecond laser refractive surgery not only exists its clinical advantages,but also has its limitations.It is very important to put into perspective clinical advantages and limitations of all-in-one femtosecond laser corneal refractive surgery.

Objective To investigate the efficacy of ambroxol combined with imipenem on severe neonatal pneumonia .Methods 62 newborns with severe pneumonia were randomly divided into the two groups ,31 cases in the control group and 31 cases in the treatment group .Two groups of children were given warm ,conventional oxygen ,anti-biotics,and correction of the acid-base balance,and so on.The control group received intravenous imipenem on this basis,the treatment group was given ambroxol on the basis of the control group .The time of body temperature returned to normal,pulmonary rales disappeared time,the times of daily suction and treatment time were observed .Results The total effective rate of treatment group(93.5%) was significantly higher than the control group (83.9%)(P<0.05).The treatment time,time of temperature returned to normal ,pulmonary rales disappeared time and the times of daily suction of treatment group were significantly shorter than those of the control group ( t=8.12,7.99,7.63,7.21, P<0.05).Conclusion Ambroxol combined with imipenem can significantly shorten the duration of treatment ,time of body temperature returned to normal ,pulmonary rales disappeared time and the times of daily suctioning in patients with neonatal pneumonia ,ambroxol can enhance treatment effect of imipenem ,they have synergistic effect in the treat-ment of neonatal pneumonia ,,and have no significant adverse reactions ,which worthy of clinical use .

Objective: To analyze the Effect of rt-PA thrombolytic therapy on elderly patients with cerebral infarction. Methods: Chosen elderly patients with cerebral infarction between November 2012 to November 2013 as study object, randomly divided into observe group receive rt-PA thrombolytic therapy and control group receive aspirin and Batroxobin, detecting neurological impairment, physical function score and adverse treatment outcomes. Results: 1)before thrombolytic treatment, neurological deficit situation of two groups were no significant difference (P>0.05), after treatment, observation group patients’ neurological deficit scores were significantly lower than control group at each time point (P<0.05); 2)after treatment, limb function defective number of observation group patient was significantly less than observation group(P<0.05); 3)after treatment, observation groups’ adverse outcomes as again infarction, large area cerebral hemorrhage after thrombolysis, plant survival, incidence of death was significantly lower than control group (P<0.05). Conclusion: The injection of rt-PA thrombolytic therapy can significantly optimize neurological and physical function in patients , reducing the incidence of adverse treatment outcomes, with positive clinical significance.