Objective: To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi. Methods: The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could′t be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could′t be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ² test. Results: There were 1 to 3 mini tracts (M(Q_R): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(Q_R): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ²=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ²=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups. Conclusion Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.

Objective To investigate the expression of interleukin 6 (IL-6) in tumor microenvironment of natural killer/T cell lymphoma (NKTCL) and its relationship with clinical characteristics and prognosis. Methods From January 2005 to December 2012, 93 patients with NKTCL and available paraffin-embedded tissue in Sun Yat-sen University Cancer Center were included. The expression or IL-6 in tumor microenvironment was investigated by immunohistochemistry. The positive IL-6 expression was identified as≥10 cells/HP. The enumeration data and measurement data were compared by t test andχ2 test, respectively. Overall survival (OS) and progression free survival (PFS) were estimated with the Kaplan-Meier method. Survival rates were compared by the Log-rank test. Statistical significance was determined at a level of P<0.05. Results The median count of IL-6 positive cell number was 21 cells/HPF (range, 0-150 cells/HP), and 61.29%(57/93) patients were positive. Positive IL-6 expression was mostly associated with fever and high Korean prognostic index (KPI) score (both P< 0.05). The serum c-reactive protein (CRP) level was (29.28 ± 2.62) mg/L in IL-6 positive patients and (11.14±2.77) mg/L in IL-6 negative patients (t= -2.276, P= 0.025). Patients with negative IL-6 expression had better survival, with 52.7 % of 5-year PFS rate,and 60.0 % of 5-year OS rate; the 5-year PFS and OS rates in those with IL-6 positive were 23.6 % and 27.1 %, respectively (both P= 0.001). Conclusion The high expression of IL-6 in patients with NKTCL might be associated with adverse clinical feature and poor survival.

Objective To explore the clinical effect of dorsal digital artery reverse island flap in the repair of distal finger skin defect.Methods From January,2011 to January,2015,60 fingers of 60 cases with dorsal branch of the digital artery were used to repair the defect of the distal finger skin.The 30 refers to the index finger,middle finger 15 fingers,10 ring fingers and 5 little fingers.Harvested area of 1.2 cm ×1.7 cm to 3.2 cm × 3.6 cm,the wrist or distal medial arm full thickness skin graft donor site.Evaluation of sensory recovery by the British Medical Research Association.Results All flaps survived.Twelve finger flap tension blisters,and the flaps survived after the stitches.Follow-up of 60 cases of 60 to hand function according to the Chinese medicine will hand surgery society of upper extremity function evaluation standard trial Tam method to evaluate the:50 excellent,10 fingers good,the excellent and good rate was 100％;48 fingers flap sensation recovery to S4 class,and 12 refers to the recovery to S3.The two-point discrimination perception of 5 to 8 mm,average 6.5 mm;patients far,nearly interphalangeal joint average activity recovery was good.Skin flap skin ruddy,soft texture,no fat,no pigmentation,fearless cold performance.No scar hypertrophy and contracture,skin pain no allergy and reoperation.Conclusion The flap for repair of distal finger skin defect is a simple,no damage to the main artery and nerve and good sensory recovery,less postoperative complications,and excellent method of flap survival.It is worth promotion in primary hospitals.

Objective:To evaluate the efficacy and toxicity of single-agent bendamustine in patients with indolent B-cell non-Hodgkin's lymphoma (NHL) refractory to rituximab. Methods:Between April 2010 and April 2013, 100 patients with rituximab-refrac-tory indolent B-cell NHL from 8 institutions were enrolled. Bendamustine was administered at 120 mg/m2 on days 1 and 2 every 21 days for 6-8 cycles. The primary endpoint was the overall response rate (ORR). The secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results:One hundred patients with a median age of 56 (rang-ing from 28 to 74) years were recruited in this clinical study. The total number of chemotherapy was 447 cycles, and the median number was 4 cycles. Ninety-three patients could be evaluated for efficacy. Fifteen patients (16.1%) had complete remission (CR), 52 (55.9%) had partial remission (PR), 22 (23.7%) had stable disease (SD), and 4 (4.3%) had progression disease (PD). The ORR and DCR were 72%and 95.7%, respectively. After a median follow-up of 26.6 months (ranging from 2 to 48.4 months), 59 patients (63.4%) had PD.The median PFS was 8.53 (95%CI:6.518-10.542) months, and PFS rate for 1 year was (40.6±5.3)%. Forty-eight patients (48%) had 3/4 grade adverse events, including leucopenia (26%), neutropenia (24%), and anemia (11%). Conclusion:Single-agent bendamustine produced a high rate of objective responses in patients with rituximab-refractory indolent B-cell NHL and could be one of the new op-tions for second-line treatment of these patients. The most common adverse event is hematologic toxicity.

Antineoplastic Protocols ; China ; Humans ; Lymphoma, Large B-Cell, Diffuse ; therapy ; Treatment Outcome

The treatment status and progress in T cell lymphoma including epigenetic involved mutations that control DNA and histone methylation were reported and intensively discussed in 2014 international T cell lymphoma forum.According to the theory,treatment with HDAC inhibitor belinostat and romidepsin for peripheral T cell lymphoma (PTCL) can achieve 29 ％-38 ％ overall response rate (ORR) and 13.6 months median relief time.NK/T cell lymphoma in southeast asia is a common malignant lymphoma,15 ％-28 ％ of the NHL accounted in China and Japan for,which is significantly higher than that in the European and American countries,mainly related to EB virus widespread infection.L-asparaginase enzymes,such as SMILE and AspMetDex,can make the early cases with more than 70 ％ long-term survival rate,advanced cases with 40 ％ response rate.Some new drugs,such as pralatrexate,combined with romidepsin can be used in PTCL cases to improve the complete remission rate.

Objective To study the effects of hyperbaric oxygen (HBO) preconditioning (PC) on motor function and mitochondrial apoptosis after spinal cord injury (SCI) in rats.Methods Thirty-six healthy,male Wistar rats were randomly divided into 3 groups (each n =12):a control (CON) group,an SCI model group and an HBO-PC group.The SCI group and the HBO-PC group after 7 sessions of HBO-PC treatment were subjected to SCI modeling using Allen's method.The CON group was not given any special treatment.Two weeks after the modeling,Basso,Beattie,and Bresnahan BBB scale was used to rate the rats' locomotor function,and the T8 segment of the rats' spinal cords was removed.After extracting total RNA from the spinal cord tissue,real-time quantitative PCR was used to detect the mRNA expression levels ofcaspase-3,cytochrome C (CYC),Bak,Bax,Bcl-x and Bcl-2 in the spinal cord tissue.Results Two weeks after modeling,compared with the CON group,the average BBB locomotion score of the SCI model group had decreased.In contrast,caspase-3,CYC,Bak and Bax mRNA expressions had increased significantly.Compared with the CON group,the average BBB locomotion score of the HBO-PC group had decreased,caspase-3 expression had increased,and Bax mRNA expression had decreased,but the differences in the changes between the two groups were not statistically significant.Bak mRNA expression increased and CYC expression decreased,and the difference between the two groups was statistically significant.Compared with the SCI model group,the average BBB locomotion score of the HBO-PC group increased while caspase-3,CYC,Bak and Bax mRNA expressions decreased,but none of these differences between the two groups was statistically significant.Bak mRNA expression increased and CYC mRNA expression decreased,and those differences between the two groups were statistically significant.Bcl-x and Bcl-2 mRNA expression in the CON,HBO-PC and SCI model groups were significantly different.Conclusion HBO-PC can reduce the loss of motor function after SCI,at least in rats.The mechanism may be related to reducing neuron mitochondrial apoptosis.

Objective To determine the relationship between the serum level of β2-microglobin (β2-MG)and international prognostic index (IPI) and investigate the role of IPI in predicting the prognosis and making individualized therapy for peripheral T-cell lymphoma (PTCL).Methods Eighty-one patients with PTCL were treated by standard CHOP regimen.The clinical characteristics,response,long-term surival rates and the relationship between serum level of β2-MG and IPI scores were analyzed retrospectively.Results Eighty-one patients were eligible.All of them were treated by CHOP regimen.The overall response rate (RR) was 82.7 ％ with 53.1％ complete remission (CR) rate.The RR of IPI low risk,low-intermediate risk,high-intermediate risk,and high risk were 95.7 ％,87.5 ％,53.8 ％ and 20.0 ％,with CR rate 74.5 ％,37.5 ％,15.4 ％ and 0,respectively (P ＜0.05).The median survival times (MST) were 31.2 months at a median follow-up of 30 months (2-98 months).The acturial 1-,3-,and 5-year overall survival (OS) rates were 83.5 ％,41.8 ％ and 34.7 ％,respectively.The 5-year OS rates of low risk,low-intermediate risk,high-intermediate risk,high risk were 57.3 ％,55.9 ％,0 and 0,respectively (P ＜0.05).The OS rates of low risk group (IPI 0-2 scores) and high risk group (IPI 3-5 scores) were 54.8 ％ and 0,respectively (P ＜0.05).Serum levels of β2-MG were significantly elevated in the high risk group than those in the low risk group.The proportion of abnormal serum level of [β2-MG were also significantly elevated in the high risk group than those in the low risk group.The results of multivariante analysis showed that serum level of β2-MG and IPI scores were independent prognostic factors for PTCL (P＜0.05).Conclusion The serum level of β2-MG with IPI scores system can be uscd for evaluating the prognosis of PTCL patients.

BACKGROUND: The comparative study concerning the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for the treatment of nervous system lesions is insufficient. OBJECTIVE: To assess the safety of umbilical cord and bone marrow-derived mesenchymal stem cells transplantation for treatment of nervous system lesions. METHODS: A total of 214 cases with neuropathy were randomly divided into A, B groups. Patients in the A group received umbilical cord derived stem cell transplantation, and those in the B group received bone marrow-derived mesenchymal stem cells transplantation. Totally (5-12)×108 stem cells were transplanted into each patient. RESULTS AND CONCLUSION: The count of lymphocytes, alanine aminotransferase, aspartate aminotransferase, IgA, and IgM were increased compared with those before treatment in both groups (P < 0.01); However there were no significant differences between two groups (P > 0.05). Moreover, white blood cell count and red blood cell count in cerebrospinal fluid of all patients were significantly greater than the normal level. There were no significant differences between two groups (P > 0.05). No significant differences of the positive rate of Pandy test and the incidence rate of adverse effect were found in both groups (P > 0.05). The safety of umbilical cord and bone marrow-derived mesenchymal stem cell transplantation for treatment of nervous system lesions showed no marked differences.

[Objective]This study was aimed to evaluate treatment outcomes and toxicity of continuous-infusion EPOCH regimen for NK/T-cell lymphoma(NK/TCL).[Methods]From June 2003 to June 2008,34 patients including 30 nasal NK/TCL (88.2%)and 4 nasal type NK/TCL(11.8%)received doxorubicin,vincfistine,etoposide over 96 hours infusion with bolus eyelophosphamide and oral predinisone(EPOCH)chemotherapy as first-line treatment.Median cycles of EPOCH administered were 2.5(1-6 cycles).Additional involved field radiation therapy(IFRT)was administered to patients with localized nasal focus after chemotherapy.[Results]Among 34 patients,33 were eligible for response evaluation.The response rate(RR)was 60.6% (20/33)with complete remission(CR)rate of 45.5%(15/33).The RR of patients with nasal NK/TCL was 66.7%(20/30)with CR rate of 50%(15/30).Only one of the 3 nasal type NK/TCL patients achieved stable disease(SD),the other 2 had progressive disease(PD)during chemotherapy.After a median follow-up of 22(2-68)months,the estimated 3-year overall survival rate(OS)was 52.2%.For patients with nasal NK/TCL,the estimated median survival time was not reached,the 3-year OS was 59.4%.For patients with nasal type NK/TCL,the estimated median survival time was only 7 months.The CR rate was 75.0% for localized nasal NK/TCL who received initial EPOCH chemotherapy followed IFRT with the 3-year OS of 75.0%.Major adverse effect was myelosuppression.The incidence of grade Ⅲ～Ⅳ neutropenia was 30.9%.No treatment-related mortality occurred.[Conclusions]EPOCH regiment was effective and well tolerant for nasal NK/TCL.Combined EPOCH chemotherapy followed by IFRT produced promising outcome for patients with localized disease.However,patients with nasal type NK/TCL responded poorly and more efficacious treatment strategies are urgently needed.