Objective:To investigate the efficacy and safety of geritinib in the treatment of acute myeloid leukemia (AML) with FLT3 mutation.Methods:The clinical data of 5 AML patients with FLT3 mutation who were diagnosed in the University of Hong Kong-Shenzhen Hospital, Shenzhen People's Hospital, Shenzhen Second People's Hospital, Shenzhen University General Hospital from March 2020 to April 2021 were retrospectively analyzed. Relapsed patients concurrently received two- or three-drug chemotherapy combined with geritinib. Blood routine was checked once a week; liver function and renal function were checked once every 2 weeks during treatment. Bone marrow puncture was performed once every 1 to 3 months to monitor the bone marrow morphology, minimal residual disease (MRD) and FLT3 mutation expression levels. The efficacy, side effects, overall survival of these patients were analyzed after treatment with geritinib.Results:The white blood cell was increased in all the 5 patients at the initial diagnosis. FLT3 mutations analysis showed FLT3-internal tandem duplication (ITD) (3 cases) and FLT-3 tyrosine-kinase domain (TKD) (2 cases). Among 5 patients, 1 patient was relapse-free with maintenance therapy of oral geritinib after hematological stem cell transplantation (HSCT) for 60 days; among other 4 relapsed and refractory patients, 1 female patient after pregnancy relapsed after transplantation and then achieved complete remission followed by the maintenance therapy with geritinib after oral geritinib, 1 16-year-old patient achieved treatment outcome close to the complete remission after treatment with geritinib, 1 patient achieved complete remission after treatment with geritinib, and then underwent haplo-HSCT followed by the maintenance therapy with geritinib and the other 1 relapsed patient achieved complete remission after treatment with geritinib. After transplantation, 3 patients receiving maintenance treatment of geritinib did not relapse. The main side effects included anemia, decreased neutrophil count, rash, and increased aminotransferase. The median follow-up time of 5 patients was 15 months (6-20 months). All 5 cases survived until the last follow-up in November 2021 and 4 patients were disease-free.Conclusions:Relapsed and refractory AML patients with FLT3 mutation can achieve complete remission after treatment with geritinib and get a chance for transplantation. Geritinib may reduce the risk of recurrence after transplantation and improve survival rate. No serious side effects occur in geritinib treatment.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Awareness of Health-Preservation management of traditional Chinese medicine (TCM) in public was investigated from June to early July in 2017 by the web of question nairein vestigation"Wenjuanxing". The result showed that 324 of 369 questionnaires were received and checked, accounting for 87.8%. In conclusion, the awareness of Health-Preservation management of TCM in public was poor, and it's important to raise the publicity of Health-Preservation management of TCM firstly in the community hospital in order to increase the awareness of people's acception.

Objective To investigate the effectiveness of Uromentor virtual reality simulator in flexible ureteroscopy training for catechumen.Methods Fifty-one catechumen were selected.After 1 hour training of basic operation in Uromentor virtual reality simulator, all trainees performed special-purpose exercise ( kidney inspection with flexible ureteroscopy ) for 3 hours. Using right kidney inspection, a preliminary assessment for each trainee was made before the special-purpose exercise and data such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and global rating scale ( GRS ) were recorded.The same assessment was performed once again after the special-purpose exercise ( secondary assessment ) , and data were recorded and compared to the preliminary assessment. Results Each trainee made a significant improvement in flexible ureteroscopic skill after the special-purpose training.The parameters such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and GRS of all trainees in preliminary assessment were 14.63 ±1.01 min, 8.62 ± 2.67, 51.05%±20.79%and 10.31 ±2.53, respectively;while in secondary assessment, parameters were 7.71 ±1.13 min, 1.67 ±1.23, 98.04% ±5.42% and 29.14 ±3.01, respectively.The differences between the preliminary assessment and the secondary assessment of each parameter were significant ( P<0.01).Conclusions The Uromentor virtual reality simulator can improve the trainee′s skills of flexible ureteroscopy.It is a good instrument of the flexible ureteroscopic training for catechumen.

Objective To set up the methods of establishing rat primary benign prostatic hyperplasic glandular epithelial cell line.Methods Male spontaneously hypertensive rats were raised to 29 weeks,and then evaluated the situation of BPH with HE staining.The prostate tissue from ventral prostate lobe was aseptically removed,dissected,minced,and then dissociated in collagenase type Ⅰ.Isolated cells were collected,seeded in WAJC-404 and PrEGM medium separately,then cultured and passaged.Specificity of primitive cultured prostatic epithelial cells was identified by cell immunochemistry with CK8/18,and the cell growth curves were drawn.Then the situation of growth of the two prostatic hyperplasic glandular epithelial cell lines were analysed and compared.Results The prostatic hyperplasic glandular epithelial cell lines of the spontaneously hypertensive rats in WAJC-404 and PrEGM medium were successfully primarily cultured,purified and passaged in vitro.Cell immunochemistry proved that the cell lines specifically express cytokeratin 8/18.Cell growth curve showed that prostatic epithelial cells in PrEGM,compared with prostatic epithelial cells in WAJC-404,possessed better cell morphology,more exuberant cell vitality,faster growth rate to enter the logarithmic growth period(4 d vs.7 d)and higher peak of cell growth curve(15.3× 104/ml vs.12.8×104/ml).Conclusions Rat primary benign prostatic hyperplasic glandular epithelial cell line can be established conventionally in vitro.PrEGM medium is more suitable for primary culture of the rat benign prostatic hyperplasic glandular epithelial cell line than WAJC-404 medium.

Objective To observe the clinical effect of adenoidectomy in the treatment of children with chronic rhinosinusitis ,to discuss its postoperative complications and postoperative rehabilitation .Methods Chose 100 children with chronic rhinosinusitis from February 2011 to April 2013 treated in our hospital as observation objects ,the cases were randomly divided into experimental group and control group ,with 50 cases in each group ,patients in experimental group was given drug and adenoidectomy treatment ;patients in control group was given drug orally external treatment only .Observed the postoperative complications and postoperative recovery ,then compared treatment effect of two groups .Results The total efficiency of experimental group was 96% ,control group was 60% ,the difference was statistically significant (P<0 .05);compared with those before operation ,there were significant differ-ence in experiment group in postoperative snoring ,purulence stuff ,sinus patency ,etc(P<0 .05) .Moreover ,experimental group and control group had difference in hospitalization days .The control group not only had high cost and long hospital stay but also had relatively high recurrence rate (P<0 .05) .Conclusion The curative effect of adenoidectomy combined with drugs in the treatment of children with chronic rhinosinusitis was much better than drug treatment only .

OBJECTIVE: To test the immunoglobulin free light chain (FLC) from nasal secretion and serum of patients with allergic rhinitis(AR)and non-allergic rhinitis(NAR) for the purpose of exploring the possible immunological mechanism. METHOD: Ninety consecutive patients were selected between January 2009 and January 2012, involving 45 patients with AR and 45 patients with NAR diagnosed by symptoms,signs,skin prick tests(SPT) and specific IgE (slgE). Forty-five volunteers were chosen as healthy control (HC). According to the visual analogue scale (VAS) scores,the nasal symptoms of AR and NAR,including sneeze. Nasal discharge. Nasal obstruction and nasal itching were compared. ELISA was used to detect the total IgE, IL-16, IL-17 in nasalsecretion and serum. The data was analyzed by SPSS 17.0 software. RESULT: There was no statistical difference between AR and NAR group in nasal symptoms (P > 0.05); In serum, IL-16 and IL-17 increased in AR group comparared to NAR group (P < 0.05); IL-16 and IL-17 increased in NAR group comparared to HC group (all P < 0.05); In nasal secretion, IL-16 and IL-17 increased in NAR and AR group comparared to HC group (all P < 0.05). CONCLUSION IL-16, IL-17 takes part in the path of physiological process of AR and NAR with the immunological mechanism.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Interleukin-16 ; blood ; metabolism ; Interleukin-17 ; blood ; metabolism ; Male ; Middle Aged ; Rhinitis ; immunology ; metabolism ; Rhinitis, Allergic ; immunology ; metabolism ; Young Adult

ObjectiveTo evaluate the efficacy of intravenous and intra-arterial thrombolysis with urokinase for acute cerebral infarction.Methods Fifty patients with acute cerebral infarction occurred within 6 hours were divided into two groups by random digits table method with 25 cases each:intravenous and intra-arterial thrombolysis group and intravenous thrombolysis group.The patients in intravenous and intra-arterial thrombolysis group were given 200 000 U urokinase by intravenous infusion for 30 minutes immediately after being hospitalized,and arterial thrombolysis was prepared at the same time.With cerebrovascular angiography,the thrombolytic therapy was carried out in the target vessel blocking points through micro-catheter.Urokinase dissolved in 0.9％ sodium chloride was infused at the rate of 10 000 U per minute,the total volume would not be more than 1 000 000 U.The patients in intravenous thrombolysis group were given 1 000 000 U urokinase in 100 ml 0.9％ sodium chloride by intravenous infusion within 60 minutes.The clinical efficacy after thrombolysis was assessed according to the National Institutes of Health stroke scale (NIHSS) score,the quality of life was judged by Barthel index (BI) score and the prognosis was evaluated by modified Rankin scale (mRS) score of 90 days after thrombolysis.ResultsThere was no significant difference between two groups before thrombolysis according to the NIHSS score (P ＞ 0.05).After thrombolysis,NIHSS scores in two groups showed a downward trend,but they were obviously lower in intravenous and intra-arterial thrombolysis group after 24 h,7 d and 14 d than those in intravenous thrombolysis group [(8.97±4.56) scores vs.(11.01±3.65) scores,(6.88±2.31) scores vs.(8.34±3.05) scores,( 4.06±3.02 ) scores vs.( 6.73±2.15 ) scores ] ( P ＜ 0.05 or ＜ 0.01 ).BI scores before thrombolysis between two groups had no significant difference(P ＞0.05),while BI score of 90 days after thrombolysis in intravenous and intra-arterial thrombolysis group [(79.55±19.64) scores] was higher than that in intravenous thrombolysis group [(69.31±21.35) scores](P=0.0162).The rate of mRS score 0-2 (good efficscy) in intravenous and intra-arterial thrombolysis group [72.0％(18/25) ] was obviously higher than that in intravenous thrombolysis group [ 52.0％ ( 13/25 ) ] (P =0.0198 ).ConclusionsIt is significantly effective to treat acute cerebral infarction by superselective intravenous and intra-arterial thrombolysis.Therefore,it is supposed to be an optimal option for treating acute cerebral infarction in the future.

ObjectiveTo evaluate the relationship between metabolic syndrome (MS) and benign prostatic hyperplasia ( BPH ) in men over 50 years old.Methods Male participants over 50 years old form a community in Beijing were randomly selected.Age,blood pressure,past history,and the international prostate symptom score (IPSS) were recorded.Plasma glucose,triglyceride,high density lipoprotein,prostate specific antigen (PSA),prostatic volume,and Qmax were measured.The morbidity and severity of BPH were compared with statistical analysis.ResultsFour hundred and forty men were enrolled,and were divided into 2 groups:MS group (n =105) and non-MS group (n =335).Compared to the non-MS,non-obesity,and non-hyperlipidemia group respectively,the morbidity of BPH was higher in MS,obesity and hyperlipidemia group (33.3％ vs.11.9％,P ＜ 0.05 ; 20.4％ vs.11.8％,P ＜ 0.05 ; 25.0％ vs.14.1％,P =0.007).The morbidity of moderate and severe LUTS in MS group was higher than non-MS group (61.9％ vs.31.3％,P ＜ 0.05).Significant differences were found in IPSS,prostate volume and PSA between the MS and non-MS groups ( P ＜ 0.05 ),but not found in Qmax ( P =0.069).Obesity,hyperlipemia and diabetes mellitus were risk factors of BPH (OR 1.75,95％ CI 1.40 -21.82,P =0.041 ; OR 3.36,95％ CI 2.34-48.13,P=0.037; OR 2.08,95％ CI 1.32-13.67,P=0.045). Conclusions There is higher morbidity of BPH in MS patient.MS could increase IPSS and prostate volume,and reduce PSA in BPH patient.Obesity,hyperlipemia and diabetes mellitus are risk factors of BPH.MS should be considered when treating BPH.

Objective To review the clinical features of small cell neuroendocrine carcinoma of the prostate (SCPCa). Methods The ages of 4 cases were 25-77 years. Four cases had progressive dysuria with 2 cases had chronic urinary retention and 2 had upper urinary tract hydronephrosis. On admission, all cases were palpated a hard prostate mass in digital rectal examination. Serum tPSA were 0. 57-6.36 ng/ml with a ratio f/t PSA 0. 26-0.63. B ultrasound, CT and MRI detected 3.9 cm×3. 9 cm×1.6 cm-11.3 cm×7. 9 cm×9. 5 cm irregular shape mass in prostate. 2 cases had seminal vesicle involved, 2 cases had rectum involved, 2 had unilateral ureter involved, and 1 case had sacrum involved. Pelvic lymphonodes metastasis were seen in 3 cases. Bone scan detected multiple bone metastasis in 3 patients. Results The final diagnoses were accomplished by prostate biopsy. Under light microscope, tumor cells were orbivular-ovate or fusiform shape, small volume, and had little cytoplasm. The margin of tumor cells was not clear. Caryokinesis phase could be found with hyperchromatic chromatin. Immunohistochemistry showed positive ChA staining in 4 eases, positive NSE expression in 2 patients and negative PSA in 4 cases. 3 cases were given cisplatin-based chemotherapy, pelvic radiation, or chemotherapy plus radiotherapy. All patients appeared widespread metastasis quickly and died or lost visit within one year. Conclusions SCPCa is a rare, poor prognosis malignancy with early extensive metastasis. The diagnosis is based on pathology.