A novel nomogram can predict pathological T3a upstaged from clinical T1a in localized renal cell carcinoma

ABSTRACT Hypothesis: Nomogram can be built to predict the pathological T3a upstaging from clinical T1a in patients with localized renal cell carcinoma before surgery. Purpose: Renal cell carcinoma (RCC) patients with clinical T1a (cT1a) disease who are upstaged to pathological T3a (pT3a) have reduced survivals after partial nephrectomy. We aimed to develop a nomogram-based model predicting pT3a upstaging in RCC patients with preoperative cT1a based on multiple preoperative blood indexes and oncological characteristics. Materials and Methods: Between 2010 and 2019, 510 patients with cT1a RCC were individually matched according to pT3a upstaging and pathological T1a (pT1a) at a 1:4 ratio using clinicopathologic features. Least absolute shrinkage and selection operator regression analysis was used to identify the most important risk factor from 40 peripheral blood indicators, and a predictive model was established. Multivariate logistic regression analysis was performed with the screened blood parameters and clinical data to identify significant variables. Harrell's concordance index (C-index) was applied to evaluate the accuracy of the model for predicting pT3a upstaging in patients with cT1a RCC. Results: Out of 40 blood indexes, the top ranked predictor was fibrinogen (FIB). Age, the ratio of the tumor maximum and minimum diameter (ROD), FIB, and tumor size were all independent risk factors for pT3a upstaging in multivariate analysis. A predictive ARFS model (Age, ROD, FIB, tumor Size) was established, and the C-index was 0.756 (95% CI, 0.681-0.831) and 0.712 (95% CI, 0.638-0.785) in the training and validation cohorts, respectively. Conclusions: Older age, higher ROD, increased FIB level, and larger tumor size were independent risk factors for upstaging. The ARFS model has a high prediction efficiency for pT3a upstaging in patients with cT1a RCC.

Effects of aspirin, vitamin D3, and progesterone on pregnancy outcomes in an autoimmune recurrent spontaneous abortion model

High proportions of placental lymphocytes expressing DX5+/CD25+/FOXP3+/CD45+/CD4+ are beneficial to maintain immune tolerance and improve pregnancy outcomes. This study aimed to compare and evaluate the therapeutic effects of aspirin, vitamin D3 (VitD3), and progesterone on the autoimmune recurrent spontaneous abortion (RSA) model. The autoimmune RSA mouse model was constructed, and the embryo loss rate was calculated for each group. Then, primary mouse placental lymphocytes were isolated, and the expression of DX5+/CD25+/FOXP3+/CD45+/CD4+ was detected through flow cytometry. The serum levels of anti-cardiolipin antibody (ACA), β2-GP1, CXCL6, IFN-γ, and IL-6 were measured by ELISA to evaluate the proportion of Th1 and Th2 cells. Autoimmune RSA significantly increased the embryo loss rate, which was improved by aspirin, VitD3, and progesterone treatment, and progesterone treatment had the best effect among the three treatments. The positive expression of DX5+/CD25+/FOXP3+/CD45+/CD4+ in the VitD3 and progesterone groups was significantly higher than that in the autoimmune RSA group, and the expression was highest in the progesterone treatment group. In the plasma of autoimmune RSA mice, the ACA, β2-GP1, CXCL6, and IFN-γ levels were significantly higher and the IL-6 level was lower than the levels in control mice. All these changes could be reversed by aspirin and progesterone treatment. In conclusion, aspirin, VitD3 and progesterone treatment improved pregnancy outcomes in autoimmune RSA mice by regulating the Th1/Th2 balance and cytokines, and progesterone had the best effect of the three treatments.

Folic Acid Supplementation in Chinese Peri-conceptional Population: Results from the SPCC Study / 生物医学与环境科学（英文）

Objective@#To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.@*Methods@#This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018.@*Results@#Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older ( : 1.13, 95% : 1.08-1.18), had higher education ( : 1.71, 95% : 1.53-1.92), and were residing in urban districts ( : 1.06, 95% : 1.01-1.11) of FA supplementation; female pregnancy planners with alcohol consumption ( : 0.95, 95% : 0.90-0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level ( : 1.04, 95% : 1.03-1.06), who underwent pre-pregnancy examination ( : 1.02, 95% : 1.01-1.03) had higher odds of using an FA supplement; older aged ( : 0.99, 95% : 0.98-0.99), and multigravida ( : 0.97, 95% : 0.96-0.98) had lower odds of FA supplementation.@*Conclusion@#Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.

The individualized formular administration of tacrolimus after kidney transplantation based on the CYP3A5 and MDR1 gene polymorphism / 中华器官移植杂志

Objective To explore the feasibility and clinical significance of individualized formular administration of tacrolimus after renal transplantation based on the CYP3A5 and MDR1 gene polymorphism.Methods Total 129 renal transplantation recipients from Oct.1,2015 to July 30,2016 were included in this study and divided into 2 groups.In experimental group,tacrolimus was administrated by the individualized formula based on CYP3A5 and MDR1 gene polymorphism;in control group,tacrolimus was administrated by doctors' experience based on patient's body weight.The blood trough level of tacrolimus was determined 3 days after administration.The first blood trough level of tacrolimus,plasma creatinine level,acute rejection rate,and necessity for dialysis were compared between two groups.Results The first blood trough levels of tacrolimus in experimental and control groups were 9.24 ± 2.32 and 9.39 ± 3.47μg/L respectively (P＞0.05).The tacrolimus levels of 7 cases in experimental group and 18 cases in control group were not in normal range (P＜0.05).The plasma creatinine level at day 7 after surgery was 157.36 ± 110.55 μg/L in experimental group,and 174.01 ± 130.68μg/L in control group (P＞0.05).Acute rejection was found in both two groups:2 in experimental group and 5 in control group (P ＞ 0.05).There was significant difference in necessity for dialysis between two groups:4 in experimental group and 10 in control group (P＜0.05).Conclusion The individualized formular administration of tacrolimus based on the CYP3A5 and MDR1 gene polymorphism is more feasible and reasonable than experimental administration,which is more easier to come to an appropriate blood level and would benefit the early recovery of renal function.

Predictors for the mortality of malignant tumor patients with invasive candidiasis / 中国肿瘤临床

Objective:To evaluate the predictors for the mortality of patients with malignant tumor and invasive candidiasis in order to contribute to the strategies of prognosis improvement. Methods:This retrospective study includes patients with malignant tumor and invasive candidiasis who were hospitalized during 2013 to 2015. Their clinical characteristics, medication treatment, types of tumor, and mortality rate were collected and analyzed. Categorical data were analyzed by the Fisher's exact test. Factors with a P value<0.05 were included in the multivariate Logistic regression model to determine the independent risk factors. Results:A total of 125 patients with malignant tumor with invasive candidiasis were included. The major pathogen was still Candida albicans, which caused 42.4％of the infections, followed by Candida glabrate (21.6％), Candida parapsilosis (16.8％), and Candida tropicalis (10.4％). Abdominal candidia-sis (51.2％) was the most common type of infection. The crude mortality rate for invasive candidiasis was 26.4％. Azotemia, more than two indwelling catheters, delayed antifungal treatment, and combination with bacterial infections were the independent risk factors for the death of patients with malignant tumor and invasive candidiasis as compared with the survival group. Surgery within 30 days before diagnosing candidiasis was confirmed to be a protective factor for prognosis. Conclusion:Invasive candidiasis among patients with malignant tumor induced a high mortality rate. The data on the predictors for death may be valuable in developing strategies for prognosis improvement.

Platelet-rich-plasma for intervertebral disc degeneration: from bench to bedside / 中国组织工程研究

BACKGROUND: Intervertebral disc degeneration (IDD) is a common cause of low back pain. Microenvironmental and cytological changes of intervertebral disc are main factors inducing disc degeneration. However, the underlying mechanism still remains unclear.OBJECTIVE: To review the application of platelet rich plasma (PRP) in the treatment of IDD.METHODS: First, the article structure was designed, and then WanFang and CNKI databases were retrieved for related articles using Chinese and English keywords. After analyzing the abstract and main body, the eligible articles were enrolled according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION: Surgical treatment has achieved remarkable outcomes in the treatment of middle- and late-stage IDD. However, there is still no good conservative therapy for early degeneration. PRP has been extensively applied in the treatment of IDD due to its improvement in tissue healing and regeneration. PRP has been proved to be capable of effectively delaying and even reversing IDD through cytology tests and animal experiments. Some clinical trials have shown that PRP treatment can ease low back pain, while others have demonstrated that the combination of PRP and other biological treatments can significantly improve IDD. Nowadays, most of the experiments are limited in the study of cytology and zoology rather than clinical trials, and there is still no unified standard for extraction method, dose and optimal injection time of PRP. Moreover, there is little reported on its side effects. Consequently, the curative effect of PRP for IDD needs to be verified further.

Teratoma at the Esophagogastric Junction in a Neonate.

Background: Teratoma at the esophagogastric junction is extremely rare. Case Report: A 26-day-old male neonate who presented with vomiting and melena. Observation: Investigations revealed a mass at the esophagogastric junction, which was excised and confirmed to be a teratoma. Outcome: A fistula at the lower end of the esophagus and an esophageal hiatal hernia were observed as complications. Message: A careful surgical approach is warranted for a teratoma in esophagogastric junction, to avoid postoperative complications.

Establishment and Applications of Double-Fluorescent Protein Allo-Transplantation Mice Model / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To establish allo-transplantation model by using mRFP⁺ to eGFP⁺ transgenic mice and to observe the distribution of donor cells and donor-recipient cellular interaction in the bone marrow after semi-solid decalcification (SSD).</p><p><b>METHODS</b>After myeloablative irradiation, C57BL/6 female eGFP⁺ transgenic mice were infused with (5 × 10⁶) bone marrow cells from FVB male donor mice through tail vein. The control group was infused with PBS. Then the general conditions, engraftment level, hematopoietic recovery, incidence of GVHD and survival of recipients were evaluated after transplantation. In the recovery process, SSD was used to treat the femora before observing the cells distribution, morphology and interaction by confocal microscopy directly or after making frozen section.</p><p><b>RESULTS</b>WBC of recipient eGFP⁺ mice was recovered on (20 ± 3.07) d, (93.94 ± 1.59)% in peripheral cells were RFP⁺ cells (n = 10), GVHD happened in 4 of 10 mice within 1 month. During SSD, the hard components were replaced gradually and RFP⁺ cells could be seen mainly in the bone trabecula and surrounded by eGFP⁺ cells under confocal microscope, their interactions could be further observed clearly in bone marrow microenvironment in three-dimensional reconstruction.</p><p><b>CONCLUSION</b>The double fluorescent allo-transplantation mouse model successfully established, by means of our novel protocol named SSD, the donor and recipient cell location and their interaction can be visually observed, which provides the basis for clinical studies on the distribution and homing of donor cells, and some related explorations after transplantation.</p>

Strengthening the CCP Party building of public hospitals leveraging CCP Party building performance evalua-tion / 中华医院管理杂志

To meet the needs of serving the general strategy,the central work and hospital development,the CCP committee of Beijing Municipal Administration of Hospitals has innovated and improved the leadership of the CCP building,and promoted the model at public hospitals by formulating and announcing the Indicators System for Municipal Public Hospitals ’ Party Building Performance Evaluation.This implementation aims to to guide,regulate and encourage the CCP work,which proves effective enhancement of the CCP building in municipal hospitals in terms of quality,efficiency,and effectiveness.

Clinical analysis of bilateral same-day myringoplasty for 22 cases with bilateral tympanic membrane perforation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of bilateral same-day myringoplasty and the indications for myringoplasty for patients with bilateral tympanic membrane perforation, and to summarize relevant experience.</p><p><b>METHODS</b>Twenty-two patients underwent bilateral same-day underlay myringoplasty, and all cases were consistent with the indications for myringoplasty. The preoperative hearing and postoperative hearing at three months were compared, and the postoperative symptoms and complications were observed. Forty patients underwent monaural myringoplasty as the control group over the same period. All cases were followed up for 1 - 3 years.</p><p><b>RESULTS</b>The postoperative hearing was increased by an average of 18 dB, and the rate of closure of tympanic membrane perforation was 93.2% (41/44). There were seven patients with ear fullness after operation in the bilateral myringoplasty group and two patients in the control group (χ(2) = 4.5374, P = 0.0332). There were no differences in the postoperative hearing improvement, the rate of closure and the rates of other discomfort symptoms except for ear fullness between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>It was feasible and safe to perform bilateral same-day myringoplasty for bilateral tympanic membrane perforation, but the postoperative temporary discomfort of bilateral ear fullness should be informed the patients in advance.</p>

Anti-apoptotic effect of Astragalus Polysaccharide on myeloid cells / 中国实验血液学杂志

This study was aimed to assess the effect of Astragalus Polysaccharide (ASPS) on in-vitro hematopoiesis. CFU-GM assays were used to determine the effect of ASPS and thrombopoietin (TPO) on granulocytic-monocyte progenitor cells. The CFU assays were also used to investigate the effect of ASPS on the proliferation of HL-60 cells.HL-60 cells were cultured with serum-free RPMI 1640 medium and treated with or without of different concentrations of ASPS. After 72 h incubation, the number of cells were counted.In addition, the caspase-3 and JC-1 expression was determined by flow cytometry with Annexin V/PI double staining. The results showed that ASPS (100, 200 µg/ml) and TPO (100 ng/ml) significantly promoted CFU-GM formation in vitro. Various concentrations of ASPS and TPO also promoted the colony formation of HL-60 cells, the largest effect of ASPS was observed at a concentration of 100 µg/ml. There were no synergistic effects between TPO and ASPS on cellular proliferation. The results also showed that ASPS significantly protected HL-60 cells from apoptosis in condition of serum-free medium culture, suppressed caspase 3 activation, and reduced the cell apoptosis. It is concluded that ASPS can significantly promote the formation of bone marrow CFU-GM and the proliferation of HL-60 cells, the optimal concentration of ASPS is at 100 µg/ml. In the absence of serum inducing apoptosis, ASPS also significantly reduced the apoptosis of HL-60 cells via suppressing the activation of caspase-3.

Functional analysis of the vertical semicircular canal using vertical plane swing test and study of its normal values / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The purpose of this study was to set up a method to analyze the vertical semicircular canal function and study the normal values of the vertical semicircular canal function using the vertical plane swing test.</p><p><b>METHODS</b>A prospective analysis of 100 normal persons (aged from 18 to 59 years), who were treated by using the vertical plane swing test with the newly developed automatic vestibular function diagnosis and therapy system (SRM-IV). These persons were rotated 180° at a sinusoidal speed (acceleration 45°/s, maximum speed 90°/s) in the vertical semicircular canal plane. Using a PC, evoked vertical nystagmus was analyzed in order to evaluate the excitability of vertical semicircular canals, including the number and the duration of nystagmus, the slow phase velocity and other parameters. Meanwhile, the all persons were divided into two groups, order and younger than 45 years respectively. In the test procedure, with the two pairs of the right anterior vertical semicircular canal and left posterior vertical semicircular canal (RALP) as well as the left anterior vertical semicircular canal and the rear right vertical semicircular canals (LARP), the average slow phase velocity of the vertical nystagmus and the canal paresis (CP) of the two pairs of vertical semicircular canals were calculated using PC and SPSS13.0 software for statistical analysis.</p><p><b>RESULTS</b>There was no significant difference between the two groups (P > 0.05). The general CP of RALP was 10.2% ± 7.1%, and LARP was 10.4% ± 6.2%. The normal CP range of the vertical semicircular canal in the health group was identified (idea: ≤ 20%; normal high: 20% - 25%).</p><p><b>CONCLUSION</b>The 180° vertical plane sinusoidal swing method is effective in functional analysis of the vertical semicircular canal, it is expected to be reliably used in clinical treatment.</p>

Operation of hypopharyngeal carcinoma with restrained vocal cord motility / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of laryngeal function preservation in surgical treatment of hypopharyngeal carcinoma with restrained vocal cord motility.</p><p><b>METHODS</b>Twenty-six cases of hypopharyngeal carcinoma treated with conservative hypopharyngectomy were retrospectively analyzed. Partial resection of pyriform sinus and partial laryngectomy were performed. Suturing the remaining hypopharyngeal mucosa was used to cove the wound of hypopharynx in 5 cases, epiglottis complex flap in 21 cases. All patients received postoperative radiotherapy.</p><p><b>RESULTS</b>The overall 3- and 5-year survival rates were 61.4% and 50.8% respectively. 76.9% (20/26) patients have laryngeal functions (voice, respiration and deglutition) completely restored and 23.1% (6/26) partially restored (voice and deglutition).</p><p><b>CONCLUSIONS</b>To improve the quality of life of the cases, the preservative surgery is feasible for the selected hypopharyngeal carcinoma cases with restrained vocal cord motility.</p>

Study of the key points and safety measures during perioperative period in patients with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the safety measures during perioperative period in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), to minimize uvulopalatopharyngoplasty (UPPP) major complications.</p><p><b>METHODS</b>The complications and other relative information of 1446 OSAHS patients treated with UPPP were analyzed. Complications of 1004 OSAHS patients adopted standardized management measures after 2004 and 442 OSAHS patients who performed UPPP before 2003 were compared.</p><p><b>RESULTS</b>Among the 1446 cases of OSAHS surgery, there were 49 cases (3.39%) of difficult intubation; 8 cases (0.55%) intraoperative mild arrhythmia; 13 cases (0.90%) of surgery dangerous situations after extubation; 19 cases (1.31%) of intraoperative primary hemorrhage; 11 cases (0.76%) of mild arrhythmia during the postoperative observation period; 21 cases (1.45%) of uncontrolled hypertension immediately after surgery; 32 cases of secondary hemorrhage a week after surgery. All complications were cured and no death occurred. Compared with those operations before 2003, complications were significantly reduced with enforcement of standardized management of perioperative measures since 2004. The data had significant difference by chi(2) test (P < 0.05).</p><p><b>CONCLUSIONS</b>There are five key points during the perioperative period of OSAHS surgery: preoperative examination, intubation, surgery, postoperative extubation, and postoperative care. Risk factors and complications could be prevented effectively in the above five important processes.</p>

Simultaneous analysis of telomere length and cell surface antigen in leukemia by multicolor Flow-FISH / 中国实验血液学杂志

This study was purposed to explore the feasibility of simultaneous analysis of telomere length and cell surface antigen by multicolor Flow-FISH to assess minimal residual disease (MRD) in leukemia. The telomere length in 34 leukemia patients versus 20 normal controls was compared by using Flow-FISH, and the relationship between telomere length and therapeutic effect and prognosis was analyzed preliminarily. As for those patients with follow-up samples, the changes of telomere length combined with surface antigen in different courses of disease were observed by multicolor Flow-FISH. The results indicated that the telomere length of de novo patients was significantly shorter than that of controls except the patients in chronic myeloid leukemia-chronic phase (CML-CP). The shorter telomere, the lower complete remission (CR) rates were observed in acute leukemia cases and the shorter duration of CP before onset of blast phase (BP) occurred in CML cases. The acute leukemia patients showed longer telomere and fewer cells expressed the related antigen after CR. The telomere length of cases with continued CR remained at normal level during remission, and there was no increased expression of the specific antigen. However, the telomere of relapsed cases shortened again after relapse with elevated specific antigen expression. In the relapsed cases, the telomere of related antigen positive cells shortened ahead of telomere length change of the whole cells and morphologic change of bone marrow cells. It is concluded that analysis of telomere length by flow-FISH manifests the significance for monitoring disease conditions, estimating prognosis and guiding therapy in all kinds of leukemia. The simultaneous analysis of telomere length and cell surface antigen by multicolor flow-FISH may monitor abnormal clone or clonal evolution to predict recurrence more sensitively and specifically, and may provide a promising and widely applicable method for monitoring MRD in leukemia.

CD56 and CD11b antigen expressions in patients with acute monocytic leukemia and the clinical implications / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expressions of cell surface differentiation antigen CD56 and CD11b antigen in acute monocytic leukemic (AML-M(5)) cells and their clinical significance.</p><p><b>METHODS</b>A total of 113 cases of de nove adult AML-M(5) were examined genetically and immunologically using G-banding technique, interphase fluorescence in situ hybridization (I-FISH) and flow cytometry immunophenotyping, and the results were analyzed in relation to their clinical data.</p><p><b>RESULTS</b>Of the 113 cases, the expression rates of CD56 and CD11b was 28.32% and 73.45%, respectively. The CD56(+) patients had high CD11b expression, and the expression levels of CD11b and CD56 were positively correlated (P<0.05). The incidence of karyotypic abnormalities was 48.57% (55 cases) in these patients, including 25 (22.12%) with 11q23 aberrations. Twenty-five cases were positive for MLL gene abnormalities as found by I-FISH analysis. Compared with the patients positive for both CD56 and CD11b, those negative for both CD56 and CD11b showed increased peripheral blood white blood cell (WBC) count and also increased blast and progenitor cells in the bone marrow (P<0.05); the former patients often had karyotypic abnormalities, commonly involving 11q23 aberrations (P<0.05), whereas the latter patients presented more likely with extramedullary infiltration and refractory leukemia (P<0.01) with lowered complete remission rate and shortened median survival time (P<0.01). CD56-positive patients were more likely to have karyotypic abnormalities and refractory leukemia than CD11b-postive patients (P<0.05), but the peripheral blood WBC counts, bone marrow blast and progenitor cells, extramedullary infiltration, complete remission rate or median survival time showed no significant differences between them (P>0.05).</p><p><b>CONCLUSION</b>AML-M(5) patients with CD56 positivity and high expression of CD11b often have aberrant karyotypes, commonly involving 11q23/MLL gene abnormality. These patients frequently develop extramedullary infiltration and refractory leukemia often with poor prognosis.</p>

Clinical characteristics and outcomes of 59 patients with acute lymphoblastic leukemia positive for BCR/ABL / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the clinical characteristics and outcomes of BCR/ABL-positive acute lymphoblastic leukemia (BCR/ABL360888725-ALL) and screen the prognostic factors for BCR/ABL360888725-ALL.</p><p><b>METHODS</b>From January 2001 to May 2008, 59 patients (median age of 32 years ranging from 3 to 69 years) with the diagnosis of BCR/ABL360888725-ALL by fluorescence in situ hybridization received induction chemotherapy with VDLP-/+Ara-C regimen. The patients who failed to respond to the chemotherapy received subsequent consolidation chemotherapy with imatinib (400-800 mg/day) (17 cases) or allogeneic hematopoietic stem cell transplantation (allo-HSCT) (16 cases).</p><p><b>RESULTS</b>Of the 59 patients, 32 (58.3%) achieved complete remission (CR) after the first induction cycle. In patients with peripheral white blood cell (WBC) count <30=10(9)/L, 30-99.9(9)/L and > or =100(9)/L, the CR rates were 75.0% (18/24), 56.3% (9/15) and 26.3% (5/19) (P=0.006), and the overall survival probability of 2 years ( OSs of 2-yrs) was 24.7%, 22.5% and 21.1%, respectively (P=0.180). According to the FAB classification, 56 cases were divided into L1, L2 and biphenotypic acute leukemia (BAL) subgroups, and their CR rates were 66.7% (6/9), 63.2% (24/38) and 22.2% (2/9) (P=0.029), with OSs of 2-yrs of 22.2%, 27.0% and 22.0%, respectively (P=0.623). In terms of immunophenotype grouping by EGIL, the patients with ALL, myeloid antigen-positive ALL and BAL had CR rates of 61.1% (11/18), 60.6% (20/33) and 12.5% (1/8) (P=0.039), and the OSs of 2-yrs of 22.7%, 21.0% and 18.8%, respectively (P=0.643). In 55 patients with known karyotype, the CR rates were 71.4%(5/7), 70.8% (17/24) and 37.5% (9/24) in normal, sole t(9;22) abnormality, t(9;22) with additional abnormalities groups (P=0.046), with the OSs of 2-yrs of 42.9%, 34.0% and 7.3%, respectively (P=0.000). The patients complicated by septicemia had significantly lower OSs of 2-yrs than those without septicemia (0% vs 38.8%, P=0.005). The OSs of 2-yrs were significantly higher in patients with consolidation chemotherapy with imatinib than those without (48.0% vs 11.2%, P=0.001), and allo-HSCT was associated with significantly higher OSs of 2-yrs than exclusive chemotherapy (54.2% and 8.5%, P=0.000).</p><p><b>CONCLUSION</b>BCR/ABL360888725-ALL with WBC> or =100 x 10(9)/L, presence of BAL diagnosed by FAB or FACM, t(9;22) with additional chromosome abnormalities all adversely affect the treatment results, and additional chromosome abnormalities and septicemia are associated with lower OSs of 2-yrs. Imatinib treatment and allo-HSCT can both improve the OSs of 2-yrs of the patients with BCR/ABL(+)-ALL.</p>

Applied study of voice function rehabilitation by mucosa tube performed in operation of late laryngocarcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the voice function rehabilitation by mucosa tube performed in operation of late laryngocarcinoma and to improve the survival quality of patients with late laryngocarcinoma.</p><p><b>METHODS</b>Forty-six patients were treated between Oct. 1991 and May 2006, including 41 males and 5 females. The average age of the patients was 54. Seventeen cases were glottic carcinomas (T3N0M0 12, T3N1M0 5), 27 cases were supraglottic carcinomas (T3N1M0 16, T4N1M0 5, T3N0M0 6), 2 cases were pyriform sinus cancer (T4N1M0 2). For those patients with late laryngocarcinoma, who had lost the chance of partial laryngectomy, mucosa tube shaping during the operation could realize voice functional rehabilitation. Only the survive arytenoids of healthy side was preserved, in order to rehabilitate voice, a mucosa tube was sutured using healthy survive arytenoids and a mucosa strip was connected to the trachea and the mucosa of hypopharynx. Survival analysis was performed by using Kaplan-Meier method.</p><p><b>RESULTS</b>Forty-one out of 46 patients obtained almost normal voice and swallow function. The 5-years survival was 76%.</p><p><b>CONCLUSIONS</b>The operation of voice function rehabilitation by mucosa tube performed can get good voice and swallow function to patients with late laryngo carcinoma.</p>

Analysis and application of the images from the segmenting CT in the space of nasal endoscope / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the images from the segmenting CT in the space of nasal endoscope and to observe the benefits in applying the method in endoscopic sinus surgery.</p><p><b>METHODS</b>Five patients with inverted papilloma and ten patients with chronic rhinosinusitis were enrolled. The images from the coronal CT were put in the ideal model of the nasal cavity, which had been designed by SketchUp software package, and the space of the model in the 0 degree rod-lens telescope was simulated and observed according to definite elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. The surgical plan was designed and compared with the models of the intraoperative corresponding vision.</p><p><b>RESULTS</b>The anatomical form of the images from the coronal CT and the directions of the space in the visual field of the endoscope were correlative with the elevation angle between the endoscope and bottom of nasal cavity and the distance of the endoscope entering the nasal cavity. Based on the elevation angle and the entering distance of the endoscope, the images from the CT scan in the space of nasal endoscope were analysed according to the order, which were consistent with the findings in the intraoperative corresponding vision, providing the accurate directions of the space for the endoscopic sinus surgery.</p><p><b>CONCLUSIONS</b>The changes of the images of the CT scan in the space of the endoscope were consistent with the perspective law. To know the perspective law could grasp the directions of the space in the visual field of the endoscope and ensure the safety of the endoscopic surgery. The method was simple and feasible. The benefits of this technique were confirmed by clinician.</p>

Clinical, electromyographic and cervical magnetic resonance imaging features of Hirayama disease / 中华神经医学杂志

Objective To investigate the clinical, electromyographic and cervical magnetic resonance imaging (MRI) characteristics of Hirayama disease. Methods Fifteen patients with Hirayama disease were observed for special clinical manifestations and underwent electromyographic examination of the bilateral distal upper limb muscles and peripheral nerve conduction velocity. MRI of the neck in neutral and fully flexed positions was performed to identify potential lower cervical cord atrophy and cervical curvature anomalies. Results All the 15 male patients had disease onset during puberty with asymmetric muscular atrophy and weakness of the hands and forearms. Concentric needle electromyography revealed prolonged duration and large amplitude of the motor unit potentials in the compromised distal limb muscles with also increased polyphasic potentials and poor recruitment, involving mainly the C7, C8 and T1 myotomes. In neutral neck position, MRI identified lower cervical cord atrophy in 9 patients, occurring mainly at C5, C6 levels;in fully flexed position, all patients showed forward displacement and flattening of the lower cervical cord, occurring mostly at C6 level. Conclusion Hirayama disease occurs mainly in puberty in young male patients, whose clinical features and electromyographic examination often indicate localized anterior horn anomalies in the lower cervical cord. MRI of the neck in neutral and fully flexed position can provide valuable assistance in the diagnosis of this disease.