ABSTRACT
The clinical data of 6 acute promyelocytic leukemia (APL) patients with thrombosis as the first manifestation were retrospectively analyzed. Among 6 patients, 5 were males and 1 female.The median age at diagnosis was 55 years old. All patients had risk factors for cardiovascular disease (CVD), and 5 patients met the diagnostic criteria for disseminated intravascular coagulation (DIC). There were 3 patients at low risk (bcr1 subtype), 1 at intermediate risk (bcr2 subtype) and 2 at high risk (1 bcr3 subtype and 1 unknown). FLT3-ITD mutations were tested in 3 cases, all of whom showed negative results. Arterial thrombosis was found in all 6 cases, 4 cases had cerebral infarction, 1 had lower limb arterial embolism, and 1 had multiple arterial and venous thrombosis. Four patients with cerebral infarction received all-trans retinoic acid (ATRA) combined with arsenic trioxide (ATO)±chemotherapy and symptomatic treatment (1 patient at high risk did not receive ATRA), 2 patients achieved complete remission (CR), and the other 2 patients died of cerebral hemorrhage and cerebral infarction, respectively. One patient with lower extremity arterial thrombosis died suddenly within 12 h after admission likely due to acute myocardial infarction. One patient with mixed thrombosis received low molecular weight heparin and rivaroxaban successively after inferior vena cava filter implantation, and achieved CR after ATRA+ATO treatment. Thrombosis is a less common and under-recognized presentation in APL.Thrombosis patients with blood cells and/or coagulation abnormalities should consider the possibility of APL. APL patients complicated with thrombosis have a high probability of DIC and remain mostly intractable to existing treatments, who are at high risk of death and poor prognosis.
ABSTRACT
Objective To study the effects of Yunnan BaiYao on the expressions of c-fos and c-jun mRNA in HPDLFs and explore the potential mechanism that Yunnan BaiYao promotes the proliferation and differentiation of HPDLFs.Methods The HPDLFs tissue was obtained from the extracted healthy premolar.The HPDLFs used underwent four to six passages.Cells were divided into untreated group,positive control group and treated group.In treated group,HPDLFs were co-cultured with Yunnan BaiYao solution for 4h with gradient concentration.The expressions of c-fos and c-jun mRNA were determined by RT-PCR.Results The results showed that the expressions of c-fos and c-jun mRNA were up-regulated significantly in treated group compared with control group (P＜0.05) Conclusion Yunnna BaiYao can upregulate the expressions of c-los and C-jun mRNA in HPDLFs.Through upregulating the expressions of c-fos and c-jun mRNA in hPDLs,Yunnan BaiYao can promote proliferation and differentiation of ossification of HPDLFs to induce bone formation.
ABSTRACT
BACKGROUND:The structure surrounding upper thoracic spine is complicated. Transverse diameter of pedicle was relatively smal . There were important organs in front of the vertebral body. Screws deviated from axis or screws were too long. The safety and effectiveness of screw implantation were not implemented. It is necessary to understand the key structure of surroundings. OBJECTIVE:To analyze the relationship of anatomic position between the axis of screw of pedicle of upper thoracic spine and key adjacent structure of the vertebral body. METHODS:A total of 30 healthy adult volunteers received T 1-T 4 pedicle axis paral el to CT scans. The positions of esophagus, trachea position, aortic arch, carotid and vertebral arteries were observed when the pedicle screw was implanted along the pedicle axis. The shortest distance on both sides of a vertebral pedicle axis from these structures was measured. Paired t-test was utilized for analysis. RESULTS AND CONCLUSION:240 measurement parameters were analyzed. The distance from the left pedicle axis on T 1-3 to esophagus was smal , and the left pedicle on T 2 was minimal. The distance from the right pedicle axis on T 2-4 to trachea was smal . The distance from right pedicle axis on T 3 , T 4 to right main bronchus was smal . Carotid and vertebral artery did not show the risk of injury. 62%of the patients were in the aortic arch on T 4 plane, and no risk of damage was found. These results indicated that the left pedicle screws were easy to damage the esophagus, and the right pedicle screw was easy to damage trachea. Carotid artery, vertebral artery and aortic arch were not easy to be damaged. The anatomic position of easily damaged structure could be identified by careful analysis of CT data before screw implantation in the pedicle of upper thoracic spine.