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Objective To explore the pregnancy outcomes in women whose fetal/embryonic heart rate( FHR) were below 120 beats per minute( bpm) before 8 weeks pregnancy and determine the predictive value of FHR in pregnancy outcome . Methods The laboratory examinations ,clinical data and clinical history of the pregnant women whose FHR were below 120 bpm before 8 weeks pregnancy were retrospectively analyzed . Results When gestational age(GA) was less than 8 weeks ,pregnancy loss was observed in 11 .0% ( 110/998 ) cases with an FHR less than or equal to 120 bpm ,and pregnancy loss occurred in all the cases ( 23/23) with an FHR less than or equal to 70 bpm . The proportions of first trimester loss were 86 .4% (19/22) for pregnancies with an FHR of 71 －80 bpm ,75 .7% (28/37) for pregnancies with an FHR of 81－90 bpm ,25 .5% (14/55) for pregnancies with an FHR of 91 －100 bpm , 6 .3% (13/208) for pregnancies with an FHR of 101 －110 bpm ,and 2 .0% (13/653) for pregnancies with an FHR of 111 －120 bpm .ROC analysis showed that the best cut-off value to predict adverse pregnancy outcomes was an FHR of 94 bpm . The area under the ROC curve was 0 .906 ( P ＜ 0 .0001 ) and its sensitivity and specificity values were 97 .86% and 71 .43% respectively . Conclusions Fetal/embryonic heart monitoring before 8-weeks pregnancy can be an effective predictor for early pregnancy outcome . The best cut-off value to predict adverse pregnancy outcomes is an FHR of 94 bpm .
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Objective To study the time of monoclonal immunoglobulinemia of undetermined significance (MIUS) transforming into multiple myeloma (MM),and the changes of immunoglobulin level and the clinical features.Methods A retrospective analysis was conducted in 22 patients with MM.According to the follow-up of immunoglobulin levels,patients were divided into formal and informal groups.The changes in immunoglobulin,serum calcium,hemoglobin and creatinine concentrations,and the time of MIUS transforming into MM were detected,and the impact of treatment on the prognosis was analyzed.Results The median age at diagnosis as MIUS was 69 years in formal group and 79 years in informal group.The median time for MIUS transforming into MM was 9.8 years in formal group and 1.3 years in informal group (P 0.006).The initial average concentration of immunoglobulin in patients with MIUS was 12.5 g/L (2.0-31.6 g/L) in informal group and 11.5 g/L (2.8-29.0 g/ L) in formal group (P＞0.05).There were no significant differences in levels changes of immunoglobulin,serum calcium,hemoglobin,creatinine index before and after the outcome.The transfer time for MIUS transforming into multiple myeloma was 9.8 years and 9.7 years,and the survival time was 13.6 years and 13.5 years in patients with versus without treatment (P＞ 0.05).Conclusions Regular formal follow up can accurately assess the transfer time for MIUS to MM,and the transfer time is longer in formal groups than in informal group.The changes in concentrations of immune globulin,serum calcium,hemoglobin,and creatinine cannot serve as indicators for outcome evaluation.Drug treatment neither delays the progress time of MIUS to MM nor reduces the complications of MM and nor prolongs the survival time.
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Objective: To investigate the short term clinical efifcacy of endovascular repair for complicated acute type Stanford B aortic dissection. Methods: To retrospectively analyze the clinical data of 36 patients with complicated acute type Stanford B aortic dissection who received endovascular repair in our hospital from 2010-01 to 2014-06 including operational procedure and post-operative follow-up of CT angiography. There were 27 male and 9 female patients with the average age of 43.7 years (41-62) years. Results: Successful operations were conducted in all 36 patients. 22 patients received endovascular repair combined with covering left subclavian artery (LSA),10 received endovascular repair combined with chimney technique, 2 received endovascular repair combined with vascular prosthesis bypass from left common carotid artery to LSA, 2 received endovascular repair combined with vascular prosthesis bypass from right common carotid artery to left common carotid artery, whose proximal parts were ligated. Viscera artery and lower extremity artery supply were restored gradually. No complication of endoleak occurred. There 30/36 (83.33%) patients were followed-up for 1 year, and 10 patients developed thrombus in full false lumen and 20 developed thrombus in partial false lumen after 1 year. Compared with pre-operative values, thoracic aortic true lumen volume increased in either thrombus in full false lumen (190 ± 68.7) ml vs, (125.3 ± 63.4) ml and thrombus in partial false lumen (166.2 ± 71.8) ml vs (110.1 ± 62.7) ml,P Conclusion: For endovascular repair of complicated aortic dissection, covering LSA with chimney technique and hybrid operation of small incision could extend anchor zone and expand the range of endovascular repair which may improve the effect and reduce the complication for good short term effect.
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<p><b>OBJECTIVE</b>To explore the clinical characteristics and prognostic value of monosomal karyotype (MK) patients in adult acute myeloid leukemia (AML).</p><p><b>METHODS</b>We retrospectively studied 45 patients of MK⁺ in newly-diagnosed adult AML in our center from Oct 2000 to Dec 2012. Clinical characteristics, cytogenetic data and prognostic features were analyzed in the cohort of MK⁺ patients.</p><p><b>RESULTS</b>MK was found in 45 patients (19.0%) of 237 newly-diagnosed adult AML with cytogenetic data available at diagnoses. Among these 45 cases, there were 28 male (62.2%) and 17 female (37.8%). Median age of MK⁺ patients at diagnose was 58(18-91) years old. The presence of -5(31.1%) and -7(17.8%) were the most common chromatid among MK⁺ AML patients. MK was much more prevalent among elderly patients. Among AML patients, the proportions of MK⁺ patients younger than 30, 30 to 59 and older than 60 years old groups were 11.5%, 17.7% and 22.4%, respectively. There was no difference between MK⁺ and MK⁻ patients in gender distribution (P=0.545). There was also no difference between MK⁺ and MK⁻ patients in the distribution of FAB castigation (P=0.239). Median survival of MK⁺ AML patients was 6.5 months. Cumulative 5-year overall survival (OS) of was 5.2%. Forty-three MK⁺ patients (43/45, 95.6%) also had a complex karyotype (CK). Two cases that did not meet the CK had not achieved complete remission (CR), and died within 6 months. There were 12 patients who were CK⁺ in 192 MK⁻ patients. The differences of OS and CR rates between MK⁺CK⁺ patients and MK⁻CK⁺ were statistically significant (P<0.05).</p><p><b>CONCLUSION</b>The increased detection rate of MK with age was associated with lower CR and OS in AML patients.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Chromosome Aberrations , Karyotyping , Leukemia, Myeloid, Acute , Diagnosis , Genetics , Monosomy , Prognosis , Remission Induction , Retrospective StudiesABSTRACT
Objective To investigate the in vitro effects of human bone marrow derived mesenchymal stem cells (hBMSC) on Th17 cells of the human peripheral blood.Methods The density gradient centrifugation combined with lymphocyte separation medium was used to isolate hBMSC,which were then cultured.Cytokine IL-17 in the peripheral blood from a healthy person was measured by enzyme-linked immunosorbent assay (ELISA).Proportion of Th17 cells was evaluated by flow cytometry.Results The expression level of IL-17 in spent culture supernatant of the healthy person PBMC and AML hBMSC was (292.32±37.25) pg/ml,and was significantly higher than that of the healthy person PBMC and healthy hBMSC [(169.64±17.47) pg/ml,P ＜ 0.01].There was no significant difference between the expression level of IL-17 in spent culture supernatant of the healthy person PBMC and ALL hBMSC [(159.89±23.71) pg/ml] and the level of the healthy person PBMC and hBMSC.The percentages of Th17 cells of co-culture systems from hBMSC,ALL-hBMSC,and AML-hBMSC and PBMC were (10.13±2.19) ％,(13.77±4.04) ％ and (21.53±5.05) ％,respectively,with the result between AML patients and healthy people being statistically different (P ＜ 0.01).ALL patients and healthy people showed no difference (P ＞ 0.05).Conclusion AML-hBMSC promotes the CD~ T cells to generate Th17 cells,which suggests that the MSC from AML marrow may play a role in the regulation of immune suppression.
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Objective To reproduce an SD rat model of prostatic calculus by using nanobacteria (NB), and explore the role of NB in contributing to prostatitis and prostatic calculus. Methods Twenty adult male SD rats were randomized to the control group and 20 to the model group. Rat prostate infection models were reproduced by infusing 0. 2 ml (Concentration, 1 Mai unit) NB suspension transurethrally. 0.2 ml physiological saline was infused transurethrally in the rat control group. The rats were sacrificed 4 and 8 weeks later and prostatic pathology were viewed by hematoxylin and eosin (HE) staining. Lithogenesis was observed by scanning electron microscope (SEM) or Transmission electron microscopy (TEM). Re-isolation, culture and identification of nanobacteria were also done in rat prostatic tissues. Results Chronic inflammatory changes of prostates were shown in the model group at both 4 weeks and 8 weeks after infusing NB suspension. Prostatic calculi were detected by SEM and TEM at 8 weeks in the prostates of the rat model group (7/10). Neither chronic inflammatory changes nor prostatic calculus was found in the control group. NB was positive in the model group, but negative in the control group. Conclusions NB infection could cause chronic prostatitis and prostatic calculus in rats.
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Objective To explore the outcome of monoclonal gammopathy of undetermined significance (MGUS). Methods The data from 14 MGUS patients in our hospital including clinical features, outcome and change of M protein concentration were analyzed retrospectively. Results The MGUS didn't have the clinical manifestations of multiple myeloma (MM), the time of outcome from MGUS to MM was about 4-20 years (mean time, 10 years). The most types of MM were IgA and IgG, 6 cases were IgA type, 6 cases were IgG type and 2 cases were light chain type. The concentration of immune globulin in general showed an upward trend year by year. A few showed fold lines ascend. Conclusions The elevated monoclonal immunoglobulin may develop into MM after many years. We must follow up frequently to avoid error diagnosis and missed diagnosis.
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OBJECTIVE To investigate the incidence and pathogens of infection in 1659 consecutive cases in single center hematological unit.METHODS The incidence,pathogen,and outcome of infection in 1659 hospitalized patients with hematological disorders from 1999 to 2006 were retrospectively analyzed.RESULTS The overall incidence of infection was 24.4% according to the person-times of hospitalization,which included 22.1% of nosocomial infection and 2.3% of community acquired infection.Most of the pathogenic bacteria of the nosocomial infection were Gram-negative.The most common bacteria in the sputum samples included Enterobacter cloacae(19.3%) and Pseudomonas aeruginosa(14.8%).The most common bacteria in the blood samples were coagulase negative Staphylococcus(CNS,39.3%),the next was Pseudomonas aeruginosa and Escherichia coli.There were 4.21% bacteria resistant to most of antibiotics in nosocomial infection.There were 114 fungi isolated.Candida albicans was accounted for 35.1%.The mortality due to nosocomial infection was 7.4%.CONCLUSIONS The patients in hematology ward are susceptible to infection.The pathogens of nosocomial infection are most likely G-bacteria.Some bacteria are resistant to almost all antibiotics.The incidence of fungal infection is increasing in the near 8 years.