Effect of fludarabine combined with cytarabine on acute myeloid leukemia / 新乡医学院学报

Objective To investigate the effect of fludarabine combined with medium dose cytarabine on acute myeloid leukemia(AML).Methods A total of 55 AML patients were selected from January 2011 to January 2016 in the First People's Hospital of Xinxiang City.Among the patients,there were 16 cases of poor response after initial induction of chemotherapy (double induction group),15 cases of first induction failure(first induction failure group) and 24 cases of relapsed and refractory AML(relapsed-refractory group).All the patients were treated with fludarabine combined with medium dose cytarabine,four weeks was a course,and after treated for two courses the therapeutic effect and survival status of the patients in the three groups were compared.Results The total effective rate in the double induction group,the first induction failure group and the relapsed-refractory group was 81.3％ (13/16),66.7％ (10/15) and 33.3％ (8/24),respectively;the total effective rate in the double induction group and the first induction failure group was significantly higher than that in the relapsed-refractory group (x2 =8.839,4.127;P ＜ 0.05),but there was no significant difference in the total effective rate between the double induction group and the first induction failure group(x2 =0.860,P ＜ 0.05).The median of disease-free survival time in the double induction group,the first induction failure group and the relapsed-refractory group was 29,21 and 10 months,respectively.The disease-free survival time in the double induction group was significantly longer than that in the first induction failure group and the relapsed-refractory grouP(x2 =9.536,33.256;P ＜ 0.05),and the disease-free survival time in the first induction failure group was significantly longer than that in the relapsed-refractory group (x2 =21.077,P ＜ 0.05).The median overall survival time in the double induction group,the first induction failure group and the relapsed-refractory group was 40,29 and 12 months,respectively.The median overall survival time in the double induction group and the first induction failure group was significantly longer than that in the relapsed-refractory group (x2 =33.686,28.649;P ＜ 0.05),but there was no significant difference in the median overall survival time between the double induction group and the first induction failure group (x2 =2.417,P ＜0.05).Conclusion Fludarabine combined with medium dose cytarabine in the treatment of AML can obtain significant curative effect,and the effect in the patients with poor response after initial induction and the first induction failure is better than that in the patients with relapsed and refractory AML.

Technology of finite-element analysis and its application in the field of acetabular prosthesis / 中国骨伤

The hip with distinctive anatomical structure and complicated function plays an important role in normal standing and activity. The clinical doctors have paid attention to studies on hip biomechanics of normal structure and reconstruction. It was difficult for us to analyze hip in vivo because of its complex structure. Many examinations were preformed on animal models, but the reliability of results was unavoidably affected. Technology of finite-element analysis as one of the main methods of mechanics had been successfully applied in many fields, especially in analyzing on irregular bodies. The application in the field of orthopaedic surgery, for example the optimal design for prosthesis, stress analysis of grafts etc, had made great progress. The method could help us to improve current thoughts on study of biomechanics and make continuous advance in the future.

Design of ABC damage variable and positioning system for acetabular fractures and 1122 cases multi-center statistic analysis / 中国骨伤

<p><b>OBJECTIVE</b>To design ABC damage variable and positioning system for acetabular fracture and explore the feasibility and clinical practical value of the system through the multi-center analysis of 1122 acetabular fractures.</p><p><b>METHODS</b>According to acetabular three-column conception, and pelvic ring lesions damage direction caused by acetabular fracture domino effect and injury degree of proximal femur joint, it defined class A as any column acetabular fracture; class B as any two-column acetabular fracture; class C as front, dome and posterior mixture acetabular fracture. Lower case English letters a, m, p represented front, dome, posterior fracture, respectively. Acetabular damage variables: 1 was simple displaced fractures; 2 was comminuted fractures; 3 was compression fractures. Pelvic ring lesions damage variables: alpha was sacroiliac joints or sacroiliac fracture horizontal separation deflection; beta was sacroiliac joints or sacroiliac fracture vertical separation deflection; gamma was pubic symphysis separation/superior and inferior ramus of pubis fracture deflection; alpha beta gamma delta was compound floating damage. Proximal humerus joint damage variables: I was femoral head fracture; II was femoral neck fracture; II was intertrochanteric fractures of femur; IV was I to III compound fracture. The ABC damage variable positioning system for acetabular fracture was made up by the above-mentioned variables. The statistics from March 1997 to February 2010 showed 1122 cases acetabular fractures with 18 cases of double side acetabular fracture and 1140 cases of acetabular fractures. The pelvics anterior-posterior view, ilium and obturator oblique view, and 2/3D-CT materials were analyzed and researched.</p><p><b>RESULTS</b>Each damage variables distribution situation in 1140 cases of acetabular fracture involved A in 237 cases (20.8%), B in 605 cases (53.1%), C in 298 cases (26.1%);front column fracture in 808 cases(70.9%), dome fracture in 507 cases (44.5%), posterior fracture in 1026 cases (90%). Acetabular variables: variabe 1 in 203 cases of simple displaced fracture (17.8%); variabe 2 in 516 cases of comminuted fracture(45.3%); variabe 3 in 421 cases of compression fracture (36.9%); 249 cases of pelvic ring lesions damage (21.8%), 75 cases femoral head fracture (6.6%); 18 cases of double side acetabular fracture and relative pelvic ring and proximal humerus joint variables (1.58%). Key part and curative effect elements of 1140 cases acetabular fracture: 507 cases of dome or posterior acetabular fracture (44.5%); 421 cases of compression fracture (36.9%); 249 cases of pelvic ring variables (21.8%); 75 cases of proximal humerus joint variables (6.6%); 486 cases of simple Aa/pl/2,Bapl/2 acetabular fracture (42.6% ).</p><p><b>CONCLUSION</b>Compression fracture, especially defected compression fracture, takes important part in acetabular damage variables, and also presents that acetabular fracture with pelvic ring and proximal femoral damage variables are not rare at all. The relationship of the acetabular fracture damage variables, and its percentage shows the key points and elements in clinical treatment: weight-bearing to dome accounts for 44.5%; compression to defects account for 36.9%, pelvic ring to float accounts for 21.8%; dome fracture to double side fracture account for 6.6%. The system has significant guiding effects on clinic in terms of evaluation of injury severity, anatomic localization, difficulty index, alternative strategy, operative approach, effect of treatment,and prognosis. And the most important thing is that the system creates the comparison of damage variables in same type of fracture and the communication of homo-language and explores a new method.</p>

Study on the setting property and compressive strength of β-TCP/α-CSH combined bone graft / 医用生物力学

Objective To investigate the setting property and compressive strength of β-TCP (β-tricalcium phosphate)/α-CSH (α-calcium sulphate hemihydrate) combined bone graft. Method β TCP/α CSH combined bone graft and distilled water were mixed with different ratio: 1 g∶0.1 mL、1 g∶0.2 mL、1 g∶0.3 mL、1 g∶0.4 mL、1 g∶0.5 mL, respectively. The initial setting time (Ti), final setting time (TF), compressive strength were recorded, and the X-ray diffraction (XRD) and the scanning electron microscope (SEM) were examined. Results The initial and final setting time of combined bone graft increased along with the increase of solid/liquid ratio. The Ti and TF were (4.6±1.3) min and (13.1±2.9) min respectively when the solid/liquid ratio was 1 g∶0.2 mL. The average compressive strength was 7.86 MPa in one day after setting, which was about two times higher than that of β-TCP alone. The XRD results showed that no other materials were produced except that α-CSH was transformed to CSD in the setting process. The SEM results indicated that thick CSD granules were adhered to the porous surfaces of β-TCP granules after setting. Conclusions The setting time and compressive strength of β-TCP/α-CSH combined bone graft could be adjusted by the different solid/liquid ratio.

Clinical experience of treating infection after total hip arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To present the experience in the management of the infected total hip arthroplasty (THA).</p><p><b>METHODS</b>Forty-three cases (44 hips) of infection after THA were reviewed. Eighteen women and 25 men with a mean age of 54 years (range, 24-81 years) were studied. Follow-up ranged from 5 months to 16 years (mean, 3.2 years). Treatment strategies included: one-stage revision (n = 7), two-stage revision (n = 15), resection arthroplasty (n = 13), debridement and retain prosthesis (n = 5), and others (n = 3).</p><p><b>RESULTS</b>Forty cases had positive culture result with 59 organisms including 19 staphylococcus epidermidis and 10 staphylococcus aureus. Thirty-six cases had been followed up, and no case had infection recurrence. Twenty-nine cases had postoperative Harris hip score averaged 78.5 (45-98).</p><p><b>CONCLUSIONS</b>The diagnosis and treatment of infection after hip replacement is very difficult. The violence and antibiotic resistant rate of the organisms is high. Two-stage reconstruction of the infected hip is useful and effective because of higher eradication rate of the infection and good postoperative functional result.</p>

Analysis on causes of death of childhood leukemia from 1981 to 2000 in the city of Tianjin / 中华儿科杂志

<p><b>OBJECTIVE</b>Leukemia is a major cause of death of children in China, which accounts for 50 % of all cancers of children. Data from Tianjin Cancer Hospital was analyzed for mortality of leukemia in children under 20 years from 1981 to 2000 in the city of Tianjin.</p><p><b>METHODS</b>All physicians and medical staff of the hospitals and clinics in the registry area were responsible for filling out the report forms for every new case diagnosed as malignant tumors. Death certificates for malignant tumors have been registered at the local police station and the residential files were checked. All cancer cases with insufficient information were traced to his/her family and relevant persons worked in the clinic. Tianjin Cancer Registry Center periodically conducted an active re-checking program to review all patient records on cancers that was not registered in this period. Tumors diagnosed in this study were coded according to the International Classification of Diseases for Oncology (ICD-O). Mortality rates were calculated by age, sex and date of death.</p><p><b>RESULTS</b>The types of acute lymphoid leukemia, acute myeloid leukemia and chronic myeloid leukemia were the most common types of childhood leukemia in Tianjin, comprised 69.3%, 20.9 % and 8.0%, respectively. The mortality for childhood leukemia decreased slowly during the period of 1981 to 2000 in Tianjin. Mortality and morbidity ratios were 0.51.</p><p><b>CONCLUSION</b>Combined with characteristics of individual forms of childhood leukemia mortality, further epidemiological research is needed to prevent childhood leukemia.</p>

Risk factors of lung cancer in Tianjin / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the risk factors of lung cancer in Tianjin and to provide evidence for further monitor there of.</p><p><b>METHODS</b>A case-control study involving interviews with 193 new cases and 259 controls aged 30 - 76 years was carried out. Structured questionnaires were used to collect information on general condition, living environment, living style, disease and family history, etc. Logistic regression model univariate and multivariate analysis were used to pick out the significant lung cancer risk factors.</p><p><b>RESULTS</b>By monovariate analysis, risk factors such as smoking, passive smoking, drinking, history of malignancy in family and occupation were found. By multivariate analysis, smoking, passive smoking, higher body mass index (BMI) and average income and living space per capita ten years earlier were ascertained, their operations research (OR) values were 3.302, 1.193, 1.003, 1.067 and 0.913.</p><p><b>CONCLUSION</b>Smoking and passive smoking are independent risk factors of lung cancer. Monthly income per person and living space per person 10 years earlier are associated with elevated risk of lung cancer. Higher body mass index has protective effects on lung cancer risk.</p>

An experimental study of demineralized bone matrix to repair bone defects as a scaffold of tissue engineering / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate application of the sponge of demineralized bone matrix (SDBM) in tissue engineering of bone.</p><p><b>METHODS</b>SDBM was prepared from long bone of rabbits. Bone marrow cells were flushed from the bone shaft of femurs of a two-month-old New Zealand white rabbit. After the cells were cultured for 9 days, the flasks were added into dexamethasone (10(-8) mol/L), beta-glycerophosphate sodium (10 mmol/L) and L-ascorbic acid (50 micrograms/ml). After 5 weeks, the cultured cells were collected and marked by 5-Bromo-2'-dexyouridine (BrdU). The grand sum of cells seeded on a piece of SDBM was about (4-6) x 10(6). The composites of cells and SDBM (tissue engineered chip, TEC) were implanted into muscles and bone defects of radius in rabbits. A standard procedure was applied to make a 10 mm long defect bilaterally in the radius of nine skeletally mature male New Zealand white rabbits. All of the 18 defects were randomly divided into three groups: group I, six defects were grafted by TEC; group II, six defects were grafted with SDBM alone; group III, six defects were empty.</p><p><b>RESULTS</b>The results of radiographic and histological evaluation showed that all of the defects were repaired in group I and group II at 6 weeks, none of the defects was repaired in group III. The results of BrdU staining showed that the staining was positive in group I, but negative in group II. Biomechanical test showed that the compressive ultimate strength (CUS) of new bone in TEC implanted group was comparable with normal radius (P = 0.623) and in SDBM implanted group was significant lower than normal radius (P = 0.038).</p><p><b>CONCLUSIONS</b>The TEC can form cartilage and bone tissue in muscles and repair segmental bone defects. SDBM is a kind of effective natural scaffold in tissue engineering of bone.</p>