Effect of carotid artery flow changes on the stability of plaque and typing characteristics of cerebral infarction / 局解手术学杂志

objective To observe the influence of hemodynamic changes caused by extracranial carotid stenosis on the plaque stability, and analyze the relationship of cerebral infarction classification,criminal artery stenosis degree and plaque stability to offer evidence for evalu-ating nosogenesis,clinical diagnosis,treatment and prevention of cerebral infarction. Methods CDFI,CTA were performed in 168 patients with acute cerebral infarction,some moderate and severe and occlusive carotid artery which were demonstrated by CTA and CDFI were further checked by DSA during convalescence. Totally 168 acute cerebral infarction patients were divided into 5 groups based on the criminal artery stenosis degree. To evaluate the plaque stability and flow field changes with CDFI and CTA,OCSP clinical classification and brain image clas-sification were finished according to CTA. Patients were classified into 4 subtypes,namely cortical infarction,basal ganglion infarction,corona radiata infarction and posterior infarction,according to the lesion distributions. Observe the changes of flow field and stability of plaque,and compare the relationship between different degree of stenosis and the classification of lesion of infarction. Results Among the 168 criminal arteries,there was 17. 9% of normal,22. 6% of mild stenosis,30. 9% of moderate stenosis,14. 8% of severe stenosis,and 14. 3% of occlu-sion,and the moderate stenosis proportion was the highest. When the stenosis degree was over 50%,it may lead to the changes of flow field, speeding up of blood flow,forming of turbulent flow,and increasing of plaque instability in which lipid plaque and admixture plaque was the highest. PACI is the commonest in all moderate groups. Admixture plaque is usually seen in severe stenosis and occlusion, while fibrous plaque is usually seen in mild stenosis. Conclusion Moderate carotid stenosis may lead to the increase of plaque instability as a result of the changes of flow field,and it may prone to artery-artery embolization.

Significance of dysplasia and cytogenetic changes on the diagnosis and typing of myelodysplastic syndrome / 白血病·淋巴瘤

Objective To explore the significance of dysplasia and cytogenetic changes to the diagnosis and typing of myelodysplastic syndrome (MDS).Methods The dysplasia performance of each series in every isoforms was observed by the bone marrow aspiration and peripheral blood smear to the 132 patients with MDS. At the same time do the chromosome karyotype was analizad combined with morbidness cells and chromosome karyotype abnormal analysis associated with MDS subtype. Resuits Acorrding to the dysplasia ≥0.10, the totle detection rate of granulocyte series, erythrocyte series and megakaryocytic was 43.4 ％.The morbidness granulocyte and megalokaryocyte ≥0.10was mainly in RCMD (P ＜ 0.01); morbidness erythrocytes≥0.10 mainly in RA + RARS (P ＜ 0.01). the totle detection rate of chromosome karyotype abnormal in MDS was 44.0 ％.The detection rate in RA and RARS was lower than other isoforms,but showed no statistically significant (P ＞ 0.05).the relationships of dysplasia and chromosome karyotype abnormal with the isoforms of MDS:in RA group,50.0 ％(3/6) patients had karyotype abnormal simultaneous the detection of morbidness cells≥0.10, 76.0 ％(19/25) in RCMD group and 60.9 ％(14/23) in RAEB group (P ＜ 0.01).Conclusion Theve is relationships between the patients with chromosome karyotype abnormal and dysplasia ≥0.10 and the isoforms of MDS. Closely monitoring the hemopoiesis and cytogenetic changes is significance to diagnose MDS.

Application of WHO standards in diagnose and classification of MDS / 白血病·淋巴瘤

ObjectiveTo diagnose and classify 249 patients with myelodysplastic syndrome (MDS) according to the WHO standards.MethodsAccording to the WHO standards,cell morphology,cytogenetics,immune phenotype and bone marrow pathologic biopsy in 249 cases of MDS were analyzed.ResultsGreat shape and oval cell of mature erythrocyte could be observed in all MDS patients peripheral blood. The incidence of immature erythrocyte,immature granulocyte,pelger-like abnormal nucleus and neutrophils cells without granular increased with subtypes progressing.These abnormal characteristics and proportion tended to more apparent with MDS subtypes progressing.With the dynamic follow-up,we found the rate of MDS transition to AL increased with subtypes progressing(P＜0.05 ).The immune phenotype analysis of 148 patients was undertook and found that the trend to express myeloid specific antigen (CD33) increased gradually with subtypes progressing The chromosome inspection in 138 patients was undertook and found that 53 patients (38.7 ％ with abnormal karyotype,mainly in 20q- and +8;16 cases with complex abnormal karyotype (28 ％), two patients in 5q-. 180 patients were underwent bone marrow biopsy at the same time and found that 19 patients with abnormal morphology;42 patients with bone marrow fibrosis.ConclusionsCombining with multiple index to detect the MDS contributes to the classification and diagnosis more accuratcly and long-term follow-up helps to judgment the prognosis.

The clinical significance of ABR testing in the diagnosis of the large vestibular aqueduct syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyse the clinical audiological significance in the diagnosis of large vestibular aqueduct syndrome (LVAS) by the auditory brain stem response (ABR) testing.@*METHOD@#Patients with sensorineural hearing loss were examined by temporal bone CT scanning from January, 2008 to September, 2009. The result of CT scanning of 70 cases inner ear malformation were analysed. Patients were divided into two groups, LVAS group including 38 cases (76 ears) and other inner ear malformation group including 32 cases (62 ears). All patient accepted clinical audiology analysis and auditory brainstem response (ABR) test.@*RESULT@#Twenty-four cases (41 ears) of LVAS group were detected with ASNR in 2 3 cm by the ABR testing, the positive rate was 54%, while ASNR was not detected in patients of other inner ear malformations group. There was significant differences (P=0.01) of the ASNR between two groups.@*CONCLUSION@#There is high incidence of LVAS on the patients with non-syndromic deafness. ASNR by ABR testing could help diagnosing the LVAS.

The clinical outcome of HLA haploidentical vs HLA-matched peripheral blood hematopoietic stem cell transplantation without in vitro T-cell depletion for malignant hematological diseases / 中华器官移植杂志

Objective To explore the clinical outcome of HLA haploidentical vs HLA-matcbed peripheral blood hematopoietic stem cell transplantation (PBSCT) without in vitro T-cell depletion for malignant hematological diseases. Methods 111 patients with malignant hematological diseases underwent PBSCT without in vitro T-cell depletion between May 2004 and February 2009, including 51 patients with HLA-haploidentical and 60 patients with HLA-matched. All patients have received myeloablative conditioning regimen. A two-agent based graft-versus-host disease (GVHD) prophylaxis was used as cyclosporine A and a short course of methotrexate. Mycophenolate mofetile was added for the patients with one locus mismatch. Mycophenolate mofetile, antithymocyte globulin and CD25 monoclonal antibody were added for the patients with 2-3 loci mismatch. The grafts were granulocyte colony-stimulating factor-mobilized peripheral blood stem cells without in vitro T-cell depletion. Results 111 patients achieved sustained and full donor-type engraftment. The median time to reach an absolute neutrophil count above 0.5×10~9/L was 14 days and that to a platelet count exceeding 20×10~9/L was 15 days in 51 HLA-haploidentical patients, and that was 12 days and 13 days in 60 HLA-matched patients, respectively. In 51 HLA-haploidentical patients, 25 patients developed aGVHD, including 20 cases of grade Ⅰ aGVHD, and 5 cases of grade Ⅱ. Thirty-three patients developed cGVHD with limited in 30 and extensive in 3. The 4-year cumulative incidence of cGVHD was 70.4 %. The 3-year probabilities of leukemia-free survival (LFS) were 74.5% (77.3 % for standard risk patients and 68.2 % for high risk patients respectively). Seven patients had recurrence. In 60 HLA-matched patients, 14 patients developed aGVHD, including 10 cases of grade Ⅰ, 2 cases of grade Ⅱ and 2 cases of grade Ⅲ. Thirty-seven patients developed cGVHD with limited in 32 and extensive in 5. The 4-year cumulative incidence of cGVHD was 58.1%. The 3-year probabilities of LFS were 72.1% (77.6 % for standard risk patients and 52.7 % for high risk patients respectively). Ten patients had recurrence. The incidence of aGVHD in HLA-haploidentical cohort was significantly higher than in HLA-matched cohort (P<0.05). There was no significant difference in incidence of cGVHD, incidence of relapse and LFS between HLA-haploidentical and HLA-matched cohorts (P>0.05). Conclusion Haploidentical PBSCT is feasible and safe for malignant hematological diseases to use myeloablative conditioning regimen in combination with intensive immunosuppressants without in vitro T cell depletion.

Haploidentical peripheral blood stem cell transplantation without in vitro T-cell depletion for the treatment of malignant hematological diseases / 中国组织工程研究

BACKGROUND: Lack of human leucocyte antigen-matched family donors has restricted the application of hematopoietic cell transplantation. Due to immunological disorder of humam leucocyte antigen misfit, common way for haploidentical transplantation is associated with poor engraftment and severe graft-versus-host disease. Because not every patient has HLA-Jdentical family member, a substantial proportion of patients will receive haploidentical transplantation. OBJECTIVE: To explore the curative effect on malignant hematological diseases of haploidentical peripheral blood stem cell transplantation (PBSCT) using myeloablative conditioning regimen in combination of proper immunosuppressants without in vitro T-cell depletion. DESIGN, TIME AND SETTING: A case observation was performed at the Department of Hematology in the First Affiliated Hospital of Xinjiang Medical University from July 2002 to June 2008. PARTICIPANTS: Forty-two patients with malignant hematological diseases, including 29 standard-risk patients and 13 high-risk patients, age from 10 to 48 years, were transplanted with cells from a haploidentical family donor with 1-3 mismatched loci of HLA antigens. Seven patients had 1 locus mismatched donors and thirty-five patients had 2-3 loci mismatched donors. METHODS: The patients have received myeloablative conditioning regimen. A two-agent based graft-versus-host disease (GVHD) prophylaxis was used as cyclospodne A and a short course of methotrexate. Mycophenolate mofetile was added for 1 locus mismatched patients. Mycophenolate mofetile, antithymocyte globulin and CD25 mono-colonal antibody were added for 2-3 loci mismatched patients. The grafts were granulocyte colony-stimulating factor-mobilized peripheral blood stem cells without in vitro T-cell depletion. MAIN OUTCOME MEASURES: Engraftment, GVHD incidence and severity, relapse and leukemia-free survival and the immune function of patients in months 1, 3, 6, 12 and 18 postoperatively. RESULTS: Totally 42 patients achieved complete and sustained donor-type engraftment. Nineteen patients developed acute GVHD, the 2-year cumulative incidences of acute GVHD were 50.8%, gradeⅠ acute GVHD occurred in 16 cases and grade Ⅱ in 3 cases. Thirty-one patients were followed up more than 6 months, 23 of them developed chronic GVHD with limited in 20 and extensive in 3, the 2-year cumulative incidences of chronic GVHD were 57.1%. No patients died of GVHD. There were no significant differences in the reduction and recovery of T cells and B cells between HLA haploidentical PBSCT without in vitro T cell depletion and HLA-matched PBSCT. CONCLUSION: Haploidentical PBSCT is feasible and safe for malignant hematological diseases to use myeloablative conditioning regiment combination of intensive immunosuppressants without in vitro T cell depletion. A large amount of clinical cases need to be investigated in the near future.

Popliteal artery endovascular angioplasty for the treatment of diabetic foot (a report of 65 cases) / 中国综合临床

Objective To evaluate the effect of pepliteal artery endovascular angioplasty for the treatment of diabetic foot. Methods 65 cases (69 limbs) of diabetic foot were treated by long bloon endovascular angioplasty. Results No death occured. 60 cases (64 limbs) were successfully treated and 5 cases (5 limbs) failed. The imme-diately success rate was 92.75%. The pain relieved, the temperature was improved and the ankle brachial index (ABI) was up to 0.84±0.11. Anterior tibial artery or posterior tibial artery of 39 limbs could be touched. 21 limbs were cured by debride and change dressings. 10 limbs were cured after the gangrene was ablated. 6 limbs were cured after the gangrene was debrided. 22 limbs were cured after toe amputation. Half of the foot was amputated. No limb was amputated. Every month was further consulted by Doppler and the rate of follow upwas 100%. 6 limbs of 6 cases were reobliterated (1,1,2,2 cases occurred after 1,6,12,18 month respectively.) and treated by endovascular an-gioplasty again. Conclusion Endovascular angioplasty below the knees for the treatment of diabetic foot is an effec-tive method for the limbs saving, with minimal invasive, safety, less complication and retreatment. It can be used as a first choice for the artery obliteration of diabetic foots.

Treatment Strategies for Children with Autism Spectrum Disorders / 中国康复理论与实践

Autism is a perplexing developmental disorder that presents itself in a variety of behavioral disorders. Research indicates that through early intervention and appropriate treatment these behaviors can be improved. This article reviews and critiques several of the current treatment programs for children with autism. These include Applied Behavioral Analysis (ABA), TEACCH,Sign Language, Facilitated Communication, Piture Exchange Comminication System (PECS), Object Exchange, Auditory Integration Therapy (AIT), and augmentative communication. When appropriate, the treatments were reviewed for their abilities to increase attention, imitation and initiation, social interaction and intentional communication, language development, and emotional regulation. The article, hopefully, provides parents and professionals a clearer choice as to what treatment is most appropriate for which child and when to use them.

Botanical characters of test-tube plantlets and seed plantlets in Bupleurum chinense / 中草药

Objective To provide a scientific basis for the creation and promotion of the rapid propagation of excellent Bupleurum chinense and study on botanical characters of test-tube plantlets and seed plantlets in B.chinense.Methods B.chinense with high effective medicinal ingredients and great stability of genetic characters was selected for rapid propagation,and some of botaninal characters between test-tube plantlets and seed plantlets were compared.Results The tiller number,the branch stem number,and the inflorescence number of the test-tube plantlets were significantly greater than those in seed plantlets.Conclusion Through the rapid propagation and the large-scale cultivation of test-tube plantlets of B.chinense,much more roots and seeds are obtained comparing with those of seed plantlets,while maintaining the excellent traits of B.chinense.

Condition for induction and differentiation of callus and propagation of adventitious buds in Bupleurum chinese / 中草药

Objective To study the condition for induction and differentiation of callus and propagation of adventitious buds in lamina,stem,and bud of Bupleurum chinese and establish a new method for rapid propagation.Methods In MS media added with different phytohormones,calli were induced from explants of lamina,stem,and floral bud of B.chinese,adventitious buds and adventitious roots were differentiated from calli of stem and floral bud,test-tube plantlets were formed.Results MS Medium added with 2,4-D 1.0 mg/L,KT 0.5 mg/L,and 6-BA 0.5 mg/L was suitable for calli induction of the lamina,stems,and floral buds.In medium added with 6-BA 1.0 mg/L,NAA 0.03 mg/L,CM 15% and CH 500 mg/L,the differentiation rate of floral buds callus was the highest.MS Medium added with 6-BA 1.5 mg/L,NAA 0.05 mg/L and CH 250 mg/L was suitable for propagation of test-tube plantlets,1/2 MS medium added with NAA 0.5 mg/L was suitable for rooting.Conclusion A great deal of test-tube plantlets could be differentiated and propagated rapidly by calli induced from stems and floral buds of B.chinese.Then the regeneration plantlets with normal growth and development are obtained.

Rapid propagation and seed germinating condition of Bupleurum chinense / 中草药

Objective For selecting and developing the excellent Bupleurum chinense to mass-produce seedlings and seeds in high quality.Methods B.chinense was picked from eight different areas,such as Lingchuan and Wanrong county in Shanxi Province,Longxi county in Gansu Province,and Shangluo in Shaanxi Province,etc.Rapid propagation was done.The testa of Zhongchai No.1 was scrapped or seeds were soaked in different phytohormones.The effects on germination rates of seeds were compared.ResultsThe optimum medium for bud propagation was B5supplemented with 1.0 mg/L 6-BA and 0.2 mg/L KT.The optimum medium for root induction of test-tube plantlets was 1/2 MS added with 0.1 mg/L NAA,0.5 mg/L IBA,and 1.0 mg/L DSC.The annual propagation coefficient of B.chinense plants was more than 1?108,and the survival rate of transplantation reached to 94%—97%.The phytohormone has little effect on seed germination of B.chinense,but scraping the testa could increase the germination percentage of seeds to 20% and shorten the germinating time greatly.Conclusion By tissue culture of excellent B.chinense,a great deal of plants and seeds could be produced in short time.By scrapping testa in a certain extent,the germination of seeds could be increased.