α-IFN联合LD-HA方案治疗难治性急性髓细胞性白血病疗效观察

目的 :探讨难治性急性髓细胞性白血病的治疗方法。方法 :对临床上不能耐受标准化疗的难治性急性髓细胞性白血病 (AML) 7例 ,应用α 干扰素 (α IFN)联合小剂量高三尖杉酯碱和阿糖胞苷 (LD HA)方案治疗。结果 :7例难治性AML病人达到CR的有 4例 (5 7.14 % ) ,达到PR的有 1例 (14 .2 9% ) ,NR有 2例 ,总有效率为 71.4 3%(5 / 7)。结论 :本方案可明显提高难治性AML的缓解率 ,对于过渡到标准剂量强化治疗创造机会具有积极意义 。

多模态影像融合在颅底肿瘤的诊断、治疗中的应用价值

目的探讨多模态影像融合在颅底肿瘤的诊断、治疗中的应用价值。方法 9例颅底肿瘤术前均行DynaCTA检查及MRI薄层(2 mm)增强扫描检查,将多组影像数据输入工作站,采用"双容积重建"技术进行脑血管及MRI的影像融合,通过静态及动态融合影像观察肿瘤与脑结构、血管及颅骨的毗邻关系,并对肿瘤的诊断、手术治疗及预防血管并发症进行分析。结果 9例均获得满意的影像融合、具有很好的空间一致性,在一张影像上可以清晰显示病变及其周围脑结构、血管及颅骨解剖关系,提高精准性诊断,并应用于指导治疗策略、设计手术划及预防并发症。9例均恢复满意出院。结论多模态影像融合对提高颅底肿瘤的诊断精准性、提高肿瘤全切除率、降低病死率和残疾率效果肯定,对血管损伤并发症治疗疗效肯定。

Impact of triple antithrombotic therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention in real-world practice

Objective The optimal antithrombotic regimen for patients on oral anticoagulation （OAC） after acute coronary syndrome （ACS） and percutaneous coronary intervention （PCI） remains debated. This study sought to evaluate the efficacy and safety of OAC plus clopidogrel with or without aspirin in a real-world setting. Methods We retrospectively analyzed data from an international, multi-center registry be- tween 2003 and 2014 （n = 15,401）. Patients with ACS and receiving OAC after PCI were screened. The composite primary endpoint was 1-year all-cause death, re-infarction, or severe bleeding. Results The final analysis enrolled 642 patients including 62 patients （9.7%） with OAC and clopidogrel （dual therapy）, and 580 patients （90.3%） with the combination of aspirin, OAC and clopidogrel （triple therapy）. Pa- tients on triple therapy were more often female and were more likely to have comorbidities. There was no significant difference regarding the primary end point between dual therapy with triple therapy patients [17.74% vs. 17.24%; unadjusted hazard ratio （HR）： 1.035; 95% confi- dence interval （CI）： 0.556-1.929; adjusted HR： 1.026; 95% CI： 0.544-1.937]. However, the re-infarction rate was significantly higher in dual therapy than triple therapy patients （14.52% vs. 5.34%; unadjusted HR： 2.807; 95% CI： 1.329-5.928; adjusted HR： 2.333; 95% CI： 1.078-5.047）. In addition, there was no difference between two regimes in all-cause death and severe bleeding. Conclusions In real-life patients with ACS following PCI and with an indication of OAC, triple therapy was not associated with an increased rate of adverse out- comes compared to dual therapy. Moreover, it decreased risk of re-infarction and did not increase risk of severe bleeding.

FibroSURE^(TM) and FibroScan~ in relation to treatment response in chronic hepatitis C virus

AIM:To compare histological endpoint assessment using noninvasive alternatives to biopsy during treatment in a chronic hepatitis C virus(HCV)cohort.METHODS:Patients with chronic HCV were randomized to receive interferon-based therapy for 24(genotypes 2/3)or 48(genotype 1)wk.FibroSURE～TM(FS)was assessed at baseline and at week-12 post-treatment follow-up.Baseline biopsy for METAVIR was assessed by a single pathologist.FibroScan～ transient elastogra-phy(TE)was performed during treatment in a patient subset.RESULTS:Two thousand and sixty patients(n = 253 in Asia)were classif ied as METAVIR F0-1(n = 1682)or F2-4(n = 378).For F2-4,FS(n = 2055)had sensitiv-ity and specif icity of 0.87 and 0.61,respectively,with area under the receiver-operating curve of 0.82;corre-sponding values for TE(n = 214)and combined FS/TE(n = 209)were 0.77,0.88 and 0.88,and 0.93,0.68 and 0.88.Overall FS/TE agreement for F2-4 was 71%(κ = 0.41)and higher in Asians vs non-Asians(κ = 0.86 vs 0.35;P < 0.001).Combined FS/TE had 97% accuracy in Asians(n = 33).Baseline FS(0.38 vs 0.51,P < 0.001)and TE(8.0 kPa vs 11.9 kPa,P = 0.006)scores were lower in patients with sustained virological response than in nonresponders,and were maintained through follow-up.CONCLUSION:FS and TE may reliably differentiate mild from moderate-advanced disease,with a potential for high diagnostic accuracy in Asians with chronic HCV.

Precision Treatment of Primary Liver Cancer with Traditional Chinese Medicine

The precision treatment of liver cancer in TCM belongs to macroscopic precision treatment. Precision treatment uses minimal medical resources to maximize medical outcomes. At present, there is no precision treatment system of TCM for liver cancer. In clinical, we summed up the precision treatment route of TCM for liver cancer： TCM and Western medicine axe closely integrated, and the dialectical content fits perfectly with nature of disease, accurate correspondence between the treatment method and the syndrome type, the nature of drug and human body nature are just ＂neutralizing＂. Make good quality control in these four aspects. Any big deviation in any aspect will affect the curative effects.

Precision Treatment of Primary Liver Cancer with Traditional Chinese Medicine

The precision treatment of liver cancer in TCM belongs to macroscopic precision treatment. Precision treatment uses minimal medical resources to maximize medical outcomes. At present, there is no precision treatment system of TCM for liver cancer. In clinical, we summed up the precision treatment route of TCM for liver cancer： TCM and Western medicine are closely integrated, and the dialectical content fits perfectly with nature of disease, accurate correspondence between the treatment method and the syndrome type, the nature of drug and human body nature are just ＂neutralizing＂.

For a Still “Social” Housing： The Fluent Governance

Network governance, widely used as theoretical model in investigations on social housing, is not free from critiques, first of all, for the fact that it has a uni-directionality of bottom-up processes, when oriented to public deliberation, or top-down when decision-makers are technical experts at the political level. Given the new complexity of the social housing issue and the considered limits of the network governance, this work aims at looking for a possible different theoretical framework able to give different tools to simplify decision making processes without any alteration of any basic decisional element. The contribution given by this work is the proposition of what has been called ＂fluent governance＂ as a framework of decision making able to represent the whole spectrum of interventions in the process, also taking into account aspects not captured by standard models. The paper reports an experimentation of the proposed model conducted in Italy in the field of renovating social housing policy.

The Effects of Calcium Chloride and Ascorbic Acid Treatment on Ready-to-use Carrot Shreds

This study aimed to evaluate the effect of calcium and ascorbic acid treatments on the quality of carrot shreds during storage. Towards this aim, carrot shreds were dipped into a 5 L solution of 2 g/L ascorbic acid containing 1%, 3%, or 5% CaCI2 （Ca ＋ AA） for 3 min at room temperature （-20 ℃）. In case of the control group （control, C）, samples were dipped into distilled water for the same time interval. Subsequent to treatment, carrot shreds were stored in a cold room at 5 ± 1 ℃, 85-90% RH for a period of 11 days. Color values （L＊, a＊ b＊）, whiteness index, saturation index, hue angle values, visual quality, firmness scores, bitterness scores, total soluble solids （TSS） and electrolyte leakage measurements were conducted at various sampling dates. The results from this study demonstrated that brightness of carrot shreds was augmented by calcium and ascorbic acid treatments irrespective of the dosage used. Whiteness index values for the 5% Ca ＋ AA treated samples were observed to be low whereas saturation indices of 5% Ca ＋ AA and 3% Ca ＋ AA treated carrot shreds were higher as compared to other treatments. This study concludes that treatment with calcium at high doses improves the color quality of carrot shreds under storage conditions. Visual quality and firmness of carrot shreds was maintained till day 4 of storage, thereafter it declined as compared to the control group, Bitterness of carrot shreds was also observed to increase upon treatment with calcium and ascorbic acid. However, calcium treatment of the test carrot shreds was seen to decrease weight loss and cause an increase in the TSS under storage conditions.

DIOPTER REGRESSION ANALYSIS OF LASER IN SITU KERATOMILEUSIS IN THE TREATMENT OF MYOPIA

Objective To evaluate the relevant factors of regression phenomenon of laser in situ kerato-mileusis (LASIK) for treatment of myopia. Methods We studied 408 eyes of 250 myopic patients who received LASIK. Patients were divided into 2 groups according to preoperative diopters (- 6 .00D- -10 .00D, 194 eyes;-10.10D- -15 .00D, 214 eyes). Mean period of follow-up were 12 months and the results were statistically analyzed. Results 12 months after surgery, in the first group (- 6.00--10.00D) the regressionequal to or beyond -1 .0D were 21 eyes (10.8%), range from -1 .0D to - 3 .0D. The average regression was -1.33D. In the second group (- 10 .10D - - 15 .00D) regression equal to or beyond -1.0D were 78 eyes (36.5%), range from -1 .0D to -5.50D. The average regression was -1 .99D. Conclusion The results indicate that excimer LASIK can be used to treat myopia between -6 .00D-- 15 .00D effectively with minimal regression within 12 months. Preoperative thin corneas with intraoperative small ablation zone could induce regression . Some modification of the surgical algorithms and laser nomogram will help to improve predictability and reduce regression.

Study on the treatment of eutrophic water with a new integrative apparatus for water purification

This paper studied the treatment of the landscape river in ChangZhou Scientific and Educational Town by a new integrative apparatus for water purification, which used ozone pre-oxidation-moDified clay-ozone biological activated carbon integrated process. The results indicate that the effectiveness of the algal removal with mentioned integrated process is much higher and the apparatus can operate stably. When the turbidity, chemical oxygen demand （CODMn）, total nitrogen （TN）, total phosphorus （TP） and algae densities of the raw water are 29-38 NTU, 7.45-7.79 mg/L, 2.496-2.981 mag/L, 0.237-0.255 mg/L and 5.78-7.94×10^8 cells/L respectively, it can be reduced to 0.8-1.7 NTU, 1.69-2.84 rag/L, 0.579-0.692mg/L, 0.013-0.038 mg/L, 0.06-0.38×10^8 cells/L. The average removal rates of turbidity, CODMn, TN, TP and algae density can reach 96.4%, 71.5%, 76.8%, 92.0% and 96.9% respectively. The treated water can meet the requirements of class Ⅰ- Ⅱ in Environmental Quality Standard, for Surface Water.

Exact Controllability for Nonautonomous First Order Quasilinear Hyperbolic Systems

By means of the theory on the semi-global C^1 solution to the mixed initialboundary value problem （IBVP） for first order quasilinear hyperbolic systems, we establish the exact controllability for general nonautonomous first order quasilinear hyperbolic systems with general nonlinear boundary conditions.

Definition, classification and treatment of destructive fractures

Destructive injury is defined as a very serious damage both to the bone and the soft tissues. But in clinical practice we found that in some fracture cases, the damage to soft tissues is not as severe as ＂destructive injury＂ indicates, whereas comminuted fractures still cannot show the severity of bone damage. Therefore we proposed a new term ＂destructive fractures＂ after combining the definition of destructive injury with typical clinic cases. Destructive fractures refer to the fractures whose osseous tissues are damaged too seriously to be repaired, but soft tissues, nerves and veins are less severely injured and can be repaired. From the year 2001 to 2010, 75 cases of destructive fractures were admitted in our department. According to whether the fractures interlinked with the external environment, together with the fracture sites, they were divided into 6 types： al type, closed diaphysis destructive fracture; a2 type, open diaphysis destructive fracture; b1 type, closed joint-involved destructive fracture; b2 type,open joint-involved destructive fracture; cl type, closed mixed destructive fracture; c2 type, open mixed destructive fracture. Corresponding clinical treatments were conducted for each type.The new classification criterion of destructivefracture is simple and practical and thus can be used as an important guide to make reasonable treatment plans for destructive fractures.