Spinal myeloid sarcoma in two non-leukemic patients

Myeloid sarcoma, formerly termed granulocytic sarcoma or chloroma, consists of neoplastic granulocytic precursors and myeloblasts. Isolated chloromas (granulocytic sarcomas) are rare tumors. Spinal complications of chloromas, such as cord compression secondary to epidural tumor or cauda equine syndrome have been described but are rare. We herein report two cases with spinal granulocytic sarcomas in non-leukemic patients. The case of a previously healthy 22-year-old man diagnosed with multiple spinal granulocytic sarcomas with no evidence of bone marrow or other hematological involvement is described. And, a 43-year-old woman diagnosed cervical spinal granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was totally removed by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcoma should be considered in the differential diagnosis of an epidural mass in patients with or without acute leukemia, because early diagnosis followed by appropriate combined chemotherapy and radiation may obviate surgical intervention and eventually prevent leukemic transformation.     

离子选择性电极法测定温泉与中药材中痕量氟

目的:测定两处海南温泉水样与巴戟天、槟榔仁、益智仁等24种海口市售中药材中氟元素含量。方法:采用离子选择电极法测定温泉水与中药材中痕量氟。结果:氟元素含量:温泉水Ⅰ13.06 mg/L,温泉水Ⅱ6.44 mg/L,丹参1.10 mg/kg,鸡骨草7.26 mg/kg,苦楝皮5.56 mg/kg,白鲜皮1.29 mg/kg,石斛1.38 mg/kg,半夏0.10 mg/kg,桑叶9.33 mg/kg,槟榔仁,益智仁,槐花,金不换,当归,白芍,巴戟天,胡椒根,益母草,旱莲草,溪黄草,桑白皮,茯苓皮,牡丹皮,红藤,天南星,枇杷叶等17种中药材均未检出氟。结论:所测两处温泉水样均达到氟医疗价值浓度(F-≥1 mg/L);中药材氟元素含量远小于《农业部2003年茶叶行业标准(NY659-2003)》(F-≤200 mg/kg)。     

The use of a decremental dose regimen in patients treated with a chronic low-dose step-up protocol for WHO Group II anovulation: a prospective randomized multicentre study

BACKGROUND: In women with chronic anovulation, the choice of the FSH starting dose and the modality of subsequent dose adjustments are critical in controlling the risk of overstimulation. The aim of this prospective randomized study was to assess the efficacy and safety of a decremental FSH dose regimen applied once the leading follicle was 10-13 mm in diameter in women treated for WHO Group II anovulation according to a chronic low-dose (CLD; 75 IU FSH for 14 days with 37.5 IU increment) step-up protocol. METHODS: Two hundred and nine subfertile women were treated with recombinant human FSH (r-hFSH) (Gonal-f) for ovulation induction according to a CLD step-up regimen. When the leading follicle reached a diameter of 10-13 mm, 158 participants were randomized by means of a computer-generated list to receive either the same FSH dose required to achieve the threshold for follicular development (CLD regimen) or half of this FSH dose [sequential (SQ) regimen]. HCG was administered only if not more than three follicles >or=16 mm in diameter were present and/or serum estradiol (E(2)) values were <1200 pg/ml. The primary outcome measure was the number of follicles >or=16 mm in size at the time of hCG administration. RESULTS: Clinical characteristics and ovarian parameters at the time of randomization were similar in the two groups. Both CLD and SQ protocols achieved similar follicular growth as regards the total number of follicles and medium-sized or mature follicles (>/=16 mm: 1.5 +/- 0.9 versus 1.4 +/- 0.7, respectively). Furthermore, serum E(2) levels were equivalent in the two groups at the time of hCG administration (441 +/- 360 versus 425 +/- 480 pg/ml for CLD and SQ protocols, respectively). The rate of mono-follicular development was identical as well as the percentage of patients who ovulated and achieved pregnancy. CONCLUSIONS: The results show that the CLD step-up regimen for FSH administration is efficacious and safe for promoting mono-follicular ovulation in women with WHO Group II anovulation. This study confirms that maintaining the same FSH starting dose for 14 days before increasing the dose in step-up regimen is critical to adequately control the risk of over-response. Strict application of CLD regimen should be recommended in women with WHO Group II anovulation.     

Changes in vascular endothelial growth factor, angiopoietins, and Tie-2 levels with G-CSF stimulation in healthy donors

The roles of vascular endothelial growth factor (VEGF), Tie-2, and angiopoietins in the mobilization of the hematopoietic stem cells (HSCs) in humans are not yet clearly understood. In order to elucidate mechanisms of HSC mobilization from their niches, we aimed to investigate the effects of mobilization with granulocyte colony-stimulating factor to the levels of VEGF, Tie-2, and angiopoietins 1 and 2 in the allogeneic HSC transplantation donors. Soluble VEGF, Tie-2, angiopoietin 1 and angiopoietin 2 levels were studied in 20 healthy allogeneic HSC transplantation donors before (from peripheral blood) and 5 days after mobilization (from apheresis material). Mean VEGF level in the postmobilization apheresis sample was significantly higher compared to baseline premobilization peripheral blood (t test, p < 0.001). In contrast, mean Tie-2 level in the postmobilization aphaeresis sample was significantly lower compared to baseline premobilization peripheral blood (t test, p = 0.01). Angiopoietin 1 and angiopoietin 2 levels did not differ between baseline and postmobilization samples. A significant rise in VEGF level after mobilization suggests stimulation of the angiogenesis. A significant fall in Tie-2 level suggests suppression of the angiopoietin 1/Tie-2 signaling, leading to release of HSC from the hematopoietic niches and mobilization to the peripheral blood.     

宫腔灌注生长激素有助于改善胚胎反复着床失败后冻融胚胎移植的妊娠结局

目的:探讨宫腔内灌注生长激素对与冻融胚胎移植周期反复着床失败(RIF)妊娠结局的影响。方法:选择2013年至2015年胚胎RIF再次行FET患者的病例资料进行回顾性分析,随机分为对照组和实验组,对照组灌注生理盐水,实验组灌注生长激素,分析比较两组患者子宫内膜厚度、分型、血流等情况,观察两组患者着床率、自然流产率、生化妊娠率、临床妊娠率等有无统计学差异。结果:实验组子宫内膜厚度(9.04±1.20mm)高于对照组(8.59±0.97mm),差异有统计学意义(P0.05)。实验组内膜分型较对照组有所改善,差异有统计学意义(P0.05)。实验组HCG扳机日Ⅱ+Ⅲ血流类型(72.5%)较对照组Ⅱ+Ⅲ血流类型(56%)显著增加,差异有统计学意义(P0.05);实验组PI(2.14±0.13)、RI(0.83±0.06)较对照组PI(2.20±0.17)、RI(0.89±0.06)下降,差异有统计学意义(P0.05)。实验组着床率,生化妊娠率,临床妊娠率均高于对照组,差异有统计学意义(P0.05)。而早期流产率、多胎妊娠率未见明显差异。结论:宫腔灌注生长改善子宫内膜容受性,提高着床率以及临床妊娠率,改善反复种植失败患者妊娠结局。     

Paget-Schroetter syndrome associated with FV:Q506 and prothrombin 20210A--a case report.

Effort thrombosis of the axillary-subclavian vein (Paget-Schroetter syndrome) develops usually secondary to heavy arm exertion. An underlying chronic venous compressive anomaly at the thoracic outlet or intimal damage of the axillary vein following forceful hyperabduction, external rotation of the shoulder joint has been proposed to explain the pathophysiology of this thrombosis. This condition is usually not attributed to an underlying hypercoagulability such as deficiency of natural coagulation inhibitors. Here, the authors present a case with thrombosis of the axillary-subclavian vein following an effort, with factor V Leiden and prothrombin 20210A mutations. Both factor V Leiden and the genetic variant in the prothrombin gene have been shown to confer an increased risk for venous thrombosis. Although rare, effort thrombosis may develop in a patient with hereditary thrombophilia, so laboratory evaluation should include the common causes of thrombosis.     

Cardiac and great vessel thrombosis in Behçet's disease

Beh?et's disease (BD) is a chronic relapsing systemic vasculitis in which orogenital ulceration is a prominent feature. The disease affects many systems and causes hypercoagulability. We present a 27-year-old male patient who exhibited widespread great vessel thrombosis including right atrial and ventricular thrombi in the setting of right-sided infectious endocarditis and orogenital aphthous ulcerations and erythema nodosum due to BD. We reviewed the enigmatic prothrombotic state of BD, and discuss our prior experiences in this field.