Objective To study the expression of BMI-l gene in children with acute leukemia and its clinical significance.Methods The clinical specimens of 46 children with acute leukemia who were diagnosed lately in the Third Affiliated Hospital of Zhengzhou University and other hospitals in Zhengzhou from Jul.1,2008 to Apr.30,2009 were collected,while peripheral blood specimens of 30 healthy children were collected as control group.With the guardians′ informed consent,the experiment was approved through the hospital ethics committee.The level of BMI-1 mRNA′s expression was tested using reverse transcription-polymerase chain reaction(RT-PCR),while data were analyzed through the application of SPSS 12.0 statistical software.Results 1.The level of BMI-l gene′s expression in children with acute leukemia was significantly higher than that in control group(P0.05),after complete remission,BMI-1 mRNA was not detected in the 2 groups;4.Compared with the complete remission group,expression of BMI-1 mRNA in the untreated group and the recurrence group was significantly higher(P0.05).Conclusions BMI-1 gene was highly expressed in children with acute leukemia,and the level of the gene expression in patients of complete remission normalized,which suggests that the gene may be involved in the occurrence and the development process of leukemia;therefore,it is possible to regard the gene as a molecular marker to evaluate the development,relapse and prognosis of the patients with acute leukemia.

Objective To investigate the effects of fracture displacement and operation method on perioperative blood loss of femoral neck fractures. Methods From December 2013 to October 2014, 130 cases (58 males and 72 females, aged from 18 to 91 years, with an average age of 71.1±12.9 years) with femoral neck fractures were retrospectively analyzed for the periopera?tive blood loss. The degree of displacement was described according to Garden's grades. According to the degree of fracture dis?placement, the patients were divided into two groups:GardenⅠ-Ⅱgroup and Garden Ⅲ-Ⅳgroup, and patients' preoperative hidden blood loss was compared between two groups. According to the degree of fracture displacement and the method of opera?tion, the patients were divided into four groups:Group 1 indicates the group in which patients received cannulated screws fixation for Garden gradeⅠ-Ⅱ;Group 2 in which patients received hemiarthroplasty for Garden gradeⅠ-Ⅱ;Group 3 in which patients received cannulated screws fixation for Garden grade Ⅲ-Ⅳ; Group 4 in which patients received hemiarthroplasty for Garden grade Ⅲ-Ⅳ; and variation in the following four parameters was analyzed: the dominant blood loss, postoperative hidden blood loss, total hidden blood loss, total blood loss in the four different groups. Results For the Garden gradeⅢ-Ⅳfemoral neck frac?ture group, the preoperative hidden blood loss was significantly higher than that of the Garden gradeⅠ-Ⅱfemoral neck fracture group (t=2.267, P=0.001). The dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss vol?ume and total blood loss volume of hemiarthroplasty groups (402.1 ± 36.8 ml, 641.3 ± 53.2 ml, 880.7 ± 61.7 ml, 1 246.1 ± 76.7 ml) were higher than those of the cannulated screws fixation group (45.8±34.9 ml, 301.9±50.6 ml, 436.6±58.6 ml, 478.5±72.9 ml). Conclusion The perioperative hidden blood loss is mainly related with the degree of fracture displacement, the greater the de?gree of fracture displacement, the more the preoperative hidden blood loss. While the dominant blood loss volume, postoperative hidden blood loss volume, total hidden blood loss volume and total blood loss volume are mainly related to the method of operation, the blood loss in which patients received hemiarthroplasty should be increased significantly.

Medical science is a practical subject.Before entering the clinical practice,medical students should promote clinical-practice ability by using medical models and reviewing photograph recordings,and then take short reinforcement training by suing standardized patient in order to esteem the patients' rights.

?AlM: To evaluate the long - term effects of laser peripheral iridectomy ( LPl ) and trabeculectomy in treating early chronic angle-closure glaucoma.
?METHODS: Ninety-eight patients (102 eyes) with early chronic primary angle-closure glaucoma were randomly divided into two groups. Group A of 50 patients (54 eyes) was treated with LPl and group B of 48 patients (48 eyes) with trabeculectomy. After 3 - 8y of follow - up observation, comparison would be made from the perspectives of postoperative eyesight, intraocular pressure, anterior chamber angle, visual field and cup/disc ratio ( C/D) .
?RESULTS:ln group A, 24 eyes with eyesight declining, 22 eyes with theintraocular pressure>21mmHg (1mmHg=0. 133kPa), 21 eyes with chamber angle synechia >180o, 21 eyes with visual field narrowed, 21 eyes with C/D ratio enlarged. The results of group B for the same items were 10, 5, 4, 4, 4 eyes respectively. The comparative difference was statistically significant (P<0. 05).
?CONCLUSlON:Good effects will be achieved for early-stage chronic angle - closure glaucoma with surgical method. Trabeculectomy is obviously better than LPl for the long-term effects.

Objective To investigate the effect of smoking status after vascular construction on the long term prognosis in the patients with coronary heart disease(CHD).Methods Totally 893 patients with CHD were divided into 3 groups according to the smoking status before and after vascular construction,non-smoking group(n=458),quiting smoking group(n=287) and smoking group(n=148).The occurrence situation of major adverse cardiovascular and cerebrovascular events(MACCE) during follow-up period were recorded in detail.The postoperative cumulative survival rate was described by using Kaplan-Meier survival analysis.The effect of smoking status on the all-cause death and MACCE was compared.The Cox stepwise regression analysis was used to analyze the all-cause death and the influence factors of MACCE.Results The average follow up time was about 27 months,the postoperative smoking rate was significantly lower than the preoperative multivariable smoking rate(16.57 ％ vs.48.71％),the patients in the smoking group were younger (P＜0.01);the patients in the non-smoking group were mainly female (P＜0.01),the body mass index (BMI) was smaller(P＜0.01).The all-cause death in the smoking group was higher (1.53％ vs.1.05％ vs.6.76％,P=0.002) and the occurrence rate of MACCE was higher (4.37％ vs.5.23％ vs.15.54％,P=0.001).The Cox multivariable stepwise regression analysis showed that postoperative persistent smoking was an important risk factor leading to the all-cause death[HR=2.753,95％CI(1.695-4.473),P＜0.01] and MACCE[HR=1.552,95％CI(1.049-1.754),P=0.001].Conclusion Persistent smoking is an independent risk factor leading to all-cause death and MACCE occurrence in CHD patients after vascular construction.

Objective To observe the change of profilin-1 during the aging of rats' aorta and the anti-aging effect of grape procyanidins (GPC).Methods Young male Wistar rats (9 weeks) and middle rats (12 months) were randomly divided into GPC treatment and control groups respectively.We quantified arterial aging changes through morphological methods.Thoracic aortas were stained with hematoxylin eosin.Serum levels of 3-nitrotyrosine (3-NT),malondialdehyde (MDA),superoxide dismutase (SOD) and nitric oxide (NO) were tested using enzyme-linked immunosorbent assay (ELISA).Western blotting was performed to measure the protein expression of inducible nitric oxide synthase (iNOS) and profilin-1.Results Compared with the young male Wistar rats group,aging change in the aortic morphology of middle rat group were shown by hematoxylin-eosin staining (HE) staining:media thickness (MT) increased [(98.3±0.5)μm vs.(83.1±1.0)μm,P＜0.05],luminal internal diameter (LD) decreased [(15.5 ±0.2) μm vs.(18.2±0.5,P＜0.05)μm,P＜ 0.05],(MT/LD)％ increased [(6.4±0.1) ％ vs.(4.6±0.1)％,P＜0.05],the protein expressions of profilin-1 and iNOS both increased [profilin-1:(1.58 ± 0.09) vs.(1.29 ± 0.04),iNOS:(1.02±0.12) vs.(0.75±0.02),both P＜0.05],levels of NO and SOD in serum decreased [NO:(6.3±0.2)μmol/L vs.(8.4±0.2) μmol/L,SOD:(172.3±1.6) U/ml vs.(189.1±1.5) U/ml,both P＜0.05],the levels of MDA and 3-NT increased[MDA:(11.3±0.3) μmol/L vs.(9.4 ±0.1) μmol/L,3 NT:(40.2±0.3) nmol/L vs.(35.6±0.5) nmol/L,both P＜0.05)].After treatment with GPC,compared with the control group,MT decreased,LD increased and MT/LD (％)decreased in the middle GPC treatment group.The protein expressions of profilin-1 had no changes before and after treatment with GPC both in young and middle groups.After the GPC treatment in middle group,compared with the middle control group,iNOS expression decreased,serum levels of NO and SOD increased,and the levels of MDA and 3-NT decreased significantly (all P ＜0.05).Conclusions Profilin-1 is related with age-related changes in rat aorta.Profilin-1 participates in vascular aging through iNOS induced oxidative stress.GPC may defer vascular aging by inhibiting vascular oxidative stress.

Objective: To investigate the compliance of smoking cessation and the effect of smoking status on long-term clinical prognosis in male patients with acute coronary syndrome (ACS) after drug-eluting stent (DES) therapy. Methods: A total of 656 ACS patients after DES therapy were studied, according to the post-operative smoking status, the patients were divided into 3 groups: Non-smoking group,n=226, Quit smoking group,n=283 and Persistent smoking group, n=147. The patients were followed-up for the average of 27 months, the major adverse cardio-/cerebral-vascular events (MACCE) were recorded in detail, and the effect of smoking status for MACCE occurrence were evaluated by multivariable Cox regression analysis. Results: The pre-operative smoking rate was 65.5% (430/656) of patients and post-operative smoking rate was 22.4% (147/656). Compared with Non-smoking group and Quit smoking group, the patients in Persistent smoking group had the younger age (P<0.001), more patients with abnormal blood lipids (P=0.005) and having lower level of education (P<0.001). The all cause death rates in Non-smoking group, Quit smoking group and Persistent smoking group were at 1.8%, 1.1% and 6.1% respectively,P=0.004; the MACCE occurrence rates were at 7.1%, 5.3% and 15.0% respectively,P=0.002. Multivariable Cox regression analysis showed that post-operative smoking was the independent risk factor for MACCE occurrence, HR =1.404, 95% CI (1.206-1.793),P=0.008. Conclusion: Smoking is the independent risk factor for MACCE occurrence in male ACS patients after DES therapy.

Objective To investigate the value of emergency bedside focused assessment with sonography for trauma (FAST) in combination with regional organ focused ultrasonography in patients with closed abdominal trauma.Methods Two hundred and thirty-seven patients with closed abdominal trauma underwent bedside ultrasonography in the Emergency Department at General Hospital of Chengdu Military Command.In patients with unstable hemodynamics or severe craniocerebral injury,ultrasonography was ended immediately after FAST screening.In patients with stable vital signs,the focused regional organ injury after FAST screening was determined based on the mechanism of trauma,action location and direction of external force,abdominal symptoms,and signs.The results of operation and CT scanning were considered as golden criteria and used to compare with those of ultrasonography.Results (1) The diagnostic sensitivity of FAST to abdominal organ rupture and ascites due to abdominal organ rupture calling for emergency operation was 79.3％ and 100％,respectively.The total specificity of FAST was 98.2％,positive predictive value 93.9％,and negative predictive value 86.7％.(2) The diagnostic accordance rate of single visceral injury examined by regional organ focused ultrasonography was 91.2％ and that of multiple visceral injury was 63.6％.The missed diagnoses were predominantly contusion and microlaceration.Conclusions FAST can quickly screen out the patients with unstable hemodynamics due to abdominal organ rupture calling for emergency management.Regional organ focused ultrasonography can increase the rate of correct diagnosis of visceral injury and decrease the rate of missed diagnosis.

Objective To investigate the effect of acute high altitude exposure on lung functions and the relationship between lung functions and acute mountain sickness ( AMS) .Method We collected the lung function and Lewis Lake data of 73 subjects (aged 18 to 26,male) at 400 m above sea-leve and those at high altitude(exposure to 3900 m, 5 d).Results Compared with sea-level, lung functions decreased in forced vital capucity (FVC), maximum midexpiratory flow(MMF), V50, V25 while forced expiratory volume in 1 second(FEV1), peak expiratory flow(PEF), V75 did not change.FVC, FEV1, PEF, MMF were used to analyze the relationship between lung functions and AMS .There was no difference in lung functions between AMS group and NON AMS group at sea-level, but lung functions of AMS group were significantly lower than those of NON AMS group in FVC , MMF at high altitude .There was difference between AMS group and NON AMS group in the rate of change of FVC and MMF .Logistic regression analysis showed that the rate of change of FVC was an independent risk factor , while correlation analysis showed that the change of FVC and the change of oxygen saturation were relevant.Conclusion Lung functions showed restrictive decrease after acute high altitude exposure .Changes of lung func-tions will increase hypoxia and susceptiblity to AMS .

OBJECTIVETo investigate the changes of the cardiac hemodynamics after acute high altitude exposure in healthy young males and the relationship with acute mountain sickness(AMS).

METHODSLeft ventricular function and oxyhemoglobin saturation (SaO2), heart rate (HR), blood pressure (BP) were measured in 218 healthy young males before and after high altitude exposure within 24 h respectively. According to the lake louise score criteria, the subjects were divided into two groups: acute mountain sickness group (AMS group) and non acute mountain sickness group (non-AMS group).

RESULTSHR, diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular ejection fraction (LVEF), stroke volume (SV), stroke index (SI) cardiac output (CO), cardiac index (CI) were significantly increased upon acute high altitude exposure (P < 0.05). Whereas SaO2 and end-systolic volume (ESV) were significantly decreased (P < 0.05). In addition, HR, systolic blood pressure (SBP) and MAP in AMS group were significantly higher than those in non-AMS group (P < 0.05). But stroke index (SI) and end-diastolic volume (EDV) in AMS group were significantly lower than those in non-AMS group (P < 0.05).

CONCLUSIONCardiac function in healthy young males upon acute high altitude exposure was enhanced. EDV, HR and SI might become the indexes of predicting the acute mountain sickness in the future.