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.

?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.

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.

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.

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 .

Objective　To investigate the feasibility of applying transvescal approach laparoendoscopic single-site radical prostatectomy (TVSSLRP) and assess the oncological and functional outcomes.Methods　Eight patients with clinically localized prostate cancer (PCa) of low risk underwent TVSSLRP.Demographic data were accrued including patient age,body mass index (BMI),preoperative PSA level,the International Index of Erectile Function 5,biopsy Gleason score,clinical TNM stage and D'Amico risk classification.One surgeon performed all TVSSLRP procedures.A homemade triple-port was introduced percutaneouly into the bladder to establish pneumovesicum through a 4 cm incision.The major steps of the surgery were described as follows:initial incision was made along posterior margin of the bladder neck to expose bilateral vas deference and spermatic vesicle.After opening Denonvilliers' fascia and extending the space to lateral prostatic pedicles,an intra-fascial nerve sparing procedure was performed.The puboprastatic ligaments were then separated close to the prostate surface and the dorsal vein complex was cautiously swept off.Subsequently,careful apical dissection and urethral transection was sequentially conducted. To reduce the tension of vesico-urethral anastomosis,3 additional incisions parallel to vesio-urethral margin were created and a novel tension - reduced V-LocTM barbed polydioxanone sutures was used.　Results　All the operations were successfully performed and there was no conversion to standard laparoscopic approach or open surgery.The total operative time range was 75 - 180 min with mean time of 125 min.The blood loss was 85 -450 ml with mean 140 ml and no blood transfusion was required.The catheter was removed after a mean (range) of 14 (9 -16) days.No intra-operative complications occurred. No patient had positive surgical margins.The mean (range) hospital stay was 17 (13 -25) days after surgery. All the cases were continent after removal of the catheter.No cases demonstrated vesico-urethral stricture and biochemical recurrence on 12 - 18 months follow up postoperatively.　Conclusions　TVSSLRP is technically feasible for cases with organ-confined prostate cancer with good oncological and functional results.

Objective To investigate the common sites and risk factom of reoperation for bleeding after coronary artery bypass grafts(CABG).Methods During Jan 2000 to July 2011,2765 CABG procedures hed been done in our hospital,including 874 cases with CABG by cardiopulmonary bypass,1891 cases with off-pump coronary artery bypass grafts (OPCAB),105 cases combined with other procedures (cardiac valve operation,resection of ventricular aneurysm,et al),216 cases applied intra-aortic balloon pump (LABP)).67 patients needed reoperation for bleeding,the morbidity is 2.4％.Factors that might affect the result of reoperation were analyzed by single-factor analysis.Results The following factors were related to high rates of reoperation (P ＜ 0.05 ):the internal mammary artery (IMA) used,anfithrombotic medication discontinued less 5 days before elective surgery,concurrent hypertension,combined with other surgery procedures and ages ＞70 years.It was not signifieantly related to CABG or OPCAB,ff use of IABP,ff concurrent diabetes,number of grafts inserted.Major sources of bleeding found in 48 patients were the IMA and its vessels bed,vein grafts,sternum,aortic faucet,midriff,thymus glrard bed vessels.Conclusion Prepared satisfactorily before operation,avoid risk factors can reduce reoperation for bleeding,but the most important is the operation carefully during operation of hemostasis.

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 summarize the first 16 eases in mainland China and to discuss the cli-nical experience of robot-assisted laparoseopie radical prostateetomy(RLRP). Methods Sixteen pa-tients with localized prostate carcinoma underwent RLRP with da Vinci S surgical system (Intuitive Surgical Inc.). The age of the patients was 62-76 years, average 69 years. The preoperative t-PSA level was 0.2-79. 2. Ng/ml. The volume of prostate was 9.8-232.9 ml. Fifteen patients were with biopsy-proven prostate cancer, the average Gleason score was 7(4-9). Three were T2a. N0 M0, 4 were T2b N0 M0 and 8 were T2c N0/M0 by clinical stage. One was prostatic intraepithelial neoplasm-Ⅲ. The level of t-PSA in serum and the result of urinary continence were followed up after RLRP. Results All the operations were accomplished successfully. The mean preoperative set-up time of the da Vinci surgical system was 64(60--90)min;the mean operation time was 236(190--390)rain;the mean esti-mated blood loss was 231(50-500)m.L The patients were ambulant between the 2nd and 3rd postop-erative days. Foley catheter was sueeeasfully removed on day 10 to 14, and mean hospital stay was 13 (6-19) days. Two eases had positive surgical margins, the pathological stages were both pT3b N0 M0. The average serum t-PSA was less than 0. 1 ng/ml during a median follow-up of 9(6-12) months. By the conventional definition of urinary continence (0 to 1 pads daily), 94%(15/16) and 100% (16/16)of patients were continent at 3 and 6 months, respectively. Of the patients, 75% (12/16)and 88% (14/16)had no urinary leakage(0 pads daily). Conclusions RLRP is small incision and safe. It is the direction of minimally invasive urologic surgery.

Objective To present the preliminary experience with laparoscopic ureteral reimp1ant for distal ureteral stricture without everted ureteral nipple or submucosal tunneling. Methods Six patients with distal ureteral stricture underwent transperitoneal laparoscopic ureteral reimplantation.The ureteral was reimplanted into the bladder without everting the ureter or without a tunnel.The seromuscular wall of the ureter was anastomosed eircumferentially to the bladder muscle layer by continuous suture. Results All procedures were successfully performed without any intraoperative complications or need for open conversion.Intravenous urography showed normal drainage without obstruction or reflux during follow-up. Conclusion Laparoscopic ureteral reimplantation might be technically simple and feasible.