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.

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.

Objective The aim of this study was to evaluate the accuracy of calculating the insertion length of the overtube for estimating the insertion depth of the scope at double-balloon enteroscopy (DBE).Methods Patients with intestinal lesions found at DBE and confirmed by surgery were included. The advancing distance of the enteroscope at DBE was estimated by either cumulative length of push/pull cycle or calculation of the overall insertion length of the overtube. The accuracy of these two methods was evaluated with reference to surgery. Results Data from 51 patients who had their lesions found at DBE and treated by surgery were included in the study. DBE included 41 antegrade and 10 retrograde procedures. The average difference in the evaluation of the length of enteroscopic insertion between the two methods was 17 cm ( range 0-60 cm) on antegrade DBE and 12 cm (range 0-30 cm) on retrograde DBE. Furthermore, regardless of insertion route of DBE procedure, the mean differences between the insertion length evaluated by the two methods and surgical findings were 19 cm (range 0-50 cm) and 17 cm (range 0-60 cm), respectively, which was not significantly different ( P ＞ 0. 05 ). Conclusion The new method of calculating the length of the overtube passage is the same accurate and much simpler than the traditional method in estimating the insertion depth of the enteroscope at DBE, which is appliable in clinical practice.

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 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.

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.