Objective To investigate the clinical significance of flow cytometry(FCM)in cell apoptosis and prognosis in patients with acute leukemia.Methods FCMpropidium iodide(PI)DNA quantitative stain was used in 55 patients with acute leukemia(acute lymphoblastic leukemia treatment in 20 cases,alleviating period of 25 cases, 10 cases of acute non lymphocytic leukemia)to detect cell apoptosis and DNA cycle content changes,and compared with the control group.Results Acute leukemia cell apoptosis percentage Apo% in remission period was the highest, and it was (26.70 ±4.11)%,which of the initial treatment group was (10.23 ±1.05)%,remission with early treat-ment group and control group,the differences were statistically significant(t =3.970,2.341,all P <0.05).Leukemia DNA index (DI),aneuploid (AN rate),S phase cell percentage (SPF)value were (2.03 ±0.66 ),40% and (15.68 ±2.17)respectively,which were significantly increased.Conclusion The content of DNA in patients with acute leukemia is abnormal,the amount of apoptosis,SPF and other indicators have certain reference value for the prognosis of patients with acute leukemia.

Objective To investigate the application and clinical significance of flow cytometry(FCM)in cerebrospinal fluid(CSF)detection in the diagnosis of central nervous system leukemia(CNSL).Methods By the CD34,CD45 based different monoclonal antibody combined FCM detection method,CSF of 100 patients with CNSL was detected multi parameter of minimal residual disease(MRD).And with the natural sedimentation of cerebrospinal fluid after smear method,CSF cytology results were compared and analyzed.Results Of the 100 patients,CSF exami-nation was positive in 42 patients.CSF cytology was positive in 16 cases,the difference was statistically significant (χ2 =4.19,P <0.05).10 cases of nervous system symptoms of CSF examination were positive,and only 5 cases of CSF cytology positive(χ2 =6.81,P =0.018).In 100 cases of MRD detection,18 cases increased in white blood cell count,FMC detected in 17 cases,cytological diagnosis of 11 cases (χ2 =5.89,P =0.024).CSF with elevated pres-sure in 11 patients,FCMpositive in 11 cases,cytology detected in 4 cases(χ2 =5.12,P =0.031).CSF protein was elevated in 19 cases,FCMdetected 17 cases,cytology detected 7 cases(χ2 =7.14,P =0.001).Conclusion FCM combined with routine CSF detection can improve the positive rate of CNSL diagnosis,and it has important significance for early detection and treatment of CNSL,and to prolong the disease -free survival of patients with leukemia.

Objective To analyze the comparability and correlation of reticulocyte parameters on the Beckman‐Coulter LH780 (LH780)and Sysmex XN‐1000(XN‐1000)hematology analyzers .Methods 80 blood samples were measured by the two instru‐ments ,the RBC count ,percentage of Ret(Ret% ) ,Ret value(Ret#)and immature reticulocyte fraction(IRF) were analyzed ,and the correlation of Ret% ,Ret# and IRF between two instruments were also analysed .The correlation between percentage of high laser reticulocyte(HLR% ) of LH780 and percentage of middle fluorescent reticulogyte(MFR% )+percentage of high fluorescent reticu‐locyte(HFR% ) of XN‐1000 were compared using two calculation methods of each instrument ,and the application value of HLR%were analysed .Results No significant differences were founded in RBC count ,Ret% ,and Ret# between the two instruments(P>0 .05) ,while there was statistical difference in IRF between the the two instruments (P<0 .05) .The relative deviation coincidence rate of RBC count was 97 .5% ,the correlation coefficent (r) of Ret% ,Ret# and IRF were 0 .912 ,0 .895 and 0 .666 respectively . There were statistical differences and correlations between HLR% and MFR% + HFR% when using calculation method of XN‐1000 and LH780 respectively(r were 0 .666 and 0 .767 respectively ,P<0 .05) .Conclusion The RBC count could meet the matc‐hing requirement ,and the Ret% and Ret # may be highly correlated on the two instruments .While the reference range of IRF should be established in each instrument .

Objective To study the effect of 2-methoxyestradiol (2-ME) on proliferation,apoptosis and its mechanism.Methods K562 cells were treated with 2-ME of different concentrations and time in vitro.Cell apoptosis rate was measured by flow cytometry(FCM).Activity of NF-Kappa B in nucleus was detected by electrophoretic molility shift assay(EMSA).Results After treatment with 2-ME,K562 cells apoptotic rate increased significantly.After treatment with 4μmol/L 2-ME for 24h、36h、48h,the activity of Caspase-3 and Caspase-9 were significantly higher and activity of NF-Kappa B in nucleus was significantly lower.Conclusion The present study showed that 2-ME induced apoptosis of K562 cells via active Caspase-3 and Caspase-9 and inhibit the activity of NF-kappa B in nucleus.This study provided useful experimental data for clinical application of 2-ME.

Objective To discuss the protective effects and mechanisms of dexamethasone and Shenfu sepa-rate and joint administration of flap after ischemia-reperfusion injury. Methods 40-month-old fairly healthy rats were randomly divided into 4 group as A, B, C, D, and to product the abdominal island flap, then blocking the flow of blood of the pedicle artery respectively before 30 minutes when injecting with normal saline (1 ml/kg), dexametha-sone (1 ml/kg), Senate (10 ml/kg), joint injection with dexamethasone (1 ml/kg) and Shenfu (10 ml/kg). 4 groups of animals' blood samples were collected from the pedicle vein before the time of I hour when blocking vascu-lar pedicle and reperfusion after the time of 1 h, 6 h, 12 h, 24 h, respectively. Then the plasma concentration of TNF-α was measured. Results The concentration of TNF-α in the treatment group was significantly lower than the blank group(P <0.01). And the group D and the group B、C has significant differences either(P <0.01). Conclu-sion Using Dexamethasone, Shenfu injection in early can reduce the concentration of TNFα in repeffusion injury of flap and has a protective effect on the flap, but make better effect in combined.

Objective To investigate the preventive effect of oral ulcer using two methods in radio-therapeutic patients after tongue squamous cell carcinoma operation. Methods Thirty-six radiotherapeutic patients after tongue squamous cell carcinoma operation were collected from May 2012 to May 2014 and divided into control group and treatment group according to the random number table method. Regular oral nursing was administered to control group, treatment group were received regular therapy plus orally vitamin B and cetylpyridinium chloride gargle for gargling, and then evaluated the efficacy according related standards. Results Less oral ulcer (1/18 vs.7/18,χ2=-2.372,P<0.05), better oral lustration (Z=-2.093,P<0.05) and overall oral nursing effect (Z=-2.166,P<0.05) were observed in treatment group compared to control group after 7 days of therapy, however, treatment group presented no significantly better comfort level at the same time (Z=-1.708,P>0.05). Conclusions Regular therapy plus orally vitamin B and cetylpyridinium chloride gargle for gargling are effective for the prevention of oral ulcer in radiotherapeutic patients after tongue squamous cell carcinoma operation.

Objective To detect the effect of low-dose heparin on endothelial function by detecting the change of yon Willebrand factor (vWF) in blood plasma of patients with sepsis shock after treatment with low-dose heparin in order to observe organ function and prognosis of patients.Methods A total of 118 patients with sepsis shock were randomized into low-dose heparin group and control group.In addition to the routine treatment,the patients in low-dose heparin group were given low-dose heparin,while those in control group were not.The levels of APTT,PT,platelet (PLT) count,hepatic function and renal function were determined before and after treatment in two groups,and hemorrhagic events or other complications were recorded.The lengths of stay in ICU and in hospital,the days of mechanical ventilation and the rates of acute respiratory distress syndrome (ARDS),disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) and 28-day survival rate in the two groups were documented.The levels of vWF in patients of two groups were determined by using immunoturbidimetry before and after treatment.Results The rates of DIC and MODS in low-dose heparin group decreased significantly after therapy (rate of DIC,10.6％ vs.26.7％,P ＜ 0.05;rate of MODS,19.3％ vs.32.0％,P ＜ 0.05).Hepatic function and renal function in low-dose heparin group were significantly improved than that in the control group (P ＜ 0.05),28-day survival rate in the low-dose heparin group was higher than that in the control group (78.3％ vs.69.1％,P ＜0.05),the differences between low-dose heparin group and control group were not statistically significant in the lengths of stay in ICU and hospital,the days of mechanical ventilation and the rate of ARDS (P ＞ 0.05).The differences in APTT,PT and PLT were not significant from pre-treatment to after treatment and between the two groups (P ＞ 0.05).The levels of vWF in low-dose heparin group decreased significantly after therapy rather than those in control group (P ＜ 0.05).Conclusions The endothelial function is improved in patients with sepsis shock after employment of lowdose heparin.Low-dose heparin alleviates the interaction between coagulation and inflammation,improves hepatic,renal and other important organs function,decreases the rate of MODS and increases 28-day survival rate patients with sepsis.The low-dose heparin therapy is a safe and promising treatment in sepsis patients without severe side effects.

BACKGROUND: Peri-implant crestal bone resorption is considered as a normal reaction according to traditional butt-joint prosthesis around two-piece implants. OBJECTIVE: To evaluate bone loss around two-piece implants restored according to the platform switching concept in the posterior area of the mandible. METHODS: Eighty-eight implants were consecutively placed in 50 patients following submerged surgical protocol. In the test group, 40 Ankylos implants were placed using platform switching technique, while 48 3i implants using traditional butt-joint in the control group. All the implants were positioned at the crestal level. Definitive prosthesis was delivered after 3 months. RESULTS AND CONCLUSION: All implants were judged to be successfully osseointegrated. The success rate was 100%. Twelve months after restoration, radiographic analysis showed an average bone reduction level of (0.31±0.39) mm in the test group that was statistically significantly different (P < 0.01) from the average reduction in the control group [(0.94±0.43) mm]. In the follow-up time, no implants were loose or lost and healthy gingival was seen. These findings show that the platform switching technique can reduce peri-implant crestal bone resorption and preserve alveolar bone level around dental implants 12 months after restoration.Oral Implantology Center, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China

Objective To explore the correlation of pulse pressure(PP) and outcome in refractory septic shock patients.Methods A total of 68 patients with refractory septic shock consecutively admitted in our ICU from January 2012 to December 2012 were retrospectively studied.Hemodynamic data and arterial lactate concentration were collected at the time of admission and 24 hours after admission.The outcome of Day 28 post-diagnosis was also recorded.Results (1) Compared with the survivors,heart rate(HR) at 24hours after admission was higher in non-survivors,while 24 h lactate clearance rate (rLac) was lower in them (P ＜ 0.05).Other hemodynamic parameters showed no difference between the non-survivors and the survivors at 24 hours after admission,including central venous pressure (CVP),mean arterial pressure (MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP),PP,pulse pressure/heart rate (PP/HR),pulse pressure/mean arterial pressure(PP/MAP),pulse pressure/systolic pressure(PP/SBP),pulse pressure/diastolic pressure (PP/DBP),the value of SBP above MAP (SMP) and the value of DBP below MAP(MDP).(2)The mortality rate was higher in the patients with HR≥100 b/min than those with HR ＜ 100 b/min,but without statistical significance (56.25％ vs 36.11％,P =0.096).Compared with the survivors,no matter with HR≥100 b/min or HR ＜ 100 b/min,lactate(Lac) at the 24 hours after admission was higher in all the non-survivors (P ＜ 0.05),while with lower rLac (P ＜ 0.05).In those with HR ≥100 b/min,the following hemodynamic parameters were higher in the non-survivors than in the survivors,including PP,PP/HR,PP/MAP,PP/SBP,PP/DBP,SMP and MDP (all P values ＜ 0.05),while no statistical difference was observed in those with HR ＜ 100 b/min.(3)The mortality rate showed no statistical difference in those with MAP≥85 mmHg(1 mmHg =0.133 kPa) and with MAP ＜ 85 mmHg(42.42％ vs 48.57％,P =0.611).No matter MAP≥85 mmHg or MAP ＜ 85 mmHg,compared with the survivors,all the non-survivors had higher Lac at the 24 hours after admission (P ＜ 0.05),while with lower rLac (P ＜ 0.05).In those with MAP≥85 mmHg,HR was higher in the non-survivors than the survivors (P ＜ 0.05).In those with MAP ＜ 85 mmHg,compared with the survivors,the non-survivors had higher PP,PP/MAP,PP/SBP,PP/DBP,SMP and MDP (P ＜0.05),while with lower DBP (P ＜0.05).Conclusion PP is correlated with the outcome in refractory septic shock patients.When the HR and MAP differ,PP has different effect on the outcome and contributes more to the tissue perfusion and outcome in those with higher HR and lower MAP.

Objective To establish an early cognitive disorder model in rats and investigate the early cognitive functioning after ischemic hypoxic brain injury during the neonatal period. Methods Forty-six newborn Sprague-Dawley rats were randomized into a 21-d-old group and a 31-d-old group. These 2 groups were then subdivided into model and sham-operated subgroups (M21, n=12; SH21, n=11; M31, n=12; SH31, n=11). A model of neonatal early cognitive disorder was established in the rats of the M21 and M31 groups using a modification of Rice's method. Rats in the SH21 and SH31 groups received skin incisions and common carotid artery separation without ligation or hypoxia. Each group was tested with a Morris water maze. The rats were sacrificed after testing, and brain tissue was examined under the electron microscope. Nissl staining allowed Nissl body quantification and neurocyte acin the M21 group was significantly longer than in the SH21 group. The 31-d-old subgroups had shorter average escaping latencies than the corresponding 21-d-old subgroups. (b) Spatial memory: The average platform times, Ⅰ region times and Ⅰ region distances showed no significant differences among groups. ②Brain pathology (a) Gross appearance: Obvious ischemic hemisphere atrophy was observed in the M group, and no abnormality was observed in the SH group. (b) Electron microscopic observation: In the SH group cell ultrastructures in the ischemic hippocampus were normal. Karyopyknosis and dilated endoplasmic reticulums were found in the M group. More mitochondria were found in the presynaptic membranes of the ischemic hippocampus in the M group than that in the SH group. (c) Nissl body quantification and neurocyte activity analysis: Significantly less activity in the ischemic cortex was found in the M21 group compared to the SH21 group. More activity was observed in the 31-d-old subgroups than in the corresponding 21-d-old subgroups. Conclusions ①The neonatal rats with ischemic hypoxic brain injury had prolonged average escaping latency and depressed neuronal activity. ②The 31-d-old rats had better spatial localization learning ability than the 21-d-old rats.