It is proposed that surviving leukemia stem cell (LSC) is a major contributing factor to leu-kemic relapse because of its molecular and cellular features.Several recent studies have proved that LSC can be eliminated by target therapy.

AlM:To observe the clinical effect of 2. 2mm micro-incision phacoemulsification ( Phaco ) combined intraocular lens( lOL) implantation in the eyes with short axial length and compared with traditional 3. 0mm incision phacoemulsification operation for clinical work and research objective information.METHODS:ln this prospective clinical control study, 60 cases (60 eyes) with cataract performed 2. 2mm micro-incision phacoemulsification combined lOL implantation ( micro-incision group, implanted Akreos Ml60 lOL ) and 3. 0mm incision phacoemulsification operation ( small incision group, implanted Akreos Adapt lOL ) , whose axial length ranged 17. 68 ~ 21. 32mm, average 20. 35 ± 0. 61mm. Average axiall ength respectively of two groups:20.57±0.39mm and 20.21±0.52mm. Effect Phaco time ( EPT ) and average ultrasonic energy ( AVE ) were recorded. The best corrected visual acuity ( BCVA ) , intraocular pressure ( lOP ) , anterior chamber depth ( ACD) , corneal endothelial cell density and the operative complications were observed postoperatively. All cases were followed up at 1, 7, 30 and 90d after operation.RESULTS:EPT and AVE between two groups had no statistical significance(P>0. 05). At the 1, 7 and 30d after surgery, induced astigmatism ( SlA ) of micro-incision group was lower than that of small-incision group. SlA between two groups had statistically significant ( P <0. 05), but in the 90d SlA between two groups had no statistical significance(P>0. 05). At the 7d, the BCVA between two groups had statistical significance(P<0. 05), but at the 30 and 90d, BCVA between two groups had no statistical significance(P>0. 05). At the 7, 30 and 90d, corneal endothelial cell density of micro-incision group was higher than that of small incision group. Corneal endothelial cell density between two groups had no statistical significance. The mean ACD was significant increased postoperatively than preoperatively and had no statistical significance ( P>0. 05 ) . The anterior chamber stabilized during the operation. There was not incision hot harmed during operation and postoperation.CONCLUSlON:Compared with 2. 2mm micro-incision and traditional 3. 0mm incision phacoemulsification, two groups have the same safety and 2. 2mm micro-incision phacoemulsification has small SlA, organization small harm and improved visual acuity in early stage.

Diabetes mellitus is a metabolic syndrome characterized by hyperglycemia, and is caused by complex interaction between genetic and environmental factors. Diabetes mellitus can lead to various ocular surface disorders, including dry eye, superficial punctuatekeratitis, corneal epithelial defects, and recurrent corneal erosion et al. This review focuses on the domestic and overseas research progress on dry eye in diabetics.

Objective To test the reliability and validity of the home care demand forecasting scale for fracture patients when they were before discharge. Methods This study was descriptive study. Convenience sampling was used and 412 patients with fracture from 5 comprehensive hospitals in Yanbian Korean Autonomous Prefecture were selected. Finally, the number of valid questionnaires is 398 which were used for testing. Results Five factors and 32 items were eventually determined. The split-half reliability coefficient was 0.910, and split-half coefficient in each dimension was over 0.75; the content validity showed scale level content validity index(S-CVI) was 0.948, and the index in each item′s item level content validity index (I-CVI) was between 0.76 to 1.00. The result of factor analysis included 5 factors and the cumulative contribution of variance was 59.181%. The result of construct validity χ2/df=1.554, root mean square error approximation (RMSEA)=0.037, goodness-of-fit index (GFI)=0.920. The total of scale′s Cronbach coefficient was 0.948, Each dimension′s Cronbach coefficient was between 0.797-0.875. Conclusions The home care demand forecasting scale was proved to be reliable and valid. It can be used to assess the home-care needs of fracture patients before they were discharge.

Aged ; Anemia, Hemolytic, Autoimmune ; complications ; Female ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications

Professor GAO Yuchun is considered as the key successor of GAO's academic school of acupuncture and moxibustion in Yanzhao region. Professor GAO's clinical experience of, "sequential acupuncture" is introduced in details in this article. In Professor GAO's opinions, appropriate acupuncture sequence is the key to satisfactory clinical effects during treatment. Based on different acupoints, sequential acupuncture can achieve the aim of qi following needles and needles leading qi; based on different symptoms, sequential acupuncture can regulate qi movement; based on different body positions, sequential acupuncture can harmonize qi-blood and reinforcing deficiency and reducing excess. In all, according to the differences of disease condition and constitution, based on the accurate acupoint selection and appropriate manipulation, it is essential to capture the nature of diseases and make the order of acupuncture, which can achieve the aim of regulating qi movement and reinforcing deficiency and reducing excess.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Needles ; Qi ; history

Objective To evaluate the value of DWI parameter ADC and intravoxel incoherent motion(IVIM) derived parameters in grading extrahepatic cholangiocarcinoma(EHCC).Methods Thirty-eight consecutive patients with surgically resected and pathologically confirmed EHCC while the minimum diameter of the lesions large than 5 mm were included in this retrospective study.Patients underwent upper abdomen 3.0 T MR(including conventional MRI and DWI scansequences).Importing original images into the IVIM post-processing software,each patient were set three times of ROIs and each time interval was one week.ROI were selected in the same position of the maximum solid part of lesions area,the average value of ADC,blood flow(BF),pure molecular diffusion(D),perfusion-based molecular diffusion(D*),perfusion fraction(f) were measured.According to WHO digestive tumor specimens grading method,divided these cases into Ⅰ,Ⅱ,Ⅲ grade group.Evaluate the association by Spearman correlation analysis and compare the diagnostic potential of parameters ADC、BF、D、D*、f by using ROC analysis.Results Thirty eight cases of EHCC include:grade Ⅰ 11 cases,grade Ⅱ] 15 cases and grade Ⅲ 12 cases.ADC values of these three groups were (1.33 ± 0.22) × 10-3,(1.21 ± 0.18) × 10-3,(0.98 ± 0.10) × 10-3mm2/s,respectively.BF values were (2.40± 1.01) × 10-3,(2.37± 1.19) × 10-3,(1.64±0.46) × 10-3mm2/s.D values were (1.30±0.13) × 10-3,(1.15 ±0.13) × 10-3,(0.87±0.11) × 10-3mm2/s.D* values were (5.67±0.70) × 10-3,(6.58 ± 1.82) × 10-3,(5.43±2.82) × 10-3mm2/s.And f values were (38.03± 10.02)％,(31.36±8.34)％,(22.04±7.93)％.ADC,D,and f values were significantly correlated with histologic grade(r=0.624,0.809,0.580;P＜0.01,respectively).BF and D* were both not significantly correlated(r=0.271,0.017;P=0.099,0.920,respectively).Areas under the ROC curve for the five parameters ADC,BF,D,D*,f were 0.785,0.603,0.889,0.421,0.781,respectively.Conclusions With the reduction of histological differentiation degree,ADC,D,f values decreased.Correlation between f value and pathological differentiation degree is poor whie the correlation of D and ADC were excellent,and the correlation of D is the highest.

The term epigenetics refers to a number of biochemical modifications of chromatin that, without altering the primary sequence of DNA, play a role in genomic regulation and in control of particular gene expression. These modifications involve several kinds, such as DNA methylation, histone code modifications and chromatin remodeling. It is accepted that these modifications is as common in solid tumors as it is in hematologic malignancies such as myelodysplastic syndromes(MDS). So many specialists suggest that the study of this area is very valuable. The current clinical information regarding different forms of epigenetic therapy in patients with MDS were focused in this review.

BACKGROUND: Severe acute respiratory syndrome (SARS) is caused by a genetically novel coronavirus that is caused by acute infectious disease. It is not yet clear for the immunology function of SARS patients in their convalescent stage.OBJECTIVE: To study the effects on T lymphocyte, and the titer profiling of 24 T cell receptor (TCR) V β subfamilies expressions in SARS convalescent patients.DESIGN: A self-control observation.SETTING: Central Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICIPANTS: Seventy-six cured SARS patients who received treatment in the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and April 2003. All the patients corresponded to "clinical diagnostic criteria of atypical pneumonia", " diagnostic criteria of severe atypical pneumonia and discharge criteria" and "clinical diagnostic criteria and discharge criteria of severe acute respiratory syndrome". The involved patients, 30 male and 46 female, averaged (32±11 (years old. Another 10 subjects who simultaneously received health examination in the same hospital, 5 male and 5 female, aged (32±7(years, were involved in the study. Informed consents of detected items were obtained from all the subjects.METHODS：①Detecting the expression of 24 T cell receptor(TCR)V β subfamilies in SARS convalescent patients：Peripheral blood(2 mL) was collected from the healthy convalescent subjects,and EDTA-K2 was used as anticoagulant．In the flow cytometry delection tubes．10 μL various fluorescein-labeled mAb，such as anti-CD3,anti-CD4，anti-CD8,anti-CD25，anti-CD28，anti-HLA-DR，anti-CD3mAb conjugated with PC5，TCR Vβ1(PE+FITC)．Vβ2(PE+FITC)。Vβ3 (FITC)，Vβ4(PE+FITC)，Vβ5．1(PE+FITC),Vβ5．2(PE),Vβ5．3(PE)，Vβ7．1(PE+FITC)，Vβ7．2(FITC),Vβ8(FITC),Vβ9 (PE)，Vβ11(PE)，Vβ12(FITC)，Vβ13．1(PE),Vβ13．2(PE),Vβ13．6(PE+FITC)，Vβ14(FITC),Vβ16(FITC),Vβ17 (PE+FITC)，Vβ18(PE)，Vβ20(FITC)，Vβ21．3(FITC),Vβ22(PE+FITC)and Vβ23(PE)，was added in special flow tubes,and then 50 μL whole blood was added．The mixed solution was incubated away from light for 15 minutes．After erythrocytolysin being added，mixed solution was washed．Finally．cell deposit was dissolved in 300 μl phosphate buffer solution (PBS)．Coulter ESP flow cytometer was used for detection．For the analysis of TCR expression,an electronic gate was set on these cells and at least 5000 events per sample were collected．Three-color cytofluodmetric analysis was performed using a Coulter ESP flow cytometer．②Detecting the T cell subset,activated T and B cells,and the percentage of Ts and Tc cells：5000 cells were collected and used to calculate the expression of T cells (CD3,CD4 and CD8),the activated T and B cells(CD3+／CD25+,CD3+/HLA-DR+ and CD3-／HLA-DR+),as well as the percentage of Ts and Tc cells by Coulter ESP flow cytometer and its software．MAIN OUTCOME MEASURES：①The change of T cell subset(CD3，CD4，and CD8)from SARS convalescent patients．②The change of activated T and B cells(CD3+／CD25+，CD3+／HLA-DR+ and CD3-／HLA-DR+)．③The percentage of Ts and Tc cells(CD8+／CD28+，CD8+/CD28-)in convalescent patients．④Analysis of the 24 TCR V β subfamilies from SARS patients in convalescence．RESULTS：All data were explored to analyze the expression profiling of 24 TCR Vβ subfamilies,the data from 74 SARSpatients and 10 healthy controls were explored to other result analysis．①The detecting results of T celI subset：The percentage of CD4+T cell mean value was lower than the reference value[(33．33±6．64)％ vs．(43±9)％，P＜0．01]．The percentage of CD8+T cell mean value was higher than the refefence value[(34．07±6．40)％ vs．(30±9)％,P＜0．01]．② The expression of activated T and B cells：Percentage of HLA-DR+ T and B cell was Increased while the percentage of CD25+ T-cell was decreased compared with reference values．In 53 out of 74 patients,the percentage of CD25+ T cells was lower than the reference value,and 64 patients had a lower percentage in CD3+/CD25+ T cells．The percentages of CD3+/HLA-DR+ and CD3-／HLA-DR+ cells were higher than the normal reference value．T cells expressing higher CD3+／HLA-DR+ were found in 36 patients，and T cells expressing higher CD3-/HLA-DR+ were found in 30 patients．③The ratios of Ts and Tc cells：The percentage of Ts cells which expressed CD8+／CD28- was increased compared with reference value [(28．75±7．31)％ vs．(15．99±5．1)％，P＜0．01],while the percentage of Tc cells which expressed CD8+／CD28+ was decreased [(5．99±3．60)％ vs．(13．2±4．1)％，P＜0．01]．Thirty-nine patients were found to possess the lower Tc cells and forty-eight patients were found to possess the higher Ts cells．The ratios of both CD4+ and CD8+ T cells were in the normal reference value．④24 TCR Vβ subfamilies expressions in T cells：It was noteworthy that Vβ14 had a highest percentage in all 24 Subfamilies,and followed by Vβ 5．3,and Vβ 23 in the convalescent patients．The percentage of Vβ 14 was the highest in the normal controls,which was consistent with the results of SARS patients．But the other subfamilies expression patterns were different．There were significant differences between Vβ1,Vβ5．2,Vβ5．3,Vβ7．2，Vβ9，Vβ11,Vβ13．1,Vv13．2，Vβ17,Vβ18，Vβ22 and Vβ23．In the convalescent period，each TCR Vβ expression of SARS patients was higher than that of controls(P＜0．05-0．01)．CONCLUSION:In SARS convalescent patients,the increased CD8+CD28- T cell may elevate CD8+ T cell number;Meanwhile.the reduced CD3+ and CD4+ T cell number may be corresponding to the increased Ts cell number．For some inhibiting factor secreted by Ts cell was also increased．The usage pattern of 24 TCR Vβ subfamilies in SARS patients is different from that of control group．The increase of percentage of CD3+／HLA-DR+ and CD3-／HLA-DR+ T cell may be related to the late response of activated T and B cells.

Objective To investigate MR imaging features of parotid gland in Sj?gren′s syndrome ( SS).Methods Twenty-seven cases of xerostomia patients were collected and divided into SS group ( n=21) and non-SS group (n=6) according to the international classification (diagnosis) criteria for SS.Ten healthy volunteers were recruited as the control group.All the subjects underwent conventional MRI of parotid gland and MR sialography ( MRS).Standard deviation of T 1 WI and T2 WI signal intensity among 3 groups was observed, meanwhile, grading was made according to parotid glands , fat signal and parotid duct expansion degree respectively.With clinical diagnosis as the gold standard , diagnostic value of conventional MRI , MRS and their combination used in SS was compared.One-way ANOVA was used in comparison of standard deviation of parotid gland′s signal intensity among 3 groups , and Chi-square test was applied in comparison of conventional MRI and MRS diagnostic value.Moreover , Kappa value was calculated to assess the consistency of two grading results in SS.Results Signal intensity of parotid glands in control group and non-SS group was homogeneous.However , bilaterally diffused and heterogeneous high signal intensity on both T1WI and T2WI was found in SS patients, which was depressed on T2WI fat suppression sequences.Forty-two parotid glands were graded by fat signal:Grade 0 (n=2 glands), Grade 1 (n=10), Grade 2 (n=10), Grade 3 (n=6) and Grade 4 (n=14).Parotid peripheral ducts of control group and non-SS group were unexpanded , while bilaterally expanded parotid peripheral ducts were shown in SS patients.The grading of 42 parotid glands by expansion degree of parotid duct , Grade 0 was rated in 12, Grade 1 in 8, Grade 2 in 10, Grade 3 in 5, and Grade 4 in 7.Standard deviation of T1WI signal intensity of parotid glands among SS group , non-SS group and control group were 124.1 ±30.0, 81.8 ±27.6, and 86.3 ±35.0 respectively;and standard deviation of T 2 WI signal intensity were 115.1 ±35.2, 69.8 ±23.5, and 80.1 ±31.4 respectively; the standard deviation of T 1 WI and T2 WI signal intensity of SS group was higher than both non-SS group and control group′s ( F value =13.780 and 13.301, respectively, P <0.01), however, the difference of standard deviation of signal intensity of non-SS group and control group had no statistical significance (P>0.05).Among 42 parotid glands with SS, conventional MRI and MRS showed parotid gland lesions in 40 and 30 respectively , and the difference was statistically significant (χ2 =13.04, P=0.013).There was no false positive result.The combination of the two methods detected all 42 lesions.The consistency of detecting parotid abnormalities with SS between conventional MRI and MRS was poor (Kappa=0.12, P=0.092).Conclusions Diffuse fatty infiltration on conventional MRI and diffuse peripheral duct dilatation on MRS in the parotid gland are characteristic features of SS , and conventional MRI could be used as the preferred technique for the SS.combination with MRS may improve diagnostic accuracy.