The recent advances in of molecular biology and pathogenesis of chronic myeloid leukemia(CML) were summarized. This article focused on the significance of p210~(BCR/ABL) on CML and the possible signal transduction pathway molecular mechanisms of CML, characteristic hematology of CML bone marrow and its relationship with clinical manifestations. Some points of the recent discovery might provide useful pointers for monitoring and treating CML.

Objective:Performance appraisal of large-scale medical equipment has a significant impact on hospital management. Process equipment performance evaluation of digital is an important part of digital medical&hospital. How to fully utilize the large number of advanced medical equipment resources, how to monitor and manage equipment are focuses that hospital administrators pay much attention to. Methods: The effective performance appraisal of large-scale medical equipment can promote the resource allocation optimization, accurate and scientific management, reasonable and benign application, and then allows large-scale medical equipment fully and effectively applied to clinical practice. Results: Collecting basic data is the basis for performance appraisal of large-scale medical equipment; its instant validity, accuracy, and scientific can enhance the operability and the scientific accuracy of the performance appraisal for large-scale medical equipment. Conclusion:The acquisition of basic data has few specialized research in previous studies, the rules set up for basic data acquisition of large-scale medical equipment in this paper can improve the timeless, accuracy and normalization of the basic data using in the performance appraisal of large-scale medical equipment.

Objective To investigate the clinical features, diagnosis and therapy of avascular necrosis of the femoral head after renal transplantation Methods Of the 24 renal transplantation patients with avascular necrosis of the femoral head 0.7 - 7.8 years postoperatively, 20 cases were unilateral and 4 bilateral respectively. According to the standard of Ficat's, all cases were classed as 0-Ⅳ stages. All cases accepted immunosuppressive therapy that included corticoids. The corticoids were reduced in dose at the time when the patients were diagnosed as having avascular necrosis of femoral head and withdrawn in 2 weeks. Surgical treatment was not done unless the expectant treatment was invalid.Results The clinical manifestations of femoral head avascular necrosis after renal transplantation included knee joint, hip joint, inguina or thigh pain in the earlier period (Ⅰ-Ⅱa stage) and hip joint pain in progression (Ⅱb-Ⅳ stage). Some cases were associated with hip joint flex, adduct, abduction and intorsion dysfunction. After expectant treatment, the symptoms of hip were alleviated or disappeared in 4 cases; In 16 cases, the symptoms of hip were relieved to some extent, but Ficat’s stage had no change. Eight cases had no reaction to expectant treatment and were subjected to surgical operation. In 4 cases, acute rejection occurred after corticoid withdrawal, reversed after therapy by MP and ATG and could tolerance corticoid withdrawal again.Conclusion Corticoid is the main reason of avascular necrosis of the femoral head after renal transplantation. The therapeutic effectiveness of avascular necrosis of the femoral head was not satisfactory and the emphasis was put on the prevention.

6.2 mmol/L) who underwent renal transplantation accepted pravastatin therapy (10 mg, qn) for 8 weeks. The changes of total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) , triglyceride (TG), endothelin (ET) and nitrous oxide (NO) were measured before and after pravastatin treatment. By using high resolution ultrasound, endotheli-um-dependent relaxing function was measured before and post pravastatin treatment. Thirty people with normal blood cholesterol served as controls and subjected to the above examinations. Results In renal transplantation group, ET was significantly higher and NO significantly lower than in control group. After treatment with pravastatin, NO was significantly increased, while ET, TC, LDL-C and TG were significantly reduced. HDL-C was increased, but no significant difference was found. Flow-mediated vasodilations were greater after pravastatin treatment than before, but smaller than control group. Conclusion Pravastatin can theat dyslipidemia after renal transplantation and improve impaired endothelium-dependent vasodilation.

Objective To investigate the effects of different DO2-directed hemodynamic man-agement on postoperative prognosis of orthotopic liver transplantation (OLT)patients with different degrees of liver function insufficiency.Methods Seventy patients (male 48 cases,female 22 cases, aged 37-66 years,ASA grade Ⅲ or Ⅳ)scheduled non veno-venous bypass OLT were divided into two groups (n = 35 each ).The oxygen delivery (DO2 )maintained respectively between 350 ml·min-1 ·m-2 and 500 ml·min-1 ·m-2 (group control)and more than 500 ml·min-1 ·m-2 (group study).After induction of anesthesia,the left radial artery was cannulated,allowing continu-ous blood pressure monitoring as well as serial blood sampling,then the Swan-Ganz catheter was in-serted via the right internal jugular vein to continuously monitor CI and S-vO2 .After anesthesia induc-tion and before operation (T1 ),10 min before anhepatic phase (T2 ),30 min after onset of anhepatic phase (T3 ),30 min after neohepatic phase (T4 )and the end of surgical procedure (T5 ),the SaO2 , PaO2 ,Hb,CI and S-vO2 were recorded to calculate the DO2 ,VO2 and ERO2 .Postoperatively,ICU and hospital length of stay,quality of life (QOL)and 1-5 year survival rate were recorded.Results In the two groups,CI,DO2 and VO2 declined at T3 to a statistically significant degree in comparison with T1 (P <0.05).CI,DO2 and VO2 in group study significantly higher than those of group control (P <0.05).ERO2 in group study was lower than that of group control significantly (P <0.05).ICU and hospital length of stay were significantly shorten in group study in comparison with group control (P <0.05).Survival rate and QOL in group study tended to be slightly higher than those of group control until the end of study period,but there was no significant difference.Conclusion The DO2-directed hemodynamic management can improve prognosis with enhanced DO2 in OLT patients with different degrees of hepatic insufficiency.It has a positive impact on their outcome of shortening ICU stay and the hospitalization days.

Scientific,accurate and real-time performance management and assessment prove key to hospital development.This paper,based on integration of various hospital operation systems,proposed to monitor medical service data in a horizontal way and manage the key sections and problems in a longitudinal way.The purpose is to extract and summarize such systems,and solve critical issues of contemporary hospital performance,effectively integrating performance data monitoring and performance management.Scientific,accurate,real-time,and fair performance evaluation can be thus achieved, ranging from data monitoring to business management and measurement of management outcomes based on data monitoring.

China ; Humans ; Laparoscopy ; education ; Mentors ; Urology ; education

OBJECTIVETo compare the clinical outcomes of anterior cervical decompression plus sublevel fusion and posterior cervical laminoplasty in treating multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 56 patients with multilevel cervical spondylotic myelopathy were retrospectively analyzed from July 2009 to June 2012. There were 32 males and 24 females, aged from 42 to 79 years old with an average of (56.9 +/- 12.8) years. All patients had the typical clinical features of cervical spondylotic myelopathy,radiological evidences, and courses of disease were from 2 months to 16 years with an average of (10.6 +/- 3.2)years. Of them,34 patients were treated with anterior cervical decompression plus sublevel fusion (anterior fusion group) and 22 patients with posterior cervical laminoplasty (posterior laminoplasty group). JOA score and radiological data were used to evaluate the clinical results:

RESULTSNo complications about nerve and blood vessel was found and the patients were followed up from 24 to 36 months with an average of 28.6 months. In anterior fusion group, the cervical anterior column height was significantly increased and the anterior cervical curvature angle was significantly decreased at 2 weeks after surgery (P < 0.05). In posterior laminoplasty group, there was no significant difference in above items between preoperative and postoperative at 2 weeks,final follow-up. Postoperative at 2 weeks and final follow-up, there was significant difference in anterior cervical curvature angle between two groups (P<0.05). Postoperative JOA score had obviously improved in all patients, at 3 months after operation and final follow-up, anterior fusion group was better than that of posterior laminoplasty group (P < .05).

CONCLUSIONThe anterior sublevel fusion can effectively restore cervical anterior column height, and compared with the posterior cervical laminoplasty, it can obviously improve the spinal cord function. It is an effective method for the multilevel cervical spondylotic myelopathv.

Adult ; Aged ; Case-Control Studies ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spinal Fusion ; Spondylosis ; diagnostic imaging ; surgery

Objective The aim of this study was to investigate the distribution and clinical significance of CD8+ T cells in bladder cancer tissues in situ.Methods Immunohistochemistry were used to examine the distribution of CD8+ T cells in bladder cancer tissues,which were obtained from January 2003 to December 2009 from 302 patients.Among all the patients,262 were male while 40 were female;mean age is 60 years;tumor size ≤ 3 cm was in 235 and tumor size ＞ 3 cm was in 67;Unifocal tumor was in 214 and multifocal tumors were in 88.Amount of tumor stage Ta-T1 was 212 and T2-T4 was 90.Sixteen patients have lymph node metastasis.Histological low grade was diagnosed in 175 and histological high grade was diagnosed in 127.According to the differences between anatomic structure and cellular composition,bladder tumor tissues can be classified to two localization patterns:(1) intratumoral regions,defined as tumor cell nests;(2) stromal regions,defined as stromal areas that lack direct contact with tumor cells.Therefore,we divided 302 bladder cancer patients into two groups based on the median frequency of intratumoral CD8+ T cells (median,3/× 400 high resolution) and stromal CD8+ T cells (median,37/× 400 high resolution),respectively.x2 analysis was used to evaluated the correlation between CD8+ T cell density and clinicalpathological variables.Kaplan-Meier analysis and Cox proportional hazards regression models were applied to estimate overall survival (OS).Results CD8+ T cells were predominantly located in the intratumoral regions (mean,14 ± 2/× 400 high resolution) rather than in associated stromal regions (mean,50 ± 3/× 400 high resolution,P ＜ 0.05).The density of intratumoral CD8+ T cells was inversely associated with age (P =0.026),tumor size (P ＜ 0.05) and tumor stage (P ＜ 0.05),and could represent a favorable prognostic predictor of OS (HR =0.427,P =0.003).However,the density of stromal CD8+ T cells was positively associated with age (P =0.004) and histological grade (P ＜ 0.01),and could represent an adverse prognostic predictor of OS (HR =2.206,P =0.009).Conclusions Our findings suggest that intratumoral/ stromal CD8+ T cells could potentially serve as favorable/ adverse prognostic markers for bladder cancer patients,respectively.

Objective To evaluate the category of the variations on bilateral renal artery and clinical significance with 64-slice spiral CT angiography. Methods CT angiography of 250 patients were retrospectively analyzed. The variations on bilateral renal artery were observed and classified. Results According to the number of the main renal artery, the anatomy of renal artery was classified and typed in details. The incidence of the variations on renal artery in the patients and kidneys was 39.20% (98/250) and 22.80% (114/500), respectively. The incidence of early branch of the main renal artery and accessory renal artery was 9.60% (48/500) and 11.80% (59/500), respectively. No statistical difference of variation incidence was found between male and female, nor between left and right kidneys. The incidence of unilateral and bilateral variations on renal artery was 32.80% (82/250) and 6.40% (16/250), respectively, and the combinations of the latter were multiform. Conclusion Anatomical variations on renal artery can be showed clearly with 64-slice spiral CT angiography. Variations on bilateral renal artery are important to select the donor in case of renal transplantation.