Flow cytometric immunophenotyping has evolved from two-parameter quantitative measurement of peripheral blood lymphocytes to five-or more parameter qualitative evaluation of bone marrow and lymph node in hematopathology.Leukemia/lymphoma immunophenotyping represents an important addition to histomorphology in the diagnosis,classification and monitoring of hematolymphoid neoplasms.The complexity of five-or more parameter analyses and the interpretation of the data rely on standardization and validation of the instrument,the reagent and the procedure.In addition,clinical flow cytometry laboratories in U.S.A are required to document proficiency testing,sample preparation as well as accuracy,specificity,sensitivity and precision of methodology.CLSI and UCCC recommend that each laboratory should validate its own qualitative and quantitative procedures.This paper introduces the procedures for validation and quality control in a clinical flow cytometry laboratory in the United States.

Objective To analyze the quality of life(QOL) of gastric cancer patients who underwent different types of gastrectomy and digestive tract reconstruction procedures.Methods Among the patients who(underwent) gastrectomy in our department over a period of 4 years,61 cases that survived for more than 2 years were analyzed for QOL using 14 parameters.The 61 cases included 13 cases of proximal subtotal(gastrectomy) and esophagogastrostomy,18 cases of total gastrectomy and jejunal P pouch reconstruction,and 30 cases of total gastrectomy and double Braun type of jejunal reconstruction.Pouch emptying function in 12 patients with different types of reconstruction was determined in by Isotope ~(99m)TC scintigraphy.Results At 6 months after operation,the parameters showed no significant differences between the 3 groups.At 12 months after operation,the QOL of patients with double Braun-type reconstruction was superior to that of patients with P jejunal pouch and patients with esophagogastrostomy in intake time(P

Objective To investigate the effect of magnesium sulfate on epidural labor analgesia with ropivacaine in the patients with preeclampsia. Methods Seventy nulliparous parturients with pre?eclampsia, aged 23-34 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, weighing 63-81 kg, with a singleton fetus in vertex presentation, without contradications to neuraxial anesthesia, waiting for vaginal delivery, received epidural analgesia for labor. The patients were divided into magnesi?um sulfate group and control group using a random number table, with 35 patients in each group. In magne?sium sulfate group, magnesium sulfate 50 mg∕kg ( 30 ml) was infused intravenously over 15 min when their cervical dilation was 3 cm, while the equal volume of normal saline was given in control group. Epi?dural labor analgesia was performed with ropivacaine. The up?and?down sequential allocation was used to determine the median effective concentration of epidural ropivacaine ( EC50 ) . The severity of pain was as?sessed with visual analogue scale score. Effective analgesia was defined as visual analogue scale score of≤1. The initial concentration of ropivacaine was 0.15%. Each time the concentration was increased∕decreased according to whether or not analgesia was effective, and the ratio between the two successive concentrations was 0.9. The EC50 and 95% confidence interval ( CI) of ropivacaine for epidural labor analgesia was calcu?lated. Results The EC50 (95% CI) of ropivacaine for epidural labor analgesia was 0.066% (0.062%-0.071%) in magnesium sulfate group. The EC50 (95% CI) of ropivacaine for epidural labor analgesia was 0.078% (0.072%-0.085%) in control group. The EC50 of ropivacaine was significantly lower in magnesi?um sulfate group than in control group ( P<0.05) . Conclusion Magnesium sulfate can enhance the effica?cy of ropivacaine for epidural labor analgesia in the patients with preeclampsia.

Objective To validate the technique and to establish the reference values of triple stimulation technique(TST)in healthy Chinese adults.Methods One hundred healthy subjects were recruited to undergo TST from April 2010 to February 2011 in both abductor digiti minimi.The TST combines transcranial magnetic stimulation(TMS)of the motor cortex with peripheral collision studies.Three stimuli were given,leading to two collisions.A first magnetic stimulus was applied to the scalp overlying the motor cortex.After a delay,an electric stimulus was applied over the ulnar nerve at the wrist.The delay was chosen so that the action potentials descending from the cortex collided with the antidromic action potentials evoked at the wrist,with the collision site at the wrist and above.After another delay,another electrical stimulus was applied to Erb' s point.This delay was chosen so that ascending antidromic action potentials evoked by wrist stimulation collided at or distal to Erb' s point.At the same time,TST test curves were recorded.The TST test curve was compared with a TST control curve in which the first stimulus was applied to Erb' s point and the other two stimulus sites were the same as the test curve.Control stimuli were thus applied successively to Erb' s point,the wrist,Erb' s point.TST quantifies the number of conducting central motor neurons(expressed by the TST amplitude ratio).The values were compared among genders,age groups,arm length and sides respectively.Results The TST amplitude ratio(TSTteat/TSTcontrol)was 85.0％ ± 6.7％.There were no difference among genders,age groups,arm length and sides respectively.The TST amplitude ratio were 85.0％ ± 2.6％ and 85.0％ ± 8.7％,respectively in subjects with arm length 61-70 cm and 71-80 cm.Conclusion TST could be examined precisely and the normative value could be got.

Complications related to CO2 pneumoperitoneum in laparoscopy surgery have led to the devel-opment of gasless laparoscopic surgery using abdominal wall lifting technique.The technique uses facilitate laparoseopic surgery without conventional pneumoperitoneum and markly reduced in the risks of anesthesiolo-gy,especially in old patients with cardiopulmonary insufficiency.The review summarizes the application of gasless laparoscopie surgery using abdominal wall lifting technique in the field of general surgery.

Objective To compare the performance of two commercially available ELISA kits for detection of diphtheria IgG antibody to provide data for the proper kit choice. Methods Thirty-three serum samples from staff of the capital airdrome and two standard sera were tested for the evaluation of the kits.Commercial ELISAs were compared with respect to their reproducibility(intra-assay variation and inter-assay variation)and accuracy.Results For the detection of standard serum,intra-assay variation(Coefficient of Variation,CV)was 13.5507% for IBL kit and 5.9541% for Virion kit,the inter-assay variation(CV)was 9.9890% for IBL and 2.4728% for Virion kit.For the serum sample,intra-assay variation(CV)was 14.5270% for IBL and 11.0612% for Virion,the inter-assay variation(CV)11.0039% for IBL and 8.1506% for Virion kit.For the detection of standard serum,inter-assay variation(CV)was 9.9890% for IBL and 2.4728% for Virion.The accuracy was analyzed by variation between the actual concentration and measured concentration of standard serum,the CV was 17.6889% for IBL and 1.3966% for Virion.Conclusion The intra-assay and inter-assay variation of the two kits are generally acceptable(CV

Objective This study was aimed to investigate the methodology of radiofrequency ablation for paroxysmal atrial fibrillation (PAF) in complicated cases Methods 130 cases (87 males) with the average age of 56 years were enrolled consecutively Each patient was diagnosed PAF by Holter and ECG After routine transseptal procedure and cannulation, retrograde pulmonary venography was taken to show the anatomic morphology of all pulmonary veins (PVs) Under the guidance of Lasso circular mapping catheter, all cases underwent electrical isolation for four PVs using the saline irrigated ablation catheter Results (1) By venography,21 PVs (16 2%) were found to have enormously dilated ostia in 21 out of 130 cases 5 PVs (3 8%) had left common trunks 3 PVs (2 3%) had right common trunks In 6 cases right PVs were found to have multiple bifurcated ostia, and the prevalence rate was 4 7% (2) A total of 341 PVs were targeted for segmental ablation in 130 cases Complete isolation was failed in 29 PVs, including 11 PVs with dilated ostia Among the 29 PVs, 14 were left superior PVs (LSPVs), 8 were left inferior PVs (LIPVs), 5 were right inferior PVs (RIPVs), and 2 were right superior PVs (RSPVs) Conclusion The anatomical variants of PV was the main cause of complicating radiofrequency ablation in patients with PAF

Objective To discuss the timing and methods of operative treatment of acetabular fractures of AO Type C (double- column fractures). Methods From February, 1999 to January, 2004, we treated operatively 46 cases of AO Type C acetabular fractures, including 23 cases of C- 1 type, 14 cases of C- 2 type, and 9 cases of C- 3 type. 15 cases were treated through ilioinguinal approach, 10 cases through improved Kocher- Langenbeck approach, and 21 cases through combined anterior and posterior approaches. There were 3 groups of patients according to the time from injury to operation: 15 cases got operation within 1st week after injury (Group A); 23 cases within 2nd week (Group B); 8 cases within/after 3rd week (Group C). All of them were checked with radiography and 3D CT scan before and after operation. Results 34 cases( 73.9% ) obtained anatomical reduction, 8 cases( 17.4% ) got imperfect reduction, and 4 cases( 8.7% ) had unsatisfactory reduction. All the patients were followed up for 1 year to 4 years, averaging 31 months. According to D' Aubigne and Postel Hip Score, joint function was rated as excellent in 32 cases( 69.6% ) , good in 5 cases( 10.9% ) , fair in 5 cases ( 10.9% ) and poor in 4 cases ( 8.7% ) . As far as reduction was concerned, there was a significant difference (P0.05). As far as joint function was concerned, there was a significant amelioration in Groups A and B compared with Group C (P0.05) between group A and Group B. Conclusions Good knowledge of AO classification of acetabular fractures combined with particular radiological data can result in correct diagnosis of Type C acetabular fractures. Operations should be carried out within 2 weeks after injury and efforts should be made to ensure anatomical reduction. To achieve good clinical results in treatment of Type C acetabular fractures, suitable approaches and correct reduction and internal methods are essential

Objective To investigate the drug-resistant status of Acinetobacter baumannii in clinical strains isolated from our hospital,and get to know the distribution of integrons carried by Acinetobacter baumannii,analyze the correlation between integron and drug-resistant of Acinetobacter baumannii..Methods Collected 85 Acinetobacter baumannii isolated in our lab,the drug-sensitivity tests were completed by the method of KB,the integrase genes were amplified by polymerase chain reaction(PCR),and identified the type of integron..Analyzed the correlation between the drug-resistant and integron in Acinetobacter baumannii..The open reading frame of integron were amplified by PCR,the polymorphism of integron was identified,and sequenced the PCR products.Results Except for Imipenem and Cefoperazone/ sulbactam(drug resistant rate less than 10%),the drug resistant rate of other 15 antibacterial was no more than 30% among the 85 Acinetobacter baumannii isolated in our lab..66.1 %(57/85) stains carried the integrons I,we didn't find out the integron Ⅱ and Ⅲ.The drug-resistant rates of Acinetobacter baumannii with integron were higher than that of Acinetobacter baumannii without integron.The length of amplified products in variable region of open reading frame of integron varied from 03 to 25kb,.The sequencing results confirmed the integron included multidrug resistant gene code.Conclusion In our hospital,the drug-resistant rate of Acinetobacter baumannii was high,and the majority were multidrug resistant strains.The drug-resistant rate of Acinetobacter baumannii was enhanced with integron,The multidrug resistant of Acinetobacter baumannii was associated with integrons.

Objective To study the efficacy and safety of laparoscopic high ligation of indirect inguinal hernia in children. Methods From February 2006 to February 2008,totally 260 children with indirect inguinal hernia underwent laparoscopic high ligation in our hospital.Two trocars were used to ligate the inner circle.Results The procedure was completed successfully in all of the cases.The mean operation time was 22 minutes(range,15-45 minutes).A 2-to 23-month follow-up(mean 11.6 months) was achieved in 259 of the patients.During the period,no patient showed incisional hernia,iatrogenic cryptorchidism or atrophy of the testicles,or intestinal adhesion.One patient showed recurrent hernia in 5 months after the surgery(0.4%). ConclusionLaparoscopic high ligation of indirect inguinal hernia is a minimally invasive,effective,and safe procedure for children.