T-cell acute lymphoblastic leukemia (T-ALL) is a highly aggressive hematologic malignancy associated with poor prognosis.Increasing data regarding to alteration of gene expression signatures of oncogenes and tumor suppressors involved in the pathogenesis of T-ALL and the major mechanisms of T-cell transformation may contribute to define the biological markers for treatment response and prognosis,and has important clinical implications.In this review,advance knowledge concerning the characteristics of early T-cell precursor ALL,the alteration of TAL1 and NOTCH1 related genes and target inhibiton effects based on these alterations from 2012 the 54th ASH annual meeting ars summarized.

Objective To evaluate the performance of a latex enhanced immunoturbidimetric?2-microglobulin kit in clinical use. Methods The lower limit of detection,precision,accuracy and linearity range was determined on the automatic chemistry analyzer Hitachi 7170S. Results The lower limit of detection was 0. 09mg/L. The within-run precision was less than 4% while the between-run precision was less than 8%. The accuracy was 99.29 % and the linearity range was 0.2～18mg/L. Conclusion The?2-microgiobulin kit shows good performance in clinical use.

Angioplasty, Balloon, Coronary ; Humans ; Myocardial Infarction ; therapy

Objective To investigate the association between malnutrition parameters and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in male patients aged ≥ 80 years with normal ejection fraction.Methods A total of 197 elderly male patients aged 80 95 years (average 85.4±9.7) were enrolled.Each patient received echocardiograms following admission,and ejection fraction was calculated.Serum concentrations of NT-proBNP were measured by electrochemiluminescence immunoassay.Multiple Logistic regression analyses and receiver operating characteristic (ROC) curves were used to assess the association between malnutrition parameters and serum level of NT-proBNP.Results Serum NT-proBNP level was higher in patients with malnutrition than in the controls [(711.9±1063.3) ng/L vs.(1375.2-±1891.7) ng/L,P=0.006].Pearson correlation analysis showed that the malnutrition parameters such as body mass index (BMI),blood hemoglobin,albumin and pre-albumin were negatively correlated with serum NT proBNP level (all P＜0.05).Logistic regression analysis showed that BMI and serum pre albumin level were independently associated with serum NT-proBNP level elevation (P=0.028 and 0.006,respectively).ROC curve analysis showed that the malnutrition parameters could predict the serum NT-proBNP level elevation.The area under the ROC curves for BMI,levels of blood hemoglobin,albumin and prealbumin in predicting serum NT proBNP level elevation was 0.7 (P=0.002),0.7 (P=0.004),0.6 (P=0.036),0.6 P=0.002),the sensitivity was 75.5％,51.0％,38.8％,89.8％,and the specificity was 54.4％,70.2 ％,84.2％ and 31.6 ％,respectively.Conclusions The malnutrition parameters including BMI,blood hemoglobin,albumin and pre-albumin can predict serum NT-proBNP level elevation.BMI and serum pre-albumin level are independently associated with serum NT-proBNP level elevation in male patients aged ≥ 80 years with normal ejection fraction.

Objective To reconstruct the soft tissue defect in the back or neck after excision of hypertrophoc scar or giant nevus by using transmidline pre expanding scapula flap vascularied by ipsilateral circumflex scapular artery. Methods The reconstruction can be accomplished in two stage procedures. First, scapular flaps were expanded for 4 6 weeks prior to transfer in 8 patients. Second,the pedicled flaps were designed across the entire back to incorporate both scapular territories but were rotated on a single vascular pedicle. Results All flaps survived. Only two flaps had marginal necrosis, and the wound healed well by dressing. Conclusion Flap expansion produces a delay that augments blood supply and increases the area of skin that survives on a single vascular pedicle. This technique may be useful in selected patients in whom a large and thin fasciocutaneous flap is required and there is sufficient time to allow flap expansion prior to thansfer. It is easy to harvest, and donor site morbidity is negligible. The patients can get better functions and quality of life.

Abstract： Objective　To investigate the epidemiological and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae isolated from blood cultures of patients with bloodstream infections in Shanxi Bethune Hospital from January 2015 to January 2022. Methods　Klebsiella pneumoniae strains isolated from blood cultures of patients with bloodstream infections at Shanxi Bethune Hospital from January 2015 to January 2022 were collected for the study. Bacterial identification, drug sensitivity testing, and an improved carbapenem inactivation test were conducted to screen for carbapenem-resistant Klebsiella pneumoniae. Next-generation sequencing was performed on all strains, while whole genome sequencing was carried out on two strains that tested positive for the modified Hodge test indicating resistance to carbapenems. Results　A total of 431 strains of Klebsiella pneumoniae were isolated from blood cultures of patients with bloodstream infections at Shanxi Bethune Hospital between January 2015 to January 2022, among which 33 were carbapenem-resistant strains including 11 highly virulent ones and 2 of these exhibited positive for the modified Hodge test. All strains were resistant to both ertapenem and imipenem, with only one strain being intermediate-resistant to meropenem. Among the 33 resistant strains, KPC-2 was detected in 26 strains and NDM-1 in 4; three strains possessed dual carbapenemase types (KPC-2/NDM-9, KPC-2/OXA-1, NDM-1/OXA-1), while four did not show any detectable carbapenem-resistance genes. Evolutionary analysis following next-generation sequencing revealed that the main sequence types (ST) among these isolates were ST11, ST147, and ST412; and the predominant serotypes were KL64, KL47, and KL25. The plasmid conjugal transfer experiments were successful in 18 strains. The two high virulence strains identified in the modified Hodge test were found to carry virulence and resistance plasmids upon whole genome sequencing. Conclusions　The detection of carbapenem-resistant Klebsiella pneumoniae in patients with bloodstream infections has been increasing annually since 2015, with an outbreak occurring in 2021. The carbapenemase KPC-2 gene was the most prevalent, with the majority of strains being of the ST11/KL64 type. Strengthening screening and control measures for clinical drug-resistant strains is crucial for effective anti-infective treatment.

The donated organ after cardiac death would undergo warn ischemia injury inevitably,and the incidences of primary non-function of donated organs,transplanted organ loss and ischemic-type biliary lesions were increased.It is a paramount research dilemma to devise how to avert,lessen and recover the warm ischemia organs after donation of cardiac death (DCD).Since February 2009,the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation (ECMO) to protect the organs of DCD.The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation,and it is an important method to solve the problem of donor shortage in China.Spreading the application range of ECMO in DCD and establishing the standard procedures and techniques in China is of great importance.

Objective To evaluate the laparoscopic ovarian cystectomy of benign lesions of security,superiority.Methods Laparoscopic ovarian cystectomy of benign lesions of security,superiority.Results The operation time of laparoscopic group (40.5 ± 5.3) min,significantly shorter than the control group (60.7 ± 6.8) min (t =-14.815,P =0.000) ; Bleeding (55.1 ± 9.8)ml was significantly less than that in the control group (90.0 ±15.0) ml (t =-18.275,P =0.001) ; Anus exhaust time (13.5 ± 8.3) hour was significantly shorter than that in control group (24.5 ± 9.6) hour (t =-4.351,P =0.000).The average postoperative hospital stay was (3.5 ±1.3) days was significantly shorter than that in control group (5 ± 2) days (t =-2.158,P =0.000).Postoperative morbidity was not statistically different from controls (t =0,5,P =0.053).Postoperative pain was significantly lower than that in control group (x2 =8.525,P =0.002).Conversion to open operation in laparoscopic group:2 cases,postoperative analgesic drugs were not needed,the postoperative 12h after catheter removal started eating and ambulation,postoperative shoulder pain in 2 cases ; open operation group after all need to use analgesics,postoperative 24h after catheter removal started eating and ambulation,abdominal incision fat liquefaction and delayed healing in 4 cases.The two groups had no visceral injury,postoperative bleeding,and chemical peritonitis.Conclusion Laparoscopy in the treatment of benign ovarian tumor is safe,less bleeding,rapid recovery,fewer complications and other characteristics.

Objective To compare the different effects of two rehabilitative therapies on cardiac rehabilitation of patients with acute myocardial infarction after interventional program.Methods Eighty AMI patients with no complications after interventional treatment were randomized equally into the observation group and the control group.The patients in the control group were given two-week cardiac rehabilitative training in line with the clinical nursing pathway.Besides the treatment in the control group,those in the observation group were given 10-day cardiac rehabilitative training by optimizing the nursing pathway.The two groups were compared in terms of left ventricular ejection fraction,self-care ability,heart function grading,incidence of complications,hospital stay and hospitalization cost.Results At discharge,The observation group was significantly better than the control group in terms of left ventricular ejection fraction,self-care ability and grading of cardiac function(all P<0.05).In regard to the incidence of complications,there was no statistically significant difference between the groups.Hospital stay in the observation group was obviously shorter than that in the control group and the hospitalization cost significantly less than that in the control group(P<0.01).Conclusion The 10-day cardiac rehabilitation program can promote patients’recovery,shorten the hospital stay and reduce the medical expense.

Objective To design a vehicle-mounted X-ray diagnosis simulation training system based on the field X-ray diagnostic vehicle to solve the problems during its training and utilization.Methods The field X-ray diagnostic vehicle had its internal and external structure analyzed,and was divided into several functional modules.The technologies of computer programming and database were used for the simulation of the modules.An example was given to simulate the operating process of the vehicle by establishing traumatic condition model,war injury image library and etc.esults The system developed realized the simulation training of the vehicle,and the trainee gained feedback after simulation as references.Conclusion The system implements informatized training of the field X-ray diagnostic vehicle,shortens the training period,decreases the training cost and increases the training efficacy.