Objective Mapping the sites of earliest activation in AF patients with rheumatic heart disease. Finding out the ratio of AF originate from the pulmonary veins. Methods There were 9 patients with valvular atrial fibrillation (1 male, 8 females age (42?13) years, histories of rheumatic heart disease (11?9) years, and mitral valve area 1.01?0.02 cm2) involved in the research. 3 patients had organized thrombus in left atrial appendage. 6 patients with persistent AF received anticoagulation therapy (warfarin 2 or 3 weeks) and drug cardioversion (amiodarone 400 mg, three times per day, for 7 days) before procedures, while other 3 patients with paroxysmal AF received neither anticoagulation therapy nor drug cardioversion. All patients received percutaneous balloon mitral valvotomy (PBMV). After finished PBMV, four multipolar electrode catheters were placed in the high right atrium (HRA), coronary sinus (CS), left atrium (LA) and pulmonary veins (PVs). S1S2 and S1S2S3 programmed stimuli were delivered in HRA, CS, LA and PVs respectively. For the patients who failed to induce AF, burst stimuli were used. Results 11 AF generating sites, which induced by S1S2 and S1S2S3 programmed stimuli, could be confirmed by identification of the earliest regions of atrial activation for the first AF cycle. However, 1 AF obtained by 260 ms RR interval burst stimuli, affirmed by shortest activation cycle length. All confirmed 12 AF original sites were original as following: RA (n=4), LA (n=1), CS (n=2); PVs (n=5). Among the 5 PVs original sites, 3 was from left superior pulmonary vein, while the other 2 were from right superior pulmonary vein and left inferior pulmonary respectively. Conclusion PVs could be the ectopic origin of valvular AF.

Objective To establish a rapid and specific method for identifying megkaryocytes under the light microscope and to provide a new method and new idea for diagnosis and differential diagnosis of blood diseases.Methods Unfixed smears of blood or born marrow were exposed firstly to an alcoholic solution of Basic Royol Blue for 5 min.Next, an equal amount neutral HEPES buffered solution of the same dye was added to the first stain solution.The two solutions were mixed by adding the second stain.After 10 min, the smears were washed for 2 min with flooding water and drained dry.Meanwhile, the stain was compared with traditional histochemistic stains and flow cytophotometer.Results Megakaryocytes showed purple red cytoplasm and bright blue nuclei.Platelet displayed purple red. Other blood cells(such as granulocytes、monocytes、lymphocytes、plasmacytes and ucleated erythrocytes) had no such stainning character. Compared with traditional histochemistic stains and flow cytophotometer, the stain of two steps by using Basic Royole Blue for megkaroblasts、promegkaryocytes and megkarocytes was credible and distinctive.Conclusion Basic Royol Blue for megkaryocytes stain was worth to contribute to the diagnosis and differential diagnosis of blood diseases.This technique can be used in clinical laboratory.

ObjectiveTo investigate the association between cuplike nuclei morphology and FLT3-ITD mutation, so as to provide evidence for the minor classification of AML. MethodsThe articles on the association of cuplike nuclei morphology and FLT3-ITD mutation were retrieved by searching international and national databases from 1999 to 2011. The relationship was assessed by meta analysis with Statal 1 software.The OR value and confidence interval(CI)were calculated, and the publication bias was assessed by Begg test and Egger test.ResultsThere was significant difference between cuplike nuclei morphology appearance and FLT3-ITD mutation (OR =2.59,95 ％ CI 1.55-4.33,P =0.00).Results from both Begg' s test and Egger’ s test did not show significant difference indicating that there was no publication bias existed.ConclusionThe uncommon morphologic variant of AML with cuplike nuclei is highly associated with FLT3-ITD mutation, and the presence of cuplike nuclei in AML represents a distinctive morphologic finding that can be used to prioritize the molecular workup of patients with AML.

Objective To synthesize a novel vector of chitosan-particles loaded with gadolinium (Gd-CPs) and observe the adhesion and absorption of the particles in the colon wall of mice with MR imaging in-vivo.Methods Chitosan particles (CPs) with and without gadolinium loaded were synthesized with the emulsion-droplet coalescence method.Sixteen mice were randomly classified into two groups.The suspension with Gd-CPs or with CPs was infused into the rectum of the 8 mice of each group,respectively.MR scans were performed before,during and 40 minutes after infusion for each mouse.Samples of the colon correlated to the enhanced area were obtained for electron microscopy examination.Signal intensity (SI) of ROIs in the wall of rectum or colon,muscles of the pelvis near the rectum and background were measured and corresponding relative SIs were calculated.Relative SI values between the two groups and pre- and post- infusion were compared with pared t test.Results Dimension of the Gd-CPs was about 500 nm,and content rate was about 30%. Values of relative SI of the rectum for pre- and post- infusion in the Gd-CPs group were 0.84±0.06 and 0.98±0.09(t=4.327,P＜0.01),respectively,while those in CPs group were 0.83±0.04 and 0.84±0.05(t=0.658.P＞0.05). The medial value of signal increase rate for CPs group was 19.0%.Gd-CPs particles were found inside the mucosal cells under the electron microscopy.Conclusion MR imaging in-vivo can reveal the phenomenon of adhesion and absorption of mucosa targeted chitosan particle carriers. Clinical MR imaging based on small animal coil is a good method to monitor colon mucosa targeted particle vectors in-vivo.

Objective To construct a lentiviral expression vector of peroxiredoxin2(PRDX2) RNA interference (RNAi) and to investigate the effect of siRNA of PRDX2 genes on the proliferation of human colonrectal cancer SW480 cell .Methods RNAi tar‐get sequences were designed and synthesized towards the PRDX2 gene sequences .The lentiviral vector pGC‐EGFP‐shPRDX2 was constructed and identified .The vector was transformed into SW480 cells ,and the transfection efficiency was evaluated by fluores‐cence microscopy .The expression of PRDX2 was detected with Quantitative real‐time PCR (qRT‐PCR) and Western blot in the transfected cells .Cell growth and colony forming ability were detected with MTT and plate cloning technique .Results PRDX2 gene lentiviral vector was successfully established and was proved by gene sequencing .The expression of PRDX2 in mRNA and pro‐tein was significantly reduced(P<0 .05) .The PRDX2 mRNA and protein expression in SW480 transfected with lentiviral were sig‐nificantly reduced (P< 0 .05) ,and the ability of growth and proliferation were significantly reduced(P< 0 .05) .Conclusion PRDX2 gene lentiviral vector could be a stable and reliable tool .The proliferation and growth of SW480 cells transfected by pGC‐EGFP‐shPRDX2 could be effectively suppressed ,which could facilitate further investigation of the roles of PRDX2 gene in the de‐velopment and progression of colorectal cancer .

Objective To summarize the experiences with early treatment of the wounded associated with 4 · 20 Lushan earthquake in army hospitals.Methods Emergency response programs were started and tent hospitals were set up.According to the basic principle of wartime wound treatment regulation,emergency triage,emergency medical care,transferring,specialized treatment and evacuation were performed for the wounded in this earthquake.Results After the earthquake,the emergency rescue programs were started in the hospital.Twenty minutes later,emergence medical team with full equipment were set out for the epicenter and the tent hospitals were set up.A total of 181 earthquake cases were admitted within two weeks,of which 68 (37.6％) were transferred from the scene of earthquake and 113 (62.4％) were transferred after the primary treatment (including cases evacuating from other hospitals).Forty-nine surgeries had been done,including 30 emergence ones.Thirty-four cases (including 14 severe wounded) were evacuated to superior hospitals as their vital signs turned stable.There was no death or surgical wound infection.Conclusions Peacetime complete emergence programs and materials reserves,unified and well-organized command as well as normative grading treatment system in army hospitals assure the standardized medical care with high efficiency and high quality for earthquake victims.However,more researches are needed over diagnosis methods and standards for wound severity,equipment improvement and standards for casualty evacuation.

Objective To evaluate the clinical efficacy and safety of application of anterograde flexible ureteroscope in the treatment of ureterointestinal anastomotic strictures in patients after Bricker urinary diversion. Methods From March 2009 to July 2012, 6 patients with ureterointestinal anastomotic strictures after Bricker procedure were enrolled in this study. The average age of the patients was (61 ±7) years old. The first clinical presentation was averagely (6.3 ±2.5) months after the Bricker procedure. There were 4 cases with left side strictures and 2 cases with right side ones. The urinary tract ultrasound, CT, KUB+IVP and antegrade urography were carried out to identify the obstructive portion. The mean length of stricture was 0.9cm (0.4~2.5) . First, all patients underwent percutaneous nephrostomy (PCN), then inside incision by Holmium:YAG laser under anterograde flexible ureteroscopy and lithotripsy (with calculi) . The F6 double J ureteral stent was indwelled for 12 weeks. KUB+IVP was performed after removal of double J ureteral stents. Results The mean operative time was (53±8) min. The mean hospital stay was (5.5±2) days. The blood loss was 3~6 mL. The average follow-up was 18 months (6~30) . No recurrence was found in 5 patients. One case had recurrent stricture after the first procedure, which was successfully managed by the flexible ureteroscopy again and replacing double J ureteral stent every 12 months. Conclusion The inside incision by anterograde flexible ureteroscopic Holmium:YAG laser is safe and effective for ureterointestinal anastomotic strictures in patients after Bricker urinary diversion, with less complications.

To construct the lentiviral vector containing Peroxiredoxin 2(Prdx2) gene and the colorectal cancer cell line stably transduced with Prdx 2-containing vector , so as to provide a useful tool for studying the role of Prdx 2 in colorectal cancer.Methods: Prdx2 was amplified by PCR and inserted into lentiviral expression vector Ubi-MCS-EGFP-IRES-Puromycin (GV218) to generate Ubi-Prdx2-EGFP-Puromycin(LV-Prdx2) vector.The inserted Prdx2 gene was verified by double enzyme digestion and DNA sequencing.Subsequently ,lentiviruses were produced and transduced into SW 480 cells.EGFP expression was examined under fluorescence microscopy ,the expression of Prdx2 was detected with qRT-PCR and Western blot.Cell growth and colony forming ability were detected with MTT and plate cloning technique.Results: The lentiviral Prdx2 expression vector was successful construc-ted.Overexpression of Prdx2 was verified in SW480 cells with LV-Prdx2 vector.Prdx2 promoted SW480 cell growth and colony forming ability(P<0.05).Conclusion:Ubi-Prdx2-EGFP-Puromycin(LV-Prdx2) vector is successfully constructed,and the SW480/LV-Prdx2 cell line with stable transduction of Prdx2 containing vector is established.Overexpression Prdx2 can significantly promote the proliferation of colorectal cancer SW 480 cells.

Objective To evaluate the clinical efficacy of transurethral resection of ureteral orifice invaded by advanced prostate cancer caused hydronephrosis. Methods A retrospective study was done in 15 patients who were diagnosed by advanced prostate cancer with invasion of ureteral orifice and treated by transurethral resection of ureteral orifice and maximal androgen blockade. 24 kidneys were diagnosed as hydronephrosis by ultrasound. Before the procedure, the average serum BUN was 13.2 mmol/L (8.9~28.5), the average serum Cr was 243.3 μmol/L (126.7~369.2), the average GFR evaluated by renal radionuclide imaging was 48.6 mL/min (31.1~66.2), and the upper urinary tract was obstructed in kidneys with hydronephrosis. Results All 15 patients underwent successfully transurethral resection of ureteral orifice and discharged after 4 days stay. The average procedure time was 65 min (50~100 min) and mean blood loss was 45 mL (30~65 mL) . The patients were followed up for 2~4 weeks. Hydronephrosis examined by ultrasound was ameliorated in 18 kidneys (75%) and not obviously changed in 6 kidneys (25%) in one week after procedure. Hydronephrosis examined by ultrasound was ameliorated in 20 kidneys (83.3%) and not obviously changed in 4 kidneys (16.7%) in two weeks after procedure. Within two weeks after procedure,the average serum BUN was 10.75 mmol/L (6.6~21.30 mmol/L), the average serum Cr was 187.3μmol/L (97.5~286.6 μmol/L), the average GFR evaluated by renal radionuclide imaging was 58.1 mL/min (37.8~79.2 mL/min),and upper urinary tract was unobstructed. Conclusion Upper urinary tract obstruction and renal function were ameliorated and improved in a short time by transurethral resection of ureteral orifice invaded by advanced prostate cancer which caused hydronephrosis.

Objective To compare the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for solid pancreatic masses performed with three different needle types through the cytological results.Methods All patients with solid pancreatic masses larger than 2cm from December 2010 to May 2011 were enrolled,and divided into two groups according to different access of EUS-FNA,trans-gastric approach with 19-,22-and 25-gauge needles (n =42) and trans-duodenal approach with 22-and 25-gauge needles (n =10).In both groups,EUS-FNA was performed with randomization of needle types.During the puncture,the suction,the number of movements,and the depth of insertion were fixed.At the end of the puncture,a liquid-based cytological (LBC) preparation was used to fix the specimen.One cytopathologists was assigned to make the diagnosis and comparison.Results Technical success was 100％ and no procedure related complications occurred.No statistically significant differences were observed in different needles in terms of all cytological parameters between two groups (P ＞ 0.05).However,the 25-gauge needle showed a trend towards a higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy.Conclusion There is no significant difference in yield of cytological results between different needle types,although 25-gauge needle shows a relative superiority.