Objective To explore the clinical significance of minimal residual disease (MRD) and WT1 in patients with acute myeloid leukemia (AML).Methods 349 bone marrow specimens of 42 patients with AML (except M3) before and after chemotherapy were collected.The expression level of MRD was determined by flow cytometry (FCM) and WT1 gene was detected by real time quantitative PCR (RQ-PCR).Results No correlation was observed between WT1 gene expression level of AML patients before chemotherapy with treatment response (x2 =0.166 3,P ＞ 0.5).34 AML patients achieved morphological complete remission (CR) after the first course of inductive chemotherapy.The recurrence rate was significantly higher in patients with high MRD level than that in those with low MRD level (63.6 ％ vs 21.7 ％) (x2 =5.729,P ＜ 0.025),and significantly higher in patients with high WT1 expression than that in those with low WT1 expression (87.5 ％ vs 23.1％) (x2 =10.749,P ＜ 0.005).WT1 expression level of patients with CR was significantly lower than that of patients without CR (t =4.669,P ＜ 0.001).The recurrence rate of patients with both low level of MRD and WT1 was significantly lower than those of either high level of MRD and WT1 (15.0 ％ vs 64.3 ％,P ＜ 0.05).The level of WT1 in patients with CR had positive correlation with the level of MRD (r =0.835,P ＜ 0.001).Conclusions MRD and WT1 have great importance in evaluating the therapeutic effects among patients with AML and increasing the positive rate of MRD.They also provide experimental basis for the individual and gradation treatment in the clinic.

Objective To evaluate the method and clinical effect of subtalar joint distractor assisted open reduction and internal fixation of comminuted intra-articular calcaneal fracture.Methods Twenty-two patients with fresh closed calcaneal fracture treated with open reduction and internal fixation from May 2011 to July 2013 were included in the study.According to the modes of operation,the patients were randomly divided into two groups (n =11 in each):in group A patients underwent fracture reduction assisted by subtalar joint distractor and in group B patients underwent Steinmann pin traction and poking reduction.All were fixed using the lateral calcaneal plate.Operation time,B(o)hler angle,Gissanes angle,calcaneus height,incision healing time and complications of the two groups were investigated for evaluating the effect of operation.Clinical effect was evaluated using the American Orthopedic Foot & Ankle Society (AOFAS) score before the removal of internal fixation.Results Period of follow-up was (14.3±0.8)months (range,12 to 18 months).Two patients in group B had delayed wound healing,and were treated with regular wound care.At the final follow-up,no infection,nonunion,malunion and internal fixation failure were observed.B(o)hler angle,operation time and calcaneus height observed in group A were superior to those in group B (P ＜0.01).There was no significant difference in Gissanes angle between the two groups (P ＞ 0.05).Compared to the preoperative data,B(o)hler angle,Gissanes angle and calcaneus height were significantly improved in both groups (P ＜0.01).AOFAS score was (83.6 ± 1.4) points in group A and (81.7 ± 1.5) points in group B.Conclusion Subtalar joint distractor assisted open reduction and internal fixation is effective to shorten operation time,improve fracture reduction,reduce wound complications and increase the operative effect for comminuted intraarticular calcaneal fracture.

Objective To investigate the clinical efficacy of fixation of distal radius fracture with dorsal instability with locking compression plate (LCP) via radial approach.Methods From September 2009 to October 2012, 21 cases underwent LCP fixation of the distal radius fracture with dorsal instability via radial approach.The study included 14 males and 7 females (mean age, 54.5 years;range, 38-81 years).Twelve cases were injured in traffic accidents, 7 in falls and 2 in high falls.Fracture AO classification was type A3 in 10 cases, type C1 in 8 cases and type C2 in 3 cases.Two cases (one type A3 and one type C1) had malunion.When the lateral column, intermediate column, radial edge and dorsal plane were exposed by radial incision, LCP fixation with bone grafting was performed to restore the height of radial styloid process, ulnar deviation and palmar tilt.According to the GartlandWerley score, wrist joint function was evaluated.Results Mean duration of follow-up was 13.5 months (range, 12 to 24 months).Stage Ⅰ bone union was shown on X-rays, with the healing time of 7.5 weeks.Based on the X-rays at postoperative 6 months, 1 year and 2 years, the shortening of radial styloid process was ≤ 2 mm, mean volar tilt was 12.5°(range, 8°-17°) , mean ulnar tilt was 20.5° (range, 15°-26°), and step-off or gap of the articular surface was ≤ 2 mm.In postoperative wrist motion assay, mean volar flexion was 60°(range, 30°-70°), mean dorsal flexion was 55° (range, 30°-65°), mean radial deviation was 17°(range, 10°-20°), mean ulnar deviation was 25.5° (range, 20°-30°),pronation was 65.5° (range, 60°-70°) , and mean supination was 75.5° (range, 60°-80°).Mean grip strength was 75％ (60％-95％)of the contralateral side.Two cases suffered from pain (one complained of moderate pain and one minor pain occasionally).According to the Gartland-Werley score, 16 cases were rated excellent, 2 good, 2 fair and 1 poor, with the excellent rate of 86％.No complication was found as injury of the superficial branch of radial nerve, infection, nonunion, nail loosening, medium neuritis and tendon injury.Conclusions Lateral column, intermediate column, radial edge and dorsal plane can be shown via the radial approach.LCP fixation combined with bone grafting contributes to fracture anatomical reduction.