The efficiency of Siemens E.CAM is evaluated by analyzing and practicing the technology of Siemens U-fly.Basic testing procedure is run.Standard source 99mTc and 57Co is used respectively and the operation is performed according to the instruction.The detecting head's uniformity can be corrected in this way with satisfactory results.It is suggested uniformity should be tested every day before study because it is the most important factor for the quality of clinical images.

According 1o the genome sequences of α.β,e,ι toxins of Clostridium perfringens in GenBank,four pairs of primers targeting α,β,ε,ι toxin genes were designed.After the multiplex PCR reaction condition was optimized,the multiplex PCR for identification and toxintyping of C.perfringens strains was developed.The specificity test showed that the expected fragments of C.perfringens reference strains including A.B,C,D,E five toxin types were amplified successfully from genomic DNA of C.perfringens,respectively.However,a band could not be amplified from Clostidrium novyi and Clostridium septicum as negative control groups.The sensitivity test showed that the limit detection of multiplex PCR was 9.0,17.8,12.2,13.8,18.5 pg DNA of A,B,C,D,E five toxin types C.perfringens,respectively.Repetitive testing showed that the established method had a good repeatability.Nine type A strains of and 1 type C strains of C.Perfringens from 21 clinical samples of dead goat were detected by the multiplex PCR developed in this study.This study establishes the multiple PCR method which not only can detect C.perfringens rapidly but also can identify five toxin types of C.perfringens.

Objective To compare the efficacy of laparoscopic-assisted hemicolectomy with that of open hemicolectomy for right colon carcinoma and to explore the safety and effectiveness of the formor procedure. Methods The clinical data on 46 patients who had undergone laparoscopic-assisted hemicolectomy and 68 patients who had received open hemicolectomy between December 2009 and December 2013 in our department were retrospectively analyzed. Length of postoperative hospital stay, surgical duration, amount of intraoperative blood loss, number of lymph node dissection, time to postoperative anal exhaust, surgical costs, postoperative complications, and survival rate were compared between the two groups. Results There were no statistical differences between the two grounps in gender, age, body mass index, pathological typing, depth of invasion, and total number of lymph node dissection. Length of hospital stay was 6.84 days in the group of laparoscopic-assisted hemicolectomy and 11.72 days in the group of open hemicolectomy , with a statistical significance. Surgical duration and treatment costs did not differ significantly between the two groups; while amount of intraoperative blood loss (76.63 mL vs. 141.5 mL) and time to postoperative anal exhaust differed significanly. Conclusions Laparoscopic-assisted hemicolectomy is safe and effective for treatment of colon cancer , It has advantages of small trauma, rapid postoperative recovery, and a nice-looking surgical incision.

Objective To explore the influence of mononuclear cells (MNC), CD34+ cells, CD3+ , CD3+ CD4+ , CD3+ CD8+ , CD4+ CD25+ T cells, CD3- CD16+ CD56+ natural killer cells (NKs), and dendritic cells (DCs) doses in graft on acute graft-versus-host disease (aGVHD) following HLA-identical sibling allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT).Methods Sixty-five patients receiving HLA-identical sibling allo-PBSCT were studied.The number of CD34+, CD3+, CD3+ CD4+, and CD3+ CD8+ T cells in the graft was counted by fluorescence-activated cell sorting (FACS).The number of CD4+ CD25+ T cells, CD3 CD16+ CD56+ NKs, and DCs in the graft was also measured by FACS in 31 patients among above-mentioned 65 patients.The doses of each kind of cells in the graft were calculated according to per kilogram of recipients body weight.The patients were divided into high or low dose groups according to whether or not more than or equal to median of MNC, CD34+, CD3+, CD3+ CD4+, CD3+CD8+, CD4+ CD25+, CD3 CD16+ CD56+ or DC cell doses, respectively.Acute GVHD was analyzed between two groups.Results The frequency of the cumulative incidence of grade Ⅱ～Ⅳ aGVHD was increased in CD3+ CD4+ and CD3+ CD8+ T cells high dose groups as compared with correspondingly low dose groups, but the difference had no statistically significant difference (P = 0.089 and 0.098, respectively).Recipients in CD4 + CD25 + T cells high dose group had significantly reduced cumulative incidence of grade Ⅲ～Ⅳ aGVHD as compared with those in correspondingly low dose group (P< 0.05).The cumulative incidence of total aGVHD was significantly higher in DC1 high dose group than in correspondingly low dose group (P<0.05) and the cumulative incidence of grade Ⅱ～Ⅳ aGVHD was also higher in high dose group, but the difference had no statistically significant difference (P = 0.069).There was no significant difference in cumulative incidence of total and grade Ⅱ～Ⅳ aGVHD between MNC, CD34+ , CD3+, NK or DC2 high dose groups and correspondingly low dose groups (P>0.05, respectively).Conclusion Recipients in DC1 high dose group have significantly increased cumulative incidence of total aGVHD, but those in CD4+ CD25+ T cells high dose group have significantly reduced cumulative incidence of grade Ⅲ～Ⅳ aGVHD.

Purpose/Significance To conduct the real world research on the application and impact of artificial intelligence(AI)technology in medical institutions,and to assist in intelligent governance decision-making in the field of medicine and health.Method/Process Taking Peking University Third Hospital as the research scene,the AI medical social experiment is carried out through literature meta-analysis,knowledge graph construction and mixed methodology research.Result/Conclusion Scholars at home and abroad are cautious and optimistic about the application of AI technology in the field of health.The research,development and application of AI technology in domestic public hospitals are very active,but small-scale field studies suggest that AI technology may lead to problems such as misleading decision-making and weakening of human subjectivity while improving the efficiency of diagnosis and treatment.In-telligent governance in the field of health,represented by AI technology,requires a long period and a wide range of sociological observa-tions.It is recommended to build a research base for medical AI technology R&D and supervision based on public hospitals,and continue to pay attention to issues such as human subjectivity,medical ethics and scientific and technological ethics in AI social governance.

Objective To analyze the outcomes and the prognostic factors of hematopoietic stem cell transplantation (HSCT) in combination with imatinib for Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). Methods All 32 patients with Ph+ ALL achieved hematologic complete remission (CR) at time of transplantation, including 27 cases in the first CR (CR1) and 5 in CR2. Nineteen patients achieved molecular remission (MR). Among 32 patients, 4 received autologous HSCT (AHSCT), and 28 allogeneic HSCT (allo-HSCT). The conditioning regimens comprised of total body irradiation (TBI), cyclophosphamide, fludarabine and cytarabine. The median number of transfused mononuclear cells was 5. 6 × 108/kg, and that of CD34+ cells was 2. 94 × 106 /kg. Thirty-one patients were administrated imatinib orally before transplantion, at a dose of 400～600 mg/day, and 16 patients after transplantation, including 7 for prevention at a dose of 300～400 mg/day and 9 for salvage treatment at a dose of 400 ～ 600 mg/day. Results Hematopoietic reconstitution was achieved in all 32 patients. Three-year estimate of overall survival (OS) was (62. 1±8. 6)%, leukemia-free survival (LFS) (59. 2 ± 8. 7)%, relapse rate (RR) (17. 7 ± 7. 2)% and transplant-related mortality (26. 2 ± 8. 0) %. All 4 undergoing AHSCT were alive, and 3 out of them were in continuous CR with durations of 14, 18 and 67 months respectively. The univariate analysis for prognosis in allo-HSCT showed that the OS of HLA-matched sibling donors group was 76. 5 %,higher than that of unrelated or haploidentical donors group (27. 3 %, P＜0. 05), and so was LFS (70. 6 % vs 27. 3 %, P＜0. 05). RR in patients achieving MR at time of transplantation was 5. 6 %,lower than that in those not achieving MR (40. 0 %, P＜0. 05). RR in patients in CR1 at time of transplantation was 12. 5 %, lower than that in those in CR2 (50 %, P ＜0. 05). Conclusion Imatinib improved the outcomes of HSCT for Ph+ ALL, especially to patients achieving MR at time of transplantation and transplantation in early stage (CR1).

Objective:To evaluate the efficacy of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of type IIIA acute symptomatic osteoporotic lumbar fracture (ASOLF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 117 patients with type IIIA ASOLF admitted to Honghui Hospital of Xi′an Jiaotong University from April 2016 to February 2018, including 32 males and 85 females, aged 60 to 88 years [(68.3±5.7)years]. Injury segments were located at L 1 in 35 patients, at L 2 in 38, at L 3 in 26 and at L 4 in 18. All patients were treated with PKP. A total of 61 patients were treated using the midpoint of the transverse process-articular process displacement as the puncture point (unilateral puncture group) and 56 patients were treated using the traditional "2" point and "10" point as the puncture point (bilateral puncture group). The operation time, amount of radiation exposure of patients and surgeons and bone cement injection volume were compared between the two groups. The Cobb angle, height of anterior edge of injured vertebrae, visual analogue scale (VAS) and Oswestry disability index (ODI) were compared before operation, at day 1 after operation and at the final follow-up. Intraoperative and postoperative complications were observed. Results:All patients were followed up for 24-35 months [(26.3±4.7)months]. The operation time and amount of radiation exposure of patients were (20.4±5.6)minutes and (1.08±0.44)mSv in unilateral puncture group, significantly different from (37.5±9.2)minutes and (2.24±0.58)mSv in bilateral puncture group (all P<0.01). There were no significant differences in amount of radiation exposure of surgeons and bone cement injection volume between the two groups (all P>0.05). In unilateral puncture group and bilateral puncture group, the Cobb angle of fractured vertebrae at day 1 after operation [(22.4±10.7)°, (23.4±11.1)°] and at the final follow-up [(24.3±8.3)°, (23.5±9.5)°] was significantly decreased from that before operation [(29.6±9.7)°, (30.6±12.9)°] (all P<0.01); the height of anterior edge of injured vertebrae at day 1 after operation [(80.4±12.6)%, (78.8±11.9)%] and at the final follow-up [(79.3±10.7)%, (77.4±11.2)%] was significantly increased from that before operation [(65.7±6.3)%, (66.4±9.7)%] (all P<0.01); the VAS at day 1 after operation [(2.1±0.5)points, (2.3±1.1)points] and at the final follow-up [(1.9±0.8)points, (2.0±0.6)points] was significantly decreased from that before operation [(7.1±0.7)points, (7.2±0.9)points] (all P<0.01); the ODI at day 1 after operation (21.1±9.7, 22.9±7.9) and at the final follow-up (18.5±4.6, 19.8±9.4) was significantly decreased from that before operation (72.7±4.5, 73.1±3.7) (all P<0.01). While the above four parameters between the two groups had no significant differences at each time point, with no significant differences within each group at day 1 after operation and at the final follow-up (all P>0.05). There were 13 patients [21% (13/61)] with cement leakage in unilateral puncture group as compared to 18 patients [29% (18/56)] in bilateral puncture group ( P<0.05). There were 4 patients [7% (4/61)] with adjacent vertebral fracture in unilateral puncture group, similar to 5 patients [9% (5/56)] in bilateral puncture group ( P>0.05). The lower back pain caused by facet injury were noted in 8 patients [14% (8/56)] in bilateral puncture group who were relieved after 1 month of non-surgical treatment, but none occurred in unilateral puncture group ( P<0.01). Conclusions:Unilateral and bilateral PKP can obtain satisfactory clinical efficacy in the treatment of type IIIA ASOLF, but the former has advantages of shorter operation time, less radiation exposure and lower incidence of bone cement leakage and facet injury.

Objective:To evaluate the efficacy between pedicle screws combined with vertebroplasty (PSV) and pedicle screws combined with intermediate screws (PSIS) for the treatment of osteoporotic thoracolumbar fracture (OTLF).Methods:PubMed, Cochrane Library, Web of Science, CNKI, VIP and Wanfang database were searched for all randomized controlled trial (RCT) or case-control trial (CCT) studies that comparing PSV and PSIS for the treatment of OTLF. Two reviewers independently screened the studies in the light of the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. The Meta-analysis was performed using the RevMan 5.4 software. The subjects were divided into PSV group and PSIS group according to different treatment methods. Operation time, intraoperative blood loss, postoperative incision infection rate, postoperative short-, mid- and long-term visual analogue scale (VAS) score, postoperative short- and mid-term Oswestry disability index (ODI), hospitalization time, postoperative short-, mid- and long-term Cobb angle, postoperative short-, mid- and long-term anterior vertebral height ratio (VBH) and implant failure rate were compared between the two groups.Results:A total of 12 studies were enrolled for review, involving 870 subjects (433 in PSV group and 437 in PSIS group). The results showed insignificant difference between the two groups in operation time ( WMD=7.07, 95% CI -4.00, 18.13, P>0.05), intraoperative blood loss ( WMD=0.62, 95% CI -7.19, 8.43, P>0.05), postoperative incision infection rate ( OR=0.65, 95% CI 0.10, 4.08, P>0.05), postoperative short-term Cobb angle ( WMD=-0.19, 95% CI -0.43, 0.05, P>0.05) and postoperative short-term VBH ( WMD=0.91, 95% CI -1.30, 3.13, P>0.05). However, there was significant difference between the two groups in postoperative short-term VAS score ( WMD=-0.59, 95% CI -1.02, -0.15, P<0.05), mid-term VAS score ( WMD=-0.41, 95% CI -0.65, -0.16, P<0.05), long-term VAS score ( WMD=-0.51, 95% CI -0.59, -0.43, P<0.05), postoperative short-term ODI ( WMD=-6.26, 95% CI -9.65, -2.87, P<0.05), postoperative mid-term ODI ( WMD=-2.44, 95% CI -3.43, -1.45, P<0.05), hospitalization time ( WMD=-2.65, 95% CI -4.61, -0.68, P<0.05), postoperative mid-term Cobb angle ( WMD=-1.40, 95% CI -2.41, -0.39, P<0.05), postoperative long-term Cobb angle ( WMD=-1.06, 95% CI -1.59, -0.52, P<0.05), postoperative mid-term VBH ( WMD=3.06, 95% CI 1.31, 4.81, P<0.05), postoperative long-term VBH ( WMD=4.11, 95% CI 2.44, 5.77, P<0.05) and implant failure rate ( OR=2.06, 95% CI 0.11, 0.59, P<0.05). Conclusion:Compared with PSIS, PSV can not reduce the operation time, intraoperative blood loss and incision infection in the treatment of OTLF, but it can significantly relieve pain, improve function, decrease reduce hospitalization time, help to maintain Cobb angle and anterior vertebral height after operation, and reduce implant failure rate.

Objective:To compare the efficacy of percutaneous vertebroplasty (PVP) in the treatment of osteoporotic lumbar compression fracture (OLCF) via the approach through midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach.Methods:A prospective cohort study was conducted to analyze the clinical data of 794 patients with OLCF treated in Honghui Hospital affiliated to Xi′an Jiaotong University School of Medicine from January 2017 to December 2019. The patients were divided into transitional-zone puncture group (400 patients, 400 vertebrae) and pedicle puncture group (394 patients, 394 vertebrae) according to the envelope method. The transitional-zone puncture group was treated with PVP via the approach through midpoint transverse process-transition zone of articular process, and the pedicle puncture group was treated with PVP via the unilateral transpedicular approach. The operation time and radiation dose were documented. The visual analogue score (VAS) and Oswestry dysfunction index (ODI) were evaluated before operation and at 1 day, 3 months, 1 year after operation. The cement distribution and the incidence of complications such as cement leakage, re-fracture of the injured vertebra, spinal cord nerve injury and facet joint injury were detected.Results:The patients were composed of 270 males and 524 females, at the age of 68.9-78.5 years [(73.7±4.8)years]. All patients were followed up for 12-14 months [(13.4±0.8)months]. The operation time and radiation dose in transitional-zone puncture group were reduced compared with pedicle puncture group ( P<0.01). There was no significant difference in VAS and ODI between the two groups before operation (all P>0.05). The VAS between transitional-zone puncture group [(2.1±0.9)points, (2.3±1.1)points, (2.7±1.3)points] and pedicle puncture group [(2.3±0.7)points, (2.5±0.9)points, (2.9±1.1)points] was obviously reduced from that before operation (all P<0.01), significantly different at 1 day, 3 months, 1 year after operation ( P<0.05 or 0.01). The ODI between transitional-zone puncture group (14.3±1.8, 13.6±3.4, 11.3±4.4) and pedicle puncture group (25.5±5.7, 20.7±6.3, 20.6±6.9) was significantly different at 1 day, 3 months, 1 year after operation (all P<0.01), and all were obviously reduced from that before operation (all P<0.01). With regard to the cement distribution, the number of bilaterally cemented vertebrae in transitional-zone puncture group (324) was more than that in pedicle puncture group (94) ( P<0.01). The incidence of cement leakage, re-fracture of the injured vertebra and facet joint injury was 8.25%(22/400), 0.00%(0/400) and 3.25%(13/400) in transitional-zone puncture group, significantly different from 20.81%(82/394), 2.03%(8/394) and 9.90%(39/394) in pedicle puncture group ( P<0.05 or 0.01). There was no significant difference in spinal cord nerve injury between the two groups ( P>0.05). Conclusion:For OLCF, PVP via the approach through the midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach are both effective, but the former has advantages of shorter operation time, smaller radiation dose, greater dispersion of bone cement and lower incidence of cement leakage, re-fracture of the injured vertebra and facet joint injury.

Objective To explore the impact of IL-10 gene polymorphisms on the outcome in HLA matched sibling hematopoietic stem cell transplantation (HSCT).Methods PCR-sequencespecific primer (PCR-SSP) assay was used to analyze the SNP of IL-10 in 77 recipient and donor pairs:-1082 A/G,-819 T/C,-592 C/A.Results IL-10 ATA/ATA (1082,-819,-592) genotype in recipients significantly decreased the incidence of grade Ⅱ-Ⅳ acute graft vursus-host disease (aGVHD) (6.1％ vs.25.0 ％,P＜0.05),reduced 5-year transplant-related mortality (TRM) (10.7 ％± 5.9％ vs.29.7％ ± 5.2％,P＜0.05) and increased disease free survival (DFS) (81.8％ ± 6.7％ vs.56.8％ ± 7.5％,P＜0.05).With regard to the donor genotype,the incidence of grade Ⅱ-Ⅳ aGVHD,extensive chronic GVHD,5-year TRM and DFS had no signicant difference between IL-10 ATA/ATA and non ATA/ATA subgroup.Multivariable analysis also revealed that IL-10 non-ATA/ATA genotype in recipients and high-risk status of disease were two independent risk factors for DFS (HR =2.911,P =0.029; HR =2.686,P =0.027).Conclusion In HLA-matched sibling HSCT,the presence of recipient IL-10 ATA/ATA significantly decreased the incidence of grade Ⅱ-Ⅳ aGVHD and TRM,and increased DFS.