OBJECTIVETo analyze the heterogeneous biological characteristics of acute leukemia (AL) patients with mistranslation expressed lymphoid and myeloid-related antigens, and it's prognosis-related factors.

METHODSTwo hundred and fourteen AL patiens with mistranslation expressed lymphoid and myeloid-related antigens were grouped according to immunophenotypes, and the heterogeneous biologic charecteristics and prognosis related factors were analyzed, moreover the survival curves were drawn to analyze the survival of patiens.

RESULTSThe immunophenotype in 214 cases was mainly cross-expression of myeloid and B lineage antigen (118 cases), followed by cross-expression of myeloid antigen and T lineage (88 cases), while the cross-expression of myeloid, T and B lineages, was less (only 8 cases). In ALL patiens with cross-expression of myeloid antigen, the CD33 was main type; while in AML patients with cross-expression of lymphoid antigen, CD7 was main type of lineage antigen, CD19 was main type of B lineage antigen. Among 214 AL patients, the cross-expression of CD55 and myeloid antigen was found in 30 cases, the cross-expression of CD7, CD19 and CD74 was observed in 6 cases, the cross-expressions of CD7, CD34 and CD56 was detected in 4 cases. Among AML patients with lymphoid antigen expression, the recurrent chromosmal abnormalities were found in 16 cases; among ALL patients with myeloid antigen expression, the recurrent chromosomal abnormalities were observed in 10 cases. The mistranslation antigen expression existed in 26 patients with recurrent chromosomal abnormalities, the mistranslated CD33 and CD13 in ALL patients with myeloid antigen expression was common, while the mistranslated CD2, CD56 and CD19 in AML patients with lymphoid antigen expression was common. As compared with patients without lymphoid antigen expression, the survival rate decreased significantly in patients with mistranslated CD7(+) and CD34(+) (both P<0.05). The logistic regression analysis showed that CD7, CD34 were main influencing factors for prognosis of AL patients (both P<0.05).

CONCLUSIONThe AL with mistranslation expressed lymphoid and myeloid antigens is a special kind of leukemia which possesses the heterogencous biological characteristcs and unique prognostic features, thus the immunophemotype of AL patients should be detected by flow cytometry. The existance of mistranlation-expressed differatiation antigens such as CD7 and CD34 is mainly influencing factors for the prognosis of AL patiens.

Objective To investigate the clinical curative effect of laparoscopic cholecystectomy in the treatment of elderly patieuts with acute gaugrenous cholecystitis,and summarized the advantages and disadvantages compared with open cholecystectomy.Methods Using retrospective study,68 elderly patients with acute gangrenous cholecystitis patients in Xiaogan First People's Hospital from January 2010 to January 2015 were selected,and divided into minimally invasive group (36 cases) and laparotomy group (32 cases) according to the different surgical treatment methods,the minimally invasive group patients were treated with laparoscopic cholecystectomy,the laparotomy group patients were treated with open cholecystectomy.Recorded and statistical analysised the incision length,operative time,intraoperative blood loss,laparotomy,postoperative first exhaust time,drainage tube pulled out of time,the degree of pain after operation (visual analogue scale),length of hospital stay,postoperative complications of the two groups.All the patients were followed up by outpatient or telephone,inquiried and recorded the patient's health status up to July 2015.The measurement data were expressed by (x ± s),and the t test was used comparison between groups.The enumeration data was expressed by percentage (％),and the x2 test was used comparison between groups.Results The incision length,intraoperative blood loss,postoperative first exhaust time,length of hospital stay,extubation time were respectively (4.67 ±2.13) cm,(65.67 ±23.61) ml,(31.18 ±4.35) hours,(7.53 ±2.33) days,(2.44±1.31) days in the minimallyinvasive group and (8.48 ±3.49) cm,(103.96 ±35.65) ml,(40.41 ±5.87) hours,(12.34 ±2.94) days,(3.73 ± 1.52) days in the laparotomy group,with statistically significant differences between the 2 groups (all P ＜ 0.05).There was no significant difference in the operation time between the two groups (t =3.574,P ＞ 0.05);The pain scores in the minimally invasive group after 1,3,5 and 7 days were respectively (4.96 ± 1.38) scores,(3.48 ± 1.04) scores,(2.01 ± 0.89) scores,(1.11 ± 0.85) scores and (6.55±1.84) scores,(5.69±1.54) scores,(2.97± 16) scores,(1.81 ±0.94) scores in the laparotomy group,with statistically significant differences between the 2 groups (all P ＜ 0.05).The incidence of complications in minimally invasive group was 17.14％ 6/35),which was significantly lower than that of laparotomy group 41.94％ (13/31) (x2 =15.234,P ＜ 0.05),all the complications were relieved after symptomatic treatment such as anti infection,drainage and so on.All patients were followed up.Among 68 patients enrolled in the study group,1 patient in the minimally invasive group was converted to laparotomy because of excessive adhesion and uncontrollable intraoperative bleeding.The laparotomy group died of septic shock in 1 case,and the remaining patients were treated by surgical treatment.Conclusion Cholecystectomy is effective in treatment of elderly patients with acute gangrenous cholecystitis,and laparoscopic cholecystectomy has the advantages of small incision,less bleeding,less pain,fewer complications and faster recovery after operation thus deserving popularization.

Objective To explore the difference between the curative effect and the prognosis under different time of surgery for calculus incarcerated cholecystitis patients.Methods Ninty-three cases of acute cholecystitis caused by stone inlay in the neck of the gallbladder patients in Xiaogan First People's Hospital from April 2013 to April 2015 were divided into group A and group B according to the duration.Group A:the course of disease was within 72 hours(n =43).Group B:the course of disease was over 72 hours (n =50).The observation indicators of the two groups included (1)operation condition:operation time,postoperative anal exhaust time,postoperative pain time,intraoperative blood loss and length of hospital stay;(2) conversion to laparotomy situation;(3) the postoperative complications of pulmonary infection,abdominal infection,incision infection,bile leakage.All the patients were followed up by outpatient or telephone,inquiried and recorded patient's health status.The deadline for follow-up was October 2015.The measurement data were expressed by ((x) ± s) and comparison between groups was analyzed by using t test.Count data were analyzed using x2 test.Results (1) The average operation time,postoperative anal exhaust time,postoperative pain time,intraoperative blood loss and hospitalization time of group Awere (56.4±12.7) minutes,(37.8±4.6) hours,(24.2±3.8) hours,(58.3± 14.3) ml,(4.8± 2.9) days respectively,the data of group B were (82.5 ± 15.8) minutes,(76.2 ±7.8) hours,(53.8 ± 7.8) hours,(71.4 ± 16.9) ml,(7.8 ± 2.5) days respectively,the difference between the two groups were statistically significant (all P ＜ 0.05);(2) The conversion rate of laparotomy in group A (4.65％,2/43) was significantly less than group B (18.00％,9/50),and the difference was statistically significant (P ＜ 0.05);(3)The complication rate in group A (4.65％,2/43) was significantly less than group B (16.00％,8/50),and the difference was statistically significant (P ＜ 0.05).Conclusion The prognosis of calculous incarcerated cholecystitis with different surgical time is significantly different,the prognosis of the patients duration within 72 hours surgery prognosis was significantly better than the duration more than 72 hours surgery.

Objective: To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat. Methods: A multi-center, retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province. Results: A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old. The only route of poisoning was ingestion. Among these cases, suicide was the most common cause of poisoningaccounting for 90.70%. In emergency treatment, the constituent ratios of gastric lavage, hemoperfusion and glucocorticoid were 87.50%, 72.50% and 42.50%, respectively. The total mortality increased to 60.00% after follow-up, while the in-hospital mortality was 18.60%. The mortality of patients with toxic dose < 50 mL was 11.11%. Conclusions The incidence of acute herbicide poisoning with "diquat" as commercial component is gradually increasing. At present, the mortality is very high. Ingestion poisoning dose is the key factor affecting prognosis, and the prognosis of patients with oral dose > 50 mL is poor.