Background and Purpose:It has been proved that CD117 may be used as an immunology marker for diagnosis of leukemia of myeloid origin.The relationship between CD117 expression and effect of chemotherapy on the patients with Acute Nonlymphoblastic Leukemia(ANLL) remains unclear.This study is to investigate the relationship between CD117 expression and the response of patients with ANLL to chemotherapy.Methods:Flow cytometery(FCM) was used to detect the positive rate and the levels of CD117 expression of the bone marrow mononuclear cell(BMMNC) from 38 patients with acute lymphoblastic leukemia(ALL) and 81 patients with ANLL,respectively.All-trans Retinoic Acid(ATRA) was taken to treat M_(3) type of ANLL and protocol DA and/or HA was used to treat the other types.ANLL was divided into two groups: positive(+) and negative(-) expression of CD117.At the same time we compared the difference of rates of complete remission(CR) between CD117(+) and CD117(-) groups from ANLL after chemotherapy.Results:Positive percentage of expression of CD117 in ALL and ANLL groups were 13% and 70% respectively(P=0.000).Positive levels of CD117 decreased successively as follows: M_(3)/ M_(1)、M_(2)/ M_(6) / M_(4)、M_(5).CR rates of CD117(+) and CD117(-) groups of ANLL after chemotherapy were 51%(29/57) and 67%(16/24)(P=0.192),respectively.Conclusions:CD117 may serve as an immunology marker for the diagnosis of ANLL,but positive or negative expression of CD117 in ANLL was not associated with the response of the patients with ANLL to chemotherapy.

Objective:To study expressions of CD117 and CD34 in the patients with acute promyelocytic leukemia(APL,M3) and in M1-M2 subtype from FAB classification for acute leukemia(AL).The focus of the study would be laid on the clinical significance of CD117/CD34 co-expression in the patients of M3 subtype.Methods:Researched cases of acute nonlymphoblastic leukemia(ANLL) were divided into two groups:M1-M2 subtype and M3 subtype.Flow cytometery(FCM) was used to detect the rates of positive expression of CD117 and CD34 on bone marrow mononuclear cell(BMMNC) in 54 patients of M3 and 63 patients of M1-M2 subtype respectively.Meanwhile,we compared the differences between the rates of expression of CD117 and CD 34.And,the rates of CD117/CD34 co-expression in patients of M1-M2 subtype and M3 subtype were studied.Results:Our results revealed that the positive rates of CD117 expression in M1-M2 subtype and M3 subtype were 71.4%(45/63) and 66.7%(36/54) respectively(P=0.58).The positive rates of CD34 expression in M1-M2 subtype and M3 subtype were 66.7%(42/63) and 11.1%(6/54) respectively(P=0.000).The positive rates of CD117/CD34 co-expression in M1-M2 subtype and M3 subtype were 71.1%(45/63) and 7.4%(4/54) respectively(P=0.000).Conclusion:CD117 may be used as immunology marker for leukemia of myeloid origin.CD34 had lower expression in M3 subtype than in M1-M2 subtype.The positive rate of CD117/CD34 co-expression in M3 subtype was significantly lower than that in M1-M2 subtype,which can help for diagnosis of M3 subtype and help differentiate M3 subtype from M1-M2 subtype as well.

OBJECTIVE:To determine the related compounds in compound vitmine injection by RP-HPLC.METHODS:The determination was performed on C18 column,and the mobile phase was composed of methanol-alcohol(80∶ 20)with a flow rate of 0.5mL? min-1 and detection wavelength of 270nm.RESULTS:The related substances in compound vitamine injection were separated effectively.The total peak area of all foreign materials was no more than 3% of the main peak area of contrast solution,and the peak area of single foreign material was no more than 1.5% of the main peak area of the contrast solution.CONCLUSION:The method is simple and rapid,suitable for the quality control of compounds of compound vitmine injection.

Background Nowadays,customized ablation is widely used in the excimer laser corneal refractive Burgery.And the Q-value guide LASIK is one of the research hotspots. Objective Present study was to evaluate and compare the effectiveness of Q-value guide LASIK and standardized LASIK for myopia.Methods A systematic literature retrieval from 2003 through 2010 was conducted in the MEDLINE,CNKI,Cochrane Library,EMBASE.The literature examine possible difierences in uncorrected visual acuity(UCVA),Q-value,higher order aberrations(HOAs),and spherical equivalent(SE) between Q-value guide LASIK and standardized LASIK for correcting myopia.Statistical analysis was performed using a Review Manager 5.0 software.The data was extracted,and the methodological quality was evaluated by two reviewers independently.The quality of included literature was scored according to the Jadad Scale. Results A total of 14 studies involving 1617 patients(2956 eyes)was included in the meta-analysis.Of these fourteen studies,six studies were randomized trials and the other eight studies were retrospective cohort studies.According to the Jadad Scale,2 studies scored 3 points,and the other 12 studies scored 1～2 points.The results showed that the Q-value guide LASIK group had a better postoperative effectiveness in uncorrective visual acuity(UCVA)(WMD=0.04.95% CI 0.00 to 0.08,P<0.05).Q-value(SMD=-1.52,95% CI -2.23 to-0.81,P=0.00),total HOAs (SMD=-1.63,95% CI-2.57 to-0.69,P<0.05) and spherical-like aberrations ( SMD =-1.49,95% CI-2.22 to-0. 76,P<0. 00) after surgery. However, the number of eyes achieved UCVA≥20/20 ( OR= 1.16,95% CI 0. 61 to 2. 19,P=0. 65) ,coma-like aberrations (SMD=-1. 02,95% CI-0. 36to 0.11,P=0.29) and SE (WMD=0.10,95% CI-0.11 to 0.31,P=0.34) after surgery were comparable.Conclusion The effectiveness of Q-value guide LASIK is superior to standardized LASIK for treatment of myopia.High-quality clinical randomized-controlled study should be performed to further evaluate the comparable outcome of Q-value guide LASIK with standard LASIK.

Objective To evaluate the clinical value of a novel anvil insertion technique in intracorporeal esophagojejunostomy and esophagogastrostomy after laparoscopic total or proximal gastrectomy.Methods A total of 40 patients with gastric cancer underwent laparoscopy-assisted radical total or proximal gastrectomy with lymph node dissection,followed by esophagojejunostomy or esophagogastrostomy using a reverse anvil insertion technique (the observation group,n =22) or traditional open surgery technique (the control group,n =18).Data of the two groups were compared.Results In observation group,laparoscopic total gastrectomy and esophagojejunostomy were successfully performed in 17 patients,laparoscopic proximal gastrectomy and esophagogastrostomy were successfully performed in the 5 patients,and no conversion to open surgery occurred.The mean time of operation was (272.0 ±49.8)min,including (12.9 ±4.3)min for anvil insertion and (48.1 ± 12.8)min for digestive tract reconstruction,which were significantly shorter than those in control group (P ＜ 0.05).The mean time of getting out of bed in observation group was (3.4 ± 0.8) d,the mean time of post-surgical eating was (8.0 ± 2.6) d,and the mean time of hospitalization was (10.8 ±3.3)d,which were all similar with those from the control group (P ＞0.05).Conclusion The reverse anvil insertion technique is a reliable strategy for laparoscopic esophagojejunostomy or esophagogastrostomy.

Objective To compare the effectiveness and safety of tranexamic acid and fibrin sealant in joint arthroplasty . Methods The literatures on the application of tranexamic acid and fibrin sealant in joint arthroplasty were retrieved from PubMed , Embase ,Cochrane Library ,CNKI and other internet databases .Two reviewers independently screened the literatures according to the inclusion and exclusion standard .The RevMan 5 .2 software was adopted to conduct the statistical analysis on the extracted da‐ta .Results Four randomized controlled trials(RCTs) and 2 retrospective experiments were included ,involving 449 patients .The meta analysis results showed that tranexamic acid and fibrin sealant had no statistically significant difference in total blood loss[MD= -192 .24 ,95% CI(-496 .16 ,111 .69) ,P=0 .22] and hemoglobin loss amount[MD= -0 .49 ,95% CI(-1 .19 ,0 .20) ,P=0 .16] , had statistically significant difference in the blood transfusion rate[OR=0 .30 ,95% CI(0 .18 ,0 .52) ,P<0 .01] ,and had no statisti‐cally significant difference in the postoperative complications[OR=1 .20 ,95% CI(0 .36 ,3 .99) ,P=0 .76] .Conclusion Tranexamic acid is more effective than fibrin sealant of controlling postoperative transfusion rate in joint arthroplasty .

The operation path, lymph node dissection and reconstruction of the alimentary tract are the three most technical difficulties of laparoscopy-assisted gastrectomy. The essential difference between laparoscopy-assisted gastrectomy and open gastrectomy is the operation path. Based on our clinical experience, we investigated reasonable paths for laparoscopyassisted gastrectomy. Patients were placed in a supine position with their legs apart, and the operator stood on the left side of the patient. Five trocars were placed in the abdominal wall in a curved line. The operation was carried out in the order of greater gastric curvature, the lower region of the pylorus and antrum,the upper region of the pancreas, omentum minus, cardia, and arcuate diaphragm. From May 2004 to April 2010, we successfully carried out 761 laparoscopy-assisted gastrectomies with satisfactory outcomes.

Objective To investigate the clinical value of a new anvil inserting method for esophagogastrostomy or esophagojejunostomy during laparoscopic radical proximal gastrectomy or radical total gastrectomy for gastric cancer.Methods The clinical data of 21 patients with gastric cancer who received laparoscopic radical proximal gastrectomy or radical total gastrectomy at the Southwest Hospital from March 2010 to February 2011 were retrospectively analyzed.Five trocars were inserted through the abdominal wall of the patients.After perigastric lymphadenectomy and mobilization of esophagus,an incision was made on the esophagus above the tumor,and then the anvil with drawn wire attached was inserted into the esophagus.An endo-cutter was applied to cut the esophagus adjacent to the incision left the drawn wire untouched,and then the stem of the anvil was pulled out by the drawn wire for laparoscopic anastomosis. Results The operations were successfully accomplished under the laparoscope with no conversion to open surgery.Fifteen patients received laparoscopic radical total gastrectomy and 6 received laparoscopic radical proximal gastrectomy. The mean operation time,volume of blood loss,time to off-bed activity,passage of flatus and postoperative duration of hospital stay were (257 ± 38) minutes,( 119 ± 32) ml,(2.5 ± 0.5 ) days,( 3.7 ± 0.8 ) days and (7.5 ± 2.6) days,respectively.No perioperative mortality,anastomotic bleeding or anastomotic fistula was detected.One patient was complicated with pulmonary infection + pleural effusion and was cured by conservative treatment; 1 was complicated with anastomotic stenosis which was alleviated by gastroscopic balloon dilation; 1 was complicated by incisional infection and was cured by medical treatment after drainage.No cancer cells were detected at the anastomotic ring or resection margin of the specimen.There were 4 patients with well-differentiated adenoma,8 with moderate-differentiated adenoma and 9 with poor-differentiated mucinous adenoma.There were 5 patients in stage Ⅰ,10 in stage Ⅱ and 6 in stage Ⅲ (UICC staging).Twenty-one patients were followed up for a mean period of (11 ±4) months (range,6-17 months ),no tumor recurrence or metastasis was detected. Conclusions The new technique for anvil insertion is safe,effective and easy for manipulation and learn.It offers a new approach for laparoscopic digestive tract reconstruction.

Advanced gastric cancer is usually dealt with D2 radical dissection. There are different opinions as to whether it is necessary to perform D3 radical lymphadenectomy.Some scholars thought that properly enlarged radical dissection can improve long-term outcomes for the treatment of advanced gastric cancer.In recent years,laparoscopic D1 and D2 radical dissection of gastric cancer could be carried out in many hospitals.However,the technique and related skills for performing D3 radical lymphadeneetomy through laparoscope remains to be explored.Based on our previous experiences,D3 radical lymphadeneetomy using artery suspension method and medial-to-lateral approach for advanced gastric cancer is proved to be safe and feasihle.

ObjectiveTo evaluate the feasibility, safety and the long-termoutcomes of laparoscopy-assisted distal gastrectomy (LADG) for advanced gastric cancer (AGC).MethodsWe retrospectively analyzed the clinical and follow-up data of 346 cases after LADG from January 2004 to June 2009, compared with 313 cases after conventional open distal gastrectomy (ODG) for advanced gastric cancer at the same period at our hospital. The surgical safety, postoperative complications, survival rate, and the recurrence and metastasis of cancer were compared.ResultsThere was no significant difference at the average time of LADG and ODG procedures (211 ± 56) min vs.(204 ±41 ) min, but blood loss during operation and length of incision in LADG group were significantly less than in the ODG group. The proximal and distal length were, respectively, (6. 3 ± 2. 0) cm and (5. 7 ± 1.7 ) cm in LADG group and (6. 3 ±2. 1 ) cm and (5.6 ± 1.6) cm in ODG group, the difference was not significant. The number of lymph node dissections was also similar: (33 ± 13) in LADG group and (33 ± 16) in ODG group. The incidence of postoperative complications in LADG group was significantly lower than that in ODG group ( 6. 7％ vs.13. 1％, P ＜ 0. 05). During the follow-up period of 6-72 months (average 37 months), the 1-, 3-and 5-year survival rates were, respectively, 87. 2％, 57. 2％ and 50. 3％ in LADG group and 87. 1％, 54. 1％and 49. 2％ in ODG group, the difference was not significant. The differences in recurrence and metastasis between the two groups were not statistically significant.ConclsionLaparoscopy-assisted gastrectomy for advanced gastric cancer is not significantly different with open surgery in postoperative survival rate or recurrence. It is less traumatic and of fewer complications.