Clonal progression to myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) remains a dreaded complication for a subset of patients with bone marrow failure (BMF). Recognizing risk factors for the development of MDS or AML would inform individualized treatment decisions and identify patients who may benefit from early or upfront hematopoietic stem cell transplantation. Now that next-generation DNA sequencing is available in the clinical laboratory, research has focused on the implications of germline and somatic mutations for diagnosing and monitoring patients with BMF. Most germline genetic BMF disorders are characterized by a high propensity to develop MDS or AML. Recent studies of somatic variants in marrow failure revealed a high frequency of clonal hematopoiesis with the acquisition of mutations in genes associated with MDS or AML. The evaluation and implications of germline and somatic mutations for the development of clonal disorders in patients with BMF and challenges of clinical genetic testing will be summarized in this paper based on the reports from the 58th American Society of Hematology (ASH) Annual Meeting.

OBJECTIVE: To evaluate three therapeutic schemes for sudden deafness with cost-effectiveness analysis for guiding rational use of drugs. METHODS:Using pharmacoeconomic cost-effectiveness analysis to evaluate 61 patients with 62ears of sudden deafness treated by Salvia Miltiorrhiza(groups A), Salvia Miltiorrhiza and cerebroprotein hydrolysate(groups B) or cerebroprotein hydrolysate(groups C) . RESULTS: The effective rates of three groups were 73.9%, 75.0% and 80.0% respectively without significant difference among them(P ＞ 0.05) . The average drug costs for one patient in three groups were 617.89 yuan, 2 651.29 yuan and 2 647.99 yuan respectively. The costs for 1% increase of effective rate in three groups were 8.36 yuan, 35.35 yuan and 33.10 yuan respectively. CONCLUSION: Salvia Miltiorrhiza scheme is the most rational one for sudden deafness.

ObjectiveTo explore the efficacy of large trauma craniotomy with bilateral frontal coronal incision in treating contusion and laceration of bilateral frontal lobes.MethodsThe clinical data of 68 patients with contusion and laceration of bilateral frontal lobes who were treated with bilateral decompressive craniectomy were analyzed retrospectively.There were 36 cases(observation group) treated with large trauma craniotomy with bilateral frontal coronal incision and 32 cases (control group) given bilateral decompressive craniectomy by stages.The prognosis of two groups were observed and compared.The prognosis was evaluated at 6 months after surgery by Glasgow outcome scale (GOS) score.ResultsThere were 23 cases (63.89％,23/36) who got good recovery,8 cases(22.22％,8/36) with poor prognosis and 5 dead cases (13.89％,5/36) in observation group.There were 11 cases (34.38％,11/32) who got good recovery,9 cases (28.12％,9/32) with poor prognosis and 12 dead cases (37.50％,12/32) in control group.The rate of good recovery and mortality between two groups had significant differences (P ＜ 0.05).ConclusionsThe large trauma craniotomy with bilateral frontal coronal incision can significantly relieve or ease intracranial hypertension of patients with contusion and laceration of bilateral frontal lobes.And it can improve the prognosis and decrease the mortality.

Anti-neutrophil cytoplasmic antibodies( ANCA)-associated vasculitis ( AAV) has various clinical symptoms, thus various treatment schemes were used in clinics.To date, there has been no validated diagnostic criteria or treatment guideline for AAV.There are three aspects to be considered when assessing the treatment with AAV patients:staging of disease, distinction between disease activity and chronic damages, and quality of life ( QOL) .This review focuses on the latest classification of vasculitis, the rela-tion between disease stages and its severity, the importance of distinguishing active diseases from permanent damages, the therapeutic choices and the management of complications.

Objective Abdominal pain, shoulder pain, and incision pain after laparoscopic cholecystectomy ( LC) are com-mon complaints of the patients.This study was to observe the effects of pulmonary recruitment ( PR) in reducing post-LC abdominal pain, shoulder pain, and incision pain. Methods A total of 138 patients treated by LC were randomly assigned to a PR ( n=67) and a control group (n=71).The former underwent postoperatively five 5-second-long manual inflations of the lungs by positive pres-sure ventilation with 40 cmH2 O to discharge CO2 from the abdominal cavity, while the latter received traditional passive deflation of CO2 .At 6, 12, 24, and 48 h after surgery, we recorded the incidences of abdominal pain, shoulder pain, and incision pain and as-sessed the pain intensity using the visual analogue scale ( VAS) . Results Compared with the control group at 12 and 24 h after sur-gery, the PR group showed significant decreases in the incidence rate of upper abdominal pain (90.14%vs 74.63%and 91.55%vs 73.13%, both P<0.05), with VAS scores of 4.32 ±2.73 vs 2.72 ±1.67 and 4.04 ±2.55 vs 2.67 ±1.49 (both P<0.05), as well as in that of shoulder pain (56.34% vs 47.76% and 74.65% vs 56.72%, both P<0.05), with VAS scores of 3.68 ±3.10 vs2.61 ±1.97 and 4.15 ±3.23 vs 2.78 ±1.88, both P <0.05). However, no significant differences were observed in the incidence or severity of incision pain between two groups at any time points after surgery (P>0.05). Conclusion Pulmonary recruitment can re-duce the incidence rates and severity of upper abdominal pain and shoulder pain, but has no effect in alleviating incision pain following laparoscopic cholecystectomy.

Objective To discuss treatments of femoral intertrochanteric fractures by external fixators which can prevent complications caused by lying in bed for long periods after operation. Methods After proper closed reduction had the fragments maintained in good position, the fracture was fixed by external fixators through closed pinning under the roentgenoscopy. After the operation the patients with femoral intertrochanteric fractures could conduct early exercises to recover the functions of the fractured limb. Results Compared with traction or inner fixation, this method to treat femoral intertrochanteric fractures showed significant superiority in trauma, healing time, expenditure, functional recovery and complications for the majority of the patients. Conclusion The external fixators are recommendable for patients with femoral intertrochanteric fractures when their bone matrix and physical conditions are good enough.

The application of Field Programmable Gate Array (FPGA) to the elimina tion of 50Hz noise in physiological signal, such as ECG signal, is discussed in this article. The high speed and flexibility are acquired because of FPGA's app lication, which give the system the ability to acquire and process multi bio-par ameters.

Hardy-Weinberg equilibrium test is the base of genetic epidemiology. The new methods for Hardy-Weinberg equilibrium test involve: X chromosome-linked single nucleotide polymorphism Hardy-Weinberg test, inbreeding coefficient(F) test, an incomplete enumeration algorithm for an exact test of Hardy-Weinberg proportions with multiple alleles, and graphical tests for Hardy-Weinberg equilibrium based on the ternary plot. It is necessary to conduct Hardy-Weinberg equilibrium test in genetic epidemiology studies and adjust the associations as deviation of Hardy-Weinberg equilibrium occurs.

The striatum is involved in diverse behaviors which depend on intact dopaminergic innervation. Recent electrophysiological studies have revealed that dopamine alters both voltage dependent conductances and synaptic transmission, resulting in state dependent modulation of target cells. This review makes clear predictions about how dopamine should alter the responsiveness of striatal neurons to extrinsic excitatory synaptic activity.

Objective To investigate the relationship between hypervariable regionsⅠ(HVRⅠ) mutation of mitochondrial DNA (mtDNA) and lung squamous carcinoma and to explore its significance in carcinogenesis. Methods White blood cells and carcinoma tissues were obtained from 13 cases of lung squamous carcinoma patients and mtDNA were extracted by one step method. HVRⅠfragments were amplified by PCR. Mutations were determined by DNA sequencing. Results In 13 lung squamous carcinoma patients, 8 cases showed mutation in HVR Ⅰ, and 30 mutations were found in 25 different nucleotide sites, in which 17 were point mutations and 13 were insertions and deletions, including a 10-bp deletion in one patient. Conclusion These results suggest that the mutation rate of HVRⅠsequence in lung squamous carcinoma tissue was relatively high, and point mutation might play an important role in lung carcinogenesis.