Drugs and symptomatic and supportive treatment are still the main treatment in the primary myelofibrosis (PMF),but they can only improve symptoms without the natural course change of PMF.Hematopoietic stem cell transplantation (HSCT) is the only curable means to PMF,however,serious transplantrelated complications limit its extensive application in PMF patients.In this paper,donor selection process,pretreatment,successful transplantation factors and other factors on HSCT in PMF patients will be reviewed.

Although the efficacy of tyrosine kinase inhibitor (TKI) for the treatment of chronic myeloid leukemia (CML) is obvious, the drug resistance is still inevitable, therefore, TKI drug resistance has become one of the reasons for the failure treatment of CML. According to the literature, about 5 % patients have primary resistance to TKI, and 20 %-30 % patients have secondary resistance to TKI. Current TKI drug resistance molecular mechanisms include the over-expression of bcr-abl, gene mutation, defect of DNA repair mechanism, medicine excretion mediated by ATP-binding cassette translocator, abnormal signaling pathway and bone marrow microenvironment. Meanwhile, the occurrence of drugs, based on the drug resistance mechanism development in preclinical or clinic investigation stage, are likely to provide the possibility for the overcoming of TKI drug resistance. This paper will review the progress of molecular mechanism of TKI drug resistance and the therapy strategy after drug resistance.

Epstein-Barr virus (EBV) related post-transplant lymphoproliferative diseases (EBV-PTLD) is a rare and deadly complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical manifestations often show the unexplained fever, swollen lymph nodes, hepatosplenomegaly, pharyngitis, and central nervous system symptoms, with rapid disease progression and high fatality rate. As allo-HSCT for treatment of complex and refractory hemopathy has made a great progress, the prevention of graft versus host disease (GVHD) requires more application of immune inhibitors, resulting in an increasing incidence rate of PTLD. In addition to conventional treatments, such as antiviral therapy, reduction of immune suppression , local surgery and traditional chemotherapy, monoclonal antibodies and adoptive immunotherapy with T-cells for treatment of PTLD have brought a profound influence. This paper reviews the latest progress of treatment of EBV-PTLD.

Eighty-eight patients with obstructive sleep apnea hyperpnoea syndrome (OSHAS) were assigned to the mild (n =21 ), moderate (n =30), or severe group (n =37) according to apnea-hypopnea index( AHI ). Twenty-five healthy individuals were selected as normal controls. Color Doppler ultrasonography was used to measure the intimae-media thickness of the carotid coteries and the occurrence of sclerosis plagues. Our data found that increased severity of OSHAS led to the elevated intimae-media thickness of the carotid coteries and more sclerosis plagues, which suggests OSHAS may influence the development of the carotid artery arthrosclerosis.

Tumor markers have been of vital importance in cancer diagnosis and treatment.However,the sensitivity of tumor markers for early diagnosis is low and can not be widely used.Quantum dots are new fluorescent nanoparticles with unique photophysical and chemical properties,thus having a great potential impact on cancer pathogenesis,early diagnosis,targeted therapy,prognosis and monitoring by combining with tumor marker.The current research is focused on the detection of specific tumor markers or molecules based on tangible carriers such as cells and tissues.One of the most promising clinical applications would be to explore the potential of this highly sensitive labeling technique for the detecting and imagining of tumor markers in serum and other body fluids,where some progress has already been made recently.How to detect early cancer based solely on invisible carriers would be the next step of quantum dots bio-probes in clinical use,so as to develop a new detection technique with greater sensitivity,specificity,rapidity and convenience.

Objective To understand information of initial sexual behavior age of females in Linxiang district of Yunnan province and investigate HPV and HPV vaccine awareness of rural women ,health workers and government staff .Methods During Decem-ber 2009 to December 2010 ,750 cases aged from 15 to 59 years included rural women ,government officials and medical staff in Linxiang district were randomly selected and investigated .Results The age of first sex was (22 .4 ± 2 .3) years old .The number of sexual partners was (1 .2 ± 0 .3) and proportion of premarital sex was low (8 .8% ) .HPV vaccine awareness of rural women was 8 .59% .The proportion of people who knew HPV vaccine could prevent cervical cancer was 6 .57% .The proportion of people who wanted to be vaccinated was 97 .66% .The cost of HPV vaccine which rural women could accept was 300 yuan .Conclusion Women in Linxiang area of Yunnan province have less premarital sex and lack of awareness in HPV .

Objective To evaluate the value of PET/CT in preoperative assessment and postoperative monitoring of ovarian cancer. Methods A retrospective analysis was conducted in 45 patients of ovarian neoplasm with clinical records underwent 18F-FDG PET/CT, including 10 patients underwent PET/CT before surgery and 35 patients after surgery. The clinical follow-up time was 6 months at least. The diagnosis based on pathology and clinical follow-up data. Results (1) The sensitivity, specificity and accuracy of PET/CT in detecting ovarian cancer were 94.6%,75.0%and 91.1%, respectively. (2) Ten patients before surgery were all detected tumor by PET/CT, but 2 of them were false positive based on pathologic results. (3) Two patients with non-standard surgery were detected tumor by PET/CT. In 33 patients after standard surgery, 6 patients were no tumor detected by PET/CT. In addition,4 patients with normal CA125 and no signs of recurrence and metastasis were detected tumor by PET/CT. The pathology and clinical follow-up data supported the results. 23 patients with higher CA125 were diagnosed recurrence and metastasis based on pathology and clinical follow-up data, 21 of them were detected tumor by PET/CT. Conclusion 18F-FDG PET/CT plays an important role in preoperative assessment, early diagnosis and accurate positioning of recurrent and metastasis of ovarian cancer. It can be used to guide the clinical treatment.

AIM: To observe the difference of actions among three traditional compl ex prescriptions with the same composition but the different dosage, including X iaochengqi Decoction, Houpudahuang Decoction and Houpusanwu Decoction, so as to provide evidence for their different clinical applications. METHODS: A series of experiments were performed, including carbon p rop ellance in small intestine, black stool excretion, cough induced by ammonia liqu or and phenol red secretion from trachea. RESULTS: Three prescriptions all enhanced carbon propellance in sma ll intestine at the high dosage, while at the low dosage only Houpusanwu Decoct ion showed the significant effect. They all shortened the latency of black stool a nd increased their total amounts in 6 hours at the high dosage, while at the low dosage Xiaochengqi Decoction and Houpudahuang Decoction had the significant p urgative action. Houpudahuang Decoction remarkably prolonged cough latency, dec reased cough times and enhanced phenol red secretion from trachea, while other t wo prescriptions had no obvious effects. CONCLUSION: Such results showed that Xiaochengqi Decoction had the better purgative action, while Houpusanwu Decoction regulated Qi strongerly, a nd Houpudanghuang Decoction showed the marked actions of relieving cough and re solving phlegm.

Objective To detect mutations of p53 gene 2-4 exons from peripheral blood and to explore their relevance in HPV16-positive cervical cancer susceptibility and clinical significance. Methods Collected firstly cases from the Third Affiliated Hospital of Kunming Medical University from October 2012 to April 2014, included 167 cases HPV16-postive cervical cancer and 160 cases HPV-negative healthy women. Genomic DNA from the host peripheral venous blood was taken, mutations of p53 gene 2-4 exons were analyzed with software DNAstar after PCR and bidirectional sequencing. Meanwhile,mutations of p53 gene 2-4 exons among different clinicopathological characteristics in HPV16-postive cervical cancer were distinguished. Results (1)Three mutations and an 16-bp insertion/deletion sequences were found in p53 gene exons 2-4, included C/G mutation of single nucleotide polymorphism(SNP)11827 in intron2, A/C mutation of SNP11992 in intron3, C/G mutation in codon 72 (rs1042522) of exon4 and 16-bp(acctggagggctgggg) repeat insertion or deletion in intron3 (rs17878362), while deletion recorded as A1, insertion recorded as A2. No significant differences were found in each point allele and genotype frequency(P＞0.05). (2) Stratified analysis for cervical cancer group resulted with some differences. Compared group of non-squamous carcinoma with squamous carcinoma group, there were obviously decreased in allete A2 [11.8%(4/34) vs 3.5%(10/284); χ2=4.90,P=0.027], genotype A1A2 [4/17 vs 7.0%(10/142); χ2=5.14,P=0.023], and haplotype C-A2 [11.8%(4/34)vs 3.5%(10/284);χ2=4.91,P=0.027]. Compared with poorly differentiated group,allele C of SNP11827 and rs1042522 were obviously decreased in medium high differentiation group [50.8%(61/120)vs 38.8%(62/160);χ2=4.07,P=0.044], while haplotype G-A1 were apparently higher [49.2%(59/120)vs 61.2%(98/160);χ2=4.07,P=0.044], genotype GG of SNP11827 and rs1042522 were obviously decreased in superficial myometrial invasion depth group than that in deep myometrial invasion depth group [46.3%(25/54) vs 21.1%(8/38); χ2=7.06,P=0.029]. No significant differences were found between stage Ⅰ and Ⅱ, pelvic lymph node metastasis or not (all P＞0.05). Conclusions No obvious correlation is found between polymorphisms in exons 2-4 of p53 gene and susceptibility of HPV16-postive cervical cancer. But the patient with allete C and A2, genotype GG and A1A2, haplotype C-A2 and G-A1 may be increase risk of poorly differentiation, deep muscular invasion and bad pathological type. Analysis of p53 gene polymorphism may be provide a basis for the prognosis evaluation and individualized treatment of cervical cancer.

Objective To measure the effect of one-stage transplantation of reverse-flow vascular pedicle fibular grafts in treatment of infected nonunion of the distal tibia.Methods From January 2001 to December 2012,23 patients sustaining the infected nonunion of the distal tibia were transplanted with reverse-flow vascular pedicled fibular grafts in one-stage.There were 13 males and 10 females,aged 26 to 59 years (mean,38.7 years).Tibial nounion based on the Jain-Sinha classification was rated as Type A in 6 patients and Type B in 17 patients.After the operation,the patients received 2-3 weeks of intravenous antibiotic treatment and then 4-week oral antibiotic therapy.Wound healing,limb and ankle joint fucntion and outcomes in fibular transplantation were observed.Results Duration of follow-up was 16-46 months (mean,28.6 months).There were no exudates and ulcerations of the skins.Smooth healing was achieved in all the patients except that fibular fracture was noted in one patient healed after cast immobilization.Healing time ranged from 12 to 28 weeks (mean,15.6 weeks).Limb function evaluated with Ennecking system had (87 ± 11) ％ restoration.According the Olerud-Molander scoring system,ankle function was excellent in 16 patients and good in 7 patients,with the excellent-good rate of 100％.Conclusion One-stage reverse-flow vascular pedicle fibular grafting is an optional procedure for treatment of infected nonunion of the distal tibia,due to the technique is easy and effective.