The myelodysplastic syndrome (MDS) is a clonal disorder characterized by inefficient haematopoiesis,dysplasia of hematopoietic cells in bone marrow and unable production of mature cells with normal differentiation resulting in peripheral cytopenias.The incidence of MDS is increased with the increasing age,suggesting that the accumulation of genetic or epigenetic changes lead to DNA mutations in hematopoietic stem cell,activation of oncogenes and inactivation of tumor suppressor genes,increasing limitless self-proliferation,and eventually resulting in aberrant clonal hematopoiesis and the occurrence of MDS.About thirty percentage of patients with MDS will transform into acute myeloid leukemia (AML) at last.MDS is always not sensitive to cytotoxic drugs,but targeted drugs maybe help to improve the prognosis.

JAK2 V617F gene mutation positive myeloproliferative neoplasms (MPN) consists of polycythemia vera (PV),essential thrombocythemia (ET) and primary myelofibrosis (PMF).This article focuses on their risk scoring systems and treatment including first-and second-line therapies,JAK2 inhibitors,cytoreduction,antifibrosis and other single-agent or combination therapy.

In order to enhance the students’knowledge of clinical medicine and lay the foundation for using clinical medicine,we adjusted the content and compiled pharmacognosy teaching materials,aiming at its professional features of clinical pharmacy of Xuzhou Medical College.The pharmacognosy teaching material has been applied in several rounds.Feedback from students suggested that using this teaching material was well-targeted,clear and practical.

Objective To study the relationship between the changes of ten elemental contents in serum and schizophrenia.Methods Calcium (Ca), magnesium (Mg), zinc (Zn), iron (Fe), aluminum (Al), arsenic (As), selenium (Se), copper (Cu), lead (Pb), manganese (Mn) in serum in the of schizophrenic patients and normal subjects are measured by inductively coupled plasma mass spectrometer and inductively coupled plasma emission spectrometer, compared the content of elements between the schizophrenia and normal.Results There were significant differences ( P<0.05) in other elements between two groups except lead.The contents of Ca,Fe,Mg,Zn,As,Se,Cu in the patients with schizophrenia were significantly lower than those in control, while Al, Mn were significantly higher than those in control.Most of elements in serum between case and control groups were correlated (P<0.05).Some of element ratios which have physiological significance were significant statistically (P<0.05), such as: Ca/Mg, Ca/Fe and so on.Conclusion These findings suggest that the patients with schizophrenia might have an abnormal elemental metabolism.Given the relationship among the elements, the element ratios are more valuable in reflecting the relationship between schizophrenia and elements.

Objective To explore the expression of cadherin (Cad) genes in patients with chronic myeloid leukemia (CML),and to elucidate the significance of Cad genes in the development of CML.Methods E-Cad and N-Cad gene expression levels in bone marrow mononuclear cells (BM-MNC) from 48 CML patients (29 in chronic phase,19 in progressive phase) were detected by real time quantitative polymerase chain reaction (qRT-PCR).Results Gene expression of E-Cad and N-Cad was detectable in CML BM-MNC.E-Cad gene expression level was lower in progressive CML than that in chronic CML (0.20 ± 0.35 vs 1.19 ± 0.87,P ＜ 0.01),while N-Cad was highly expressed in progressive CML than in chronic CML (0.89 ± 0.45 vs 0.57 ± 0.47,P ＜ 0.05).E-Cad gene expression level was negatively corrclatcd with thc pcrccntagc of peripheral blood progenitor cells (r =-0.705,P ＜ 0.01).Conclusion E-Cad and N-Cad gene expression correlates with the progression of CML,and might be used as an evaluation index for disease development.

Objective To analyze the role of hDOT1L signaling pathway on the proliferation of human acute monocytic leukemia cell line THP-1 cell inhibited by demcitabine, and to explore the other effects except DNA demethylation and the mechanism of hDOT1L signaling pathways involved in leukemia. Methods Methyl thiazolyl tetrazolium (MTT) method was used to detect the influence of decitabine on THP-1 cell proliferation, and trypan blue anti-staining was applied to detect the effect of decitabine on THP-1 cell survival rate, reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect the expression levels of hDOT1L, HOXA9, HOXA10, MLL-AF10 (MLLT10) mRNA, then the methylation level of H3K79 was detected by Western blotting assay. Results Compared with the control group, decitabine inhibited the proliferation of THP-1 cell in a time and dose-dependent manner. The inhibitory effect of 72 h was the highest, and the highest inhibition rate was 56.18%. In addition to 0.5 μmol/L in decitabine treatment group, the other groups were statistically significant (all P<0.05). There were high expressions of hDOT1L, HOXA9, HOXA10, MLLT10 mRNA and H3K79 hypermethylation in the THP-1 cell, meanwhile decitabine reduced the levels of hDOT1L mRNA after 48 h as well as HOXA9, HOXA10, MLLT10 mRNA, and there was a significant difference compared with the control group (all P < 0.01). Decitabine reduced obviously the methylation of H3K79 in cell after 48 h, especially the expression levels of bis and three methyl protein, and these differences were significant compared with the control group (all P< 0.01). Conclusion Decitabine plays its inhibitory effect on the proliferation of THP-1 cells probably through reducing the expression level of hDOT1L and H3K79 methylation level and decreasing the expression levels of key molecules, HOXA9, MLL-AF10, HOXA10, MLLT10 in the hDOT1L signal pathway.

Objective To investigate the relationship between alexithymia and event-related potential P300 in patients with somatoform disorders.Methods Forty-two patients aged 18 to 65 years fulfilling ICD-10 diagnosis criteria for somatoform disorders were recruited as experiment group.Forty normal healthy persons were selected as control group.The Toronto alexthymia scale-20 (TAS-20) was employed to investigate the alexithymia of the subjects.P300 potentials was employed to investigate the cognitive ability of the subjects.A comparison was made between the patients and the healthy subjects.Results The latencies of N1,P2,N2 and P3 were significantly longer in patients with somatoform disorder than those in the normal controls (P ＜ 0.05 or 0.01),the amplitudes of N2 and P3 were significantly lower in the patients (P ＜ 0.05 or 0.01).The three factors scores and the total score of TAS-20 test in patients with somatoform disorder were significantly lower than those in the normal controls (P ＜ 0.05 or 0.01).There was significant correlation between the latency and the three factors scores and the total score of TAS-20 as well as between the amplitude of P300 and the three factors scores and the total score of TAS-20:the latencies of N1,P2,N2 and P3 recorded at Pz was positively correlated with the factors scores (r =0.32 ～ 0.48,P ＜ 0.05 or 0.01),and the amplitudes of N1,P2,N2 and P3 recorded at Pz was negatively correlated with theTAS-20 scores (r=-0.31 ～-0.51,P＜0.05 or0.01).Conclusions There existed significant correlation between the alexithymia and cognitive impairment in patients with somatoform disorders.Both alexithymia and event-related potential P300 can be used as a clinical evaluation index for patients with somatoform disorder.

Objective To explore surgical options and clinical outcome of preperitoneal hernia repair (TAPP) and totally ext raperitoneal hernia repair (TEP) in inguinal hernia repair.Methods The clinical data of 302 patients underwent laparoscopic herniorrhaphy were retrospectively analyzed.Results None of patient s was changed to open operation.The TAPP and TEP outcome measures:the unilateral hernia surgery time from (31.2 ± 8.3) min and (55.3 ± 15.2) min,bilateral hernia surgery time was (46.2 ± 11.2)min and (80.2 ± 23.2) min; blood loss was (6.4 ± 2.0) ml and (7.2 ± 1.6) ml,bed activity for the first was (16.0 ± 1.8) h and (16.0 ± 1.5) h,hospital stay was (3.0 ±0.6) d and (3.1 ±0.8) d.Conclusions Laparoscope herniorrhaphy is safe due to lower recurrence and complications.It also has the advantages of slight pain and rapid recovery.

Objective To analyze cancer incidence and mortality in Fujian in 2012 and to provide sci-entific basis for tumor prevention .Methods In accordance with the methods and criteria of data quality control made by NCCR,7 regristries data qualified from 9 submitted regritries in Fujian after data assessment were mer-ged and analyzed.Results In 2012,the cancer incidence rate was 251.44/105 (308.44/105 in male and 193.03/105 in female),age standardized incidence by Chinese standard population (ASR China)and by world standard population(ASR world)were 205.15/105 and 201.11/105.The cumulative incidence(0~74 age)was 23.51%.The mortality rate was 161.85/105(220.87/105 in male and 101.37/105 in female).ASR China and ASR world were 128.54/105 and 127.70/105 the cumulative incidence(0~74 age)was 15.04%.The age-spe-cific incidence and mortality reached maximum value in 75 ages and 80 ages respectively .The top 5 cancer inci-dences were lung cancer ,stomach cancer ,liver cancer ,esophagus cancer and breast cancer .The top 5 cancer mor-tality were lung cancer ,liver cancer ,stomach cancer ,esophagus cancer and colorectum cancer .Conclusion Di-gestive malignancies ,lung cancer ,and breast cancer in female were the most frequent in Fujian province ,and the prevention and control for those cancers should be enhanced .

Human resources are the key to TCM development. This article explored the effective channels to construct the system by deeply studying and identifying problem of the quantity, quality, configuration, development and training of TCM human resources under the characteristic medical reform of Gansu Province to provide references for better research and plan of TCM human resources for relevant department, further to realize the sustabile development of TCM characteristic medical reform in Gansu Province.