Idiopathic thrombocytopenic purpura(ITP),which is the most common acquired hemorrhagic disease in childhood period,is also called immune thrombocytopenia because it is an immune-mediated disorder characterized by isolated thrombocytopehia.In recent years,the diagnosis and treatment of ITP has been dramatically improved,and some consensuses concerning the staging,symptom scoring,treatment indications and prognosis have been achieved.This article reviews the pathogenesis,epidemiology,symptom scoring,staging,grading of severity,treatment and prognosis evaluation of ITP in children.

Objective To discuss the influence of systematic nursing on cancer related fatigue and life quality of patients with breast cancer during perioperative period.Methods 197 patients in our hospital with breast cancer were randomly divided into the experimental group (99 cases)and the control group (98 cases)from November 2010 to December 2011.The experimental group was given systematic nursing method and the control group received traditional nursing.After treatment,the influence of nursing intervention on cancer related fatigue and QOL were compared between two groups.Results The score of QOL was(92.1±1.6)after nursing in the experimental group,higher than before systematic nursing and the control group.The severity of cancer related fatigue in the experimental group was apparently lower than before nursing intervention and that in the control group.There was significant difference.Conclusions The systematic nursing can reduce the level of perioperative cancer related fatigue and improve the life quality for the patients with breast cancer,so it can be widely used in clinic.

Specific fusion genes of leukemia are currently the main biomakers for minimal residual disease (MRD)monitoring. Recent studys have found that the WT1, PRAME, ERG genes may be the potential acute leukemia related molecules, and can be used to monitor acute myeloid leukemia's MRD, directing clinical stratified therapy and estimating prognosis. This article reviews the pathogenesis, incidence of these genes and the relationship to the clinical prognosis.

Objective:To study the clinical characteristics of retinoblastoma in children.Methods:To analyze the age,sexuality,symptom,the accompaniment of symptom and the diagnostic feature of 53 retinoblastoma cases.Results:The average diagnostic age was two years and three months.There was no obvious sex difference.The principal first symptom of 24 cases was leukocoria,11 cases was strabismus,8 cases was big cornea or muddy cornea,6 cases was exophthalmos,1 case was nystagmus,2 cases was anterior chamber bleeding,and 1 case with health examination.It was significantly higher in single eye(85%) than in both eyes(15%).Conclusion:More and more people recognize the importance of eye health care,and the average diagnostic age becomes younger.The principal first symptom remains "galeamaurosis".The clinical characteristics of retinoblastoma in children are diversified?concealed?puzzling and easy to make missed diagnosis.

Thioredoxin(TRx) is a kind of endogenous protein which widely distributes in prokaryotic and eukaryotic cells.It possesses two vicinal cysteine residues at the active site and therefore can provide strong reducing activity and catalyze the reduction of protein-protein disulfides effectively.In addition,TRx plays a vital role in regulating intracellular redox homeostasis.Recent studies showed that TRx is muhifunctional and has a protective effect on the occurrence and development of a variety of human diseases including ocular diseases,such as age-related cataract,choroidal neovascularization,retinal diseases and optic nerve diseases,etc..Many researchers assessed the protective effect of TRx on ocular diseases in recent years.The progress in the relationship of TRx with eye diseases was reviewed in this article.

Based on the main body's definition of philosophy,the article points out that patients are the main body of clinic activities.It also analyzes patients'main status in the performance of clinic activities and in the medical countermeasure.The concluson is that a harmonious relationship between doctors and patients should be composed from bi-main bodies characteristic of the clinic activities.

Objective To summarize and analyse the clinical data of death cases in the department of emergency internal medicine. Methods The clinical data of patients presenting at the department of emergency internal medicine from January 2005 to July 2010 were analyzed retrospectively. Results Among 13 211 patients of department of emergency internal medicine, 145 died. More cases died in winter( 32.0% , 39/122 ).More than half of deaths occurred within 6 hours after admission( 54.5% ,79/145 ). The top six death causes were sudden death, pulmonary infection, cerebrovascular accident, advanced cancer, gastrointestinal bleeding,cardiovascular diseases and the occurrence rates were 18. 6%, 13.8%, 13.8%, 10.3%, 9. 7% and 9.0%respectively. Conclusion The first three death causes in department of emergency internal medicine were sudden death, cerebrovascular accident, pulmonary infection. Prevention of these diseases, cooperation between emergency department and other departments and special training on standardized treatment of critically ill patients should be enhanced.

BACKGROUND:Rib fractures are frequently treated with analgesic or compression band,which relieves pain but attenuates respiration.Memory metal chest shield as a new product has been used clinically for patients with multiple rib fractures to alleviate the pain.It displays many advantages compared with traditional approaches OBJECTIVE:To compare the effect of the memory metal chest shield versus the traditional fixation for multiple rib fractures.METHODS:A total of 104 patients with multiple rib fractures confirmed by transthoracic X-ray were selected and randomly divided into control group(n=40)treated with the traditional fixation methods(chest strap or a thick pad)and experimental group(n=64)treated with memory metal chest shield.At 1,24,48,and 72 hours after admission,the visual analog scale(VAS)at rest and cough.the incidence of pulmonary complications,and hospitalization were recorded Of them,32 from the experimental and21 from the control group rccepted pulmonary function tests.and their vital capacity was recorded at 1,24,48,and 72 hours after treatment RESULTS AND CONCLUSION:Pain intensity of experimental group was reduced at rest,while significantly reduced in forced breathing(such as cough).Of the 32 patients with use of memory metal sheeting,vital capacity continuously increased during the observation period,but pulmonary complications were significantly less,and the average hospital stay was significantly less than the control group(P＜0.05).Results show that the memory metal shield displayed fixation effect on the area of broken ribs,which significantly reduced pain,increased lung capacity,reduced the incidence of pulmonary complications and shortened the average length of stay.It is a simple and effective method of treating multiple rib fractures .

Objective To analyze the existing problems in the management of outpatient, to change the traditional manage-ment mode and to provide convenience for outpatient medical care.Methods By adopting the establishment of outpatient manage-ment by walking -around team, making the inspection content and quality standards of walking -around management and implemen-ting three class patrol management, We realized the transformation of the traditional outpatient management mode .Results After im-plementing the management by walking around, outpatients'satisfaction were improved and complaints reduced.Conclusion Man-agement by walking around has great effect on meeting the medical needs of patients, improving the quality of clinic service, optimi-zing the management process, and improving the hospital's reputation.

Periprosthetic infection is one of catastrophic complications which appear anytime after joint arthroplasty. Resear?ches show that the patients′risk factors are the keys to affect prosthetic joint infection after primary hip and knee arthroplasty. The au?thor summarized new study progress about risk factors for prosthetic joint infection after primary hip and knee arthroplasty at home and abroad. To investigate risk factors for prosthetic joint infection, the condition were analyzed by investigator from the following three as?pects:the patients′features, comorbidity, and preoperative medication.