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.

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 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.

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.

SUMMARY The male patient reported here presented as gangrene and central diabetes insipidus ( CDI) , who had characteristics of vasculitis. The patient complained about polydipsia and polyuria half a year ago, and then developed tingling, pain and blackish discoloration of some fingers and toes 3 month ago. He also had Raynaud' s phenomenon. After admission, his laboratory examination showed the rise of erythrocyte sedimentation rate, C-reactive protein, immunoglobulin,β2-glycoproteinⅠand the activi-ty of rheumatoid factors, lupus anticoagulant test. his pituitary gland showed loss of posterior signal on magnetic resonance imaging. In addition, his vasopressin test was active. However, there was no suffi-cient evidence to diagnose any specific disease;as a consequence the patient was diagnosed as idiopathic systemic necrotizing vasculitis ( SNV) . For SNV, the patient was treated with glucocorticoid 40 mg/d and impact therapy of cyclophosphamide 0. 4 g every 2 weeks. He also received symptomatic treatment for gangrene and CDI. Cutaneous involvement leading to gangrene was widely reported in SNV, however pi-tuitary involvement in SNV leading to CDI was rare. The prognosis of this patient was poor.

The elderly patients with diabetes often have a high prevalence of hypertension.Meanwhile,hypertension is a major vascular risk factor in this population.The benefit of proper management of hypertension in elderly patients with diabetes has been well recognized.According to the IDF Global Guideline for Managing Old People with Type 2 Diabetes,lifestyle interventions are recommended to form the first step in managing hypertension in elderly patients with diabetes.Pharmacological therapy should be initiated in addition to lifestyle interventions after 6 weeks during which non-pharmacological therapy has failed to achieve blood pressure targets.ACE-inhibitors are the first choice for initial medication,especially in the presence of diabetic nephropathy.ARBs can be used in people who cannot tolerate ACE-inhibitors.Diuretics or calcium channel blockers can be used as the first add-on therapy to ACE-inhibitors or ARBs if they fail to achieve target blood pressure.β-blockers should be considered for combination therapy in people with tachycardia or coronary artery disease.The generally recommended blood pressure target for older people with diabetes should be less than 140/90 mmHg(1 mmHg=0.133 kPa).

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.

Objective To develop a method to determine molybdenum in radix puerariae and the soil. Methods A method for determination of trace molybdenum in radix puerariae and the soil where it growth by single sweep polarography has been used. Results The linear range was 0.010-1.0 ?g/ml, r=0.999 0, the detection limit was 6.0?10-3 ?g/ml, the recovery rates were 98.0%～106.0%, RSD was 2.2%-4.8%. Conclusion This method is suitable for the determination of molybdenum in radix puerariae and the soil. The content of Mo in radix puerariae is related to that in the soil.