The discovery of an acquired mutation affecting the gene for janus kinase 2(JAK2 V617F)in a high proportion of patients with polycythaemia vera(PV)represents a major breakthrough in molecular understanding of the PV.This article will review the impact of the JAK2 mutation on the diagnosis and treatment of PV.

Objective To investigate the clinical efficacy of plastic surgery techniques for facial trauma emergency repair.Methods 36 patients with facial trauma were chosen as the research subjects ,all accepted the skin sutured,intradermal continuous suture and adjacent flap four kinds of plastic surgery in the treatment ,and the healing was observed after 6 month follow-up.Results 36 patients which were selected receiving orthopedic treatment tech-nology didn′t appear after infection,hematoma,and skin graft or flap necrosis and other phenomena ,after surgery wounds and wounds could heal .After 36 patients were followed up for 6 months,the following-up results for the intro-duction of the skin was sutured no scar ,skin and dermis sutured continuous suture had a small amount of scar near the flap dislocation-facial deformity and dysfunction;according to trauma treatment area and the reasons for judgment Ⅰhit stage repair of 35 cases,Ⅱ of repairing one case; treatment Ⅰ stage repair of 28 cases,Ⅱ stage repair eight cases,there were significant difference between before and after treatment (χ2 =4.64,4.75,all P <0.05). Conclusion Emergency repair facial trauma orthopedic surgical techniques used in facial trauma treatment can restore function well ,the treatment effect is good ,which is worthy of clinical further promotion .

Objective To understand the preventive medicine students' education demand and effectiveness evaluation to train handling skills of public health critical incidents, to analyze the education problems, and to look for countermeasures to meet the demand for the talents. Methods The investigation was conducted in 105 students of preventive medicine major from two universities whose questionnaire included the handling public health critical incidents knowledge, public health critical incidents knowledge demand, education evaluation and so on. Results All the students believed that it was essential to handle knowledge of public health critical incidents. 78.1 percent of students believed that it was important to master knowledge of public health critical incidents for improving their competitiveness. 84.8 percent of students thought it inadequate to have textbook knowledge only. 75.2 percent of students held the professional training should be strengthened. Conclusions The current education programs are unable to meet the students' demand for knowledge on handling public health critical incidents and lack the relevant contents. The education organizations are supposed to reform preventive medicine education model, to increase the content of courses, and to prolong training duration. The pertinent knowledge of public health critical incidents should also be integrated into the training programs for students.

Objective To discuss surgical techniques of laparoscopic treatment for intrahepatic stones.Methods A total of 57 cases of intrahepatic stones from March 2000 to March 2005 were studied. Under laparoscopic visualization,openings of left and right hepatic bile ducts were exposed through a longitudinal incision in the common hepatic duct to the bifurcation of left and right hepatic ducts.Stones in left and right hepatic bile ducts were evacuated with the use of a lithotomy forceps,a tiny basket,or pressure irrigation.Then openings of secondary hepatic ducts were exposed through the dilated primary ducts for the removal of stones in secondary hepatic ducts.Sometimes even openings of tertiary hepatic ducts could be seen for stone removal.When mud-or sand-like calculi were encountered,repeated irrigation of bile ducts was carried out.Results Conversions to open surgery were required in 3 cases(3/57,5.3%).The time of operation was 75～275 min(136?54 min).Residual stones were found in 49 cases(49/57,86.0%),which required postoperative choledochoscopy for 1~4 times to clear the intrahepatic stones.Complete clearance of all intrahepatic stones was achieved in 53 cases(53/57,93.0%).In 2 cases of calculi impacted in the lower common bile duct,laparoscopic electrohydraulic lithotripsy was performed for stone extraction.Postoperative bile leakage occurred in 5 cases(5/57,8.8%),and was cured with tube drainage.Follow-up observations for 0.5~5 years(2.3+1.5 years) in 43 cases showed excellent outcomes in 38 cases(88.4%),good outcomes in 3 cases(7.0%),and poor in 2(4.6%).Conclusions Intrahepatic stones can be removed laparoscopically through a longitudinal incision in the common hepatic duct to the bifurcation of left and right hepatic ducts for the exposure of primary and secondary hepatic ducts,or even tertiary hepatic ducts.

Objective To assess the effect of transitional empowerment education on the quality of life of patients with inflammatory bowel disease (IBD) and to analyze the factors affecting the quality of life, so as to pro-vide clinicians with information on effective intervention strategy. Methods From January 2015 to June 2016, 155 IBD patients were randomly divided into traditional care group (n=78) and transitional empowerment educa-tion group (n=77). The patients in the traditional care group received clinic outpatient follow-up, and the patients in the transitional empowerment education group received follow-up led by IBD management team. IBD patients in the two groups were investigated with self-management ability questionnaire, self-efficacy scale, and quality of life questionnaire before discharge and the six month after intervention. Results After the sixth month, the total scores on self-management ability (t=7.219, P=0.000), self-efficacy (t=2.845, P=0.005) and quality of life (t=7.705, P=0.000) in the transitional empowerment education group were higher than those of the traditional care group. Conclusion The transitional empowerment education can improve self-management ability, self-efficacy, quality of life of IBD patients.

Cellular immunotherapy such as that.initiated by dendritic cell (DC) is capable of eradicating cancer stem cells and restoring the homeostasis imbalance,and therefore has emerged as a promising approach to cure tumor.The first therapeutic DC vaccine in world has been approved by American FDA.However,the satisfactory therapeutic benefits of DC vaccine observed in vitro and in vivo (animal) studies could barely be recapitulated in clinical settings.The advantages of DC immunotherapy,achievements and challenges are introduced.

Obiective To study the clinical characteristics and therapeutic measures of the antibiotic associated diarrhea (AAD) in children with severe bacterial pneumonia. Methods The information of antibiotic use history in children with severe bacterial pneumonia from January 2013 to June 2013 was retrospectively analyzed. Results The incidence rate of AAD was 70.59%in children with severe bacterial pneumonia. According to the frequency, the third-generation cephalosporins, penicillin and carbapenems were the major causes of AAD. The percentage of the age≤3 y, the duration of antibiotic usage>7 d and the number of antibiotics≥2 were significantly higher in AAD children than in non-AAD children (χ2=89.81~119.45, P<0.001). All the patients were improved after cessation or change of antibiotics. Conclusions The incidence of AAD in children with severe bacterial pneumonia is high, which is related to the age, the duration of antibiotic usage and the combination use of antibiotics.

Objective To investigate the effect of dendritic cells(DC)pulsed with tumor lysate antigens of K562/A02 co-cultured with cytokine induced killer(CIK)cells on cytotoxicity against multidrug resistant(MDR)leukemia K562/A02 cells with high expression of p-glycoprotein(P-gp).Methods Bone marrow mononuclear cells isolated from healthy adult donors were induced to obtain CIK cells and DC respectively and then CIK were co-cultured with DCs which were pulsed with tumor lysate.The morphologic features were observed with optical microscopy and expressions of markers typical were measured using flow cytometry.The cytotoxicity of three effect cells was measured with MTT assay respectively.Results After pulsing DCs with tumor lysate antigens co-cultured CIK or DC-CIK led to a significant increase of lymphocyte proliferation of both populations.The cytotoxicity of CIK co-culturing with DCs pulsed with tumor lysate antigens to K562/A02 and K562 cells was(42.90?0.67)%、(49.85?0.28)%(63.36?0.46)% and(23.56 ?0.43)%、(26.11?0.34)%、(34.46?0.35)% respectively at an effector-to-target ratio of(5∶1、 10∶1 、20∶1).Conclusion This study indicates that DC pulsed with tumor lysate antigens co-cultured with CIK can improve lymphocyte proliferation and enhance the cytotoxic activity.Especially,it can induce a P-gp specific anti-leukemic immune.

Objective To observe caesalpinia sappan aqueous extract's growth inhibiting and apoptosis inducing effects on human ovarian cancer cell line SKOV3. Methods Cell growth inhibiting effect was detected by cytometry; Examined were by trypan blue staining under a light microscope; Electronic microscopy was used to observe ultrastructure of SKOV3 cell affected by caesalpinia sappan aqueous extract's;With different concentration of caesalpinia sappan aqueous extract's acting on cells, cells cycle and apoptosis rate were analyzed by flow cytometry (FCM). Results The growth of SKOV3 was inhibited effectively by caesalpinia sappan aqueous extract's; typical morphology of apoptosis (cell shrinkage, chromatin condensation and apoptotic body formation) were observed and in a concentration-dependent manner. Flow cytometry detection showed: the experiment in vitro revealed growth of SKOV3 after treatment by caesalpinia sappan aqueous extract's at the different concentration. Apoptosis rate was increased with the increasing of the concentration of caesalpinia sappan aqueous extract's. Conclusion Caesalpinia sappan aqueous extract's can obviously inhibit growth of human ovarian cancer cell line SKOV3 and induce its apoptosis.

Four cases of rejection reactions after acupoint embedding with chromic catgut as well as the diagnosis and treatment course were reported to reveal the importance of rejection reaction and its generality. Besides, the cause and mechanism were discussed. By combining the treatment experience, it was recommended to replace the catgut with third-generation absorbable medical suture, which could prompt execution of standardized manipulation of acupoint embedding.
Acupuncture Points ; Acupuncture Therapy ; adverse effects ; instrumentation ; Adult ; Catgut ; adverse effects ; Female ; Humans ; Obesity ; therapy