Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

Objective To observe the effect of HBO in the treatment of artery complications after liver transplantation.Method Five cases were treat by HBO(202.65 kpa,once every day,oxygen inhalation 60 min) and other therapies after operation.Result After HBO,the whole-body situations were obviously improved,liver functions were ameliorated,no new necrotic focuses were found,and the primary necrotic focuses were reduced or vanished.Conclusion HBO was an effective way to treat and prevent the artery complications after liver transplantation and protect the ischemic liver cells.

Great advances have been made in understanding the genesis,diagnosis,risk stratification and the targeted therapy of myeloproliferative neoplasms (MPNs) in the past decade.This article reviews the current situation in the genesis,diagnosis and risk stratification of these classic bcr-abl-negative MPNs presented in the 56th American Society of Hematology (ASH) annual meeting.

Primary myelofibrosis is a kind of chronic myeloproliferative neoplasms.The discovery of the JAK2V617F mutation as well as other molecular abnormlities underly the pathogenesis of Philadelphia negative myeloproliferative neoplasms (MPN).The initial description of JAK2V617F mutation in 2005,the reporting of calreticulin (CALR) mutations last year and the clinical application of JAK inhibitors,showed the gradually deepening understanding with regard to the pathogenesis and the development of therapeutic strategies for primary myelofibrosis (PMF).This article reviewed the progress in diagnosis,risk stratification of of PMF,the benefits and potential side effect of JAK inhibitors,which reported on the 2014 European Hematology Association annual congress.

Objective To investigate the clinical features,treatment and prognosis of paraneoplastic pemphigus (PNP).Methods A retrospective study was performed on 11 patients with PNP hospitalized in the Department of Dermatology,Ruijin Hospital.Clinical characteristics of these patients were analyzed.Results Of the 11 patients,10 had oral or labial erosions or ulcers,and 6 had obstructive bronchiolitis.Computed tomography (CT)showed solitary internal tumors in all the patients after appearance of skin lesions,and 8 of them were diagnosed with Castleman's disease.All the patients had been treated with corticosteroids before operation,but achieved no obvious improvement.After 2-7 months of postoperative treatment with low-dose prednisone and thalidomide,both cutaneous and mucosal lesions healed with the relief of pulmonary symptoms in 5 patients.Conclusions Oral erosions or ulcers appear to be the most common initial manifestation of PNP with Castleman's disease as the most frequent accompanying tumor.Early detection and timely resection of tumors are keys to successful treatment of PNP,and postoperative treatment with glucocorticoids and thalidomide proves to be effective for PNP.

Objective To observe the effect of intranasal dexmedetomidine on total intravenous anesthesia for thyroid surgery postoperative analgesia.Methods Sixty female patients who were undergoing elective thyroid surgery were enrolled.Patients by total intravenous anesthesia were randomized in mechanical sampling method to receive intranasal dexmedetomidine 1 μ g/kg (group Ⅰ,30 cases),or the same volume sodium chloride (group Ⅱ,30 cases) before anesthesia induction,then flurbiprofen 100 mg intravenous 10 min before surgery.The postoperative surgical pain was assessed utilizing visual analogue scale (VAS),and the postoperative pain of cough was assessed by comfort score (BCS) at 1,2,4,6,8,12,24 h after surgery,in addition,the adverse reactions were recorded.Results The VAS scores at 1,2,4,6,8,12 h in group Ⅰ were lower than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The BCS scores at 1,2,4,6,8 h in group Ⅰ were higher than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The nausea and dizziness morbidity in group Ⅰ were lower than those in group Ⅱ (8 cases vs.14 cases,6 cases vs.14 cases),and there were statistically significant (P ＜ 0.05).Eight patients were required supplemental analgesic within 12 h after surgery in group Ⅱ,which was more than that in group Ⅰ (0 case),and there was statistically significant (P ＜ 0.05).Conclusion Receive total intravenous anesthesia for thyroid surgery,the patients who are given intranasal dexmedetomidine 1 μ g/kg combined with flurbipmfen can reach satisfactory postoperative analgesia,decrease the nausea and dizziness morbidity,increase the comfortable degree.

Objective To investigate and analyze the risk factors,morbidity and mortality rates of multiple organ dysfunction syndrome (MODS) after multiple trauma.Methods The clinical data of all 155 patients with multiple trauma admitted to our ICU from Sep 2008 to Jun 2011 were retrospectively analyzed,including treatment,injury severity score (ISS) and its relationship with MODS.Results The morbidity of MODS among all 155 patients was 18.7％ (29/155).There were 3,7 and 19 patients died due to multiple trauma in 39 ISS ＜ 16,58 ISS 16-25,and 58 ISS ≥25 cases respectively.The morbidity of MODS was significantly higher in patients with ISS ≥25 ( x2 =12.321,P =0.002) than in others.There were 15 cases with MODS and 28 cases without MODS died respectively in multiple trauma patients ( x2 =10.236,P =0.001 ).Conclusion MODS is the important reason for death in multiple trauma patients.It is pivotal to actively deal with primary trauma to avoid the second insult to the patients and support vital organs early in order to improve the prognosis of multiple trauma.

[Objective] To introduce the experience of Professor ZHANG Biao in the treatment of infantile dyspepsia. [Methods] Through the long-term study with Professor ZHANG, large amounts of medical records are collected and generalized, so that the experiences concerning infantile dyspepsia are summarized, when and how to choose activation, tonification or digestion depends on excess and deficiency,and proven cases are presented. [Results] It is thought that infantile dyspepsia mostly belongs to excess syndrome, or excess syndrome combined with deficiency syndrome, so the treatment is heiping digestion, tonifying spleen and harmonizing stomach. Professor ZHANG thinks that the cause of children's dyspepsia is the weakness in spleen and stomach eventually. It is characterized by excess in syndromes and deficiency in root causes. Its clinical manifestations are concurrence of excess and deficiency. As for the treatment, there's no need to wait for the pathogenic qi to disappear. The basic principle of treatment is always to activate the spleen, regulate qi and help digestion. Professor ZHANG raises that syndromes with more deficicency than excess are treated by activating spleen, which is complemented by tonification. That is to say, activation and tonification are combined, while helping digestion is considered, also. But as to syndromes with more excess than deficiency, the treatment will be activating spleen combined with helping digestion, also with regulating qi. He also cares for children 's regulating and giving reasonable advice. [Conclusion]According to the children's characteristics of physiology and pathology, we should pay more attention to excess and deficiency to choose better method, at the same time, proper feeding and teaching are also important.

It remains an urgent need to develop effective malaria vaccine for global control of malaria.Application of high technologies such as biotechnology has facilitated the process of vaccine development for malaria.In the past 30 years,a large number of vaccine candidate antigens for malaria have been identified and some of them are currently in clinical trials.Major progress in malaria vaccine development has also been made in China.The PfCP-2.9 blood stage vaccine for malaria has entered clinical studies and some other vaccine candidates including combination malaria vaccine are currently in pre-clinical studies.The availability of various national research programs and international funding has stimulated laboratory and pre-clinical studies of malaria vaccine candidates.It remains a long-term goal to develop a safe and effective malaria vaccine to control and even eliminate the disease in the world,and many issues including malaria immunology and various types of technologies need to be addressed.However,efforts need to be continued toward the goal.

Objective To explore the association between rheumatoid arthritis (RA) with HLA-DRB1 in China. Method The reported articles about HLA-DRB1 RA in China were searched and Meta-analysis was performed. Result Fourteen studies enroll 1118 RA patients and 1301 controls, the associated gene was HLA-DR4 (OR=4.05, P