Objective To explore the efficacy of transthoracic endoscopic T2～3 sympathectomy in the treatment of palmar hyperhidrosis with chilblain. Methods A total of 16 patients underwent bilateral transthoracic endoscopic T_2～3 sympathectomy. The sympathetic chain was cut off on the third posterior rib. Palmar skin temperature was monitored simultaneously during the operation. Results The procedure was successfully completed without complications in all the 16 patients. The palmar temperature on the side of prior thoracotomy was significantly higher at 15 min after sympathectomy (33.8?1.3 ℃) than before operation (29.8?0.8 ℃; q=12.513, P

The knowledge and understanding of myeloproliferative neoplasms (MPN) over the last hundred years has been reviewed in this article,focusing on clinical practice.The identification of JAK2 V617F gene mutation leads Philadelphia chromosome-negative (Ph) MPN into a new era of molecular biology.These advances not only provide a reliable diagnostic tool and important evidence for diagnosis of MPN,also induce a lot of investigation and manufacture of targeting drugs to JAK2 mutation.However,JAK2 V617F mutation is not the gold standard for the diagnosis of MPN,as unique as bcr-abl in CML.Certain routine lab results and differentiation with some other diseases are still necessary.A JAK1/JAK2 inhibitor,ruxolitinib,has been approved for clinical use,but indication should be followed.Further follow-up is needed to assess the longterm outcomes with respect to efficacy and safety.It is not time to give up conventional medicine,such as hydroxyurea or aspirin.

As a patient's right,informed consent has been acknowledged universally.Both hospital and patients attach great importance to normal informed consent during clinic.But the subjects' right in clinical trial didn't draw enough attention,which leads to encroachment of the subjects' right and even the clinical disputes.The law and rule,based on the ethics principle,can enhance the protection of the subject's right of informed consent.In this article,the problem on the legal protection against the infringement of the subject's right and the corresponding counter-measures are discussed.

OBJECTIVE:To provide the reference for the Chinese government to establish medication policy in paediatrics.METHODS:The paediatric medication strategy set up by British Drug and Health Product Administration Bureau was introduced,and the current situation and problems in paediatric medication were analyzed.RESULTS & CONCLUSION:China should learn from British experience,and establish our own medication strategy in paediatrics as soon as possible.

Objective:To establish a HPLC fingerprint determination which could separate the main principles of alkaloids, flavonoids and iridoids in Huanglianjiedu Decoction. Methods: The HPLC method was used and chromatography conditions were C 18V column, binary or ternary solvent-delivery gradient elution and diode-array detector. Results: A HPLC fingerprint determination method was established, which could separate main principles of the three effective groups of Huanglianjiedu Decoction. Conclusion: The ingredients of traditional Chinese medicine consist of several effective groups with different chemicals and physical properties, compared with the plant standard extracts, further studies are required for establishing HPLC fingerprint.

Objective To analyze causes for complications after proximal femoral intramedullary nail treating unstable femoral intertrochanteric fractures in the elderly.Methods A total of 172 cases of unstable intertrochanteric fractures treated with proximal femoral intramedullary nail from December 2001 to May 2007 were reviewed upon postoperative complications to find out the causes for complications and discuss countermeasures.Results Of all, 149 cases were followed up for 6-42 months(mean 18. 5 months), which showed excellence rate of 89. 0% in aspect of functional recovery of the hip. Postoper-ative systemic complications occurred in 26 cases and local complications in 21.Condusions Proxi-real femoral intramedullary nail can be used in most elderly patients with unstable intertrochanteric frac-tures. A thorough evaluation of physiological function, treatment of preoperative comorbidities and aug-mentation of surgical technique are prerequisites for operation safety and decrease of complications.

Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; therapy

Acupuncture Points ; Acupuncture Therapy ; Adult ; Elephantiasis ; therapy ; Female ; Humans

BACKGROUND: The basic way for the releasing pattern of secretory granules of neurohypophysis is still not clear, neither is the extracellular normal transport route of neurohypophysis polypeptide hormones to enter the cerebrospinal fluid.OBJECTIVE: To provide the morphological evidences for the structural foundations of the releasing pattern and extraeellular normal transport route for secretory granules or polypeptide hormones of neurohypophysis by observing the structure of rats' neurohypophysis.DESIGN: Randomized controlled study.SETTING: Department of human anatomy in a university.MATERIALS: The experiment was completed in the Department of Human Anatomy of Hebei Medical University from May 2003 to January 2004. Twelve healthy clean grade adult male Sprague-Dawley rats with a body mass of about 300 g were supplied by the Experimental Animal Center of Hebei Province.METHODS: The 12 rats were randomly divided into 3 groups with 4 rats in each group. The neurohypophysises of each group were respectively observed with light microscope, transmission microscope and scanning electron microscope.MAIN OUTCOME MEASURES: The microstructure and ultrastructure of the neurohypophysis.RESULTS:All 12 rats entered the final analysis. In the coronary section of rat hypophysis, pars distalis, pars intermedia and pars nervosa were discernable under the light microscope. Under the transmission electron microscope, the neurohypophysis was composed of unmyelinated nerve fibers, pituicytes and connective tissue abound in blood capillaries. The endothelium of the blood capillary belonged to the fenestrated type(50 nm), separated from perivascular space by basement membrane. The intact secretory granules (100 -300 nm) coated with membrane existed not only in the endings of the unmyelinated nerve fibers but also occasionally in perivascular space. Under the scanning electron microscope, the pituitary capsule was composed of simple squamous epithelial cells and subepithelial connective tissue. Many irregular epithelial openings(2-5 μm) were observed among epithelial cells. Secretory granules were seen frequently near the epithelial opening.CONCLUSION: The releasing pattern of secretory granules or polypeptide hormones of neurohypophysis involves a whole-releasing pattern together with granular membrane. After released into perivascular space, they enter easily into cerebrospinal fluid via interspace of tissue and epithelial openings rather than into blood circulation through the walls of capillaries, and then into the cerebrospinal fluid.

Objective To study the characteristic and influential factor of the hidden blood loss after total knee arthroplasty (TKA) so as to provide a reference frame for clinical work. Methods There were 75 patients with osteoarthritis of the knee who were operated with unilateral primary TKA. The patients including 21 males and 54 females at a mean age of 68.7 years were retrospectively analyzed.The perioperative blood loss and the hidden blood loss following TKA were calculated by Gross formula. It was analyzed that if the perioperative blood loss and the hidden blood loss following TKA were affected by gender, haemostasis during operation with deflating tourniquet and reinfusion of the drained blood. Results The preoperative blood loss was (1551.3 ± 369.6) ml and the hidden blood loss was (792.3 ±228.6) ml. The hidden blood loss of male was significantly higher than that of female (P ＜ 0.05). The hidden blood loss was reduced by haemostasis during operation with deflating tourniquet (P ＜ 0.05) but was not affected by postoperative shed blood reinfusion. Conclusions The lowest value of Hct is a representative parameter for calculation of the hidden blood loss. There is no significant difference between male and female about the relative hidden blood loss. Haemostasis during operation with deflating tourniquet can reduce teh hidden blood loss but not affect the total perioperative blood loss. Reinfusion of the drained blood can reduce the transfusion rate but does not affect the total preoperative blood loss and the hidden blood loss.