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

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.

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.

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

Objective To evaluate the effectiveness of "screen and target population intervention policy" for stroke intervention in Nanhui county of Shanghai city.Methods A cross sectional survey on stroke was carried out in January 1999,and 696558 population in Nanhui county of Shanghai city were investigated in the study. Surveillance data on incidence and mortality rate of stoke from January 1996 to December 1998 in the county were retrospectively checked and reinvestigated.The CVHI of 35 years old and over in this population which have one and more of risk factors were measured,their CVHI total score

Objective To compare the efficacies of electrothermal needle acupuncture versus nimesulide in treating knee osteoarthritis and the relieving effects of them on the pain and explore the possible mechanism of electrothermal needle treatment for knee osteoarthritis.Method Eighty patients with knee osteoarthritis were randomly allocated to electrothermal needle and Western medicine groups, 40 cases each.The electrothermal needle group received electrothermal needle therapy and the Western medicine group took nimesulide sustained-release tablets.The therapeutic effects were compared after thecompletionof treatment.Therelieving effects of the two treatments on the pain were evaluated using the Pain Visual Analogue Scale(VAS).Serum SOD and MDA were measured in all the subjects before and after treatment.Result The marked efficacy rate and the total efficacy rate for knee osteoarthritis were higher in the electrothermal needle group than in the Western medicine group.There was no significant post-treatment difference in the VAS pain score between the electrothermal needle and Western medicine groups.After treatment, serum SOD increased and MDA decreased in the electrothermal needle group and they did not change significantly in the Western medicine group.Conclusion Electrothermal needle therapy can well relieve the symptoms of knee osteoarthritis.Its relieving effect on the pain is equal to that of nimesulide.The mechanism of electrothermal needle treatment for knee osteoarthritis may be relatedto its improving bodilyoxidative stress levels.

Objective To reproduce a rat model of metabolic syndrome (MS) to analyze the variations of related gene expression. Methods 30 male rats aged 8w were randomly divided into two groups, the rats in NC group (control) were fed with normal diet (10% fat and 0.5% salt ), and those in metabolic syndrome (MS) group with high fat diet (49% fat and 2% salt). The body weight, blood pressure, fasting blood glucose (FBG), blood lipid and fasting insulin level were serially measured. Such feedings were continued for 24 weeks, and then the intraperitoneal glucose tolerance test and hyperinsuline-euglycemic gomphosis test were performed, and carotid arterial pressure and visceral fat were measured. RT-PCR was used to detect the genes related to energy consumption, glucose-lipid metabolism in white adipose, brown adipose and muscle tissue. Results Compared with NC group, all the variables were increased significantly, such as body weight, visceral fat weight, blood pressure, serum levels of TG and FFA. A marked insulin-resistance and decreased glucose tolerance were found in MS group. Hyperinsuline-euglycemic gomphosis test revealed that the mRNA expression of 23 genes related to glucose-lipid and energy metabolism changed significantly in white adipose, brown adipose and muscle tissue in MS group as compared with NC group. Conclusion Prolonged high fat plus high salt diet may cause the clinical features of MS in rats. The changes in various genes may be involved in the mechanisms involved in the pathogenesis.