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 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.

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

External evaluation of large medical institutions is key to performance management in the medical sector,which is both a major means for the government to manage such institutions and a key guideline for their internal performance management. Based on a study on the pathways of such institutions in the UK,the USA and Japan in their external evaluation of performance,the paper summarized practices of Shanghai,Shenzhen,Zhenjiang and Beijing,in an attempt to offer references for building the external evaluation system for such institutions in China.

OBJECTIVE: To study the changes of SOD, GSH and MDA in the renal tissues of diabetes rat models through the comparison of their metabolic features. METHODS: Two types of diabetes rat models were established by feeding high-lipid food along with small dose injecting of streptozotocin (STZ) (model group 1) and repeated small dose injecting of STZ with complete Freund's adjuvant (CFA) (model group 2). And changes of the following were observed: body weight, urine volume, blood sugar, blood lipid, serum insulin, insulin sensitive index (ISI),superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) of the renal tissues. RESULTS: The body weight of the two model groups of rats decreased, while the urine volume and the blood sugar increased predominantly. These indexes of the two model groups were significantly different from those of the normal group (P<0.05). The renal tissue MDA level increased while the SOD and GSH level decreased in both model group 1 and model group 2, but the changes in model group 1 were more obvious than those in the model group 2. The serum insulin level which decreased in model group 2 did not decrease significantly in model group 1, but the ISI in model group 1 decreased more significantly than that in model group 2 (P<0.05). CONCLUSION: The antioxidase activity decreased in renal tissues of diabetes rats and hyperlipidemia was the main cause of the corresponding oxidations.

OBJECTIVE: To study the modifying effect and mechanism of Tangshenning Recipe on micro-albuminuria in rats with early diabetic nephropathy (DN). METHODS: Male Wistar rats were randomly divided into the normal group (n=8) and model group (n=24). Intraperitoneal injecting of streptozotocin (STZ) plus complete Freund's adjuvant (CFA) was applied once a week for 3 times to induce the DN rats model. Three weeks later, the model group rats were randomly divided into pathologic group (n=8), monopril group (n=8) and Tangshenning Recipe group(n=8) according to the 24 h U-Alb. Each group's renal hemodynamics index and SOD, GSH, MDA in renal tissue were determined by radioimmunoassay (RIA) and colorimetric method respectively. RESULTS: The levels of plasmatic TXB(2), the ratio of TXB(2) and 6-keto-PGF1alpha, and the CGRP in pathologic group were significantly higher than those in normal group. The levels of plasmatic ET decreased obviously, SOD decreased and MDA increased significantly in the rats' renal tissue of pathologic group. The levels of plasmatic TXB(2), the ratio of TXB(2) and 6-keto-PGF1alpha decreased significantly in both Tangshenning Recipe group and monopril group, and the therapeutic effect of Tangshenning Recipe group was better than that of monopril group. SOD was higher and MDA was lower in Tangshenning Recipe group than that in pathologic group. CONCLUSION: The results indicates that Tangshenning Recipe can lower the micro-albuminuria in early DN rats, the mechanism of which probably lies in the modification of glycometabolism, the ratio of TXB(2) and 6-keto-PGF1alpha, the plasmatic CGRP and the renal lipid preoxidation.