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 observe the clinical efficacy of acupuncture plus Chinese medicine iontophoresis in treating dry eye syndrome.Method Sixty-two patients with dry eye syndrome were randomized into a treatment group and a control group, 31 cases in each group. The treatment group was intervened by acupuncture plus Chinese medicine iontophoresis, while the control group was intervened by artificial tears. After 4-week treatment, the changes of tear secretion, tear film break-up time (BUT) and symptoms score were observed, and the clinical efficacies were compared.Result The total effective rate was 87.1% in the treatment group versus 61.3% in the control group, and the between-group difference was statistically significant (P<0.05). The total symptoms score, tear secretion and BUT were significantly changed after the treatment in both groups (P<0.05). After the treatment, the total symptoms score, tear secretion and BUT in the treatment group were significantly different from those in the control group (P<0.05).Conclusion Acupuncture plus Chinese medicine iontophoresis is an effective method in treating dry eye syndrome.

Objective To study the biofilm-forming ability and the distribution of biofilm-related genes in Acinetobacter baumannii clinical isolates as well as antimicrobial resistance,to analyze their relationships with the bacterial resistance phenotype.Methods A prospective study was conducted.Biofilm models of 70 strains Acinetobacter baumannii collected in Chengwu County People's Hospital from October 2012 to October 2013 were constructed using 96-well polystyrene plate.In order to analyze the biofilm-forming ability,a qualitative and quantitative analysis was conduct by crystal violet staining assay.And the antimicrobial resistance of different biofilm-forming ability strains was compared including imipenem,amikacin,meropenem,cefepime,sulbactam cefoperazone,trimethoprim,levofloxacin,gentamicin,ciprofloxacin,cefotaxime,ceftizoxime,aztreonam,piperacillin,ceftriaxone,cefuroxime.In addition,the expressions of biofilm-related gene Bap,bfs and intI1 were tested with polymerase chain reaction (PCR) assay.Results Among 70 strains Acinetobacter baumannii,40 strains were multi-drug resistant (57.14％) and 6 strains were pan-drug resistant (8.57％); 68 strains had biofilm-forming ability (97.14％),14 of which were weakly positive,20 were positive and 34 were strongly positive.The antimicrobial resistant rate of Acinetobacter baumannii to imipenem,amikacin,meropenem and cefepime was decreased,it was 30.00％,32.86％,38.57％ and 41.43％,respectively.However,the antimicrobial resistant rates to other commonly used antibiotics were all higher than 50％.The drug resistance of Acinetobacter baumannii to levofloxacin (85.71％,45.00％,38.24％,x2=9.225,P=0.010),cefepime (71.43％,45.00％,29.41％,x2=7.222,P=0.027),gentamicin (78.57％,55.00％,38.24％,x2 =6.601,P=0.037) was significantly decreased when biofilm-forming ability reinforced (weakly positive,positive,hadro-positive).Bap gene positive rate of weakly positive,positive and strong positive biofilm-forming strains Acinetobacter baumannii was 50.00％,65.00％ and 79.41％ (x2=4.244,P=0.120),respectively.Bfs gene positive rate was 35.71％,65.00％ and 88.24％,respectively (x2=13.602,P=0.001) and intI1 gene positive rate was 42.86％,75.00％ and 91.18％,respectively (x2 =12.902,P=0.002).Moreover,the antimicrobial resistances of biofilm-related gene positive strains were higher than the negative,of which the drug resistance of intI1 positive group to amikacin was significantly higher than the negative group (40.38％ vs.11.11％,x 2=5.194,P=0.023).Conclusions The Acinetobacter baumannii collected from the hospital had strong multi-drug resistance as well as strong biofilm-forming ability.The drug resistance of Acinetobacter baumannii decreased when biofilm-forming ability reinforced.In addition,genes,such as Bap,bfs,and intI1,contributed to biofilm formation.

OBJECTIVE To establish a method for detecting adenovirus type 7 by cells culture combined with real-time fluorescent RT-PCR.METHODS After purified adenovirus was dissociated from nasopharyngeal secretion in A549 cells,ADV7 E1A genes were detected by real-time RT-PCR assay and sequence analysis of cells infected with 0.1,0.5,5.0 and 10.0 MOI ADV7 at 3,6,12 and 24 h postinfection.Then the adenovirus in nasopharyngeal secretion was detected with the similar method.RESULTS Early transcription of E1A genes of adenovirus type 7 could be detected by real-time RT-PCR at 3 h postinfection with 0.5MOI virus;or at 6 h postinfection with 0.1MOI virus;Early transcription of E1A genes could be detected at 6 h postinfection in nasopharyngeal secretion.CONCLUSIONS The method by cells culture combined with real-time fluorescent RT-PCR is sensitive,specific and rapid.It can be applied in clinics for diagnosis of adenovirus type 7 infection.

To investigate the knowledge, attitude and practice (KAP) on rabies among a mass of the exposed population in Beijing so as to provide scientific evidence for development of measures on the prevention and protection of rabies, the descriptive studies were employed, in which patients were interviewed face to face with a standard questionnaire in hospital or the center for disease control and prevention (CDC), including history of exposure, knowledge on rabies, post-exposure treatment etc. Of 478 respondents, 76% of them were bitten on the upper limbs with the exposure proportions in category Ⅰ, Ⅱ and Ⅲ of 24%, 70% and 6% respectively. The proportions of awareness of knowledge in rabies before biting, its prevention, the correct measure to treat their wounds themselves, rabies vaccine inoculation, and injections with rabies antiserum constituted in 82%, 55%, 59%, 99% and 22% respectively. Result of this investigation indicates that most of the people investigated had a lower awareness of knowledge on rabies, the correct measures to treat rabies after biting as well as the measures to prevent rabies, suggesting that community-based prevention and control measures should be emphasized, especially targeting the population with high risk and the heath education on rabies should performed promptly by several governmental departments.

Objective:To investigate the value of proton magnetic resonance spectroscopy (1H-MRS) on the diagnosis of SCA3/MJD,and to calculate the correlation between 1H-MRS ratio and the clinical score.Methods:Sixteen patients with SCA3/MJD and 19 healthy volunteers were scanned with 1H-MRS.The data of N-acetyl aspartate,creatine,choline-containing compounds,myoinositol,NAA/Cr,Cho/Cr,and mI/Cr ratio were collected,which were grouped for comparative study.The onset patients with SCA3/MJD were evaluated with the International Cooperative Ataxia Rating Scale and Scale for the Assessment and Rating of Ataxia,the correlation between NAA/Cr,Cho/Cr or mI/Cr ratio and the clinical score was calculated.Results:The NAA/Cr in the pons and cerebellar dentate nucleus from the onset patients with SCA3/MJD was significantly reduced compared to that in the normal control group.The NAA/Cr in the cerebellar dentate nucleus of onset patients with SCA3/MJD was obviously correlated with ICARS.Conclusion:SCA3/MJD lesions are mainly located in the cerebellum and brainstem,where gray and white mater are also involved.The cerebellar dentate nucleus may be the earliest involved area.There is a correlation between the ICARS and the cerebellar lesion degree.The ICARS reflects the severity of clinical manifestations.1H-MRS is useful in the diagnosis of SCA3/MJD.

Objective To investigate the related factors of international cooperative ataxia rating scale (ICARS) and scale for the assessment and rating of ataxia scores (SARA) in patients with spinocerebellar ataxia type 3/Machado-Joseph disease. Methods A total of 126 SCA3/MJD patients were assessed by ICARS and SARA. The relation between ICARS or SARA scores and age of onset, disease duration and CAG repeat size was analyzed. Results Either the total ICARS or the total SARA score was positively related with the disease duration(r=0.586,P＜0.05；r=0.643,P＜0.05). Simple linear regression equations were: Y1(total ICARS score)=13.072+2.388 X2(disease duration)(F=68.874,P＜0.05); Y2(total SARA score)=4.403+ 0.961 X2(disease duration)(F=87.254, P＜0.05). Either age adjusted the total ICARS score or age adjusted the total SARA score was positively related with CAG repeat size(r=0.328, P＜0.05; r=0.335, P＜0.05). Both the ICARS subscores and the SARA subscores were positively related with the disease duration(r=0.257-0.589, P＜0.05; r=0.432-0.623, P＜0.05). Both age adjusted ICARS subscores and age adjusted SARA subscores were positively related with CAG repeat size(r=0.263-0.403, P＜0.05; r=0.189-0.366, P＜0.05). Analysis of variance showed that the total ICARS score and the total SARA score increased with the disease stage. Conclusion ICARS and SARA are both reliable and effective scales in assessing the severity of ataxia in patients with SCA3/MJD, and researchers can choose the most suitable scale according to specific requirement.

Objective:To explore the effect of handicraft training administered over the Internet on sensation disorders and on the mental status and life quality of stroke survivors.Methods:A total of 75 stroke survivors in the sequelae stage and with sensory disturbance were randomly divided into a general training group of 26 (group A), a handicraft training group of 26 (group B), and a handicraft training group of 23 using Internet instruction (group C). In addition to 40 minutes of routine physical and sensory training rehabilitation every morning, groups A and B were given traditional training and handicraft training, while group C was given handicraft training delivered over the Internet for 40 minutes every afternoon, five days a week for 4 weeks. The traditional training involved inserting wooden boards, plate grinding, as well as sorting beans. The handicraft training involved digital painting, making non-woven flowers, silk screening flowers and paper-rolling. Before and after the 4 weeks of treatment, all of the subjects were assessed using the Fugl-Meyer sensory assessment (FMA-S), the Hamilton Anxiety Scale (HAMA), the Modified Barthel Index (MBI), and the physical component summary scale (PCS) and mental component summary scale (MCS) of the 36-item short-form health survey.Results:After the treatment, significant improvement was observed in their average scores of all three groups in all of the assessments. Groups B and C showed significantly greater improvement in the average FMA-S, HAMA and MBI scores than group A. And the average HAMA and MCS scores of group C were significantly better than those of group B.Conclusion:Handicraft training delivered over the Internet can improve the sensory functioning, mental status and life quality of stroke survivors in the sequelae stage with sensory disturbance.

Objective To find some risk factors correlated with test anxiety of middle school students,and to find out influencing pathway for test anxiety. Methods 647 middle school students were investigated with Sarason' Test Anxiety Scale (TAS), Achievement Motivation Scale (AMS), Coping Style Scale for School Students ( CSS), Eysenck Personality Questionnaire( EPQ), Egma Minnen av Bardndosnauppforrestran(EMBU) and Family Environment Scale-Chinese Version(FES-CV). Statistics were done with version of SPSS14.0,and data were analyzed by Pearson correlation, multiple linenear stepwise regression and path analysis. Results The rates of test anxiety respectively was mild 25.97% ,moderate 45.65% ,severe 28.38%; there were no significant different between the male and female students anxiety ( 16.71 ± 6.44,17.01 ± 7.02, t = 1. 469, P = 0.334). Test anxiety positively correlated with Achievement motivation, reach motivation of competition, endurance, escape, expos, deny the fantasy,family conflicts,parental punished severely,excessive interference,objective deny,overprotective of father.( r 1-16 :0. 214,0. 135,0. 254,0. 216,0. 308,0.472,0. 492,0. 168,0. 249,0. 537,0. 282,0. 102,0. 238,0. 185,0. 233,0.301,0.273; P 1-16 = 0. 000 ～ 0. 030) , and negatively correlated with Problem-solving, rationalizing interpretation, family cohesion, informative, entertaining, emotional expression, organization, parental warmth and understanding ( r1-9: -0. 121, -0. 134, -0. 178, -0. 215, -0. 221, -0. 101, -0. 298, -0. 136, -0. 168; P 1-9 =0.000 ～0.007). Enter test anxiety regression equation is the reached motivation of competition,emotional expose,organization, psychosis, Neuroticism, parent's warm and understanding , mother's refuse and deny ( t 1-7: 2.496,2.521, -2.687, -2. 150,3.503,2.237,2.259; P1-7 =0.001 ～0.038). Conclusion Test anxiety is commonly find in middle school students. Test anxiety is affected by some paths that are personality,achievement motivation,emotional coping style,family environment and parental education methods.

Objective To investigate the expressions of CD147,MMP-9 and TIMP-1 in human gliomas and analyze the correlations.Methods Expressions of CD147,MMP-9 and TIMP-1 were assessed in paraffin-embedded specimens collected from 78 gliomas and 12 benign brain lesion tissues by immunohistochemistry.Real time PCR was performed to detect CD147 mRNA expression.Results The positive rates of CD147,MMP-9 and TIMP-1 expression were 62%(48/78),71%(55/78),59%(46/78) respectively.We found a significant positive correlation between CD147,MMP-9,TIMP-1 expressions and poor gliomas differentiation by Spearman analysis(rs=0.2671-0.5631,Ps＜0.01).There was also a significant positive correlation between CD147 and MMP-9 expression(rs =0.3576,P＜0.01).In addition,the expressions of CD147(47% vs.80%,x2=9.510),MMP-9(56% vs.89%,x2=10.702),and TIMP-1(49% vs.71%,x2=4.138) were significantly higher in advanced gilomas than early gliomas(Ps＜0.05).The relative expression levels of CD147 mRNA in gliomas of Ⅰ to Ⅳ pathological grades were 0.15,0.27,0.46,0.78 respectively.Conclusion The expressions of CD147,MMP-9 and TIMP-1 were important characteristic of gliomas,which may serve as biomarkers in the glioma prognostic prediction.