As originated from hematopoietic stem cell clonal diseases,bcr-abl-negative chronic myeloproliferative neoplasms (MPN) include polycythemia vera (PV),essential thrombocythemia (ET) and primary myelofibrosis (PMF).With the discovery of JAK2 mutations,many new mutations have been identified.With the in-depth study of gene mutation,the pathogenesis of MPN has been gradually uncovered.Novel drugs have been developed accordingly.

Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P ＜ 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6％(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3％ (31/81),there were statistical differences (P ＜ 0.01 or ＜ 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P ＜ 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.

Objective To compare complication,nutritional status and quality of life between total gastrectomy and jejuna interposition after proximal radical gastrectomy in patients with advanced proximal gastric carcinoma.Methods Eighty-five patients with proximal stomach cancer were enrolled from Jan.2002 to Dec.2008,total gastrectomy group(Control group) had 40 cases,jejuna interposition after proximal radical gastrectomy(Experimental group) included 45 cases.Nutritional status,incidence of reflux esophagitis and cholecystolithiasis,5-year survival rate,quality of life were investigated.Results There was no significant difference in 5-year survival rate between two groups(P ＞ 0.05).Incidence of reflux esophagitis in Experimental group was significantly lower than that in Control group(P =0.042).Incidence of cholecystolithiasis in Experimental group was significantly lower than that in Control group (P =0.038).Hemoglobin,albumin,vitamin B12 and ferritin in Experimental group were significantly higher than those in Control group[(142.2 ±8.6) vs (128.4 ±8.4),(41.3 ±5.8) vs (35.9 ±3.8),(271.5 ± 49.7) vs (184.5 ± 24.6),(220.2 ± 59.7) vs (170.2 ± 27.6),P =0.036,0.024,0.032,0.026].Diet and labor in Experimental group were better than those in Control group (P =0.042,0.048).Conclusion Jejuna interposition after proximal radical gastrectomy decrease incidences of reflux esophagitis and cholecystolithiasis,improve nutritional status and quality of life.

[Objective]To probe the research and treatment for Hashimoto thyroiditis in Th1/Th2 migration.[Methods]By referring to related literature from both home and abroad,the author tries to analyze and sort the literature and comes to a reasonable conclusion. [Result]There is a lot of experimental re-search on correction of Hashimoto thyroiditis Th1/Th2 migration at home and abroad,but less clinical treatment research.[Conclusion]Th1/Th2 cellmigra-tion is one of the reasons for Hashimoto thyroiditis.It can promote the development of the disease, have something to do with the rise of thyroid autoanti-bodies.

Objective To compare expression and distribution of CD68 protein and TRAP positive protein in ankylosing spondylitis (AS), rheumatoid arthritis (RA), osteoarthritis (OA), and normal synovial tissues to study the differentiation of osteoclast in synovial tissues obtained from AS patients and its role in the pathogenesis of bone destruction in AS. Methods Immunohistochemical analysis was performed using CD68 monoclonal antibody to detect CD68 expression, and the distribution of TRAP positive cells in the synovial tissues was examined by enzyme histochemistry in 13 AS, 16 RA, 17 OA patients and 6 healthy controls. The above two variables were quantified in the labeled sections by digital image analysis and semiquantitative analysis to compare the expression of CD68 positive cells in different patient groups and normal subjects. Results Positive CD68 staining was seen in synovial cells from all the patients with AS, RA, OA and normal subjects, and the expression levels of CD68 from patients with AS and RA were higher than those from OA patients and healthy subjects. The CD68 positive cells were abundant mainly in lining layer. In areas where elevated RANKL expression levels were present, the number of TRAP positive cells was found significantly increased in AS and RA synovium. TRAP positive cells were rarely observed in synovium from OA patients and normal controls. There was positive correlation between the number of TRAP positive cells and the RANKL expression (r=0.442, P=0.043) in RA patients. Conclusions An obvious increase in the number of CD68 positive cells and TRAP positive cells in synovium may provide a main source of osteoclastogenesis in AS patients. The up-regulation of activity and quantity of osteoclast may have an important role in peripheral articular destruction in patients with AS.

Observations were made on 27 subjects suffering from burns. Treatment withexercise in water was given to 21 patients with 48--95%, or an average of 68.9%, ofthe body surface burned--37.3% of the affected area to cc 28.6% to deep Ⅱ?, and3% to superficial Ⅱ?. Six patients were in the control group, with 55--81%; or anaverage of 66.9%, of the body surface burned-36.5% of the affected area to Ⅲ?,26.7% to deep Ⅱ?, and 3.1% to superficial Ⅱ?, patients receiving this kind of treat-ment were required to do both active and passive exercises with the whole bodysubmerged in warm water before their wounds were completely healed. Then it wasfollowed by exercises on dry land. The control group did the same amount of exer-cise, but only on dry land. In terms of function recovery, 12 in the group under aquatic exercise treatmentgained "excellent" results and nine "good" results, while three in the controlgroup gained "satisfactory" results and the rest three showed no improvement. The advantages and efficacy of aquatic exercise treatment and precautions inusing this method were also discussed.

Diploid and triploid types of Paragonimus westermani were compared in the aspect of ultrastructure of spermatogenesis. The results showed that the process of spermatoge nesis in the diploid type was normal. The cells at every stage are well developed. A great number of morphologically and functionally normal spermatozoa could be formed. On the other hand, the process of spermatogenesis in the triploid type was abnormal, the cells at every stage developed abnormally. They were apparently degenerated or va-cuolated, lacking organelles. The cytophore was broken into small particles. No normal spermatozoa were found (Figs. 1-5).

Objective To analyse the relationship between vascular dementia in senitity and diffuse white matter lucencice.Methods Observing 54 patients older than 60 of diffuse white matter lucencice for three years with clinical methods CT and/or MRI.Diagnosing vascular dementia by MMSE and Hachinski.Results The degree of diffuse white matter lucencice within the 54 patients were 34 cases as first degree,14 cases as second degree, 6 cases as third degree in the first year, 17 cases, 19 cases and 18 cases in the second year restectively, 8 cases, 17 cases and 29 cases in the third year.The 6 cases of group suffer from the vascular dementia in senitity in the first year,13 cases in the second year,33 cases in the third year.The average annual growth was 32%.Conclusion Diffuse white matter lucencice is a critical factor of vascular dementia in senitity. The positive correlation between the degree of diffuse white matter lucencice and the occurrence of vascular dementia in senitity has been shown( r =0.82, P

Objective:To observe the roles of p50 protein in pathologic responses of cerulein(CR)pancreatitis in mice deficient in p50 protein of NF-?B.Methods:Pancreatitis was induced by i.p.injection of 50?g/kg CR.The express and compensation of p65,p50 and cRel proteins of NF-?B,NF-?B activity were measured using electromobility shift assay;parameters of pancreatitis,eg,amylase,lipase and trypsin were evaluated.The apoptosis,necrosis and caspase-3 activity were observed.Results:p50 knockout(KO)mice had no p50 protein expression and increased p65 and cRel proteins expression.p50 KO mice's NF-?B activity decreased and apoptosis increased in pancreatitis compared with wild type(WT)mice.There was no caspase-3 activition in both mice before and after pancreatitis.All KO mice had an increased necrosis and amylase,lipase,trypsin activity compared with WT mice in pancreatitis.Conclusions:The results indicated that NF-?B p50 genetic deletion might attenuate cerulean induced pancreatitis.

Objective To investigate the expression of TGF?2 in proximal OFT septum in connexin(Cx) 43 knockout(KO) mice and illustrate its relationship with myocardialization and reveal whether exogenous TGF?2 could promote myocardialization in vitro.Methods Objects were C57/BL6 mice of E12.5 to E15.5 by the mating of 2 month old Cx43 heterozygous mice,which included Cx43 homozygotes(Cx43-/-),heterozygotes(Cx43+/-) and wild-types(Cx43+/+) genotyped by PCR method.?-sarcomeric actin(?-SCA) and TGF?2 were detected by immunohistochemistry.TGF?2 with 3 different dosages was used to be the intervent added to the heart culture system in which the wild-type hearts of E12.5 were cultured till E15.5 before detecting the expression of ?-SCA by immunohistochemistry.Results The expression of ?-SCA in the proximal OFT septum was delayed obviously in Cx43-/-predominantly at E13.5 and E14.5.As compared with the Cx43+/+,the expression of TGF?2 in proximal OFT septum decreased obviously in Cx43-/-mice predominantly at E14.5,and less obviously in(Cx43+/-) mice.None of the intervention groups showed the obvious promoted myocardialization.Conclusions Cx43 KO mice exhibited delayed myocardialization,and the decreased TGF?2 may involve in the abnormal myocardialization of Cx43 KO mice.Application of TGF?2 in vitro could not exactly mimic the in vivo expression pattern of TGF?2,or the process of myocardialization may require precise dosage of TGF?2 and stringency of cultured system.