High platelets 650×10⁹/L are commonly seen in primary increases such as essential thrombocythemia, and less commonly in reactive increases that require treatment. 1. The reference value of platelets is (100~300)×10⁹/L, and 650×10⁹/L is usually seen in primary myeloproliferative neoplasms such as true erythrocytosis and primary thrombocythemia. Therapeutic agents include aspirin, hydroxyurea, or interferon and the use of JAK2 inhibitors such as rucotinib. The prognosis of primary myeloproliferative neoplasms is variable, with true erythrocytosis surviving for 10-15 years or more, primary thrombocythemia surviving longer, and primary myelofibrosis surviving for about 5 years after diagnosis. 2. Reactive increase, can be seen in blood concentration, after surgery, infection, etc., need to be targeted treatment, such as levofloxacin anti-infection. Patients should consult the doctor in time to confirm the cause of the disease and receive timely treatment under the guidance of the doctor.