BACKGROUND: It has been confirmed that platelet aggregation defect presents in patients with hemorrhagic thrombopathy, and platelet membrane glycoproteins play a significant role in the process of platelet aggregation.OBJECTIVE: To observe the expression changes of platelet membrane glycoproteins between patients with hemorrhagic thrombopathy and healthy people.DESIGN: Case-control analysis.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College,Huazhong University of Science and Technology.PARTICIPANTS :① Seventy-nine patients with hemorrhagic thrombopathy who received treatment from January 2001 to March 2003 in the Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were enrolled in this study. The patients, including 31 male and48 femlae, averaged (35.76±14.14)years old. They all agreed to participate in this study and met with the diagnosis of hemorrhagic thrombopathy revised in 1996.Informed consents were obtained from all the patients and their relatives.The course of multiple bleeding symptoms was 1 to 14 years. And the bleeding sites were totally 167: extremity petechia was found in 64 cases, rhinorrhagia in 33 cases, hypermenorrhea (more than 150 mL in each cycle) in 29 cases, gingival bleeding in 28 cases, ocular fundus bleeding in 8 cases and conjunctival hemorrhage in 5 cases.②lnclusive criteria: All the cases presented clinical manifestation of multiple focal bleeding;The laboratory tests including platelet counts,bleeding time and coagulation profiles were examined with no marked abnormal changes;According to hemorrhage sites, the patients were examined by specialists of internal medicine,otorhinolaryngology, gynecology, stomatology and ophthalmology, and no specific diagnostic focuses of infection were found; They had normal blood pressure and heart rate,and those with thrombocytasthenia had been ruled out through ristocetin test. ③Another 34 healthy volunteer donors, 15 males and 19 females with an average age (30.12±7.14) years,were selected as normal control group.METHODS:① Detection of platelet aggregation ratio: Adenosine diphosphate (ADP, final concentration 1.90 μmol/L),arachidonic acid(AA, final concentration 0.37 μmol/L),and platelet activating factor(PAF, final concentration 150 nmol/L)were used as aggregation inductors, and Chronolog 430 type aggregometry was used to detect platelet maximum agglutination ratio.When maximum agglutination ratio was within 21％ and 40％, it was considered as aggregation defect, and when below 20％, it was considered as aggregation absence.② Test of platelet membrane glycoprotein: 3.6 mL cubital venous blood was drawn from the patients and mixed with 20 g/L disodium ethylenediamine tetraacetic acid(EDTA-NA2) for the purpose of anticoagulation at 1:9, and the same procedure was performed on the blood samples from the normal control group. The plasma was isolated and collected, after being centrifuged, the supernatant liquid was discarded, and paraform was added to fix the rest of the platelet solution. The platelet concentration was adjusted to 3×107 L-1. 100 μL regulated platelet solution was extracted, and fluorescein isothiocyanate (FITC)-marked CD42b (anti-GP Ⅰ b),CD41 (anti-GP Ⅱ b), CD61 (anti-GP Ⅲ a), CD42b/CD42a (anti-GP Ⅰ b/Ⅸ ), CD41/ CD61 (anti-GP Ⅱ b/Ⅲ a) and CD62p(anti-P-selectin)clonal antibodies 200 μL were added respectively and well mixed,and then cultured for 30 minutes at room temperature away from light. Finally phosphate buffer solution was added to the solution till the volume reached 1 mL,and FACS420 flow cytometer was used to analyze the samples, one sample for 10000 platelets, and the results were demonstrated by positive fluorescence percentage.MAIN OUTCOME MEASURES: ① Platelet aggregation ratio. ② Expression of platelet membrane glycoproteins.RESULTS:All the patients and the healthy subjects were involved in the analysis of results. ①All the cases were found to have platelet aggregation defect or absence which could be induced by single or more platelet aggregating agents. No abnormal platelet aggregations were found in the control group. ② The fluorescence intensities of GPIb/Ⅸ, GP Ⅱ b/Ⅲa complexes, GPIb, GPⅢa and P-selectin in patients with hemorrhagic thrombopathy were lower than those in the healthy subjects (t =2.50-5.57,all P ＜ 0.05). The fluorescence intensity of GP Ⅱb in patients with hemorrhagic thrombopathy was slightly higher than that in the healthy subjects, but no significant difference was found. (t =0.86, P ＞0.05).CONCLUSION: Abnormal expressions of platelet membrane glycoproteins may be partial pathogenesis of hemorrhagic thrombopathy.

Objective:To explore the efficacy and safety of ornidazole in the treatment of trichomonal vaginitis. Methods:Totally 112 cases of trichomonal vaginitis from February 2011 to December 2012 in our hospital were selected and randomly divided into the ob-servation group and the control group with 56 cases in each. The control group was treated with metronidazole tablets 200mg, po,tid, and the observation group was treated with ornidazole tablets 500mg, po,bid. The treatment course was 7 days. The clinical effect, score of clinical symptoms and incidence of adverse reactions of the two groups were compared. Results:The total effective rate of the observation group was 96. 4%, which was higher than that of the control group (82. 1%), and the difference was statistically signifi-cant (P<0. 05). The symptom scores of the two groups were significantly improved after the treatment (P<0. 05), however, the score between the two groups showed no significant difference (P>0. 05). The incidence rate of adverse reactions in the observation group was 10. 71%, which was significantly lower than that in the control group (37. 5%), and the difference was statistically signifi-cant (P<0. 05). Conclusion:The clinical curative effect of ornidazole in the treatment of trichomonal vaginitis is notable with faster onset, shorter treatment course, lower adverse reaction rate and better patient tolerance,which is valuable in the clinical promotion.

Objective To investigate the different clinical behavior and the diagnosis and trearment of primary hyperparathyroidism(PHPT). Methods Clinical data of 53 patients with PHPT treated in Beijing Jishuitan Hospital from May 1977 to April 2004 were collected and analyzed. Results 53 patients with PHPT were confirmed by operation and pathology. The majority of the patients were aged 20~50 years. There were more female than male patients. There were various clinical manifestations, and the duration of illness was (protracted). Many cases were misdiagnosed. There were bone pathologic changes of varying extent in all (patients), stones in urinary system plus bone pathology in 11 cases, serum level of calcium was raised in 51 patients(96.2%) and (parathyroid) hormone (PTH) was elevated in all examined 48 cases. Ultrasound, MIBI and CT were done before operation after 1991, and accurate preoperative localization diagnosis was (obtained). Minimally invasive (parathyroidectomy) (MIP) was successfully completed in 39 of 45 cases, and the primary operation cure rate was 97.4%. At postoperative follow-up of 10 months to 10 years, with the (exception) of 15 cases of severe bone deformity that had no obvious improvement, the other symptoms and signs were all relieved to varying (extents), the laboratory markers returned to normal, and there was no permanent hypoparathyroidism or (recurrent) nerve injury or other complications.Conclusions Early diagnosis of PHPT and effective early (treatment) by surgical removal of the pathologic lesion can alleviate the occurrence of severe bone changes and deformity. The preoperative combined use of imaging localization technique and overall assessment can improve the accuracy of diagnostic localization of the lesion.

OBJECTIVE To investigate the resistance of clinical isolated strains to the commonly used antibacterials in our hospital 2007-2008.METHODS Clinical isolated strains and sensitivity of drugs were detected by ATB system.The result of drug sensitivity was judged by CLSI standard and analyzed with statistical software WHONET5.3.RESULTS Altogether 3150 strains bacteria were isolated,17.4% were Gram-positive strains and 82.6% were Gram-negative strains,and the top five isolates were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Staphylococcus aureus.The reasistance rate of Gram-positive strains to minocycline was 15.4%.Five VRE strains were isolated.Various Enterobacteriaceae bacteria were sensitive to imipenem meropenem,cefoperazone-sulbactam and piperacillin-tazobactam,and their rate was 86.5% to 97.7%.Some of Acinetobacter and Stenotrophomonas maltophilia were multidrug resistant.CONCLUSIONS It is serous that multidrug resistance of isolated strains of the patients exists in our hospital.

Objective:Influence of clinicopathological characteristics and different therapy patterns on the overall survival of patients with gastric cancer with bone metastasis was investigated. Methods:A total of 146 gastric cancer patients with bone metastasis were enrolled from December 1996 to December 2014. Data of clinicopathological characteristics, treatment methods, and overall survival were collected. Univariate and multivariate analyses were performed using log-rank tests and Cox's proportional hazard model, respec-tively. Results:A total of 51 (34.9%) patients had synchronous metastasis, while 95 (65.1%) had metachronous metastasis. Moreover, 35 (24.0%) patients only had bone metastasis, while 111 (76.0%) patients were complicated with other organ metastases, such as liver (30.0%), peritoneal (24.0%), lung (15.1%), and bone marrow (7.5%). After diagnosis of bone metastasis, bisphosphonates, bone radio-therapy and bone surgery were applied in 99 (67.8%), 34 (23.3%), and 5 (3.4%) patients, respectively. Additionally, 96 (65.6%) patients received palliative chemotherapy. The median overall survival was 5.8 months (95%CI:4.284-7.316). Multivariate analysis revealed that KPS<80 (P=0.030), bone marrow metastasis (P<0.001), elevated serum CA199 (P<0.001), and without palliative chemotherapy (P<0.001) were independent poor prognostic factors. Conclusion:The outcome of gastric cancer with bone metastasis is very poor, espe-cially in patients with bone marrow metastasis, worse KPS, and elevated CA199. Palliative chemotherapy may be beneficial for the sur-vival of these patients.

Objective To evaluate CT diagnositic value for endo-bronchial tuberculosis(TB).Methods CT findings of 14 cases with endo-bronchial TB proved by fibro-bronscopy(FOB) were studied retrospectively.Results The bronchiarctia was seen at lobar bronchas or segmental bronchas in all 14 cases.Of them,in 6 cases,the bronchiarctia appeared as conic stenosis accompanied with atelactasis and a large amount of plearal effusions,in 8 cases,the bronchial walls were thichened including centrality stenosis in 3 cases,unilateral stenosis in 5 cases and accompanied with polyus in 3 cases.No hilar mass and opposite "S" sign were found.The "bronchial air sign" was showed at the area of ateectasis.9 cases were accompanied by active pulmonary TB(64.3%).Conclusion CT is of important value in diagnosing endo-bronchial TB and differentiating the tumorous or no-tumorous bronchiarctia,while the diagnonsis at early stage of this disease has to depend on FOB.

Objective: To observe the effects and immunological mechanism of continuous blood(purification)(CBP) in treatment of children with infectious shock.Methods: Twelve children with infectious shock treated with continuous veno-venus hemofiltration(CVVH) in intensive care unit(ICU) from June 2002 to October 2005 were selected as CBP treatment group,and 20 children with infectious shock without the(treatment) were selected as controls at the same time.The levels of pH,oxygenation index,HCO~-_3,base(excess(BE)),blood urea nitrogen(BUN),serum creatinine(SCr),blood pressure and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) were examined before and 24,48 hours after treatment dynamically,while the levels of tumor necrosis factor?(TNF?),interleukin1(IL1),IL6 and IL8 were detected and analyzed by SPSS 10.0 software.Results: Among the 12 patients,8 cases survived,4 cases died and the mortality rate was 33.3%.In CBP treatment group,APACHE Ⅱdecreased after treatment,and other biochemical parameters were all improved,plasma concentrations of TNF?,IL1 and IL8 decreased(P

Objective:To observe the effects of acupuncture-moxibustion on symptoms,signs,and Th1/Th2 cytokine,and regulation on Th1/Th2 in patients with perennial allergic rhinitis(PAR) to provide experimental basis for acupuncture treating allergic rhinitis and investigate the mechanism.Methods:Thirty patients with allergic rhinitis were treated with acupuncture-moxibustion,and 30 healthy cases were the control.Clinical symptoms,signs,and nasal mucosa were observed,and contents of IL-4,IFN-γ,and granulocyte-macrophage colony stimulating factor (GM-CSF) in the supernatant of peripheral blood monocyte cultured with PHA by ELISA,before treatment,after one course of treatment,and after two courses of treatment.Results:Before the treatment,the contents of IL-4,and GM-CSF were higher (P＜0.01) and IFN-γ was lower (P＜0.01) in the PAR cases than in the control cases.In the PAR cases,the content of GM-CSF was positive correlation with that of IL-4 (P＜0.01),and negative correlation with IFN-γ (P＜0.01).After the treatment,contents of IL-4 and GM-CSF were lowed (P＜0.01),content of IFN-γ was increased (P＜0.05),and all IL-4,GM-CSF and IFN-γ had no difference compared with those in the control cases.Conclusion:Acupuncture moxibustion could improve the symptoms and signs in PAR patients,enhance the immune function.It may be achieved by regulating the expression of Th1 and Th2,correcting the imbalance of Th1/Th2.

BACKGROUND: It has been proved that platelet activation is involved in the development of diabetic angiopathy. Glycoprotein (GP) Ib/IX/V complex is one of the main platelet membrane glycoproteins, and the receptor of both von Willebrand Factor and thrombin. It plays a key role in the process of platelet activation.OBJECTIVE: To observe the expression changes of GP Ib/IX/V complex and its component GP Ibα in patients with type 2 diabetes mellitus. DESIGN: Case-control study. SETTING: Department of Integrated Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: A total of 51 type 2 diabetic outpatients who visited Union Hospital were enrolled from December 2005 to January 2007. The diagnosis was based on the independent criteria from WHO in 1999. Of all the 51 patients, there were 23 females and 28 males, with a peripheral platelet count of over 50×109 L-1. All the subjects had no history of administrating drugs two weeks before the examination, which would potentially influence platelet count. According to disease controlling condition, the patients were assigned to well controlled patient (WCP) group (n = 25) and poorly controlled patient (PCP) group (n =26); and according to whether angiopathy was accompanied, diabetic patients were divided into vascular disease (VD) group (n =27) and non-vascular disease (NVD) group (n =24). Meanwhile 23 healthy subjects were enrolled as normal control group. Informed consents were obtained from subjects and their relatives. The experiments were approved by the ethical committee of Union Hospital.METHODS: Fasting venous blood was harvested from all the subjects' elbow on the early morning of visit day.①Biochemical analysis: Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c) and fasting plasma insulin (FINS) was measured by the Clinical Chemistry Department in Union Hospital.② Measurement of platelet membrane GP Ib/IX/V complex and its component GP Ibα: First, 3 mL cubital fasting blood was drawn from each subject and was anti-coagulated with 38 g/L natrium citricum. After that, all samples were fixed with 10 g/L paraform for 45 minutes. Then 50 μL well-fixed blood was added into the polystyrene tube, meanwhile 20 μL monoclonal antibody, such as CD42a-b-c-d and PE-labeled CD42b, was respectively mixed gently with the blood sample and incubated at room temperature in dark for 30 minutes. Next, 20 μL FITC-labeled rat IgG was mixed with the sample containing CD42a-b-c-d and incubated equally. In the end all blood samples were analyzed by FACS420 flow cytometry and the results were expressed as mean fluorescence intensity (MFI). ③ Platelet maximun aggregation rate (MAR) was detected according to reference.MAIN OUTCOME MEASURES: ①Biochemical indicators;②The expressions of GP Ib/IX/V complex and GP Ibα;③Platelet MAR.RESULTS: Fifty-one patients with type 2 diabetes mellitus and twenty-three healthy subjects were all involved in the result analysis.①There were significant differences in FINS in WCP group and PCP group compared with normal controls (P ＜ 0.01). FPG and HbA1c were significantly higher in PCP group compared with normal control group and WCP group (P ＜ 0.01).②Expressions of GP Ib/IX/V complex and GP Ibα were significantly lower in WCP group and PCP group compared with normal control group (P ＜ 0.01), significantly lower in PCP group than in WCP group (P ＜ 0.05), and also significantly lower in VD group and NVD group compared with normal control group (P ＜ 0.01). Moreover the expression of GP Ibα in VD group and NVD group was significantly lower than that of normal control group (P ＜ 0.05), and it also significantly decreased in VD group compared with NVD group (P ＜ 0.05). MFI of GP Ib/IX/V complex had an obvious negative correlation with FBG, HbA1c and FINS (r =-0.634, -0.573, -0.649, P ＜ 0.05), and GP Ibα MFI was obviously negatively correlated with FBG and HbA1c (r =-0.602, -0.543, P ＜ 0.05).③Platelet MAR of diabetic patients were remarkably higher than in healthy subjects (t =-3.852, P ＜ 0.01). Platelet MAR in PCP and VD groups were respectively higher than those in WCP and NVD groups (P ＜ 0.05). CONCLUSION: Platelet activation exists in the early stage of type 2 diabetes mellitus without diabetic angiopathy, and is more obvious after diabetic angiopathy. There is a positive correlation between platelet activation and blood glucose. As a receptor of thrombin and von Willebrand Factor, GP Ib/IX/V complex may be involved in the development of diabetic angiopathy.

Objective: To analyze the uncertainty of quercetin concentration determination in Sicao Tongmai capsules by HPLC. Methods: The source of uncertainty was confirmed by analyzing the HPLC determination process. The uncertainty components were quantified by statistics, and the extended uncertainty and confidence level were finally obtained. Results: The extended uncertainty of the measurement results was 0. 19 μg · g-1 . Quercetin concentration in Sicao Tongmai capsules was (353. 65 ± 0. 19)μg·g-1 . Conclusion: The uncertainty analysis method is suitable for the standard limit formulation for Sicao Tongmai capsules, and it is important to establish uncertainty analysis methods for traditional Chinese medicines.