Objective To investigate the etiology and clinical characteristics of pregnancy-emerged thrombocytopenia.Methods A retrospective analysis was conducted on clinical data of 159 pregnancies with thrombocytopenia,who were admitted to Peking University People's Hospital from January 2000 to January 2010.All the patients recruited in this study had no history of blood or immune system disease before pregnancy,and thrombocytopenia was the predominate clinical manifestation during pregnancy,with platelet counts less than 100 × 109/L at least twice during pregnancy.The thrombocytopenia should not be induced by drugs,viral infections,preeclampsia or hemolysis,elevated liver enzymes,and low platelets syndrome (HELLP).All cases were followed up.The general condition,the onset time of thrombocytopenia,platelet changes,accompany symptoms,maternal and perinatal outcomes as well as follow-up conditions were compared based on the etiology.Results ( 1 ) Etiology:among the 159 cases,101 (63.5％) were diagnosed gestational thrombocytopenia (GT) ;43 ( 27.0％ ) were idiopathic thrombocytopenic purpura(ITP) ;9 ( 5.7％ ) were blood system diseases,including 4 cases of megaloblastic anemia( MA ),2 cases of aplastic anaemia (AA),and 3 cases of myelodysplastic syndrome(MDS).Six cases (3.8％)were diagnosed immune system diseases,including 3 cases of systemic lupus erythematosus ( SLE),2 cases of antiphospholipid syndrome (APS),and 1 case of Evans syndrome.(2)Maternal and perinatal outcomes:pregnancy induced hypertension was diagnosed in 21 cases ( 13.2％ ),abnormal glucose metabolism in 13 cases ( 8.2％ ),anemia in 44 cases ( 27.7％ ) and preterm delivery in 18 cases ( 11.3％ ).Twenty-nine cases ( 18.2％ ) were treated with corticosteroids or gamma globulin during pregnancy.The average gestational week was 38 weeks.Fifty-five cases ( 34.6％ ) underwent vaginal delivery,104 cases ( 65.4％ ) received cesarean section.Postpartum hemorrhage was observed in 34 cases (21.4％),and puerperal infection happened in 2 eases ( 1.3％ ).No maternal death was found.In a total of 160 fetuses (including twins),there were 157 live births.Three cases of fetal death and 2 cases of early neonatal deaths were observed.Fetal growth restriction was observed in 4 cases,and neonatal thrombocytopenia was seen in 6 cases.No intracranial hemorrhage was detected.(3)The onset time of thrombocytopenia:among the 159 cases,29 cases ( 18.2％ ),67 cases (42.1％ ),63 cases (43.6％) of thrombocytopenia were detected in the first,second and third trimester,respectively.There was a significant difference of the onset time of thrombocytopenia between GT and ITP groups( P ＜ 0.05 ).Patients with GT tended to have a later onset of thrombocytopenia,which mainly happened in the second and third trimester,while patients with ITP tended to happen in the first and second trimester.(4)The degree of thrombocytopenia:the cases with the minimum platelets level of (51 - 100) × 109/L,(31 - 50) × 109/L,( 10 - 30) × 109/L,＜ 10 × 109/L during pregnancy were 75 (47.2％ ),39 (24.5％ ),31 ( 19.5％ ),14( 8.8％ ) respectively.There was a significant difference between GT and ITP groups in the lowest platelets level (P ＜ 0.01 ).(5)Thrombocytopenia accompany with anemia:among the 159 cases,there were 44 cases (27.7％ ) accompanied with anemia.The proportion was 9.9％ ( 10/101 ) in GT group,58.1％ (25/43) in ITP group,with significant difference(P ＜0.01 ).Anemia was also found in 5 cases in blood system disease group (5/9),and 1 case in immune system disease group (Evans syndrome,1/6).Pancytopenia was observed in 2 cases with ITP (4.7％,2/43 ) and 3 cases with blood system disease ( AA:1 cases,MA:2 cases,3/9).(6) The recovery of the platelets counts postpartum:the postpartum follow-up periods were 7 months to 10 years.Patients recovered within 1 week,6 weeks,6 months postpartum were 66 cases ( 41.5％ ),43 cases ( 27.0％ ),17 cases ( 10.7％ ) respectively.The platelets counts did not recover within 6 months postpartum in 33 cases(45.7％ ).Conclusions GT is the leading cause of pregnancy-emerged thrombocytopenia followed by ITP.There are significant differences between GT and ITP in the onset time of thrombocytopenia,the lowest platelets level,the proportion of anemia accompanied and the postpartum recovery.Other etiologies including immune and blood system diseases are rare.The relevant examinations should be taken for etiology and differential diagnosis.

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

ObjectiveTo investigate the efficacy and toxicity of postoperative radiochemotherapy compared with chemotherapy alone in the treatment of locally advanced gastric cancer.MethodsA total of 83 patients with resected adenocarcinoma of the stomach were randomly assigned to postoperative radiochemotherapy group (RCT) ( n =43 ) or chemotherapy alone group (CT) ( n =40 ).Patients in RCT group received radiotherapy concurrent with capecitabine chemotherapy then followed by 4 - 6 cycles of FOLFOX4 chemotherapy.The total dose of radiation was 45 Gy.The dose of capecitabine was 1600 mg/m2per day.In the CT group,patients received 6 - 8 cycles FOLFOX4 chemotherapy.Survival was analyzed using Kaplan-Meier method and Logrank test. Results The follow-up rate was 96％. The number of patients who had a minimum of 2-,3-year follow-up time were 37,12 in the RCT group and 31,10 in the CT group.The 1-,2-,3-year local control rates for RCT and CT groups were 100％,97％,94％ and 95％,87％,73％ (x2 =4.54,P =0.033),respectively.The 1-,2-,3-year survival rates were 98％,86％,81％ in the RCT group,with 93％,80％,64％ in the CT group ( x2 =3.96,P =0.047 ).The incidence of grade 3hematological toxicity in the RCT and CT group was 23％ vs 15％ ( x2 =0.93,P =0.630 ),and grade 3gastrointestinal toxicity was 16％ vs 10％ ( x2 =0.95,P =0.624 ). Conclusions Compared with chemotherapy alone,postoperative radiochemotherapy can improve survival of locally advanced gastric cancer patients with acceptable toxicities.

GPS was used in the snail survey of Nuanhuping marshland in Poyang Lake region and its application value was discussed. The results suggest that GPS which can measure the marshland area and survey area at real-time and draw electronic maps of snail situation rapidly, could realize the electronic and image management of the data from snail survey and provide more accurate information to the department in charge of schistosomiasis control.

Objective:To assess the feasibility and safety of 2-staged hybrid technique for treating coronary artery disease (CAD) patients with multi-vessel lesions.
Methods: Our research included 2 groups:Hybrid group, CAD patients with left anterior descending artery (LAD) lesion or with other major epicardial vessel stenosis>70%who received 2-staged hybrid treatment in our hospital from 2012-03 to 2015-03 and Control group, CAD patients received elective conventional off-pump coronary artery bypass (OPCAB) by the same surgeon at meanwhile. n=91 in each group. The peri-operative conditions and complications were compared between two groups.
Results: Compared with Control group, Hybrid group had the shorter post-operative mechanical ventilation time (7.9 ± 4.8) h vs (21.6 ± 35.9) h, shorter ICU-stay time (29.6 ± 20.8) h vs (47.5 ± 38.3) h, all P<0.01 and less peri-operative blood transfusion (0.59 ± 1.48) U vs (2.82 ± 3.81) U, P<0.01. The post-operative complications of mortality, MI occurrence and delayed wound healing were similar between 2 groups, P>0.05.
Conclusion:2-staged hybrid technique is a safe, feasible and minimally invasive technique for treating CAD patients with LAD and multi-vessel lesions.

Objective To explore the relationship between pulse wave velocity(PWV)and blood pressure classification and cardiovascular risk factors stratification in patients with essential hypertension. Methods Totally,390 patients with essential hypertension were recruited in the study and their carotid- femoral PWVs were recorded by an automatic pulse wave velocity measurement system.The patients were stratified by their cardiovascular risk factors.PWVs were compared between patients with varied blood pressures or with and without cardiovascular risk factors.Results There was no significant difference in PWV between patients of phase 1 and phase 2 hypertension,[(10.8?1.7)m/s vs.(11.9?1.2)m/s,P =0.398].PWV in patients with more than one risk factor was significantly higher than that in those with hypertension alone,[(10.4?1.4)m/s vs.(11.7?1.4)m/s,P=0.018].Conclusions PWV in hypertensive patients with one or more than one other risk factors was significantly higher than that in those without other risk factors.Cardiovascular risk factor might play a more important role in arterial stiffness.

Natural products are important sources for the discovery of anti-tumor drugs. Evodiamine is the main alkaloid component of the traditional Chinese herb Wu-Chu-Yu, and it has weak antitumor activity. In recent years, a number of highly active antitumor candidates have been discovered with a significant progress. This article reviews the research progress of evodiamine-based antitumor drug design strategies, in order to provide reference for the development of new drugs with natural products as leads.

This study was aimed to discriminate the alleles in the HLA-C*07:01:01G and HLA-C*07:02:01G groups and analyze their associations with HLA-B locus. Samples previously typed as HLA-C*07:01:01G and HLA-C*07:02:01G were collected. The nucleotide sequences in exons 1 to 7 of the HLA-C locus were sequenced by polymerase chain reaction sequence-based typing (PCR-SBT) and HLA-B genotyping was also preformed by PCR-SBT in these samples. The results showed that 4 samples (30.8%) were confirmed as HLA-C*07:01:01 and 9 samples (69.2%) were HLA-C*07:06 among 13 samples previously typed as HLA-C*07:01:01G. Linkage disequilibrium (LD) analysis showed that HLA-C*07:06 allele was strongly related with HLA-B*44:03. All samples were typed as C*07:02:01 among 102 individuals previously typed as C*07:02:01G. LD analysis showed that C*07:02:01 was strongly related with HLA-B*51:01, B*46:01, B*39:01, B*40:01, B*38:02, B*15:02 alleles. It is concluded that HLA-C*07:01:01 and HLA-C*07:06 alleles are confirmed in the HLA-C*07:01:01G group and HLA-C*07:02:01 is a preferred allele in the HLA-C*07:02:01G.
Alleles ; Base Sequence ; Exons ; HLA-B Antigens ; genetics ; HLA-C Antigens ; genetics ; Humans ; Molecular Sequence Data ; Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA

OBJECTIVESTo evaluate the inhibitory effect mediated by combination of small interfering RNAs (siRNAs) targeting different sites of hepatitis B virus (HBV) transcripts on the viral replication and antigen expression in vitro.

METHODS(1) Seven siRNAs targeting surface (S), polymerase (P) or precore (PreC) region of HBV genome were designed and chemically synthesized. (2) HBV-producing HepG2.2.15 cells were treated with or without siRNAs for 72 h. (3) HBsAg and HBeAg in the cell culture medium were detected by enzyme-linked immunoadsorbent assay. (4) Intracellular viral DNA was quantified by real-time PCR (Polymerase Chain Reaction). (5) HBV viral mRNA was reverse transcribed and quantified by real-time PCR. (6) The change of cell cycle and apoptosis was determined by flow cytometry.

RESULTSOur data demonstrated that synthetic small interfering RNAs (siRNAs) targeting S and PreC gene could efficiently and specifically inhibit HBV replication and antigen expression. The expression of HBsAg and HBeAg and the replication of HBV could be specifically inhibited in a dose-dependent manner by siRNAs. Furthermore, our results showed that the combination of siRNAs targeting various regions could inhibit HBV replication and antigen expression in a more efficient way than the use of single siRNA at the same final concentration. No apoptotic change was observed in the cell after siRNA treatment.

CONCLUSIONOur results demonstrated that siRNAs exerted robust and specific inhibition on HBV replication and antigen expression in a cell culture system and combination of siRNAs targeting different regions exhibited more potency.

Apoptosis ; Cell Cycle ; Cell Line, Tumor ; DNA, Viral ; biosynthesis ; Flow Cytometry ; Gene Expression Regulation, Viral ; genetics ; Hepatitis B Surface Antigens ; metabolism ; Hepatitis B e Antigens ; metabolism ; Hepatitis B virus ; genetics ; physiology ; Humans ; RNA, Small Interfering ; genetics ; metabolism ; Virus Replication ; genetics

To investigate the effects of allicin on rats by NMR-based metabonomic method, the changes of endogenous metabolites in normal rat urine and the influences on metabolism were analyzed with bio-nuclear magnetic resonance (NMR) method and partial least-squares discriminant analysis (PLS-DA) after intraperitoneal administration of allicin solution. The identified biochemical effects associated with allicin dosing included elevated then gradually recovered urinary levels of Kreb's cycle intermediates, such as citrate, alpha-ketoglutarate and succinate and increased concentrations of ketones. Meanwhile, decreased urinary concentrations of glucose, lactate, alanine, hippurate and trimethylamine oxide were observed. The PLS-DA revealed that the metabonomic profiles of allicin treated groups were obviously different from those of the control group. Allicin may change metabolism significantly in normal rats. The study of the pharmacologic mechanism of allicin by metabonomic method is practicable and it could be explored further.
Animals ; Magnetic Resonance Spectroscopy ; Male ; Metabolomics ; Rats ; Rats, Sprague-Dawley ; Sulfinic Acids ; metabolism ; urine