Objective To investigate the clinical characteristics of vaccine-associated immune thrombocytopenia(VA-ITP)based on the US Vaccine Adverse Event Reporting System(VAERS), and to provide a reference for vaccine safety monitoring, vaccination prevention, and clinical diagnosis and treatment.Methods Data from VAERS on all reported cases of immune thrombocytopenia(ITP) after vaccination since the establishment of the database in 1990 to the data lock point of 7th November 2023 were analyzed retrospectively for information on such as sex, age, vaccine type, vaccine dose, and occurrence time of ITP.Results Among the 877 cases of VA-ITP, there were 868 cases of effective statistical vaccine types, involving 43 vaccine types. The top 10 vaccine types were COVID-19 vaccine(434 cases, 50%), MMR vaccine(82 cases, 9. 4%),HEPA vaccine(48 cases, 5. 5%), FLU3 vaccine(41 cases, 4. 7%), FLU4 vaccine(32 cases, 3. 7%), HPV4 vaccine(30 cases,3. 5%), DTAP vaccine(29 cases, 3. 3%), MMRV vaccine(32 cases, 3. 7%), VARZOS vaccine(17 cases, 2. 0%) and HPV9vaccine(13 cases, 1. 5%). Among the 877 reported cases, 843 cases with definite sex were counted, including 374 males and469 females, with a male-to-female ratio of 1∶1. 25. The 377 cases of patients were under 18 years of age, accounting for about 44. 7% of the total, and there was significant difference in the composition ratio of sexes among patients with VA-ITP at different ages(χ~2= 10. 029, P < 0. 05). The incidence of ITP within 8 days after vaccination, with a total of 336 cases, was39.9%, and there was no significant difference in the occurrence time composition ratio of ITP between different sexes(χ~2=3. 296, P > 0. 05). The 54. 9% of ITP occurred after the first dose of vaccine, and there was no significant difference in the composition ratio of different vaccination doses between male and female recipients(χ~2= 5. 323, P > 0. 05), but there was significant difference in the composition ratio of vaccination doses among different age groups(χ~2= 30. 591, P < 0. 01).Conclusion By analyzing the summary data from VAERS database, the adverse reaction of VA-ITP was fully recognized.After clinical vaccination, attention should be focused on the platelet status of minors and the elderly, as well as those who were vaccinated within 8 days, and the continuous vaccine safety monitoring should be carried out, which is helpful to reduce the missed diagnosis of vaccine adverse events(AE) and improve the efficiency of clinical diagnosis and treatment.

Objective To investigate 16-slice spiral CT findings of bony canals of the internal auditory canal ( IAC ) fundus withmultiplanar reformation (MPR) and provide evidence for dignosis of lesions in the IAC fundus and surgery.Methods CT scan of thetemporal bone was performed in 30 volunteers. Bony canals of the IAC fundus were measured in images acquired with MPR.Results The mean?SD measurements (in mm) of the anteroposterior diameter and superoinferior diameter of fundus of the IAC was (4.07?0.97) mm and (3.24?0.88) mm respectively. The mean?SD measurements (in mm) of the length and width of bony canal for the labyrinthinesegment of the facial nerve was (3.04?0.52) mm and (0.96?0.31) mm, respectively. The mean?SD measurements (in mm) of the length and width of bony canal of the superior vestibular nerve was (2.52?0.48) mm and (0.83?0.30) mm respectively. The mean?SD measurements (in mm) of the length and width of bony canal of the cochlear nerve was (0.89?0.19) mm and (2.05?0.39) mm respectively. The mean?SD measurements ( in mm ) of the length and width of bony canal of the inferior vertibular nerve was ( 1.07?0.23 ) mm and (0.73?0.21) mm respectively. The mean?SD measurements ( in mm ) of the length and width of singular canal was (3.56?0.68) mm and (0.56?0.11) mm respectively . Conclusion MPR with 16-slice spiral CT can demonstrate the shape and measurements of the IAC fundus,which would contribute in dignosis of lesions in the IAC fundus and surgery.

Objective To study the correlation with ketamine and its metabolite norketamine concentration in plasma and saliva in acute toxic rabbits.Methods Experimental rabbits were given intragastric(i.g.group,n=6)and intravenous(i.v.group,n=6)administration of ketamine respectively,and control tabbits(n=6)were given a same volume of physiologic saline.The plasma and saliva were collected before and after ketamine administration.Ketamine and norketamine in plasma and saliva were determined using GC/MS and GC.The correlation with ketamine(norketamine)concentration in plasma and saliva were artalyzed by a double variable Pearson correlation analysis.Results The correlation coefficients(r)of ketamine (norketamine)concentrations in plasma and saliva were from 0.80 to 0.95 in ketamine i.g.group and i. v.group.Conclusion There is a good relativity between the concentration of ketamine(norketamine)in plasma and in saliva.The ketamine(norketamine)concentration in saliva can be used to estimate the plasma concentration in the forensic identification of ketamine abuse.

Objective To investigate diagnostic value of CTA for traumatic pseudoaneurysms (TPA) in the cavernous segment of the internal carotid artery (ICA) when they rupture into the sphenoid sinus. Methods CTA of 7 patients with TPA in the cavernous segments of ICA verified by DSA were retrospectively analyzed. All the patients were performed CTA scanning. The post-processing techniques included VR,MIP,MPR, and CPR. Results All the CTA images of 7 patients showed irregular mass in the sphenoid sinus with obviously enhancement in the same phase to ICA, which communicating with ICA in wide base. The peripheral area of the mass showed no enhancement. The size varied from 3 mm × 2 mm × 1 mm to 33 mm × 30 mm × 27 mm. The adjacent lateral wall of sphenoid sinus showed fractures in all cases. TPA located at anterior-knee segments of cavernous ICA in 6 cases, and cavernous free segment in 1 case. All the disruptions were found at medial or anterior medial wall of ICA. Conclusions Cranial CTA is the effective non-invasive method for diagnosing TPA in the cavernous segment of ICA when they rupture into sphenoid sinus. Combined using of VR, MIP, MPR, and CPR can delineate the location and size of the sphenoid wall fracture and the ICA rupture, which help to clarify the anatomical relationship between them.

Objective To study the MRI features of nasopharyngeal carcinoma (NPC) in patients who presented with ocular abnormalities. Methods The clinical signs and MRI features of Ⅲ, Ⅳ and/or Ⅵ cranial nerve involvement in 22 cases of histologically proved nasopharyngeal carcinoma were retrospectively analyzed. Results All 22 cases showed perineural tumor spread along the course of Ⅲ, Ⅳ and Ⅵ cranial nerve. Diplopia was the most common sign, occurred in 14/22 patients. The incidence of incomplete palsy of Ⅲ, Ⅳ and Ⅵ cranial nerve were 16/44, 7/44 and 4/44, respectively. There were four types of abnormal MRI findings: cavernous sinus thickening (10/44) and mass ( 16/44), superior orbital fissure enlargement (4/44) and abnormal signals (9/44), thickened oculomotor muscles with obscured adjacent fatty space and abnormal enhancement (10/44). The dynamic contrast enhancement patterns of the masses in cavernous sinus and orbital were the same as that of nasopharynx lesions; all appeared as rapid initial enhancement followed by a plateau phase. Conclusion Oculomotor nerve involvement can be the first clinical signs of NPC, and MRI can show the perineural extension along the Ⅲ, Ⅳ and Ⅵ cranial nerve in NPC.

Objective To investigate the influence of pre-chemotherapy hemoglobin and platelet levels on the effect of chemotherapy and prognostic outcome in patients with endometrial carcinoma (EC).Methods 104 patients with EC who underwent surgical treatment following neoadjuvant chemotherapy were retrospectively analyzed.Multiple logistic regression was carried out to evaluate the relationship between the probability of achieving an optimal clinical response and the variables.The log-rank test was used to compare the homogeneity of progression-free survival and overall survival functions across strata defined by categories of prognostic variables.Results The Cox proportional hazard model was used to assess the significance of potential prognostic factors for progression-free survival and overall survival.Multivariate logistic regression analysis indicated that FIGO staging (OR =3.234,95 ％ CI:1.324-13.454) and lymph node metastasis (OR =8.235,95 ％ CI:1.563-18.574) were independent factors of influencing effects of new adjuvant chemotherapy in the treatment of EC patients.Multivariate Cox regression model analysis showed that the FIGO staging(HR =4.342,95％ CI:1.643-15.856) and lymph node metastasis (HR =3.853,95％ CI:1.864-9.675) were independent factors of influencing 5 years survival rate of EC patients received new adjuvant chemotherapy.Conclusion The curative effect and prognosis after receiving neoadjuvant chemotherapy operation in treatment of EC patients before chemotherapy,there was no significant correlation between hemoglobin and platelet levels,and lymph node metastasis,FIGO stage.

Objective: To analyze the hospitalization expense and management status of severe mental illness, and to provide evidences for rational controls of medical expenses and the management of the patients. Methods:Collecting patients with severe mental illness from 2005 to 2012, analyzing the changing trends of hospitalization cost and management status with descriptive analysis, and use multiple linear regression to analyze the influence factors. Results: The average stay is 51 days, average medical costs by person and by day are RMB 8 319.69 and 169.02; treatment costs, drug costs and bed care costs are the main proportion. The medical costs were significantly affected by prolonged days of hospitalization, age, numbers of hospital admissions, nursing level and admitting diagnosis. The largest proportion of management system is schizophrenia, which counted 74.03% of current patients and the poverty incidence rate is 50.62%. Conclusions: Increasing the financial compensation to patients with severe mental illness, shorting hospital stay, strengthening the screening of patients with severe mental illness and incorporated into the management system would help to reduce the economic burden of the patients.

Objective To observe the effects of misoprostol on the reduction of postpartum bleeding in cesarean section.Methods With oxytocin as control,the amount of bleeding during and two hours after cesarean section was observed.Results The mean amount of bleeding was (232.0±46.6) ml in misoprostol group and (385.0±74.7) ml in oxytocin group respectively.The difference between the two groups was significant (P＜0.01).Conclusion Misoprostol is more effective to improve uterin contraction than oxytocin and is better in the reduction of postpartum bleeding with safety and convenience.

Object It was reported that salvianolic acid A from Salvia miltiorrhiza Bge could improve memory dysfunction of mice with cerebral ischemia reperfusion injury The effects of total salvianolic acids (Sal), including salvianolic acid A and B, rosmaric acid and protocatechic aldehyde was now studied to observe its effect on cerebral ischemia reperfusion injury in hope of obtaining a preliminary view on its mechanism of action Methods The effects of Sal on lactic dehydrogenase (LDH), superoxide dismutase (SOD) and malondialdehyde (MDA) of cerebral ischemia reperfusion injured mouse and rat models were observed Results Sal 10, 20 mg/kg iv and 5, 10 mg/kg iv could markedly increase the activities of LDH and SOD and lower the production of MDA in the injured cerebral tissue On focal cerebral ischemia reperfusion injured rat, 24 h reperfusion after 2 h ischemic injury, 5, 10 mg/kg iv Sal could decrease infarct size, ameliorate neurological deficit with obvious inhibition of the decrease of LDH and SOD activities and the over production of MDA Conclusion Sal showed obvious protective effects on cerebral ischemia reperfusion injuries of mice and rats via attenuating oxygen free radical

Objective To evaluate the effect of bone marrow stem cells (BMSCs) transplantation in the treatment of hepatolenticular degeneration of liver fibrosis. Methods Sixty cases with confirmed hepatolenticular degeneration of liver fibrosis were randomly divided into 3 groups: penicillamine group [40 mg/(kg·d)], BMSCs group and BMSCs + penicillamine group. Autologous BMSCs (2 mL) were injected into vein with normal saline (100 mL). Liver tissue pathology biopsy was inspected and the changes in HA, PCⅢ, LN, CⅣ, TIMP-1 and MMP-1 were observed at 0, 4th, 8th and 12th week during the therapeutic process. Results The level of serum fibrotic markers were reduced in every group , while the changes in BMSCs + penicillamine group were especially obvious (P < 0.05). Conclusion Penicillamine combined with BMSCs was effective in the therapy of hepatolenticular degeneration of liver fibrosis.