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 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.

To investigate effect of the transplantation of mesenchymal stem cells (MSCs) in combination with nerve growth factor (NGF) on the repair of spinal cord injury (SCI) in adult rats, spinal cord of adult rats (n= 32) was injured by using the modified Allen' s method. One week after the injury, the injured cords were injected with Dubecco-modified Eagles medium (DMEM , Group Ⅰ), MSCs (Group Ⅱ), NGF (Group Ⅲ), and MSCs plus NGF (Group Ⅳ). One month and two months after the injury, rats were sacrificed and their injured cord tissues were sectioned for the identification of the transplanted cells. The axonal regeneration and the differentiation of MSCs were examined by immunocytochemical staining. At the same time, rats were subjected to behavioral tests by using the open-field BBB scoring system. Immunocytochemical staining showed that axonal regeneration and the transplanted cells partially expressed neuron-specific nuclear protein (NeuN) and glial fibrillary acidic protein (GFAP). At the same time, significant improvement in BBB locomotor rating scale (P＜0.05) were observed in the treatment group. More importantly, further functional improvement were noted in the combined treatment group. MSCs could differentiate into neurons and astrocytes. MSCs and NGF can promote axonal regeneration and improve functional recovery. There might exist a synergistic effect between MSCs and NGF.

Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.

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.

Objective To observe the survival and migration characteristics after intracarotid transplantation of bone marrow stem cells(BMSCs) and its effect on learning-memory abilities across the blood-brain barrier(BBB) in the vascular dementia(VD) rats .Methods Bone mononuclear cells(BMNCs) were isolated from bone marrow in vitro by standard Ficoll-Hypaque technique , then cells were enriched and expanded by using bone marrow adherent culture .72 Wistar rats were meanly divided into control group ,model group and treatment group .The VD rat model was established by modified pulsinellis 4-vessel occlusion(4 VO) .The treatment group received intracarotid infusion of 0 .5 mL 1 .2 × 107/mL BMSCs which were labeled with BrdU in vitro after opera-tion .Their survival ,migration and the learning-memory abilities were observed at 4th and 8th week .Results BMSCs transplanted by intracarotid transplantation survived and had been found throughout the brain tissue .They major migrated and localized in the is-chemic zone of injury such as hippocampus and cerebral cortex .Compared with the control group ,active avoidance response(AAR) ratio in the model group(42 .1 ± 4 .5) ,group(43 .6 ± 3 .6)showed significantly decrease compared with the control group (90 .0 ± 4 .3) ,(92 .5 ± 5 .0)(P<0 .01) ,and the treatment group(69 .2 ± 4 .7) ,(70 .8 ± 4 .7)was significant higher than the model group(P<0 .01) .Conclusion Intracarotid transplantation of BMSCs could enter the VD rats cerebra parenchyma via BBB ,migrate into the damaged brain tissue to gather and survive .Learning-memory abilities can be improved significantly by transplanted BMSCs .

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 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.