In autoimmune thrombocytopenic purpura (AITP) specific autoantibodies bind platelet GP via their Fab fragments. Both splenic CD5+ B and CD5- B cells produce platelet glycoprotein-specific antibodies. There is limited number of antigenic determinants, and the GP-specific autoantibodies are derived from a restricted number of B-cell clones in chronic AITP. Blocking co-stimulatory signals could induce platelet-specific T cell anergy. MMF could be used as a second line agent for the treatment of steroid-resistant AITP. Detection of plasma thrombopoietin levels play an important role in the differentiation of thrombocytopenic states caused by platelet destruction or due to bone marrow hypoplasia. Endogenous TPO level is also important on the differential diagnosis of ET and RT. Quinine- or heparin-dependent antibodies could induce thrombocytopenia. PCR-SSP is useful for the genotyping of the platelet-specific alloantigen HPA. Biotinylated platelets have an impaired response to agonists as evidenced by in vitro platelet aggregation tests.
Antigens, Human Platelet ; immunology ; Blood Platelets ; immunology ; Heparin ; adverse effects ; Humans ; Platelet Membrane Glycoproteins ; immunology ; Purpura, Thrombocytopenic, Idiopathic ; etiology ; immunology ; Thrombopoietin ; blood

Objective To explore the relationship between chronic tonsillitis and allergic purpura.Methods Fifty-six allergic purpura children with chronic tonsillitis were selected,26 children were given tonsillectomy (operation group),and 30 children were not given tonsillectomy (no-operation group).The duration of abdominal pain,duration of erythra,proteinuria negative time,hematuria negative time,antistreptolycin O rite,complement C3 were compared between the 2 groups,and the 24 h urine protein quantitarion and urine red blood cell count in operation group were compared between preoperative and postoperative.Results The duration of erythra,duration of abdominal pain,proteinuria negative time,hematuria negative time in operation group were significantly better than those in no-operation group [(10.58 ±4.22) d vs.(16.70 ±9.68) d,(6.49 ±2.45) d vs.(9.20 ± 2.21) d,(12.3 ±4.1) d vs.(16.5 ± 5.6) d,(10.1 ± 3.3) d vs.(12.7 ± 4.9) d],there were statistical differences (P ＜ 0.01 or ＜ 0.05).There were no statistical differences in antistreptolycin O tite and complement C3 between the 2 groups (P＞ 0.05).In operation group,the 24 h urine protein quantitation and urine red blood cell count postoperative were significantly better than preoperative [(0.72 ± 0.28) g vs.(1.61 ± 1.22) g,(14.95 ± 4.76) / μ l vs.(56.61 ± 12.57)/μ 1],there were statistical differences (P＜ 0.01).Conclusion Chronic tonsillitis is one of the important factors which can make allergic purpura erythra relapses and induce purpura nephritis,and tonsillectomy is the optional means of treatment of purpura nephritis with chronic tonsillitis and erythra relapses.

Objective To explore the correlation between serum adipokines and cytokines levels in obese patients with colon cancer.Methods 53 patients with obese colon cancer treated in our hospital from January 2011 to June 2013 were selected as the observation group and at the same time 51 cases of non-obese colon cancer were selected as the control group.TNF-α,IGF-1,VEGF and adipokines levels were measured in the two groups.Results The IGF-1 level in the stage A-B and the stage C-D of the ob-servation group was significantly increased compared with the same stages of the control group (P <0.05).The TNF-α,IGF-1 and VEGF levels in the stage C-D of the observation group were significantly higher than those in the stage A-B (P <0.05 ),the TNF-αand VEGF levels in the stage C-D of the control group were significantly increased compared with the stage A-B (P <0.05).The visfatin and leptin levels in the stage A-B of the observation group were significantly increased compared with the same stages of the control group (P <0.05),the visfatin,resistin and leptin levels in the stage stage C-D of the observation group were significantly increased compared with the same stages of the control group (P <0.05).Visfatin was positively correlated with IGF-1 and VEGF (P <0.05),resistin was positively correlated with IGF-1 (P <0.05 ),leptin was positively correlated with TNF-α, IGF-1 and VEGF (P <0.05).Conclusion Obvious lipid metabolism and cellular cytokines disorders exist in obese colon cancer, their disorder level could promote the progression of colon cancer.

AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand - held autorefractor for refraction screening in cadet candidates.
METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students ( 634 eyes ) after mydriasis. Main index of refraction values ( spherical, cylindrical mirror degree and axial) were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.
RESULTS: Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy ( P< 0. 05 ), but the correction analysis showed that there was high correlation (r=0. 733, 0. 694), axial of refration measured by these two methods were non - significant ( P > 0. 05 ). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.
CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

Aromatase Inhibitors ; adverse effects ; Arthralgia ; chemically induced ; therapy ; Humans ; Integrative Medicine

Aim To study the effects of preconditioning with desflurane, sevoflurane and isoflurane on adenosine triphosphate (ATP) in anoxia-reoxygenation myocardial cells. Methods Rat ventricular myocytes, cultured for 4～5 days, were randomly allocated to five groups: Control group, anoxia-reoxygenation group and groups preconditioned with 1.5 MAC desflurane, sevoflurane or isoflurane following anoxia-reoxygenation. The content of intracellular ATP ,the activities of lactic dehydrogenase(LDH) and creatine kinase(CK), and the cell viability were measured at the end of experiment.Results Preconditioning with 1.5 MAC desfllurane, sevoflurane or isoflurane significantly attenuated the great reduction in ATP and cell viability and the increase of LDH and CK caused by anoxia-reoxygenation. There was a positive correlationship between ATP and cell viability,and a negatiue correlationship between LDH and CK (r was 0.83, -0.87 and -0.82 respectively, P

ObjectiveTo guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.MethodsThirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.ResultsEVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P ＜ 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P ＜ 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P ＜ 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P＜0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.ConclusionEVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.

Objective Using MR defecography to assess the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and evaluate the joint disease of anterior and mid pelvic. Methods One hundred and seven female patients, aged 20 to 84 years ( average, 55 years), were diagnosed as outlet obstruction constipation based on clinical symptoms and signs. They all received MR defecography in our institution. The high compliance homemade balloon was inserted into rectum to simulate stool Then relevant measurements were obtained during rest, squeezing and straining, respectively. Results In all the 107 cases, 70 ( 65.4% ) presented rectocele on dynamic MRI; 28 ( 26. 2% ) presented anismus;60 (56. 1% ) presented cystocele; 59 presented vaginal or cervical prolapse(55. 1% ); and, 54 (50. 5% )presented descending perineum. In 85 females (79.4%) multiple disorders were detected, involving more than one pelvic compartment. Conclusion MR defecography allowed to accurately evaluate the morphological and functional anorectal anomalies related to female outlet obstruction constipation, and the joint disease of anterior and mid pelvic.

High-level researchers,who can efficiently enhance the research strength of the college,are often brought in at high cost.Therefore there is often the need to scientifically evaluate these researchers when introduce them.We here discuss the main indicators for the evaluation of High-level researchers.Taking into consideration of their age,research span,et al.,we propose a model for the quantitative evaluation of research capability based on research achievement and prediction of future achievement,

BACKGROUND:Total knee arthroplasty is always associated with peripheral blood loss.Blood transfusion not only involves additional cost and prolongs rehabilitation time,but also carries substantial risk of immunologic reaction and disease transmission.Therefore it is very important to reduce blood loss of total knee arthroplasty.OBJECTIVE:To investigate the efficacy and safety of tranexamic acid on reducing blood loss after total knee arthroplasty.METHODS:We enroled 64 patients with primary osteoarthritis undergoing a unilateral total knee arthroplasty and randomized them into two groups,with 32 patients in each group.Tranexamic acid group: patients received intravenous drop infusion of tranexamic acid dissolved in 250 mL normal saline (10 mg/kg) at 15 minutes before operation; control group: patients just received 250 mL normal saline.Intraoperative blood loss,postoperative blood loss,postoperative hemoglobin levels,amount of blood transfusion,and number of patients requiring blood transfusion were compared.Fibrinogen,prothrombin time and other coagulation indicators were also examined before operation and 3 hours after operation.Deep vein thrombosis in both limbs of al patients was examined bythe color Doppler ultrasonography 30 days after operation.RESULTS AND CONCLUSION:There was no significant difference in intraoperative blood loss between the two groups (P＞0.05).Postoperative volume of blood loss was lower in the tranexamic acid group than in the control group (P＜0.001).The amount of blood transfusion and number of patients requiring blood transfusion were lower in the tranexamic acid group than in the control group (P＜0.001).The postoperative hemoglobin levels were obviously higher in the tranexamic acid group than in the control group (P＜0.001).There was no significant difference in coagulation indicators between two groups at postoperative 3 hours,but D-dimer value in the two groups was significantly higher than that before surgery,and the tranexamic acid group was lower than the control group (P＜0.001).No cases appeared deep vein thrombosis after operation.Experimental findings indicate that,tranexamic acid can effectively reduce postoperative blood loss and blood transfusion,as wel as number of blood transfusions after total knee arthroplasty.And it did not increase the risk of deep vein thrombosis.