Adult ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; therapy

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 assess the efficacy and safety of aricept in treatment of mild to moderate Alzheimer disease(AD).Methods 188 patients with AD were followed up in a multicentre,with randomized study for 12 weeks. 89 patients had a single -blind,placebo-controlled trial and 99 a self-matched trial.Results The results of randomized single-blind,placebo-controlled trial showed that the improvements in MMSE、CDR and ADL were statistically significantly greater with aricept 5 mg/d than with placebo(P value respectively 0.05).Conclusion Aricept is effective in treating patients with mild to moderate AD. It could produce improvements in cognition and ability of daily life. Aricept was well tolerated and safe.

Objective To study the pathologic characteristics and clinical significance of high intensity zone (HIZ) of lumbar intervertebral disc in the patients with discogenic low back pain. Methods 52 patients with low back pain without disc herniation underwent MRI and following discography of lumbar vertebrae. All patients previously were treated conservatively without relief of their symptoms for more than 6 months. Specimens of lumbar intervertebral discs containing HIZ in the posterior annulus from 11 patients with discogenic low back pain during posterior lumbar interbody fusion (PLIF) were collected to investigate the morphologic patterns and clinical significance. Results In all of 142 discs in 52 patients at discography, 17 discs in 17 patients presented HIZ, all showed painful reproduction and abnormal morphology with annular tears extending either well into or through the outer third of the annulus fibrosus. The histologic study of the consecutive sagittal slices in the HIZ lesions revealed that the normal lamellar structure was replaced by disorganized, vascularized granulation tissue that consisted of small round cells, fibroblasts, and newly formed blood vessels around the tears extending from the nucleus pulposus to the outer region of the annulus fibrosus. Blood vessel proliferation and inflammatory cell infiltration were seen extending along the margins of the tears into the middle and inner annulus, and sometimes the tears were bridged with granulation tissue. Ingrowth of vascularized tissue was sometimes observed to end abruptly at the junction between the inner third of the annulus and the nucleus pulposus. There was also matured scarring collagenous tissue. Conclusion The HIZ in the lumbar disc in the patients with symptomatic low back pain can be considered as a reliable marker of painful outer annular disruption.

Objective The theory of chemical radiculitis was put forward about 30 years ago, but it has not been proved by clinical study so for. The current study was initiated to assess whether the annular tear in painful disc was the cause of radiating leg pain (radiculopathy) in patients with discogenic low back pain. Methods Forty-two patients with chronic low back pain in single level and shooting leg pain in unilateral or bilateral lower limbs without lumbar disc herniation on CT and MR imaging were treated (age range, 19-52 years; mean age, 34.9 years; 27 males, 15 females). All patients showed annular disruption and pain reproduction on injection of the contrast during discography at single disc level (not including patients who had two or three levels disc disease). CT scan was performed to identify the location of annular tears after discography. The examinations of electromyography(EMG) and motor nerve conduction velocity (MCV) were performed in all patients, which were used to analyze the degree of nerve root injury and the relation with radiating leg pain. Results The patients with posterolateral annular disruption in single side mainly presented single lower limb radiation pain, in contrast, the patients with posterolateral annular disruption in two sides or posterior midline annular disruption mainly presented dual lower limb radiation pain. There was a significant positive correlation between the site of annular tear and the side of radiation pain. The examinations of EMG in all 42 cases found that there were abnormal insertional activities such as fibrillation potentials and positive sharp waves in 32 cases(76%). Of the 23 patients with unilateral lower limb radiation, nerve root lesions were found on the symptomatic side in 17 cases(74%). Of the 19 cases with bilateral lower limb radiation pain, root lesions were suggested in 15 patients(79%). The conduction velocities of common peroneal nerve and tibial nerve decreased with a statistically significant difference in symptomatic side compared with normal side. Conclusion Inflammatory chemical mediators and cytokines produced in painful disc leaking into epidural space through annular tear could lead to the injury to adjacent nerve roots, which might be primary pathophysiologic mechanism for the production of chemical radiculitis.

BACKGROUND:Currently, what we know about exosomes is that it can be produced by a variety of cel s and transfer a variety of materials, producing subsequent function of regulation.
OBJECTIVE:To review the function of exosomes in mesenchymal stem cel differentiation, in order to provide reference for further in-depth study.
METHODS:With the key words of“exosome, mesenchymal stem cel , differentiation”in Chinese and English, respectively, a computer-based search was performed for articles published in CNKI, Medline and Embase databases from January 2001 to September 2016. After the initial screening, the reserved articles were further detailed, summarized and concluded.
RESULTS AND CONCLUSION:Exosomes are a kind of vesicles 40-100 nm in diameter, which can be secreted by a variety of cel types, containing functional products, such as functional protein, gene product, lipid and so on. As a bridge of adjacent cel s transferring functional products, exosomes are becoming an issue of concern in the microenvironment for cel interaction. In the differentiation of mesenchymal stem cel s, exosomes also play an indispensable role via pathway regulation.

Objective To study the change of the structural and biological properties of the cardiovascular tissue after cell extracting. Methods The native and treated pulmonary cusp and pulmonary artery wall were evaluated by HE stain, ETVG stain, immunochemistry stain and scan electron microscopy. The contents of the main macro-molecules were measured. The content and position of calcium was investigated by subcutaneous implantation in a rat model. Results The acellularization procedure resulted in an almost complete removal of the original cells while the construction of the matrix remained. The contents of colleagen and elastin increased while soluble GAG reduced. The content of calcium in acellular tissue by xenogenic implantation was less obviously than that in fresh one. Conclusion A suitable acellularization procedure can remove all cells and most soluble proteins, and matrix remains nearly intact, so as to alleviate obviously calcification via xenogenic implantation in vivo.

The antitumor effect of sodium morrhuate (SM ) and cis - diaminoaichloroplatinum (CDDP ) for gastric cancer cell SGC - 7901 in vitro is observed with MTT assay. Human gastric cancer cells line SGC - 7901 were inoculated subcutaneously in the naked mice , so xenografts were established. The tumor of the mice in the combination groups were cross injected with SM 50mg . kg~(-1) . time~(-1) , 50?l and CDDP ( 3mg ? kg~(-1)? time~(-), 50?l)in varying order at an interval of 30 minutes. In each mouse the tumors were injected every third davs for a total of three injections. lt was found SM had strong antitumor effect on gastric can- cer cells in vitro experiment. The antitumor effect of local injection in combination groups were much stronger than that in any other single drug groups. The histopathological section observation showed that all tumors cells were necrotic in combination groups, There could be seen fibrous histocysts around the . necrotic tumor tissue in observation groups , and necrotic vascular endotheliocytes. The experiment showed that combined injection with SM and CDDP had a synergic antitumor effect.

BACKGROUND:Artificial valve replacement for valvular disease has good biocompatibility and hemodynamic characteristics, but there are stil many factors that affect its therapeutic effects. OBJECTIVE:To detect the level of serum Apelin-12 in the perioperative period of valve replacement in valvular disease patients with atrial fibrilation. METHODS: Sixty-two patients with valvular heart disease scheduled for artificial valve replacement were selected, including 30 patients with persistent atrial fibrilation (atrial fibrilation group) and 32 patients with sinus rhythm (sinus rhythm group). There were 33 males and 29 females, with a mean age of (55±11) years. Levels of serum Apelin-12 and makers related to inflammation and oxidative stress were detected in two groups at admission. Furthermore, the sinus rhythm group was sub-divided into postoperative atrial fibrilation (POAF) group (n=8) and non-POAF group (n=24) after valve replacement, and the above-mentioned indicators were detected and compared between these two subgroups. RESULTS AND CONCLUSION:Compared with the sinus rhythm group, the serum level of Apelin-12 was significantly lower in the atrial fibrilation group, while the levels of high-sensitivity C-reactive protein and interleukin-6 and total antioxidant capacity were significantly higher in the atrial fibrilation group (P <0.05). Correlation analysis showed that the serum level of Apelin-12 was negatively correlated with high-sensitivity C-reactive protein level and total antioxidant capacity (r=-0.265,P=0.045;r=-0.960,P <0.001), but not correlated with the interleukin-6 level (r=-0.155,P=0.230). Compared with the non-POAF group, the serum level of Apelin-12 was significantly lower in the POAF group (P< 0.05), but the left atrial diameter, high-sensitivity C-reactive protein level were higher in the POAF group (P < 0.05). Apelin-12 may take part in the occurrence and maintenance of atrial fibrilation through the regulation of inflammations and oxidative stresses. The testing of serum Apelin-12 has a certain value in predicting the occurrence of postoperative atrial fibrilation.

Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; Dry Socket ; drug therapy ; etiology ; Humans ; Inflammation ; drug therapy ; Mandible ; Molar, Third ; microbiology ; surgery ; Surgical Wound Infection ; drug therapy ; etiology ; Tooth Extraction ; adverse effects ; Tooth, Impacted ; microbiology ; surgery