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

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

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunoglobulin D ; Male ; Middle Aged ; Multiple Myeloma ; classification ; pathology ; Retrospective Studies

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 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 To explore the information on the clinical features of the severe acute respiratory syndrome (SARS) prevalent recently. Methods We collected and analyzed clinical date from the 85 inpatients suffered from SARS in Nanfang Hospital, Guangzhou. Results The patients ranged from 4 to 87 years old (mean age 38.2?16.7 years). The incubation period ranged form 2 to 16 days (mean periods 7.4? 3.8 days). The most common symptoms included fever (in 97.8 percent of the patients), cough (81.2%), malaise (74.1%), headache (63.5%), myalgia (41.2%). Peripheral vein blood test showed normal leukocytes and leukopenia in 82.4 percent of the patients. Other common findings were lymphopenia (in 27.1 percent of the patients), elevated alanine aminotransferase (44.7%), elevated aspartate aminotransferase (57.6%), elevated lactase dehydrogenase (49.4%) and elevated creatinine kinase (20.0%). Chest radiographs predominately showed air-space shadowing, such as ground-glass opacities, focal consolidation or patchy consolidation. The air-space shadowing was mostly in the lower lung zones (in 88.3 percent of the patients, bilateral and unilateral for 51.8% and 36.5% respectively). The mean period of complete resolution of the air-space shadowing was 20.3?8.4 days and 13.1?6.9 days after onset of illness and absent fever respectively. Empirical therapy most commonly included ribavirin, antibiotics. Conclusions SARS appears to be infectious. Fever followed by rapidly progressive respiratory compromise is the key complex of signs and symptoms from which the syndrome derives its name.

0 05). Conclusions The administration of glucocorticoid in early phase of SARS in small dosage and short term regimen could shorten the course of the disease and accelerate resolution of inflammation in the lung

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.