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

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

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

Objective To investigate the effects of changes in protein bile sugar chain structure for differen-tiating benign and malignant biliary tract disease .Methods 100 patients with biliary tract diseases who were treated in Department of General Surgery ,Qingdao Haici Medical Group were selected in this study .According to benign or malignant biliary disease ,the patients were divided into control group ( benign biliary tract disease ) and observation group ( cholangiocarcinoma ) ,50 cases in each group .Two groups of patients with bile drops on the nitrocellulose mem-brane,through the comparison of wheat germ agglutinin (WGA),Datura stramonium agglutinin (DSA),lentil lectin (LCA),concanavalin A(CONA) positive rate of test,to explore the relationship between sugar chain of glycoprotein in bile and bile duct benign and malignant diseases .Results In control group,the positive rates of WGA,DSA,LCA, CONA agglutinin test were 22.0%,14.0%,2.0%,76.0%,those in the observation group were 76.0%,66.0%, 76.0%,82.0% respectively.No statistically significant difference between the two groups of CONA agglutinin test positive rate was observed(P>0.05).The WGA,LCA,DSA agglutination test positive rates in observation group were significantly higher than those in the control group ,the differences were statistically significant (χ2 =29.17,28.17, 57.55,all P<0.05).Conclusion Changes in bile glycoprotein chain structure are closely related to benign and ma -lignant biliary tract disease ,positive rates of WGA ,LCA,DSA agglutination test can be used to determine the benign and malignant biliary disease ,it should be popularized in clinical practice .

Objective To investigate the proportion and the clinical significance of status of different hepatitis B virus(HBV) serological markers in HBV related chronic liver disease(CLD),including chronic hepatitis B(CHB),liver cirrhosis(LC) and hepatocellular carcinoma(HCC).Methods The related clinical data of 2 482 inpatients during the period of January 2006 to December 2007 were collected and analyzed statistically.Results In 1 226 patients with CHB,64.4% of them were hepatitis B e antigen(HBeAg)-positive,and 35.6% of them were HBeAg-negative.In 362 patients with LC,27.1% of them HBeAg-positive,66.0% HBeAg-negative,6.9% HBsAg-negative,and in 894 patients with HCC,16.4% were HBeAg-positive,75.1% HBeAg-negative and 8.5% HBsAg-negative.In every disease entity of CLD,the sex ratio for serological markers was similar,though the ratio of male-to-female in the patients with HCC(8.8∶1) was significantly higher than that of LC(4.5∶1) and CHB(4.4∶1),respectively.The age of HBeAg-negative patients with CHB was significantly older than that of HBeAg-positive patients with CHB.The average age of patients with different status of serological markers in LC or HCC was similar.No statistical difference was found in ALT levels between the HBeAg-positive and HBeAg-negative patients with CHB.However,the proportion of low ALT levels became higher in the patients with LC or with HCC when HBeAg positive turned to be HBeAg-negative then to HBsAg-negative.Conclusions The proportion and the clinical significance of changes in serological markers are different in three different entities of CLD.

Objective To test the hypothesis that attachment of synovial cell to &?2-microglobulin modified with advanced glycation end products (ACE-?2m) would affect cell adhesion, spreading and proliferation.Methods Normal human synovial cells (type B cells) were isolated and plated in culture dishes coated with AGE-?2m or with normal extracellular matrix proteins (EMP). Adhesion was analyzed by counting the isotope-labelled cells. Spreading was tested using a light microscope and proliferation determined by 3H-TdR incorporation and counting the number of cells. Results Synovial cells adhered less effectively to AGE-?2m, ?2m and AGE-collagen than to the normal EMP (collagen and fibronectin). Cells interacting with AGE-?2m, ?2m or AGE-collagen also demonstrated less extensive spreading throughout the examined time intervals (60-120 minutes after plating), and decreased 3H-TdR incorporation and cell numbers after 72 hours of plating when compared to cells interacting with normal EMP. Conchusion AGE-?2m in amyloid may alter synovial cell behavior in situ in ways which cods contribute to the development of dialysis-related amyloidodsis(DRA).

To elucidate whether the mutations in X region of hepatitis B virus (HBV) might be responsible for the different clinical profiles in cases positive for antibody to hepatitis B e antigen. The nucleotide sequences of X gene regions in serum HBV were examined in 14 asymptomatic carriers (AsC) and 14 chronic active hepatitis (CAH) patients with antibody to hepatitis e antigen. The results showed that 12 of 14 AsCs (85.7%) had insertions, deletions or point mutations in nucleotide sequence of X region resulting in truncation of the X protein by creating frame shift mutation or a new stop codon, whereas no patient with CAH had those X gene mutations( P

Objective:To further study the pathogenesis of classic Schm orl′s nodes based on clinical practice.Methods:A patient with severe low back pain was found that the irregularity of the endplates and the presence of Schm orl′s nodes in L2 - 3 and L3- 4spaces in lumbar radiographs.Two painful intervertebral discs with Schm orl′s nodes in their superior or inferior endplates were identified by discography and pain provocation.Two foci of Schnorl′s nodes were rem oved in en bloc via a retroperitoneal approach for histological examination.Meanwhile,anterior intervetebral body fusion of painful discs were undertaken.Results:The radiographic manifestation of Schmorl′s nodes was the end- plate indentation.Schmorl′s nodes in CT scan was shown as a round- like or multicystic irregular zone of bone density with an indistinct sclerotic margin beneath the cartilaginous endplate,which was sim ilar to the typical CT changes of osteonecrosis.The histological examinations of en bloc slices of Schm orl′s nodes revealed subchondral osteonecrosis.Conclusion:The current study indicate classic Schm orl′s node shown in radiograph is osteonecrosis zone beneath cartilaginous endplate,suggesting the necessity of further study on Schmorl′s node form ation. [

Objective In order to further study the influence of a mutant on viral replication and transfection, a eukaryotic vector with mutation of 20/21 bp deletion (1748/ 1747 to nt 1767) in core promoter region and precore stop mutation (nt.1896) was constructed. Methods A linearized genome containing the entire HBV 3.5kb mRNA transcriptional units (P3.8Ⅰ vector) and initiating from the basic core promoter upstream sequences was used as a tool, the objective eukaryotic vectors were constructed by the molecular cloning and PCR based site directed mutagenesis in vitro. The capability of progeny virus production and transcription were examined with Southern blot and Northern blot analysis respectively, after transfection of the recombinant HBV plasmids into HepG2 cells by using liposome. Results The eukaryotic vectors were constructed successfully and their sequences were confirmed by clone sequencing. Both Southern and Northern blotting of DNA and RNA extracted from the transfected cells showed markedly reduced mutant activity to produce progeny virus, to transcript both 3.5kb precore/pregenome mRNA and 2.1kb preS/S mRNA. Conclusions The levels of replication and transcription are markedly reduced in the mutant compared with those in wild type HBV.

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.