Objective To discuss the correlation of P-glycoprotein(P-gp) and lymphocyte subgroup(CD4+,CD8+) in patients with immune thrombocytopenia.Methods A total of 20 patients with immune thrombocytopenia were selected from August 2015 to September 2016 in the Eighth Hospital Affiliated to Sun Yat-sen University.According to the platelet count,all patients were divided into mild group and severe group,20 cases of health persons were selected at the same period as the healthy group,flow cytometry technique was used to detect the plasma lymphocyte subsets(CD4+,CD8+) and P-gp level of all the objects.Pearson correlation analysis was used to analyze the relationship between plasma P-gp and plasma CD4+,CD8+,CD4+ / CD8+ level,analyzed all the objects plasma platelet count,P-gp and CD4+,CD8+,CD4+ / CD8+ levels.Results Plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of severe group were significant higher than those of mild group(t=3.587,2.957,2.315,2.646,P<0.05),plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of mild group patients were significant higher than those of healthy group(t=5.479,2.921,4.536,7.750,P<0.05).Pearson correlation analysis results showed that the plasma levels of P-gp and plasma CD4+,CD8+,CD4+ / CD8+ levels were positively correlated(r=0.683,0.617,0.548,P<0.05).Conclusion Plasma CD4+,CD8+,CD4+/CD8+and P-gp level is associated with immune thrombocytopenia patients condition,plasma levels of P-gp closely links with abnormal immune function in patients with hyperthyroidism,prompting detection the level of change could help doctors to assess patients medication curative effect.

Objective: To explore the role of human hematopoietic growth factors (HGFs) in proliferation and differentiation of cord blood CD34+ cells. Methods: Human cord blood mononuclear cells (MNC) were cultured with different combinations of HGFs (including rhIL-1,rhIL-3, rhIL-6, rhG-CSF, rhGM-CSF and rhSCF). The expansion folds of MNC, the changes of cellular surface markers by FACS, and CFU-GM of hematopoietic cells were observed. Results: The total nucleated cells expanded by 44 folds after cultured with 6 cytokines for 20 days. The number of CFU-GM increased by 14 .74 folds after cultured in liquid for 8 days, but decreased heavily after 18 days. The total number of CD34+ cells increased by 127. 79 ~ 196 .40 folds at 6 to 8 day, but decreased to 101.51 folds at 18 day. Conclusion: Human hematopoietic growth factors can increase the expansion of cord blood CD34+ cells and CFU-GM significantly.

OBJECTIVE: To analyze the causes for misplacement of pedicle screw in thoracolumbar spine.METHODS: From January 2002 to January 2008, 19 patients with misplacement in thoracolumbar spine were treated in Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, including 12 males and 7 females with an average age of 52.5 years (range 23-68 years). The diagnoses were thoracolumbar fracture in 5 cases, lumbar spondylolisthesis in 8 and degenerative lumbar disease in 6. The fixation systems were Steffee used in 4 cases, DRFS in 3, RF in 6, AF in 4 and GSS in 2. X-ray and CT scanning were used to observe pedicle screw location, including screw,pedicle and membranous sac and great vessels.RESULTS: The time of misplacement of pedicle screw was 5-69 days with an average time of 18.5 days, including 7 cases of screw penetrating into lateral cortex, 4 of screw penetrating into medial cortex, 2 of screw penetrating into pedicle cortex, 2 of overplacement, 2 of intervertebral foremen placement and 2 of intervertebral space placement.CONCLUSION: The causes for screw misplacement were anatomic variation and poor surgical skills, and the key factors in precise insertion of pedicle screw are fine surgical skills, carefully study of preoperative image and the intra-operative monitoring.

Purpose:To study the effects on T lymphocyte subtypes with chemical splanchic denervation for patients with pancreatic carcinoma and intractable pain.Methods:32 cases with advanced pancreatic carcinoma accepted chemical splanchic denervation-pure alcohol injection around celiac ganglion guided by B US to relieve the severe pain. The fasting peripheral blood concentration of CD + 3 ,CD + 4 ,CD + 8 and ? endorphin were determined before treatment ,3rd,7th,15th and 30th day after therapy. 38 healthy persons were taken as control group.Results:The percentage of CD + 3 ,CD + 4 ,CD 8+ cell were apparently decreased in patients with pancreatic carcinoma comparing with control group( P

OBJECTIVE:To establish a method for the analysis of chemical compositions in Jinqiancao granule. METHODS:HPLC-ESI-Q-TOF-MS was adopted. The chromatographic conditions:the column was Inertsil ODS-4 with mobile phase of 0.1%formic acid- methanol (gradient elution) at a flow rate of 0.8 ml/min,column temperature was 30 ℃,and the injection volume was 15 μl. MS conditions:ion source was ESI(negative ion mode),endplate offset voltage was -500 V,capillary electrophore-sis was 3500 V,carrier gas was helium gas,atomization and drying gas was high purity nitrogen gas at a flow rate of 6 L/min and a pressure of 1.0 bar,drying air temperature was 180℃. Scanning range was 50-1500 m/z. ChemBioDraw Ultra13.0 and Bruk-er data analysis software 4.0 were used to analyze the chemical composition molecular formula. RESULTS:A total of 27 kinds of chemical components were identified in Jinqiancao granule,involving sucrose,uridine,gallic acid,new chlorogenic acid,(-)-epi-gallocatechin,protocatechuic acid,chlorogenic acid,schaftoside,caffeic acid,schaftoside,vanillc acid,ferulic acid,hyperin,ros-marinic acid,rutin,isoquercitrin,astragalin,quercetin-3-rhamnoside,myricetin,4-hydroxybenzoic acid,quercetin,naringenin, luteolin,kaempferol,isorhmnetin,apigenin and emodin. CONCLUSIONS:Caffeic acid,rosmarinic acid,vanillic acid,(-)-epigal-locatechin,uridine and emodin are firstly found and reported in the chemical compositions in Jinqiancao granule.

BACKGROUND:Hidden blood loss is one of most important complications after total knee arthroplasty, but the mechanism and influential factors are not yet clear. OBJECTIVE:To analyze the relative influential factors for hidden blood loss in primary unilateral total knee arthroplasty. METHODS:Data of 235 patients who had undergone primary unilateral total knee arthroplasty from April to September 2014 were retrospectively studied. There were 38 males and 197 females aged from 48 to 82 years old with a mean age of 66 years. The Gross formula was used to calculate the amount of hidden blood loss. The effects of gender, age, height, body weight, body mass index, anesthesia method, administration of tranexamic acid, postoperative anticoagulation method, typeof prosthesis, tourniquet time and pre-operative coagulation function on the postoperative hidden blood loss and total blood loss after total knee arthroplasty were analyzed. RESULTS AND CONCLUSION:(1) Significant differences in hidden blood loss and total blood loss after total knee arthroplasty were detected between male and female patients (P< 0.01). Significant differences in hidden blood loss and total blood loss were found between tranexamic acid and non-tranexamic acid groups (P< 0.05,P< 0.01).(2) Multivariate linear regression analysis showed that preoperative hemoglobin level and heightwere important factors influencing the blood loss after arthroplasty. Hidden blood loss and total blood loss were not correlated with age, body mass index, anesthesia method, postoperative anticoagulation method, type of prosthesis, tourniquet time and preoperative coagulation function. (3) Results indicate that gender and administration of tranexamic acid affect hidden blood loss and total blood loss after total knee arthroplasty. However, age, body mass index, anesthesia method, postoperative anticoagulation method, type of prosthesis, tourniquet time and preoperative coagulation function do not greatly affect hidden blood loss.

AIM: To investigate the change of myopic choroidal neovascularization treated by ranibizumab and evaluate their value in monitoring the effect of anti-vascular endothelial growth factor ( VEGF) therapy. ·METHODS: The study enrolled 30 patients ( 30 eyes ) diagnosed with myopic choroidal neovascularization. All affected eyes were treated with intravitreal ranibizumab 0. 05mL ( 10mg/mL ). Best corrected visual acuity ( BCVA ) , non-contact tonometer, ophthalmoscope, fundus fluorescein angiograph ( FFA ) and OCTA were evaluated monthly until 6mo. The changes of BCVA and central macular thickness ( CMT) were compared at 1, 3 and 6mo after treatment. ·RESULTS:All patients received an average of 1. 70±0. 65 injections. BCVA was 0. 96 ± 0. 17 ( LogMAR ) before therapy, and BCVA 1, 3 and 6mo after treatment respectively improved by 0. 23 ± 0. 09, 0. 34 ± 0. 07, 0. 38 ± 0. 11. The differences were significant ( t=5. 461, 8. 191, 8. 894; P<0. 05 ). Mean CMT decreased form 281. 07 ± 13. 72μm to 261. 33 ± 13. 13μm, 243. 47 ± 16. 65μm, 234. 73 ± 17. 52μm respectively 1, 3 and 6mo after treatment, showing significant differences (t=12. 007, 13. 360, 9. 531;P<0. 05). OCTA revealed a progressively smaller vascular lesion and reduction in capillary density. · CONCLUSION: Intravitreal ranibizumab for CNV secondary to pathologic myopia is effective and safe;OCTA is a noninvasive and time-saving new technology, and it also is a promising tool for clinicians to make preliminary diagnosis and assess treatment efficacy in the follow-up visits.

OBJECTIVE:To explore the effects of ursodeoxycholic acid and adenosine methionine combined with polyene phos-phatidylcholine on related indicators of pregnancy with intrahepatic cholestasis(ICP). METHODS:Medical information of 90 ICP female were analyzed retrospectively and divided into control group(45 cases)and observation group(45 cases)according to drug use. Control group was given Ursodeoxycholic acid tablet 300 mg orally,3 times a day+Transmetil for injection 1 g added into 5%Glucose injection 250 mL intravenously,once a day. Observation group was additionally given Polyene phosphatidylcholine injec-tion 15 mL added into 5% Glucose injection 250 mL intravenously,once a day,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. The itching score,the levels of serum total bile acid(TBA),ALT and AST,pregnancy outcome and the occurrence of ADR were observed in 2 groups before and after treatment. RESULTS:Before treatment,there was no statistical significance in itching score,the levels of TBA,ALT and AST between 2 groups (P>0.05). After treatment,itching score,the levels of TBA,ALT and AST in 2 groups were significantly lower than before treatment,and the observation group was significant-ly lower than the control group,with statistical significance (P<0.05). The cesarean section rate,premature birth rate,fetal dis-tress rate and amniotic fluid rate of observation group were significantly lower than those of control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Ursodeoxycholic acid,ademetionine combined with polyene phosphatidylcholine can effectively alleviate itching symptoms,liver function and pregnancy outcome of ICP patients,with good safety.

Objective To investigate the regulatory effects of Zishen Yutai Pills on the expression levels of homeboxA10 (HOXA10) and its downstream target gene empty spiracles homebox 2 (EMX2) in the endometria of ovulation-inducing mice at different implantation stages. Methods Seventy-five estrous female Kunming mice were randomly divided into 5 groups, namely normal group, model group 1, model group 2, treatment group 1, treatment group 2, 15 mice in each group. The model group 1 was given short-term protocol for ovulation induction; the model group 2 was given long-term protocol for ovulation induction; the treatment group 1 was given Zishen Yutai pills (at the dose of 0.4 g/mL) on the basis of the protocol for the model group 1; the treatment group 2 was given Zishen Yutai Pills (at the dose of 0.4 g/mL) on the basis of the protocol for the model group 2; the normal group was given intragastric administration or intraperitoneal injection of the same volume of normal saline. The mRNA and protein expression levels of HOXA10 and EMX2 in mouse uterus were detected by real-time fluorescent quantitative polymerase chain reaction (qPCR) and Western blot method, respectively. Results Compared with the normal group, the mRNA and protein expression levels of HOXA10 were decreased, and the mRNA and protein expression levels of EMX2 were increased in model group 1 and model group 2(P< 0.01). Compared with the corresponding model group 1 and 2, the mRNA and protein expression levels of HOXA10 were significantly up-regulated (P < 0.01) , and the mRNA and protein expression levels of EMX2 were decreased in the treatment group 1 and 2 (P < 0.01), respectively. Conclusion Zishen Yutai Pills may improve mouse endometrial receptivity by up-regulating HOXA10 expression and inhibiting EMX2 expression.

Objective:To investigate the correlation of serum hs-CRP,D-dimmer and Lp-PLA2 with vulnerable plaque of coronary artery atherosclerosis in patients with coronary heart disease.Methods:Selected 106 cases of patients in our hospital from January 2014 to December 2015,all taken coronary angiography and intravascular ultrasound.Divided into three groups according to the results of the examination,the levels of serum hs-CRP,D-dimmer and Lp-PLA2 were examined and compared,and the correlation with fiber cap thickness,plaque eccentricity index,and vascular remodeling index were tested by Pearson correlation analysis.Results:Serum levels of hs-CRP,D-dimmer and Lp-PLA2 of vulnerable plaque group and stable plaque group were significantly higher than that of the control group (P＜0.05),and the serum levels of hs-CRP,D-dimmer and Lp-PLA2 of vulnerable plaque group were significantly higher than that of stable plaque group (P＜0.05);hs-CRP was negative correlated with the thickness of fibrous cap (r=-0.712,P＜0.05),and positive correlated with eccentric plaque index and vascular remodeling index (r=0.813,0.756;D-,P＜0.05),D-dimmer was negative correlated with the thickness of fibrous cap (r=-0.654,P＜0.05),and positive correlated with eccentric plaque index and vascular remodeling index (r=0.912,0.853,P＜0.05);Lp-PLA2 was negative correlated with the thickness of fibrous cap (r=-0.796,P＜0.05),and positive correlated with eccentric plaque index and vascular remodeling index (r=0.836,0.729,P＜0.05).Conclusion:Hs-CRP,D-dimmer and Lp-PLA2 have high correlation with vulnerable plaque in coronary artery disease,can be used as reference indexes for assessing the instability of coronary atherosclerotic plaque.