Chronic refractory autoimmune thrombocytopenia (C/RITP) comprises complex and heterogeneous pathogenesis.Beyond the classic immune disorders such as platelet autoantibodies and cellular immune imbalance,other important considerations that can cause acquired C/RITP include infection,drug,vaccines,autoimmune diseases,tumor,or platelet function disorder.In addition,advances in the molecular mechanism and genetic correlations of C/RITP for children are also discussed.

Fatal Outcome ; Herbicides ; poisoning ; Humans ; Injections, Intramuscular ; Male ; Paraquat ; poisoning ; Young Adult

Objectives To determine the serum levels of high mobility group box-1 protein ( HMGB1 )in patients with acute pancreatitis (AP) and to investigate the contributions of HMGB1 in the pathogenesis of AP. Methods The serum HMGB1 concentrations were determined by enzyme-linked immunosorbent assay in 33 patients with severe acute pancreatitis (SAP), 38 patients with mild acute pancreatitis (MAP) and 28 healthy controls at the time of admission within 72 h after the onset. THe relationships between the serum HMGB1 levels and sex, age, etiology, disease onset, Ranson score, Balthazar CT score, C-reactive protein,lactate dehydrogenase and serum creatinine, total bilirubin levels, local and systematic complications were analized. Results The serum HMGB1 levels in healthy control group, MAP group and SAP group were ( 1.82 ±0.64)μg/L, (6. 13 ±5.80) μg/L and (11.48 ±6.94)μg/L, respectively. The mean value of serum HMGB1 level in MAP group was significantly higher than that in healthy group ( P < 0. 05 ), while it was significantly lower than that in SAP group ( P <0.05 ). Within 24 h after disease onset, the serum levels of HMGB1 began to increase, and reached the peak at 48 h, then decreased and remained higher than normal value at 72 h.There were no remarkable relationships between the serum HMGB1 levels and sex, age, etiology, but it was positively correlated with Ranson score, Balthazar CT score, C-reactive protein, lactate dehydrogenase and serum crkatinine. The serum levels of HMGB 1 in patients with local and / or systematic complications were higher than those in patients without complications, but the difference was not statistically significant.Conclusions HMGB1 is a late inflammation mediator and serum HMGB1 levels were correlated with the severity of AP. HMGB1 may participate in the development of acute renal insufficiency during SAP.

Adult ; Humans ; Liver Transplantation ; United States

Cognitive behavior therapy (CBT) has been proved to be an effective psychological treatment method for depression,especially for mild-to-moderate depression,however,due to the influence of various factors,its application in patients with depression is limited.Studies abroad have confirmed self-help intervention based on CBT has good effects on patients with depression.By reviewing efficacy of self-help interventions based on CBT on depression,it can be known that most of the literatures support that self-help interventions based on CBT has good effects on depression.Related researches abroad have been more mature,but few similar studies have been conducted in our country.So self-help CBT for depression has broad prospects in our country,which can play an important role in the prevention and therapy of depression,alleviating the shortage of medical resources,and reducing the patients' medical expenses,etc.Based on bibliotherapy (a major form of self-help interventions based on CBT),future studies need to learn from foreign practice to expand the audience to the clinic,community and non-clinical patients,in order to provide advice for interventions for depression in China.

Objective To explore the factors of medical anthropology related to malaria control among Wa Ethnic minority in Ximeng County, Yunnan Province. Methods The study was conducted by the combination of anthropology and epidemiology, qualitative and quantitative, statistical analysis and description. Results Wa people considered malaria as one of three major diseases in the community. In Wa Ethnical language, the word of malaria, “Saihui” (Sai-illness and pain, Hui-being attacked quickly), does not mean of fever. About one third of Wa people had not thought fever as one of malaria symptoms. Most of Wa people only knew vivax malaria, but not falciparum malaria. Only 32.7% of people could connect malaria with mosquitoes, and a few of them could confirm mosquitoes as the only malaria vector. The proportions of sound knowledge of malaria causes, prevention and treatment seeking assessed were lower than 25.0%. As a result of multivariate logistic regression, 3 kinds of malaria knowledge were closely correlated each other, and the connection between causal knowledge and prevention (adjusted OR: 36.610, 95%CI: 10.242-130.866, P

Ear, Inner ; surgery ; Humans ; Neuroma, Acoustic ; surgery ; Otologic Surgical Procedures ; methods

Adenoviridae ; genetics ; Animals ; Apoptosis ; drug effects ; Carcinoma, Squamous Cell ; genetics ; metabolism ; therapy ; Cell Cycle ; drug effects ; Clinical Trials as Topic ; Genes, p53 ; Genetic Therapy ; Genetic Vectors ; Humans ; Mouth Neoplasms ; genetics ; metabolism ; therapy ; Mutation ; Tumor Suppressor Protein p53 ; genetics ; metabolism ; Viral Vaccines ; pharmacology ; therapeutic use

Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Pancreatic Ductal ; metabolism ; pathology ; surgery ; Carcinoma, Papillary ; metabolism ; pathology ; surgery ; Cystadenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Duodenal Neoplasms ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mucin-2 ; Mucins ; metabolism ; Neoplasm Invasiveness ; Pancreatic Neoplasms ; metabolism ; pathology ; surgery ; Pancreaticoduodenectomy

Objective To investigate the expression and clinical significance of platelet autoantibodies in children with persistent/chronic immune thrombocytopenia (pITP/cITP).Methods Total of 34 children diagnosed with pITP/cITP(14 cases and 20 cases,respectively)in the Department of Hematology and Oncology,Shanghai Children's Hospital from December 2013 to August 2014 were enrolled as the study group,including 20 male and 14 female,the median age of 5 years old.The study also included 20 healthy children (the healthy control group) matched with gender and age,and 24 cases of newly diagnosed ITP (newly diagnosed ITP group) serving as the control groups.Platelet-associated immunoglobulin (PAIg) and platelet-specific autoantibodies on surface of platelets were mea-sured by flow cytometry or flow cytometric bead.Results Significant elevation of PAIgA,PAIgM,PAIgD and specific autoantibodies against glucoprotein(GP) Ⅲa,and GP Ⅱb were demonstrated in children with cITP,as well as specific autoantibodies against GP Ⅰ b,GP Ⅲ a,GP Ⅱ b,and granule membrane protein 140 (GMP140) in children with pITP,compared with the healthy control group(P ＜ 0.05);the levels of GPⅨ,GP Ⅲ a,GMP140 in cITP group and GP Ⅱ b in pITP showed significant declination,compared with the newly diagnosed ITP group(P ＜ 0.05);between piTP group and cITP group,autoantibodies GPⅨ,GP Ⅰ b,GP Ⅱ b,and GMP140 in the latter were much lower(P ＜ 0.05).Significant negative relation between PAIgM and platelet count was found in cITP group (P ＜ 0.05).Receiver operating characte-ristic (ROC) curve analysis showed that the area under ROC curve (AUC) of GP Ⅲ a autoantibodies was larger than that of other platelet-autoantibodies in pITP/ciTP diagnosis.Conclusions Platelet autoantibodies play a significant role in pITP/ciTP,especially platelet-specific autoantibodies,which show a declining tendency in the course and may be the main mechanism.The detection of GPⅢa specific autoantibody is more advantageous against other autoantibodies in the diagnosis of piTP/ciTP.