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

Adult ; Humans ; Liver Transplantation ; United States

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.

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

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

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

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 evaluate the efficacy of nasal intermittent positive pressure ventilation (nIPPV) in preventing extubation failure in very low birth weight infants (VLBWI) compared with nasal continuous positive airway pressure (nCPAP).Methods A single-center randomized controlled trial was conducted from Jun 2012 to Jun 2013 in the NICU of Children's Hospital of Hebei Province.Eighty-four cases of VLBWI (birth weight 700 ～ 1 500 g,gestational age 27 ～ 32 weeks) with respiratory failure and subjected to mechanical ventilation were eligible for the study if they needed non-invasive,assisted ventilation at the time of first extubation attempt.They were randomly assigned to receive nIPPV (40 cases) or nCPAP (44 cases) according to random number table method,using the rate of successful extubation as primary outcome.Blood gas data were obtained and PaO2,PaCO2,FiO2,PaO2/FiO2 were monitored at 0 h,24 h,48 h and 72 h after extubation as enrollment for oxygenation and duration,the rate of successful extubation and the incidence of adverse events including frequent apnea,bronchopulmonary dysplasia,intraventricular hemorrhage,periventricular leukomalacia and retinopathy of prematurity and mortality as secondary outcomes.Results There were no significant differences in the baseline characteristics including the proportion of primary disease,sex,weight,gestational age,score for neonatal acute physiology and application of pulmonary surfactant between nIPPV group and nCPAP group (P ＞ 0.05).There were no significant differences in PaO2,PaCO2 and PaO2/FiO2 ratio between the two groups at 0 h of enrollment (P ＞ 0.05).The values of PaO2 and PaO2/FiO2 ratio in nIPPV group were significantly higher[48 h:PaO2:(63.2 ± 3.6) mmHg vs (52.3 ±6.7) mmHg,PaO2/FiO2:(243.2 ±32.8) mmHg vs (187.6 ±34.0) mmHg;72 h:PaO2:(66.4 ±5.8) mmHg vs (51.8±5.9) mmHg,PaO2/EO2:(280.6 ± 16.8) mmHg vs (245.2 ±40.5) mrnHg;1 rnmHg =0.133 kPa],whereas PaCO2 lower[48 h:(40.3 ±4.8) mmHg vs (49.2 ±6.6) mmHg,72 h:(42.2 ±5.6) mmHg vs (57.3 ± 6.9) mmHg],than nCPAP group at 48 h and 72 h after extubation (P ＜ 0.05).The oxygenation status in nIPPV group were significantly improved at 48 h and 72 h after extubation compared with the intra-group data at 0 h (P ＜ 0.05).The total ventilation time was shorter in nIPPV group than nCPAP group[(130.9 ±46.7) h vs (180.5 ±50.1) h,P ＜0.05],but the oxygen exposure time had no significant difference[(190.6 ± 45.2) h vs (216.8 ± 54.4) h,P ＞ 0.05].The rate of successful extubation in nIPPV group was significantly higher as compared with nCPAP group[92.5％ (37/40) vs 75.0％ (33/44),P ＜ 0.05].The incidence of frequent apnea and bronchopulmonary dysplasia in nIPPV was lower than nCPAP group[15.0％ (6/40) vs 34.1％ (15/44) ;2.5％ (1/40) vs 15.9％ (7/44),P ＜ 0.05].There were no significant differences in the incidence of severe intraventricular hemorrhage,perivenwicular leukomalacia,retinopathy of prematurity,late of infections,necrotizing enterocolitis,patent ductus arteriosus,patent ductus arteriosus operation and mortality before discharge between the two groups (P ＞ 0.05).Conclusion nIPPV after extubation in VLBWI has beneficial effects as compared with nCPAP in improving oxygenation,shortening noninvasive ventilation time,improving the rate of successful extubation,and can reduce the incidence of frequent apnea and bronchial pulmonary dysplasia in VLBWI.