Objectives To study the influential factors of the von Clauss method and to promote the method for fibrinogen assay in clinical laboratories in China. MethodsKits of foreign and domestic products were used. Calibration curves for fibrinogen determination were established, and calibration plasma was used for comparison. Effects of pH value, thrombin activity, and temperature on the measurement were studied.Results The reproducibility of the von Clauss method using domestic thrombin and related reagents was excellent, the within day CV being 0.039 1, and the between day CV 0.049 7. The percentage variations of calibration plasma determination, with the foreign fibrinogen assay kits using domestic reagents, were +3.17% , +4.76%, and -6.03%, respectively. Determination of a lyophilized plasma using the two sources reagents showed similar results.Conclusions Thrombin and relevant reagents produced in China could be used as a substitute for kits purchased abroad, which would promote the use of von Clauss method in clinical laboratories of China.

Objective To evaluate the efficacy and safety of dipeptidyl peptidase-4 inhibitor,linagliptin,in subjects aged 60 years or older with type 2 diabetes mellitus (T2DM).Methods Data from eight 24-week,multinational,multicenter,randomized,double-blind,placebo-controlled,parallel-group studies were analyzed.Patients aged 60 years or older with T2DM were received oral linagliptin (5 mg/d) or placebo in combination with mefformin,or metformin plus sulfonylurea.Efficacy was assessed by the changes in glycosylated hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) from baseline to 24 weeks of treatment.Safety endpoint included the frequency and intensity of adverse events.Results A total of 1 421 patients (placebo 429,linagliptin 992) were included in the full analysis set (FAS).Mean ages of the subjects were (67.4 ± 5.6) years in the linagliptin group and (66.7-± 5.6) years in the placebo group.Baseline HbA1c was (8.0 ±0.8) ％ in the linagliptin group and (8.1 ±0.9) ％ in the placebo group.At the end of 24-week,placebo-adjusted reduction in HbAlc in subjects with linagliptin was (0.7 ±0.1)％ (95％ CI 0.6-0.8,P ＜0.000 1),and placebo-adjusted reduction in FPG in subjects with linagliptin was (0.88 ±0.12) mmol/L(95％ CI 0.65-1.11,P ＜0.000 1).Overall safety and tolerability in the two groups were similar.Adverse events occurred in 57.1％ of patients in the placebo group and 61.1％ of patients in the linagliptin group,and the incidence of adverse events leading to discontinuation was 3.2％ in the placebo group and 3.8％ in the linagliptin group.Serious adverse events occurred in 1.6％ of patients in the placebo group and 2.8％ of patients in the linagliptin group.Investigator-defined hypoglycaemia occurred in 7.3％ of patients in the placebo group and 11.9％ of patients in the linagliptin group.Among them,most were mild or moderate hypoglycaemia,and severe hypoglycaemia only occurred in 0.2％ of patients in the placebo and 0.5％ in the linagliptin groups.Overall incidence of hypoglycaemia in linagliptin group was slightly higher than that in placebo group,which might be due to the fact that more patients were taking sulfonylureas in linagliptin group than in placebo group (26.8％ linagliptin;18.4％ placebo).No difference could be viewed in hypoglycaemia between the two groups in patients without sulfonylureas (1.2％ linagliptin,1.1％ placebo)Moreover,no severe hypoglycaemia was reported in subjects without sulfonylureas.The incidences of other adverse events were similar in both groups.Conclusion Linagliptin was efficacious in lowering glucose with a safety profile similar to placebo in type 2 diabetic patients aged 60 years or older.

Objective To observe the changes of the multifocal electroretinograph (mf-ERG) in commotio retinae. Methods The affected eyes (traumatic group) and the fellow eyes (control group) of 31 patients with unilateral commotio retinae were examined by RETI scan 3.15 system. The responses of 61 retinal regions were recorded, and the average amplitude densities of the N 1 (the first negative) wave and P 1 (the first positive) wave in different regions of retinal were analyzed. Results The average amplitude densities of 1-4 rings in N 1 wave and 1-5 rings in P 1 wave were much lower in traumatic group than those in the control. Conclusions The average amplitude densities of N 1 wave and P 1 wave of mf-ERG in retinal affected regions decreases markedly in eyes with commotio retina; mf-ERG may provide the quantificational and orientational detection for the visual ability of the eyes with commotio retinae.

Objective To develop a measurement method for determination of optical parameters of a red blood cell ( RBC) suspension based on the measurement of spatial scattered light signals without using an integrating sphere.Methods Multiple independent photoelectric sensors and light intensity modulation were used to obtain the measured values of diffuse reflectance,diffuse transmittance and collimated transmittance.The measured data results were imported into a Monte Carlo simulation based RTE to inversely determine the absorption coefficient, scattering coefficient and anisotropy factor of the measured sample using a new perturbation method.Results The described measurement method was applied to determine the optical parameters of a polystyrene microsphere suspension with a mean diameter of 2.6μm,and the results were essen-tially consistent with the calculated optical parameters by Mie code.Then, the RBC suspension was used for testing optical parameters,and the results were basically consistent with the parameters in the literature.Conclusion The system based on the measurement of spatial scattered light signals without using an integrating sphere will provide a quick and accurate approach for quantitative analysis of free hemoglobins and RBC suspensions.

Objective To study the imaging features of MRI in children glioblastoma and improve the understanding of this disease.Methods The clinical data and MR features of 5 cases in children with glioblastoma confirmed by surgery and pathology were analyzed retrospectively. Imaging features including location,shape,growth pattern,peritumoral edema and contrast enhancement were assessed.Results 4 cases occurred in the cerebral hemisphere and 1 in cerebellar hemisphere,all of which manifested obvious mass effect with 2 cases across midline.3 cases were round-like,while another 2 cases were irregular in shape.In spite of 1 case without peritumoral edema, 4 cases performed mild to moderate peritumoral edema.Among all patients,one showed cystic mass,2 caese showed cystic-solid mass,and the other 2 cases showed solid mass.Cystic portion presented long T1 and long T2 signal,as well as low signal on FLAIR. Solid part of lesion showed iso-intense on T1 WI and T2 WI,as well as high signal on FLAIR and DWI.After contrast enhancement,cyst wall showed annular enhancement.Ring-shaped or nodular enhancement was seen in solid components of cystic-solid mass.And solid mass showed irregular and lump-like enhancement.Conclusion Glioblastoma in children has certain characteristic MRI appearances. The surgical and pathological results are still required to establish the final diagnosis.

AIM: The purpose of this study was to evaluate the mechanism of high altitude pulmonary edema (HAPE) and high altitude acute response (HAAR). METHODS: Pulmonary function and partial oxygen pressure were measured in 10 patients with HAAR and 6 patients with HAPE before and after bronchoalveolar lavage (BAL),10 high altitude healthy volunteers were served as control subjects. RESULTS: The partial oxygen pressure of HAAR and HAPE significantly decreased before BAL compared with control; DLCO%, DLCO/VA%, PaO_2 of HAPE increased significantly [from 76.01%?6.29%, 150.30%?15.20%, (31.73?3.01) mmHg before BAL to 103.31%?9.23%, 176.04%?16.10%, (45.31?3.56) mmHg after BAL]. The above parameters were also changed in HAAR and controls, but had no statistical significance. CONCLUSION: High concentration of proteins and cells in BAL fluid for HAPE, gas exchange impairment and PaO_2 increase after BAL suggest accumulation of protein-rich fluid and cells in the alveolar space plays a crucial role in the development of HAPE.

Objective To investigate the pathogenicity of Alternaria alternata in ICR mice. Methods The cell suspension of Alternaria alternata was inoculated into testes and footpads of normal and immunocompromised ICR mice. H istopathologic examination and fungal culture were performed on 5th d, 7th d, 10 th d, 14th d, 21st d, 28th d, 35th d and 42nd d respectively after inoculation. Results The abscesses were developed at the inoculated sites in all normal and immunocompromised mice. The lesions in immunocompromised mice were more severe and persisted longer than those in normal mice. The abscesses in footpads mostl y disappeared within 14 days in normal mice but in 28 to 35 days in immunocompro mised mice. Alternaria alternata was isolated from the inoculated tissues in bot h groups. The histopathologic examination showed abscess and granulomas in which thick hyphae were observed. The necropsy revealed no disseminated infection of Alternaria alternate in all the test mice. Conclusion Alternaria alternata is a kind of opportunistic fungus with low virulence.

The present paper is aimedto investigate the effect of basic fibroblast growth factor (bFGF) on proliferation, migration and differentiation of endogenous neural stem cell in rat cerebral cortex with global brain ischemia-reperfusion. A global brain ischemia-reperfusion model was established. Immunohistochemistry was used to observe the pathological changes and the expression of BrdU and Nestin in cerebral cortex. RT-PCR was used to measure the NSE mRNA in brain tissue. The results of measurements indicated that in sham operation group, there was no positive cell in cerebral cortex, and the content of NSE mRNA did not change. In the operation group, the expression of BrdU and Nestin increased significantly at the end of the 3rd day, and peaked on the 7th day. NSE mRNA expression did not significantly increase. In bFGF group, compared with sham operation group and model group, the number of BrdU-positive and Nestin-positive cells increased significantly at each time point (P<0. 05), and peaked at the end of the 11th day, and the content of NSE mRNA increased significantly (P<0. 05). This research demonstrated that the proliferation of endogenous neural stem cells in situ could be induced by global cerebral ischemia and reperfu- sion, and could be promoted and extended by bFGF. In additiion, bFGF might promote endogenous neural stem cells differentiated into neurons.
Animals ; Brain Ischemia ; pathology ; Cell Differentiation ; Cell Movement ; Cell Proliferation ; Cerebral Cortex ; cytology ; metabolism ; pathology ; Fibroblast Growth Factor 2 ; pharmacology ; Nestin ; metabolism ; Neural Stem Cells ; drug effects ; Rats ; Reperfusion Injury

Objective To compare the effectiveness and safety of central venous catheters inserted from the left side and right side during peripheral inserted central catheterizations (PICC). Methods Totally 458 adult patients undergoing PICC between May 2007 and May 2008 were enrolled in this study and divided randomly into right-sided group (n = 228)and left-slded group (n = 230). Chest X-ray was performed immediately after catheterization to identify the initial tip locations. Other parameters were evaluated during follow-up. Results The rate of difficult insertion was significantly lower in right-sided group than in left-sided group (14.9% vs 24. 8% , P =0.003). The rate of tip projection angle ＞40°was also significantly lower in right-sided group (2.2% vs 23.4% ,P = 0. 000). The rate of tips reaching the central veins was not significantly different between two groups (54.4%vs 53.0% , P = 0. 538). Compared with right-sided catheters, the tip positions in the left-sided group was significantly less frequently located in the inferior segment of superior vena cave in the central tip locations (6. 6% vs 21.0% , P =0. 001)and more commonly positioned in the nominate vein in non-central tip locations (66. 7% vs 48.1% , P = 0. 008). In addition, the catheter detaining time (P = 0. 617), incidence of local phlebitis after puncture (P = 0. 561), catheter obstruction rate (P = 0. 774), and catheter-related infection rate (P = 0. 854)showed no significant differences between two groups. The incidence of swollen limb was significantly lower inright-sided group than in left-sided group (4. 4% vs 8.3%, P = 0. 043). Conclusions Right-sided catheters provide better outcomes than left-sided catheters. PICC through the right elbow veins should be preferred in clinical practices.