Objective To investigate the clinical efficacy of laparoscopic splenectomy (LS) for immune thrombocytopenic purpura (ITP).Methods The clinical data of 84 patients with ITP who underwent LS at the First Affiliated Hospital of Chongqing Medical University from January 2007 to January 2014 were retrospectively analyzed.The potential prognosing indexes (gender,age,course of diseas,preoperative response to steroid,preoperative PLT,operation time,volume of intraoperative blood loss and postoperative PLT peak within 7 days) were collected and analyzed.The evaluation of surgical efficacy was done according to the American Society of Hematology 2011 evidence-based practice guideline for ITP.The complete response and partial response were defined as effective and no response as void.All of the patients were followed up by outpatient examination and telephone interview till December 2014,the follow-up information included platelet count,bleeding performance,presence of long-term complications and postoperative recurrence,etc.Measurement data with normal distribution were presented as x ± s,and skew distribution data were described as M (range).The postoperative long-term effective rate was analyzed by Kaplan-Meier method.The univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model,respectively.Results The operation time of 84 patients was (154 ±40)minutes with a median volume of intraoperative blood loss as 200 mL (10-1 000 mL).Lienculus was detected in 11 patients and resected.Seven patients had complications and recovered after symptomatic and supportive treatment.There was no perioperative death.Among the 84 patients who were followed up for an average follow-up time of 51 months (12-96 months),45 patients had complete response,18 patients had partial response and 21 had no response,without serious spontaneous visceral and intracranial hemorrhage.Eighteen partial-response patients underwent symptomatic medical therapy and 21 no-response patients took orally prednisolone,among which 13 had PLT ＞ 30 × 109/L stably.During the follow-up,only one complete-response patient died of lung cancer with systemic metastasis at 2 years after surgery.Four patients had pneumonia,1 noresponse female patient had pyothorax repeatedly for a long time,and they all recovered after symptomatic and supportive treatments.There were no serious complications and overwhelming postsplenectomy infection in other patients.The 1-,3-,5-,7-year effective rates were 82.1％,77.6％,72.5％ and 67.9％,respectively.Univariate analysis showed that preoperative response to steroid,preoperative PLT and postoperative PLT peak within 7 days were related factors affecting long-term effecacy of patients with ITP (x2=5.600,6.006,21.733,P ＜ 0.05),but gender,age,course of disease,operation time and volume of intraoperative blood loss were not related factors affecting long-term effecacy of patients with ITP (x2=0.018,2.684,0.000,0.064,0.397,P ＞ 0.05).Multivariate analysis showed that preoperative response to steroid and postoperative PLT peak within 7 days ≥300 × 109/L were independent protective factors affecting long-term efficacy (OR =5.426,19.454,95％ confidence interval:1.220-24.129,4.704-80.449,P ＜ 0.05).Conclusions LS is safe and feasible for the treatment of ITP with a high long-term effective rate.Preoperative response to steroid and postoperative PLT peak within 7 days may be the predictors of LS for ITP.

Myeloproliferative neoplasms (MPN) are a group of diseases with malignant cloning in hematopoietic stem / progenitor cells. The main clinical feature is excessive proliferation of one or more lineage of myeloid cells, which cause increasing count of erythrocytes, granulocytes and platelets in peripheral blood.Arterio-venous thrombosis and complications are responsible for the mortality of MPN. Low molecular weight heparin (LMWH) is a kind of anticoagulant that commonly used for its safety and validity. It can improve the hyperviscosity of blood , affect platelets, and interact with leukocytes and endothelial cells, by which can reduce cells aggregation. LMWH can effectively play an active role of anticoagulant in high-platelet plasma. All of these provides a theoretical basis to its availability in MPN.

Objective Seek countermeasures against the debt risk in universities. Methods Taking the debts of Kunming Chenggong universities construction as an example, analyze the reasons and countermeasures for the debts of universities in Yunnan province. Results Due to the enrollment expansion policy, the higher education in Yunnan province has been transformed from the elite education into mass education. The universities in Kunming have gained unprecedented development opportunities,especially with the completion of the Kunming Chenggong University Town. However, loan funds for the new campus construction mostly came from banks. So,the huge debt stress from banks has been brought with the development of the universities. Conclusion The sustainable development of universities requires the moderate debt. The government, universities and society need to work together to control the scale of debt effectively and avoid the debt crisis.

Humans ; Medicine, Chinese Traditional ; Translating

Abstract: The theory of formulas corresponding to syndromes is a relatively mature and integrated method contained in the classics of traditional Chinese medicine (TCM) for diagnosing and treatment of diseases. The development of the theory mainly includes three stages, i.e. prototype stage before Han Dynasty, sublimation stage of late Eastern Han Dynasty and the following improving stage. People recorded what they saw and heard of during their medical activities in prototype stage. In sublimation stage, Treatise on Febrile Diseases written by Zhang Zhong-jing found out the relationship of structure-fixed prescriptions used more often with symptoms and signs. Doctors after Han Dynasty repeated and verified the truth of classical prescriptions and the theory of formulas corresponding to syndromes. They also developed and improved the theory. Based on clinical experience, and classics, it was enriched, advanced and improved by doctors after then. It could provide reference for clinical treatment through systematically hackling the theories.

Intrauterine growth restriction is a common perinatal complication of major harm to the fetus. In recent years, immunological mechanism has been found in the pathogenesis of intrauterine growth restricition. Abnormal immune mechanism may be the developmental programming of ways to affect the fetal immune function, as well as extrauterine.

Objective To explore the change characteristics of platelet derived growth factor BB (PDGF-BB),transforming growth factor beta 1 (TGF-beta 1),and alkaline fibroblast factor (bFGF) of the wound exudates after the hysteroscopy adhesion separation technique.Methods Thirty two cases of intrauterine adhesions patients were selected who received the hysteroscopy adhesion separation technique from June 2014-June 2015 as the observation group,and 24 cases of hysteroscopy septum resection patients during the same period as the control group.PDGF-BB,TGF-beta 1,and bFGF of the wound exudates were measured with enzyme-linked immunosobent assay (ELISA) method at the postoperative 3,6,9,12,24,48,72 h.Results At the postoperative 3,6,9 and 12 h:PDGF-BB level of the observation group was (2.73 ± 0.72) ng/ml,(3.69 ± 0.74) ng/ml,(5.78 ± 0.82) ng/ml,and (5.94 ± 0.85) ng/ml,respectively;TGF-β1 level was (3.63 ±0.57) ng/ml,(9.89 ±0.95) ng/ml,(8.24 ±0.82) ng/ml,and (7.64 ±0.75) ng/ml,respectively;bFGF level was (20.23 ± 2.35) ng/ml,(92.46 ± 23.96) ng/ml,(387.84 ±76.63)ng/ml,and (1178.53 ± 127.95)ng/ml,respectively.PDGF-BB level of the control group was (2.52 ± 0.53) ng/ml,(2.63 ± 0.55) ng/ml,(4.72 ± 0.67) ng/ml,and (4.52 ± 0.61) ng/ml,respectively;TGF-β1 level was (3.07 ±0.59)ng/ml,(7.43 ±0.67) ng/ml,(5.43 ±0.57) ng/ml,and (4.68 ±O.77)ng/ml,respectively;bFGF level was (18.25 ±2.46) ng/ml,(81.49 ±20.18) ng/ml,(237.06 ±53.97) ng/ml,and (747.02 ± 107.73) ng/ml,respectively.The PDGF-BB,TGF-beta 1,and bFGF levels of two groups at the postoperative 3,6,9 h were risen quickly,and continued to the 72 h after surgery,the peak concentration of three indices of the observation group were higher than the control group,the difference had statistical significance (P ＜ 0.05).Conclusions The levels of PDGF-BB,TGF-beta 1,and bFGF of the wound exudates were obviously increased after the hysteroscopy adhesion separation technique.

Multiple myeloma (MM) is a heterogeneous disease with certain cytogenetic abnormalities [1q21 gains,t(4;14),del 17p] associated with worse outcome.The extensive use of thalidomide,lenalidomide and bortezomib has dramatically improved the outcome for patients with MM and some cytogenetic abnormalities.It is also widely proved that bortezomib can partly overcome the harmful affects of t (4;14).However,till now,there are many controversies about the effects of some novel agents worked on certain cytogenetic abnormalities.In this review,the effects of novel agents in cytogenetic abnormalities were summaried to provide new information on clinical treatment of this disease.

Malnutrition occurs as a result of inadequate nutrient intake,malabsorption and altered me-tabolism in pediatric liver failure. Malnutrition may be associated with a poor outcome. The current evidence indicates that the provision of adjunctive nutritional support ( parenteral nutrition or enteral nutrition or nutri-tional supplements) to patients with a variety of liver diseases. It may be reasonable to start enteral nutrition in 5 to 7 days in acute liver failure or hepatic coma. According to individualized appropriate nutritional evalu-ation,the metabolic demand,to provide appropriate nutritional support in pediatric liver failure.