Objective To analyze the related factors of donor′s donation reaction in first time apheresis platelets to provide a basis for formulating the preventive measures of donation reactions in apheresis platelets.Methods The donation data in 743 cases of first time apheresis platelet in this blood station were retrospectively analyzed,and the factors possible influencing the donation reaction occurrence in donors of the first time apheresis platelet were performed the univariate Logistic regression analysis,then observation indicators with statistical significance were performed the multivariate Logistic regression analysis.Results The univariate Logistic regression analysis showed that gender,age,body mass,whole blood donation history were the influencing factors of donors′ donation reaction in the first time apheresis platelets.In multivariate Logistic regression analysis,the main factors were age (OR=0.301,P<0.05),body mass (OR=0.411,P<0.05)and whole blood donation history(OR=0.441,P<0.05).Conclusion Age,body mass and whole blood donation history are the main influencing factors of donors′ donation reactions in the first time apheresis platelets.

Objective To investigate the expression and prognostic role of ADP-ribosylation factor 6 (ARF6) in human endometrial carcinoma.Methods 51 endometrial carcinoma tissues and matched tumor-adjacent tissues were collected from Jan.2010 to Dec.2011 in People's Hospital of Linzi District of Zibo City and Penglai People's Hospital.mRNA expression of ARF6 was detected by qRT-PCR,and the protein expression of ARF6 was detected by immunohistochemistry.The correlation between ARF6 and clinicopathological features was analyzed by chi-square test,and the Kaplan-Meier survival curves were drawn to describe the prognostic effects of ARF6 expression.Results Both mRNA and protein expression of ARF6 were down-regulated in endometrial carcinoma tissues than those in matched tumor-adjacent tissues (P＜0.05).Positive expression of ARF6 was associated with lynphatic metastasis (P＜0.05) and advanced TNM stage (Ⅲ+Ⅴ,P＜0.05).Both the 3-year overall survival rate and disease-free survival rate were lower in ARF6 positive expression group than in ARF6 negative expression group(P＜0.05).Conclusion Positive expression of ARF6 in human endometrial carcinoma is related to the malignant clinicopathological features and poor prognosis.

In the present study, the fluoro-gold(FG) and horseradish peroxidase(HRP) combined tracing method was used to investigate the localization of parasympathetic preganglionic neurons and ascending projection neurons in lumbosacral spinal cord of the rat. FG was injected into the lateral parabrachial nucleus(PBL) or into Barrington's nucleus on one side, and HRP was applied to the contralateral pelvic nerve. The retrogradely FG-labeled neurons were found in bilateral "visceral field" at segments L_5-S_2, and the majority of them were concentrated in the intermediolateral nucleus (IML), and the dorsal commissural nucleus (DCN). In addition to these areas, some labeled neurons were also observed in bilateral lamina I and lateral spinal nucleus (LSN). The parasympathetic preganglionic neurons labeled with HRP were seen in the IML at segments L_6-S_1, occasionally appeared in the intercalated nucleus. In the IML area, HRP-labeled parasympathetic preganglionic neurons were located in its ventral part, however, the localization of FG-labeled neurons projected to the PBL and Barrington's nucleus were mainly found in the dorsal and dorsomedial part of the IML, and a few FG-labeled cells were scattered among HRP-labeled cells. Based on the present and other investigations, the nomenclature, organization and function of the IML and the composition of the LSN were discussed.

BACKGROUND:Currently, modified laminoplasty with C7 spinous process and muscle attachment points reserved and C2, C7 decompressive laminectomy can reconcile both ful decompression and structure stability. With early isometric neck muscle exercise, it can enhance cervical dynamic and static force balance and maintain the stability of the cervical spine.
OBJECTIVE:To investigate the clinical effects of modified cervical laminoplasty with postoperative isometric neck muscle exercise on cervical spondylotic myelopathy patients.
METHODS:114 patients with cervical myelopathy were separately performed traditional cervical laminoplasty (control group), modified cervical laminoplasty (modified group), modified cervical laminoplasty, and neck muscle isometric exercise (combined group). Fol ow-up was conducted for 24 months.
RESULTS AND CONCLUSION:(1) Cervical Japanese Orthopaedic Association score, cervical Neck Disabilitv Index scores and the incidence of axial symptoms:There was no significant difference in the Japanese Orthopaedic Association score of three groups at 6, 12 and 24 months after surgery. At 6, 12 and 24 months after surgery, Neck Disability Index scores and constituent ratio of axial symptoms were better in the modified group than the other groups (P<0.05). (2) Results show that modified cervical laminoplasty with isometric neck muscle exercise can get better clinical results in the treatment of cervical myelopathy.

Objective To evaluate the value of CT and MRI in diagnosis and directing clinical management of vertebral burst fracture.Methods The imaging features of vertebral burst fracture in 66 cases were analyzed,including cervical vertebrae 6,thoracic vertebrae 3,thoracolumbar area 48,and lumbar vertebrae 9 cases.There were 50 male and 16 female,the average age was 35 years.CT and MRI were taken in all patients.Results CT clearly demonstrated the vertebrae and accompanying appendix fracture,spinal canal stenosis and retropulsed fragment.While MRI in showing injury and tear of ligament and intervertebral disc,abnormal signals due to spinal cord compression were superior to CT.Conclusion CT in combination with MRI in diagnosis and directing surgical management is of important value.

Background:Oryz-Aspergillus Enzyme and Pancreatin Tablet is a double-deck digestive enzyme pellet containing Oryz-Aspergillus enzyme and pancreatin that has been widely used for treatment of functional dyspepsia (FD)in clinical practice. However,there is no randomized controlled trial focusing on the efficacy of this agent versus other drugs used for treatment of FD such as prokinetics and proton pump inhibitors (PPI). Aims:To compare the efficacy and safety among Oryz-Aspergillus Enzyme and Pancreatin Tablet,Domperidone Tablet and Esomeprazole Magnesium Enteric-coated Tablet, three drugs with different mechanisms of action on FD,in Chinese population. Methods:A total of 82 Helicobacter pylori-negative outpatients fulfilling the diagnostic criteria of FD in Rome Ⅲ were recruited from Nov. 2015 to Jun. 2016 at the First Affiliated Hospital of Zhejiang Chinese Medical University. These patients were randomly allocated into 3 groups,and received Oryz-Aspergillus Enzyme and Pancreatin Tablet (group A),Domperidone Tablet (group B)and Esomeprazole Magnesium Enteric-coated Tablet (group C)orally for 4 weeks,respectively. The improvement of dyspeptic symptoms and adverse events were observed and recorded. Results:After 4 weeks treatment,the overall efficacies for global symptoms in group A,group B and group C were 93. 1%,88. 9% and 69. 2%,respectively,statistically significant difference was existed among the three groups (P < 0. 05). Domperidone Tablet was effective for postprandial fullness and early satiety;Esomeprazole Magnesium Enteric-coated Tablet was sensitive for epigastric pain,epigastric burning,and belching and regurgitation;the efficacies of Oryz-Aspergillus Enzyme and Pancreatin Tablet for all five dyspeptic symptoms were in between. No adverse events were observed during treatment course. Conclusions:Digestive enzymes,prokinetics and PPI have different sensitive symptoms and optimal indications for treatment of FD. The overall efficacy of Oryz-Aspergillus Enzyme and Pancreatin Tablet is superior to that of prokinetics and PPI.

Objective To analyze the clinical features and laboratory data of 10 patients with macrophage activation syndrome (MAS) complicating systemic onset juvenile idiopathic arthritis (soJIA),which were characterized by acute severe liver injury.Methods Data of 10 patients with soJIA/MAS from Nanjing Children's Hospital were collected retrospectively.The clinical features,laboratory findings,treatment,outcomes and prognosis were analyzed.Results In the total 10 patients,female (6/10) outnumbered male.Their age ranged from 1.5 to 9.5 years old (average 5.2±2.6).The most remarkable clinical manifestations were severe liver injury without systemic features,representing as hepatomegaly (10/10),splenomegaly (2/10) and strikingly increased transaminase (10/10,median:ALT 1 445 U/L,AST 885 U/L).Central nervous system dysfunction and hemorrhages were recorded in 20％ of the patients.Two patients had pulmonary infection.Laboratory data showed that platelet count was less than normal or precaution value (10/10,≤262×10g/L).Hyperferritinaemia (10/10,median:17 329 mg/ml) and soluble CD25 elevation (median:3 140 U/ml) were common in the soJIA/MAS patients.Evidence of macrophage hemophagocytosis was found in 90％ of the patients (9/10) who underwent bone marrow aspiration.Pathological findings of liver biopsy from 1 patient revealed massive infiltration of mononuclear cells in the portal tracts.Nearly all patients (9/10) received intravenous pulse methylprednisolone therapy,combined with cyclosporine A and high-dose intravenous immunoglobulin.Eight patients had good outcome.Only 2 patients were complicated with severe interstitial lung disease during 12-months follow-up.Conclusion MAS should be considered when patients with soJIA represents acute severeliver injury without systemic features combined with other laboratory data.Intravenous pulse methylprednisolone and cyclosporine A therapy may improve the prognosis of soJIA/MAS.

Objective To investigate the efficacy and safety of tocilizumab inpatients with refractory systemic'onset juvenile idiopathic arthritis (SoJIA),and to provide a new option for the treatment of this severe disease.Methods We retrospectively studied 25 cases of hospitalized patients with refractory SoJIA treated withtocilizumab,of whom 22 had data that fit for analysis,from May 2005 to February 2016.Data of 22 cases were collected retrospectively from physicians in charge of the patients.Children with SoJIA were treated with nonsteroidal antiinflammatory drugs (NSAIDs),Glucocorticoid (GC),methotrexate,cyclosporin A,etanerceptetc before,but still in high disease activity due to inadequate response were involved.Weretrospective analyzedthe laboratory test results like C'reactive protein (CRP),Erythrocyte sedimentation rate (ESR),Ferritin and other inflammatory index.Improvement of pain,fever,rash,hepatosplenomegaly and lymphadenectasis of active SoJIA (disease course ≥6 months,and inadequate response to NSAIDs and GC) after tocilizumab treatment (Body weight ≥30 kg,8 mg/kg;Body weight＜30 kg,12 mg/kg,per 4 weeks) were analyzed.Safety data of 22 cases were collected throughout the treatment period including neutropenia,infections,anaphylaxis and elevated liver enzymes etc.We also retrospectively analyzedthe dose change of GC and the long'term effect.Dichtomous paramenters were compared teween groups using thex2 test.Continuous parameters were compared using the analysis of uariance.Results In comparison to the indices before the treatment,the level of CRP [(8.7±2.2) mg/L vs (111.6±74.4) mg/L,F=5.192,P=0.002],ESR [(6.4±6.3) mm/1 h) vs (65.6±24.3) mm/1 h,F=50.393,P=0.000],white blood cell (WBC) [(8.4±2.5)×109/L vs (17.6±8.6)×109/L,F=9.321,P=0.000],Neutrophil count [(4.9±2.4)×109/L vs.(14.4±8.7)×109/L,F=10.541,P=0.000],blood platelet (PLT) [(269.5±79.2)×109/L vs (405.4± 145.3)×109/L,F=5.704,P=0.000] and globulin [(19.2±4.1) g/L vs (30.1±3.8) g/L,F=22.896,P=0.000] decreased rapidly and hemoglobin [(118.3±9.0) g/L vs (108.5±9.8) g/L,F=4.693,P=0.002] increased significantly at 24 weeks after Tocilizumab (TCZ) treatment.Clinical manifestationssuch as fever,rash,hepatosplenomegaly,joint swelling and pain were significantly improved.GC dose [(1.25±3.8) mg·kg-1·d-1 vs (16.2±12.8) mg·kg-1·d-1,F=8.21,P=0.000] were significantly reduced after TCZ treatment (P＜0.05);American College of Rheumatology (ACR) Pedi 30/50/70/90 was improved after TCZ treatment.Adverse events occurred in 3 cases of 25 children,who were not included in the statistical analysis group.Conclusion This retrospective case series has demonstrated the efficacy of tocilizumab in SoJIA,low incidence of adverse reactions.Further studies are needed to be developed because this case series haslimited sample size.

Diabetes is the most important comorbidity of cardiovascular disease, and cardiovascular disease is the main cause of mortality and disability of patients with type 2 diabetes. In order to standardize the diagnosis and treatment of patients with diabetes and cardiovascular disease, the National Health Commission Capacity Building and Continuing Education Center organized the experts from the field of cardiology and endocrinology systematically reviewing the research progresses and expert experiences of relevant disciplines from home and abroad, and formulated this consensus. This consensus covers the diagnosis, drug treatment, and risk factor management for patients with diabetes and cardiovascular disease (including atherosclerotic cardiovascular disease and heart failure) from the perspective of cardiovascular disease and diabetes management aiming to strengthen the comprehensive management of patients and ultimately to improve the prognosis of patients. The management of cardiovascular diseases mainly includes the management of blood pressure, blood lipids, anti-thrombosis, anti-myocardial ischemia, anti-ventricular remodeling and so on. Diabetes management mainly includes lifestyle intervention (including diet, exercise, weight loss, etc.), anti-hyperglycemia therapy (including drugs and insulin), blood glucose monitoring, and hypoglycemic prevention. In addition, specific clinical recommendations are given to patients with special health care needs such as diabetic nephropathy, elderly (>75 years), and cardiovascular critical illness.

Dronedarone, a class Ⅲ antiarrhythmic drug, is a deiodinated benzofuran derivative of amiodarone. It has similar antiarrhythmic effects with amiodarone, but much lesser adverse effects than amiodarone, particularly in those outside the heart. It is suggested to use dronedarone for the rhythm control of atrial fibrillation/flutter, for it has been shown to prevent the recurrence of atrial fibrillation/flutter and reduce rehospitalization in patients with paroxysmal or persistent atrial fibrillation/flutter. Dronedarone is not recommended for the rhythm control in patients with long-term persistent atrial fibrillation or permanent atrial fibrillation, and atrial flutter or atrial fibrillation patients with reduced ejection fraction. Liver function, electrolyte tests and an electrocardiogram should be performed before and after the drug initiation. Potential interactions with other kinds of drugs have to be taken into consideration as well.