Immune thrombocytopenia (ITP) is the most common hemorrhagic disease in childhood,and immunological abnormality is the most common cause of this disease.Humoral immune abnormalities are the major cause of ITP,involving platelet,platelet membrane surface glycoproteins associated antibodies,impaired Breg cells and upregulation of platelet Toll like receptors.Cellular immune abnormalities include the imbalance of Th1/Th2 cells results in increased inhibitory cytokines [interleukin (IL)-2,interferon-α,tumor necrosis factor-β],IL-17 and Th17 cells in patients with chronic ITP are higher than those in control group,and Treg decline is also common seen in ITP.Increased expression of apoptosis related genes Bak and Bax are also the cause of chronic ITP.Helicobacter pylori is an important cause of chronic ITP,which can be eased in some cases but not effective in new diagnosed cases.Vaccination can lead to ITP,repeated vaccines are applied usually in 3-6 months after the onset.

This study developed a management information system for rural basic publication health. The system, which is convenient for management of public health information and can improve the efficiency, is suitable for management of rural basic public health at various health administration sections.

Objective To observe the effects of exercises on early stage of steroid-induced necrosis of the femoral head in rabbits with magnetic resonance imaging (MRI). Methods 24 adult rabbits were divided randomly into three groups, i.e. control group (group A), routine model group (group B) and experimental group (group C) with 8 animals for each group. Dexamethasone (DXM) was administrated in a dosage of 2.5mg/kg via intramuscular route to reproduce the aseptic necrosis of femoral head (ANFH) model in groups B and C, while only isotonic physiological saline was given to the animals in group A. MRI examinations were done at 2nd, 4th, 6th and 8th week after administration of DXM for bilateral femoral heads, and also on a medial coronary area of the hip joints with a fixed area of circumambient soft tissure of 3 mm in diameter. Results At 2nd, 4th, 6th and 8th week after the reproduction of the model, the t2-de3d-sag spot-signals given by MRI in the circumambient soft tissue of hip joints were 56.26?0.45, 58.05?0.27, 59.04?0.29 and 59.23?0.25 in group A, 61.40?0.41, 63.71?0.34, 69.65?0.28 and 71.84?0.3 in group B, and 59.54?0.39, 60.06?0.32, 62.71?0.19 and 63.18?0.40 in group C, respectively. Significant differences existed between each of two groups (F=84.93, P

0.05).There are significant statistical differences in NIHSS(91.3% vs 71.3%)and BI(93.8% vs 75.0%)between two groups af- ter treatment(P0.05). Conclusion Multidisciplinary integrated treatment mode is an effective treat ment for stoke.

The hospital is a dynamic, discrete, flexible, open and complicated system. The paper offered an analysis of the hospital system from the Wuli-Shili-Renli perspective, simplifying the complex process of medical activities into a clear-cut diagram of the system architecture. It also gave an account of the construction of a simulation model of specialized knowledge in hospital management by means of KBS, with the integration of the Wuli-Shili-Renli ideology into the KBS, and expounded the significance of Renli in the model of hospital management.

Objective To investigate the clinical value of diffusion weighted imaging (DWI) in diagnosis of atypical cancerization nodules (CNs) of liver cirrhosis. Methods Totally 34 patients with atypical CNs of liver cirrhosis confirmed pathologically underwent routine MR, dynamic enhancement, and DWI (b=0, 500, 1000 s/mm~2). The detection rate of CNs of liver cirrhosis between routine MR and DWI was compared. Results Totally 21 patients with 28 cancerization nodules were diagnosed with routine and dynamic enhancement MR, while 27 patients with 37 cancerization nodules were detected with DWI. Significant difference was found in the detection rate between routine scan and DWI (P=0.025). Conclusion DWI shows more advantage than routine and dynamic enhancement MR for detection of liver cirrhosis with atypical CNs.

ObjectiveTo evaluate the significance of ankler-brachial index (ABI) to predict the extent of intracranial artery stenosis in ischemic stroke patients. Methods243 ischemic stroke patients were enrolled, brain angiography were examined and all of the ABI and basic data were collected. ResultsABI≤0.9 was associated with a specificity of 84.6% and a sensitivity of 16.8% for predicting the presence of severe stenosis in intracranial artery. The area under receiver operating characteristic curve was (0.591±0.046) (P<0.05). ConclusionABI≤0.9 has a relative specificity and sensitivity for predicting the presence of severe stenosis of intracranial artery.

Objective To investigate the effect of cystatin C (CysC) concentration on outcome of intravenous thrombolysis in patients with acute ischemic stroke.Methods The consecutive patients with acute ischemic stroke who underwent intravenous thrombolysis were enrolled retrospectively.They were divided into a good outcome group (≤2) and a poor outcome group (＞2) according to the Rankin scale.They were also divided into a hemorrhagic transformation (HT) group and a non-HT group according to whether they had HT or not.Their demographic data and clinical data were compared.Results A total of 103 patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled,44 in the good outcome group,59 in the poor outcome group; 23 in the TH group,and 80 in the non-HT group.The age (62.34 ± 13.41 years vs.68.09 ± 9.74 years; t-2.521,P =0.013),baseline CysC concentration (1.008±0.28 mg/L vs.1.27±0.86 mg/L; t=2.237,P=0.027),incidence of HT (14％ vs.34.9％; x2 =6.016,P =0.014) and National Institutes of Health Stroke Scale (NIHSS) score (10.39 ± 3.11 vs.18 ±2.65; t =13.35,P ＜0.001) in the good outcome group were significantly lower than those in the poor outcome group.Multivariate logistic regression analysis showed that there was no significant independent correlation between CysC and clinical outcome (odds ratio 1.783,95％ confidence interval 0.443-7.185 ; P =0.416).The baseline CysC concentration (1.41 ± 0.54 mg/L vs.0.96± 0.18 mg/L; t =3.941,P=0.001) and the NIHSS score (15.96 ± 3.7 vs.13.05 ±4.87; t =3.017,P =0.004) in the non-HT group were significantly lower than those in the HT group.Multivariate logistic regression analysis showed that the plasma CysC concentration ＞ 1.03 mg/L (odds ratio 9.050,95％ confidence interval 2.384-34.359; P =0.001) was an independent risk factor for HT.Conclusions The increased baseline plasma CysC concentration was associated with the occurrence of HT in patients with acute ischemic stroke after intravenous thrombolysis therapy,but it was not associated with the outcomes.

Objective To summarize the clinical experience of laparoscopic appendectomy(LA).MethodsA retrospective analysis was conducted on the clinical data of 683 patients with appendicitis treated by LA,including 258 cases of chronic appendicitis,425 cases of acute appendicitis(87 cases of complicated appendicitis).ResultsThe procedure was completed in all the patients without conversion to open surgery.The operation time was 30 min in average(15-150 min).The average hospital stay was 4d (2-15d).Postoperative complications included 26 cases of incision infection,3 cases of abdominal abscess,1 case of appendical mesenterium hemorrhage,1 case of small intestine fistula and 1 case of appendical stump fistula.The patients were followed up for 2 to 12 months with a mean of 6 months,during which no intestinal adhesive obstruction occurred.Conclusion LA is safe and effective for appendicitis,with advantages of minimal trauma,lighter pain,quicker recovery,shoter hospital stay,less complications and so on.For complicated appendicitis,the abundant surgical experience and proficient endoscopic technique are indispensable to reduce the occurrence of complications effectively.

Objective: A high-performance liquid chromatographic (HPLC) procedure with a fluorescence detector was developed to rapidly separate ?,?,?,?- tocopherol isomers in human serum Methods: The HPLC system consisted of Inertsil silica column (100-A, 3?m,4.6mm?250mm) and 7% (v/v) methyl-tert- butyl ether in n-hexane as mobile phase . Prior to HPLC, the serum sample wa deproteined by ethanol (BHT 0.0625%) and the tocopherol isomers were efficiently extracted in thei original isomeric conformations using n-hexane-ethyl acetate (5:1) in the presence of 2,6-bi-buty p-methylphenol (BHT). Result: The quantification limits, defined as the lowest quantitatively measurable concentration of the different compounds (ng/ml) are calculated according to the experiment:?-tocophero 1.0,?-tocopherol 1.0,?-tocopherol 0.5,?-tocopherol 0.5. The recovery rates are between 95%~105% Correlation coefficients are over 0.999 when the concentration is between 5 ng/ml~5 ?g/ml. Conclusion This technique is suitable for assay of tocopherol isomers in human serum at all ages.