Objective To explore the significance of the changes of serum B cell activating factor(BAFF) in children with idiopathic thrombocytopenic purpura(ITP).Methods The concentrations of BAFF were detected by ELISA in 42 children with ITP(test group) before and after treatment in the Children′s Hospital Affiliated to Chongqing Medical University from Apr.to Nov.2008,the blood platelet count(BPC) was detected also.And 40 children who were operated selectively were selected as control group.The variation of concentrations of BAFF were analyzed among children with ITP before,after treatment and control group.Moreover,the relationship between serum BAFF expression and BPC were analyzed by the Pearson test.Results The concentrations of serum BAFF were higher in children with ITP before treatment compared with that in control group [(0.943 3?0.583 5) ?g?L-1 vs(0.538 9?0.234 7) ?g?L-1,P0.05).There was negative correlation between serum BAFF expression and BPC(r=-0.305,P

Idiopathic thrombocytopenic purpura(ITP) as an autoimmune disease,is the most common clinical hemorrhagic disease.But,its pathogenesis is not completely clear yet.Low platelet count can easily repeate in chronic ITP patients,there are poor efficacy in refractory ITP patients,too.In recent years,a series of important progress on the pathogenesis of ITP had been made.In the humoral mechanism,there were significant progress on the emergence of autoantibodies;the theory on anomaly of the megakaryocyte quantity and quality caused by autoantibody were put forward.In the cellular mechanisms,the theory on reduction in the number of Tr cells,Co-stimulative signal and platelets directly dissolved by cytotoxicity T cells were put forward also.This review will be made to sum up the study progress on the pathogenesis of ITP.

To detect the expression of the human papilloma virus (HPV) 16 and HPV18 in esophageal squamous cell carcinoma in Minnan area. Methods: Real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) was applied to detect HPV DNA in 100 esophageal carcinoma sample and 100 normal tissues beside the tumor. Results:The positive rates of high-risk HPV 16 and HPV 18 infection in Minnan esophageal carcinoma and in normal tissues beside the tumor were 14.00%, 15.00%and 7.00%, 8.00%, respectively. The positive rates of lymph node and non-lymph node metastases were 40.98%and 10.25%, respectively. These re-sults exhibited statistical significance (P<0.01). HPV 16 and HPV 18 infection was uncorrelated with patient age, pathological type, and tumor grade (P>0.05). Conclusion:HPV16 and HPV 18 infection was correlated to esophageal squamous cell carcinoma in Minnan ar-eas. Such infection may also contribute to the occurrence and development of esophageal squamous cell carcinoma.

Objective:To compare the clinical value of early enteral nutrition(EEN) with total parenteral nutrition(TPN) in postoperative elder patients with esophageal and cardiac cancer. Methods: 102 cases of postoperative elder patients with esophageal and cardiac cancer were randomly divided into EEN group(n=51)and TPN group(n=51).The weight loss,serum albumin, prealbumin,liver function were measured before operation and on the eighth day after operation. The anal exsufflation time, infectious complication, duration of hospital stay and treatment cost were observed. Results: The weight loss in EEN group were less than those of TPN group(P<0.05). The levels of ALT, AST, BIL and GGT in EEN group on the eighth day after operation was lower than those in TPN group(P<0.05). The anal exsufflation time and duration of hospital stay in EEN group were shorter than those of TPN group(P<0.05). The treatment cost of EEN group was significantly less than that of TPN group(P<0.05). The infectious complication rate of EEN group was lower than that of TPN group(P<0.05). Conclusion: EEN in postoperative elder patients with esophageal and cardiac cancer can decrease the postoperative infectious complication and the treatment cost, shorten the duration of hospital stay, improve nutritional status and recovery of gastrointestinal function with less side effects of liver function.

Avascular necrosis of the carpal lunate (Kienbock's Disease) was first described by Peste in 1843. It's etiology is still unknown. Since Lippman, in 1949, there have been many operative treatments for this disease but they had many complications and technical difficulties. The treatment of Kienbock's disease by resection of the lunate and replacement with fascia lata through the dorsal approach is very simple in operation method and its results were satisfactory in follow up study for postop 12, 18 months. We report two cases of Kienbock's disease with brief review of literature.
Fascia Lata ; Fascia ; Follow-Up Studies ; Methods ; Necrosis ; Osteonecrosis

OBJECTIVE To investigate the genotypes of plasmid-mediated AmpC beta-lactamases carried in Klebsiella pneumoniae,to provide reasonable use of antibacterial agents and to reduce the spread of these drug resistant genes.METHODS Two hundred and eighteen strains of K.pneumoniae were performed in Tongji Hospital in Wuhan.Plasmid-mediated AmpC beta-lactamases-producing strains were screened by improved three-dimensional method and identified by multiplex PCR.DNA sequencing method was used to confirm these drug resistant strains.The MIC of 15 kinds of antibacterial agents against the clinical isolates was detected by double agar dilution method.RESULTS Thirteen strains of K.pneumoniae were detected by improved three-dimensional method.The detection rates were 5.96%.There were seven of thirteen positive strains of K.pneumoniae through improved three-dimensional method harboring DHA-1 type plasmid-mediated AmpC beta-lactamase by multiplex PCR and confirmed by DNA sequencing.Plasmid-mediated AmpC beta-lactamase producers revealed a highly drug resistance to cephalosporins,monobactams,beta-lactam/beta-lactamase inhibitor combinations,aminoglycosides and fluoroquinolones.Only imipenem was susceptible to all of these detected strains.CONCLUSIONS DHA-1 plasmid-mediated AmpC beta-lactamase is detected in K.pneumoniae strains from Tongji Hospital.The detection rate is 3.2%.The pAmpC-producing strains reveal multi-drug resistance.Only imipenem is susceptible to them.

Plasma ghrelin level was measured by RIA in 49 grids with idiopathic central precocious puberty(ICPP)and 35 girls with simple premature thelarche(PT).The results showed that the plasma ghrelin level was negatively correlated with Tanner stage,bone age,Lid at 15,30 and 60 min after GnRH activation, uterus and ovary volumes.The plasma ghrelin level in the ICPP group was remarkably lower than that in the PT and control groups(both P

Objective To discuss the clinical diagnostic method of postural orthostatic tachycarda syndrome(POTS) in children.Methods Thirty-six children with POTS were selected for the research.Among them 15 were boys,21 cases were girls.The age ranged from 5.9 to 16 years,average age 12.3 years.Among them 28 patients(78%) were in between 11-16 years.The age distribution,clinical courses and hemodynamic indexes were analyzed and also the incidence of clinical manifestations and investigation reports were observed.Results Among 81 patients of orthostatic regulation disturbance,36 patients were diagnosed POTS,which was 47% of total.The clinical courses ranged from 1 day to 5 years,average clinical course 10.2 months.The clinical courses of more than half of the total patients were within 6 months(56%).The common clinical features of POTS were chest tightness on standing,vertigo,fatigue,palpitation,syncope,orthostatic regulation disturbance.Ten patients were also associated with gastrointestinal symptoms like nausea,vomiting.The most common feature of POTS patients was tachycardia(HR increased by ≥30 times/min) within 10 min after head-up tilt test(HUT).Average HR increased by 38 times/min.In some patients HR increased up to ≥120 times/min.There were no significant changes in blood.In 23 cases(64%),the T waves were descended by ≥0.2 mV in 2 or more than 2 leads in ECG reading.Investigations reports showed that there were 12 cases whose urine specific gravity was increased.In 11 cases HCO_3~-decreased.Conclusions POTS is commonly seen in schooling female children.The common symptoms are vertigo,chest tightness,fatigue,palpitation.HUT is an important method for the diagnosis of POTS.

Objective To master the prevalence trend of Kaschin-Beck disease in Xinghai county (Shanglujuan and X.ialujuan village of Tangnaihai township) from 2003 to 2008 in order to understand changes of selenium level of internal and external environments. Methods According to monitoring method on national Kaschin-Beck disease,we carried out epidemical investigation,clinical examination and X-ray photograph on school children aged 7-12 in Xinghai county,a monitoring region,and collected samples of hair and grain. The content of selenium was detected by 2,3-naphthalene fluorescence. Results From 2003 to 2008,in Shanglujuan village,the prevalence rate of clinic examination was fluctuating between 0(0/34)-17.14%(6/35); the detectable rate of X-ray examination was fluctuating between 11.11% (3/27)-20.59% (7/34),the prevalence rates of metaphysis and extremities were fluctuating between 0 (0/27)-13.21%(7/53) and 2.63% (1/38)-11.43% (4/35). In Xialujuan village,the prevalence rate of clinic examination was fluctuating between 2.94% (1/34)-13.33% (6/45); the detectable rate of X-ray examination was fluctuating between 26.67% (12/45)-43.63%(24/55),the prevalence rate of metaphysis and extremities were fluctuating between 8.33% (6/72)-26.47% (9/34) and 13.33% (6/45)-38.18% (21/55). The selenium contents in hair samples were (139.92±92.27),(134.98±63.77)μg/kg respectively in Shanglujuan and Xialujuan village in 2003; the selenium contents in grain samples were (12.90± 7.18),(14.58±9.90)μg/kg respectively in Shanglujuan and Xialujuan village in 2005. Conclusions The prevalence state of Kaschin-Beck disease in national monitoring region is rigid and pathogenetic factors of Kaschin-Beck disease are active. Selenium levels of internal and external environments are low in this region.

The clinical characteristics of patients who presented in poor clinical grade due to ruptured middle cerebral artery aneurysms (MCAAs) associated with large sylvian hematomas (SylH) were analyzed and an ingenious designed prophylactic hinged craniectomy was introduced. Twenty-eight patients were graded into Hunt-Hess grades IV-V and emergency standard micro-neurosurgeries (aneurysm clipping, hematoma evacuation and prophylactic hinged craniectomy) were performed, and their clinical data were retrospectively analyzed. 46.43% of the patients reached encouraged favorable outcomes on discharge. The favorable outcome group and the poor outcome group significantly differed in terms of patients' anisocoria, Hunt-Hess grade before surgery, extent of the midline shift and time to the surgery after bleeding (P<0.05). There were no significant differences in age, sex, volume and location of the hematoma, size of aneurysm between the favorable and poor groups (P>0.05). However, ingenious designed prophylactic hinged craniectomy efficiently reduced the patients' intracranial pressure (ICP) after surgery. It was suggested that preoperative conditions such as Hunt-Hess grading, extent of the midline shift and the occurrence of cerebral hernia affect the prognosis of patients, but time to the surgery after bleeding and prophylactic hinged craniectomy are of significant importance for optimizing the prognosis of MCAA patients presenting with large SylH.