Objective To evaluate if the assay of platelet-associated immunoglobulin G (PAIgG) can improve the sensitivity of monoclonal antibody immobilization of platelet antigens assay (MAIPA) in immune thrombocytopenic purpura (ITP).Methods Anti-GP Ⅱb/Ⅲa and anti-GP Ⅰb/Ⅸ autoantibodies were detected by a modified MAIPA;PAIgG was detected by competitive ELISA.MAIPA and PAIgG were done simultaneously in 190 patients with thrombocytopenia,in which 132 were diagnosed as ITP according to the diagnostic criteria Kappa test was used to analyze the concordance between MAIPA and PAIgG.Results The sensitivities of PAIgG alone or in parallel with MAIPA to ITP were 32.6% and 37.2% higher than MAIPA alone respectively,while their specifieities were 51.7% and 56.9% lower respectively.The sensitivity,specificity,positive predictive value,negative predictive value of PAIgG in series with MAIPA were all not superior to MAIPA alone.The kappa values between MAIPA and PAIgG in ITP and non-immune thrombocytopenia were 0.129 and 0.012 respectively,which meant the concordance between them was poor.Conclusion The detection of PAIgG should not be used as screening before MAIPA in distinguishing immune from non-immune thrombocytopenia.

Aged ; Cavernous Sinus ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Syndrome

By reshaping the cornea without the creation of a stromal flap, excimer laser corneal surface ablation eliminates flap-related complications and avoids the risk of ectasia that may occur after laser assisted in situ keratomileusis ( LASIK ) . Post-operative pain is one of the most significant disadvantages of surface ablation and thus the management of pain and discomfort following surface ablation is of great importance. We summarize mechanism of corneal pain and current approaches to pain management after surface ablation.

OBJECTIVETo investigate the malondialdehyde (MDA) level and paraoxonase-1 (PON-1) activity in the serum and seminal plasma of infertile men with chronic viral hepatitis and their influence on the semen parameters of the patients.

METHODSWe collected serum and semen samples from 42 infertile men, 45 infertile males with chronic viral hepatitis, and 50 healthy fertile men as controls. We measured the MDA level in the serum and seminal plasma by spectrophotometry, detected the PON-1 activity by spectrophotometry, and determined the sperm DNA fragmentation index (DFI) by acridine orange fluorescence staining.

RESULTSThe MDA level was significantly higher but the PON-1 activity remarkably lower in the serum and seminal plasma of the infertile males with chronic viral hepatitis than in the healthy controls and infertile patients (P <0.01 or P <0.05). Total sperm motility and sperm survival rate were significantly lower while the sperm DFI markedly higher in the former than in the latter two groups (P <0.01 or P <0.05). No statistically significant difference was found among the three groups in sperm concentration (P >0.05). The WBC counts in the semen of the infertile and infertile with chronic viral hepatitis groups were significantly higher than that in the health controls (P <0.05). The MDA level and PON-1 activity in the seminal plasma were positively correlated with those in the serum in the infertile males with chronic viral hepatitis (r=0.57 or 0.48, P <0.01).

CONCLUSIONVirus-induced chronic active hepatitis enhances oxidative stress in the reproductive system, aggravates sperm damage, and affects sperm quality parameters.

Adult ; Aryldialkylphosphatase ; analysis ; Case-Control Studies ; DNA Fragmentation ; Fertility ; Hepatitis, Viral, Human ; complications ; Humans ; Infertility, Male ; blood ; Male ; Malondialdehyde ; analysis ; blood ; Oxidative Stress ; Semen ; Sperm Count ; Sperm Motility ; Spermatozoa

BACKGROUND: This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS: Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn't meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method. RESULTS: Twenty patients were involved, but one patient wasn't analyzed because he didn't meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05). CONCLUSION: Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.

Japan moxibustion methods originate from China and form moxibustion methods with Japanese characteristics and diathermal moxibustion as main, in combination with Japanese practice in development course. In the present paper, diathermal moxibustion and folk traditional moxibustion methods in Japan are introduced and moxibustion methods between China and Japan are preliminarily compared.
Humans ; Japan ; Medicine, East Asian Traditional ; Moxibustion ; methods

A study on the microbial transformation of glycyrrhetinic acid (GA) was conducted by a fungus, Cunninghamella blakesleeana CGMCC 3.970 systematically. After incubation with the cell cultures of C. blakesleeana CGMCC 3.970 at 25 degrees C for 7 days on a rotary shaker operating at 135 r x min(-1), GA was converted into one major product and five minor products. The products were extracted and purified by solvent extraction, macroporous adsorbent resin, silica gel column chromatography, and semi-preparative RP-HPLC chromatography. Their structures were identified as 3-oxo-15α-hydroxy-18β-glycyrrhetinic acid(1), 3-oxo-15β-hydroxy-18β-glycyrrhetinic acid (2), 7β,15α-dihydroxy-18β-glycyrrhetinic acid (3), 3-oxo-7β, 15α-dihydroxy-18β-glycyrrhetinic acid (4), 7β-hydroxy-18β-glycyrrhetinic acid(5) and 15α-hydroxy-18β-glycyrrhetinic acid(6) by the analyses of MS, 1H-NMR and 13C-NMR spectroscopic data respectively. Among them, 2 was a new compound. These results suggest that C. blakesleeana CGMCC 3.970 has the capability of selective ketonization and hydroxylation for GA. [Key words] glycyrrhetinic acid; Cunninghamella blakesleeana CGMCC 3. 970; microbial transformation
Biotransformation ; Cunninghamella ; metabolism ; Glycyrrhetinic Acid ; analogs & derivatives ; chemistry ; metabolism ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

Actins ; metabolism ; Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Hypophosphatemia ; blood ; etiology ; Ilium ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Osteomalacia ; blood ; etiology ; Phosphates ; blood ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tomography, X-Ray Computed

Objective To explore the effect of upgrade of dialysate quality on the microinflammation in maintenance haemodialysis (MHD) patients. Methods Fifty-three MHD patients in Kidney Center of the First Affiliated Hospital,Medical College,Zhejiang University in January 2003 were enrolled in the prospectively study.The main end-points were survival at 8 years or weaning from haemodialysis during 8-year period including death, receiving renal transplantation or transferring to peritoneal dialysis.The endotoxin level of dialysate and patients' serum levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),C reaction protein (CRP),and albumin were recorded during the observation period. Results After the upgrade of water management system,endotoxin level of dialysate obviously decreased [(0.046±0.012) EU/ml vs (0.454±0.002) EU/ml,P＜0.01],and serum IL-6 [(3.947±3.624) ng/L vs (13.779±7.106) ng/L,P=0.036],TNF-α [(7.935±3.864) ng/L vs (12.804±8.017) ng/L,P=0.012] as well as CRP [(0.194±0.149) mg/L vs (0.561 ±0.309) mg/L,P＜0.01] decreased significantly,while serum albumin increased [(41.900±6.803) g/L vs (38.140±7.083) g/L,P=0.042].Hemoglobin level did not change significantly after the system upgrade,however,the dose of erythropoietin decreased [(93.0±12.7) U·kg-1·week-1 vs (131.0±10.1) U·kg-1·week-1,P=0.015]. Conclusions The upgrade of central dialysis fluid delivery and water management system by application of double reverse osmosis,high frequency heat disinfection and endotoxin filter can improve the quality of dialysate.Improvement of dialysate quality can ameliorate the microinflammation state of MHD patients.