Objective To investigate the expression and clinical significance of platelet autoantibodies in children with persistent/chronic immune thrombocytopenia (pITP/cITP).Methods Total of 34 children diagnosed with pITP/cITP(14 cases and 20 cases,respectively)in the Department of Hematology and Oncology,Shanghai Children's Hospital from December 2013 to August 2014 were enrolled as the study group,including 20 male and 14 female,the median age of 5 years old.The study also included 20 healthy children (the healthy control group) matched with gender and age,and 24 cases of newly diagnosed ITP (newly diagnosed ITP group) serving as the control groups.Platelet-associated immunoglobulin (PAIg) and platelet-specific autoantibodies on surface of platelets were mea-sured by flow cytometry or flow cytometric bead.Results Significant elevation of PAIgA,PAIgM,PAIgD and specific autoantibodies against glucoprotein(GP) Ⅲa,and GP Ⅱb were demonstrated in children with cITP,as well as specific autoantibodies against GP Ⅰ b,GP Ⅲ a,GP Ⅱ b,and granule membrane protein 140 (GMP140) in children with pITP,compared with the healthy control group(P ＜ 0.05);the levels of GPⅨ,GP Ⅲ a,GMP140 in cITP group and GP Ⅱ b in pITP showed significant declination,compared with the newly diagnosed ITP group(P ＜ 0.05);between piTP group and cITP group,autoantibodies GPⅨ,GP Ⅰ b,GP Ⅱ b,and GMP140 in the latter were much lower(P ＜ 0.05).Significant negative relation between PAIgM and platelet count was found in cITP group (P ＜ 0.05).Receiver operating characte-ristic (ROC) curve analysis showed that the area under ROC curve (AUC) of GP Ⅲ a autoantibodies was larger than that of other platelet-autoantibodies in pITP/ciTP diagnosis.Conclusions Platelet autoantibodies play a significant role in pITP/ciTP,especially platelet-specific autoantibodies,which show a declining tendency in the course and may be the main mechanism.The detection of GPⅢa specific autoantibody is more advantageous against other autoantibodies in the diagnosis of piTP/ciTP.

Objective To explore the influencing factors of daunorubicin (DNR) induced apoptosis in Jurkat cells of acute lymphoblastic leukemia. Methods Jurkat cells were treated with different concentrations of DNR(0, 0.05, 0.1, 0.5 and 1 μg/mL)or pretreated with N-acetylcysteine (NAC). Cell proliferation was detected by MTT assay, cell apoptosis was observed by Hoechst/PI, reactive oxygen species (ROS) level and apoptosis were determined by flow cytometry, and the expression of survivin, bax, bcl-2 and bcl-xl mRNA was examined by RT-PCR. Results DNR siguificantly inhibited the proliferation of Jurkat cells. After treatment with 0, 0.05, 0.1, 0.5, 1 μg/mL DNR and pretreated with NAC for 24 h, ROS levels were (7.98±0.55)%, (8.88±0.86)%, (9.46±0.98)%, (17.48±2.98)%, (24.46±2.43)% and (11.59±1.29)%, respectively, and cell apoptosis rates were (11.41±1.44)%, (34.96±3.32)%, (45.58± 3.12)%, (84.19±2.65)%, (87.93±1.74)% and (80.47±0.63)%, respectively. After pretreatment with NAC, the levels of ROS were siguifieantly inhibited (P < 0.01). There was no significant difference in apoptosis rates between treatment with 0.5μg/mL DNR and pretreatment with NAC(P>0.05). The expression of bax mRNA was down regulated and the expression of survivin, bcl-2 and bcl-xl was up regulated (P < 0.05). Conclusion DNR can induce apoptosis of Jurkat cells. ROS may participate in the DNR induced Jurkat cell apoptosis, and apoptosis-related gene bax, bcl-2, bcl-xl and survivin may interact with ROS in the regulation of DNR induced Jurkat cell apoptosis.

Objective To investigate students' view about the laboratory medicine curriculum and teaching reform,and to provide reference for further reform and development. Methods The students specialized in laboratory medicine in School of Medicine,Shanghai Jiaotong University were involved in the survey.Questionnaires were answered and analyzed.The research method of expert consultation was adopted. Results Students had some different opinions for course content,structure and so on,and they expected more clinical practice,more hands operation,and more teachers' guidance.Conclusion To train laboratory technicians,it was necessary to build a reasonable system of professional courses and train practical talents.

Objective To observe the effect of Zhuyun Capsule(Pregnant-promoting Capsule)on serum sex hormone and expres- sion of ovarian cytokine of polycystic ovary syndrome(PCOS)rats.Methods Progestogen plus human chorionic gonadotrophin (HCG)was adopted to make PCOS rat models.Totally 40 SD rats were randomized into control group,PCOS model group,Zhuyun Capsule group,and clomiphene citrate group with 10 in each.Radioimmune assay(RIA)was used to measure the sex hormone and immunohistochemical test was done to measure the expression of tumor necrosis factor-?(TNF-?)of ovarian tissue,insulin-like growth factors-1(IGF-1),and leukemia inhibitory factor(LIF)to analyze the relations among these factors.Results Zhuyun Capsule could reduce greatly serum testosterone(T)and luteinizing hormone(LH),decrease expression of TNF-?and IGF-1,but increase expres- sion of LIF.Conclusion Zhuyun Capsule could regulate endocrine function and expression of ovarian cytokine to improve gonad func- tions of PCOS rats and to promote the maturation of follicle and ovulation.

ve To understand the levels of trace elements in hair of patients with hypertension disease and coronary heart disease. Methods The contents of zinc, copper, manganese and iron in hair were determined among 45 patients with hypertension disease, 36 patients with coronary heart disease and 40 healthy controls by flame-atomic absorption spectrophotometry respectively. Results The contents of zinc and the ratio of the contents of zinc vs the contents of copper in hair of patient with hypertension disease and coronary heart disease showed significantly higher levels compared with those of healthy controls (P

Objective To explore the clinical value of virtual touch quantification (VTQ) technique in assessing the hepatic fibrosis. Methods A total of 115 inpatients with chronic liver disease receiving liver biopsy were enrolled in this study, all patients liver tissue was checked by VTQ technique, and the results were compared with those of the control group including 80 healthy subjects. Results VTQ value was significantly different between the two groups (P = 0.0000).The VTQ value among different degree of hepatic fibrosis but between S0 and S1 had statistical significances (P = 0.0212, P = 0.0000).ROC curve displayed that VTQ value of 1.4 m/s could be used to diagnose middle-high-grade liver fibrosis, the sensitivity and specificity were 85.4 % and 64.7%, respectively. Conclusions VTQ can be used as a noninvasive and effective means for assessing the degree of hepatic fibrosis.

OBJECTIVETo evaluate the sensitivity of NT-pro-BNP in daunorubicin (DNR) induced myocardial damage by monitoring the level of NT-pro-BNP and myocardial enzymes (CK, CKMB) before and after DNR treatment in childhood acute leukemia (AL) and performing control study.

METHODSSixty-two cases (total 194 samples) which diagnosed as primary AL were enrolled and had received the conventional chemotherapy. According to the cumulative dose of DNR, they were divided into three groups: cumulative dose ≤ 60 mg/m(2) (group A); cumulative dose 60 - 120 mg/m(2) (group B); cumulative dose > 120 mg/m(2) (group C) and 15 cases with idarubicin (IDA) or mitoxantrone (MXR) as altervative to DNR (group D).

RESULTSThere was a significant difference (P = 0.000) in the level of NT-pro-BNP before and after DNR therapy, but did not in the myocardial enzymes activities (CK, P = 0.085 and CKMB, P = 0.076). The level of NT-pro-BNP appeared obviously elevated (P = 0.001) when DNR cumulative dose > 60 mg/m(2). While the level of CKMB did (P = 0.022) until DNR cumulative dose > 120 mg/m(2). In the 15 cases used IDA or MXR as alternative to DNR, the level of NT-pro-BNP fall from (239.9 ± 230.0) ng/L to (137.0 ± 131.9) ng/L (P = 0.024).

CONCLUSION(1) Compared with myocardial enzymes detection, NT-pro-BNP level can predict earlier DNR-induced cardiotoxicity. (2) Selection of the second or third generation anthracycline to treat AL can significantly reduce the cardiotoxicity in children.

Objective To evaluate the practicability of using flow cytometry analysis for diagnosis of non-hodgkin′s lymphoma ( NHL) among children with serous effusion.Methods Twelve children who were diagnosed with malignant lymphoma from February 2011 to November 2013 at Shanghai Children′s hos-pital were recruited in this study.Pleural effusion and ascites samples were collected from those children who showed serous effusion as initial symptoms and analyzed by using flow cytometry based immunophenotyping. The antibodies used for immunophenotyping included CD45, CD10, CD33, CD7, CD1a, MPO, cCD3, CD79a, CD22, CD19, CD20, CD5, CD3,κ,λ,αβ,γδ,CD56 and other common markers for T, B and NK cells.Anti-CD30 antibody was used when necessary.Results All of the twelve cases with serous effusion were diagnosed with aggressive NHL.Six out of the twelve children including five cases with ascites and one case with pleural effusion showed high expression of CD20 and were classified as NHL-B type by flow cytom-etry.Three children with pleural effusion and one child with both pleural effusion and ascites were typed as NHL-T as characterized by monoclonal expression of αβorγδ.The other two children with pleural effusion were diagnosed with anaplastic large cell lymphoma with positive expression of CD30 and morphological het-erogeneity.Conclusion Flow cytometry analysis based immunophenotyping could be used as an auxiliary method for rapid and accurate diagnosis of lymphoma in children with serous effusions.

AIM:To observe the effect of fresh amniotic membrane transplantation ( FAMT) in acute ocular chemical burns.
●METHODS:A prospective study of 25 consecutive cases (36 eyes) with acute ocular chemical burns were treated with FAMT. The clinical efficacy was observed such as the time of amniotic membrane absorbed, corneal epithelialization & transparency, visual acuities and complications.
●RESULTS: With follow-up ranged from 3 to 6mo, 31 eyes′ amniotic membrane were dissolved in 2wk (86%). A total of 33 eyes showed corneal epithelialization in 4wk ( 92%) , 3 eyes showed persistent corneal epithelial defects and need secondary limbal stem cell transplantation or corneal transplantation ( 8%) . A total of 10 eyes showed superficial corneal vascularization (28%), 6 eyes′ cornea were opacity in part (17%), and one eye was symblepharon (3%).
●CONCLUSION:Early FAMT is an effective treatment in the management of acute ocular chemical burns to support epithelial healing, restore ocular surface integrity with potential to improve vision and reduce the incidence of complications. Furthermore, FAMT has advantages of easily obtain and convenient usage, which is suitable in local hospital of our country.

Objective To investigate the clinical teaching situation by using developmental inspection of School of Medicine,Shanghai Jiaotong University(SJTU-SM),and to put forward some suggestions. Methods By checking questionnaires and informal discussions,the relevant information was collected and analyzed by using SPSS statistics sofware. Results The clinical teaching quality of SJTU-SM was basically satisfied.The satisfaction from internship of grade 2004 was better than that of grade 2003.However,some problems in clinical teaching must be improved.Conclusion The investigation showed that the clinical teaching quality of SJTU-SM is being improving.However,in order to achieve the international accreditation standards,the quality guarantee system of clinical teaching need to be further perfected.