Idiopathic thrombocytopenic purpura is a common hemorrhagic disease of child,and the chronic type of it is easier to recur.This paper introduces Professor SHI Yu-min's experience in treating chronic idiopathic thrombocytopenic purpura with methods of strengthening kidney,benefiting qi and activating blood flow combining with tonification and regulation.In addition,this paper expounds Prof.SHI's characteristics and laws in herbal prescription.And a case is presented.

Objective To investigate the characteristics of the heart rate variability(HRV) in the elderly bedridden patients. Methods 91 hospitalized patients (age≥60 years ) were divided into three groups according to the function independent measure: independent group (32 cases), partial dependent group (31 cases), dependent group(28 cases). Eight items of HRV were measured, including 24 hour standard deviation of successive normal-to-normal R-R interval(SDNN), total power (TP),standard deviation of all means of 5-minutes R-R interval all over 24 hour(SDANN), low frequency (LF), root mean squared successive difference(MSSD),Edingburgh Index(PNN50), high frequency(HF)and ratio of LF to HF(LF/HF). Results Seven items of HRV of the dependent group and partial dependent group were significantly lower than those of independent group (P0.05). SDNN and FIM were positively correlated (r =0.853, P=0.017). Other factors such as pathogen and the number of concomitant diseases did not affect on HRV in the elderly bedridden patients. Conclusions The HRV in the elderly bedridden patientsdecreased , the changes relatedthe decrease of the activity.

Animals ; Bile ; Carps ; Hemofiltration ; Humans ; Poisoning ; therapy

Antineoplastic Agents ; administration & dosage ; therapeutic use ; Hematologic Neoplasms ; drug therapy ; Humans

Fibroblast Growth Factors ; metabolism ; Humans ; Phosphorus ; metabolism

Child ; Child, Preschool ; Cross Infection ; epidemiology ; etiology ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Retrospective Studies

Objective To evaluate the effect of the pathological changes of the pelvic cavity and fallopian tube on the outcome of in vitro fertilization and embryo transfer(IVF-ET).Method One thousand and thirty-two patients who underwent IVF-ET were divided into tubal and pelvic infertile group(605 cases)and non-tubal and pelvic infertile group(427 cases).The tubal and pelvic infertile group was also divided into salpingemphraxis group(243 cases),tubal resection group(104 cases),fallostomy group(149 cases),tubal dropsy group(109 cages)according to the tubal lesion regions,and combined with pelvic group(194 cases),combined without pelvic group(411 cases).The data of clinical pregnancy,ectopic pregnancy,and abortion was analyzed respectively.Results The ectopic pregnancy and abortion rates in tubal and pelvic infertile group[10.63%(27/254)and 9.06%(23/254)]were higher than those in non-tubal and pelvic infertile group [3.27%(5/153)and 4.58%(7/153)](P<0.01 or<0.05).The ectopic pregnancy rate was the lowest in tubal resection group[2.17%(1/46)],the highest in fallostomy group[22.41%(13/58)],there was significant difference among the groups(P<0.01).The abortion rate in fallostomy group and tubal dropsy group[10.34%(6/58)and 15.00%(6/40)]was higher than that in salpingemphraxis group and tubal resection group [7.27%(8/110)and 6.52%(3/46)],there was significant difference among the groups(P<0.05).The abortion rate in combined with pelvic group[11.54%(9/78)]was higher than that in combined without pelvic group[7.95%(14/176)](P<0.05).Conclusions The pathological changes of the pelvic cavity and fallopian tube are higher risk factors of ectopic pregnancy and abortion occurrence.The assessment and treatment of pelvic cavity and fallopian tube before assisted reproductive treatment cycles should be enhanced.

Objective:To investigate the alteration of retinal perfusion in aquaporin-4 antibody (AQP4-ab) positive neuromyelitis optica spectrum disorders (NMOSD) patients by optical coherence tomography angiography (OCTA).Methods:A case-control study. Forty-eight AQP4-ab positive NMOSD patients (96 eyes) and 20 age and gender matched healthy controls (40 eyes) were recruited from September 2015 to August 2017 at the Eye & ENT Hospital of Fudan University. Patients of both eyes were included in the groups. The patients were further divided into 4 subgroups (0 ON, 1 ON, 2 ON, 3+ ON group) according to the number of episodes of ON (0, 1, 2, or 3+) with respect to 30、22、31、13 eyes. 0 ON group had no history of ON episodes; 1 ON group, 2 ON group, and 3+ ON group had ON episodes 1, 2, ≥3 times, respectively. All patients underwent complete ophthalmological examinations including BCVA, visual field and OCTA examination. The BCVA was recorded for each eye using metric notation from the Snellen chart, and then converted to the logarithm of the minimum angle of resolution. The central visual field was assessed using a Humphrey Field Analyzer 750 and the mean deviation (MD) was determined. OCTA scans of the optic disc (4.5 mm × 4.5 mm) and macula (6 mm × 6 mm) were acquired. Radial peripapillary capillary (RPC) vessel density, superficial capillary plexus vessel density (SVD), the thickness of ganglion cell and inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) were determined. The generalized estimating equations was performed to compare the difference of BCVA, MD, pRNFL thickness, GCIPL thickness, RPC vessel density and SVD among the groups and the correlations between retinal perfusion and retinal structure, visual function were analyzed.Results:The RPC vessel density and SVD were significant lower in the 0 ON group compared with healthy group (Wald χ2=7.190, 10.134; P<0.01), however, the BCVA, pRNFL and GCIPL thickness were not significant difference between the two groups (Wald χ2=2.308, 1.020, 2.558; P>0.05). The BCVA, visual field MD, RPC vessel density, SVD, pRNFL and GCIPL were significant lower in 1 ON, 2 ON and 3+ ON groups compared with healthy group and 0 ON group (Wald χ2=12.390, 11.346, 38.860, 18.040, 45.418, 26.608; P<0.001 ), but the parameters had no significant difference among the three groups ( P>0.05). The RPC vessel density was significantly correlated with pRNFL thickness ( β=0.372, standard error=0.018, P<0.001), and the SVD was significantly correlated with GCIPL thickness ( β=0.115, standard error=0.204, P<0.001). The MD and BCVA was significantly correlated with peripapillary vessel density after adjustment for other variables (BCVA: β=0.025, standard error=0.005, P=0.000; visual field MD: β=0.737, standard error=0.185, P=0.000). Conclusions:Subclinical primary retinal vasculopathy may occur in NMOSD prior to ON attack, the ON attack may further impair visual function, retinal structure and perfusion, however, the extent of injure is not relevant with the increase of ON attack. The peripapillary vessel density might be a sensitive predictor of visual outcomes in NMOSD patients.

Objective To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99Tcm-sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99Tcm-diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. x2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter ＞3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type,50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 forsmall foci (with maximal diameter≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone ( x2 = 4. 48, P ＜ 0. 05;x2 =4.27, P ＜0.05 ). Conclusion Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients.

Objective　To analyze the advantages of intracrani al hematoma smash puncture (IHSP) in the treatment of cranial hemorrhage for the elderly. Methods　A total of 104 cases of cerebral hemorrhage a dmitted in the recent 3 years were collected and divided into 4 grou ps, i.e . group A, elderly with IHSP treatment (n=36), group B, elderly with regular medical treatment (n=33), group C, non-elderly with IHSP treatment (n= 21) and group D, non-elderly with routine therapy (n=14). The clinical and follow-up outcomes were studied and analyzed. Results　There w as significant difference in rehemorrhage rate after puncture between grou p A (0/36) and group C (2/21). Significant difference was found in early mortali ty rate in group A (16.67%) and group B (39.40%). The rate of activity of daily living (ADL) 1-2 was significantly higher in group A (58.62%) than group B (5.88 %)(P<0.005) and that of ADL 4-5 was obvious lower in group A (13.79%) than g roup B (47.06%)(P<0.025). Conclusion　Intracranial hematoma smash hemorrage is safe and efficient in the treatment of elderly cerebr al hemorrhage, especially in reducing the disability rate.