Objective To investigate the inaccurate causes of platelet(PLT)count and to propose the correcting measures.Meth-ods 180 specimens of abnormal PLT count were collected and divided into 4 groups:low PLT count group (PLT ≤20×109/L,72 cases),microcyte group(54 cases),large platelets group(33 cases)and platelet aggregation group(21 cases).The PLT count was simultaneously performed by using the three ways of the optical method (PLT-O),impedance method (PLT-I)and manual micros-copy method (PLT-M).The detection results were analyzed by the paired t test.Results The PLT count in the low PLT group, microcyte group and large platelets group had no statistical differences between PLT-O and PLT-M(P >0.05),and had statistical differences between the PLT-I and PLT-O(P <0.05).The PLT count of PLT-O in the platelet aggregation group was more close to actual value than that of PLT-I(P <0.05).Conclusion The PLT count by PLT-I has many influencing factors,which are mainly the microcytes interference leading to higher PLT count,missed detection of large PLT leading to lower PLT count,PLT aggrega-tion,etc.When the PLT count appears abnormal,the re-detection should be conducted according to the re-detection regulation, which can be corrected by adopting PLT-M or PLT-O,in necessity,the blood specimen could be re-collected for detection.

Objective To evaluate the effect of enteral nutrition emulsion on the immunologic function and intestinal mucous barrier in diabetic patients. Methods Eighty diabetic patients were randomly divided into con-trol group (n=40) and enteral nutrition group (n=40). The urine lactulose (L) and mannitol (M) levels and the blood immunologic indicators recorded on day 1 and day 8. Results The L/M ratio was significantly lower in enteral nutrition group than in control group on day 1 and day 8 ( P < 0. 05 ). The IgG level was significantly higher in enteral nutrition group than in control group on day 8 ( P = 0. 02 ). Conclusion Enteral nutrition emulsion can decrease the permeability of intestinal mucous membrane and improve the immunologic function in diabetic pa-tients.

Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

Objective To study the clinical effect of specific immune therapy for children with allergic rhini-tis(AR)and its influence on the level of serum IL -17 and IL -35.Methods 174 children with AR were chosen as the research group,who were used specific immune therapy for 24 months.In same period,110 cases of healthy chil-dren were selected as the control group.Curative effect was evaluated by rhinitis symptoms total score(TRSS)points rate.quality of life was evaluated by nasal conjunctivitis related quality of life questionnaire(RQLQ)score.Pulmonary function before and after treatment,serum Eos counting,IL -17,IL -35 were detected.Results (1 )In research group,the total effective rate after treatment of 2 years was 89.66%,which was significantly higher than 71.26% after treatment of 1 year,there was statistically significant difference(χ2 =18.716,P <0.05).(2)In the research group, TRSS score and RQLQ score after treatment of 1 year and 2 years were lower than that before treatment(t =28.360, 42.850,7.749,42.850,all P <0.05 ),and the data after treatment of 2 years were less than that after treatment 1 year(t =19.207,10.558,all P <0.05).(3)In the research group,FEV1 /predictive value after treatment of 1 year and 2 years elevated compared to that before the treatment,the airway resistance value /forecast and Eos count were lower than that before the treatment(t =15.972,27.811,48.780,62.211,10.930,62.211,all P <0.05).FEV1 /pre-dicted value after treatment of two years was higher than that after treatment of 1 year,airway resistance value /forecast and Eos counts were less than that after treatment of 1 year(t =8.728,14.707,16.488,all P <0.05 ).(4)In research group,serum IL -17 after treatment of 1 year and 2 years reduced,while IL -35 rose (t =9.162,14.522, 10.235,14.522,all P <0.05).And IL -17 after treatment of 2 years was lower than that after treatment of 1 year,IL-35 was higher than after treatment of 1 year(t =5.795,7.731,all P <0.05).(5)Correlation analysis showed that the serum IL -35 and the level of IL -17 showed a negative correlation(r =-0.36,P <0.05).Conclusion Effect of specific immune treatment on children with allergic rhinitis is better,specific immune treatment can improve the clinical symptoms,inhibit IL -17,promote IL35 and improve lung function and quality of life of patients.

OBJECTIVE:To observe therapeutic efficacy of zoledronic acid in the treatment of acute pain of vertebral compres-sion fractures during different courses. METHODS:207 patients with acute thoracic or (and) lumbar vertebral compression frac-tures were selected and randomly divided into trial group(107 cases)and control group(100 cases). Control group was given calci-um carbonate(1 200 mg/d)diclofenac sodium sustained-released tablet(75 mg/d).Trial group was additionally given zoledronic ac-id 5 mg added into 5%Glucose solution 100 ml,intravenous dripping for 15-30 min,on the basis of control group. RESULTS:Af-ter treatment,VAS score of two group decreased significantly,and trial group the decrease was more significant than control group,with statistical significance (P<0.05),there was no statistical significance in VAS score between course≤one month and one month 0.05);after 4d treatment,there was statistical significance in VAS score between course≤one month and one month 0.05);after one week,there was statistical significance in VAS score between one month 2 months (P<0.05).CONCLUSIONS:Zoledronic acid may partly alleviate the pain of acute vertebral fractures,the analgesic effect is more clear in early stage.

Objective To investigate the effect of Tongqiao Yinao decoction ( TYD) on postoperative cogni-tive dysfunction in elderly patients and its underlying mechanisms .Methods 100 anesthetic patients for orthopedic surgery were randomly divided into the TYD-treated group and control group ,50 patients in each group .In TYD-trea-ted group,patients received 150mL TYD orally,twice daily for constitutive 15 days,beginning from the day of admis-sion in addition to conventional symptomatic and supportive treatment .While patients in control group received no TYD.Mini-mental state examination ( MMSE) was used to evaluate the patients′cognitive function before and after anesthesia.Meanwhile,blood samples of patients were also collected to test the expression levels of IL -6.Results There was no significant difference between the two groups before operation .However ,TYD-treated patients had signif-icantly lower incidence rate of POCD than the controls ( 20% in the control group , and 12% in the TYD-treated group;χ2 =4.332,P=0.037) 7 days after operation.The incidence rates of POCD in the TYD-treated group and control group were 30%and 38%1 day after operation ( P>0.05),28% and 20% 3 days after operation ( P>0.05),respectively.Compared with that before operation ,the blood levels of IL-6 in the two groups significantly increased 3 days after operation (control group,t=2.412,P=0.009;TYD-treated group,t=1.429,P=0.039).In contrast to the control group,the level of IL-6 in TYD-treated group declined to the baseline (the control group,t=0.851,P=0.049;TYD-treated group,P=0.404).Interestingly,compared with the controls,the TYD-treated patients had a significant lower level of IL-6 after operation (t=1.198,P=0.035).Furthermore,Pearson correlation analysis showed that change of IL-6 level in blood was negatively correlated with MMSE score (r=-0.782,P=0.022). Conclusion TYD can improve postoperative cognitive dysfunction in elderly patients ,presumably through decreasing the level of IL-6 in blood.

Objective · To investigate antiemetic effect of aprepitant for moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Methods · From 2014 July to 2015 August, 130 cases of gastrointestinal cancer patients were collected in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, who received moderate emetogenic risk of chemotherapy for at least four courses. One hundred and nine patients were treated with aprepitant, palonosetron and dexamethasone on day 1, and aprepitant and dexamethasone on day 2 and 3. Twenty-one patients only received aprepitant and dexamethasone on day 1 and dexamethasone on day 2 and 3 in the first course of chemotherapy. During subsequent courses of chemotherapy they received aprepitant and treated in the same way as 109 patients. MASCC antiemetic tool (MAT) was used to evaluate the intensity of nausea. The primary endpoint was complete response (CR, no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after chemotherapy) at the second course. The secondary endpoint was complete protection (CP, CR plus no significant nausea) during the overall, acute (0-24 h), and delayed (24-120 h) phases at the second course. Results · The CR rates were 90.0%, 94.6% and 90.8% of patients in the overall, acute and delayed phases, respectively. The corresponding CP rates were 83.8%, 87.8% and 84.6 %, respectively. The CR rate increased from 42.9% to 57.1% during acute phase and increased from 9.5% to 90.5% during delayed phase for 21 patients after treatment with aprepitant. The main adverse reactions include constipation, anorexia and hiccups. Conclusion · Aprepitant combined with palonosetron and dexamethasone can effectively prevent moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Aprepitant therapy can effectively maintain antiemetic effect in patients with many chemotherapy courses.

Objective To investigate the relation of autophagy and postherpetic neuralgia in elderly patients,and provide new methods for prevention and treatment of postherpetic neuralgia.Methods One hundred thirty-five specimens were obtained from elderly patients with herpes zoster,containing 83 patients with herpes zoster plus neuralgia and 52 cases with non-neuralgia herpes zoster.The level of autophagy was determined by acridine orange-stain.The protein expressions of autophagy marker protein LC3 and autophagy related protein Beclinl were detected by Western blot.Results Flow cytometer detection after acridine orange-stain showed that mean fluorescence intensity (MFI) of herpes zoster plus neuralgia patients was 0.775±0.068 and non-neuralgia herpes zoster patients was 0.342±0.025.The level of autophagy of non-neuralgia herpes zoster patients was significant lower than herpes zoster plus neuralgia patients (P＜0.05).The expressions of autophagy marker protein LC3 and autophagy related protein Beclin1 detected by Western blot also showed the level of autophagy of non-neuralgia herpes zoster patients was decreased compared with herpes zoster plus neuralgia patients.Conclusions High level autophagy is risk factor for postherpetic neuralgia in elderly patients.

Objective To investigate the expression and significance of Smad4 in peripheral hepatocytes of lesions in mice with hepatic alveolar echinococcosis.Methods Eight mice in the test group were inoculated with alveolar echinococcosis and 8 mice in the control group were injected with normal saline.The expression of Smad4 protein in the hepatic tissue of the mice was detected by immunohistochemistry method,and the data were analyzed by chi-square test.The effect of alveolar echinocoeeosis on the expression of Smad4 protein was investigated.Results Smad4 was detected in cell nuclei and partly in the cytoplasm.Six months after the establishment of the mice model for alveolar echinococeosis,the expression of Smad4 in the hepatic tissue in the test group was significantly higher than in the control group(x2=19.869,P＜0.05).The number of Smad4 with positive expression in the hepatocytes in the test group was slightly higher than in the control group,and the expression intensity of Smad4 in the test group was greater than in the control group(x2=58.3 10,P＜0.05).Conclusions The increase of the expression of Smad4 protein in the periphery hepatocytes and tissues of hepatic alveolar echinococcosis lesions may play a role in hepatic cirrhosis and immune evasion.

Objective To build experimental animal model of cerebral alveolar echinococcosis disease of sheep,in order to study of human alveolar hydatid disease of the brain.Methods Experiment animal models of ten Xinjiang big-tail sheep were performed by, direct skull puncture,intracerebral inoculation of echinococcus multilocularis.MRI was used to observe the growth status of cerebral alveolar echinococcosis disease of sheep after 8 months,and morphological and pathological characteristics after autopsy were ana-lysed.Results 4 sheep models (40%)were successful built which were confirmed by pathology and MRI.On MRI,4 cases all were single lesion,on T2 WI there was multiple follicles bubbles under the background of low signal in one case,and low signal in other three cases.Under the microscope,a large number of lymphocytes,eosinophils and plasma cells infiltrated the lesion area,around which small blood vessels were blocked and had inflammatory reaction were showed.Conclusion The method using artificial inocula-tion rat alveolar echinococcosis to establish experimental model of cerebral alveolar echinococcosis disease of sheep has the character-istic of feasibility,simplicity and repeatability.