In autoimmune thrombocytopenic purpura (AITP) specific autoantibodies bind platelet GP via their Fab fragments. Both splenic CD5+ B and CD5- B cells produce platelet glycoprotein-specific antibodies. There is limited number of antigenic determinants, and the GP-specific autoantibodies are derived from a restricted number of B-cell clones in chronic AITP. Blocking co-stimulatory signals could induce platelet-specific T cell anergy. MMF could be used as a second line agent for the treatment of steroid-resistant AITP. Detection of plasma thrombopoietin levels play an important role in the differentiation of thrombocytopenic states caused by platelet destruction or due to bone marrow hypoplasia. Endogenous TPO level is also important on the differential diagnosis of ET and RT. Quinine- or heparin-dependent antibodies could induce thrombocytopenia. PCR-SSP is useful for the genotyping of the platelet-specific alloantigen HPA. Biotinylated platelets have an impaired response to agonists as evidenced by in vitro platelet aggregation tests.
Antigens, Human Platelet ; immunology ; Blood Platelets ; immunology ; Heparin ; adverse effects ; Humans ; Platelet Membrane Glycoproteins ; immunology ; Purpura, Thrombocytopenic, Idiopathic ; etiology ; immunology ; Thrombopoietin ; blood

Objective To investigate the efficacy of terlipressin in the management of ascites after hepatectomy.Methods Fifty-four patients with hepatic cancer who were admitted to the Union Hospital of Tongji Medical College from January 2010 to January 2011 were randomly divided into the research group (28 patients) and control group (26 patients) according to the random number table.Patients in the research group were treated by the terlipressin and albumin,and patients in the control group were treated by furosemide and albumin.The volume of ascites,urine output,renal function,electrolyte balance,recovery after hepatectomy and complications of the 2 groups were investigated.All data were analyzed by the t test,chi-square test or Fisher exact probability.Results The volume of postoperative maximum drainage was (351 ± 174) ml in the research group,which was significantly lesser than (551 ±233)ml in the control group (t =3.604,P ＜ 0.05).The total urine output of the research group was significantly higher than that of the control group at postoperative day 1 and day 3 (t =5.816,2.722,P ＜ 0.05).All patients had normal renal function except 1 patient was complicated by hepatorenal syndrome in the control group.Electrolyte imbalance was observed in 3 patients (11％) in the research group and 9 patients (35％) in the control group,with a significant difference (x2 =4.456,P ＜ 0.05).The postoperative time of intensive care unit stay and the anal exsufflation time of the research group were (22 ± 12)hours and (68 ±24)hours,which were similar to (23 ± 10)hours and (76 ±28)hours of the control group (t =0.331,1.130,P ＞0.05).The abdominal drainage tube removal time and hospital stay of the research group were (102 ± 42)hours and (15 ±4)days,which were significantly shorter than (140 ±50) hours and (18 ±5)days (t =3.032,2.443,P ＜ 0.05).There were 1 patient in the research group complicated with high blood pressure and 1 patient in the control group with cardiac arrhythmia.The incidences of adverse reaction were 4％ (1/28) in the research group and 4％ (1/26) in the control group,with no significant difference (P ＞ 0.05).Conclusion Terlipressin is effective in the management of ascites after hepatectomy,has less effect on electrolyte balance and is beneficial to quick recovery.

This paper summarizes researches about research-oriented hospital,and proposed the concept of research hospitals.The connotation construction of a research hospital is discussed in terms of the quality of medical care,personnel training,scientific research and management capacity.

Objective To investigate the protective effects of cardioplegic solution containing different concentrations of Shenfu injectio on isolated rabbit heart against ischemia-reperfusion(I/R)injury.Methods Forty adult long-ear white rabbits weighing 3.8-4.2 kg were anesthetized with intraperitoneal thiopental 40 mg?kg~(-1).Heparin 4 mg?kg~(-1) was injected Ⅳ.Hearts were immediately removed and mounted on a Langendorff apparatus and perfused via aorta with Krebs-Henseleit solution aerated at 37℃ with 95 % O_2 and 5 % CO_2.Forty isolated hearts were randomly divided into 5 groups(n=8 each):control group in which cardiac arrest was induced with St Thomas hyperkkaelemic cardioplegic solution and 4 Shenfu groups(SF)in which cardiac arrest was induced with St Thomas cardioplegic solution containing different concentrations of Shenfu injectio:1%(SF1), 5%(SF5),10%(SF10)and 15%(SF15).All hearts in the 5 groups were subjected to global ischemia for 45 min followed by 40 min reperfusion.Coronary effluent was collected after reperfusion for determination of CK-MB activity.Mitochondria were isolated arid Ca~(2+) and MDA content was measured.Myocardial ultrastructure was observed using electron microscope.Mitochondrial injury was assessed by using Flameng score and stereology(NA and ?).Results The CK-MB activity in coronary effluent,mitochondrial MDA and Ca~(2+) content and Flameng score were decreased and NA was increased in group SF1,SF5 and SF10 as compared with control group(P＜ 0.05 or 0.01).The ? of mitochondria was increased in group SF5 and SF10 as compared with control group(P＜ 0.01).The CK-MB activity and Ca~(2+) content were increased and MDA content was decreased in group SF15 as compared with control group(P＜0.05).The pathological damage to myocardium was significantly less in group SF5 and SF10 than in control group.Conclusion Shenfu injectio added to St Thomas cardioplegic solution at concentration of 5%～10% can protect myocardial mitochondria against I/R injury.

Objective To explore the clinical characteristics of thyroid disease in patients with primary Sj(o)gren's syndrome (pSS).Methods A total of 81 pSS patients were retrospectively investigated for thyroid dysfunction and the presence of anti-thyroid peroxidase antibody (TPOAb),antithyroglobulin antibody (TGAb).Sex,age,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),white blood cell count,and serum immunoglobulins were also analyzed.Results Thirty-one patients were identified as having thyroid dysfunction,including 3 with hyperthyroidism,18 with hypothyroidism,and 10 with subclinical hypothyroidism.There were no significant differences in the incidences of some clinical manifestations between patients with or without thyroid dysfunction,such as dry mouth,dry eyes,joint pain,Raynaud's phenomenon,palpable purpura,peripheral neuropathy,interstitial lung disease,liver involvement,and renal tubular acidosis.Differences were not statistically significant for ESR and CRP between two groups.Also,the titers of anti-nuclear antibody,anti-SSA antibody,antiSSB antibodies,and rheumatoid factor between two groups showed no significant differences.However,white blood cell count [(5.65 ± 0.49 vs 7.22 ± 0.48) × 109/L,P＜0.05] and hematoglobin [(110.50 ± 3.64 vs 122.80 ± 3.02) g/L,P＜0.05],as well as the titers of TGAb [(587.30 ± 204.30 vs 58.76 ± 13.78) U/ml,P＜0.05] and TPOAb [(213.70 ± 39.64 vs 29.57 ± 8.49) IU/ml,P ＜ 0.05] were significantly different between the two groups.Conclusions Thyroid diseases are frequently associated with pSS.Therefore,extended screening for existing thyroid diseases during the routine assessment of pSS patients is recommended.

AIM: To study the effect of heat shock protein (HSP) on the maturation of dendritic cells (DCs) and observe the morphological changes of DCs dynamically. METHODS: The HSP (gp96)-peptide complex was purified from the tissues of hepatocellular carcinoma. Hepatoma cells were treated by heat shock for preparation of the HSP expressed on cell surface and then marked with DiI fluorescence. Immature DCs from peripheral blood mononuclear cells were cocultured with two types of HSPs. The morphological changes of DCs were observed dynamically and the effects of HSPs on the maturation of DCs analyzed by Flowcytometer. RESULTS: The morphological changes and the processes of antigen capture of DCs cocultured with DiI marked tumor cells were well showed. Four ways to capture antigens of DCs were observed, including direct contact, besieging, forming bubbles and extending pseudopodia with bubbles on the terminals. Results also indicated that both types of HSP could promote the maturation of DCs. CONCLUSION: DiI is a good fluorescent dye suitable for the morphological studies of DCs. Four ways for DCs to capture antigens were indicated in this paper. Different types of HSP, purifed from tumor tissues or expressed on tumor cells surface, promote DC maturation, and the purified HSP is more effective. [

AIM: To explore a new method of hepatocyte growth factor (HGF) inducing bone marrow mesenchymal stem cells (MSC) to differentiate into cardiomyocytes. METHODS: Bone marrow MSC was cultured with DMEM media (10% fetal calf serum) 4-6 passages, and induced by HGF (10 ?g/L) for 30 d. Automatical beating of the differentiated cells was observed daily with transverse microscopy, or under condition of 0.1% isoproterenol or cal (cium-deprived) incubation. Specific cardiac myosin in the cells was indentified by immunochemistry. RESULTS: At 14-20 d of differentiation, bone marrow mesenchymal stem cells formed clones, in 10%-50% of which spontaneous beating cell-mass had come to continuously exist. Isoproterenol increased the beating rate and calcium-deprived media inhibited the beating. The cells were identified to be cardiomyocytes by expression of cardiac myosin heavy chain. CONCLUSION: HGF may induce bone marrow mesenchymal stem cells into cardiomyocytes with high efficiency, but the differentiating pathway of stem cells remains to be further studied. [

Head ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Periodicals as Topic

Achievement ; Otolaryngology ; Otorhinolaryngologic Surgical Procedures ; Periodicals as Topic

Otorhinolaryngologic Diseases ; Otorhinolaryngologic Surgical Procedures ; Periodicals as Topic