Objective To investigate the clinical characteristics of vaccine-associated immune thrombocytopenia(VA-ITP)based on the US Vaccine Adverse Event Reporting System(VAERS), and to provide a reference for vaccine safety monitoring, vaccination prevention, and clinical diagnosis and treatment.Methods Data from VAERS on all reported cases of immune thrombocytopenia(ITP) after vaccination since the establishment of the database in 1990 to the data lock point of 7th November 2023 were analyzed retrospectively for information on such as sex, age, vaccine type, vaccine dose, and occurrence time of ITP.Results Among the 877 cases of VA-ITP, there were 868 cases of effective statistical vaccine types, involving 43 vaccine types. The top 10 vaccine types were COVID-19 vaccine(434 cases, 50%), MMR vaccine(82 cases, 9. 4%),HEPA vaccine(48 cases, 5. 5%), FLU3 vaccine(41 cases, 4. 7%), FLU4 vaccine(32 cases, 3. 7%), HPV4 vaccine(30 cases,3. 5%), DTAP vaccine(29 cases, 3. 3%), MMRV vaccine(32 cases, 3. 7%), VARZOS vaccine(17 cases, 2. 0%) and HPV9vaccine(13 cases, 1. 5%). Among the 877 reported cases, 843 cases with definite sex were counted, including 374 males and469 females, with a male-to-female ratio of 1∶1. 25. The 377 cases of patients were under 18 years of age, accounting for about 44. 7% of the total, and there was significant difference in the composition ratio of sexes among patients with VA-ITP at different ages(χ~2= 10. 029, P < 0. 05). The incidence of ITP within 8 days after vaccination, with a total of 336 cases, was39.9%, and there was no significant difference in the occurrence time composition ratio of ITP between different sexes(χ~2=3. 296, P > 0. 05). The 54. 9% of ITP occurred after the first dose of vaccine, and there was no significant difference in the composition ratio of different vaccination doses between male and female recipients(χ~2= 5. 323, P > 0. 05), but there was significant difference in the composition ratio of vaccination doses among different age groups(χ~2= 30. 591, P < 0. 01).Conclusion By analyzing the summary data from VAERS database, the adverse reaction of VA-ITP was fully recognized.After clinical vaccination, attention should be focused on the platelet status of minors and the elderly, as well as those who were vaccinated within 8 days, and the continuous vaccine safety monitoring should be carried out, which is helpful to reduce the missed diagnosis of vaccine adverse events(AE) and improve the efficiency of clinical diagnosis and treatment.

Objective To investigate 16-slice spiral CT findings of bony canals of the internal auditory canal ( IAC ) fundus withmultiplanar reformation (MPR) and provide evidence for dignosis of lesions in the IAC fundus and surgery.Methods CT scan of thetemporal bone was performed in 30 volunteers. Bony canals of the IAC fundus were measured in images acquired with MPR.Results The mean?SD measurements (in mm) of the anteroposterior diameter and superoinferior diameter of fundus of the IAC was (4.07?0.97) mm and (3.24?0.88) mm respectively. The mean?SD measurements (in mm) of the length and width of bony canal for the labyrinthinesegment of the facial nerve was (3.04?0.52) mm and (0.96?0.31) mm, respectively. The mean?SD measurements (in mm) of the length and width of bony canal of the superior vestibular nerve was (2.52?0.48) mm and (0.83?0.30) mm respectively. The mean?SD measurements (in mm) of the length and width of bony canal of the cochlear nerve was (0.89?0.19) mm and (2.05?0.39) mm respectively. The mean?SD measurements ( in mm ) of the length and width of bony canal of the inferior vertibular nerve was ( 1.07?0.23 ) mm and (0.73?0.21) mm respectively. The mean?SD measurements ( in mm ) of the length and width of singular canal was (3.56?0.68) mm and (0.56?0.11) mm respectively . Conclusion MPR with 16-slice spiral CT can demonstrate the shape and measurements of the IAC fundus,which would contribute in dignosis of lesions in the IAC fundus and surgery.

Objective To investigate the influence of pre-chemotherapy hemoglobin and platelet levels on the effect of chemotherapy and prognostic outcome in patients with endometrial carcinoma (EC).Methods 104 patients with EC who underwent surgical treatment following neoadjuvant chemotherapy were retrospectively analyzed.Multiple logistic regression was carried out to evaluate the relationship between the probability of achieving an optimal clinical response and the variables.The log-rank test was used to compare the homogeneity of progression-free survival and overall survival functions across strata defined by categories of prognostic variables.Results The Cox proportional hazard model was used to assess the significance of potential prognostic factors for progression-free survival and overall survival.Multivariate logistic regression analysis indicated that FIGO staging (OR =3.234,95 ％ CI:1.324-13.454) and lymph node metastasis (OR =8.235,95 ％ CI:1.563-18.574) were independent factors of influencing effects of new adjuvant chemotherapy in the treatment of EC patients.Multivariate Cox regression model analysis showed that the FIGO staging(HR =4.342,95％ CI:1.643-15.856) and lymph node metastasis (HR =3.853,95％ CI:1.864-9.675) were independent factors of influencing 5 years survival rate of EC patients received new adjuvant chemotherapy.Conclusion The curative effect and prognosis after receiving neoadjuvant chemotherapy operation in treatment of EC patients before chemotherapy,there was no significant correlation between hemoglobin and platelet levels,and lymph node metastasis,FIGO stage.

Objective To observe the survival and migration characteristics after intracarotid transplantation of bone marrow stem cells(BMSCs) and its effect on learning-memory abilities across the blood-brain barrier(BBB) in the vascular dementia(VD) rats .Methods Bone mononuclear cells(BMNCs) were isolated from bone marrow in vitro by standard Ficoll-Hypaque technique , then cells were enriched and expanded by using bone marrow adherent culture .72 Wistar rats were meanly divided into control group ,model group and treatment group .The VD rat model was established by modified pulsinellis 4-vessel occlusion(4 VO) .The treatment group received intracarotid infusion of 0 .5 mL 1 .2 × 107/mL BMSCs which were labeled with BrdU in vitro after opera-tion .Their survival ,migration and the learning-memory abilities were observed at 4th and 8th week .Results BMSCs transplanted by intracarotid transplantation survived and had been found throughout the brain tissue .They major migrated and localized in the is-chemic zone of injury such as hippocampus and cerebral cortex .Compared with the control group ,active avoidance response(AAR) ratio in the model group(42 .1 ± 4 .5) ,group(43 .6 ± 3 .6)showed significantly decrease compared with the control group (90 .0 ± 4 .3) ,(92 .5 ± 5 .0)(P<0 .01) ,and the treatment group(69 .2 ± 4 .7) ,(70 .8 ± 4 .7)was significant higher than the model group(P<0 .01) .Conclusion Intracarotid transplantation of BMSCs could enter the VD rats cerebra parenchyma via BBB ,migrate into the damaged brain tissue to gather and survive .Learning-memory abilities can be improved significantly by transplanted BMSCs .

Objective: To analyze the hospitalization expense and management status of severe mental illness, and to provide evidences for rational controls of medical expenses and the management of the patients. Methods:Collecting patients with severe mental illness from 2005 to 2012, analyzing the changing trends of hospitalization cost and management status with descriptive analysis, and use multiple linear regression to analyze the influence factors. Results: The average stay is 51 days, average medical costs by person and by day are RMB 8 319.69 and 169.02; treatment costs, drug costs and bed care costs are the main proportion. The medical costs were significantly affected by prolonged days of hospitalization, age, numbers of hospital admissions, nursing level and admitting diagnosis. The largest proportion of management system is schizophrenia, which counted 74.03% of current patients and the poverty incidence rate is 50.62%. Conclusions: Increasing the financial compensation to patients with severe mental illness, shorting hospital stay, strengthening the screening of patients with severe mental illness and incorporated into the management system would help to reduce the economic burden of the patients.

Objective To study the MRI features of nasopharyngeal carcinoma (NPC) in patients who presented with ocular abnormalities. Methods The clinical signs and MRI features of Ⅲ, Ⅳ and/or Ⅵ cranial nerve involvement in 22 cases of histologically proved nasopharyngeal carcinoma were retrospectively analyzed. Results All 22 cases showed perineural tumor spread along the course of Ⅲ, Ⅳ and Ⅵ cranial nerve. Diplopia was the most common sign, occurred in 14/22 patients. The incidence of incomplete palsy of Ⅲ, Ⅳ and Ⅵ cranial nerve were 16/44, 7/44 and 4/44, respectively. There were four types of abnormal MRI findings: cavernous sinus thickening (10/44) and mass ( 16/44), superior orbital fissure enlargement (4/44) and abnormal signals (9/44), thickened oculomotor muscles with obscured adjacent fatty space and abnormal enhancement (10/44). The dynamic contrast enhancement patterns of the masses in cavernous sinus and orbital were the same as that of nasopharynx lesions; all appeared as rapid initial enhancement followed by a plateau phase. Conclusion Oculomotor nerve involvement can be the first clinical signs of NPC, and MRI can show the perineural extension along the Ⅲ, Ⅳ and Ⅵ cranial nerve in NPC.

Objective To study the correlation with ketamine and its metabolite norketamine concentration in plasma and saliva in acute toxic rabbits.Methods Experimental rabbits were given intragastric(i.g.group,n=6)and intravenous(i.v.group,n=6)administration of ketamine respectively,and control tabbits(n=6)were given a same volume of physiologic saline.The plasma and saliva were collected before and after ketamine administration.Ketamine and norketamine in plasma and saliva were determined using GC/MS and GC.The correlation with ketamine(norketamine)concentration in plasma and saliva were artalyzed by a double variable Pearson correlation analysis.Results The correlation coefficients(r)of ketamine (norketamine)concentrations in plasma and saliva were from 0.80 to 0.95 in ketamine i.g.group and i. v.group.Conclusion There is a good relativity between the concentration of ketamine(norketamine)in plasma and in saliva.The ketamine(norketamine)concentration in saliva can be used to estimate the plasma concentration in the forensic identification of ketamine abuse.

Objective To calculate the social economic burden of mental illness,and to analyze the economic impact of different patients with mental illness in Shandong Province.Methods Direct method was used to calculate the direct economic burden,and human capital method was employed to estimate the indirect economic burden.Results The social economic burden increased from 10.076 billion in 2005 to 31.277 billion in 2013,and the proportion of the social economic burden accounting for GDP of Shandong province was between 0.5 ％ ～ 0.7％.The economic burden caused by women,18-39 years old patients,rural patients and mood disorders was higher than that of men,more than 55 years-old patients,urban patients and other diagnoses,respectively.Conclusions The economic burden brought by mental illness was heavy and increasing during 2005-2013.The economic burden caused by different people was heterogeneous.

Objective To observe the effects of misoprostol on the reduction of postpartum bleeding in cesarean section.Methods With oxytocin as control,the amount of bleeding during and two hours after cesarean section was observed.Results The mean amount of bleeding was (232.0±46.6) ml in misoprostol group and (385.0±74.7) ml in oxytocin group respectively.The difference between the two groups was significant (P＜0.01).Conclusion Misoprostol is more effective to improve uterin contraction than oxytocin and is better in the reduction of postpartum bleeding with safety and convenience.

Objective To investigate diagnostic value of CTA for traumatic pseudoaneurysms (TPA) in the cavernous segment of the internal carotid artery (ICA) when they rupture into the sphenoid sinus. Methods CTA of 7 patients with TPA in the cavernous segments of ICA verified by DSA were retrospectively analyzed. All the patients were performed CTA scanning. The post-processing techniques included VR,MIP,MPR, and CPR. Results All the CTA images of 7 patients showed irregular mass in the sphenoid sinus with obviously enhancement in the same phase to ICA, which communicating with ICA in wide base. The peripheral area of the mass showed no enhancement. The size varied from 3 mm × 2 mm × 1 mm to 33 mm × 30 mm × 27 mm. The adjacent lateral wall of sphenoid sinus showed fractures in all cases. TPA located at anterior-knee segments of cavernous ICA in 6 cases, and cavernous free segment in 1 case. All the disruptions were found at medial or anterior medial wall of ICA. Conclusions Cranial CTA is the effective non-invasive method for diagnosing TPA in the cavernous segment of ICA when they rupture into sphenoid sinus. Combined using of VR, MIP, MPR, and CPR can delineate the location and size of the sphenoid wall fracture and the ICA rupture, which help to clarify the anatomical relationship between them.