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.

To investigate effect of the transplantation of mesenchymal stem cells (MSCs) in combination with nerve growth factor (NGF) on the repair of spinal cord injury (SCI) in adult rats, spinal cord of adult rats (n= 32) was injured by using the modified Allen's method. One week after the injury, the injured cords were injected with Dubecco-modified Eagles medium (DMEM, Group I), MSCs (Group II), NGF (Group III), and MSCs plus NGF (Group IV). One month and two months after the injury, rats were sacrificed and their injured cord tissues were sectioned for the identification of the transplanted cells. The axonal regeneration and the differentiation of MSCs were examined by immunocytochemical staining. At the same time, rats were subjected to behavioral tests by using the open-field BBB scoring system. Immunocytochemical staining showed that axonal regeneration and the transplanted cells partially expressed neuron-specific nuclear protein (NeuN) and glial fibrillary acidic protein (GFAP). At the same time, significant improvement in BBB locomotor rating scale (P<0. 05) were observed in the treatment group. More importantly, further functional improvement were noted in the combined treatment group. MSCs could differentiate into neurons and astrocytes. MSCs and NGF can promote axonal regeneration and improve functional recovery. There might exist a synergistic effect between MSCs and NGF.

Objective To explore the clinical significance of total serum immunoglobulin ( IgE) , peripheral blood eosinophils ( EOS) and urinary leukotriene E4 ( LTE-4 ) detection on pediatric asthma clinical symptoms of the inacute phase .Methods 90 cases with pediatric asthma clinical symptoms of the inacute phase from March 2014 to March 2015 were selected as experimental group, and divided into the general asthma group(n=32), the moderate asthma group(n=31), the sereval asthma group(n=27) and another 30 health children as control group.Give each patients children doses of β2 agonists (LABA) as monotherapy, and inhaled corticosteroids (ICS) used as combination therapy.The use of LABA is 3-4 times/d.After three months' treatment, clinical efficacy were evaluated, and IgE, EOS, LTE-4 content were detected.Results After 3 months' treatment, IgE, EOS, LTE-4 contents in three experiment groups were significantly decreased (P<0.05), improved to the basic condition compared to control groups.The clinical efficacy among three groups had no significant differences.Conclusion IgE, EOS, LTE-4 levels detection of patients with pediatric asthma clinical symptoms of the inacute phase had evaluation significance, can be a good indicator of pediatric asthma health recovery in patients of the inacute phase.

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 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 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.

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 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.