Adult ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; therapy

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

Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; Dry Socket ; drug therapy ; etiology ; Humans ; Inflammation ; drug therapy ; Mandible ; Molar, Third ; microbiology ; surgery ; Surgical Wound Infection ; drug therapy ; etiology ; Tooth Extraction ; adverse effects ; Tooth, Impacted ; microbiology ; surgery

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunoglobulin D ; Male ; Middle Aged ; Multiple Myeloma ; classification ; pathology ; Retrospective Studies

Objective To investigate the diagnostic value of CA125 and CA153 for the combined detection of the disease in breast cancer patients.Methods 100 cases of breast cancer patients were selected as the breast cancer group,and the same period 100 cases of benign breast lesions were selected as the benign group,100 cases of normal healthy subjects were selected as the control group.The expression levels of CA125 and CA153 in the three groups were detected.Results CA153 and CA125 levels in the breast cancer group was (78.4 ± 23.76) U/mL,(71.3 ± 24.7) U/mL; The benign group CA153 and CA125 content were (13.4 ± 3.7) U/mL,(20.6 ± 12.4) U/mL;CA153 and CA125 in the normal control group content were (0.9 ± 0.8) U/mL,(19.3 ± 11.3) U/mL; CA153 and CA125 in the breast cancer group were significantly higher than those of the benign group and the normal control group,the difference was statistically significant (F =34.15,28.42,all P ＜ 0.05) ; CA153 and CA125 alone detected in breast cancer detection rate was 31.0 ％,24.0 ％,respectively,combined detection of CA153 and CA125 in breast cancer detection rate was 66.0％,CA153 and CA125 alone detected in breast cancer detection rate was significantly lower than the combined detection CA153 and CA125 in the breast cancer detection rate (F =8.21,P ＜ 0.05).CA153 and CA125 expression of breast cancer patients after treatment than that of before treatment significantly reduced,and compare the data with statistically significant (t =21.82,22.31,all P ＜ 0.05).Conclusion The clinical detection of CA125 and CA153 united can effectively improve the diagnosis of breast cancer effect,combined detection of higher sensitivity and specificity.Meanwhile,the combined detection of breast cancer clinical monitoring also ha ssome significance,which is worthy of clinical application.

Objective To study the pathologic characteristics and clinical significance of high intensity zone (HIZ) of lumbar intervertebral disc in the patients with discogenic low back pain. Methods 52 patients with low back pain without disc herniation underwent MRI and following discography of lumbar vertebrae. All patients previously were treated conservatively without relief of their symptoms for more than 6 months. Specimens of lumbar intervertebral discs containing HIZ in the posterior annulus from 11 patients with discogenic low back pain during posterior lumbar interbody fusion (PLIF) were collected to investigate the morphologic patterns and clinical significance. Results In all of 142 discs in 52 patients at discography, 17 discs in 17 patients presented HIZ, all showed painful reproduction and abnormal morphology with annular tears extending either well into or through the outer third of the annulus fibrosus. The histologic study of the consecutive sagittal slices in the HIZ lesions revealed that the normal lamellar structure was replaced by disorganized, vascularized granulation tissue that consisted of small round cells, fibroblasts, and newly formed blood vessels around the tears extending from the nucleus pulposus to the outer region of the annulus fibrosus. Blood vessel proliferation and inflammatory cell infiltration were seen extending along the margins of the tears into the middle and inner annulus, and sometimes the tears were bridged with granulation tissue. Ingrowth of vascularized tissue was sometimes observed to end abruptly at the junction between the inner third of the annulus and the nucleus pulposus. There was also matured scarring collagenous tissue. Conclusion The HIZ in the lumbar disc in the patients with symptomatic low back pain can be considered as a reliable marker of painful outer annular disruption.

0 05). Conclusions The administration of glucocorticoid in early phase of SARS in small dosage and short term regimen could shorten the course of the disease and accelerate resolution of inflammation in the lung

Objective The theory of chemical radiculitis was put forward about 30 years ago, but it has not been proved by clinical study so for. The current study was initiated to assess whether the annular tear in painful disc was the cause of radiating leg pain (radiculopathy) in patients with discogenic low back pain. Methods Forty-two patients with chronic low back pain in single level and shooting leg pain in unilateral or bilateral lower limbs without lumbar disc herniation on CT and MR imaging were treated (age range, 19-52 years; mean age, 34.9 years; 27 males, 15 females). All patients showed annular disruption and pain reproduction on injection of the contrast during discography at single disc level (not including patients who had two or three levels disc disease). CT scan was performed to identify the location of annular tears after discography. The examinations of electromyography(EMG) and motor nerve conduction velocity (MCV) were performed in all patients, which were used to analyze the degree of nerve root injury and the relation with radiating leg pain. Results The patients with posterolateral annular disruption in single side mainly presented single lower limb radiation pain, in contrast, the patients with posterolateral annular disruption in two sides or posterior midline annular disruption mainly presented dual lower limb radiation pain. There was a significant positive correlation between the site of annular tear and the side of radiation pain. The examinations of EMG in all 42 cases found that there were abnormal insertional activities such as fibrillation potentials and positive sharp waves in 32 cases(76%). Of the 23 patients with unilateral lower limb radiation, nerve root lesions were found on the symptomatic side in 17 cases(74%). Of the 19 cases with bilateral lower limb radiation pain, root lesions were suggested in 15 patients(79%). The conduction velocities of common peroneal nerve and tibial nerve decreased with a statistically significant difference in symptomatic side compared with normal side. Conclusion Inflammatory chemical mediators and cytokines produced in painful disc leaking into epidural space through annular tear could lead to the injury to adjacent nerve roots, which might be primary pathophysiologic mechanism for the production of chemical radiculitis.

Objective To investigate the proportion and the clinical significance of status of different hepatitis B virus(HBV) serological markers in HBV related chronic liver disease(CLD),including chronic hepatitis B(CHB),liver cirrhosis(LC) and hepatocellular carcinoma(HCC).Methods The related clinical data of 2 482 inpatients during the period of January 2006 to December 2007 were collected and analyzed statistically.Results In 1 226 patients with CHB,64.4% of them were hepatitis B e antigen(HBeAg)-positive,and 35.6% of them were HBeAg-negative.In 362 patients with LC,27.1% of them HBeAg-positive,66.0% HBeAg-negative,6.9% HBsAg-negative,and in 894 patients with HCC,16.4% were HBeAg-positive,75.1% HBeAg-negative and 8.5% HBsAg-negative.In every disease entity of CLD,the sex ratio for serological markers was similar,though the ratio of male-to-female in the patients with HCC(8.8∶1) was significantly higher than that of LC(4.5∶1) and CHB(4.4∶1),respectively.The age of HBeAg-negative patients with CHB was significantly older than that of HBeAg-positive patients with CHB.The average age of patients with different status of serological markers in LC or HCC was similar.No statistical difference was found in ALT levels between the HBeAg-positive and HBeAg-negative patients with CHB.However,the proportion of low ALT levels became higher in the patients with LC or with HCC when HBeAg positive turned to be HBeAg-negative then to HBsAg-negative.Conclusions The proportion and the clinical significance of changes in serological markers are different in three different entities of CLD.

Objective To study the change of the structural and biological properties of the cardiovascular tissue after cell extracting. Methods The native and treated pulmonary cusp and pulmonary artery wall were evaluated by HE stain, ETVG stain, immunochemistry stain and scan electron microscopy. The contents of the main macro-molecules were measured. The content and position of calcium was investigated by subcutaneous implantation in a rat model. Results The acellularization procedure resulted in an almost complete removal of the original cells while the construction of the matrix remained. The contents of colleagen and elastin increased while soluble GAG reduced. The content of calcium in acellular tissue by xenogenic implantation was less obviously than that in fresh one. Conclusion A suitable acellularization procedure can remove all cells and most soluble proteins, and matrix remains nearly intact, so as to alleviate obviously calcification via xenogenic implantation in vivo.