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

Objective To investigate the effects of different selective attention on the amplitudes of distortion product otoacoustic emission (DPOAE) .Methods DPOAE measurements were performed in 30 young adults (60 ears) in no task (baseline) ,visual selective attention and auditory selective attention ,respectively .The suppression of DPOAE amplitudes were observed in different selective attentions .The visual selective attention was to counter the number of letter Q presented on computer screen .The auditory selective attention was to counter the number of 2 .0 kHz toneburst in the insert earphone .Results Visual and auditory selective attention both decreased the DPOAE amplitudes in mid - low frequencies (0 .75 ~ 2 .0 kHz) .The suppression effects of visual selective attention were significant stronger than that of auditory attention in 0 .75 ~ 1 .0 kHz .The suppression amplitudes were 8 .54 ± 4 .76 and 5 .27 ± 2 .32 dB at 0 .75 kHz ,respectively .They were 7 .66 ± 5 .22 and 3 .22 ± 2 .15 dB at 1 .0 kHz ,re‐spectively .There were significant differences between the two selective attentions suppression (P< 0 .05) .Conclu‐sion Visual and auditory selective attention can both decrease the DPOAE amplitudes .The suppression effects of visual selective attention were significant stronger than that of auditory attention .

Graduate education is the maln approach to cultivate advanced medical talents. However, the current clinical research ability tralning for postgraduate students is poor. This article discusses about four possible reasons: the misunderstanding of the medical research, system defects of the endowment of scientific research fund, drawbacks of evaluation criteria, and deficiency of grad-uate student curriculum. In order to improve the clinical research ability of medical graduates, this article also discusses the possible solutions: clarifying the understanding, strengthening policy support, im-proving the evaluation methods, and perfecting the tralning course of the clinical medical research.

Concepts and techniques of spinal fusion as a therapeutic modality may date back to the origins of spinal surgery. Spinal fusion has been considered as the standard treatment of progressive deformities,including instability,scoliosis and trauma. In this study,we shall attempt to define and review the bone graft materials,progress on the operative techniques,postoperative complications and related therapy,the latest dynamic fixation,and minimally invasive technique to lumbar spine fusion.

Necrosis is also tightly controlled by signaling path-ways,thus it is called as regulated necrosis,which includes ne-croptosis,ferroptosis,parthanatos and CypD-mediated necrosis. It has been shown that regulated necrosis is closely related to the occurrence,development and prognosis of injury-relevant disea-ses such as myocardial infarction,stroke,neurodegenerative dis-eases.It will be significant for prevention and therapy of injury-relevant diseases to clarify the signal transductions and regulatory mechanisms for the regulated necrosis.

Objective To investigate the clinical efficacy and safety of alteplase thrombolysis in the treatment of patients with acute ischemic stroke.Methods 42 patients with acute ischemic stroke were randomly divided into the control group and the study group.1 8 cases in the control group were treated by urokinase thrombolysis, and 24 cases in the study group were treated by alteplase thrombolysis.The clinical efficacy and safety were compared between the two groups.Results The total effective rate of the study group(91 .7%)was higher than that of the con-trol group(77.8%),and the difference was statistically significant(χ2 =9.7,P <0.01 ).Compared with the control group,the total vascular patency rate was higher,the difference was statistically significant(χ2 =97.6,P <0.01 ).The NIHSS score was lower in the two groups after treatment(t =1 0.1 58,1 5.962,all P <0.05),and that in the study group was more lower,the difference between the two groups was statistically significant(t =1 0.564,P <0.05 ). Conclusion Alteplase thrombolysis in the treatment of acute ischemic stroke patients,thrombolytic therapy for patients,in the use of drugs within the time window patients can get good clinical curative effect,no more than drug use the most extensive restrictions rarely cause patients with intracranial hemorrhage,and being suitable for populari-zation and application.

Objective: To study therapeutic effect of atorvastatin on patients with asymptomatic heart failure (AHF) after myocardial infarction, and its influence on prognosis.Methods: Clinical data of 100 AHF patients after myocardial infarction, who were treated in our hospital from Jul 2014 to Jul 2015, were analyzed.According to random number table, patients were randomly and equally divided into routine treatment group and atorvastatin group (received atorvastatin based on routine treatment).Cardiac function indexes, plasma levels of BNP and N-terminal pro B-type natriuretic peptide (NT-proBNP), 6min walking distance (6MWD) and cardiac function score were measured and compared between two groups before and after treatment.Course of treatment was one year.Results: Compared with before treatment, after treatment, there were significant rise in left ventricular ejection fraction (LVEF) and 6MWD, and significant reductions in left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic dimension (LVESd), plasma levels of BNP and NT-proBNP, and cardiac function score in both groups(P=0.001 all).Compared with routine treatment group after treatment, there were significant rise in LVEF [(52.48±8.65)% vs.(57.86±9.70)%] and 6MWD [(262.60±12.40)m vs.(282.65±15.50)m], and significant reductions in LVESd [(36.23±2.13)mm vs.(30.08±2.05)mm], LVEDd [(58.61±6.40)mm vs.(51.25±6.18)mm], plasma levels of BNP [(267.48±42.10)pg/ml vs.(149.40±32.30)pg/ml] and NT-proBNP [(524.65±138.60)pg/ml vs.(406.20±112.45)pg/ml], and cardiac function score [(2.30±0.22) scores vs.(1.15±0.10) scores] in atorvastatin group(P<0.01 all).Conclusion: Atorvastatin can alleviate left ventricular remodeling, reduce plasma levels of BNP and NT-proBNP, and improve cardiac function in AHF patients after myocardial infarction, which is worth extending.

Objective To investigate the effect of steroid receptor coactivator family in initiation, development, treatment and prognosis of breast cancer. Methods The literatures in recent years which have related to the effect of steroid receptor coactivators in breast cancer are reviewed. Results Steroid receptor coactivators are essential for several kinds of steroid hormones binding to steroid receptors, so they are important accessory factors that induce the initiation, development and recurrence of breast cancer, and predictive factors that estimate the prognosis of breast cancer. Conclusion Inhibition of the expression and signaling pathway of steroid receptor coactivators may be effective for breast cancer prevention and treatment.