Objective Drug-induced immune thrombocytopenia (DITP) is a major adverse drug effect mediated by drugdependent antibodies.It can be actuated by a wide range of medications,including Rifampicin.Methods Rifampicin-dependent antibody (rd-Ab) from a rifampicin-treated tuberculosis patient with thrombocytopenia (RITP) was characterized by in vitro and in vivo assays,which includes flow cytometry,monoclonal antibody immobilization of platelet antigens (MAIPA) assay,platelet aggregation assay and RITP mouse model.Results The rd-Ab could bind glycoprotein (GP) Ⅱ b/Ⅲ a,as shown by the MAIPA assay.The binding of rd-Ab could be blocked by AP2,a monoclonal antibody that binds a calcium dependent site on GP Ⅱ b/Ⅲ a complex and inhibits ADP-induced platelet aggregation.These results suggested that rd-Ab binds the same site or proximal sites on the GP Ⅱ b/Ⅲ a complex as AP2.Furthermore,the rd-Ab inhibited platelet aggregation in vitro.In an established NOD/SCID mouse model of RITP,the rd-Ab caused a rapid clearance of human platelets (MPL=1.1 ± 0.2h).The in vivo platelet loss could be partially prevented by treatments with intravenous immunoglobulin (IVIG) or corticosteroids (MPL=4.7 ± 0.7h and 4.2 ± 1.1h,P＜0.05).Slowing of platelet clearance was observed immediately upon IVIG treatment,while upon corticosteroid treatment at 24h,and reaching its peak at 72h.Combination of IVIG and corticosteroid treatments was more efficacious (MPL=6.2 ± 1.5h,P＜0.05).Conclusions 1.The rd-Ab binds to calcium-dependent-epitopes on the calcium dependent site of GP Ⅱ b/Ⅲ a complex,which causes platelet damage and inhibits platelet aggregation.2.Either IVIG or corticosteroid alone can partially block platelet clearance by rd-Ab.Slowing of platelet clearance is observed immediately upon IVIG treatment,or upon corticosteroid treatment several days later,indicating that IVIG may be more suitable for acutely raising the platelet count than corticosteroid treatment for RITP.3.Combination of IVIG and corticosteroid treatment is more efficacious than IVIG or corticosteroids alone.

OBJECTIVE:To establish a method for bacterial endotoxin test of Boric acid rinse.METHODS:According to appendix volumeⅡof Chinese Pharmacopoeia(2005 edition),the tachypleus amebocyte lysate(TAL)method was applied for the pre-inference test and interfence test to investigate non-inference concentration,pH value and sensitivity of TAL.RESULTS:Boric acid did not interfere with TAL and the reaction of bacterial endotoxin at 2 times diluted concentration with pH value adjusted above 6.The sensitivity 0.25 EU?mL-1 of TAL was available.CONCLUSION:The TAL method can control the limit of bacterial endotoxins in Boric acid rinse.

12E7 Antigen ; Adult ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Desmin ; metabolism ; Desmoplastic Small Round Cell Tumor ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Neoplasm Recurrence, Local ; Neuroblastoma ; metabolism ; pathology ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Phosphopyruvate Hydratase ; metabolism ; Rhabdomyosarcoma, Embryonal ; metabolism ; pathology ; Sarcoma, Ewing ; metabolism ; pathology ; Vimentin ; metabolism

Objective To study the effect of evidence-based nursing on improving the nursing requirement of patients with ureter external drainage and inner stent drainage after urological operation. Methods 62 patients in department of urinary surgery from June 2009 to October 2011 were selected as research object,and they were randomly divided into the control group and the observation group with 31 cases in each group,the two groups adopted routine nursing mode and evidence-based nursing mode respectively.Then the nursing requirement and nursing effect before and three and five days after nursing were compared between two groups. Results All the patients existed needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the needs of patients between ureter external drainage and inner stent drainage showed no significant differences,improvement level of each items of the observation group after nursing were all better than those of the control group. Conclusions The patients with ureter external drainage or inner stent drainage have needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the evidence-based nursing mode can effectively improve the patients'demand situations of these items.

Objective: This study aims to investigate the positive practice environments evaluation of doctors in public hospital and provide suggestions for Chinese health care reform from the perspective of health service providers.Methods: Using self-designed questionnaire, a national cross-sectional survey was performed in 77 public hospitals across seven provinces/ metropolis, involving a total of 3564 doctors.Positive practice environment includes organizational management and doctor-patient two-dimension relationships.Results: The doctor''s mean score of positive practice environment evaluation was 18.02±4.86 (out of 40).Doctors had a higher evaluation (score) of organizational management than doctor-patient relationship.In the organizational management dimension, the personal advice got the lowest scores(2.24±1.04);and in doctor-patient relations, evasion of medical risk got the lowest scores(1.59±0.81).There was a difference in the positive practice scores of physicians in different regions, and the scores of doctors from the western China were the lowest (P<0.001.Doctors from western medicine hospitals had lower evaluation of positive practice environments than ones from Chinese Traditional Medicine hospitals(P=0.002.Conclusion: As per the analysis conducted in this investigation, the current medical practice environment of doctors in China is not a promising one.Doctor-patient relationship is worse than organizational management.Hospitals should adopt a participatory decision-making model in management and establish a broadband performance based compensation to motivate junior doctors.Besides, government should establish reasonable compensation incentive mechanism, with the aim of promoting doctor-patient trust.

Age Determination by Skeleton ; Body Height ; drug effects ; Child ; Child Development ; drug effects ; Drug Therapy, Combination ; methods ; Female ; Gonadotropin-Releasing Hormone ; administration & dosage ; analogs & derivatives ; therapeutic use ; Growth Hormone ; administration & dosage ; therapeutic use ; Humans ; Menarche ; Puberty, Precocious ; diagnosis ; drug therapy ; physiopathology ; Treatment Outcome

OBJECTIVEThe aim of this study was to investigate the effect of thalidomide on the growth of human hepatoma cell line SMMC-7721 cells in vitro, and to explore the curative possibility of hepatocellular carcinoma with thalidomide.

METHODSSMMC-7721 cells were treated with Thalidomide at different concentrations. The cell growth and proliferation was assessed by MTT assay. DNA ladder, apoptosis rate and changes of cell nuclei were studied by agarose electrophresis, fluorescence microscopy and flow cytometry, respectively. The expression of caspase-3 was analyzed with flow cytometry. The VEGF content of SMMC-7721 cells in culture medium was tested by ELSIA.

RESULTSWhen the concentration of Thalidomide solution was increased from 3.125 microg/ml to 200 microg/ml, the cell growth was inhibited by from 11.7% to 34.2%. Compared with the control group, the thalidomide solution at a concentration of 25, 50, 100 and 200 microg/ml solution significantly inhibited the proliferation of SMMC-7721 cells (P < 0.05). A ladder pattern of DNA fragments appeared after SMMC-7721 cells exposed to 200 microg/ml thalidomide for 24 h, especially for 48 h. Fluorescence microscopy revealed that the cell nuclei were condensed and fragmented after the cells were exposed to 200 microg/ml thalidomide for 48 h. In cells treated with 200 microg/ml thalidomide for 12, 24, 48 and 72 h, the apoptotic rate was 3.1% +/- 0.5%, 8.4% +/- 1.3%, 19.4% +/- 3.5% and 25.8% +/- 2.1%, respectively, significantly higher than that in the negative control group 1.6% +/- 0.6%. The cells treated with thalidomide at a concentration of 50, 100, 200 microg/ml for 48 h, the apoptotic rate was 8.7% +/- 1.2%, 16.8% +/- 2.5% and 25.4% +/- 4.5%, respectively, increasing in a dose-dependent manner, also significantly than that in the cells of control group 2.1% +/- 0.5%, (all were P < 0.05). The caspase-3 positivity of SMMC-7721 cells treated with thalidomide was increasing along with the increase of treatment time or drug concentration, but not in the control cells. The VEGF content in SMMC-7721 cells was lowering when thalidomide was used in an increasing concentration.

CONCLUSIONUnder the conditions used in this study, thalidomide can inhibit the proliferation of SMMC-7721 cells in vitro. Induction of apoptosis and inhibition of angiogenesis may be possibly two mechanisms for its anticancer action.

Angiogenesis Inhibitors ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Thalidomide ; administration & dosage ; pharmacology ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo study the effects of repeated + Gz forces on masticatory muscles.

METHODS48 male Wistar rats were randomly divided into 4 groups. Group A was normally fed. Group B was only fixed with rat-kept devices for 5 minutes. Group C was borne + 1 Gz for 5 minutes. Group D was repeatedly exposed + 10 Gz (each for 30 s, onset rate about 0.5 G/s, 5 times/d with + 1 Gz 1 minute intervals, 4 d/wk, 3 weeks in total). The histological changes of the masseter, temporal and lateral pterygoid muscles were observed.

RESULTSNo abnormal changes were observed in Group A, B and C. But pathological changes could be found in group D. The wrench and deformation of muscular fibers, the dissolution of partial myofibril, the swelling of mitochondria, the reduce of hepatin from the masseter and lateral pterygoid muscles could be found.

CONCLUSIONSRepeated + Gz stresses could induce the damage of masticatory muscles in different degrees.

Animals ; Hypergravity ; Male ; Masseter Muscle ; pathology ; ultrastructure ; Masticatory Muscles ; pathology ; ultrastructure ; Microscopy, Electron ; Pterygoid Muscles ; pathology ; ultrastructure ; Rats ; Rats, Wistar ; Temporal Muscle ; pathology ; ultrastructure ; Time Factors

OBJECTIVETo investigate the clinical application of different perforator neurofasciocutaneous flaps at the distal legs for defects at the lower legs and feet.

METHODS24 patients with defects at the lower legs and feet were treated with five kinds of perforator neurofasciocutaneous flaps, including 7 flaps with the retrolateral supramalleolar cutaneous perforator, 2 flaps with the lateral retromalleolar perforator, 2 flaps with the higher cutaneous perforator of the peroneal artery, 8 flaps with the anterolateral supramalleolar cutaneous perforator of the peroneal artery, 5 flaps with the medial supramalleolar cutaneous perforator of the posterior tibial artery. The flap size ranged from 5 cm x 4 cm-14 cm x 12 cm.

RESULTSPartial necrosis occurred at the distal end of flap in one case. All the other flaps survived completely with primary healing. 15 cases were followed up for 1-36 months with satisfactory cosmetic and functional results.

CONCLUSIONSSuitable perforator neurofasciocutaneous flaps at the distal legs can be selected for differently located defects at the lower legs and feet, leaving comparatively less morbidity at donor site.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Perforator Flap ; Young Adult

AIM: To investigate the effect of peribulbar anesthesia on intraocular pressure(IOP)and ocular amplitude pulse(OPA).METHODS: Thirty-two consecutive adult patients with monocular cataract enrolled in this study. IOP and OPA were measured with dynamic contour tonometer(DCT)before and 3, 10 minutes after administration of lidocaine anesthesia. Data were analyzed with software SPSS 11.5.RESULTS: The IOP remained stable in the injected eyes and the non-injected eyes after administration of lidocaine anesthesia. The OPA was significantly decreased after injection of anesthesia agent in the injected eyes. The OPA in the non-injected eyes increased significantly 3 minutes after injection of the anesthesia agent, returning to preinjection level 10 minutes after the injection.CONCLUSION: Peribulbar anesthesia leads to decrease of OPA and shows no effect on IOP in the injected eyes.