Objective To study the value of B-cell activating factor (BAFF) expression levels in the diagnosis and prog-nosis of children with idiopathic thrombocytopenic purpura. Methods Children with idiopathic thrombocytopenic purpura (ITP) admitted to our hospital from September 2011 to September 2013 were enrolled in observation group, and healthy check-up chil-dren during the same period were enrolled as controls. The serum levels of B-cell activating factor, platelet antibodies (PAIgG, PAIgM, PAIgA) and platelet count were detected, and curative effect in children with ITP was observed. Results The BAFF, PAIgG, PAIgM and PAIgA levels were higher and platelet count were less in both acute and chronic ITP children than those in normal controls. The difference was signiifcant (P<0.05). The results of linear regression analysis indicated that BAFF levels were positively correlated with PAIgG, PAIgM and PAIgA levels (β=1.87~2.25, P<0.05), and were negatively correlated with platelet count (β=-2.42, P<0.05). Meanwhile, BAFF levels were negatively correlated with curative effect in ITP children (β=-1.88, P<0.05). When the value of BAFF was 1.35, the sensitivity for predicting effective treatment was 0.84 and the speciifcity was 0.75. The area under the ROC curve was 0.85 (95%CI:0.73~0.98, P=0.000). Conclusions The serum BAFF expression was increased and closely related to the level of antiplatelet antibody, platelet count and treatment effect in ITP children, and therefore, was a good indicator for the diagnosis and prognosis of ITP.

China ; Occupational Exposure ; prevention & control ; Risk Assessment ; Workplace

OBJECTIVE To investigate the prevention from hospital infection and therapy in fracture patients.METHODS We analyzed the situation of hospital infection in the fracture patients ranged from 2000 to 2005 with reviewing and perspective statistical method.RESULTS Totally 43 cases were infected from 1345 fracture patients,taken 3.2%.It was the highest with infection rate under the age of 5(6.0%),then was successively at the 15-44 years old age,5-14 years old age,≥60 and 45-59 years old age.CONCLUSIONS The fracture patients or those experiencing surgical operation are easy to have hospital infection.It is a multifactorial result.For instance,the environment of ward,the disinfection measure in operation,the skilled degree of surgical operators,the length of operation time,rational selection antibiotics and so on,are all the important factors to prevent and cure hospital infection.Pay attention to the quality controlling every link,can reduce the rate of hospital infection among fracture patients.

Objective Apuinic/apyrimidic endonuclease/redox effector factor-1(APE1/Ref-1,abbreviated as APE1) is a major member of the base excision repair(BER) pathway involved in oxidative DNA damage repair.To knock down APE1 gene expression in HOS cells with pSilence APE1,and explore its effect in combination with 252Cf neutron ray radiotherapy.Methods The constructed APE1 siRNA expression vector pSilence APE1 was transfected into HOS cells by SuperFect Transfection liposome,and it was used to knock down the expression of APE1.The HOS cells and transfected HOS cells were respectively irradiated by 252Cf neutron ray,then the cell survival(D0),DNA single strand breaks(SSB) and cell apoptosis were determined by clone formation assay,alkaline comet assay and flow cytometer.Results The cell-survival curve was plotted by clone formation assay,the D0 value was 2.80 vs.1.89 and Dq value was 2.66 vs.2.00 for the control and transfected HOS cells,respectively,after being irradiated by 252Cf neutron ray.The tail moments at 2,5 and 10 Gy were 6.664?0.648 vs.7.997?0.542,20.322?1.433 vs.25.238?1.185 and 33.909?1.245 vs.39.191?1.052,respectively,for the control and transfected HOS cells,and the cell apoptosis rate at 2,5 and 10 Gy was 4.00 vs.5.68,5.91 vs.7.55 and 9.63 vs.13.51,respectively,for the control and transfected HOS cells.All these findings showed significant difference between the two groups(P

Objective To evaluate the clinical result and feasibility of anterior approach with posterior vertebral wall preserved in the treatment of thoracolumbar burst fracture with or without paraplegia. Methods From 2005 to 2010, 68 patients with thoracolumbar burst fracture were treated by corpectomy, strut graft and instrumentation with preserved posterior vertebral wall. There were 49 males and 19 females at average age of 39.8 years (16-62 years). Kyphotic Cobb' s angle and spinal stenotic rate was measured preoperatively and postoperatively. The neurological status was evaluated with Frankel impairment scale. Results All patients were successfully managed with this technique, with no neurological deteriorations, cerebrospinal fluid leakage or incision infections except for the pneumothorax in three patients who were then cured through expectant treatment. Screw distraction was performed for restoration of the disc height and kyphosis in 68 patients. After the fractured fragment became loose and was removed, the dura matter was exposed in 19 patients including the eerebrospinal fluid leakage in three patients. Retrograde lumbar myelography was applied in eight patients, of whom there found the blocked spinal canal in three patients and excision of the posterior vertebral wall was performed. Lack of vertebral distraction was found in two patients and extraction of the reversed bone fracture behind the posterior longitudinal ligament was performed in one. The preservation rate of the posterior vertebral wall was 95% (65/68). Fifty-two patients were followed up for mean 2.2 years (from 3 months to 4.5 years) ,which showed no lower back kyphosis. There showed 1-3 Frankel grades of improvement in spinal cord function except for five patients at Frankel grade A. The Cobb angle was average 18.2° in 68 patients preoperatively and was corrected to 9.7°in 52 patients at last follow-up. CT scan showed that the stenotic rate was 42% preoperatively and 9% at final follow up in 68 patients,with no breakage of the screw and plate. Conclusion In the management of thoracolumbar burst fractures,anterior approach is helpful for preservation of the posterior vertebral wall.

Column chromatography on silica gel was used to study the chemical constituents of traditional Chinese medicine Siegesbeckia pubescens. The chemical structures of the separated compounds were elucidated by spectroscopic data analyses. As a result, eighteen compounds were obtained and identified as 3, 4'-dimethoxy quercetin(1), 3, 3', 4'-trimethoxy quercetin(2), 3, 3'-dimethoxy quercetin(3), 7, 3', 4'-trimethoxy luteolin(4), ursolic acid(5), 2β,19α-dihydroxyursolic acid(6), 2β-hydroxyursolic acid (7), stigmasterol-7-one(8), 5α, 8α-epidioxy-24(R)-methyl-cholesta-6, 22-diene-3β-ol(9), β-sitosterol(10), 2, 6-di(3-hydroxy-4-methoxyphenyl)-3, 7-dioxacyclo [3. 3. 0] octane (11), aurantiamide acetate (12), 3-(m-hydroxyl-p-methoxy)-N-(2'-p-hydroxyl-phenethyl)-2E-acrylamide(13), p-hydroxy benzaldehyde (14), m-hydroxy-p-methoxy benzaldehyde (15), 3, 4, 5-trimethoxybenzoic acid(16), monoethyl malonate(17), and p-hydroxylcinnamic acid(18). Among them, compounds 1-9, 11-18 were isolated from this plant for the first time.
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Luteolin ; chemistry ; isolation & purification ; Medicine, Chinese Traditional ; Plants, Medicinal ; Quercetin ; chemistry ; isolation & purification ; Sitosterols ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

Objective To study the neuropsychological behavior development of preterm infants and low birth weight infants,and to provide a reference to the early prevention and intervention on developmental retardations.Methods A total of 101 preterm infants and/or low birth weight infants received the infant development test of 0 ～ 6 year-old children intelligence developmental scale for neurological development and autism behavior checklist(ABC).Results 25 boys and 5 girls suffered from different psychological mental disorders.The occurrences were as follows:10 cases with mental retardation,9 cases with the language development delay,9 cases with motor retardation,1 case with cerebral palsy and 1 case with autism spectrum disorder.The incidence of intelligence problems were that language retardation (18.9％),the fine motor (16.8％),the adapative ability (12.6％),social action (9.5 ％) and the motor delay (3.2％).There were significant differences in the scores of social communication(x2=8.88,P=0.003),adaptive ability(x2=7.41,P=0.007),the fine motor(x2 =6.22,P=0.01) and total developmental quotient(x2 =5.58,P=0.02) between city children'and rural area.The behavioral problems more consisted in self-care ability and language retardation.Conclusion Preterm infants and low birth weight infants are exposed to language,fine motor,adaptive and communication ability problems,especially the children living in country.It is necessary to improve the early education and intervention for the rural preterm infants and low birth weight infants.

Objective The prosthesis used for aortic valve replacement (AVR) can be too small in relation to body size,thus causing valve prosthesis-patient mismatch (PPM).The aim of this article was to summarize the preventive strategy of PPM during AVR.Methods A total of 357 patients [203 males,154 females; mean age (54.9 ± 18.7 ) years ] underwent AVR between February.2010 and December 2011.The weight and body surface area (BSA) of the group is( 60.1 ± 11.4 )kg and (1.67 ± 0.21 )m2 respectively.The aortic valve prosthesis effective orifice area (EOA) was divided by body surface area (BSA) to obtain the EOA index (EOAI).PPM was then defined as none or mild if EOAI was ＞ 0.85 cm2/m2,as moderate for (0.65 - 0.85 ) cm2/m2 and as severe for ＜ 0.65 cm2/m2.To avoid PPM,a simple three-step algorithm was applied:Step 1,Calculate the patient's BSA from weight and height;Step 2,Calculate the minimal valve EOA required based on the BSA to ensure an EOAI ＞0.85 cm2/m2 ; Step 3,Select the type and size of prosthesis that has reference values for EOA greater or equal to the minimal EOA value obtained in step 2.For patients with a small aortic root,the following three methods was used:( 1 ) Replace aortic valve with simple interrupted suture technique ; (2) Apply new type and high-performance prosthetic valves such as St.Jude Medical Regent mechanical valve ; (3) Enlarge the narrowed aortic root when necessary.Results Of all 357 patients,272 patients received mechanical AVR and 85 bioprosthetic AVR.Among the 49 patients who received AVR with simple interrupted suture technique.St.Jude Medical Regent mechanical valve was implanted in 38 patients and the aortic root enlargement was performed in 11 patients.The total prevalence of PPM was 6.4％ and there was no severe PPM.The prevalence of PPM with mechanical AVR and bioprosthetic AVR was 1.8％ and 21.2％ respectively.There were 4 deaths during early period of operation,and the operative mortality was 1.1％.Conclusion Prosthesis-patient mismatch can be effectively prevented at the time of AVR with appropriate measurement.

Background Excimer laser corneal refractive surgery is widely used because it reduces the dependency of refractive error eye to glasses.However,the adverse effects of anti-inflammatory drugs is a problem after operation.Lotemax eyedrops is a kind of steroidal anti-inflammatory drug,with a good effect on the operative eye.But its influence on intraocular pressure(IOP) after long-term topical administration is less studied.Objective This study was to investigate the influence of lotemax eyedrops on IOP after long-term topical administration in myopic eyes received excimer laser corneal refractive surgery.Methods An one-month retrospective case serial study was adopted.The case history data of 1552 eyes from 1552 Patients who received excimer laser corneal refractive surgery were collected in Tangshan Eye Hospital from 2011 January to 2012 January,including 321 eyes with laser in situ keratomileusis(LASIK),608 eyes with sub-Bowman keratomileusis (SBK) and 623 eyes with femtosecond laser for flap excimer laser in situ keratomileusis(FS-LASIK).Lotemax eyedrops was topically administered after operation 4 times per day initial and then decreased 1 time weekly for 1 month.IOP was measured in before,1 week,2 weeks,3 weeks,4 weeks after operation with non-contact tonometer.The increasing range of IOP was divided into ＜5 mmHg,5-15 mmHg and ＞ 15 mmHg after operation.Optical head parameters were measured by Heidelberg retina tomography when IOP increasing after operation.Results Within 1 month,elevated IOP was found in 47 of 1552 eyes after administration of lotemax eyedrops,including 3.12％ (10/321) in the LASIK group,3.29％ (20/608) in the SBK group and 2.73％ (17/623) in the FS-LASIK group,without significant difference among them(x2 =1.95,P＞0.05).The IOP elevated 1 week after operation and remained normal after that till drug withdrawal in all eyes.There were no significant differences in the disk area (1.65 ±0.44) mm2 vs.(1.66 ±0.44) mm2,disk volume (0.40 ±0.09)mm3 vs.(0.39±0.08) mm3 and mean nerve fiber layer thickness (0.28 ± 0.08) mm vs.(0.29 ± 0.07) mm in IOP elevation duration compared with 1 month after IOP recovery(t =0.34,0.81,0.48,P＞0.05).Conclusions Topical administration of 0.5％ lotemax eyedrops after excimer laser corneal refractive surgery leads to reversible high IOP.It is very important to monitor the IOP during use of the drug.

BACKGROUND: Neurological complications after coronary artery bypass grafting still have a high incidence rate, and the etiology is multiple.OBJECTIVE: To retrospectively investigate the occurrence and relevant factors of severe neurological complications after coronary artery bypass grafting (CABG).METHODS: A total of 761 consecutive patients with undergoing CABG were included in this study from September 2002 to August 2009 at the Nanjing Drumtower Hospital, including 443 males and 318 females, aged from 32-89 years. All patients were grouped according to age(more than or less than 70-year-old) and on pump or off pump coronary surgery. Disclose the relationship between the risk factors and the neurological complications by statistics analysis.RESULTS AND CONCLUSION: Totally 41 patients had serious neurological complications in this study. There was a higher complication incidence in 570-year-old group patients (n=22) than < 70-year-old group (n=19)(14.9% vs. 3.1%, P< 0.001). The neurological complications incidence was similar in on-Pump CABG group (n =7) and off-Pump CABG group (n = 34) (5.3% vs.5.4%, P=0.39). The incidence rate of severe neurological complications was high in carotid artery stenosis > 50% patients. A total of 8 cases died, 2 for massive hemorrhage of gastrointestinal tract; 1 for severe sepsis; 4 for multiple organ dysfunction syndrome;1 for epilepsia gravior postoperatively. Finally, 33 cases survived. The average time of follow up was 3 years, 3 cases died, 3 cases recovery from limitation of limb or hand movement partly, and 1 case had severe mental retardation. Results displayed that elderly patients(= 70 years) undergoing CABG are at higher risk of neurological dysfunction. Carotid artery stenosis is the most risk factor. There are no significant effects on postoperative complications between on-pump CABG and off-pump CABG.