Idiopathic thrombocytopenic purpura (ITP),as a heterogeneous autoimmune disease,is the most common bleeding disorder,of which etiology and pathogenesis are still unclear. Health related quality of life are severely affected,especally in chronic patients . Studys on chronic idiopathic thrombocytopenic purpura pathogenesis ,both in China and abroad,have found that genetic factors may be involved in the occurrence and prognosis of the disease. The paper gives a review from the follow aspects,such as its risk factors,relationship between genetic polymorphisms or expression levels and chronic ITP susceptibility and seriousness,the role of epigenetic,researchs about chronic and refractory ITP,et al.

Objective:To study the change rule of decocting quantity of the effective components in Amomi fructus and Amomi fructus rotundus with decocting time to determine whether or not decocted later and optimal decocting time. Methods:The herbs were extracted by the traditional water decoction, and at different time points, sampling was carried out. Using camphor and eucalyptol as the index components, the change rule of decocting quantity of the effective components with the decoction time under the condition of single and combined decoction was investigated. Results:When the decoction time of Amomi fructus was within the range of 3-6 min, the total amount of camphor in the decoction reached relatively high value, and the total amount lost more than 45% when the decoction time exceeded 10 min. Amomi fructus rotundus boiled for a short time below 2 min, and when the decoction time was more than 5 min, more than 50% eucalyptol lost. Conclusion:Amomi fructus and Amomi fructus rotundus should be decocted later with decocting time within 3-6min and below 2 min, respectively. The analytical method is reliable and precise in the quality control of relative decoction.

Objective To study the clinical effects of shortening the drainage time for patients with dural tears after posterior spinal sur -gery.Methods A total of 120 patients with dural tears after posterior spinal surgery were randomly divided into study group and control group,60 patients in each group .Patients in control group had wound drainage tubes removed after 5 days and patients in study group had wound drainage tubes removed after 3 days.The disappearance time of leakage ,incision healing time and complication rate were compared between two groups.Results The disappearance time of leakage in study group was (13.7 ±3.8)days which was significantly less than (20.0 ±5.1)days in control group(P<0.05).The incision healing time in study group was (22.7 ±4.9)days which has no significant difference with (23.9 ± 5.7)days in control group.The postoperative infection rate was 3.3%(2/60) which was significantly less than 20.0%(12/60) in control group(P<0.01).Conclusion Shortening drainage time can decrease the disappearance time of leakage and postoperative infection rate .

Objective To investigate the expression and clinical significance of platelet autoantibodies in children with persistent/chronic immune thrombocytopenia (pITP/cITP).Methods Total of 34 children diagnosed with pITP/cITP(14 cases and 20 cases,respectively)in the Department of Hematology and Oncology,Shanghai Children's Hospital from December 2013 to August 2014 were enrolled as the study group,including 20 male and 14 female,the median age of 5 years old.The study also included 20 healthy children (the healthy control group) matched with gender and age,and 24 cases of newly diagnosed ITP (newly diagnosed ITP group) serving as the control groups.Platelet-associated immunoglobulin (PAIg) and platelet-specific autoantibodies on surface of platelets were mea-sured by flow cytometry or flow cytometric bead.Results Significant elevation of PAIgA,PAIgM,PAIgD and specific autoantibodies against glucoprotein(GP) Ⅲa,and GP Ⅱb were demonstrated in children with cITP,as well as specific autoantibodies against GP Ⅰ b,GP Ⅲ a,GP Ⅱ b,and granule membrane protein 140 (GMP140) in children with pITP,compared with the healthy control group(P ＜ 0.05);the levels of GPⅨ,GP Ⅲ a,GMP140 in cITP group and GP Ⅱ b in pITP showed significant declination,compared with the newly diagnosed ITP group(P ＜ 0.05);between piTP group and cITP group,autoantibodies GPⅨ,GP Ⅰ b,GP Ⅱ b,and GMP140 in the latter were much lower(P ＜ 0.05).Significant negative relation between PAIgM and platelet count was found in cITP group (P ＜ 0.05).Receiver operating characte-ristic (ROC) curve analysis showed that the area under ROC curve (AUC) of GP Ⅲ a autoantibodies was larger than that of other platelet-autoantibodies in pITP/ciTP diagnosis.Conclusions Platelet autoantibodies play a significant role in pITP/ciTP,especially platelet-specific autoantibodies,which show a declining tendency in the course and may be the main mechanism.The detection of GPⅢa specific autoantibody is more advantageous against other autoantibodies in the diagnosis of piTP/ciTP.

Objective To evaluate effects of trichostain A (TSA) on cell proliferation, cell cycles, apoptosis and invasiveness of multiple myeloma cell line U266; as well as active changes of methylation regulating proteins including DNA methyl-transferase(DNMTs), methyl-binding domain (MBD) proteins: MBD2 and MeCP2 after treated with TSA. Methods U266 cells were treated with different concentrations of TSA for 12, 24, 48 and 60 h. The proliferation activity of U266 cells was detected by MTT and the IC50 of 24 h was calculated. After U266 cells were treated with IC50, cell cycles were check out by dying with PI. mRNA of matrix metalloproteinase-2(MMP-2), bc1-2, bcl-xl and methylation regulating proteins (DNMTs, MBD2 and MeCP2) were detected by real-time PCR. FCM and Western blotting were used to measure expressions of MMP-2 and MBD2. Results MTT results revealed TSA inhibited proliferation of U266 cells in a dose-and time-dependent manner and the IC50 of 24 h was 0.07 μmol/L FCM analysis showed that TSA could arrest the cell cycle in G0/G1 and the proliferation index (PI) in U266 cells [(49.90 0.39)%]were significantly different after exposed to TSA (0.7 μmnol/L for 24h compared with that in the control cells[(55.78 0.49)%](P <0.01). After treated by TSA, the 2-△△Ct of MMP-2, bcl-2 and bcl-xl were 0.71 0.06, 5.04 0.92 and 2.95 0.35, respectively. There were great changes on mRNA of DNMT, MBD2 and MeCP2. TSA could reverse the transcription of DNMT, MBD2 and MeCP2. Conclusion TSA can arrest the U266 cell cycle in GVG, to prevent its proliferation and promote apoptosis, which maybe greatly connect with the changes of the methylation regulating proteins.

OBJECTIVE:To establish the method for simultaneous determination of 6 components in Lonicera japonica,and to study the content changes of them before and after before and after carbonized. METHODS:UPLC method was adopted. The deter-mination was performed on Agilent Eclipse Plus C18 RRHD column with mobile phase consisting of 0.1% phosphoric acid solu-tion-acetonitrile(gradient elution)at the flow rate of 0.2 mL /min. The detection wavelength was set at 350 nm,and column tem-perature was 25 ℃. The sample size was 1 μL. RESULTS:The linear ranges of chlorogenic acid,rutin,galuteolin,isochlorogenic acid A,isochlorogenic acid B and isochlorogenic acid C were 21.2-424 μg(r=0.9993),1.17-23 μg(r=0.9995),2.18-43 μg(r=0.9998),5.10-102 μg(r=0.9993),2.60-52 μg(r=0.9991),4.95-99 μg(r=0.9998),respectively. RSDs of precision,stability and repeatability tests were all lower than 2.0%. Recoveries were 97.11%-99.76%(RSD=1.20%,n=6),95.20%-99.90%(RSD=2.20%,n=6),95.71%-100.30%(RSD=2.20%,n=6),95.00%-96.98%(RSD=0.88%,n=6),96.47%-103.00%(RSD=2.40%, n=6),95.78%-103.80%(RSD=3.20%,n=6). Compared with before processing,the contents of rutin,isochlorogenic acid B and isochlorogenic acid C in L. japonica were increased along with processing,the contents of chlorogenic acid and isochlorogenic acid A were decreased significantly,while the content of galuteolin had no significant change. CONCLUSIONS:The method is sim-ple,precise,stable and repeatable,and can be used for simultaneous determination of 6 components in L. japonica. Those chemi-cal components have certain changes before and after carbonized.

Objective To investigate the characteristic immunophenotype of B cell chronic lymphoid leukemia in china. Method Single and multiparameter flow cytometry were used to analysis 163 cases of B cell chronic lymphoid leukemia. Results 71.8%(117/163) of cases co-expressed CD5 and B cell markers. The patients were classified into category of B cell chronic lymphocytic leukemia(B-CLL), hairy cell leukemia(HCL) and other B-cell lymphoproliferative disorders(LPDs) by using the scoring system that was recommended by world health organization (WHO). The B-CLL typically display the composite phenotypes: CD5+,CD23+,CD20+,CD19+,HLA-DR+,but the CD22,CD11c,CD25 and FMC7 were variable present in some B-CLL cases.CD103 seems the most specific marker for HCL.To differentiate diagnosis of atypical B-CLL with B-prolymphocytic leukemia(B-PLL) or mantle cell lymphoma(MCL), one must not rely exclusively on immunophenotypic dates, cytogenetic or molecular biology detection would be helpful. The index of froward scatter( FSC) and antigens expression of tumor B cells could be calculated by dividing the relevant value of residual normal T cell within same sample as internal control, so the cell size and the intensity of antigen expression could be comparable each other and quantitative between different investigations. Conclusion immunophenotypic analysis is an extremely useful adjunct in the diagnosis of chronic lymphoid leukemia.

Objective To explore the effect of postweaning enriched environment and citalopram treatment during juvenility on the behaviour of male rats exposed to early adverse stress. Methods The newborn pups were randomly divided into maternal separation group (MS) and non-maternal separation group (NMS). Offspring were weaned on PND22 and housed in same-rearing groups under either standard or enriched conditions or citalopram treatment until adulthood. All of them were examined by sucrose consumption test, forced swimming test (FST) and morris water maze test (MWZ). Results (1) MS had significantly less consumption of sucrose intake (ml/g)(0.013 ±0.006, n = 10), compared with the following five groups (MS + EE (0.023 ±0.012, n = 8); MS + Drug (0.027 ±0.012, n = 9); NMS (0.022 ± 0. 007, n=11);NMS + EE (0.023 ±0.007, n = 7); NMS + Drug (0.032 ±0.011),n=7)), NMS + Drug had significantly increased the radio of sucrose consumption on NMS group. (2)The immobility in FST were longer in MS-experienced groups (MS (140. 19 ± 37.01) s, n = 8); MS + EE (129.41 ±29.50)s, n = 6) ;NMS + Drug (128.83 ±26. 11)s, n = 6)) than three non-MS groups (NMS (96.28 ±35.63)s,n = 7); NMS + EE (94.17 ±24. 87)s, n = 6) ;NMS + Drug (93.00 ±34. 21)s, n = 6)). (3) MS had shorter time and shorter percentage of distance spent in target quadrant in MWZ,citalopram treatment markedly improved spatial memory on NMS group. Conclusion Maternal separation applied in newborn rats induces a broad spectrum of behavioral changes reminiscent of depressive symptoms in humans, which might be reversed to some extent by EE and antidepressant in young adults.

Objective To evaluate the clinical value of contrast enhanced uhrasound(CEUS)for uhrasoundguided radiofrequency ablation(RFA)of liver metastasis.Methods One hundred and forty-one consecutive patients with liver metastasis asked for RFA treatment in our department.Of them,102 patients with received CEUS with SonoVue before RFA treatment.Eighty-six of the 102 patients were regarded as indications for RFA by CEUS(Group A).During the same period,another 39 patients who received conventional US without contrast before RFA were served as the control group(Group B).In Group A,the RFA protocol for each case was designed according to CEUS finding,which included perfusion feature,lesion number,size,shape,invasive range,location and relationship between tumor and surrounding structures.In Group B.the RFA protocol for each case was designed according to conventional ultrasound and CT/MRI result.Results In 102 patients who intended to receive RFA treatment,1 6 were excluded from RFA after CEUS examination.Of them,3 patients with 10 tumors received 6-10 sessions of chemotherapy and there were no enhancement within or around tumors.Another 13 cases were found that the invasive range being more than 8 cm in size,tumor number more than 7,and tumor location adhered to diaphragm and second hepatic helium by CEUS.In Grou0 A,CEUS detected additional 1-3 tumors in 36 patients(41.9%).The size range of the 58 new tumors was 8-15 mm.Of these,79.4%(46/58 tumors)were visualized in parenchymal phase.A total of 209 liver metastasis tumors were treated by RFA.CEUS before RFA demonstrated 49.7%(75/151 tumors)were 1arger in size compared with conventional US.Of these,69.3%(52/75 tumors)presented larger in arterial phase,the remaining 30.7%(23/75 tumors)presented larger in parenchymal phase,and the increased area was also ablated.On 1-3 months follow up with CT,the tumor necrosisrate in Group A was 94.7%(198/209 tumors),which was significantly higher than 87.6%(99/113 tumors)in Group B ( P=0.013). During follow-up period, local recurrence were found in 15 tumors (7.1 %) 2-17 months after REA and intrahepatic new tumors developed in 32 patients (37.2%) 2-17 months after RFA in group A,While local recurrence were found in 16 tumors (14.1%) and intrahepatic new tumors developed in 17 patients (43.5%) in group B ( P=0. 041, P ＞0.05, respectively). Conclusions CEUS provides important information for selecting candidation and designing optimal protocol for RFA in liver metastasis. The use of CEUS can increase tumor necrosis rate and decrease post-RFA tumor local recurrence,and then improve efficacy of RFA therapy.

Objective:The roles of HMGA2 in maintaining malignant phenotypes of the osteosarcoma U2OS cells was studied to explore the possibilities for it to be developed as a target for gene therapy.Methods:U2OS cells were stably transfected with a DNA based shRNA expression vector which targeted to HMGA2.The expression of HMGA2 mRNA was proved by RT-PCR;Cell growth,migration and apoptosis were determined with CCK8,hoechst33342 staining and Boyden ventricle,respectively.The mRNA levels of Caspase 3 and Caspase 9 were determined by real time quantitative RT-PCR.Results:The transfection with shRNA expression vector significantly decreased HMGA2 mRNA levels of U2OS cells.Cell growth and migration were decreased,but apoptosis and the mRNA levels of Caspase 3 and Caspas 9 were increased following the decrease of HMGA2 mRNA.Conclusion:The abnormal expression of HMGA2 plays an important role in maintaining the malignant phenotypes of U2OS cells.Gene therapy targeted to HMGA2 could be helpful in the treatment of human osteosarcoma.