ObjectiveTo study the mechanism of infection-related reactive thrombocytosis.MethodsSeventy-five infectious disease patients were selected including 42 cases with acute infections phase thrombocytosis (acute infectious phase thrombocytosis group),18 cases with acute infectious phase normal platelet count (acute infectious phase normal platelet count group),15 cases with recovered phase (infectious recovered phase group) and 16 cases with healthy controls(control group).The serum thrombopoietin (TPO),intefleukin-6 (IL-6),white blood cell,platelet was determined and compared among 4 groups.Results The serum TPO in acute infectious phase thrombocytosis group [( 159.1 ± 65.9) ng/L]was higher than that in acute infectious phase normal platelet count group,infectious recovered phase group,and control group [(43.5 ± 14.4),(40.3 ± 15.2),(41.8 ± 18.9) ng/L](P＜ 0.05).There was no significant difference in the serum IL-6 between acute infectious phase thrombocytosis group [(542.7 ± 247.0) ng/L]and acute infectious phase normal platelet count group [(598.5 ± 250.4) ng/L] (P ＞ 0.05 ),but which was higher than that in infectious recovered phase group [(43.5 ± 20.7 ) ng/L] and control group [( 38.3 ± 17.6 )ng/L] respectively (P ＜ 0.05 ).The serum IL-6,TPO was positively correlated with platelet,white blood cell.The serum TPO was positively correlated with IL-6.ConclusionElevated TPO leads to the thrombocytosis,which is the possible mechanism of infection-related reactive thrombocytosis.

BACKGROUND:Research about the repair of articular cartilage with heterograft chondrocytes is frequently reported, but the method may cause immune rejection. Since the embryonic cells possess lower antigenicity and stronger proliferation capability, it is hoped that they can be used as a novel carrier substitute in tissue engineering research.DESIGN: A randomized grouping observation and comparative experiment.SETTING: Histological Embryonic Laboratory in Guangxi Medical University.MATERIALS: A big white adult New Zealand rabbit pregnant for 4 weeks was adopted; and another 24 big white adult New Zealand rabbits were selected, with no limitationin whether they were female or male and with a body mass of 2 to 2.5 kg.METHODS: This experiment was carried out at the Histological Embryonic Laboratory in Guangxi Medical University between December 2000and June 2002. The models of defects in articular cartilage were made artificially in femur medial malleolus of the mature rabbits. In the experimental group, defects were repaired by the implantation of Fibrin Sealant and embryonic chondrocytes mixture, but for the control group, only Fibrin Sealant was implanted or nothing was done about the defect. The restoration of articular cartilage defect was then observed 4,8 and 12 weeks after the operation, and was scored according to modified Pineda's method. The standard consists of 5 items, I.e., cellular morphology, matrix staining, surfacing smoothness, cartilage thickness and host union. 0 refers to normal and the higher the score is, the more serious the pathological changes are.MAIN OUTCOME MEASURES: ①The general observation of rabbit knee joint; ② Histological observation of rabbit knee joints; ③ Histological semi-quantitative score of articular cartilage; ④ Appraisal of the curative effect of articular cartilage defects.RESULTS: Totally 24 rabbits were enrolled in this experiment and all entered the stage of result analysis. ① The general observation of rabbit knee joint: In embryonic chondrocytes plus fibrin sealant group, the color in defect area was basically the same as that of the normal cartilage, showing a strong quality and better elasticity with the boundaries from the surrounding cartilage approximately vanishing. In Fibrin sealant group and the control group, the defect did not heal completely, but the defect area became small and filled with white fibrous tissues. ② Histological observation of rabbit knee joints: In embryonic chondrocytes plus fibrin sealant group,tissues were predominated by hyaline cartilage, with bone tissues appearing in deeper position, and the surface was slightly raised or smooth, and the matrix showed normal staining, and were completely united with the surrounding cartilage and the division line was not clear. There was no lymphocyte infiltration in the tissues. In Fibrin sealant group and the control group, tissues were predominantly fibrous tissues, and part of them showed obvious residual hollow scar, connecting or partly connecting with the surrounding tissues. ③ Histological semi-quantitative score of articular cartilage: According to modified Pineda's method, the scores of embryonic chondrocytes plus fibrin sealant group after 12 weeks were obviously lower than those of the fibrin sealant group and the control group [(0.50±0.76) vs (7.88±1.13), (8.13±1.36), P ＜ 0.05]; moreover, the difference between pure fibrin sealant group and the control group was of statistical significance 4weeks after the operation (P ＜ 0.05), but there was no obvious difference 8and 12 weeks after the operation. ④Appraisal of the curative effect of articular cartilage defects: 12 weeks after the operation, in the embryonic chondrocytes plus fibrin sealant group, the defect of 8 cases healed completely. In fibrin sealant group 1 case healed but not completely, and 7cases did not get repaired for their defect. In the control group, 8 cases failed to get their defect repaired.CONCLUSION: The repaired tissues in embryonic chondrocytes trans plantation group were basically the same as normal cartilage, obviously superior to the fibrin sealant group and the control group, suggesting that such method is feasible in the repair of articular cartilage defects.

Objective: To establish an LC-MS/MS method for the determination of 4-( 4-amino-3-fluorophenoxy )-N-methylpyri-dine-2-carboxamide ( AFP-PMA) as a genotoxic impurity in regorafenib. Methods: The content of AFP-PMA was determined by an LC-MS/MS method. A Waters XBridge Shield RP18 column was adopted to separate the samples and the column temperature was 50℃. The mobile phase consisted of 5 mmol·L-1ammonium acetate aqueous (A)-acetonitrile (B) with gradient elution (0~9 min, 5%B→90%B) at a flow rate of 1. 0 ml·min-1. An electrospray ionization source (ESI) was used in a positive-ion and multiple reactions monitoring mode. The ion channel was m/z 262. 2→244. 1. Results:The standard curve was linear within the range of 2. 41-980. 90 ng·ml-1(r=0. 9998) and the limit of quantification was 8. 02 ng·ml-1. The limit of detection was 2. 41 ng·ml-1, which was e-quivalent to 0.000241% for the concentration of regorafenib. The average recovery was 100.95% and RSD was 2.37% (n=9). Conclusion:The method has good specificity, promising accuracy and high sensitivity, which can be used for determining the trace genotoxic impurity AFP-PMA in regorafenib.

Objective To explore the possible causative factors of appearance of ventricular fibrillation (VF) during emergency percutaneous coronary intervention (PCI) in patients with acute inferior myocardial infarction. Methods Five hundred and seventy two patients with acute inferior myocardial infarction who underwent emergency PCI 24 hours after onset from May 2016 to May 2018 in Cangzhou People's Hospital were enrolled, they were divided into a VF group (52 cases) and a non-VF group (NVF, 520 cases) according to whether VF occurred or not during PCI. The differences in clinical data, characteristics of coronary artery disease and coronary artery score (Gensini score) between the two groups were compared; multivariate Logistic regression analysis was used to analyze the risk factors related to the occurrence of VF during emergency PCI; the receiver operating characteristic curve (ROC) was drawn to evaluate the efficacy of each risk factor. Results There were no statistical significant differences in sex, age, past histories of drinking alcohol, smoking, hypertension, diabetes, previous use of β blockers, aspirin, the peak values at admission of systolic blood pressure, heart rate, creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTnI), etc between the two groups (all P > 0.05). The proportions of patients with grade 0 blood flow in myocardial infarction thrombolysis (TIMI) before recanalization, with high thrombus load, criminal vessels being right coronary artery (RCA) and proximal segment of RCA, Gensini score in VF group were significantly higher than those in NVF group [TIMI 0: 80.8% (42/52) vs. 58.1% (302/520), high thrombus load: 71.2% (37/52) vs. 58.1% (302/520), criminals being RCA: 84.6% (44/52) vs. 73.7% (383/520), the occlusion site of infarction-related artery (IRA) being the proximal segment of RCA: 61.5% (32/52) vs. 41.2% (214/520), Gensini scores: 93.84±16.48 vs. 61.37±20.01, all P < 0.05]. The multiple logistic regression analysis showed that the risk factors for VF occurrence during emergency PCI for patients with acute inferior myocardial infarction included the criminals being RCA [odds ratio (OR) = 1.967, 95% confidence interval (95% CI) = 1.696-3.015, P =0.032], TIMI blood flow grade 0 before re-canalization (OR = 3.032, 95%CI = 1.248-3.675, P = 0.043), the occlusion site of infarction-related artery (IRA) being the proximal segment of RCA (OR = 2.288, 95%CI = 1.458-3.895, P =0.024), Gensini score (OR = 6.558, 95%CI = 2.168-13.359, P = 0.001] and high thrombus load (OR = 1.781, 95%CI =1.016-3.017, P = 0.033); they all were risk factors of occurrence of ventricular fibrillation during emergency PCI in patients with acute inferior myocardial infarction (all P < 0.05). ROC curve analysis showed that TIMI blood flow grade 0 before re-canalization, Gensini score and higher thrombus load had certain predictive value for VF occurrence during emergency PCI for acute inferior wall myocardial infarction; the area under ROC curve (AUC) was 0.613, 0.869 and 0.605, and 95% CI was 0.540-0.687, 0.787-0.969 and 0.521-0.675, the P value was 0.007, 0.000 and 0.012, respectively, suggesting that Gensini score had moderate predictive value for intra-operative VF, while the predictive values of TIMI blood flow grade 0 before re-canalization and higher thrombus load were relatively low. When the Gensini score had an optimal cutoff value of 96.50, the sensitivity was 85.50% and the specificity was 81.20%. Conclusion The risk factors of VF occurrence in emergency PCI for patients with acute inferior myocardial infarction are criminal vessel RCA, TIMI blood flow grade 0 before re-canalization, IRA occlusion site being proximal segment of RCA, Gensini score and high thrombus load; pre-recanalization TIMI blood flow grade 0, Gensini score and higher thrombus load all have certain predictive value for the occurrence of VF in emergency PCI for acute inferior myocardial infarction.

Objective To investigate the preoperative risk factors of occurrence of intra-operative ventricular fibrillation (VF) in patients with acute inferior myocardial infarction undergoing emergency percutaneous coronary intervention(PCI). Methods A retrospective approach was conducted, 572 patients with acute inferior myocardial infarction admitted to Cangzhou City People's Hospital from May 2016 to May 2018 were enrolled, and they were divided into VF group (50 cases) and non-VF group (520 cases) according to whether the intra-operative complication of VF occurred. The clinical data of the two groups of patients were collected, and the related risk factors were analyzed by univariate and multivariate analyses to explore the preoperative risk factors related to VF intra-operative occurrence in patients with acute inferior myocardial infarction undergoing emergency PCI; the receiver operating characteristic (ROC) curve was drawn to evaluate the test efficiencies of all kinds of risk factors. Results The univariate analysis showed that the ratio of Killip > Ⅰ grade, infarct area size/blood potassium concentration (IS/[K]) and symptom onset to balloon dilatation time (SOTBT) in the VF group were significantly higher than those in the non-VF group [Killip > Ⅰ grade:36.5% (19/52) vs. 24.0% (125/520), IS/[K]: 3.2±0.3 vs. 2.5±0.8, SOTBT (hours): 6.3 (2.1, 8.0) vs. 4.6 (1.8, 6.5)], the differences were statistically significant (all P < 0.05); the T wave peak to T end interval/QT interval (Tp-e/QT) and blood potassium level of the VF group were significantly lower than those of the non-VF group [Tp-e/QT: 0.3±0.1 vs. 0.4±0.1; blood potassium (mmol/L): 2.8±0.5 vs. 4.1±1.2, both P < 0.05]. Multivariate logistic regression analysis showed that the SOTBT > 6 hours [odds ratio (OR) = 8.337], Killip >Ⅰ grade (OR = 1.721), hypokalemia (OR = 1.031) and high IS/[K] (OR = 9.167) were independent risk factors for intra-operative occurrence of VF in patients with acute inferior myocardial infarction during emergency PCI (all P < 0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of serum potassium, IS/[K], SOTBT > 6 hours and Killip > Ⅰ grade for predicting the intra-operative occurrence of VF during emergency PCI for patients with acute inferior myocardial infarction had certain values, their AUC were 0.633, 0.837, 0.821, 0.682, respectively, suggesting that IS/[K] and SOTBT > 6 hours had moderate predictive values, and serum potassium, Killip > Ⅰ grade had relatively low predicative values; when the optimal cut-off value of IS/[K] was 2.8, the sensitivity was 85.5% and the specificity was 80.0%. Conclusion SOTBT > 6 hours, Killip > Ⅰ grade, hypokalemia, and high IS/[K] are independent risk factors of intra-operative occurrence of VF in patients with acute inferior myocardial infarction undergoing emergency PCI.

Objective To investigate the prognostic risk factors of patients with acute inferior myocardial infarction and intra-operative occurrence of ventricular fibrillation (VF) when undergoing emergency percutaneous coronary intervention (PCI). Methods The data of 52 patients with acute inferior myocardial infarction treated in Cangzhou City People's Hospital from May 2016 to May 2018 were retrospectively analyzed, and they were divided into poor prognosis group (19 cases) and good prognosis group (33 cases) according to whether cardiovascular events occurred during 1 year of follow-up. The patients' gender, age, smoking or not, histories of diabetes, hypertension, hyperlipidemia, and the results of well performed color echocardiography within recent 3 days, such as left ventricular ejection fraction (LVEF), cardiac infarction size (IS), and coronary Gensini score were recorded in the two groups; the indicators with statistical significance in univariate analysis were included in the multivariate logistic regression analysis to screen out the prognostic risk factors of patients with acute inferior wall myocardial infarction undergoing emergency PCI and occurrence of intra-operative VF; Receiver operating characteristic (ROC) curve was drawn to evaluate the values of coronary Gensini score and IS in predicting intraoperative occurrence of VF in patients with acute inferior wall myocardial infarction undergoing emergency PCI. Results During 1-year follow-up, 19 of 52 patients with acute inferior myocardial infarction occurred VF, the incidence being 36.5%. The univariate analysis showed that the IS and Gensini score in poor prognosis group were significantly higher than those in the good prognosis group [IS: (3.2±0.2)% vs. (2.5±0.4)%, Gensini score: 98.8±12.5 vs. 85.7±8.4, both P < 0.05], the LVEF level was significantly lower in the poor prognosis group than that in the good prognosis group (0.37±0.08 vs. 0.46±0.11, P < 0.05). The multivariate Logistic regression analysis showed that IS [odds ratio (OR) = 5.016] and coronary Gensini score (OR = 2.415) were the risk factors of occurrence of cardiovascular events after surgery in patients with acute inferior myocardial infarction and intra-operative VF when undergoing PCI (P < 0.05). The ROC curve analysis showed that IS and coronary Gensini scores had certain predictive values for the prognosis of patients with acute inferior myocardial infarction and occurrence of intra-operative VF when undergoing emergency PCI, the area under the ROC curve (AUC) was 0.863 and 0.597, respectively, indicating that IS had a medium predictive value, while the value of coronary Gensini score was lower, when the IS optimal cut off value was 3.0, the sensitivity was 89.4% and the specificity was 88.0%. Conclusion High IS and Gensini score are the risk factors of prognosis of patients with acute inferior myocardial infarction and intra-operative occurrence of VF when undergoing emergency PCI.

OBJECTIVE:To compare the clinical efficacy and safety of Jianpi shengxue tablets and Iron polysaccharide complex capsules in the treatment of nondialysis renal anemia. METHODS:A total of 60 nondialysis renal anemia patients in our hospital during Mar. 2016 to Mar. 2017 were divided into control group(30 cases)and observation group(30 cases)with random allocation concealment method according to random number and admission order. Both groups received routine treatment as rhEPO injection,Folic acid tablets,Vitamin B12 tablets. Based on it,control group was given Iron polysaccharide complex capsules 0.15 g orally,once a day;observation group was given Jianpi shengxue tablets 1.8 g orally,3 times a day. Both groups were treated for 12 weeks. Clinical efficacies were compared between 2 groups. The levels of Hb,RBC,HCT and Ret％ were observed before treatment and 2,4,8,12 weeks after treatment;the levels of SI,SF and TS were also observed before treatment and 8,12 weeks after treatment. The occurrence of ADR was recorded. RESULTS:Both groups completed the treatment. The total effective rate of observation group(86.67％)was significantly higher than control group(63.33％),with statistical significance(P<0.05). Before treatment,there was no statistical significance in the levels of Hb,RBC,HCT,Ret％,SI,SF or TS between 2 groups (P<0.05). After treatment,the levels of above indexes in 2 groups were significantly higher than before treatment,and observation group was significantly higher than control group(except for Ret％ at 8th week),with statistical significance(P<0.05). The case number of black stool and rust colored stool in observation group were significantly lower than control group,while the incidence of black-dyed teeth in observation group was significantly higher than control group, with statistical significance (P<0.05). CONCLUSIONS:Therapeutic efficacy of Jianpi shengxue tablets are significantly better than Polysaccharide iron complex capsules in the treatment of nondialysis renal anemia,and can significantly improve iron reserve and anaemia. But Jianpi shengxue tablets causes high incidence of black-dyed teeth.