Objective To detect and determine the specificity of platelet-reactive antibodies in patients who were refractory to platelet transfusions.Methods Serum samples from 48 patients who were refractory to platelet transfusions were screened with MACE for platelet-reactive antibodies.Specificity of platelet alloantibodies was determined with PAK12 and MAIPA.Results Platelet-reactive antibodies were detected in the serum of 50% PTR patients(24/48).The incidence of HLA antibodies was 39.6%(19/48),accounting for 79.2% of serum with platelete alloantibodies.The HPA alloantibodies were found in 29.2%(14/48)serum,of which,64.3%(9/14)occurred together with anti-HLA.The following platelet-specific antibodies were identified:anti-HPA-3a(n=2),anti-HPA-5b(n=1),anti-HPA-5a(n=1),anti-HPA-2b(n=1),anti-HPA-4b(n=1).Of the 14 serum with HPA antibodies,78.6%(11/14)contained panreactive anibodies against platelet glycoprotein(GP)Ⅱb/Ⅲa,GPⅠa/Ⅱa,and/or GPⅠb/Ⅸ.Platelet-reactive antibodies were detected more in female(16/29)than in male(8/19)with a frequency of 55.2%,42.1%,respectively,but there was no statistical significant difference.Conclusion The platelet-specific antibody in PTR patients are not as rare as previous thought although alloantibodies are predominantly anti-HLA.Antibody specificities in Chinese PTR patients are different from those observed in Caucasians,in whom anti-HPA-5b and-1b are the most prevalent specificity.The most prevalent platelet-specific antibodies are anti-HPA-3 and anti-HPA-5 while anti-HPA-4b and anti-HPA-2b are also detected.

It is an important approach for CAD/CAM of prosthetic sockets to establish digital model of residual lower limbs from amputees. In this thesis, ultrasonic imaging technology is utilized to extract the internal and external contours of residual lower limbs for their 3D modeling , and an ultrasound measurement system is developed.

Objective To discuss the effect and possibility of NIPPV in ILD combined with respiratory failure. Methods A total of 37 cases of ILD combined with respiratory failure admitted by our hospital during Feb 2004 to Oct 2007 were divided into treatment group (20 cases) and control group (17 cases). Routine pharmaceutical intervention was adopted in both groups while NIPPV was given in the patients of treatment group. The symptoms、signs and the arterial blood gases were observed and analyzed. Results Among 20 patients,3 gave up treatment , 17 patients were successfully treated with the NIPPV therapy. There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h NIPPV. Conclusion NIPPV is an effective method for ILD combined with respiratory failure,which can save the patients life and decrease the complications.

Objective To investigate the therapeutic effect of ambroxol in bleomycin-induced pulmonary fibrosis of rats.Methods Sixty Wistar rats were divided into three groups:The normal control group(group N),the model group treated with bleomycinA5(group B)and the group treated with ambroxol(group A).Pulmonary fibrosis was induced by intratracheal instillation of bleomycin.Then the rats received daily ambroxol 35mg/kg(group A),or normal saline(group B).Five rats in each group were killed on 3.7.14 and 28 days after intratracheal instillation.Histological changes of the lungs were evaluated by HE stain and Masson's trichrome stain.The levels of tumor necrosis factor-?(TNF-?)in lung homogenates were measured by radioimmunoassay.Results Pulmonary fibrosis of Group A was significantly improved as compared with that of Group B(P

Objective To discuss the effect and feasibility of BiPAP in refractory asthma patients. Methods A total of 15 coses of refractory bronchial asthma admitted by our hospital during Feb 2003 to May 2006 were treated by BiPAP in addition to medical therapy。 The symptoms、signs and the arterial blood gases were observed and analyzed。Results Among 15 patients,2 gave up treatment,13 patients were successfully treated with the BiPAP therapy。There were significant improvement of PaCO2、PaO2、pH and respiratory rate ,heart rate after 2h BiPAP。Conclusions Ventilation in BiPAP is an effective method for refractory asthma ,which can save the patients life and decrease the complications.

BACKGROUND:The mechanism of differentiation and proliferation of bone marrow-derived mesenchymal stem cells remains unclear. In addition, issues such as how signal pathways such as Ca2+and bone marrow-derived mesenchymal stem cellproliferation and differentiation signals form complex signal network remain poorly understood.
OBJECTIVE:To investigate the effect of Ca2+in the induced differentiation of bone marrow-derived mesenchymal stem cells into hepatocytes.
METHODS:Bone marrow-derived mesenchymal stem cells were isolated from rat bone marrow using whone bone marrow adherence method, purified, amplified, and induced with hepatocyte growth factor. [Ca2+]i in the directional differentiated bone marrow-derived mesenchymal stem cells and control bone marrow-derived mesenchymal stem cells were detected with flow cytometry. Bone marrow-derived mesenchymal stem cells induced with hepatocyte growth factor were mixed with nimodipine of different concentration, and cells were divided into three groups:hepatocyte growth factor+nimodipine 10 mg/L, 50 or 100 mg/L groups. cellgrowth was observed with inverted phase contrast microscope and alpha 1-antitrypsin expression of the cells was confirmed by immunocytochemistry. The calcineurin M and the activation of extracellular signal regulated kinase pathway was detected by reverse transcription-PCR and western blotting, respectively.
RESULTS AND CONCLUSION:[Ca2+]i in the directional differentiated bone marrow-derived mesenchymal stem cells was higher than in the control group (P<0.05). After addition of a larger dose of nimodipine, no differentiation of cells was obeserved and growth of bone marrow-derived mesenchymal stem cells was getting worse. There were few alpha 1-antitrypsin positive cells in the nimodipine groups. Calcineurin Mexpression was significantly increased in directional differentiated bone marrow-derived mesenchymal stem cells and smal dose of nimodipine than the controls (P<0.05). However, no significant difference was found among middle, high dose nimodipine and control groups (P>0.05). These findings indicate that Ca2+could participate in the differentiation of bone marrow-derived mesenchymal stem cells into hepatocytes incuded with cytokines, and also maintain the survival and proliferation of bone marrow-derived mesenchymal stem cells.

Objective In the prosthetic socket design process, the high cost and radiation deficiency caused by CT scanning which is a routine way to obtain the cross section image of the residual limb remain problems. Ultrasonic measuring approach is proposed to gain the bones and skin contour of the residual limb. MethodsAn ultrasonic measuring device to get the multiple ultrasonic images of the residual limb was developed firstly, a compound algorithm to reconstruct the multiple images into 2D image was designed, and then the feature extraction on the bones and skin was made. Results Conclusion Comparing with the like-kind cross sectional scanning technique, the ultrasonic measuring method has the characteristic of no radiation and low cost.

BACKGROUND: The peripheral blood stem cell is a multi-differentiation precursor cell, and it can differentiate into osteoblasts. Tissue engineered bone, which is regarded as a vector of cell transplantation, has good compatibility with receptor tissue and seed cells. Transforming growth factor-β (TGF-β) is an important regulatory factor for repairing bone injury. Additionally, TGF-β can induce peripheral blood stem cells to differentiate and proliferate into osteoblasts.OBJECTIVE: To study TGF-β expression in repairing alveolar bone during synergetic transplantation of peripheral blood stem cells and tissue engineered bone. DESIGN: Observational study.SETTING: Stomatology Hospital of Xi'an Jiaotong University.MATERIALS: This study was performed at the Stomatology Hospital of Xi'an Jiaotong University from 2003 to 2006. Experimental animals were provided by the Animal Experimental Center, Medical College of Xi'an Jiaotong University (original Xi'an Medical University). All animals were intramuscularly induced with ketamine, intramuscularly anesthetized with sumianxin, and then sacrificed for surgery. The experiment was approved by the local ethics committee.METHODS: Peripheral blood stem cells were extracted from dog and prepared as a cell suspension. Iliac bone was obtained from healthy pig to prepare decalcifying-deproteinic tissue engineered bone. The tissue engineered bone was then dipped into peripheral blood stem cell suspension. Ten healthy hybrid dogs were randomly divided into an experimental group and a control group, with 5 dogs in each group. An incision was made from left to right along the canine teeth of the lower mandible, along the lip, lateral to the gingival sulcus, to the alveolar crest, and then along the bilateral vestibular groove to form a trapezoid segment. Subsequently, the segment was turned downward to expose the bone lamella lateral to the lip. In addition, a bone defect region of 2 cm × 2 cm × 1 cm was drilled between the lateral incisor of lower mandible using a turbine drill. Peripheral blood stem cell-tissue engineered bone was implanted in the experimental group but tissue engineered bone only was implanted in the control group. At 2, 3, 4, 8 and 12 weeks after surgery, during the differentiation and proliferation of peripheral blood stem cell into osteoblasts, TGF-β expression was measured using immunohistochemistry.MAIN OUTCOME MEASURES: ① Morphological changes of peripheral blood stem cells differentiating into osteoblasts and structural function of organoid were observed under optical microscopy and by transmission electron microscopy. ② TGF-β expression was measured using immunohistochemistry during the differentiation and proliferation of peripheral blood stem cells into osteoblasts.RESULTS: Two weeks after peripheral blood stem cell-tissue engineered bone transplantation in the experimental group, TGF-β expression was mildly positive at the fringe of the bone defect. Four to eight weeks after the transplantation, high numbers of osteoblasts, fibroblasts and collagenous fibers were found at the center of the bone defect region, and TGF-β expression was strongly positive. The bone defect was completely repaired after 12 weeks. In the control group, 8-12 weeks after tissue engineered bone transplantation, TGF-β expression was mildly positive only at the fringe of the bone defect. CONCLUSION: During dog alveolar bone defect repair, TGF-β can induce peripheral blood stem cells, in combination with tissue engineered bone, to differentiate and to proliferate into osteoblasts.

Objective To evaluate the effect of obesity on the potency of propofol for sedation.Methods Sixty patients of both sexes, aged 35-55 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective operation under general anesthesia, were enrolled in the study.The patients were divided into 2 groups (n=30 each) according to the body mass index (BMI) : normal body weight (BMI ＜ 25 kg/m2) group (group C) and obesity (BMI 30-40 kg/m2) group (group O).No patients received premedication.Propofol was given by target-controlled infusion.The initial target plasma concentration of propofol was set at 1.2 μg/ml.After the target concentration was steadily maintained for 30 s, it was increased in 0.3 μg/ml increment until the patients lost consciousness (OAA/S score =1).The target plasma concentration of propofol was recorded during each period.The median effective concentration (EC50) and 95％ confidence interval of propofol for loss of consciousness was calculated using probit analysis.Results The EC50 and 95％ confidence interval of propofol for loss of consciousness were 3.82 (3.73-3.90) and 3.29 (3.20-3.37) μg/ml in group C and group O, respectively.Compared with group C, the EC50 was significantly decreased in group O (P＜0.05).Conclusion Obesity can enhance the potency of propofol for sedation.

Objective To evaluate the accuracy of stroke volume variation (SVV) in monitoring the changes in blood volume during laparoscopic surgery.Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,with body mass index ranged from 20 to 25 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were studied.After induction of general anesthesia,baseline registrations of variables were obtained.After establishing pneumoperitoneum,6％ hydroxyethyl starch (HES 130/0.4) 500 ml was infused over 30 min.Before pneumoperitoneum (T1),at 5 min after pneumoperitoneum (T2),immediately before volume expansion (T3) and at 3 min after volume expansion (T4),cardiac output (CO),cardiac index (CI),SV,stroke volume index (SVI) and SVV were monitored and recorded.The changing rate of CI (△CI) was calculated.The criterion for effective volume expansion was △CI ≥ 15％.The ROC curve for SVV in determining the volume expansion responsiveness was plotted,and the diagnostic threshold was determined.The area under the curve and 95％ confidence interval were calculated.Results SVV was significantly lower at T2 than at T1.CO,CI,SV and SVI were significantly higher,and SVV was lower at T4 than at T3.The results of ROC curve analysis showed that a 9.2％ SVV threshold discriminated between responders and non-responders with a sensitivity of 61％ and a specificity of 50％,and the area under the curve (95％ confidence interval) was 0.567 (0.378-0.757).Conclusion SVV is not a suitable index in monitoring the changes in blood volume during laparoscopic surgery.