Objective To investigate the clinical characteristics of vaccine-associated immune thrombocytopenia(VA-ITP)based on the US Vaccine Adverse Event Reporting System(VAERS), and to provide a reference for vaccine safety monitoring, vaccination prevention, and clinical diagnosis and treatment.Methods Data from VAERS on all reported cases of immune thrombocytopenia(ITP) after vaccination since the establishment of the database in 1990 to the data lock point of 7th November 2023 were analyzed retrospectively for information on such as sex, age, vaccine type, vaccine dose, and occurrence time of ITP.Results Among the 877 cases of VA-ITP, there were 868 cases of effective statistical vaccine types, involving 43 vaccine types. The top 10 vaccine types were COVID-19 vaccine(434 cases, 50%), MMR vaccine(82 cases, 9. 4%),HEPA vaccine(48 cases, 5. 5%), FLU3 vaccine(41 cases, 4. 7%), FLU4 vaccine(32 cases, 3. 7%), HPV4 vaccine(30 cases,3. 5%), DTAP vaccine(29 cases, 3. 3%), MMRV vaccine(32 cases, 3. 7%), VARZOS vaccine(17 cases, 2. 0%) and HPV9vaccine(13 cases, 1. 5%). Among the 877 reported cases, 843 cases with definite sex were counted, including 374 males and469 females, with a male-to-female ratio of 1∶1. 25. The 377 cases of patients were under 18 years of age, accounting for about 44. 7% of the total, and there was significant difference in the composition ratio of sexes among patients with VA-ITP at different ages(χ~2= 10. 029, P < 0. 05). The incidence of ITP within 8 days after vaccination, with a total of 336 cases, was39.9%, and there was no significant difference in the occurrence time composition ratio of ITP between different sexes(χ~2=3. 296, P > 0. 05). The 54. 9% of ITP occurred after the first dose of vaccine, and there was no significant difference in the composition ratio of different vaccination doses between male and female recipients(χ~2= 5. 323, P > 0. 05), but there was significant difference in the composition ratio of vaccination doses among different age groups(χ~2= 30. 591, P < 0. 01).Conclusion By analyzing the summary data from VAERS database, the adverse reaction of VA-ITP was fully recognized.After clinical vaccination, attention should be focused on the platelet status of minors and the elderly, as well as those who were vaccinated within 8 days, and the continuous vaccine safety monitoring should be carried out, which is helpful to reduce the missed diagnosis of vaccine adverse events(AE) and improve the efficiency of clinical diagnosis and treatment.

Objective To investigate 16-slice spiral CT findings of bony canals of the internal auditory canal ( IAC ) fundus withmultiplanar reformation (MPR) and provide evidence for dignosis of lesions in the IAC fundus and surgery.Methods CT scan of thetemporal bone was performed in 30 volunteers. Bony canals of the IAC fundus were measured in images acquired with MPR.Results The mean?SD measurements (in mm) of the anteroposterior diameter and superoinferior diameter of fundus of the IAC was (4.07?0.97) mm and (3.24?0.88) mm respectively. The mean?SD measurements (in mm) of the length and width of bony canal for the labyrinthinesegment of the facial nerve was (3.04?0.52) mm and (0.96?0.31) mm, respectively. The mean?SD measurements (in mm) of the length and width of bony canal of the superior vestibular nerve was (2.52?0.48) mm and (0.83?0.30) mm respectively. The mean?SD measurements (in mm) of the length and width of bony canal of the cochlear nerve was (0.89?0.19) mm and (2.05?0.39) mm respectively. The mean?SD measurements ( in mm ) of the length and width of bony canal of the inferior vertibular nerve was ( 1.07?0.23 ) mm and (0.73?0.21) mm respectively. The mean?SD measurements ( in mm ) of the length and width of singular canal was (3.56?0.68) mm and (0.56?0.11) mm respectively . Conclusion MPR with 16-slice spiral CT can demonstrate the shape and measurements of the IAC fundus,which would contribute in dignosis of lesions in the IAC fundus and surgery.

Objective To observe the effects of misoprostol on the reduction of postpartum bleeding in cesarean section.Methods With oxytocin as control,the amount of bleeding during and two hours after cesarean section was observed.Results The mean amount of bleeding was (232.0±46.6) ml in misoprostol group and (385.0±74.7) ml in oxytocin group respectively.The difference between the two groups was significant (P＜0.01).Conclusion Misoprostol is more effective to improve uterin contraction than oxytocin and is better in the reduction of postpartum bleeding with safety and convenience.

Objective To investigate diagnostic value of CTA for traumatic pseudoaneurysms (TPA) in the cavernous segment of the internal carotid artery (ICA) when they rupture into the sphenoid sinus. Methods CTA of 7 patients with TPA in the cavernous segments of ICA verified by DSA were retrospectively analyzed. All the patients were performed CTA scanning. The post-processing techniques included VR,MIP,MPR, and CPR. Results All the CTA images of 7 patients showed irregular mass in the sphenoid sinus with obviously enhancement in the same phase to ICA, which communicating with ICA in wide base. The peripheral area of the mass showed no enhancement. The size varied from 3 mm × 2 mm × 1 mm to 33 mm × 30 mm × 27 mm. The adjacent lateral wall of sphenoid sinus showed fractures in all cases. TPA located at anterior-knee segments of cavernous ICA in 6 cases, and cavernous free segment in 1 case. All the disruptions were found at medial or anterior medial wall of ICA. Conclusions Cranial CTA is the effective non-invasive method for diagnosing TPA in the cavernous segment of ICA when they rupture into sphenoid sinus. Combined using of VR, MIP, MPR, and CPR can delineate the location and size of the sphenoid wall fracture and the ICA rupture, which help to clarify the anatomical relationship between them.

Objective To study the correlation with ketamine and its metabolite norketamine concentration in plasma and saliva in acute toxic rabbits.Methods Experimental rabbits were given intragastric(i.g.group,n=6)and intravenous(i.v.group,n=6)administration of ketamine respectively,and control tabbits(n=6)were given a same volume of physiologic saline.The plasma and saliva were collected before and after ketamine administration.Ketamine and norketamine in plasma and saliva were determined using GC/MS and GC.The correlation with ketamine(norketamine)concentration in plasma and saliva were artalyzed by a double variable Pearson correlation analysis.Results The correlation coefficients(r)of ketamine (norketamine)concentrations in plasma and saliva were from 0.80 to 0.95 in ketamine i.g.group and i. v.group.Conclusion There is a good relativity between the concentration of ketamine(norketamine)in plasma and in saliva.The ketamine(norketamine)concentration in saliva can be used to estimate the plasma concentration in the forensic identification of ketamine abuse.

Objective To study the MRI features of nasopharyngeal carcinoma (NPC) in patients who presented with ocular abnormalities. Methods The clinical signs and MRI features of Ⅲ, Ⅳ and/or Ⅵ cranial nerve involvement in 22 cases of histologically proved nasopharyngeal carcinoma were retrospectively analyzed. Results All 22 cases showed perineural tumor spread along the course of Ⅲ, Ⅳ and Ⅵ cranial nerve. Diplopia was the most common sign, occurred in 14/22 patients. The incidence of incomplete palsy of Ⅲ, Ⅳ and Ⅵ cranial nerve were 16/44, 7/44 and 4/44, respectively. There were four types of abnormal MRI findings: cavernous sinus thickening (10/44) and mass ( 16/44), superior orbital fissure enlargement (4/44) and abnormal signals (9/44), thickened oculomotor muscles with obscured adjacent fatty space and abnormal enhancement (10/44). The dynamic contrast enhancement patterns of the masses in cavernous sinus and orbital were the same as that of nasopharynx lesions; all appeared as rapid initial enhancement followed by a plateau phase. Conclusion Oculomotor nerve involvement can be the first clinical signs of NPC, and MRI can show the perineural extension along the Ⅲ, Ⅳ and Ⅵ cranial nerve in NPC.

Objective To find a better method to reconstruct total ear in one stage. Methods In the procedure, a compound framework was formed, in which Medpor acted as ear framework and homogenous rib cartilage as helix-framework after being sculptured, then they were vamped together. The formed framework was covered with adjacent skin flap and homogenous skin graft after it had been covered with superficial temporal fascia flap. Results From January 2001 to Augest 2003, 8 cases of congenital microtia or antotia were treated in this way, and all of them obtained satisfactory appearance in auricle. Conclusion The reconstructed ear has a delicate structure and good appearance, and looks and feels as a real one by this new procedure.

Objective To investigate the value of CT and MRI in diagnosing nasopharyngeal angiofibromas.Methods 18 cases of nasopharyngeal angiofibromas were retrospectively analyzed including the location, density ,signal intensity, extension of tumors and changes of surrounding bones.Results 16 cases located in the area around sphenopalatine foramen. 6 cases exhibited homogeneous density on CT scans(6/11 cases) and 12 cases displayed inhomogeneous signal intensity on MR scans(12/14 cases). All the Fourteen MRI examinations revealed vice signal by vessels, inhomogeneous enhancement and extensive invasion along the foramina or fissures.Conclusion MRI not only determines the location and traces out the extension of nasopharyngeal angiofibroma more exactly, but also displayes its diagnostic signal fashion. Namely MRI has greater value in diagnosing this tumor than CT.

Objective To evaluate the effect of bone marrow stem cells (BMSCs) transplantation in the treatment of hepatolenticular degeneration of liver fibrosis. Methods Sixty cases with confirmed hepatolenticular degeneration of liver fibrosis were randomly divided into 3 groups: penicillamine group [40 mg/(kg·d)], BMSCs group and BMSCs + penicillamine group. Autologous BMSCs (2 mL) were injected into vein with normal saline (100 mL). Liver tissue pathology biopsy was inspected and the changes in HA, PCⅢ, LN, CⅣ, TIMP-1 and MMP-1 were observed at 0, 4th, 8th and 12th week during the therapeutic process. Results The level of serum fibrotic markers were reduced in every group , while the changes in BMSCs + penicillamine group were especially obvious (P < 0.05). Conclusion Penicillamine combined with BMSCs was effective in the therapy of hepatolenticular degeneration of liver fibrosis.

Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.