Objective Clinical research was made to observe the relationship between idiopathic thrombocytopenic purpura(ITP)and Helicobacter pylori(ITP)and to evaluate the effect of HP eradication in the treatment of chronic ITP.Methods ~(14)C urea breath test were made in 17 patients with chronic idiopathic thrombocytopenic purpura,including 6 males and 11 females,aging from 15-48,with course of disease from 4 months to 8 years.Omeprazole,clarithromycin and amoxicillin were used for Helicobacter pylori eradication,and the effect was evaluated by platelet count.Results Thirteen out of 17 patients were HP positive,and eleven turned negative after HP eradication,eight of whom were observed platelet recovery.Conclusion Platelet count can be raised in some patients with chronic ITP after eradication of Helicobacter pylori.

Considering technology,regulations and other factors,nowadays we still use the records of print instead of in digital.《Electric Signature Law》makes a new environments for the study of electric medical records system.It regulates the writing,originally form and the save of electric medical records,affirms its value of evidence in court and prescribes what is dependable electric signature.

By analying the relationship between the construction of the periodical and the management of the medical quality, the author explained the positive effect of strengthening the former on level raising of the latter, She also proposes that the value of the periodical can be raised by the quality construction including superiority orientation and creativity development. In this way we will raise the additional value of the management of medical quality and provide a high-level information platform for the quality mangement of hospital.

Objective To morphologically evaluate the bone marrow (BM) smear specimens collected from the patients with chronic myelogenous leukaemia (CML) in accelerated phase and blastic phase receiving a short term Gleevec therapy, and to determine its clinical significance in evaluating the changes in disease condition to guide the treatment. Methods Sequential BM smear specimens of 16 Ph positive CML patients, including 9 in accelerated-phase and 7 in blastic-phase, were examined before and 3,6 and 9 weeks after Gleevec treatment (0.4/d or 0.6g/d, PO) with routine method. Periodic acid-Schiff reagent (PAS) staining was performed for a proper identification of abnormal erythroid precursor cells. Results The treatment rapidly caused following conspicuous BM changes in the process: both cellular proliferation and neutrophil granulopoiesis decreased significantly, while the accumulation of erythroid precursor cells increased obviously, and megakaryocytes decreased markedly at 3rd week. A few patients showed no such changes, but an accumulations of erythroid precursor cells, leading to misdiagnosis in some one third of the patients. In 21 percent of patients, in whom no erythroid cells were found, were classified into accelerated phase and blast phase based on both WHO classification system and FAB system. In fact the increase in red system was a bone marrow response to anemia caused by Gleevec therapy. If a condition of severe cellular proliferation of BM with a lower WBC and platelets appeared, most patients could not tolerate the therapy, then it should be ceased. Conclusion Initial treatment with Gleevec therapy exerts pronounced changes in BM morphology, which can be used as a simple and effective method to evaluate the outcome of the patients.

Objective To establish a method for detecting chimerism after allogeneic stem cell transplantation using microsatellite polymorphism. Methods DNA was extracted from bone marrow or peripheral blood of 10 recipients and their donors, DNA fragments including 5 microsatellite loci were amplified by PCR, the polymorphism of PCR products was analyzed by PAGE and sliver staining, and the quantitative analysis of chimerism was performed using image analysis software. Results [WTBZ]The five selected STR loci had high polymorphism, and were suitable for detecting chimerism. The sensitivity of sliver staining was 90%. Conclusion Microsatellite polymorphism analysis based on PCR is a sensitive and accurate method to detecting chimerism after allogeneic stem cell transplantation, but the sensitivity of sliver staining was not so good,so more sensitive methods should be used.

Objective To sum up the experience of nursing patients with spinal tuberculosis combined with open pulmonary tuberculosis? Methods Preoperative nursing was done to 16 patients with spinal tuberculosis combined with open pulmonary tuberculosis to enhance their medical appliance? The careful postoperative observations of conditions and incisions were done to prevent pulmonary infections? Results Of the 16 patients,15 were well cured and 1 was discharged with antituberculotics for home treatment due to refusing to transfer to other hospitals for financial reason? Conclusion The enhanced perioperative health education and nursing is significant for the success of the operations and rehabilitation of the disease?

Objective To explore the application of particle-gun technique in transfecting dendritic cells(DCs),and investigate the expression of DNA vaccine particle IgHV1-GM-CSF in DCs induced by particle-gun.Methods Monocytes were isolated from donor peripheral blood collected by Ficoll density gradient method and adherent culture,and then differentiated into immature DCs(imDCs) by rhGM-CSF and rhlL-4 induction.The plasmids for transfection were IgHV1-GM-CSF/pcDNA3.0 and pEGFP,which were prepared with endofree plasmid purification kit.The DCs were transfected with plasmid pEGFP by particle-gun at different transfection conditions,the green fluorescence positive cell and the total cell numbers were counted respectively under fluorescence microscope,and the transfection efficiency was calculated;the viable cell count was performed after trypan blue staining;the transfection efficiencies of particle-gun,liposome-mediated transfection and electroporation method were compared.The plasmids IgHV1-GM-CSF/pcDNA3.0 and pEGFP were cotransfected into imDCs by particle-gun under the optimum conditions,and then DNA was extracted,the expression of IgHV1-GM-CSF was determined by RT-PCR,and of GM-CSF by ELISA.Results The optimum conditions of particle-gun transfection in imDCs were: gas pressure at 120psi,PVP concentration in 0.02mg/ml,microcarrier loading in 0.5mg gold/shot,and DNA loading ratio in 1.5?g plasmid/mg gold.The transfection efficiencies of particle-gun and electroporation were 10.5%?2.4%(n=3) and 45.2%?5.6%(n=3) respectively,while that of liposome-mediated transfection was very low,and significant difference existed among the three methods(P

Objective To investigate the therapeutic outcome and its influencing factors after laparoscopic conservative surgery in treatment of tubal pregnancy. Methods From January 2003 to December 2008, 226 cases with tubal pregnancy were treated by laparoscopic conservative surgery. The tubal pateacy was evaluated in 152 cases given by hysterosalpingography (HSG) and 6 cases given by second laparoscopic exploration at 3-6 months after surgery. In their first laparoscopic surgeries, 209 got successful treatment and 19 underwent fail treatment. At 3-6 months after surgery, 89 cases with tubal patency among 207 cases with successful treatment were enrolled in group A. Nineteen cases who were failed in their first laparoscopic conservative surgery and treated by salpingectomy and 63 cases with tubal obstruction were enrolled in group B. The rate of tubal patency was calculated on patients with characteristics of gestational sac less or more than 5 era, the level serum human chorionic gonadotropin (hCG) less than 2000 IU/L,2000 IU/L to 5000 IU/L, and more than 5000 IU/L Results There was no significant difference in age,parity, amenorrhea, location of tubal pregnancy, rupture, pelvic adhesion between group A and group B.Two hundred and seven cases (91.6%, 207/226) were successfully treated at initial laparescopy. One hundred and fifty-two cases got follow up and 55 cases lost follow up at 3 to 6 months after surgery. There was statistical difference in preoperative hCG value which median were 980 (55-12 000) IU/L in group A,3150 (570-40 000) IU/L in group B(P<0.01); the diameter of tubal gestational sac were (3.4±1.3)cm in group A and (5.0±1.7) cm in group B(P<0.01); respectively, the volume of peritoneal bleeding were 200 (0-1500) ml and 300 (0-1600) ml, the rate of live tubal embryo was 2% (2/89) in group A and 11% (9/82) in group B, which all reached statistical difference (P<0. 05). Among 171 cases in both group A and 8, the rate of tubal patency were 65% (67/103) in 103 cases with maximal diameter of tubal gestational sac less than 5 cm and 32% (22/68) in 68 cases with maximal diameter of tubal gestational sac more than 5 cm, which reached statistical difference (P < 0.01). The rate were 72% (73/102) in patients with serum level of hCG less than 2000 IU/L, 29% (12/42)in patients with 2000 IU/L to 5000 IU/L and 15% (4/27)in patients with more than 5000 IU/L, which also showed statistical difference (P <0.05). It was observed that preoperative serum hCG level (OR=0.277, P<0.01), the maximal diameter of gestational sac (OR=0.577, P<0.01) and the volume of peritoneal bleeding (OR=0.999, P < 0.05) were significant factors influencing successful laparoscopy treatment by logistical regression analysis.Conclusion In order to preserve fertility, laparoscopic conservative surgery was a safe and feasible approach in treatment of tubal pregnancy. Preoperative serum hCG levels, size of tube gestational sac were significant factors influencing successful laparoscopic surgery.

Objective To study the curative effect of internal thoracic arterial chemoembolization in the treatment of advanced lung cancer.Methods Internal thoracic artery was confirmed to be the main supplied artery by digital substraction angiography(DSA) in 8 cases with lung cancer. The internal thoracic artery was embolized by stainless steel coil below the supplied segment in order to avoid the normal vascular territory occlusion.Then iodized oil combined with Cis-Diaminedichloroplatinum(DDP) and mitomycin(MMC) were injected into the supplied segment slowly until blood flow stopped,at last,the gelfoam sponge sheet was inserted into this supplied segment to decrease the wash of iodized oil by blood flow.Results Clinical symptoms were improved obviously in all cases after therapy.CT scans showed that iodized oil accumulated in the tumor better four weeks after the chemoembolization. Conclusion For these cases with advanced lung cancer which the blood supply mainly by internal thoracic artery,it is necessary to perform chemoembolization.

Objective To investigate the expression of p53,VEGF,E-cad,CK20 and its clinical meanings in bladder transitional cell carcinoma. Methods The specimen microarrays and immunohistochemistry were applied to detect selected cancer-related protein expression in 45 cases of bladder TCC and 8 cases of normal control. Results Abnormal expression of p53,E-cad and CK20 were detected 100.0%,55.6%,55.6% respectively in bladder TCC group,which were expressed normally in control group with significant differences.However,there was no VEGF expression differences between those 2 groups (87.5% v.86.7%).Abnormal expression intensity of p53 and expression rate of E-cad were closely related to the pathological features.CK20 expression was co-related positively with disease staging rather than grading.VEGF played less role in co-relating with pathological features. Conclusions p53,E-cad and CK20 play an important roles in the development of bladder TCC,and VEGF plays less.Microarrays is suggested to detect a large scale of specimen for multiple proteins,it is effective.