Objective To study the clinical significance of a novel marker of platelet clumps count provided by hematology analyzer in differentiating true thrombocytopenia from EDTA-dependent pseudothrombocytopenia (EDTA-PTCP). Methods Samples from 65 cases of thrombocytopenia (including 15 EDTA-PCTP samples and 50 random samples of true thrombocytopenia) and 50 healthy controls were analyzed using hematology analyzers, and samples with low platelet counts were checked by replacing citric acid and using manual microscope observation to identify true thrombocytopenia from EDTA-PTCP. A novel marker of platelet clumps count was used to differentiate the two diseases for samples anficoagulated with EDTA or citric acid. Results In 65 patients with thrombocytopenia, platelet counts were (48±11)×109/L detected by automatic hematology analyzers. Fifty of 65 cases were true thrombocytopenia which showed low platelet counts [(48±10)×109/L by automated analyzer and (46±11)×109/L by manual assay]. No significance was observed between them (t=-1.26, P0.05). Platelet clumps counts were 86±15. No platelet clamps were detected under microscope. The other 15 cases were EDTA-PTCP [platelet counts were (48±12)×109/L and platelet clumps counts (840±184) were increased significantly by automated analyzer and using EDTA anticoagulant] which showed obviously platelet clumps and no less platelet counts under microscope. After replacing citric acid, platelet counts [(141±13)×109/L by automated analyzer and (134±17)×109/L by manual microscope assay] were increased significantly. No significance was observed between them (t=-1.29, P0.05). Platelet clumps counts (75±12) were decreased obviously compared with EDTA anticoagulant method (t=-6.82, P<0.001). No platelet clumps were detected under microscope. Conclusion Platelet clumps counts may be a useful clinical indicator for monitoring of platelet aggregates, especially for EDTA-PTCP caused by platelet clumping.

Objective To observe the effect of 6% hydroxyethylstarch (130/0.4) on hemorheology in patients with acute myocardial infarction (AMI) complicated by shock before and after early fluid resuscitation. Methods 72 AMI patients complicated by shock were randomly divided into two groups , namely groupⅠwith 6%hydroxyethylstarch (130/0.4) for early liquid resuscitation and group Ⅱwith balanced salt (1.86% sodium lactate solution and compound sodium chloride solution for a ratio of 1∶2 ) for liquid recovery; and another 36 subjects was assigned to normal control group (groupⅢ). The hemorheological indices were detected after admission and 2 to 3 hours after fluid resuscitation in groupsⅠandⅡ. Results After fluid resuscitation , high-and low-shear viscosity , red cell aggregation index, hematocrit, fibrinogen, and platelet aggregation rate decreased in groupⅠand groupⅡ, with significant statistical differences (P < 0.05 and P < 0.01). Conclusions 6% hydroxyethylstarch (130/0.4) can effectively improve abnormal hemorheology in patients with AMI complicated by shock.

[Objective]To measure adult normal femur specimen in order to obtain accurate femoral resection and match the distal femoral in total knee arthroplasty.[Method](1)Forty-seven adult normal femur specimens of central Chinese were used for taking digital pictures in both anteroposterior and medialateral position.Five angles were measured through drawing lines of fixed point.(2)The exact position of the entry point was defined by the two wires on the specimens.[Result](1)The five angles reflect distal femoral anatomy features on the frontal plane and sagittal plane.(2)The mean value of distance from the entry point to the center of the intercondylar notch was 6.21 mm and the distance from the entry point to the anterior margin of the femoral posterior cruciate ligament(PCL) insertion is found to be 6.7 mm.[Conclusion](1)The distal one-third of femora was found to be outward bowing on frontal plane and forward bowing on Sagittal plane.Especially,the forward bowing is more remarkable than Outward bowing.So,when the position of intramedullary guide stick is decided by distal femoral anatomy,the axis alignments on frontal and Sagittal planes are both important.(2)During total knee afthroplasty the exact position of entry point may be defined by the Center of the intefcondylar notch and femoral PCL insertion.

[Objective] To evaluate the effect of Bushen Yixin Tablet (BYT) on blood pressure (BP) and hemorrheology in rats with hypertension. [Methods] Rat models of hypertension were established by constricting either of the bilateral renal arteries with one clip. Sixty rats were randomly allocated to high - dose BYT group (Group A), low - dose BYT group (Group B), nitrendipine (Group C) and normal saline group (Group D) . Ten rats served as mimic group (Group E) . BP of tail artery was examined in various groups and after a 4 - week treatment, whole blood viscosity and indexes of erythrocyte aggregation (EA) and erythrocyte deformation (ED) were detected. [Results] BP was increased, high- , middle - and low - shear whole blood viscosity and EA index were elevated and ED index was decreased in model rats as compared with those of the normal. After treatment, BP and whole blood viscosity were reduced and ED index was increased in Group A, Group B and Group C, and EA index in Group A was lowered as compared with those in Group D (P

Objective To investigate the clinical and electromyographic features of peripheral nerve involvement in MS. Methods The clinical and electromyographic (EMG) data of 29 MS patients were evaluated retrospectively.Results 18 (62.1%) patients showed clinical and/or electromyographic abnormalities of peripheral nerves. The clinical symptoms included extremity numbness in 16 cases (88.9%), limb inertia in 11 cases (61.1%), radicular pain in 5 cases (27.8%), autonomic nerve disorder and dysphagia in few patients. Signs included decrease of tendon reflex in 11 cases (61.1%), periphery or root form hypoesthesia in 9 cases (50%), muscle weakness in 7 cases (38.9%), myatrophy in 4 cases (22.2%), and reduced pharyngeal reflex in 1 case (5.6%). There was no difference in age of onset, course of disease, neurologic impairment and prognosis between the patients accompanied with peripheral neuropathy and the patients without peripheral neuropathy. The electromyographic abnormalities included spontaneous potential in 4 cases (13.8%), increased motor unit potential in 8 cases (27.6%), slow MCV in 15 cases (51.7%), slow SCV in 13 cases (44.8%), low amplitude in 9 cases (31.1%), and prolonged distal latency in 5 cases (17.2%). The neuropathies improved by treatment with corticosteroid in the all patients except one.Conclusions Some MS patients may accompany with peripheral nerve abnormalities, which may improve with the recovery of MS. EMG is useful to evaluale the site and degree of peripheral nerve damage.

Acetamides ; adverse effects ; Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Case-Control Studies ; Humans ; Liver ; drug effects ; metabolism ; pathology ; Liver Diseases ; epidemiology ; Middle Aged ; Occupational Exposure ; adverse effects ; Young Adult

Adolescent ; Adult ; Boron ; adverse effects ; Humans ; Male ; Occupational Exposure ; Sperm Count ; Sperm Motility ; drug effects ; Spermatozoa ; drug effects

AIM:To observe and analyze the change of visual field and retinal nerve fiber layer thickness of primary open-angle glaucoma ( POAG ) after the Ex-press glaucoma shunt implantation.
●METHODS:A total of 14 patients (24 eyes) with POAG were underwent Ex-press glaucoma shunt implantation. Visual acuity, intraocular pressure ( lOP ) , mean defect ( MD) , pattern standard deviation ( PSD ) , retinal nerve fiber layer thickness ( RNFLT ) , and corneal endothelial cell number were collected preoperatively. Visual acuity and lOP were collected in 1wk, 1 and 3mo postoperatively respectively. Also, MD, PSD, RNFLT, and corneal endothelial cell number were collected preoperatively and 3mo postoperatively respectively. Complication, the additional treatment, success rate were analyzed.
●RESULTS:There was no significant difference (P>0. 05) in visual acuity preoperative and postoperative 1wk, 1, 3mo. Visual acuity did not significantly reduce after operation. Compared with preoperative, there was significant decreased (P<0. 05) in lOP after 1wk, 1, 3mo postoperative, respectively. lOP keep stead in postoperative 3mo. The reduction of RNFLT had significant difference (P<0. 05) between preoperative and postoperative 3mo. Compared with preoperation, MD and PSD had no significant difference ( P > 0. 05 ) after postoperative 3mo. Corneal endothelial cell number decrease had significant difference (Z=-2. 585, P=0. 01) between preoperative and postoperative 3mo. Success rate: complete success: 79. 2% ( 19 eyes ); partial success:8. 3% (2 eyes);failure:12. 5% (3 eyes).
●CONCLUSION: Ex-press glaucoma shunt implantation could efficiently decrease the lOP in POAG patients. Although it results in reduction of RNFLT in short time. The visual acuity and visual field keep stable after operation. lt is a safe and effective device for treating primary open-angle glaucoma.

Objective To study the imaging distribution feature and diagnostic value of high resolution computed tomography(HRCT)in peripheral lung cancer(PLC).Methods The feature of imaging distribution was analysed in 37 patients with PLC by pathological proved,which compared with those in 23 cases with lung benign nodules by selected randomly.A double blind method was taken on the manifestations of HRCT about lung nodules tumor-lung interface in near heart side and far heart side.①cloudy or/and shaggy②spiculate③smooth.To search and define the correlation between its distributing feature;manifestations of 3 kinds HRCT;alteration of segment level bronchus and lung benign malignancy nodules.Results Cloudy,or shaggy,spiculalte departing from heart side in lung-tumor interface by HRCT were observed in peripheral lung cancer(79%) and benign nodules(22%);smooth was observed in peripheral lung cancer(14%) and benign nodules(74%).Some cases possed simultaneously two or more than two kinds HRCT's signs.Incidence rate of emphraxis and stenosis signs of segment level bronchus in PLC was higher than that in benign nodules.Conclusion Asymmetry apo-tip dominant position distribution of cloudy or shaggy,and spiculate change of tumor-lung interface by HRCT played an important role in qualitative diagnosis of peripheral lung cancer(≤3.5 cm).The appearance reason relates with the bronchial ventilation that the lesion results in occlusion.

Objective To investigate the accuracy and the consistency with pathological diagnosis of confocal laser endomicroscopy (CLE) in real-time diagnosis of gastric malignancy and precancerous diseases.MethodsFrom January 2010 to March 2011, the out-patients and hospitalized patients of suspected gastric malignancy or precancerous diseases in Shanghai Ruijin Hospital were screened and undergone confocal laser endomicroscopy.Fluorescein sodium was used as fluorescent agent in the examination.A four-tiered diagnostic system was applied in the real time diagnosis with CLE images, and targeted biopsy was performed accordingly. Surgery was performed in CLE diagnosed or highly malignancy suspected patients.The diagnosis of common endoscopy, CLE and pathology was reviewed.ResultsA total of 160 patients were enrolled in this study, of those one patient withdrew because of fluorescin allergy and the rest 159 patients completed the CLE examination.A total of 194 lesions were inspected, among them, 130 cases each with one lesion, 23 cases each with two lesions and 6 cases each with three lesions.Overall accuracy rate of CLE was 93.3％ (181/194).And the sensitivity and specificity of CLE in gastric malignancy diagnosis was 93.6 ％ and 99.3 ％ respectively.Ideal correlation was identified between confocal laser endomicroscopy and final pathology results (Kappa=0.876).The incidence of marked fluorescin-related adverse events was only 0.6％ (1/160). ConclusionsCLE is consistent with histopathology and is helpful to make accurate diagnosis of gastric malignancy and precancerous diseases.It is important in early diagnosis of gastric malignancy and helps to avoid misdiagnosis and missed diagnosis.