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.

Otolaryngology

Objective To establish an appropriate cut-off value of high sensitivity cardiac troponin T (hs-cTnT) and optimal combination measurement in the early diagnosis of acute myocardial infarction (AMI).Methods This research is a prospective study.342 patients admitted to emergency department with chest pain,43 patients with renal failure,40 patients with pneumonia and 18 premature with patent ductus arteriosus were involved from June 2012 to June 2013 in Peking University Third Hospital.The plasma hs-TnT,NT-proBNP,cardiac troponin Ⅰ (cTnI),CK-MB and copeptin were measured.The distribution of hs-cTnT among associated diseases was analyzed,the diagnostic performance of hs-cTnT and the role of combination hs-cTnT with NT-proBNP,CK-MB and copeptin were evaluated by receiver operating characteristic (ROC) curve.The statistical method was used to calculate the Sensitivity,specificity,negative predictive value and positive predictive value of hs-cTnT in the diagnosis of AMI.Results As compared to patients with STEMI(median 0.52 μg/L,range 0.037-7.610 μg/L),hs-cTnT was lower in the patients with Non-STEMI(median 0.127 5 μg/L,range 0.021-4.260 μg/L).However,the levels of hs-TnT in other diseases were also increased increased in varyng degrees (Chi-square =76.432,P ＜ 0.05)The areas under the curve (AUC) for hs-cTnT and cTnI in the diagnosis of AMI were 0.862 (95％ CI:0.729-0.928) and 0.748 (95％ CI0.666-0.818) respectively (Z =2.713,P ＜ 0.05).Taking 0.014μg/L and 0.035 μg/L as cut-off value of hs-TNT,the sensitivities were 100％ vs 95.1％,the specificities were 44.4％ vs 65.7％.The combination of hs-cTnT,NT-proBNP,CK-MB resulted in a increase in AUC (0.915,95％ CI:0.838-0.964) (Z =2.147,P ＜ 0.05) and the combination of hs-cTnT and copeptin resulted in a increase in AUC 0.921 (95％ CI:0.820-0.975) (Z =2.589,P ＜ 0.05).Conclusion With the cut-off value of 0.035 μg/L for diagnosis of AMI was appropriate,and the combination measurement can improve the accuracy of early diagnosis of AMI.

Objective To develop a model that could copy the pathological development of psoriasis, the triple-transgenic mice that harboring Plasminogen activator, urokinase ( PLAU) ,PLAU receptor ( PLAUR) and signal transducer and activator of transcription 3 ( STAT3 ) were generated.They are the important genes involved in the pathological development of psoriasis.Methods The transgenic plasmid was constructed by insertion of the PLAU, PLAUR and STAT3 into the downstream bovine keratin 5 promoter respectively.The transgenic mouse was produced by microinjection and the genotyping was detected by PCR.The expression level of the transgenic gene was determined by Western blotting.The pathological changes were observed by HE staining.Results One mouse line was selected with over expression of the PLAU, PLAUR and STAT3 in the tissue of skin.The transgenic mice showed decreased dermal layer, a hyperkeratinized cuticular layer and increased stratum spinosum.The number of hair follicle was reduced and developed abnormally in the transgenic mice.The Munro abscess in the dermal layer and the increased inflammatory cell infiltrates in dermal layer were also observed in the transgenic mice.Conclusions A transgenic mouse line was produced and passage stably, which expressed the PLAU, PLAUR and STAT3 in the tissue of skin and developed the psoriasis progressively.All of our results suggested that the transgenic mice were a useful animal model for psoriasis.

Objective: To investigate the changes of peripheral cardiotrophin-1 (CT-1) and brain natriuretic peptide (BNP) concentrations in patients undergoing off-pump coronary artery bypass grafting (OPCABC), and the clinical significance of peripheral CT-1 and BNP in cardiac surgery thereof. Methods:Fifty elective OPCABG patients were included in the study. The concentrations of CT-l and BNP were measured before surgery, and at 6 hours, 72 hours, 1 week and 10 months after the operation respectively. The clinical data of the heart function were also collected in patients . Results:(1 )The peripheral CT-1 levels were significantly higher at 10 months after OPCABC than those before operation. (2 )The concentration of peripheral BNP increased at 6 hours after operation. The peak level was found at 72 hours, and remained higher level until the 1 week after operation. The BNP concentration was returned to the normal level at 10 months after OPCABG. (3 )The baseline levels of CT-1 and BNP were both positively correlated with NYHA rank and the diameter of the left ventricular end-diastolic dimension (LVEED), but negatively correlated with left ventricular ejection fraction (LVEF). However, no correlations were found between CT-1 and BNP and NYHA rank, LVEF or LVEED at 10 months after OPCAB. Conclusion:The perioperative blood BNP levels were increased significantly by OPCABG, while perioperative level of CT-1 increased slowly compared with that of BNP. In cardiac surgery,perioperative concentrations of CT-1 and BNP may reflect the cardiac function in patients before OPCABG. The further studies are warranted to assess the prognosis.

This article aimed to study the antigenicity of nucleocapsid proteins (NPs) in six pathogenic phleboviruses and to provide theoretical evidence for the development of serological diagnostic reagents. NPs of six pathogenic phleboviruses were expressed and purified using a prokaryotic expression system and rabbits were immunized with individual recombinant NPs. Cross-reactions among NPs and rabbit sera were determined by both indirect ELISA and Western blotting analyses, and the sera titer was determined by indirect ELISA. Furthermore, sera from SFTS patients were also detected by each recombinant NP as a coating antigen using indirect ELISA. The cross-reactions and the sera titer were subsequently determined. Both the concentration and purity of recombinant NPs of six pathogenic phleboviruses met the standards for immunization and detection. The results of indirect ELISA and Western blotting showed that each anti-phlebovirus NP rabbit immune serum had potential serological cross-reactivity with the other five virus NP antigens. Furthermore, the sera from SFTS patients also had cross-reactivity with the other five NP antigens to a certain extent. Our preliminary study evaluated the antigenicity and immune reactivity of six pathogenic phleboviruses NPs and laid the foundation for the development of diagnostic reagents.
Animals ; Antibodies, Viral ; immunology ; Antigens, Viral ; genetics ; immunology ; Cross Reactions ; Humans ; Nucleocapsid Proteins ; genetics ; immunology ; Phlebotomus Fever ; diagnosis ; immunology ; virology ; Phlebovirus ; classification ; genetics ; immunology ; isolation & purification ; Rabbits

Objective To evaluate the pulmonary imaging features in patients with severe or critical severe A H1N1 influenza. Methods Clinical and imaging findings of 18 cases with H1N1 pneumonia were retrospectively analyzed. These patients were divided into 2 groups including severe group (n=11) and critical group (n=7). Results Among the severe group, bilateral ill-defined nodules and patch shadows were found in 8 cases, local ill-defined patchy was shown in 3 cases, and consolidation of right inferior lung was demonstrated by CT scan in 1 case. Among the critical group, diffuse ground-glass attenuation with partial consolidation were found in bilateral lungs of 4 cases, subcutaneous emphysema was observed in 1 case. CT showed diffuse ground-glass attenuation and nodular like consolidation in bilateral inferior lungs in 1 case, and other 3 cases showed diffuse consolidation of bilateral lungs. Conclusions The radiologic findings of severe and critical severe pulmonary infections with H1N1 include ill-defined nodules and patch shadows of bilateral lung in sever patients, diffuse peribronchial ground-glass opacity and multifocal consolidation in critical severe patients. The radiologists should learn the features of H1N1 pneumonia on thoracic plain film and CT to make diagnosis in time.

BACKGROUND:There are various therapies for children limb fractures involving the epiphysis or the metaphysis. According to the different methods, studies on the growth of the epiphyseal plate are a lot, most of which focus on the effects of Kirschner wires with different diameters or holow screw internal fixation on the development of epiphyseal plate. However, there are rare studies on the influence of cross-epiphyseal plate internal fixation on the growth of epiphyseal plate as wel as the influence level. OBJECTIVE:To prepare a peri-epiphyseal fracture model in young rabbits and to observe the effects of cross-epiphyseal plate implantation and removal on the growth of epiphyseal plate. METHODS: Traverse fracture models were made 5 mm above the right femoral distal epiphyseal plate of 60 young rabbits, and then fixed with suitable “L” steel plate and four screws across the epiphyseal plate and peri-epiphyseal fracture line. The left side served as control. Eight rabbits were kiled and observed at 2, 4, 8, 12 weeks after modeling, respectively, to take out the femoral specimens for measurement of femoral length, thickness of the epiphyseal plate, and number of mastocytes per unit column. Histopathology observation was done and changes in mastocytes and thickness of the epiphyseal plate were detected. Another seven rabbits were selected to remove the metal plate, continued to feed for 2 weeks and finaly executed to observe the above-mentioned indexes. RESULTS AND CONCLUSION: (1) There were significant differences in the above indexes between the plate and control groups at 4, 8, 12 weeks after modeling (P < 0.05 orP< 0.001) but not at 2 weeks after modeling (P> 0.05). These findings indicate that within 2 weeks after cross-epiphyseal plate internal fixation, proper pressue has no remarkable influence on the growth of epiphyseal plate; but after persistent internal fixation (> 4 weeks), the growth of epiphyseal plate can be partialy or completed retarded. (2) At 2 and 4 weeks after modeling, the plate was removed, and 2 weeks later, the femoral length, thickness of the epiphyseal plate and mastocyte counting per unit column were improved to different extents, and there were no differences between the plate and control group (P > 0.05). At 8 and 12 weeks after modeling, the plate was removed, and 2 weeks later, the femoral length and thickness of the epiphyseal plate were shortened, and the number of mastocytes per unit column was decreased obviously, which significantly differed from the control group (P < 0.001). These findings indicate that the chondrocytes in the proliferative and hypertrophy layers lose the differentiation and proliferation abilities, and the femoral length and epiphyseal plate thickness are difficult to recover.

Objective To explore the diagnostic value of 18F-FDG PET-CT in lymphoma associated hemophagocytic syndrome (HSP).Methods Retrospective analysis of 30 patients with HPS who underwent 18F-FDG PET-CT detection,and was also compared to pathologically confirmed lymphoma associated HPS to evaluate its diagnostic sensitivity,specificity,positive predictive value and negative predictive value,and to analyze the characteristics of PET-CT imaging in lymphoma associated HPS.Results In the 30 patients,the sensitivity,specificity,positive predictive value and negative predictive value in detecting lymphoma associated HPS by 18F-FDG PET-CT were 85.71％ (12/14),93.75 ％ (15/16),92.31％ (12/13) and 88.24 ％(15/17),respectively.The sensitivities of PET-CT between T-cell and B-cell lymphoma related HPS had no significant difference (P =0.066).In superficial lymph nodes,supraclavicular lymph nodes were the most commonly involved.In deeper tissues and organs,spleen was the most commonly involved site,followed by liver,abdominal retroperitoneal lymph nodes and bone marrow.Conclusion 18F-FDG PET-CT has a high sensitivity and specificity in the detection of lymphoma associated HPS,and may provide valuable information for diagnosis and treatment.

Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rifampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis,and compare with debridement alone.Methods From May 2005 to August 2010,48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province.Among them,27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection (Grafting group),and 21 case were treated with radical debridement only(Control group).The local wound healing,adverse reactions and regular imaging examination (pelvic X-ray and CT scan) were observed,and the surgical time,the intraoperative blood loss,postoperative 6 months and 12 months,18 months bone graft fusion rate,and Majeed scoring results of the patients were recorded and statistically analyzed.Results All patients were followed up from 20 to 30 months with an average of 24 months.There was no significant difference in terms of surgical time and operative bleeding between the two groups(P＞0.05).The rate of bone fusion in grafting group was 33.33％ (9/27) of 6 months after operation,88.9％(24/27) of 12 months after operation,and 96.3％ (26/27) of 18 months after operation.While that in control group was 4.76％ (1/21) of 6 months after operation,42.85 ％ (9/21) of 12 months after operation,and 42.85％ (9/21) of 18 months after operation.The differences of these parameters between the two groups were significant(x2 =5.85,20.92,15.90;P＜0.05).According to Majeed scoring system,the excellent and good rates were 100％ (27/27) in grafting group,76.19％ (16/21) in control group,the difference was statistically significant(x2=7.18 P＜0.05).Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sacroiliac joint tuberculosis,and reduce the adverse reactions,achieve bone fusion earlier than the control group.