Objective Drug-induced immune thrombocytopenia (DITP) is a major adverse drug effect mediated by drugdependent antibodies.It can be actuated by a wide range of medications,including Rifampicin.Methods Rifampicin-dependent antibody (rd-Ab) from a rifampicin-treated tuberculosis patient with thrombocytopenia (RITP) was characterized by in vitro and in vivo assays,which includes flow cytometry,monoclonal antibody immobilization of platelet antigens (MAIPA) assay,platelet aggregation assay and RITP mouse model.Results The rd-Ab could bind glycoprotein (GP) Ⅱ b/Ⅲ a,as shown by the MAIPA assay.The binding of rd-Ab could be blocked by AP2,a monoclonal antibody that binds a calcium dependent site on GP Ⅱ b/Ⅲ a complex and inhibits ADP-induced platelet aggregation.These results suggested that rd-Ab binds the same site or proximal sites on the GP Ⅱ b/Ⅲ a complex as AP2.Furthermore,the rd-Ab inhibited platelet aggregation in vitro.In an established NOD/SCID mouse model of RITP,the rd-Ab caused a rapid clearance of human platelets (MPL=1.1 ± 0.2h).The in vivo platelet loss could be partially prevented by treatments with intravenous immunoglobulin (IVIG) or corticosteroids (MPL=4.7 ± 0.7h and 4.2 ± 1.1h,P＜0.05).Slowing of platelet clearance was observed immediately upon IVIG treatment,while upon corticosteroid treatment at 24h,and reaching its peak at 72h.Combination of IVIG and corticosteroid treatments was more efficacious (MPL=6.2 ± 1.5h,P＜0.05).Conclusions 1.The rd-Ab binds to calcium-dependent-epitopes on the calcium dependent site of GP Ⅱ b/Ⅲ a complex,which causes platelet damage and inhibits platelet aggregation.2.Either IVIG or corticosteroid alone can partially block platelet clearance by rd-Ab.Slowing of platelet clearance is observed immediately upon IVIG treatment,or upon corticosteroid treatment several days later,indicating that IVIG may be more suitable for acutely raising the platelet count than corticosteroid treatment for RITP.3.Combination of IVIG and corticosteroid treatment is more efficacious than IVIG or corticosteroids alone.

Adult ; Heart Diseases ; etiology ; Hemorrhagic Fever with Renal Syndrome ; complications ; Humans ; Male

AIM　To investigate the transdermal delivery effects of cyclosporine A solubilized in mixed micelles composed of phospholipid and different surfactants. METHODS　When applied onto the excised abdominal skin of the mice occlusively, the enhancing effects of various mixed micelles on the penetration of cyclosporin A were assessed by an in vitro permeation technique. In vivo study was carried out by topical application of sodium cholate-phospholipid mixed micelles onto the mice skin and drug blood concentration was detected. RESULTS　In vitro, mixed micelles containing different surfactants displayed distinct permeability and corresponded to the following order: sodium cholate > sodium deoxycholate > Trition X-100 > Tween-20. In vivo, peak drug concentration was detected at 5 h and after that the concentration fell down slowly. CONCLUSION　Mixed micelles were shown to be efficient carrier for the transdermal delivery of the lipophilic polypeptide when kept in solution during the application process.

Objective:This article aimed to discusse the feasibility and effects of humanistic service using Kano model in outpatients .Methods:Using a self-designed Kano model outpatient humanistic service demand question-naire investigated clinic patients by using the Kano model analysis method , implementing humanistic service in the outpatient on the base of analyzing the starting point , and compare the satisfaction situation before and after the im-plementation .Results:There are service items including necessary quality , expected quality , attractive quality in Kano model analysis , 9, 8, 2 items respectively.After the implementation of humanistic service , patient's satisfac-tion increased significantly .Conclusion:The Kano model can be used in the outpatient services .The outpatient hu-manistic service could get the approvals from most outpatient patients .Outpatient humanistic service can improve the satisfaction of patients , so as to reduce medical disputes , alleviate conflicts between the doctors and patients , and improve the hospital popularity .

Child, Preschool ; Humans ; Infant ; Mitral Valve ; abnormalities ; pathology ; Mitral Valve Insufficiency ; pathology

Background Selective laser trabeculoplasty (SLT) is a safe and effective therapy to the treatment of primary open angle glaucoma (POAG),and the clinical application is approved by American FDA.However,the relevant researching outcomes from several single-center study are in dispute owing to non-uniform approach in China.A muhicenter clinical trial is need to verify the effectiveness of SLT for Chinese POAG.Objective This study was to investigate the safety and efficacy of SLT in Chinese POAG patients.Methods A prospective,multicenter and self-controlled clinical trail was designed.Sixty-two eyes of 62 POAG patients with the age of ≥ 18 years were enrolled.Frequency SLT was performed around 360° angle using Lumenis Selecta DuetTM or Lumenis Selecta Ⅱ laser instrument,with the 100 non-overlapping spots,3 ns preset time,400 μm size of laser spot and 0.6 mJ energy.The operated eyes were followed-up for 6 months.The curative effects were checked including intraocular pressure (IOP),IOP-lowing value,number and percentage of IOP-lowing 20％ and 30％.The therapyrelated complications were recorded including the number of conjunctival congestion and cloudy of the anterior chamber.Results The preoperative IOP was (25.7±2.6) mmHg in the 62 eyes.The IOP was significantly lowed 1 day,2 weeks,4 weeks,3 months and 6 months after SLT in comparison with preoperative IOP (all at P＜0.001) with the lowest value of (16.5±4.5)mmHg in postoperative day 1.IOP was stable from 4 weeks to 6 months after operation.The mean lowing-value of IOP was 5.3-9.2 mmHg from 1 day through 6 months after SLT.The percentage of eyes 20％ drop in lOP was 83.9％,and that of 30％ drop was 58.1％ in postoperative day 1.In 6 months after SLT,percentages of eyes 20％ and 30％ drop in IOP were 56.5％ and 27.4％,respectively.Conclusions SLT is a safe and effective method of lowing IOP for POAG eyes in Chinese population.

Objective To observe the influence of Epstein-Barr virus(EBV) infection on T cell subsets in children with infectious mononucleosis(IM).Methods Eighty children patients with IM in the Hanzhong Municipal People's Hospital from January 2013 to January 2016 were chosen as the study subjects and received the anti-virus therapy.The negative conversion rate of EBV-DNA after treatment was observed.The distributions of T cell subsets werecompared between the children patients with EBV-DNA positive and patients with EBV-DNA negative.The related factors of EBV-DNA non-negative conversion were analyzed.Results After treatment,67 children cases (83.75％) were EBV-DNA negative conversion.The proportions of CD3+ and CD8+ after treatment in the EBV-DNA negative group were lower than those in the EBV-DNA positive group,and the proportion of CD4+ and CD4+/CD8+ were higher than those in the EBV DNA positive group,the difference had statistical significance (P＜0.05).In the analysis on the related factors in the children patients with EBV DNA non-negative conversion,the gender,WBC count and lymphocyte count had no significant correlation with EBV-DNA negative conversion(P＞ 0.05),while interferon use,age and initial Ct demonstrated significant correlation with EBV-DNA non-negative conversion(P＜0.05).Conclusion EBV infection can lead to disturbance of T cell subsets in children with IM,so clinic should adopt an active anti-virus treatment.

OBJECTIVE: To investigate the features of adverse drug reaction(ADR) in our hospital and evaluate the quality of ADR report in order to promote rational clinical drug use and find out the existing problems in the report. METHODS: Microsoft Excel was designed to analyze statistically the sex and age of the patients,category of the used drugs and the clinical manifestations of ADR in 311 cases of ADR report collected between 2002 and 2005.RESULTS: The occurrence of ADR induced by antibacterials ranked the first.ADR affecting skin and its appendages counted for 50% of the total.The numbers of ADR reports were found to be less than expected.CONCLUSIONS: Professional staff training should be strengthened,the use of antibacterials should be rationalized to lessen and avoid the occurrence of ADR.

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis.
●METHODS:Retrospective study. A total of 57 cases (57 eyes ) with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non - parametric Wilcoxon test.
●RESULTS: lris were bleed in 21 eyes ( 37%) , 4 eyes ( 7%) with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes ( 7%) . The uncorrected visual acuity ( UCVA ) was significantly increased after surgery. The UCVA of 8 eyes (14%) were 0. 1 or better before surgery, and the UCVA of 42 eyes (74%) were 0. 1 or better 3mo after surgery, the difference was statistically significant ( Z=23. 42, P<0. 001). The corneal edema (17 eyes, 30%), uveitis (2 eyes, 4%) and intraocular hypertension ( 1 eyes, 2%) were appeared in postoperative 1d. The corneal edema (3 eyes, 5%) was appeared in postoperative 1wk. The uveitis ( 1 eyes, 2%) was appeared in postoperative 1mo. The corneal edema (1 eyes, 2%), uveitis (2 eyes, 4%) , intraocular hypertension ( 1 eyes, 2%) and after-cataract ( 3 eyes, 5%) were appeared in postoperative 3mo.
● CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.

Abstract: In recent years, the HIV prevention intervention strategy has had a positive effect on reducing the HIV infection prevalence in China. HIV non-occupational post-exposure prophylaxis (nPEP) has become an effective measure to prevent HIV for men who have sex with men (MSM) exposed to possible risks. From the perspective of the "knowledge, attitude, and practice" theory, domestic and overseas scholars used outpatient data and questionnaires to investigate the awareness, attitude, usage, medication, follow-up, and drug prescription of HIV nPEP among MSM in China. This article reviewed the above-mentioned and found that the overall awareness rate of HIV nPEP among MSM in China is high with a positive attitude, but the actual utilization rate is very low. On a regional level, their follow-up after the medication is not ideal despite good medication. Drug prescription varies between different regions domestically. The prescription rate of tenofovir + emtricitabine + raltegravir is the highest, followed by the prescription rate of tenofovir + emtricitabine + dolutegravir, and tenofovir + lamivudine + dolutegravir. In the future, researchers should expand the number of study objects and the scope of the research sites in China, analyze the "knowledge, attitude, and practice" of HIV nPEP, medication follow-up, and medication prescription among MSM, and increase the research on HIV nPEP service areas to provide the reference for further formulating and refining the comprehensive HIV prevention intervention strategy among MSM in China.