Objective To investigate the clinical efficacy of laparoscopic splenectomy (LS) for immune thrombocytopenic purpura (ITP).Methods The clinical data of 84 patients with ITP who underwent LS at the First Affiliated Hospital of Chongqing Medical University from January 2007 to January 2014 were retrospectively analyzed.The potential prognosing indexes (gender,age,course of diseas,preoperative response to steroid,preoperative PLT,operation time,volume of intraoperative blood loss and postoperative PLT peak within 7 days) were collected and analyzed.The evaluation of surgical efficacy was done according to the American Society of Hematology 2011 evidence-based practice guideline for ITP.The complete response and partial response were defined as effective and no response as void.All of the patients were followed up by outpatient examination and telephone interview till December 2014,the follow-up information included platelet count,bleeding performance,presence of long-term complications and postoperative recurrence,etc.Measurement data with normal distribution were presented as x ± s,and skew distribution data were described as M (range).The postoperative long-term effective rate was analyzed by Kaplan-Meier method.The univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model,respectively.Results The operation time of 84 patients was (154 ±40)minutes with a median volume of intraoperative blood loss as 200 mL (10-1 000 mL).Lienculus was detected in 11 patients and resected.Seven patients had complications and recovered after symptomatic and supportive treatment.There was no perioperative death.Among the 84 patients who were followed up for an average follow-up time of 51 months (12-96 months),45 patients had complete response,18 patients had partial response and 21 had no response,without serious spontaneous visceral and intracranial hemorrhage.Eighteen partial-response patients underwent symptomatic medical therapy and 21 no-response patients took orally prednisolone,among which 13 had PLT ＞ 30 × 109/L stably.During the follow-up,only one complete-response patient died of lung cancer with systemic metastasis at 2 years after surgery.Four patients had pneumonia,1 noresponse female patient had pyothorax repeatedly for a long time,and they all recovered after symptomatic and supportive treatments.There were no serious complications and overwhelming postsplenectomy infection in other patients.The 1-,3-,5-,7-year effective rates were 82.1％,77.6％,72.5％ and 67.9％,respectively.Univariate analysis showed that preoperative response to steroid,preoperative PLT and postoperative PLT peak within 7 days were related factors affecting long-term effecacy of patients with ITP (x2=5.600,6.006,21.733,P ＜ 0.05),but gender,age,course of disease,operation time and volume of intraoperative blood loss were not related factors affecting long-term effecacy of patients with ITP (x2=0.018,2.684,0.000,0.064,0.397,P ＞ 0.05).Multivariate analysis showed that preoperative response to steroid and postoperative PLT peak within 7 days ≥300 × 109/L were independent protective factors affecting long-term efficacy (OR =5.426,19.454,95％ confidence interval:1.220-24.129,4.704-80.449,P ＜ 0.05).Conclusions LS is safe and feasible for the treatment of ITP with a high long-term effective rate.Preoperative response to steroid and postoperative PLT peak within 7 days may be the predictors of LS for ITP.

Eight new diaryltriazine derivatives containing 4-allylamino and 4-azido substitutes guided by molecular docking have been designed and synthesized based on our previous work.The evaluation of HIV inhibitory activity demonstrated that all compounds were potent against HIV-1 replication.The most active compound 7c exhibited activity against HIV-1 (IC50=0.034 μmol·L-1,SI=6475)and the double mutant strain (IC50=9.39 μmol·L-1)in the micromolar range, which was more potent than nevirapine.

The transport of critical neonates has a high mortality. To reduce the mortality, it is very important to determine the transport indications in advance. Additionally, the neonatal transport is also based on the industrial training, the transport team combined by a variety of profession, the uniform and standard transport equipment and so on. Therefore, this article mainly reviews the education training, team, equipment, indications, the latest skill, air transport and so on.

Medical students participating in chnieal medical early is one of the good ways to cultivate students'all-around qualities From freshman year medical students begin to enter chnical medical service system and make clinical practice in spare time,They are also trained to link theory with practice to caltivate clinical thinking ability,strengthen its humanistic care idea and doctor-patient communication ability so that medical students will know the sacred profession of being adatov and from the idea of sewing patients work of the sacred doctor,set up'professional service to patients'concept.

Abstract: The theory of formulas corresponding to syndromes is a relatively mature and integrated method contained in the classics of traditional Chinese medicine (TCM) for diagnosing and treatment of diseases. The development of the theory mainly includes three stages, i.e. prototype stage before Han Dynasty, sublimation stage of late Eastern Han Dynasty and the following improving stage. People recorded what they saw and heard of during their medical activities in prototype stage. In sublimation stage, Treatise on Febrile Diseases written by Zhang Zhong-jing found out the relationship of structure-fixed prescriptions used more often with symptoms and signs. Doctors after Han Dynasty repeated and verified the truth of classical prescriptions and the theory of formulas corresponding to syndromes. They also developed and improved the theory. Based on clinical experience, and classics, it was enriched, advanced and improved by doctors after then. It could provide reference for clinical treatment through systematically hackling the theories.

Intrauterine growth restriction is a common perinatal complication of major harm to the fetus. In recent years, immunological mechanism has been found in the pathogenesis of intrauterine growth restricition. Abnormal immune mechanism may be the developmental programming of ways to affect the fetal immune function, as well as extrauterine.

Humans ; Medicine, Chinese Traditional ; Translating

Objective To observe the effect of sanfukechuangao acupoint application on changes of interleukin-18 (IL-18), eosinophils (EOS) and pulmonary pathology in asthma model of guinea pigs, and its underlying mechanism thereof. Methods A total of 60 guinea pigs were randomized into normal control group, asthma model group, acupoint-application 1 h group, acupoint-application 3 h group, acupoint-application 6 h group and dexamethasone group. Asthma model was established by intraperitoneal injection of 10%ovalbumin (OVA,1 mL) and forced inhalation of atomized 2%OVA. Skin preparation and external application of Chinese medicinal herbs were made on back of guinea pigs, and Feishu,Xinshu,Geshuwere selected in acupuncture points). Levels of IL-18 and EOS were detected by immunohistochemisty method. Results Compared with model group,the levels of IL-18 and EOS were significantly decreased, the pathological changes were significantly reduced in three acupoint-application groups. The effectiveness of acupoint-application 3 h group was the best in three groups. Conclusion Sanfukechuangao acupoint application can influence the levels of IL-18 and EOS effectively, and relieve phlegmonosis injuries in pulmonary tissue of asthma model of guinea pig.

The separation and analysis of hematoporphyrin photosensitizers PSD-001, photocarcinorin,photofrin II and other HPD preparations in comparison with authentic samples protoporphyrin (PP), 3-(8)-(1-hydroxyethyl) -8-(3-)-vinyldeuteroporphyrin ( HVD)and hematoporphyrin(HP) using thin layer chromatography(TLC) under different conditions are described here.It has been shown that there are 3 and 2 main spots in PSD-001 and photocarcinorin by common TLC, but 8-9 spots by high performance TLC.It has been found by comparison with authentic HP,HVD and PP that the amount of PP in PSD-001 or photocarcinorin is less than 3% and HVD,about 2.5% and 6.3% respectively,the HP content of photocarcinorin is much lower than other photosensitizers mentioned above and there is not any component near the origin spot.The Rf of one of the major components of photocarcinorin is 0.65.This component seems to be hardly found in other photosensitizers.These suggest that photocarcinorin is a new photosensitizing agent differing from HPD and photofrin II.

Objective:To study the association between rs1135791、rs722555、rs116799831、rs3948464 polymorphisms of Sp110 gene and susceptibility to tuberculosis of Han people in Chongqing.Methods:Using case-control study,rs1135791、rs722555、rs116799831、rs3948464 polymorphisms of Sp110 gene were detected.The test of significance was performed with the computer program,SAS Version 8.2.Results:(1)The frequencies of rs1135791 CT、rs722555 GG、rs116799831 GG、rs3948464 CC had statistically significant difference between the case and the control group.(2)The frequencies of rs1135791 C allele、rs722555 G allele、rs116799831 G allele、rs3948464 C allele had statistically significant difference between the case and the control group.Conclusion:The rs1135791 C/T、rs722555 A/G、rs116799831 A/G、rs3948464 C/T polymorphisms of Sp110 gene were possibly susceptible to the tuberculosis of the Han people in Chongqing.