Objective To establish a flow cytometric method for assay of platelet aggregation induced by shear stress(SIPA) and investigate its clinical value. Methods After the whole blood was subjected to a certain shear stress by a rotational viscometer, the platelets were activated and aggregated. Then the fluorescence antibody CD61 PerCP was added to stain the platelets. The free platelets and aggregates were counted respectively by flow cytometry, thereby the ratio of platelet aggregation was calculated. Results Shear stress-induced whole blood platelet aggregation varied with the increase of shear stress and time of stress. Only a small amount of platelet aggregation was detected at relatively low shear stress of 100S -1, and it was increased at 500S -1. However, a significant increase occurred with 2 000S -1. It approached to the maximum value (58.4%?5.3%) at 3 000S -1 with exposure of 3min, which was higher than the values at 100S -1(9.4%?1.3%)and 500S -1(26.4%?3.2%). At the same time, the aggregates increased in size and became more compact with increase in the shear stress and prolongation of time. High shear stress induced platelet aggregation(H-SIPA) was significantly enhanced in patients with AMI, cerebral infarction, TIA or diabetes, all of them were susceptible to coagulopathy, compared with normal control. Conclusion The results indicated that shear stress could induce platelet aggregation directly, and the degree of SIPA had positive correlation with the stress stength and exposure time.The measurement of H-SIPA was of some clinical value in the diagnosis of arterial thrombosis.

Through a congenital cleft hand cleft foot line analysis of clinical manifestations, the mode of inherit-ance, clinical type of 15 patients. It was found that the pedigrees of congenital foot deformity in patients with cleft hand cleft hand split foot crack were typical, and non-syndromic. The disease presents the typical pedigree body autosomal dominant mode of inheritance, clinical manifestations of the great differences between patients, the pres-ence of significant genetic heterogeneity.

In order to have a better understanding of the species diversity of medical plants in Enshi, Hubei of China, extensive field investigations and specimen collections were conducted in Enshi and adjacent regions. Based on field observations of plants in their living habitats and comparative morphological studies on specimens in herbarium of Hubei minzu University and other available herbaria as well, three new records of medical plants in Hubei, Scutellaria yunnanensis, Alangium faberi var. heterophyllum, and Drymaria diandra, were reported in this paper.
China ; Plants, Medicinal ; Records as Topic

BACKGROUND:The biological substances fixed onto the implant surface, including specific proteins, enzymes, polypeptides, could promote the proliferation and differentiation of osteogenic cells in order to achieve a good osteogenic effect.
OBJECTIVE:To introduce the biological characteristics of the arginine-glycine-aspartic acid (RGD) peptides, cellbiological behavior and implant osseointegration in osteoporosis.
METHODS:Authors retrieved the relevant articles in PubMed database (January 1984 to January 2013), Wanfang database (January 2002 to December 2012) and CHKD database (January 2002 to December 2012) using the key words“RGD peptides, osteoporosis, bone marrow mesenchymal stem cells, osseointegration, osteoblast, induced differentiation”. Papers were included concerning the biological characteristics of RGD peptides, the biological behavior of cells and the bone-implant integration in osteoporosis.
RESULTS AND CONCLUSION:Osseointegration on the surface between implant and bone tissue can be further improved by grafting biological y active substance. Bionics modification, to simulate the extracellular matrix environment in vivo, can promote celladhesion and growth, which is an effective way to improve osseointegration and is also an important direction of research in the field of tissue engineering recently. The future research is focused on designing specific and efficient polypeptides and simple and effective fixation methods.

Objective To investigate the clinical effect,safety,and value of bronchofibroscopeguided bronchoalveolar lavage and topical antibiotics in the treatment of pediatric patients with severe pneumonia.Methods A total of 60 patients with severe pneumonia was randomly divided into two groups with 30 cases in each group.Patients in the control group were treated with conventional anti-infection therapy,while patients in the treatment group were treated with bronchofibroscope-guided bronchoalveolar lavage and topical antibiotics on the basis of conventional therapy.The sputum positive rate,clinical effect,hospital stays,treatment costs,and adverse reactions were compared to analyze its value.Results The total effective rate of treatment group was 93.3％,which was significantly higher than that (60.0％) in the control group (P ＜0.01).The sputum positive rate of treatment group was 80.0％,which was significantly higher than that (43.3％) in the control group (P ＜0.01).The hospital stays and the treatment costs of the treatment group were both significantly less than those in control group (P ＜0.01 orP ＜0.05).No serious complications were found in patients of the treatment group.Conclusions Bronchofibroscope-guided bronchoalveolar lavage and topical antibiotics in the treatment of pediatric patients with severe pneumonia show exactly clinical effects and significant improvement in dyspnea,which shortens the hospital stays,reduces the treatment costs,and has no seriously adverse reactions.Therefore,it is worthy of clinical promotion and application.

Objective To explore the clinical and pandemic features and respiratory pathogen co-infection characteristics of children infected with influenza virus A (Flu A) in year 2009.Methods A retrospective study of hospitalized children with flu-like clinical symptoms in 2009 was conducted.The peripheral blood serum was analyzed to detect common respiratory agents,inclucding Flu A,respiratory syncytial virus,adenovirus,influenza virus B,parainfluenza virus 1,2 and 3,chlamydia pneumonia and mycoplasma pneumonia,klebsiella pneumonia (KP),haemophilus influenza and legionella pneumophila by using indirect immunofluorescence test for the antibody detection (IgM).And a standard medical history was recorded,including epidemiological data,clinical manifestation,and the length of hospital stay,white blood count and chest X-ray elsewhere.All specimens were collected in Department of Pediatrics,Zhongnan Hospital of Wuhan University,from Jan.2009 to Dec.2009.Results Flu A was detected in 234 of the 599 (39.1％,234/599 cases) flu-like children.The mean age was 48.8 months (range from 3 to 167 months).The detection rate in less than 1-year-old group (11.1％,18/162 cases) was obviously lower than that of the older groups (P ＜ O.001).Especially for the group ＜ 6 months,there was only 1 infant (1.43％,1/70 cases) with Flu A positive.Compared with Flu A negative group,the main clinical features of children with Flu A positive group were fever(78.2％,183/234 cases,P =0.013) and cough(76.5％,179/234 cases,P =0.04),however asthma (14.1％,33/234 cases,P =0.003)and diarrhea (6.0％,14/234 cases,P ＝ 0.001) cases were less.The detection rates of Flu A reached a peak of 57.0％ in November and December,and a secondary peak of 45.0％ in May and June.Flu A infection children less than 1 year old were simple in etiology.The children were older,the etiology was more complex.The primary coinfection pathogen was KP (53.8％,126/234 cases) and Flu B(48.3％,113/234 cases).Compared Flu A coinfection with or without KP,there was no difference between these 2 groups in the clinical features.Conclusions Intfluenza A is the main pathogen of hospitalized children with flu-like symptoms in 2009.Children over 1 year old age were the major infection groups of Flu A.The detection rates of Flu A reached peaks in May to June and November to December.Flu A positive children were prone to KP coinfection.

Objective To evaluate the difference between nodal and extra-nodal diffuse large B-cell lymphoma (DLBCL) in clinical-pathological feature and prognosis.Methods The clinical data of 134 cases of DLBCL patients were reviewed and analyzed.Results The DLBCL patients accounted for 52.14 ％ (134/257) of non-Hodgkin lymphoma of the same period and the extra-nodal DLBCL patients accounted for 69.4 ％.The proportion of stage Ⅲ/Ⅳ disease in extra-nodal DLBCL and nodal DLBCL were 55.9 ％ (52/93) and 75.6 ％(31/41),respectively.Elevated LDH was reported in 33.3 ％ (31/93) of extra-nodal DLBCL and 58.5 ％ (24/41)of nodal DLBCL Other clinical characteristics such as B symptoms,bulky disease,elevated ESR,ECOG scores and IPI scores were not significantly different between these two groups (all P ＞ 0.05).No difference in the frequency of GCB and non-GCB subtypes was observed between extra-nodal and nodal DLBCL (P =0.623).The 3-year overall survival rates and 3-year progression free survival rates for extra-nodal and nodal DLBCL were 73.2 ％,55.2 ％ (P =0.065) and 46.3 ％,44.1％ (P =0.748).Conclusions The morbidity of extranodal DLBCL is high.Primary extra-nodal DLBCL patients present early-stage disease and normal LDH more frequently than the nodal DLBCL,while no significant difference in the frequency of pathological subtypes and 3-year OS and PFS is observed between these two groups.

Objective To explore the relationship between plasma mannose-binding lectin (MBL), lipopolysaccharide (LPS) and body mass index in pregnant women with gestational diabetes mellitus (GDM). Methods 45 newly diagnosed GDM pregnant women and 45 healthy women (control group) were selected in this study. Plasma concentration of MBL and LPS were measured. All the groups were sub-divided into obesity (BMI ≥ 25 kg/m2) and non-obesity (BMI < 25 kg/m2) subgroup. The relationships of levels of plasma LPS, MBL with BMI were analyzed. Results The level of plasma MBL in GDM group was significantly lower than that in control group(P < 0.05), while the concentration of LPS in serum was much higher than that in healthy pregnant women (P < 0.05). Pearson analysis showed the level of MBL in GDM group was negatively correlated with BMI(r=-0.28, P<0.05), serum LPS concentration was positively correlated with BMI(r = 0.62, P < 0.05) and LPS was negatively correlated With MBL(r = -0.43, P < 0.05) . The above correlations were not found in control group. Conclusion Serum MBL and LPS maybe two important risk factors for those pregnant women being overweight, and could offer great significance for the prevention and treatment of GDM.

Objective To observe the corneal nerve fibres damage in different stage of diabetic retinopathy (DR) with type 2 diabetes.Methods A cross-sectional study.One hundred and twenty eyes of 120 patients with type 2 diabetes served as diabetes group.According to International Clinical Diabetic Retinopathy Disease Severity Scales (2002),diabetes patients were classified into 4 subgroups:patients without diabetic retinopathy (NDR),patients with mild or moderate non-proliferative diabetic retinopathy (mNPDR),patients with severe non-proliferative diabetic retinopathy (sNPDR) and patients with proliferative diabetic retinopathy (PDR),each subgroup has 30 eyes of 30 patients.Another 30 eyes of 30 healthy participants served as control group.All eyes were scanned with HRT3 in vivo corneal confocal microscopy.Images of sub-basal nerve plexus were quantified including nerve fiber length (NFL),nerve fiber density (NFD),nerve fiber branch density (NFB),and nerve tortuosity (NT).The correlations of corneal nerve fiber with age,duration of diabetes and glycated hemoglobin (HbA1 c) were analyzed using Spearman correlation analysis.Results NFL,NFD and NFB were found to be significantly lower in diabetic patients (F=147.315,142.586,65.898;P=0.000,0.000,0.000),NT was significantly greater in diabetic patients (F=39.431,P=0.000),when compared to control group.In diabetic patients,NFL,NFD and NFB were gradually reduced with DR severity,NT was gradually increased with DR severity.While the difference ofNFL,NFD,NFB,NT was not statistically significant between sNPDR and PDR subgroups (P＞.0.05),but was statistically significant between other subgroups (P＜0.05).Spearman correlation analysis results showed that age (r=-0.071,-0.080,0.001,0.100;P=0.391,0.328,0.991,0.224) and HbAlc (r=-0.109,-0.115,-0.126,0.025;P=0.238,0.211,0.169,0.781) had no correlation with NFL,NFD,NFB,NT.Duration of diabetes was negatively correlated with the NFL,NFD (r=-0.212,-0.264;P=0.020,0.004),positive correlated with NT (r=0.261,P=0.004),and had no correlation with NFB (r=-0.119,P=0.194).Conclusions Corneal nerve fiber loss and nerve tortuosity increased were found in patients with type 2 diabetes,and even without diabetic retinopathy.The progress of corneal neuropathy was correlated with the severity of DR,but it was not change significantly between sNPDR and PDR.

Objective:To investigate the effect of thermal conductivity on the apical sealing ability of different dental gutta-percha cones during the warm vertical condensation obturation.Methods:Four kinds of dental gutta-percha cones were used in this study:Bio-GP points (BP,B&L,Korea),large-tapered gutta-percha (DP,DENTSPLY,America),PROTAPER Universal gutta-percha points (DPP,DENTSPLY,America) and mtwo gutta-percha points (VP,VDW,Germany).Volume differences method was used to determine the main components and the thermal conductivity determinator was used to measure the thermal conductivity of these dental gutta-percha cones.Furthermore,20 cones randomly selected from each kind of dental gutta-percha cones.And 10 cones of each dental gutta-percha cones,which were cut out the part of 4 mm in length from the apical end,were heated (200 ℃) from the upper end without compression,and the temperature of the gutta perchacones surface was monitored in time by the infrared thermal imager during the whole heating process.In addition,the rest of the 10 cones of each dental gutta-percha cones were used to obturate the root canal in the transparent root canal resin model using warm vertical condensation technique.The cross-sectional surface was observed by stereomicroscope (× 40) at 1 mm and 3 mm from the working length and the gutta-percha obturation area proportion was measured and analyzed.The data were analyzed by one-way ANOVA.Results:The proportion of inorganic fillers (80.90％ ± 1.14 ％) (P ＜ 0.05) and the thermal conductivity (2.247 ± 0.002)of DP was siguificantly higher than BP (79.28％ ± 3.88％,1.179 ± 0.003),DPP (68.46％ 5.09％,0.604 ±0.001),VP (78.86％ ± 1.87％,1.150 ±0.001) (P ＜0.05).During the thermal obturation without compression at the setting temperature (200 ℃),DP could achieve 65 ℃ beyond 1 mm from the heating point,and BP,DPP and VP only reached 65 ℃ within 1 mm.After warm vertical condensation obturation,all the groups showed increased gutta-percha obturation area proportion.At the position of WL-3,DP (96.89％ ±0.03％) showed significantly higher proportion of gutta-percha obturation area than BP (95.47％ ±0.06％),DPP (95.21％ ±0.03％) and VP (95.15％ ±0.03％) (P ＜ 0.05).Conclusion:DP contains more inorganic fillers,possesses higher thermal conductivity,and leads a better apical sealing ability than BP,DPP and VP at the position of WL-3 during warm vertical condensation obturation.