Turbidimetry was used to examine the inhibitory effect of Xanthoxyin on adenosine diphosphate (ADP)-, arachidic acid (AA )- and thrombin-induced platelet aggregation in rabbits. In-vitro experiment showed that Xanthoxyin 0.037,0.l85,0.924,9.240,92.40?mol. L -1 , can significantly inhibit ADP-, AA- and thrombin-induced platelet aggregation. The inhibition rates were 22.4%-70.l%,l5.3%-68.2% and 25.8%-74.6% respectively. In-vivo experiment showed that Xanthoxylin (ig. 5 mg/kg) cand also inhibited ADP-, AA-and throbin-induced platelet aggregations. The inhibition rates were 2l.0%,35.7%,50.9% and 32.7% in ADP-induced group,23.2%,46.3%,52.4% and 4l.6% in AA-induced group, and 26.7%, 44.5%,6l.6% and 54.2% in thrombin-induced group respectively l5,30, 60 and 90 minutes after ig. Xanthoxylin.

Inherited platelet function disorders(IPFD)is a rare hereditary disease characterized by various degrees of bleeding tendency with or without thrombocytopenia.Due to the lack of standardized evaluation system in laboratory test, the diagnosis and classification of IPFD are difficult.Thus, the incidence of IPFD may be underestimated.At present, combined with symptoms and laboratory tests, the second generation sequencing technology is conductive to the fast and accurate diagnosis of complex hemorrhagic diseases of this type and can prompt assessment and treatment.However, there still exists no effective targeted treatment for IPFD.This paper was aimed at introducing the diagnosis and treatment of IPFD.

Objective To explore the early diagnostic values of serum alpha -fetoprotein (AFP),gamma -glutamyltransferase Ⅱ (GGTⅡ),and Golgi protein 73 (GP73)in patients with primary hepatocellular carcinoma (PHC).Methods The serum specimens of 100 pa-tients with liver diseases (50 cases of hepatitis and liver cirrhosis and 50 cases of PHC)and 50 healthy people were collected in our hospital from February 2013 to February 2014.Electrochemical luminescence technique,specific immuno -membrane adsorption assay,and enzyme-linked immunosorbent assay were used to measure the serum levels of AFP,GGTⅡ,and GP73.Comparison of continuous data between multiple groups was made by analysis of variance,and comparison between two groups was made by q test.The receiver operating character-istic (ROC)curves of single or combined test results were made,and the areas under the ROC curves (AUCs)were calculated.The sensi-tivity,specificity,and AUCs of AFP,GGTⅡ,GP73,and the combined test were analyzed and compared.Results The level of serum GGTⅡ in the PHC group was significantly different compared with those in the other two groups (F =16.224,P <0.05),but there was no significant difference between the normal group and the hepatitis and liver cirrhosis group (P >0.05).Significant differences in serum levels of AFP and GP73 were observed by paired comparison between the PHC group,hepatitis and liver cirrhosis group,and normal group (F =193.128,F =20.231,P <0.05 for both).When assayed alone,the specificities of GP73,GGTⅡ,and AFP were 69%,64% and 51%, respectively,and the sensitivities were 92%,84%,and 76%,respectively.In combined test,the specificity was 94.6% and the sensitivi-ty was 98.8%.Conclusion The GP73 test is the best performer in the single assays.Combined test of serum AFP,GGTⅡ,and GP73 shows a good diagnostic value for PHC with greatly improved specificity and sensitivity.

Objective To analyze the etiology and prognosis of children with thrombocytopenia (TP) in pediatric intensive care unit (PICU). Methods The data of children with TP (exclusion of congenital and unknown TP) admitted to PICU of Anhui Provincial Children's Hospital from January 2008 to December 2017 was analyzed retrospectively. According to the age of onset, the children were divided into infantile group (29 days to less than 1 year), early childhood group (1 to less than 3 years), preschool group (3 to less than 6 years), school age group (6 to less than 10 years) and puberty group (more than 10 years). Moreover, according to the lowest platelet count (PLT), the children were divided into PLT≤20×109/L group, PLT (21-50)×109/L group and PLT > (50-100) ×109/L group. The distribution and mortality of TP were analyzed, and the relationship between age, PLT decrease and prognosis were analyzed by Pearson method. Results Among 6 725 children admitted to PICU in our hospital from January 2008 to December 2017, there were 683 children with TP, with the incidence of 10.2%. Among 683 children with TP, there were 387 males and 296 females, with the median age of 2.72 (0.61, 3.08) years, and 92 children died, with a total mortality of 13.5%. Analysis of primary disease showed that TP caused by non-hematological malignant tumor disease accounted for 73.9%, with the mortality of 11.1% (56/505). TP induced by hematological malignant tumor disease accounted for 21.4%, with the mortality of 24.7% (36/146). Pseudothrombocytopenia accounted for 0.6%, with the mortality of 0% (0/4). Other children who gave up treatment accounted for 4.1%. It was shown by further analysis that multiple organ dysfunction syndrome (MODS) caused by TP associated with non-hematological malignant tumor disease accounted for 26.9%, with the mortality of 15.4% (21/136). Sepsis, severe trauma, pneumonia, central nervous system infection and disseminated intravascular coagulation (DIC) accounted for 17.4%, 16.6%, 12.7%, 11.7% and 11.5%; with the mortality of 8.0% (7/88), 2.4% (2/84), 0% (0/64), 20.3% (12/59) and 24.1% (14/58), respectively. The main causes of TP associated with hematological malignant tumor disease were hemophagocytic syndrome [accounting for 27.4%, with the mortality of 32.5% (13/40)] and bone marrow inhibition [accounting for 21.2%, with the mortality of 25.8% (8/31)]. The younger were the children with TP, the higher would be the mortality. The mortality of infantile group was significantly higher than that of early childhood group, preschool group, school age group and puberty group [18.8% (53/282) vs. 14.0% (28/200), 6.7% (7/104), 4.3% (4/92), 0% (0/5), all P < 0.01]. The lower was the PLT, the higher would be the mortality. The mortality of PLT≤20×109/L group was significantly higher than that of PLT (21-50)×109/L group and PLT > (50-100)×109/L group [18.1% (39/215) vs. 13.0% (32/247), 9.5% (21/221), both P < 0.05]. It was shown by correlation analysis that there was no association between age and 28-day death time in children with TP (r = -0.037, P = 0.727), but PLT was positively correlated with 28-day death time in children with TP (r = 0.844, P = 0.010). Conclusions MODS, infection, sepsis, severe trauma and DIC are the common causes of TP in PICU. The younger are the children with TP, the lower is the PLT, and the worse would be the prognosis.

Objective To investigate the antibiotic resistance, virulence genes, and sequence types of Enterococcus faecium ( E. faecium) strains isolated from children under 3 years old in Sui county, Henan province. Methods Kirby-Bauer antibiotic testing was performed to analyze the antibiotic sensitivi-ties of E. faecium strains to 15 common antibiotics. PCR analysis was used to detect the virulence genes car-ried by the E. faecium strains. Multilocus sequence typing ( MLST) was performed for the typing of E. faeci-um strains. Results Forty-seven E. faecium strains were isolated from 120 stool samples collected from chil-dren under 3 years old in Sui county, Henan province, of which 95. 7% were antibiotic-resistant strains. Most of the isolated E. faecium strains were resistant to rifampicin, accounting for 91. 5% (43/47) of all isolates, followed by those resistant to erythromycin and tetracycline, which accounted for 68. 1% (32/47). Moreover, high resistance rates to those antibiotics commonly used in clinical treatments of E. faecium infec-tion including β-lactam and aminoglycosides antibiotics were observed. Those strains resistant to more than three kinds of antibiotics belonged to the same clonal complex including 12 strains of clonal complex 17 ( CC17) harboring the virulence gene of hyl. All of the isolated E. faecium strains were susceptible to vanco-mycin, linezolid, chloromycetin and nitrofurantoin. Conclusion The E. faecium strains isolated from chil-dren under 3 years old in Sui county, Henan province were multi-antibiotic resistant. There were drug-resist-ance strains belonging to the CC17 and carrying the virulence gene of hyl.

Abstract BACKGROUND: Large amounts of data have shown that Chinese herbal monomer has a neuroprotective effect, and can improve the quality of life in stroke patients with cerebral nervous system injury. Nuclear-factor-erythroid 2-related (Nrf2) factor has neuroprotective effect on hemorrhagic stroke and ischemic stroke, which is an important way to reverse the damage of nervous system through the natural non-toxic Chinese herbs or composition, but it is rarely reported systemicaly. OBJECTIVE:To summarize the neuroprotective effect of Chinese herbal monomersvia the Nrf2 signal pathway in stroke patients. METHODS:The first author retrieved the CNKI, VIP, Medline, and PubMed databases by computer. The keywords were “Nrf2, ARE, stroke, traditional Chinese medicine, neuroprotection” in Chinese and English,respectively. Articles concerning the neuroprotective role of Chinese herbal monomervia Nrf2 were analyzed and discussed. RESULTS AND CONCLUSION: Totaly 85 articles were retrieved. According to the inclusion and exclusion criteria, 46 articles were included in result analysis. The results show that a variety of monomers can exert neuroprotective effectsvia the Nrf2 pathway. Chinese herbal monomers include organic acids, phenols, saponins, terpenes, flavonoids, alkaloids, and other single or composite components. Traditional Chinese medicine has the clear neuroprotective effect after stroke, but it is lack of regularity, and it is stil need to expand the data and further research as the basis.

Objective To study the pharmacokinetics difference of levofloxacin polymorphs in rats, evaluate the advantageous medical polymorph,and explore the effects of different polymorphs on clinical medicine. Methods Four crystal forms of levofloxacin were administered intragastrically to rats,and high performance liquid chromatography( HPLC)was used to measure the contents of levofloxacin in rat plasma. The pharmacokinetic parameters were calculated and compared Results After a single oral dose,the peak plasma concentration(Cmax)of crystal forms ofⅠ,Ⅱ,ⅢandⅣof levofloxacin was 6. 984,9. 692,9. 405,6.424 mg·L-1;the time to peak(tmax)was 0.6,0.9,1.0,1.0 h;the half-life(t1/2)was 4.207,2.97,4.857,1.695 h;theareaunderthecurve(AUC0→12h)was31.478,42.385,32.406,31.636mg·h·L-1. Conclusion Thereisnostatistically significant difference in pharmacokinetic parameters. However,compared with other crystal forms,plasma concentration of crystal form II is higher and maintained longer. Therefore,crystal form II of levofloxacin is an advantageous polymorph for medicine.

Objective:To understand the monitoring levels of individual dose to radiation workers in Jiangsu province from 2011 to 2018, and to analyze their changing trends.Methods:Through National Individual Dose Registry, the data on the monitoring result of occupational external exposure of radiation workers in our province was collected, and statistical analysis was performed.Results:A total of 176 134 radiation workers in Jiangsu province were collected from 2011 to 2018. The annual collective effective dose was 58 man·Sv and the average annual effective dose was 0.35 mSv. The average annual effective doses to medical radiation workers for interventional radiology and nuclear medicine were both 0.41 mSv, with significantly higher NRE ratios than others ( χ2=219.1, P<0.05). By 2018, the numbers of monitored workers were 25 714 for medical radiation, accounting for 81%, with an average annual effective dose of 0.24 mSv, and 6 169 for industrial radiation, accounting for 19%, with an average annual effective dose of 0.18 mSv. Conclusions:The average annual effective dose to radiation workers in Jiangsu province is in consistency with the relevant national standards. The dose values for radiation workers in interventional and nuclear medicine are relatively high. The protection measures in their workplace should be improved. Meanwhile oversight of radiation protection should be enhanced for individual radiation workers in Jiangsu province.

Objective To analyze the effects of achievement motivation and family environ-ment of undergraduates majoring in preventive medicine on creativity tendency. Methods The self-administered questionnaire was used to survey the general characteristics , achievement motivation , family environment, and Williams creativity tendency of undergraduates (n=243) from grade 1 to grade 5 majoring in preventive medicine in a medical college. The effects of achievement motivation and family environment on creativity tendency were tested with multiple linear regression analysis. SPSS 17.0 software was used for statistical analysis. The indexes between boys and girls was compared with group t test, and single factor analysis of variance was made for comparison between grades, SNK method was used to test and compare two groups; linear correlation analysis was made to inspect the correlation between the two indicators, and multiple linear regression analysis method was used for further analysis. Results The survey recycled 226 copies of effective questionnaires. The scores of achievement motivation, family environment, and Williams creativity tendency and all dimen-sions had no statistically significant difference among the five grades, or between the male and female (P>0.05). The positive influence factors of creativity tendency and its dimensions were pursuing success, the in-formative property, the entertaining property and organizational property, the negative influence factor was avoiding failure. R2 was 0.094-0.265 (P=0.000-0.048). Conclusion Achievement motivation and family environment of undergraduates majoring in preventive medicine may have posi-tive effects on creativity tendency. Various comprehensive measures should be taken to improve family environment and enhance achievement motivation, and to promote to increase creativity tendency, and to cultivate students' creativity and improve students' scientific research ability.

Objective To evaluate the therapeutic effects,acute and late side-effects of cisplatin plus 5-fluorouracil (PF) schemed chronomodulated chemotherapy combined with concurrent intensitymodulated radiotherapy(IMRT) for nasopharyngeal carcinoma.Methods A total of 48 nasopharyngeal carcinoma patients treated with chronomodulated chemotherapy plus concurrent IMRT were retrospectively studied.The radiation doses prescribed to the gross target volume GTVnx of nasopharyngeal,to the positive neck lymphnodes GTVnd,to the clinical target volume CTV1,and to CTV2 were 73.92-77.88,69.96,60.06-66.00 and 50.96-56.00 Gy respectively.The Kaplan-Meier survival analysis was used to calculate the local-regional progression-free rate.The acute and late side-effects were graded according to RTOG radiation morbidity scoring criteria.Results The complete remission (CR) rate was 41.6％(20/48) ; the partial remission (PR) rate was 47.9％ (23/48) ; the stable disease (SD) rate was 4.2％(2/48) ; and the local tumor control rate was 89.6％.Most of the patients had grade 1 to 2 acute side effects and grade 0 to 1 late side-effects.No grade 4 acute and late toxicity was observed.1,2,4-year survival rates were 93.8％,79.2％ and 64.5％,respectively.The DVH analysis showed that IMRT improved the total dose and dose per-fraction to the target volume with considerable dose reduction of the normal structures at the same time.Conclusions PF chronomodulated chemotherapy plus concurrent intensity-modulated radiotherapy for NPC could improve therapeutic effects with satisfactory tolerance of the side effects.