Objective To study the value of B-cell activating factor (BAFF) expression levels in the diagnosis and prog-nosis of children with idiopathic thrombocytopenic purpura. Methods Children with idiopathic thrombocytopenic purpura (ITP) admitted to our hospital from September 2011 to September 2013 were enrolled in observation group, and healthy check-up chil-dren during the same period were enrolled as controls. The serum levels of B-cell activating factor, platelet antibodies (PAIgG, PAIgM, PAIgA) and platelet count were detected, and curative effect in children with ITP was observed. Results The BAFF, PAIgG, PAIgM and PAIgA levels were higher and platelet count were less in both acute and chronic ITP children than those in normal controls. The difference was signiifcant (P<0.05). The results of linear regression analysis indicated that BAFF levels were positively correlated with PAIgG, PAIgM and PAIgA levels (β=1.87~2.25, P<0.05), and were negatively correlated with platelet count (β=-2.42, P<0.05). Meanwhile, BAFF levels were negatively correlated with curative effect in ITP children (β=-1.88, P<0.05). When the value of BAFF was 1.35, the sensitivity for predicting effective treatment was 0.84 and the speciifcity was 0.75. The area under the ROC curve was 0.85 (95%CI:0.73~0.98, P=0.000). Conclusions The serum BAFF expression was increased and closely related to the level of antiplatelet antibody, platelet count and treatment effect in ITP children, and therefore, was a good indicator for the diagnosis and prognosis of ITP.

Objective: To evaluate the effect of open-chest surgery for cancer patients in advanced stage, in aged and with respiratory insufficiency. Methods: From May 1992 to December 2002, 637 patients with lung cancer underwent thoracotomy in out hospital. 118 of the 637 patients fit in with the standards of advanced, aged or respiratory insufficiency. RVEF was consecutively assessed in 118 before pulmonary resection by echocardiography. According to right ventricular function, the 118 patients were dicided into group A(n=77, RVEF

Objective To assess the incidence and management of nocturnal acid breakthrough (NAB). Methods Forty patients with duodenal ulcer confirmed by gastroscopy were randomly divided into five groups, eight patients in each group. Patients were treated by the following strategies for a course of 5 days: group A (omeprazole 20 mg per day orally in the morning), group B (omeprazole 20 mg twice a day orally in the morning and at 4 p.m), group C (intravenous injection of omeprazole 40 mg twice a day in the morning and at 4 p.m), group D (omeprazole 20 mg per day orally in the morning plus ranitidine 150 mg at bed time) and group E (omeprazole 20 mg twice a day orally in the morming and at 4 p.m plus ranitidine 150 mg at bed time) respectively. Intragastric pH over 24 hours was recorded on the morning of the fifth day for each patient. Results In comparison with that in group A, intragastric pH was higher in the other four groups. The mean intragastric pH and mean nocturnal pH each in group B (6.2?0.7, 6.4?1.1), group C (6.9?0.7, 6.8?0.9), group D (6.0?0.7, 5.9?0.7) and group E (5.8?0.5, 6.1?0.5) were significantly higher than those in group A (4.8?0.7, 4.7?0.8, P

[Objective]To explore the surgical feasibility and clinical outcome of pedicle screw instrument for treatment of irreducible atlantoaxial dislocation and to choose an effective method of internal fixation.[Method]From June 2003 to February 2009,14 pationts with atlas dislocation followed by upper cervical cord compression were treated surgically with oral anterior soft tissue release combined with posterior reduction and pedicle screw instrument.Preoperative CT,MRI and radiographs as well as intraoperative screw placement and bone graft were administered in all pationts.Only cervical collars were used as external support for 3 months in occipitocervical fusion.[Result]All screws were successfully placed in atlas and axis.Forteen patients were followed up for an average of 18 months.Bone fusion was achieved in all cases with no complications of nerve,internal fixation failure and redislocation.Neurological recovery was significantly improved in 12 cases and took a turn for better in 2 cases.[Conclusion]Pedicle screw instrument in atlas and axis has the advantages of direct screw placement,short-segment fusion,intraoperative reduction and high fusion rate.It is a better alternative for atlantoaxial dislocation.

Objective To evaluate the effect of alendronate on osteoprotegerin (OPG) and receptor of activator of nuclear factor κB-ligand (RANKL) expression in human marrow stroma cells (hMSCs) in vitro. Methods hMSCs were isolated from haman marrow, cultured in vitro, and randomly divided into two groups: alendronate group, hMSCs culture fluid containing 1×10-7 mol/ L alendronate; control group, no special treatment but culturing hMSCs in DMEM. Two weeks after treatment, the expressions of OPG and RANKL were evaluated by RT-PCR and Western blot.Results hMSCs became uniform spindle-shaped fibroblasts. As cells proliferated, they formed colonies and showed whirlpool arrangement. After one week's treatment, hMSCs in alendronate group had reduced processes and gradually showed disc shape, which did not happen in control group but kept fibroblast shape and just increased in density. In RT-PCR, the ratio of OPG/RANKL in alendronate group and control group was 8.77±1.16 and 4.58±1.27, respec-tively. In Western blot, the ratio of OPG/RANKL in alendronate group and control group was 2.58±0.47 and 1.52±0.32, respectively. The ratio of OPG/RANKL was higher in alendronate group than in control group (P<0.01).Conclusion Alendronatc enhances OPG expression and inhibits RANKL expression of hMSCs in vitro.

Objective To investigate the changes of thyroid function and carotid atherosclerosis in patients on maintenance hemodialysis (MHD).Methods A total of 110 stable MHD patients undergoing hemodialysis for at least three months were enrolled in the study.Serum free-T3 (FT3), free-T4 (FT4) and thyroid stimulating hormone (TSH) concentrations were measured by electrochemiluminescence.Plasma levels of homocysteine (Hcy) and C-reactive protein (CRP) were detected.Clinical data and biochemical indicators were collected.These patients were divided into thyroid dysfunction group and euthyroidism group.Prevalence of atherosclerosis was detected by carotid ultrasonography.The associations between the changes of thyroid function and carotid atherosclerosis were analyzed by Logistic regression model.Results Among these 110 patients, 42 (38.18％) patients had thyroid dysfunction.Hcy and CRP concentrations were significantly higher in thyroid dysfunction group than those in euthyroidism group (P ＜ 0.05).The intima-media thickness, number of plague and arteriostenosis of carotid were higher in thyroid dysfunction group than those in euthyroidism group (P ＜ 0.05).Multivariate logistic regression analysis showed that increased Hcy and CRP, decreased serum FT3 were independent risk factors for carotid atherosclerosis.Conclusions Thyroid dysfunction with low serum FT3 is frequently found in MHD patients.In MHD patients, FT3 is closely correlated to carotid atherosclerosis.

A total of 178 patients with the time of mechanical ventilation beyond 48 hours in the second affiliated hospital of Wenzhou medical college from January 2010 to December 2013 were enrolled in this study,and there were fifty-six patients with ventilator-associated tracheobronchitis (VAT).The associated factors included age,sex,blood pressure,blood glucose,BMI,the time of mechanical ventilation,tracheal intubation methods,raise head to 30-45°,proton pump inhibitors (PPI),prophylactic antibiotic treatment,glasgow coma scale (GCS),acute physiology and chronic health evaluation (APECHE) Ⅱ score.The related factors of VAT were evaluated by using univariate logistical regression analysis,and the statistical significant variables were analyzed by using multivariate logistical regression analysis.By using univariate logistical regression analysis age,blood glucose,the time of mechanical ventilation,raise head to 30-45°,prophylactic antibiotic treatment,GCS and APECHE Ⅱ score were the important factors of VAT (P ＜ 0.05),but sex,blood pressure,BMI,tracheal intubation methods and PPI were insignificant related to VAT(P ＞ 0.05).By using multivariate logistical regression analysis the time of mechanical ventilation (OR =4.072,95％ CI 2.036-8.146),GCS[2.198(1.155-4.184)],age[2.128 (1.119-4.046)],APECHE Ⅱ score [2.109 (1.084-4.104)] and raise head to 30-45 ° [0.488 (0.243-0.979)] were associated independently with the VAT.The time of mechanical ventilation,GCS,age over 60 years,APECHE Ⅱ score and raise head to 30-45°were the independent factors associated with VAT.

BACKGROUND:Methicil in-resistant Staphylococcus aureus (MRSA) infection had been a global problem up to 1980s, and it has become a leading pathogen giving rise to nosocomial infections now.
OBJECTIVE:To determine the molecular types and drug susceptibilities of Staphylococcus aureus prevailed in burn ward, and to provide a basis for preventing and control ing MRSA intections.
METHODS:A total of 53 Staphylococcus aureus strains were col ected from the burn ward in the Urumqi General Hospital of Lanzhou Military Region of Chinese PLA. These MRSA strains were identified by PCR and cefoxitin disc diffusion test, and al MRSA strains were typed by spa, SCCmec and MLST typing. In the meanwhile, antibiotic susceptibilities of 17 kinds of drugs, such as oxacil in, to Staphylococcus aureus were also determined, and drug resistance of different types of Staphylococcus aureus especial y MRSA, was analyzed.
RESULTS AND CONCLUSION:Among 53 Staphylococcus aureus strains, 43 were identified as MRSA, containing determined for amplification of meoA (n=41) and positive for cefoxitin disc diffusion test (n=2). Three SCCmec types, four spa types, and three ST types were found. The major predominant clone was ST239-MRSA-III-t030 (90.7%), with highest resistant to oxacil in and other nine antibiotics. In conclusion, the higher MRSA isolation rate from the burn ward, and ST239-MRSA-III-t030, as the predominant clone, presents with an outbreak in the burn ward and stronger resistance to many different families of antibiotics.

Objective To discuss the clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy.Methods Forty-eight cases with ankle osteoarthritis patients admitted at the Orthopaedic Hospital of Zhengzhou from January 2012 to June 2014 were selected and all of them were given the treatment of focal cleaning under arthroscopy.The clinical effect of surgical treatment were judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system respectively.Results At the time of the last follow-up,modified McGuire ankle rating system((85.64±16.52)points vs.(52.46±10.25)points,t=-8.465),the United States after ankle surgery AOFAS ankle-full score [(85.24±11.46)points vs.(53.68±9.48)points,t=-7.548)and Mazur ankle rating system((86.45±12.57)points vs.(58.49±8.64)points,t=-6.596)all increased than that of pre-operation,the differences were statistically significant(P＜0.05).The modified McGuire ankle rating system of patients with low-grade lesion at pre-operation((62.45±7.63)points vs.(49.58±6.35)points,t=3.685)and the time of the last follow-up((93.68±11.54)points vs.(68.54±9.68)points,t=8.695)were all higher than that of patients with high-grade lesion,the differences were statistically significant(P＜0.05).The clinical effect of surgical treatment judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system were respectively 91.67％(44/48),89.58％(43/48)and 89.58％(43/48),the differences were no statistically significant(x2=0.824,P＞0.05).Conclusion The clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy is remarkable and it causes light damage to the body.It is especially suitable for patients with low-grade lesions and is worth popularization and application.

Objective To investigate the mechanism of nuclear factor-kappa B(NF-κB)in thioactamide(TAA)induced acute hepatic injury.Methods Seventy-eight Wistar rats were randomly divided into normal group(n=18),TAA model group(n=30)and pyrrolidine dithiocarbamate (PDTC)pretreated group(n=30).The rats in PDTC group were received 100 rag/kg of PDTC 1 h before induction of the model.Every 10 rats in TAA group and PDTC pretreated group and 6 rats in normal group were sacrificed at 6,24,48 hour after induction of the model tO mesure levels of endotoxin,tumor necrosis factor(TNF)-α and interleukin(IL)-6.The expression of the intercellular adhesion molecular(ICAM)-1 in hepatic tissue was tested using RT-PCR and the NF-κB activity was 48 hour were higher in TAA group[(87.11±8.23)%.(78.55±6.82)%and(74.27±6.26)%,respectively]than those in normal group[(4.64±1.82)%,(4.55±1.67)%and(4.91±2.12)%,all comparison with normal group(P＜0.01).The serum concentration of endotoxin and TNF-α in PDTC pretreated group were higher than those in normal group(P＜0.0 1).but lower than those in TAA with ticrmal group(P＜0.01).The serum concentration of IL-6 in PDTC pretreated group was higher at 24 and 48 hour than those in normal group(P＜0.01),but lower than thoes in TAA group(P＜group(P＜0.01).The expression of ICAM-1 in PDTC pretreated group was higher than that in immunohistochemical examination showed that liver necrosis was folund in TAA group and PDTC pretreated group.Conclusion The Nuclear factor-κB may aggravate the injury of liver by promoting expressions of TNF-α,IL-6 and ICAM-1.