It is a challenge in diagnosis of hemophagocytic lymphohistocytosis (HLH).Rapid diagnosis is the key to make decisions in clinical management of HLH.The timely and reliable diagnosis of HLH can be assisted by laboratory tests including nature killer (NK) cell activity, sCD25, hemophagocytosis, ferritin, surface CD107a, and genetic testing.Here is introduced lab assays and evaluate the clinical applications in HLH.The aim is to raise awareness of the values of laboratory evaluations in diagnosing HLH.

Objectives To investigate the incidence of the heparin-induced thrombocytopenia (HIT) and positivity of anti-heparin/platelet factor 4 complex antibody (HIT-antibody) in inpatients treated with heparin preparations.Methods A total of 197 consecutive patients,including 120 men and 77 women,who were treated with unfractioned heparin (UFH) or low molecular weight heparin (LMWH),were enrolled in this study.HIT-antibody was detected by enzyme-linked immunosorbent assay (ELISA).All patients were classified into subgroups based on 4Ts (Pretest Clinical Scoring System) and types of underlying disorders.The incidence of HIT and positivity of HIT-antibody among different groups were analyzed.Results The overall incidence of HIT was 3.0％ (6/197),and the positivity of HIT antibody was 12.2％ (24/197).The positivity of HIT-antibody was 10.1％ (18/178),7.7％ (1/13) and 83.3％(5/6) in low,moderate and high HIT probability group respectively.There were significant differences of HIT positivity and mean level of HIT-antibody between the high HIT probability group and the low or moderate HIT probability group (P =0.000).Both the incidence of HIT and positivity of HIT-antibody were higher in surgical patients than in medical patients (5.8％ vs 0.9％,P =0.047 and 19.8％ vs 6.3％,P =0.004).Conclusions The incidence of HIT and positivity of HIT-antibody were 3.0％ and 12.2％ respectively,both of which were related with the types of disorders.Detection of HIT-antibody has a better applicable value in patients with high HIT probability.

Objective: To explore the clinical features of hypokalemic periodic paralysis, and compare clinical features of primary group with those of thyrotoxicosis secondary group. Methods: Clinical data of 44 patients with hypokalemic periodic paralysis in Peking University First Hospital from 1996 December to 2008 December were retrospectively analyzed. Results: There were 22 patients in primary group, and 22 in thyrotoxicosis group. Identical clinical features of both the groups; (1 ) It had a predilection in young men. (2)Main symptoms were limb movement disorder and fatigue, and paralysis recurrent attacked in most patients. (3) 40. 9% to 68. 2% patients had obvious incentives, and the common ones were a heavy meal, sweet drinks, or strenuous'exercise. (4) Serum potassium levels of the two groups were obviously lower than the normal range. (5) In 20% patients of primary group and 25% patients of thyrotoxicosis secondary group, CK levels were higher than normal, while LDH and HBDH levels were normal.(6) The doses of potassium replishment were not correlated to serum potassium levels at the onset. Different clinical features of the two groups; (1) Patients of thyrotoxicosis group had hypermetabolism symptoms and thyroid dysfunction. Patients of primary group had no hypermetabolism symptoms, and all of them were euthyroid. (2) Serum potassium levels of thyrotoxicosis secondary group were lower than those of primary group significantly [(2.25±.67) vs (2.78±.49) mmol/L, P=0;007]. (3) Hyperkalemia is easier than primary group to rebound in thyrotoxicosis secondary group, after replenishment of potassium. Conclusion: Hypokalemic periodic paralysis has its clinical features, and patients with early diagnosis and replenishment of potassium in time have good prognosis. The doses of potassium replenishment are not determined by serum potassium levels at the onset. Hyperkalemia is easier to rebound in thyrotoxicosis secondary group after replenishment of potassium, serum potassium levels should be monitored closely, and hyperthyrosis radically cured.

Objective To compare the severity of hepatic ischemidreperfusion(I/R)injury caused by partial hepatectomy performed under propofol-remifentanil and isoflurane-fentanyl anesthesia.Methods Thirty ASA Ⅰ or Ⅱ patients aged 41-64 yr weighing 58-86 kg undergoing elective partial hepatectomy were randomly divided into 2 groups(n=15 each):propefol-remifentanil group(PR)and isoflurane-fentanyl group(IF).Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with TCI of propofol(Cp=3.5μg/ml)and remifentanil(Cp=4.2 ng/ml)in group PR or 1.5%-2.5% isoflurane and intermittent iv boluses of fentanyl in group IF.Muscle relaxation was maintained with intermittent iv boluses of vecuronium in both groups.Blood samples were taken before occlusion of hepatic portal(T1)immediately(T2)and 30,60 min after release of portal occlusion(T3,4)and 1 d after operation(T5),for determination of sernm levels of ALT,AST,γ-GGT,LDH,TBIL,T-SOD and MDA.Specimens were obtained from the liver left intact after partial hepatectomy for ultrastructural examination with electron microscope.ResultsSerum levels of ALT at T5,γ-GGT at T3,4,and MDA at T4,5 were significandy lower while T-SOD at T5 were significantly higher in group PR than in group IF.Electron microscopic examination showed that tissue damages were significantly aRenuated in PR group as compared with IF group.Conclusion Propofol-remifentanil anesthesia can to some extent pmtect the liver against I/R injury during partial hepatectomy by reducing oxygen free radicals.

Objective:To measure serum levels of salusins and catestatin and analyze their correlation in patients with essential hypertension (EH) .Methods :A total of 90 EH patients were selected as hypertension group .According to blood pressure level ,they were further divided into hypertension stage 1 group (n=31) ,hypertension stage 2 group (n=30) and hypertension stage 3 group (n=29) .Another 40 normotensive subjects undergoing physical examina‐tion were selected as normal control group .Enzyme linked immunosorbent assay (ELISA) was used to measure ser‐um levels of salusins and catestatin , and the correlation between serum levels of salusins and catestatin was analyzed . Results :Compared with normal control group ,there were significant reductions in serum levels of salusins [ (3.01 ± 0.66) ng/ml vs .(1.44 ± 0.42) ng/ml ,(1.35 ± 0.89) ng/ml ,(1.41 ± 0.32) ng/ml] and catestatin [(132.24 ± 7.55) ng/ml vs .(89.22 ± 6.12) ng/ml vs .(82.51 ± 8.37) ng/ml ,(83.34 ± 4.47) ng/ml] in hypertension stage 1 ,stage 2 and stage 3 group , P<0.01 all;compared with stage 1 group ,there were significant reductions in serum catestatin levels in stage 2 and stage 3 group (P<0.01 both) ,but there were no significant difference in serum salusins level a‐mong three groups of hypertension ( P>0.05 all) .Pearson correlation analysis indicated that serum salusins level had no correlation with catestatin level ( r=0.363 , P>0.05) in normal control group ,while serum salusins level was significant positively correlated with catestatin level (r=0.723 ,P<0.01) in hypertension group .Conclusion:Serum levels of salusins and catestatin significantly reduce and they is positive correlation in patients with hyperten‐sion .Along with blood pressure level rises ,serum catestatin level reduces .

Objective To optimize the extraction techique for Qingrejiedu oral liquid.Methods The amount of water, extraction time , extraction times and alcohol content were used as inspection factor, 3 levels per factor, with baicalin, chlorogenic acid , geniposide transfer rate and extraction rate as indexes,carries on Weighted comprehensive evaluation,the optimal extractin were screened by L9 (34 ) orthogonal test.ResuIts The optimal extraction condition of Qingrejiedu oral liquid were as follow:extraction for 3 times and 1h each time with 8-fold amount of water and 70% alcohol. ConcIusion Through the orthogonal test, the extraction process of Qingrejiedu oral liquid is designed reasonably, the result is reliable, and the extraction effect is good, and has higher application value.

Objective To observe the clinical efficacy of acupuncture in treating hemifacial spasm and its effect on the surface electromyogram signal of orbicularis oculi muscle under contraction state.Method Seventy-six patients with hemifacial spasm were randomized into a treatment group and a control group, 38 cases in each group. The control group was intervened by conventional medications, while the treatment group was by acupuncture in addition to the intervention given to the control group. The surface electromyogram signal of orbicularis oculi muscle under contraction before and after intervention, clinical efficacies, and side effects were compared between the two groups.Result The MF and MPF values were significantly changed after intervention in both groups (P<0.05). After intervention, the MPF value in the treatment group was significantly different from that in the control group (P<0.05). The total effective rate was 92.1% in the treatment group versus 63.2% in the control group, and the difference was statistically significant (P<0.05). The TESS scores after intervention were significantly different from that before intervention in both groups (P<0.05). After intervention, the TESS score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Acupuncture is an effective method in treating hemifacial spasm, and it can release muscle fatigue.

Objective To observe the effects of stationary cycle training on lower limb muscle tension and motor function in children with spastic cerebral palsy.Methods Sixty-seven children with spastic cerebral palsy were divided into a treatment group (n =34) and a control group (n =33).Both were treated with routine rehabilitation therapy,including neurodevelopment treatment,massage and physical agent therapy.The treatment group additionally cycled on a stationary bicycle for 20 min a day,five days a week for 3 months.Muscle tension in the children's adductor,hamstring and gastrocnemius muscles was evaluated using the modified Ashworth scale (MAS),while the adductor angle,popliteal fossa angle and foot dorsiflexion angle were measured using a joint protractor.Moreover,the 88-item version of the Gross Motor Function Measure (GMFM-88) was used to evaluate gross motor function.Results After treatment the average muscle tension of both groups was significantly lower than before treatment.The average muscle tension scores of the adductors,hamstrings and calf muscles of the treatment group [(1.79±0.54),(1.00±0.60),(2.29 ±1.77)] were significantly lower than those of the controls [(1.82 ± 0.53),(1.15 ± 0.44),(2.52 ± 1.89)].The adductor angles,popliteal fossa angles and foot dorsiflexion angles of both groups were significantly larger than before treatment,and the angles in the treatment group [(97.06 ± 19.03) °,(53.38 ± 12.54) ° and (8.38 ± 9.11) ° respectively] were significantly larger on average than those in the control [(98.94 ± 21.42) °,(56.52 ± 12.90) ° and (5.30 ± 14.30) ° respectively].After treatment the total GMFM scores of both groups were better than before treatment,but the treatment group's average score(138.18 ± 54.86) was significantly better than that of the control group(112.21 ± 62.44).Conclusion Three months of stationary cycle training can effectively reduce the muscle tension of children with spastic cerebral palsy and improve their motor function.

Peripheral artery disease is a cardiovascular risk factor. Exercise training may benefit patients with peripheral artery disease from preserving or improving functional capacity and reducing cardiovascular events. Accordingly, this article reviewed the effects of exercise training on peripheral artery disease, and the possible mechanisms

ObjectiveTo study the expression of adhesion mol ecules (CD 54 、CD 62p ) on diabetic neuropathy in the STZ induced rats and the effect of cilostazol treatment.MethodsSD rats were divided into four groups: normal control, diabetes control, insulin and cilostaz ol treated group. Sciatic nerve conductive velocity, the level of CD 54 /CD 62p on the surface of mononuclear cell/platelet were examined, and ultrast ructure of sciatic nerve was observed.ResultsCilostazol incr eased sciatic nerve conductive velocity significantly [DM=(20.3?2.2) m/s vs ci lostazol=(28.9?7.9)m/s,(P