Objective Study on the distribution of auto‐antibodies against platelet in adults and children with primary immune thrombocytopenia(ITP) .Methods Platelet auto‐antibodies were detected in 83 ITP patients and 58 non‐ITP patients by enzyme linked immunosorbent assay (PAKAUTO kit) .Anti‐GP Ⅱ b/Ⅲ a ,GP Ⅰ b/Ⅸ and GP Ⅰ a/Ⅱ a auto‐antibodies were analyzed for 46 a‐dults and 37 children with ITP .Results The positive rate of autoantibody was 66 .27% in ITP patients ,which was much higher than that of non‐ITP patients ,the difference was significant(P < 0 .05) .As for ITP patients ,female ITP patients in adult group were 28 ,while in children group were 24 ,the difference was not significant(P > 0 .05) ,but the morbidity of ITP in females was higher than that of males in both of the two groups ,the difference was significant(P< 0 .05) .There was no significant difference on the distribution of platelet auto‐antibodies in adult and children group(P> 0 .05) ,the main of them was resistance against GP Ⅱ b/Ⅲ a and GP Ⅰ b/Ⅸ antibodies .Conclusion The detection of platelet auto‐antibodies could distinguish ITP and non‐ITP patients ,and GP Ⅰ a/Ⅱ a has an important reference value about therapy .

Objective To evaluate the effect of combined laparoscopic and endoscopic treatment for cholelith of gallbladder and common bile duct(CBD).Methods Diagnosis was established in 44 patients by ERCP , and endoscopic Oddi′s sphincteromy (EST) was performed in all patients, then choledocholith was removed by endoscopic netbasket and balloon. 3～5 days after laparoscopic cholecystectomy(LC) was carried out. Results The success rate of combined treatment in this study was 98%(43/44), and stones were removed in 100%(44/44). There was no conversion to open surgery in our series, and no severe complications. All patients were discharged in 5～15 days postoperatively. Conclusions Combined laparoscopic and endoscopic procedure is a safe and effctive method to treat patients suffering from cholelith of the gallbladder and CBD.

Objective To investigate the prevalence of Helicobacter pylori infection and the incidence of gastric mucosal lesions in type 2 diabetes mellitus(DM)and diabetic kidney disease(DKD)patients with dyspepsia symptoms.Methods A total of 241 type 2 diabetic patients and 69 non -diabetic subjects with dyspeptic symptoms were enrolled in the study.Gastroduodenal lesions were observed by gastrointestinal endoscopy and the presence of Helicobacter pylori infection was identified by rapid urease test and serum IgG antibodies to Helicobacter pylori.Urine albumin excretion rate(UAE)at 24 hours was measured in all subjects.According to the urinary albumin excretion rate,patients were classified into diabetes mellitus group(DMgroup,with UAE <30mg/24h),diabetic kidney disease group 1(DKD group 1,with UAE 30mg/24h to <300mg/24h)and diabetic kidney disease group 2(DKD group 2 >300mg/24h).Estimated glomerular filtration rate were above 60mL·min -1 ·(1.73m2 )-1 in the three groups of patients.The 69 cases of non -diabetic subjects were used as the control group.Results The prevalence of H pylori infection in the DKD group[145 /72(62.5%)]and the DKD group 2[34 /53(64.15%)]were significantly higher than those in the control group[28 /65(43.1%)](χ2 =3.901,P =0.04;χ2 =4.223,P =0.03)and the DM group [27 /63 (42.9%)](χ2 =4.104,P =0.04;χ2 =5.116,P =0.03).No significant differences of H.pylori prevalence were detected between the DKD groups(χ2 =1.304,P =0.29)as well as the DMgroup and the control group (χ2 =0.723,P =0.40).Gastroscopy results showed that the incidence of normal endoscopic performance in the DMgroup was higher than that of the control group(57.1% vs.38.5%,χ2 =4.612,P =0.03).There were no significant differences between the control group and DM group,DKD1 group and DKD2 group in the incidence of gastric mucosal lesions (Superficial gastritis:χ2 =1.206,0.912,0.707;erosive gastritis:χ2 =1.422,1.836 0.870;duodenal ulcer:χ2 =243.1, 1.716,2.233;gastric ulcer:χ2 =1.440,0.971,1.322 and esophagitis:χ2 =2.116,2.318,2.488,all P >0.05). Conclusion Diabetic nephropathy patients are more susceptible to Helicobacter pylori infection.There is no significant difference in the infection rate of Helicobacter pylori between type 2 diabetic nephropathy with microalbuminuria and with macroalbuminuria.There are no significant differences in the type of gastric mucosal lesion between Type 2 diabetes mellitus,diabetic nephropathy patients and non diabetic patients.

Objective To evaluate the clinical value of the chemiluminescence immunoassay particles (CMIA)in the diagnosis of syphilis.Methods The serum specimens from 150 cases of syphilis in our hospital were selected as the observation group and con-temporaneous 150 serum samples from non-syphilis healthy people were selected as the control group.The toluidine red unheated serum test (TRUST),treponema pallidum particle agglutination test (TPPA)and CMIA were adopted to conduct the detection. The sensitivity,accuracy and specificity of the three kinds of method were calculated and their differences were compared and ana-lyzed.Results The sensitivity of TRUST and TPPA and CMIA was 65.3%,97.7% and 99.3% respectively,the specificity was 74.7%,97.3% and 100.0% respectively,the accuracy was 70.0%,97.0% and 99.7% respectively,the difference among three kinds of methods had statistical significance (P <0.05).The sensitivity,specificity and accuracy of TRUST were lower than those of CMIA and TPPA (P <0.017),there was no statistically significant difference between CMIA and TPPA (P >0.017).Conclu-sion CMIA is equivalent to TPPA in the sensitivity,specificity and accuracy,is superior to TRUST,and has the advantages of sim-ple operation,objective results and good repeatability.

Objective: To study the chemical components from the rhizomes of Cyperus rotundus. Methods: The compounds were isolated and purified by chromatographic techniques, and their structures were elucidated by spectral methods. Results: A new isoflavonoid, 5, 7, 4'-trihydroxy-2'-methoxy-3'-prenylisoflavone (1), along with nine phenolic compounds, 6-O-p-hydroxybenzoyl- 6-epi-aucubin (2), 6-O-p-hydroxybenzoyl-6-epi-monomelittoside (3), verproside (4), syringopicroside B (5), syringopicroside C (6), oleuropeinic acid (7), oleuroside (8), 10-hydroxyoleuropein (9), and senburiside I (10), were obtained from the rhizomes of C. rotundus. Conclusion: Compound 1 is a new isoflavone, named cyperotundone A, and compounds 2-10 are isolated from this plant for the first time.

Objective: To study the chemical constituents in the cultured filaments of an antitumor actinomycete strain (N2010-37). Methods: Compounds were isolated and purified by chromatographic techniques and recrystallization, and the structures were identified by spectral methods together with physicochemical analysis. The antitumor effects of these compounds were tested in vitro by MTT method. Results: Three compounds were identified including two anthrones and one novel macrolide. They were (3S, 4R, 7R, 8R, 9S)-3, 8-dihydroxy-4, 7,9-trimethyl-2,6-cyclononanediiolacetone (1), 2-hydroxy-1-methoxy-3- methylanthraquinone (2), and 1, 6, 8-thihydroxy-3-methylanthraquinone (3). Conclusion: Compound 1 is a new compound, and compounds 1 and 3 show the favorable cytotoxic activity against human chronic granulocytic leukemia cell line K562 strain by MTT method in vitro.

Objective: To study the steroidal saponins and phenylic constituents in the bulbs of Lilium lancifolium and their anti-oxidant activities in vitro. Methods: The constituents were isolated and purified by chromatographic technique and recrystallization, and their structures were identified by spectral methods together with physiochemical analyses. The anti-oxidant effects of these constituents on DPPH and ABTS were screened in vitro. Results: Eleven constituents were isolated including seven first-found ones (1-5, 9, and 10) and four known compounds in this plant. They were cis-1-O-p-coumaroylglycerol (1), trans-1-O-p-coumaroylglycerol (2), caffeoyl glyceride (3), 3,4- dihydroxybenzaldehyde (4), salicylic acid (5), (25R,26R)-26-methoxyspirostan-5- ene-3β-O-α-L-rhamnopyranosyl-(1→2)-[β-D-glucopyranosyl- (1→6)]-β-D-glucopyranoside (6), (25R,26R)-3β, 17α-dihydroxy-26-methoxyspirostan-5-ene-3β-0-a-Z.-rhamnopyranosyl-(l- >2)-[β-D-glucopyranosyl-(l-"6)]-β-D-glucopyranoside (7), diosgenin 3-O-{O-α-L-rhamnopyranosyl-(1→2)-O-[β-D-xylopyranosyl- (1→3)]-β-D-glucopyranoside} (8), (25R)-3β,17α-dihydroxy- 5α-spirostan-6-one-3-O-α-L-rhamnopyranosyl-(1→2) -β-D-glucopyranoside (9), (25R)-3β-hydroxy-5α-spirostan-6-one-3- O-α-L-rhamnopyranosyl-0 (1→2)-β-D-glucopyranoside (10), and (25R)-spirost-5-ene-3β-O-α-L-rhamnopyranosyl-(1→2) -[β-D-glucopyranosyl-(1→6)]-β-D-glucopyranoside (11). Compounds 1-5 showed the favorable scavenging effects on DPPH and ABTS. Conclusion: The study suggests that the phenylic constituents from the bulbs of L. lancifolium have the anti-oxidant effects.

OBJECTIVE: To discuss the potential problems caused by the exfoliation of the tunic albuginea after the low-temperature plasma operation. METHOD: To observe the occurrence of the tunic albuginea, exfolliating time, wound healing and its complications by following the patients received the low-temperature plasma operation from November in 2012 through June in 2013 (including 116 cases of tonsillectomy, 98 cases of adenoidectomy, 255 cases of the ablation of the inferior turbinate,8 cases of the ablation of the cyst of epiglottis, and 4 cases of the ablation of the tumor of larynx) together with reviewing the relevant literatures. RESULT: The tunic albuginea exfolliated about two weeks after tonsillectomy, bleeding was found in 3 cases, one of which was related with inappropriate eating; the exfoliation about two or three weeks after adenoidectomy, without the occurrence of the narrow nostril and pharyngeal cavity adhesion; about four weeks after the ablation of the cyst of epiglottis, bleeding was found in 1 case; about three or four weeks after the ablation of the inferior turbinate, massive bleeding was found in one case after two months; and the ablation of the tumor of larynx, one with severe atypical hyperplasia and carcinoma in situ, the theunic albuginea did not completely exfoliate four moths after the surgery and new creatures could be found, the wound looked smooth and healed well nine moths after the surgery. The full exfoliation occur four months after the surgery for one with the neurilemmoma in the left laryngeal ventricle and the new creatures could also be found. It exfoliated eighth days after the surgry for one patient with left subglottic epitheliaoid heman-gio endothelioma and it did not recur even six months after the surgery. Another one with the cyst of the left plica aryepiglottica failed to be followed. The first three patients did not suffer from such complications as bleeding, endogenous in trachea, etc. CONCLUSION Low-temperature plasma surgery has obvious advantages, but the potential problems caused by the surgery need to be taken in accounted, especially the exfoliating time of the tunia albuginea is different after the ablation of the tumor of larynx, which is inconsistent with what the literatures reported, it could partially due to the action time of low-temperature plasma surgery with surrounding tissues.
Adolescent ; Adult ; Catheter Ablation ; methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Young Adult

Objective Random allocation concealment is important in ensuring high-guality randomized controlled clinical trial.In this paper , we aimed to design a more convenient and effective two couplet random allocation method through improving the random allocation concealment technology which uses the envelope method . Methods According to the randomized sequence , a two-couplet random allocation should be prepared for every subject and bound into a book in order , which named random assignment book with cover and instructions .The first couplet is to collect the enroll information and the second couplet is to show the allocation informa -tion.The serial numbers of the two couplets which around sealant are the same , and leave blank at the same areas of the two couplets for signing the enter information .The content of the first couplet can be completely copied to the second couplet .In order to avoid expo-sing the allocation information in advance , the back of the second couplet should be black-printed. When the subjects are sure qualified, the researchers selected the corresponding two couplet in a sequential order .Exposing the allocation infromation in the second couplet, and the subjects will be allocated to the group designated on the second couplet .This random allocation book should be entrusted to professional printing mechanism ,printing according to the random assignment sequence table and in the strict quality control .For the multicenter clinical trials , it can be printed in parts . Results The method has been implemented in nearly ten randomized controlled trials and obtained the consistent high praise . Conclusion The random allocation book method is easy to produce , simple operation and convenient in monitoring , which can effectively achieve the random allocation concealment in a clinical trial as well as having a sig -nificantly practical value in ensuring the quality of randomization .

Objective To explore the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP) for elderly patients with periampullary diverticula accompanied with choledocholithiasis.Methods The retrospective cross-sectional study was conducted.The clinical data of 297 elderly patients with age ＞70 years and periampullary diverticula accompanied with choledocholithiasis who were admitted to the Zhongshan Hospital affiliated to Fudan University between January 2013 and January 2016 were collected.All the patients received lithotomy by ERCP after completion of preoperative preparation,and then underwent symptomatic treatment.Observation indicators included:(1) treatment results:cannulation time,success rate of cannulation and success rate of stones removed;(2) surgical complications:hemorrhage,perforation and pancreatitis;(3) follow-up results.All patients were followed up by outpatient examination and telephone interview up to December 2016.Follow-up included postoperative delayed perforation,patients' survival,further attack of acute cholangitis and reoperation for removing stones.Measurement data with normal distribution were represented as x ± s,and measurement data with skewed distribution were described as M (range).Results (1) Treatment results:all the 297 patients underwent successful lithotomy by ERCP,with a cannulation time of (5±4)minutes and a success rate of cannulation of 100.00％ (297/297).Of 297 patients,292 had one-off success of stones removed,with a one-off success rate of 98.32％ (292/297),and 5 received partial stones removed due to choledocholithiasis combined with acute cholangitis.(2) Surgical complications:4 patients were complicated with immediate hemorrhage during intraoperative endoscopic sphincterotomy (EST).Bleeding of 1 patient was cauterized by biopsy forceps,and 3 patients had simplex JHY-BAL compression hemostasis.Two patients with postoperative delayed hemorrhage had successful hemostasis by biopsy forceps with metal hemostatic clip under endoscope after emergency duodenoscopy.One patient with intraoperative perforation was cured by conservative treatment.Two patients with severe acute pancreatitis underwent continuous gastrointestinal decompression combined with maintenance therapy of somatostatin,and then received endoscopic ultrasound-guided puncture and drainage for pseudocyst around the pancreas,with a stable symptoms of pancreatitis after 4 weeks.(3) Follow-up results:all the 297 patients were followed up for 6-12 months,with a median time of 8 months.During follow-up,292 patients had healthy survival,without recurrences of cholangitis and bile duct stone,and no delayed perforation and death were detected.Five patients underwent the second time lithotomy by ERCP after 2-3 months postoperatively.Conclusion Lithotomy by ERCP is safe and effective in the treatment of elderly patients with periampullary diverticula accompanied with choledocholithiasis.