Objective To detect the changes and clinical significance of the expression of anti‐GPⅡb/Ⅲa and anti‐GPⅠb/ⅠX on anti‐secreting B cells in patient with thrombocytopenia .Methods Expression of anti‐GPⅡb/Ⅲa and anti‐GPⅠb/ⅠX specific autoantibodies in thrombocytopenia were tested with (CBA) .Results There were significantly more circulating anti‐GPⅠ b/ⅠX and anti‐GPⅡb/Ⅲa antibody‐producing B cells in primary ITP(P<0 .05) for all comparisons .For diagnosing primary ITP ,the an‐ti‐GPⅠb/ⅠX had 43% sensitivity and 89% specificity ,whereas the anti‐GPⅡ b/Ⅲ a had 86% sensitivity and 83% specificity . When two tests were combined ,the sensitivity improved to 90% without a reduction in specificity .Conclusion The assay for detec‐ting anti‐GPⅠb/ⅠX is useful for identifying patients with ITP ,but its utility for diagnosing ITP is inferior to the anti‐GPⅡb/Ⅲa assay .

Objective To discuss the possible enteric nervous pathogenesis in gastritis related GI motor disorders on the expression changes of protein gene product9. 5 in neurons from the gastric walls of gastritis rat model. Methods 35 clean grade Wister rats were randomly divided into 3 groups, which included gastritis group A (n =10), gastritis group B(n =15) and control group(n =10). Rats in gastritis group A and B received gastric perfusion of HP and the mixture of 2% aspirin and 0. 6N hydrochloric acid respectively. The control group only received gastric perfusion of saline. All of the rats were killed and the gastric mucosal tissues were obtained for the pathological and HP examination. After immunohistochemical pretreatment, the tissues were stained with PGP9. 5 and at the same time the maximum diameter (Dmax, μm), mean area(μm2) and mean optical density (nm) of the neurons from the gastric walls were compared among the groups with Image-Pro Plus professional image analysis system. Results In gastric group A, HP could be found sparsely in the mucous layer or gastric pits, and all of the rapid urease tests were positive. In the other two groups, HP could not be found, and all of the rapid urease tests were negarive. In both gastric group A and B, different grades of inflammatory cell infiltration with active inflammation signs could be found in the deep layers of mucosa, while the control group was normal. The expression mean area, mean optical density of neurons from the gastric wall of rat in group A[(77. 10 ±48. 46) μm2, (53. 25 ±41.40) nm] or B [(73. 92 ± 39. 60) μm2, (45.33 ± 33.20) nm] was obvious lower than control group [(143.51 ± 29. 84) μm2, (85. 00 ± 14. 32) nm], while there was no significant difference between gastric group A and B (P ＞0. 05) (table 1). Conclusions Hp and NSAIDs might cause gastritis and decrease the PGP9. 5 expression of Neurous from gastric walls. The decrease of PGP9. 5 expression of neurons from the gastric wall might contribute to the pathogenesis of GI motor disorders or symptoms of functional dyspepsia.

Objective To investigate the diagnostic value of urinary neutrophil gelatin enzyme-related lipid delivery protein (NGAL) and kidney injury molecule-1 (KIM-1) in the acute kidney injury (AKI) after cardiopulmonary bypass (CPB) operation in children with non-cyanotic congenital heart disease (CHD). Methods A retrospective analysis was conducted. 200 CPB undergoing cardiac surgery in children with non-cyanotic CHD admitted to Tianjin Children's Hospital from June 2015 to May 2017 were enrolled. All patients were divided into AKI group and non-AKI group within 48 hours after operation, and the two groups matched with age, sex, weight, basic complications, operation time and other factors. The differences in serum creatinine (SCr), urinary NGAL and KIM-1 [corrected for urinary creatinine (UCr)] between the two groups before and after operation were compared. The early diagnosis value of urinary NGAL and KIM-1 on AKI was analyzed by the receiver operating characteristic curve (ROC). Results There were 32 patients with different degrees of AKI 48 hours post operation, and the incidence was 16.0%; 60 cases were enrolled in non-AKI group. Compared with non-AKI group, urinary NGAL at 2 hours after operation, urine KIM-1 at 4 hours after operation, and SCr at 10 hours after operation in AKI group were significantly increased, which decreased gradually after reaching peak at 6, 8, 24 hours respectively. It was shown by ROC curve analysis that the area under ROC curve (AUC) and 95% confidence interval (95%CI) of postoperative 2-hour urine NGAL, 4-hour urine KIM-1 and 10-hour SCr for diagnosis of AKI were 0.940 (95%CI = 0.890-0.990), 0.939 (95%CI = 0.891-0.986) and 0.959 (95%CI = 0.916-1.000) respectively. When the cut-off value of postoperative 2-hour urine NGAL was 588.0 μg/g, the sensitivity was 87.5%, the specificity was 95.0%, the accuracy was 93.5%; when the cut-off value of postoperative 4-hour urine KIM-1 was 9.55 ng/mg, the sensitivity was 87.5%, the specificity was 91.7%, the accuracy was 90.2%; and when the cut-off value of postoperative 10-hour SCr was 61.90 μmol/L, the sensitivity was 90.6%, the specificity was 95.0%, and the accuracy was 95.7%. Conclusion Urine NGAL and KIM-1 can be used as biomarkers for early diagnosis of AKI after CPB for the non-cyanotic CHD in children.

Objective To summarize the experience of surgical treatment of severe ventricular septal defect (VSD) accompanied by pulmonary hypertension (PH) in little infants. Methods The clinical data of 11 patients with VSD accompanied by PH admitted to the Department of Cardiac Surgery of Tianjin Children's Hospital of the Pediatric Clinical College in Tianjin Medical University from January 2016 to January 2017 were retrospectively analyzed. There were 6 males and 5 females, with the ages of 3 - 6 months, mean (5.36±1.03) months and body weights 4.2 - 7.5 kg, mean (5.9±1.0) kg. Preoperatively, all patients had recurrent pneumonia and heart failure history. After 2 - 3 times of medical treatment in hospitals, the patients underwent sub-acute radical operation under cardiopulmonary bypass. All patients were followed-up with echocardiography, chest X-ray and electrocardiogram examinations at 3, 6 and 12 months after heart surgery. Results After operation, all the children spontaneously recovered the heart beats, the stay times in surgical intensive care unit (SICU) were 2 - 7 days, and total hospitalization times were 12 - 17 days. All patients were followed up for 12 months, no death occurred in the whole group, and the heart and lung functions recovered satisfactorily. Conclusions Little infants with large VSD and PH should undertake operation as early as possible. The patients with recurrent pneumonia, heart failure in a short term should receive medical and surgical doctors' cooperative treatment, and the disease situation ought to be adjusted with one's best ability to a stable status when the sub-acute surgery can be carried out safely.

OBJECTIVETo observe effects of electroacupuncture (EA) at "Weizhong" (BL 40) on morphology and expression of creatine kinase (CK) and interleukin-17 (IL-17) in rats with bupivacaine-induced multifidus muscle injury.

METHODSA total of 32 male SD rats were randomly divided into a control group, a model group, a Weizhong group and a Shenshu group, 8 rats in each one. The rats in the model group, Weizhong group and Shenshu group were treated with intramuscular injection of 0.5% bupivacaine to establish the model of multifidus muscle injury; the rats in the control group were injected with 0.9% sodium chloride solution. The rats in the Weizhong group and Shenshu group were treated with EA (2 Hz/10 Hz in frequency, 1~2 mA in intensity) at "Weizhong" (BL 40) and "Shenshu" (BL 23), 20 min per treatment. No treatment was given in the control group and model group. After 14-day treatment of EA, the inflammatory cell count, scar tissues area and muscle fiber cross sectional area of multifidus muscle were observed with HE and Masson staining method. The activity of CK and serum content of IL-17 were test with enzyme-linked immunosorbent assay (ELISA) method; the expression of IL-17 in multifidus muscle was measured with immunohistochcmical method.

RESULTSAfter intervention, the inflammatory cell count and scar tissues area in the model group, Weizhong group and Shenshu group were higher than those in the control group (all<0.01), but the muscle fiber cross sectional area was significantly reduced (all<0.01); the inflammatory cell count and scar tissues area in the Weizhong group and Shenshu group were lower than those in the model group (all<0.01), and the muscle fiber cross sectional area was significantly increased (<0.01,<0.05). After intervention, the expression of IL-17 in multifidus muscle, serum content of IL-7 and activity of CK in the model group, Weizhong group and Shenshu group were higher than those in the control group (all<0.01); the expression of IL-17 in multifidus muscle, serum content of IL-7 and activity of CK in the Weizhong group and Shenshu group were lower than those in the model group (<0.01,<0.05); compared with the Shenshu group, the down-regulation of IL-17 was more obvisous in the Weizhong group (<0.01).

CONCLUSIONEA at "Weizhong" (BL 40) can down-regulate the overexpression of serum CK and IL-17, alleviate inflammation reaction and improve the repair of multifidus muscle.