OBJECTIVE: To investigate the clinical characteristics, laboratorial and bone marrow pathological features of primary thrombocytopenia (ET) patients with different mutations of CALR, JAK2 and MPL genes. METHODS: The chinical data of 120 cases of ET in Jiangsu provincial people's hospital/ The First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2017 were collected and analyzed, including 76 cases with JAK2 gene mutation, 40 cases with CALR gene mutation, 2 cases with MPL gene mutations, 2 cases without gene mutation. RESULTS: Among the ET patients, compared with the JAK2 gene mutation, CALR gene mutation showed statistically significant deareament of white blood cells and hemoglobin (P=0.001, P=0.01) and the male platelets in CALR group showed significant increament (P=0.04). Fourthermore, the average number of megakaryocytes and its cluster numbers in each hight power field of vision showed statistically significant decreament in CALR group as compared with JAK2 group (P=0.001, P=0.001), and thrombotic events in CALR group were signicantly lower than those in JAK2 group (7.5% vs 18.4%) (P=0.03). CONCLUSION Mutations of CALR, JAK2 have different clinical characteristics and blood pathological changes of Chinese ET patients, and their clinical significance is worth to explore.
Bone Marrow ; Calreticulin ; genetics ; China ; Humans ; Janus Kinase 2 ; genetics ; Male ; Mutation ; Receptors, Thrombopoietin ; genetics ; Thrombocythemia, Essential

OBJECTIVETo evaluate the effect and safety of Kuanxiong Aerosol (, KA) on patients with angina pectoris.

METHODSBlock randomization was performed to randomly allocate 750 patients into KA (376 cases) and control groups (374 cases). During an angina attack, the KA group received 3 consecutive sublingual sprays of KA (0.6 mL per spray). The control group received 1 sublingual nitroglycerin tablet (NT, 0.5 mg/tablet). Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment (1, 2, 3, 4, 5, and >5 min). Logistic regression analysis was performed to observe the factors inflfluencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society (CCS) classes of angina.

RESULTSThe 5-min remission rates in the KA and control groups were not signifificantly different (94.41% vs. 90.64%, P>0.05). The angina CCS class signifificantly inflfluenced the rate of remission (95% confidence interval = 0.483-0.740, P<0.01). In the CCS subgroup analysis, the 3-and 5-min remission rates for KA and NT were similar in the CCSII and III subgroups (P>0.05), while they were signifificantly better for KA in the CCSI and II subgroups (P<0.05 or P<0.01). Furthermore, the incidence of adverse reactions was signifificantly lower in the KA group than in the control group for the CCSII and III subgroups (9.29% vs. 26.22%, 10.13% vs. 20.88%, P<0.05 or P<0.01).

CONCLUSIONSKA is not inferior to NT in the remission of angina. Furthermore, in CCSII and III patients, KA is superior to NT, with a lower incidence of adverse reactions. (Registration No. ChiCTRIPR-15007204).

Aerosols ; adverse effects ; therapeutic use ; Angina Pectoris ; drug therapy ; Case-Control Studies ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Remission Induction ; Treatment Outcome

Objective To explore the development and implementation of International Classification of Functioning, Disability and Health (ICF) (International Chinese Version) in China. Methods A total of 332 research papers in ICF had been selected from CNKI from 2001 to 2017 and analyzed using Citespace III. The time, authors and institutions distributions had been explored. Results There was a sus-tainable increase of ICF publications in Chinese from 2001. The core authors of ICF are QIU Zhuo-ying and his research team. Chinese Journal of Rehabilitation Theory and Practice has published most researches in ICF in China. ICF Chinese version has been widely imple-mented in the areas of disability statistics at population level, clinical and services, management and service information, and social policy. With the guidance and coordination of WHO Family of International Classifications Collaborating Center (WHO-FIC CC) and cooperation with WHO-FIC CCs Germany, Australia, and Italy, and cooperation with WHO CC Rehabilitation in China, remarkable achievements has been made in the fields of ICF research and implementation. Conclusion It is a promising new research area to research and implement ICF in China. New ideologies and tools has been developed and significant influences have been made from ICF research and implementation in the fields of health care, rehabilitation, education, social security and employment, social services, disability studies, and informatics.

In recent years, computational fluid dynamics (CFD) has been widely used in fundamental and clinical researches of cerebral aneurysms. The research direction involves: ① the hemodynamic risk factors associated with initiation, evolution and rupture of cerebral aneurysms, ② the assessment of flow field changes in cerebral aneurysms after the implantation of coils and stent as well as the effect of such endovascular treatment by establishing the patient-specific models. This review elaborates the research progress in hemodynamics of cerebral aneurysms from 3 aspects: the development of CFD models, the morphological and hemodynamic parameters for rupture risk assessment of aneurysms and the role of CFD in the endovascular treatment of cerebral aneurysms.

The rupture of carotid atherosclerotic plaques and thrombosis are the main risk factor for ischemic stroke. The risk of carotid plaque rupture is closely related with the local biomechanical situation, morphology, components and biological activity of the carotid plaques. In this article, the research progress on methodology for studying carotid stenosis biomechanics, the risk of vulnerable plaque rupture in carotid stenosis and decision-making in clinical treatment, the animal modeling and experiment on vulnerable carotid plaques, and the components and biological activities of carotid plaques was summarized, the existing problems were analyzed, and the in-depth prospective about the biomechanical mechanism and quantitative assessment indices for vulnerable carotid plaques was also proposed, expecting to provide necessary theoretical guidance for feasible decision-making on the treatment of carotid stenosis.

There contains so much physiological/pathological information in pulse wave, which can reflect the early changes in cardiovascular function parameters. Therefore, it would be valuable to quantify the information revealed by pulse wave as important reference for cardiovascular diseases. In this review, the relationship between physiological/pathological information in cardiovascular system and pulse wave was described from the viewpoint of pulse wave formation mechanism, and to explain how the non-invasive detection indexes supplied by pulse wave could be applied in clinical use by analyzing the waveforms. Cardiovascular health evaluation index established by physiological/pathological information from cardiovascular system with pulse wave theory was also discussed. The development of non-invasive detection methods for cardiovascular system based on pulse wave theory can contribute to cardiovascular health care and provide important reference for the early detection, early prevention and early treatment of cardiovascular diseases. Besides, the non-invasive detection method can simplify the process of clinical testing and reduce the costs so as to achieve health assessment on cardiovascular diseases timely and reduce the mortality and disability rates.

Objective To study the deformation and mechanical characteristics during expansion process of vascular stent in realistic stenosis model, so as to provide scientific references for interventional treatment and stent design. Methods The carotid vessel model and plaque model of patient were built by using 3D reconstruction method, and the stent model with I-shaped link was established by using Pro/E; ABAQUS/Standard was used to simulate the radial expansion (the first stage) and radial contraction (the second stage) of the stent in real stenosis model, and a realistic model of blood vessel with plaque was also established to make contrast test. Results In the first stage, radial expansion of the stent was formed. The maximum contact area was generated between the outer surface of the stent and the inner surface of the plaque/arterial wall, and the maximum stresses on the stent, plague and arterial wall were 515.000, 2.482, 1.053 MPa, respectively. In the second stage, the radial contraction of the stent resulted in “dog-bone” effect. Many gaps between the stent and vessel wall was formed, and the maximum stresses on the stent, plague and arterial wall were 464.500, 0.954, 0.316 MPa, respectively. In contrast test, the maximum stresses on stenotic vessel and stent were 0.9, 414.1 MPa in the second stage. Conclusions Compared with the model in contrast test, the stenosis model differentiating the component of vascular tissues is more consistent with the real situation of stenotic vessels, by more truly showing deformation and mechanical characteristics of the stent and blood vessel. The stent causes the maximum damage to plaque and inner wall of blood vessel in the first stage, while “dog-bone” effect of the stent is an important influencing factor that results in the gaps between the stent, plague and blood vessel. These research findings may provide significant guidance for selecting stent in interventional treatment and improving stent design.

Objective To detect the blood viscosity values and find out the statistically significant influencing factors of blood viscosity and their fitting formulas among the middle aged and elderly people with high incidence of cardiovascular diseases. Methods The subjects’ blood was collected in the hospital, together with their physiological and pathological information, and LG-R-80 series rotary viscometer detector was used to detect blood viscosity. The statistically significant factors of blood viscosity and their fitting formulas were obtained by using SPSS. Results Blood viscosity increased with age and body mass index (BMI) and reached its peak value in 60 year-old males (5.35 mPa•s) and 50 year-old females (4.45 mPa•s), respectively, then the variation of blood viscosity would be stabilized, with no more increase; the blood viscosity values of males in all groups with different ages were significantly higher than those of females, with difference value in the range of 0.28-0.90 mPa•s; the blood viscosity values were obviously higher in hypertension group than those in normal group, with statistically significant differences (P<0.1). Conclusions The blood viscosity distribution in people with high incidence of cardiovascular diseases has certain regular pattern, and the obtained fitting formula between blood viscosity and influencing factors in this study would provide useful references for further study such as variation of blood viscosity under different physiological conditions, effects of different viscosities on some cardiovascular diseases, and non-invasive detection of blood viscosities.

Objective To investigate the effects of different bypass grafting for treating DeBakey Ⅲ aortic dissection. Methods The patient-specific models of DeBakey Ⅲ aortic dissection based on CT images were reconstructed by using Mimics software, and two bridge models of bypassing between ascending aorta and abdominal aorta (AA), and between left subclavian artery and abdominal aorta (LA) were established by computer-aided method, respectively. Then numerical simulations were performed by using fluid-structure interaction (FSI) method to compare hemodynamic differences of these two models. Results After bypass surgery, the mass flow, mean and maximum velocities of the through lumen models were reduced to different degrees. Meanwhile, both the maximum blood pressures and displacements of the vessel walls of AA models were decreased, but those of LA models were increased. In contrast, all the above-mentioned hemodynamic parameters of the blind lumen models were decreased, especially for AA models. Conclusions The AA bypassing is a better treatment for DeBakey Ⅲ aortic dissection of through lumen and blind lumen. The therapeutic effects can be easily explained through simulation results, to ensure the scientific validity and clinical utility of bypassing.

BACKGROUND:The outcome of cardiopulmonary resuscitation (CPR) may depend on a variety of factors related to patient status or resuscitation management. To evaluate the factors influencing the outcome of CPR after cardiac arrest (CA) will be conducive to improve the effectiveness of resuscitation. Therefore, a study was designed to assess these factors in the emergency department (ED) of a city hospital.METHODS:A CPR registry conforming to the Utstein-style template was conducted in the ED of the First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2011. The outcomes of CPR were compared in various factors groups. The primary outcomes were rated to return of spontaneous circulation (ROSC), 24-hour survival, survival to discharge and discharge with favorable neurological outcomes. Univariate analysis and multivariable logistic regression analysis were performed to evaluate factors associated with survival.RESULTS:A total of 725 patients were analyzed in the study. Of these patients, 187 (25.8％) had ROSC, 100 (13.8％) survived for 24 hours, 48 (6.6％) survived to discharge, and 23 (3.2％) survived to discharge with favorable neurologic outcomes. A logistic regression analysis demonstrated that the independent predictors of ROSC included traumatic etiology, first monitored rhythms, CPR duration, and total adrenaline dose. The independent predictors of 24-hour survival included traumatic etiology, cardiac etiology, first monitored rhythm and CPR duration. Previous status, cardiac etiology, first monitored rhythms and CPR duration were included in independent predictors of survival to discharge and neurologically favorable survival to discharge.CONCLUSIONS:Shockable rhythms, CPR duration ≤15 minutes and total adrenaline dose ≤5 mg were favorable predictors of ROSC, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms and CPR duration ≤15 minutes were favorable predictors of 24-hour survival, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms, CPR duration ≤15 minutes were favorable predictors of survival to discharge and neurologically favorable survival to discharge, but previous terminal illness or multiple organ failure (MOF) was unfavorable.