Clinical analysis of 61 patients with thrombotic thrombocytopenic purpura / 北京大学学报(医学版)

OBJECTIVE@#To analyze and summarize the clinical features, diagnosis, treatment and prognosis of 61 patients with thrombotic thrombocytopenic purpura (TTP), so as to improve the ability of diagnosis and treatment.@*METHODS@#The clinical data of 61 TTP patients admitted to Peking University People's Hospital from January 2004 to March 2019 were retrospectively analyzed, and the clinical manifestations, blood routine, hemolysis indicators, and von Willebrand factor lyase (von Willebrand factor-cleaving protease, vWF-CP, also known as ADAMTS13) of these patients were observed. According to the outcome at the time of discharge, they were divided into survival group and death group, and the differences in clinical characteristics, neutrophil to lymphocyte ratio (NLR) and plasma exchange between the two groups were compared. The PLASMIC scores were calculated and compared with ADAMTS13 to determine the accuracy of the PLASMIC score in predicting ADAMTS13.@*RESULTS@#Among the 61 TTP patients, 22 were males and 39 were females, with an average age of (48±17) years. In the study, 48 cases had pentalogy, only 9 had triad, and the remaining 4 had no neuropsychiatric symptoms. Twenty-seven cases (44.3%) died and 34 cases (55.7%) survived. Among the 61 TTP patients, the platelet count was (12.9±9.5)×109/L, the hemoglobin (66.5±20.7) g/L, the percentage of erythrocyte fragments 3% (2%, 7%), and the plasma free hemoglobin increased to 360 (200, 457) mg /L, and the lactate dehydrogenase 1 508 (811, 2 133.8) U/L. The blood clotting was basically normal. The ADAMTS13 value of 30 patients was 49.0 (40.8, 61.3) μg/L, the ADAMTS activity of 10 patients was < 5%, and the remaining 21 patients were not checked. The PLASMIC score was 6-7 in 58 cases, 5 in 2 cases, and 4 in 1 case. The PLASMIC score predicted the decreased activity or the reduction of ADAMTS with a sensitivity as high as 97.5%. The NLR in the death group was higher than that in the survival group, but the difference was not statistically significant (P>0.05). The total amount and frequency of plasma exchange (PEX) in the death group were significantly less than those in the survival group, and the difference was statistically significant (P < 0.05). There was no significant difference in the treatment of glucocorticoids and human immunoglobulin between the two groups (P>0.05).@*CONCLUSION@#PEX can significantly improve the survival rate of TTP patients. PLASMIC score can easily and quickly predict the possibility of ADAMTS13 activity reduction, which is beneficial to the early diagnosis of TTP and PEX treatment. NLR can reflect the systemic inflammatory process, but its significance in TTP needs further study.

Clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma.</p><p><b>METHODS</b>A retrospective study was performed to review the 64-slice spiral 3-phase CT enhanced scanning of 120 patients with gastric cancer diagnosed by biopsy prior to operation and postoperative pathological reports. All the findings were reviewed by two senior radiologic diagnosticians separately and compared with pathological findings.</p><p><b>RESULTS</b>The accuracy of 64-slice spiral CT enhanced scan was 79.2%(95/120) for T staging, 66.7%(10/15) for T1, 66.7%(14/21) for T2, 84.0%(42/50) for T3, and 85.3%(29/34) for T4. For gastric wall with single layer and multiple layers, the accuracy of CT enhanced scanning was 59.4%(19/32) and 81.8%(72/88) for T staging, and the difference was statistically significant(P<0.05). The accuracy of 64-slice spiral CT enhanced scan was 73.9%(85/115) for N staging, 75.5%(37/49) for N0, 70.3%(26/37) for N1, 75.9%(22/29) for N2. The accuracy of 64-slice spiral CT enhanced scanning was 89.2% for M staging.</p><p><b>CONCLUSION</b>64-slice spiral CT 3-phase enhanced scanning can monitor the invasion, lymphatic metastasis, and distant metastasis of gastric cancer dynamically, which may become an important examination item for the preoperative evaluation of gastric cancer.</p>

Insulin-like growth factor- II induces mTOR pathway change in Rh1 sarcoma cells / 第二军医大学学报

Objective To observe the effect of insuiin-iike growth factor-II (IGF-2) on the growth and the mTOR pathway of Rh1 sarcoma cells. Methods Rh1 cells were cultured routinely, and were treated with IGF-2 at a final concentration of 10 ng/ml after starving with pure RPMI 1640 medium. The growth of cells was analyzed by flow cytometry 72 h after IGF-2 treatment. The phosphorylation of S6 and Akt (s473) proteins were examined by Western blotting analysis at 5, 10, 20, 30, and 60 min after IGF-2 treatment. Results IGF-2 treatment promoted the survival and inhibited the apoptosis of Rh1 cells compared with the control group. IGF-2 also increased the phosphorylation of S6 in a time-dependent manner. However, the phosphorylation of Akt(s473) was relatively stable in Rh1 cells. Conclusion IGF-2 can gradually increase the function of S6 in the mTOR pathway, and the function of Akt (s473) is kept relatively stable.

Teachers′ Job Burnout and Related Factors in Primary and Secondary Schools / 中国心理卫生杂志

Objective:To explore the relationship of teachers'job burnout with job stress,coping swategies associated with job stress,teachers'sense of efficacy,self-esteem,locus of control,social support in primary and secondary schools.Methods:Questionnaires about teachers'job burnout,job stress,coping strategies associated with job stress,teachers' sense of efficacy,self-esteem,locus of control,social support were applied to 766 primary and secondary teachers from Shandong and Hubei provinces.Results:(1)Teachers' job burnout was significantly positive correlated with its job stress,inactive coping and locus of control(r=0.23～0.40);(2)Teachers' job burnout was significantly negative correlated with its active coping,teachers' sense of efficacy,self-esteem and social support (r=-0.28～0.41).Conclusion:Teachers' sense of efficacy,job stress,self-esteem,locus of control,inactive coping, active coping and social support significantly can predict their job burnout.