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<p><b>OBJECTIVE</b>To investigate the levels of Th1/Th2 cytokines in peripheral blood of patients with primary immune thrombocytopenic purpura(ITP) before and after treatment and their clinical significance.</p><p><b>METHODS</b>Ninety-eight cases of ITP were treated with glucocorticoid(GC), then were divided into 2 groups: effectively treated group and uneffectively treated group according to efficacy of treatment, 40 healthy persons confirmed by health examination were selected and enrolled in control group. The levels of Th1 cytokines(IFN-γ,TNFα,IL-2) and Th2 cytokines(IL-4,IL-5,IL-10) were detected by cytometric bead array before and at 4 weeks, 3 and 6 months after treatment and the relationship among detected indexes was analyzed.</p><p><b>RESULTS</b>Before treatment with glucocorticoid, the levels of Th1 type cytokines were in 98 patients with ITP were higher and the levels of Th2 type cytokines were lower, compared with the healthy controls(P<0.05). The IL-2/IL-4 ratio was significantly higher than that of healthy controls(P<0.05). After treatment, the levels of Th1 type cytokines in effectively treated group were significantly decreased and the levels of Th2 type cytokines were significantly increased, compared with level before treatment(P<0.05). The IL-2/IL-4 ratio was significantly decreased after treatment for 6 months, compared with that before treatment(1.05±0.43 vs 2.53±0.72)(P<0.05), but the level of Th1 or Th2 type cytokines did not obviously changed.</p><p><b>CONCLUSION</b>Peripheral blood Th1 and Th2 cells express abnormally in ITP patients, ITP is a Th1 dominated disease; the change of IL-2/IL-4 ratio before and after treatment correlated with the prognosis of ITP patients, displaying clinical significance for ITP individual therapy.</p>
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Objective To analyze the risk factors,clinical characteristics,and missed factors of acute pulmonary embolism (APE) after surgery,so as to advise clinicians to improve understanding of the early postoperative APE and enhance prevention concepts.Methods Retrospectively analyzed the general information of 43 cases of surgical patients with APE after surgery categories,risk factors,clinical manifestations and prognosis.Results APE after surgery had obvious risk factors; often occurred within 2 weeks after surgery; commonly seen in malignant tumors (53.5％,23/43),orthopedics (27.9％,12/43) and other major surgery; clinical manifestations wasn't typical,of which chest distress and dyspnea was the most common symptom (93.0％,40/43),and other pestoperative symptoms were similar,easy to misdiagnosis.Conclusions Surgery is one of the important risk factors of APE.Preoperatively evaluating underlying diseases,postoperative strengthening preventional methods,early detection,early treatment,have great significance in reducing the occurrence of postoperative APE and improve the prognosis.
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<p><b>BACKGROUND</b>Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.</p><p><b>METHODS</b>Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.</p><p><b>RESULTS</b>No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.</p><p><b>CONCLUSIONS</b>Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged sternal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.</p>
Subject(s)
Adolescent , Adult , Aged , Humans , Male , Middle Aged , Debridement , Follow-Up Studies , Mediastinitis , General Surgery , Osteomyelitis , General Surgery , Retrospective Studies , Sternotomy , Sternum , General Surgery , Surgical Flaps , Surgical Wound Infection , General SurgeryABSTRACT
Objective To prepare an active anti-tumor component, compound K (C-K), from saponins in leaves of Panax notoginseng (SLPN) using immobilized β-glucanase. Methods Two entrapments, alginate gel-1 (Alg 1) and alginate gel-2 (Alg 2), were evaluated for their ability to immobilize β-glucanase. The amount and purity of C-K obtained from the transformation process were analyzed by HPLC, and the immobilizing parameters were optimized. Results β-Glucanase can be immobilized and reused with either of the entrapment. However, using AIg 1 resulted in higher enzyme activity than Alg 2. The optimal concentration of the immobilized enzyme was 10%; The optimal crosslinking time was 4-6 h; and the optimal concentration of the crosslinking agent was 6%-7%. Conclusion Immobilized β-glucanase shows sustained enzyme activity, good ethanol tolerance, and was reusable for the preparation of C-K from SLPN.