Objective To discuss correlation between PLT change with APACHEⅡ in sepsis shock. Methods Clinical data of 48 cases with sepsis from Mar 2013 to Oct 2015 were respectively analyzed. PLT of patients was detected at diagnosis， and patient's condition was evaluated with APACHEⅡ at diagnosis， and 3， 5， 7 day after diagnosis. Mortality rates of group of normal PLT and group of abnormal PLT， and APACHEⅡ scores in different time were compared， and correlation between PLT changes with APACHEⅡ in sepsis were analyzed. Results 27 cases were with abnormal PLT，and 21 cases with normal PLT. Two cases in group of normal PLT was dead， and 12 cases in group of abnormal PLT were dead， which showed significant difference(P0.05). APACHEⅡ scores of group of abnormal PLT at different time were higher than group of normal PLT(P0.05 or P0.01). PLT showed negative correlation with APACHEⅡ score(r =-0.776). Conclusion PLT shows negative correlation with APACHE Ⅱ score. Cases with low PLT are with high dead rate， which can be used as a index for evaluation of disease and prognosis.
Platelet parameters (PLT, MPV, P-LCR) in patients with schizophrenia, unipolar depression and bipolar disorder
Abstract There are no studies comparing platelet parameters platelet parameters (platelet count (PLT)， mean platelet volume (MPV) and platelet large cell ratio (P-LCR)) between patients with schizophrenia， bipolar disorder and unipolar depression. Therefore， the aim of this study was to determine and compare differences in PLT， MPV and P-LCR in patients with schizophrenia， unipolar depression and bipolar disorder. This was a retrospective， cross-sectional， naturalistic study of 2377 patients (schizophrenia n=1243; unipolar depression n=791; bipolar disorder n=343， including bipolar depression n=259 and mania n=84). There were significant differences for PLT， MPV and P-LCR values between study groups. A significant percentage of patients with bipolar disorder had abnormal (too low or too high) number of platelets. Negative correlation between PLT and age was found in all study groups and positive correlation between age and MPV and P-LCR was found in patients with schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
目的探究美沙拉嗪对溃疡性结肠 炎患者的临床疗效及对ESR、PLT、D-二聚体的影响。方法选取贵阳医学院第三附属医院、贵阳市第一人民医院、黔南州人民医院消化内科收治的溃疡性结肠 炎患者共168例，采用随机分组法，将其分为3组。对照组57例，给予西医常规治疗;安慰剂组48例;实验组63例，口服美沙拉嗪。4周为1个疗程，治疗 1个疗程。治疗前后对3组患者血沉(erythrocyte sedimentation rate，ESR)、PLT、D-二聚体以及治疗后临床症状等情况进行比较。结果治疗后，对照组及实验组ESR均比治疗前显著降低(P0.05)，且实验 组[(10.65±8.92)mm/h]显著优于对照组[(17.39±10.50)mm/h]，差异均有统计学意义(P0.05);治疗后，对照组及实 验组患者PLT数目比治疗前显著降低，且实验组(275.28±28.95)×109/L显著优于对照组(310.62±28.90)×109/L，差异 均有统计学意义(P0.05);治疗后，对照组及实验组患者D-二聚体水平比治疗前显著下降，差异有统计学意义(P0.05)。对照组与实验组便血、肠息 肉、消瘦等临床症状治疗总有效率显著高于安慰剂组，且实验组总有效率高于对照组，差异均有统计学意义(P0.05)。结论美沙拉嗪可显著降低患者血沉 (ESR)水平、减少患者血小板(PLT)数量、降低患者D-二聚体水平，且对于患者便血、肠息肉、身体消瘦等不良特征有较好的改善作用，是治疗溃疡性结 肠炎的高效药物。
摘 要： 目的：应用C-反应蛋白（CRP）和血小板（PLT）动态监测新生儿败血症病情发展和联合检测的意义。方法：应用Sysmex，xs-800i和QuikReadgoinstrument分别测定30例健康对照组和30例新生儿败血症组在发病时、治疗后第4天和第7天的PLT和CRP值。结果：败血症组在患病时PLT明显低于正常对照组，治疗期间逐步升高。病例组初期CRP明显高于对照组，随后逐步降低，第7天降至与对照组水平相当。ROC曲线显示CRP的诊断价值高于PLT。联合检测的灵敏度和阴性预测值高于单独检测。结论：CRP和PLT有助于病情的监测，联合检测更有助于疾病的诊断，可为临床提供依据。
摘 要： 目的：通过评估XN-2000血液分析仪对PLT计数的检测性能，初步探讨联合人工镜检法和血液分析仪自动复检功能来制定低值PLT的复检规则。 方法：用XN-2000血液分析仪的3种通道计数650例新鲜全血标本的PLT，得出荧光PLT计数（PLT-F），电阻抗PLT计数（PLT-I）和光学PLT计数（PLT-O）。比较分析PLT-F、PLT-I和PLT-O的精密度及其与流式细胞分析法（FCM）和镜检法计数PLT的一致性。进而对本实验室原有的低值PLT复检规则重新进行制定。 结果：PLT-F变异系数（CV）为2.7%～4.7%，低于PLT-I和PLT-O的4.2%～16.2%。PLT在（2～50）×109/L区间时，PLT-F与FCM法PLT计数的一致性高于PLT-I和PLT-O，r分别为0.969、0.826和0.950，PLT-F与镜检法PLT的一致性也高于PLT-I和PLT-O，r分别为 0.914、0.874和0.898，提示PLT-F检测低值PLT的准确性优于PLT-I和PLT-O。通过对本实验室原有的低值PLT复检规则的重新制定，使复检的假阴性率降为零，人工复检率下降了51.47%（158/307）。新的复检规则为：当PLT-I＜80×109/L时，自动追加PLT-F检测，如果没有PLT相关报警出现，可直接报告PLT-F结果；当出现报警时，进行人工镜检，报告镜检PLT结果。 结论：与PLT-I及PLT-O相比，低值PLT-F检测具有更好的精密度和准确性。通过重新制定复检规则，可明显降低低值PLT的人工复检率。
目的：研究hs-CRP和PLT动态监测新生儿败血症病情临床意 义及联合检测价值，探讨其临床适用性。方法：选择从2013年5月至2014年11月于我院新生儿科接受治疗新生儿败血症的46例患儿作为研究组，另取 46例健康新生儿作为对照组，分别对两组新生儿进行hs-CRP和PLT及两者联合检测，观察两组新生儿治疗前后的hs-CRP、PLT含量以及单一检测 与联合检测的特异度、灵敏性、阳性预期值和阴性预期值等。结果：治疗前，研究组患儿的hs-CRP含量明显高于对照组，PLT含量明显低于对照组，且差异 均具有统计学意义（P＜0.05）；治疗后，两组差异均无统计学意义（P＞0.05）；同时研究组患儿hs-CRP较PLT诊断价值高，而联合检测又明显 高于单一检测，差异具有统计学意义（P＜0.05）。结论：hs-CRP和PLT检测对新生儿败血症的诊断具有一定的价值，两项指标联合检测的诊断价值更 高，适合临床推广应用。
Metaphyseal screw augmentation with PMMA of the LISS-PLT plate improves angular stability in osteoporotic proximal third tibia fractures - a biomechanical study in human cadaveric tibiae.
ABSTRACT The incidence of osteoporotic proximal tibia fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefits of screw augmentation in Less Invasive Stabilization System - proximal lateral tibia (LISS-PLT) plates in cadaveric extraarticular comminuted proximal tibia fractures (OTA-41-A3.3). Standardized extraarticular proximal tibia fractures were stabilized with the LISS-PLT plate in 6 paired osteoporotic cadaveric tibiae. Bone mineral density was measured with high-resolution quantitative computed tomography scans to identify bone quality. In the augmented group， the 5 proximal screws of the LISS-PLT plate were augmented with 1 mL of bone cement each， whereas the contralateral tibia was instrumented conventionally as the control. Cyclic axial loading was applied to each specimen with a starting load of 150 N， using a ramp of 0.05 N per cycle to 10 mm axial displacement. Varus displacement was identified from anterior-posterior radiographs. Bone mineral density showed no significant difference between the 2 groups (P = 0.47). The non-augmented group reached 9417 load cycles (SD 753) until failure， compared with 14792 load cycles (SD 2088) in the augmented group (P = 0.002). In early-onset failure (deformation at 8250 load cycles)， varus displacement was significantly smaller in the augmented group (0.46°， SD 0.6) than in the non-augmented group (3.23°， SD 1.7) (P = 0.01). This biomechanical study showed that cement augmentation of the LISS-PLT plate screws in osteoporotic proximal extraarticular tibia fractures significantly lowers the propensity toward screw migration and secondary varus displacement.
The Ccr7 Ligand ELC (Ccl19) Is Transcytosed in High Endothelial Venules and Mediates T Cell Recruitment
Lymphocyte homing to secondary lymphoid tissue is defined by a multistep sequence of interactions between lymphocytes and endothelial cells in high endothelial venules (HEVs). After initial selectin-mediated tethering and rolling， firm adhesion of lymphocytes requires rapid upregulation of lymphocyte integrin adhesiveness. This step is mediated in part by the HEV-derived chemokine SLC (secondary lymphoid-tissue chemokine， or CCL21) that binds to the CC chemokine receptor (CCR)7 on lymphocytes. However， the CC chemokine ELC (Epstein-Barr virus-induced molecule 1 ligand chemokine， or CCL19) shares the same receptor， and ELC transcripts have been observed in the T cell areas of lymphoid organs. Here， we show that perivascular ELC is transcytosed to the luminal surfaces of HEVs and enables efficient T cell homing to lymph nodes. In situ hybridization on sections of human tonsil showed no ELC mRNA in HEVs， but immunostaining revealed ELC protein in cytoplasmic vesicles of HEV cells. Furthermore， ELC injected into the footpads of mice entered the draining lymph nodes and was presented by HEVs. Finally， intracutaneous injections of ELC in mice lacking functionally relevant ELC and SLC (plt/plt mice) restored T cell trafficking to draining lymph nodes as efficiently as SLC. We conclude that perivascular ELC is transcytosed to the luminal surfaces of HEVs and participates in CCR7-mediated triggering of lymphocyte arrest.
Objective： To study the clinical significance of hypersensitive C- reactive protein( hs CRP) and platelet( PLT) in complicated with coronary heart disease( CHD). Method： 58 diabetes patients complicated with CHD were chosen as research subjects，and in the same period，58 patients with CHD，58 patients with diabetes and 29 healthy persons were chosen as control subjects. hs CRP and PLT of the 4 groups were observed and the relevance among them was studied and analyzed. Result： Levels of hs CRP，PLT，MPV，P- LCR and PDW of diabetes complicated with CHD were obviously higher than those of the other 3 groups( P 0. 05)，indicating that hs CRP and PLT of diabetes complicated with CHD were both obviously higher than patients with diabetes or CHD only and healthy persons; there was a negative correlation between hs CRP and PLT and a positive correlation among the other indicators. Conclusion： There is an obvious correlation among hs CRP，PLT and progress of diabetes complicated with CHD，and they can be regarded as effective indicators evaluating progress and clinical effect of diabetes complicated with CHD，so this is worth of being popularized clinically.
目的探讨心脏瓣膜置换术患者血 小板(PLT)、平均血小板体积(MPV)及凝血酶原时间(PT)、国际标准化比值(INR)在手术前后的变化及相互关系。方法本文对61例心脏瓣膜置换 术患者在华法林应用前后及不同时段的PLT、MPV及PT、INR值进行动态检测，并探讨它们之间的关系。结果 PT、INP在术中与术后比较，MPV在术前与术中比较无显著性差异外，其余各值在其阶段的比较差异均有统计学意义。PLT与MPV在术前、术中与术后均 呈非线性负相关。PLT、MPV与PT，INR无相关性。结论心脏瓣膜置换术患者的PLT及MPV存在动态相关性，同时也证明了PT、INR可作为心脏瓣 膜置换术后预测血栓栓塞病发生及检测抗凝治疗的良好指标。