Laparoscopic splenectomy for primary immune thrombocytopenia:Current status and challenges

Primary immune thrombocytopenia(ITP) is an immunemediated disorder affecting both adults and children, characterised by bleeding complications and low platelet counts. Corticosteroids are the first-line therapy for ITP, but only 20%-40% of cases achieve a stable response. Splenectomy is the main therapy for patients failing to respond to corticosteroids for decades, and about two-thirds of patients achieve a long-lasting response. Although some new drugs are developed to treat ITP as second-line therapies in recent years, splenectomy is still the better choice with less cost and more efficiency. Laparoscopic splenectomy(LS) for ITP proves to be a safe technique associated with lower morbidity and faster recovery and similar hematological response when compared to traditional open splenectomy. Based on the unified hematological outcome criteria by current international consensus, the response rate of splenectomy should be reassessed. So far, there are not widely accepted preoperative clinical indicators predicting favorable response to LS. Since the patients undergoing surgery take the risk of complications and poor hematological outcome, the great challenge facing the doctors is to identify a reliable biomarker for predicting longterm outcome of splenectomy which can help make the decision of operation.

Contribution of mononuclear bone marrow cells to carbon tetrachloride-induced liver fibrosis in rats

AIM： To study the inhibitory effect of mononuclear bone marrow cell （BNC） transplantation on carbon tetrachloride （CCl4） -induced liver fibrosis in rats. METHODS： Rat liver fibrosis models were induced by CCl4 and alcohol administration. After 8 wk, twenty rats were randomly allocated into treatment group （n = 10） and control group （n = 10）. BMC were infused into the rats in treatment group via the portal vein, while heparinized saline was infused in control group. CCl4 was hypodermically injected into the rats twice a week for 4 wk. At the end of wk 12, all rats were humanely sacrificed. Uver samples were taken and stained with HE or Masson trichrome. The general conditions, liver fibrosis （hydroxyproline and collagen fibre） and liver pathological grades in rats were evaluated. RESULTS： The general conditions of the rats in treatment group improved markedly, but not in control group. Hydroxyproline was 504.6± 128.8 μg/g in treatment group, and 596.0 ± 341.8 μg/g in control group. The percentage of collagen fibre was 3.75% ± 0.98% in treatment group and 5.02% ± 0.44% in control group. There was a significant difference between the two groups （P 〈 0.05）. Liver pathological grade decreased from grade N to grade 11 partially in treatment group （P 〈 0.05） with no obvious improvement in control group （P 〉 0.05）. There was a significant difference between treatment group and control group （P 〈 0.05）.CONCLUSION： Transplantation of BMC can improve liver fibrosis due to chronic liver injury in rats.

Global Existence and Blow up for Damped Generalized Boussinesq Equation

We study the Cauchy problem of damped generalized Boussinesq equation utt - uxx ＋ （uxx＋ f（u））xx - αuxxt = 0. First we give the local existence of weak solution and smooth solution. Then by using potential well method and convexity method we prove the global existence and finite time blow up of solution, then we obtain some sharp conditions for the well-posedness problem.