Objective To study the effect of Bupi-Qufeng decoction on total serum IgE (TIgE) and EOS counts of atopic dermatitis (AD).Methods A total of 101 cases were randomly recruited into a treatment group and a control group.During the treatment both groups were give Danggui-Bohe ointment for external use,and based on this,oral Bupi-Qufeng decoction was added in the treatment group and loratadine in the control group.TIgE level and EOS count were detected both before the treatment and four weeks after the treatment.Results TIgE in the treatment group decreased significantly after the treatment (t=8.0063,P＜0.001),the decreased value of which was larger than the control group (t=3.6434,P＜0.001).EOS count in the treatment group also obviously decreased after the treatment (t=3.0314,P＜0.01) ; the decreased value of which was also larger than the control group (t=3.3331,P＜0.01).Conclnsion Bupi-Qufeng decoction could decrease TIgE and EOS level of AD patient,while the therapeutic mechanism needed further research.

Objective To investigate the clinical effect of PKP combined with anti osteoporosis drugs in the treatment of osteoporotic vertebral compression fractures.Methods 100 cases of osteoporotic vertebral compression fractures treated in our hospital from January 2014 to December 2016 were compression fracture as the research object in the course of the study, and were randomly divided into control group and experimental group,with 50 cases in each group.Patients in the control group were treated with PKP, while the experimental group was treated with PKP combined with anti osteoporosis drugs.The related clinical indicators of the two groups were compared and analyzed.Results After the corresponding treatment, there was no significant difference between the experimental group and the control group in the rate of cement leakage and the amount of bone cement injection.After operation, the ODI index and VAS scoreof the two groups were significantly better than before treatment, the difference was statistically significant(P<0.05), the patient's cone height was well recovered.After 14 to 24 months of follow-up found that, the fracture rate of the experimental group was 10.0%, significantly lower than the control group 24.0%, the difference was statistically significant(P<0.05).Conclusion PKP combined with anti osteoporosis drugs for the treatment of osteoporotic vertebral compression fractures has good clinical effect, can effectively reduce the adjacent segment cone fracture rate, improve the quality of life of patients, with further clinical promotion and application significance.

Objective To observe hepatocellular apoptosis and inflammatory cytokines expression and their mechanisms for lipopolysaeeharide (LPS)-induced acute liver failure in D-ga|actosamine (D-GalN)-sensitized rats. Methods Fifty-six rats were randomly divided into following groups: 0, 1, 2, 4, 6, 24 and 48 hours. 0 hour group served as control group and the rest did as treatment groups. The rats in the treatment groups received intraperitoneal injections of LPS (50 ng/g) and D-GaIN (300 μg/g) dissolved in 1 mL sterile 0.9% sodium chloride solution, while the rats in control group were treated with 1 mL sterile 0.9% sodium chloride solution only. The rats were sacrificed in the corresponding time points and their sera and liver tissues were collected. Liver tissues were fixed and stained with hematoxylin and eosin for optical microscopy examination. The serum cytokine expressions were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of tumor necrosing factor (TNF)-α, interleukin (IL)-1β, inducible nitric oxide synthase (iNOS) and p53 gene were detected by reverse transcriptase-polymerase chain reaction, and the 24 hours treated rats liver Caspase-3,8,9,12 activity were detected by chromogenie substrate method. Data for the experiments were expressed as x±s, and differences among means were compared using the analysis of variance. Results After drug treatment, liver tissues showed piecemeal necrosis and inflammatory cell infiltration, which significantly increased from 6 hours, 24 hours to 48 hours. The 1 hour treatment group with the highest concentration of TNF-α (727. 8 ± 261. 3) ng/L were significantly higher than the control group and other treatment groups(F= 49.82, P<0.01), 2 hours treatment group (156.4 ± 52.2) ng/L was significantly lower than the 1 hour group, but significantly higher than the control group (F = 30. 23, P< 0.01 ). But serum concentrations of IL-1β gradually increased, reaching the highest level in 24 hours group (360.5±121.6)ng/L (F= 18. 61, P<0. 01). Liver Caspase-3,8,9, 12 activity in 24 hours treatment group was significantly higher than in the control group (F= 84.96, P<0.01). The mRNA expression of iNOS gene, which were not detected in normal controls, reached the peak at 6 hours group after drug treatment and notably dropped in 24 hours and 48 hours groups(F=34.07,P<0.01), p53 gene expression significantly upregulated at 24 hours and 48 hours groups(F=37.43,P<0.01). TNF-α and IL-1β gene expression in the treatment group were higher than in the control group(F=2.94,P<0.05), and both reached the peak at 1 hour treatment group. Conclusions Acute liver failure can be induced by low dose LPS in D-GaiN-sensitized rats. One of the features changes is that Caspase-3,8,9,12 activities are markedly enhanced, and the occurrence of liver injury may be associated with the early high expression of TNF-α, iNOS and p53 gene.

Objective:To summarize the clinical manifestations and molecular genetic characteristics of 5 families with maturity-onset diabetes mellitus of the young 2 (MODY2) caused by glucokinase (GCK) gene mutations.Methods:Clinical data and biochemical results of probands were collected. Peripheral blood samples of probands and first-degree family members were collected and whole exome gene was detected using second-generation sequencing. After comparing against the database, the suspected pathogenic sites were selected for Sanger sequencing verification.Results:All the 5 probands presented with mild fasting hyperglycemia, HbA 1C<7.5%, and no symptoms of thirst, polydipsia or polyuria. There were 6 mutants in 5 families, including M1: c.555delT (P.leu186CysFS Ter19) and M3: c. 263T>A (p.Met88Lys) which haven′t been reported before. During the follow-up, all probands received life-style intervention, except 2 pregnant women who should consider insulin treatment if necessary according to fetal genotypes. Conclusion:Among patients who meet the diagnostic criteria for MODY, MODY2 screening should be performed for children or pregnant women with mild hyperglycemia and family history. GCK gene detection is the gold standard for diagnosis, and accurate diagnosis will be conducive to the selection of appropriate treatment.

Objective:To investigate the value of high-frequency ultrasound and shear wave elastography in preoperative evaluation of basal cell carcinoma (BCC) .Methods:A total of 95 patients with histopathologically confirmed cutaneous BCC were enrolled from Department of Dermatology, Hospital of Traditional Chinese Medicine of Zhongshan from January 2017 to December 2020, all of whom had underwent preoperative conventional ultrasonography and shear wave elastography. Conventional ultrasonography parametres including the maximum diameter, maximum infiltration depth, maximum blood flow velocity and resistance index were recorded, so were shear wave elastography parametres including the average Young′s modulus (Eave) , Young′s modulus standard deviation (Esd) and average Young′s modulus ratio (Eratio) . All the patients were divided into high- and low-risk BCC groups according to pathologic subtypes. Paired t-test was used to compare conventional ultrasonography and shear wave elastography findings between the 2 groups. Results:There were 15 cases in the high-risk BCC group and 80 cases in the low-risk BCC group. Compared with the low-risk BCC group, the high-risk BCC group showed significantly increased maximum depth of tumor infiltration (8.5 ± 4.6 mm vs. 4.5 ± 1.6 mm, t = 6.150, P < 0.001) , Eave (32.7 ± 11.2 kPa vs. 20.6 ± 5.1 kPa, t = 4.065, P = 0.001) and Esd (7.0 ± 4.1 kPa vs. 4.2 ± 2.1 kPa, t = 2.632, P = 0.018) , while there were no significant differences in the other measurement data between the two groups (all P > 0.05) . The areas under the receiver operating characteristic curves of the maximum infiltration depth, Eave and Esd for the diagnosis of high-risk BCC were 0.775, 0.909 and 0.822 respectively, and Eave showed the best diagnostic performance. Using 25.7 kPa as the cut-off value, the sensitivity and specificity of Eave were 86.7% and 85.0% for the diagnosis of high-risk BCC, respectively. Conclusion:High-frequency ultrasound and shear wave elastography can facilitate differential diagnosis between high- and low-risk BCC.

OBJECTIVETo analyze the expression level and clinical significance of the preferentially expressed antigen of melanoma (PRAME) transcripts in patients with acute myeloid leukemia (AML).

METHODSReal-time quantitative polymerase chain reaction with EvaGreen dye was established to detect the expression level of PRAME transcripts in the bone marrow mononuclear cells of 56 AML cases and 20 controls. The clinical association of PRAME transcripts was analyzed.

RESULTSThe PRAME transcripts were 0-1.46% (median 0.18%) and 0-21 618.09% (median 9.79%) in controls and AML cases, respectively (P< 0.01). Among the FAB subtypes, those with M1, M2, M3 and M4 had significantly higher level of PRAME transcripts than controls. However, those with M5 had similar level of PRAME transcripts as controls. There was a significantly negative correlation between the PRAME transcripts and cytogenetic risk groups (r= -0.438, P= 0.001). Cases in low risk had significantly higher level of PRAME transcripts than those in intermediate and high risk. Among cases with AML-M2, those with t(8;21) had significantly higher level of PRAME transcripts (135.06% -21 618.09%, median 2201.88%) than those without t(8;21)(0.14% -1696.30%, median 17.97%)(P= 0.002). In a patient with sequential samples, PRAME transcripts significantly decreased after induction therapy and significantly increased after relapse.

CONCLUSIONThe PRAME transcript was highly expressed in AML patients and was a favorable marker of prognosis. Quantification of PRAME transcript can be used in monitoring disease status of AML.

Antigens, Neoplasm ; genetics ; Case-Control Studies ; Cytogenetic Analysis ; Female ; Genetic Predisposition to Disease ; Humans ; Leukemia, Myeloid, Acute ; genetics ; therapy ; Male ; Polymerase Chain Reaction ; RNA, Messenger ; genetics ; Recurrence

Objective:To explore superior mediastinal lymph node zoning of thyroid cancer for accurate anatomical definition as a reference for surgical access. Methods:A method for zoning superior mediastinal lymph nodes for thyroid cancer was proposed. From Sep 2018 to Nov 2019, 36 cases of thyroid cancer with superior mediastinal lymph nodes metastases were reviewed. The diagnosis, surgical approaches, pathology, characteristics of lymph node metastasis, complications and follow-up results were analyzed.Results:The superior mediastinal lymph nodes were grouped into 10 areas: 1, 2Ra, 2Rb, 2La, 2Lb, 3A, 3P, 4R, 4La and 4Lb. According to the location of the superior mediastinum metastatic lymph nodes, direct vision approach through the neck incision, laparoscope-assisted approach, thracoscepy, laparoscope-assisted combined with thrascopy approach or conventional median sternotomy was performed for regional lymph node dissection. The average follow-up time was (10±4) months. No residual or recurrence of tumor in superior mediastinal area was found.Conclusions:The zoning of the superior mediastinal lymph nodes in thyroid cancer can be used as a guide for surgical approach to lymph node dissection .

Objective:To explore the application value of bedside lung ultrasound score(LUS)in evaluating patients with primary graft dysfunction(PGD)after lung transplantation.Methods:A total of 35 PGD patients after lung transplantation in surgical intensive care unit from June 2018 to May 2020 were selected as research objects. After lung transplantation, one physician collected the clinical data, including age, gender, preoperative 24 h APACHE II score, postoperative hemodynamic parameters, lactate and respiratory parameters; another physician was responsible for LUS examination and LUS at 12/24/48/72 h post-operation. The correlation between LUS and oxygenation index was analyzed by bivariate correlation analysis. Receiver operating characteristic curve(ROC)was utilized for calculating the predictive value, sensitivity and specificity of LUS score for severe PGD.Results:A negative correlation existed between LUS and oxygenation index in single lung transplant( r=-0.536, P<0.01)and a negative correlation between LUS and oxygenation index ( r=-0.518, P<0.01)in double lung transplant. The area under ROC curve of LUS showed that the predictive value of LUS of severe PGD patients with single lung transplant was 7.0 with a sensitivity of 86.7% and a specificity of 72.1%, the predicted value of LUS of severe PGD in double lung transplant was 13.0 with a sensitivity of 83.3% and a specificity of 60.0%. Conclusions:Lung ultrasound is simple and easy to operate and LUS can evaluate the severity of PGD patients after lung transplantation. It has a high potency of guiding clinical diagnosis and treatment.

Objective:To study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.Methods:This prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×10 5 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding ( n=257), bottle-feeding ( n=241) and mixed feeding groups ( n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data. Results:The average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log 10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log 10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences ( P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log 10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group ( P=0.553). Conclusions:For pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.

Objective:To summarize the experience of surgical methods without repairing the fistula for 92 cases with gastrointestinal intrathoracic fistula.Methods:The surgical methods without repairing the fistula were performed through VATS, small incision assisted with VATS or thoracotomy. The focus of the surgery was to promote lung expansion, eliminate the residual cavity of chest cavity and keep effective drainage. After entering the chest cavity from the affected side, wash chest cavity with a large amount of warm normal saline and sterilize intermittently with iodophor to ensure the sterile environment in the pus cavity. Then completely remove the pleural cellulose or fiberboard on visceral pleura to promote lung expansion, eliminate the residual cavity of the chest cavity. The fistula was covered tightly and supported firmly by the visceral pleura on the lung. Multiple T-tubes were placed in thoracic cavity and fistula to keep effective postoperative drainage.Results:Among 92 cases, 85 cases were cured and the cure rate was 92.4% (85/92).7 cases died and the mortality rate was 7.61% (7/92). The 7 dead cases include 5 cases with esophagogastric anastomotic fistula (the death of 3 cases was cause by aortic esophagogastric fistula, the death of 1 case was cause by thoracic gastric tracheal fistula and 1 case was dead because of pulmonary infection and respiratory failure), 1 case with esophageal rupture (the cause of death was septic shock ), and 1 case with esophageal perforation(the cause of death was pulmonary infection and respiratory failure).Conclusion:Most of the surgeries without repairing gastrointestinal intrathoracic fistula are conducted simply through VATS or small incision assisted with VATS., which is safe and effective.