Objective:To summarize the experience in the treatment of giant neurofibromas.Methods:A retrospective analysis was performed on the clinical information of patients with giant neurofibromas who were admitted to the Department of Burn and Plastic Surgery, Yichang Central People’s Hospital from January 2019 to December 2022. Preoperative endovascular embolization was performed by interventional technique. Intraoperatively, the tumor was stripped while hemostasis was performed, and the tumor was completely removed radically. Depending on the type of wound, the wound was closed directly, or with the meshed full-thickness skin taken from the surface of the tumor. The vacuum sealing drainage dressing with a stable suction pressure of -150 - -250 mmHg(1 mmHg=0.133 kPa) was used. Then tumor recurrence, defect repair, and associated complications were observed and followed up.Results:A total of 4 patients were included, 2 males and 2 females, aged 43-56 years with an average age of 49.3 years. Two patients had previous resection surgery at other hospitals. The tumors in the four patients were situated in the left thigh, buttocks, left waist and left leg respectively, with volumes of 20 cm×10 cm×10 cm, 50 cm×20 cm×15 cm, 20 cm×15 cm×10 cm and 15 cm×10 cm×8 cm correspondingly. After resection of the tumor from the left thigh and leg, the wounds were closed directly. The mesh skin graft from the tumor on the buttock and left waist was used for wound after tumor resection. Following the surgery, the patient with a neurofibroma on the buttock was transferred to the intensive care unit due to excessive blood loss. The sinus tract was formed, but healed after several dressing changes. The vacuum sealing dressing and sutures were removed two weeks after the operation for other cases. The wounds healed well and during the six months to three years follow-up, no tumor recurrence, impairment of motor or sensory function was found.Conclusion:Surgical resection and plastic surgery techniques are effective in treating giant neurofibromas. Preoperative tumor embolization and complete removal of the tumor during surgery can significantly reduce the risk of bleeding. The wounds resulted from tumor resection can be directly closed or with meshed from skin grafts on the tumor surface. Vacuum sealing drainage can also promote wound healing.

Objective:To summarize the experience in the treatment of giant neurofibromas.Methods:A retrospective analysis was performed on the clinical information of patients with giant neurofibromas who were admitted to the Department of Burn and Plastic Surgery, Yichang Central People’s Hospital from January 2019 to December 2022. Preoperative endovascular embolization was performed by interventional technique. Intraoperatively, the tumor was stripped while hemostasis was performed, and the tumor was completely removed radically. Depending on the type of wound, the wound was closed directly, or with the meshed full-thickness skin taken from the surface of the tumor. The vacuum sealing drainage dressing with a stable suction pressure of -150 - -250 mmHg(1 mmHg=0.133 kPa) was used. Then tumor recurrence, defect repair, and associated complications were observed and followed up.Results:A total of 4 patients were included, 2 males and 2 females, aged 43-56 years with an average age of 49.3 years. Two patients had previous resection surgery at other hospitals. The tumors in the four patients were situated in the left thigh, buttocks, left waist and left leg respectively, with volumes of 20 cm×10 cm×10 cm, 50 cm×20 cm×15 cm, 20 cm×15 cm×10 cm and 15 cm×10 cm×8 cm correspondingly. After resection of the tumor from the left thigh and leg, the wounds were closed directly. The mesh skin graft from the tumor on the buttock and left waist was used for wound after tumor resection. Following the surgery, the patient with a neurofibroma on the buttock was transferred to the intensive care unit due to excessive blood loss. The sinus tract was formed, but healed after several dressing changes. The vacuum sealing dressing and sutures were removed two weeks after the operation for other cases. The wounds healed well and during the six months to three years follow-up, no tumor recurrence, impairment of motor or sensory function was found.Conclusion:Surgical resection and plastic surgery techniques are effective in treating giant neurofibromas. Preoperative tumor embolization and complete removal of the tumor during surgery can significantly reduce the risk of bleeding. The wounds resulted from tumor resection can be directly closed or with meshed from skin grafts on the tumor surface. Vacuum sealing drainage can also promote wound healing.

Objective:To compare the clinical value of visual analogue scale （VAS）, Lebel scale and total nasal symptom scores （TNSS） in evaluating nasal allergen provocation test （NAPT）. Methods:A total of 151 patients suspected of allergic rhinitis admitted to the Department of Otolaryngology-Head and Neck Surgery of our hospital from April 2020 to September 2020 were included, of which 76 were positive for house dust mites and 75 were negative for allergens. Nasal airway resistance（NAR） was measured by active anterior nasal manometry. Nasal symptoms were evaluated by VAS, Lebel and TNSS. House dust mite allergen was used for NAPT by spray method. An increase≥40% in NAR was used as the gold standard for objective evaluation of NAPT. ROC curves of VAS, Lebel and TNSS were drawn to compare the evaluation effectiveness of different subjective evaluation methods, and the optimal critical point of each ROC curve was obtained. Results:With NAR increased by ≥40% as the gold standard, the area under ROC curve of VAS was 0.884, and the sensitivity and specificity were 97.75% and 80.65%, respectively. The area under ROC curve of Lebel was 0.773, and the sensitivity and specificity were 68.54% and 75.81%, respectively. The area under ROC curve of TNSS was 0.792, and the sensitivity and specificity were 68.54% and 79.03%, respectively. There was no significant difference between Lebel and TNSS（P>0.05）. The VAS differed significantly from Lebel and TNSS（P<0.05）. The Kappa values of VAS, Lebel, TNSS and NAR were 0.803, 0.432 and 0.459, respectively. Conclusion:The VAS, Lebel, TNSS subjective scale and NAR are consistent in evaluating the efficacy of NAPT, with the VAS assessment showing highest consistency with NAR. As objective assessment instruments are not widely used in China, subjective assessment method could be adopted to evaluate the efficacy of NAPT in clinical practice, and VAS scale is recommended as a priority.
Animals ; Humans ; Allergens ; Nasal Provocation Tests/methods* ; Rhinitis, Allergic/diagnosis* ; Nose ; Pyroglyphidae

Current reform of higher medical education focuses on curriculum integration and corresponding reconstruction of teaching system. Chongqing Medical University has carried out the reform of medical personnel training mode from basic to clinical, which has achieved certain results. Three aspects including teaching content, teaching methods and appraisal system of the urogenital system curriculum integration are introduced in the paper. In the teaching content, the parts related to urogenital system in basic subjects and clinical subjects are extracted and integrated. In the process of teaching implementation, a teaching team is set up across departments and multidisciplinary joint teaching is carried out. In order to arouse the enthusiasm of students, inspire and cultivate students' scientific research thinking by improving teaching methods, several teaching methods such as case introduction teaching method, question discussion and debate meeting are used. Scientific evaluation system is used to observe and record the whole process of students' learning. Meanwhile, some existing problems and solutions of curriculum integration are discussed in the paper to provide references for peers in relevant colleges and universities.

Curriculum integration has become the core content of the current medical education reform.With the rapid development of information technology,how to reflect the teaching and learning effects and to further improve them,is one of the difficulties in the reform of the integrated curriculum.In view of the problems of single form of assessment model,separate classroom teaching and extracurricular teaching evaluation,low utilization of network and electronic teaching resources,we make full use of network methods to carry out reform on the current formative teaching evaluation system.With the purpose of formative assessment and evaluation,the "Blackboard network teaching system" of the curriculum has been built,and the evaluation indexes of classroom teaching and extracurricular teaching have been established.And at the same time,the formative assessment index has been enriched and perfected in a diversified form,and the formative assessment model adapted to the integrated curriculum is preliminarily explored.

Objective To compare the clinical efficacy of minimally invasive removal of intracranial hematomas and medical con-servative treatment for hypertensive cerebral hemorrhage .Methods A total of 75 patients with hypertensive cerebral hemorrhage were collected and randomly divided into two groups according to the treatments :38 patients treated with conservative medicine and 37 patients treated with minimally invasive removal of intracranial hematomas based on standard drug therapy .Neurological impair-ment and recovery of self-care ability of patients in both groups before and after three weeks and six weeks of treatment were scored by National Institute of Health Stroke Scale (NIHSS) .Changes of diffusion tensor imaging before treatment and after two weeks of treatment were evaluated by fractional anisotropy value (FA) .Results There was no significant difference between neurological im-pairments of the patients in two groups before treatment .But the recovery degree of functional impairment and muscle nerve in min-imally traumatic treatment group was more significant than those in the conservative medical treatment group after treatments . There was significant difference between two groups (P< 0 .05) .Conclusion Minimally traumatic of hematomas is an effective method of treating hypertensive intracerebral hemorrhage .

Objective To introduce an effective nursing practice for patients with Grave's ophthalmopathy(GO) undergoing endoscopic trans-ethmoid orbital decompression(ETOD). Methods The treatment and nursing experience of 31 cases (57 eyes) undergoing orbital decompression through endoscopic trans-ethmoid approach were reviewed and analyzed. Results Three months after operation, exophthalmos was corrected in all 31 cases (57 eyes) with satisfying result, and the visual acuity was improved in all 9 cases (16 eyes),who complained of visual loss preoperatively. At the 3-months' review, 2 patients presented diplopia on the primary eye position due to newly on-set global displacement. Conclusions Advanced treatment and careful nursing are very important to improve the surgical safety and decrease the complications.

[Objective] To investigate the changes of CD4~+ CD25~+ regulatory T cells (Tr) in peripheral blood and their relation with their body mass index (BMI) of children with acute attack asthma. [Methods] Peripheral blood was obtained from 70 children with acute attack asthma, 30 remission children, and 50 normal control children. Then 70 children with acute attack asthma, were divided by normal weight group (40 cases) and overweight group (30 cases). The levels of CD4~+CD25~+Tr of the patients were tested by flow cytometry (FCM), and their BMI were calculated. [ Results] The levels of CD4~+ CD25~+ Tr [(6.17± 1.72)%] in acute attack group were lower than that in remission group [(7.56±1.48)%] or that in the control group [(7.13± 1.48)%] (P<0.05), but no difference between that in the remission and that in the control (P>0.05). The CD4~+CD25~+Tr of asthmatic children with normal weight [(6.34±1.71)%] was higher than that of asthmatic children with overweight [(4.74±1.20)%] (P<0.05). There was a remarkably negative correlation between the level of CD4~+ CD25~+ Tr of asthmatic children [(6.17±1.72)%] and the BMI (16.00±2.14) (r_p=-0.814, P<0.05). [Conclusion] The levels of CD4~+ CD25~+Tr are remarkable decrease in attack asthmatic children, and more decrease in overweight patients. There is remarkably negative correlation between the levels of CD4~+CD25~+ Tr in peripheral blood of attack asthmatic children and their BMI.

[Objective] This study was designed to determine Th1, Th2 cell numbers and investigate T-bet mRNA, GATA-3 mRNA expression of spleen MNC in a mufine asthmatic model which intended to understand effect of airway T-bet plasmid gene transfer on Th differentiation. [ Methods] A mouse asthmatic model was established by sensitization with ovalbumin (OVA). Thirty-two C57BL/6 mice were divided into four groups (8 mice in each group): the normal control group (group A ), the asthmatic model group (group B), the pcDNA3 plasmid group (group C), the pcDNA3-T-bet group (group D). All animals were sensitized and challenged with OVA, except group A normal saline was applied. The group C was intranasally administered 50 μg pcDNA3 plasmid at 24 h before intranasal challenges, and the 50 μg pcDNA3-T-bet plasmid for the mice of group D. We investigated Th1 and Th2 cell numbers by FACS and T-bet, GATA-3mRNA expression of spleen mononuclear cells (MNC) by semi-quantitative PCR in the four groups. [Result] Th1 percent in spleen MNC of pcDNA3-T-bet treated mice was significantly increased ([2.29±1.551% vs. [1.93±1.141%, P<0.05), while Th2 percent was significantly decreased ([0.93±0.64]% vs. [1.63±0.59]%), compared with that of the asthmatic control group mice by FACS. Spleen MNC was detected a high level of T-bet mRNA expression (0.53±0.027 vs. 0.28±0.035, P<0.05) and a low level of GATA-3 mRNA expression (0.24±0.022 vs. 0.58±0.038, P<0.05) after pcDNA3-T-bet treatment by RT-PCR. There was no significant change between the pcDNA3 plasmid group and the asthmatic model group. [Conclusion] The intranasal transfer of pcDNA3-T-bet plasmid was effective in modulating the imbalance of Th1/Th2 in mice asthma model, which provides a novel therapeutic strategy for transferring transcriptional factor in allergic asthma.

OBJECTIVEThe non-allergy of chlorogenic acid was demonstrated by the study result of allergy with different purity of chlorogenic acid and comprehensive analysis of literature.

METHODThe allergies of different samples, which contained the different purity of chlorogenic acid extracts, chlorogenic acid for injection, interior solution of dialysis, external solution of dialysis, post-term chlorogenic acid for injection and chlorogenic acid for injection with degradation, were validated with active systemic anaphylaxis and passive cutaneous anaphylaxis on rats and guinea pigs respectively. The range of molecular weight of macromolecular remains after dialysis were identified by LC-MS.

RESULTAllergic reactions were happened in dialysis isolated macromolecular substances, which were identified by LC-MS, and lower purity extracts (purity of chlorogenic acid < or = 40%), while the reactions were not happened in isolated micromolecular substances and high purity samples (purity of chlorogenic acid > or = 92%).

CONCLUSIONMacromolecules in lower purity of chlorogenic acid extracts were relative closely to the allergen causing anaphylaxis, but not the chlorogenic acid, which was demonstrated according to the study result and analysis of literatures home and abroad.

Anaphylaxis ; chemically induced ; Animals ; Chlorogenic Acid ; adverse effects ; Female ; Guinea Pigs ; Hypersensitivity ; etiology ; Male ; Medicine, Chinese Traditional ; adverse effects ; Rats ; Toxicity Tests ; methods