OBJECTIVE: To evaluate the efficacy and onset time of single dermatophagoides farina sublingual immunotherapy in patients sensitized to dermatophagoides farina (Df) and dermatophagoides pteronyssinus (Dp), discuss the mechanism of single allergen immunotherapy in polysensitized patients and provide evidence for clinical applications. METHOD: This is a retrospective study, we screen 50 patients with allergic rhinitis sensitized to Df and Dp in our department. The average age of those patients is 28.98 +/- 2.41 years old. The nasal symptom scores of sneezing, itching, obstruction and runny nose are recorded after three to six months. SPSS 20.0 software is used to analyze the data. RESULT: After treatment for 3 months with sublingual immunotherapy, the TNSS (P < 0.05), score of sneezing (P < 0.01) and runny nose (P < 0.01) is significantly decreased comparing with that before treatment. The scores of obstruction and itching are increased, but the differences are not statistically significant. After treatment for 6 months, the TNSS (P < 0.01), score of sneezing (P < 0.01), itching (P < 0.01), obstruction (P < 0.05) and runny nose (P < 0.01) are all decreased, the difference between the scores of 6 month after treatment and that before treatment is statistically significant. And all of the scores (Z = -5.749, P < 0.01, sneezing; Z = -5.353, P < 0.01, runny nose; Z = -3.476, P < 0.01, congestion; Z = -3.824, P < 0.01, itching; Z = -5.746, P < 0.01, TNSS) at 3 month after treatment are significant higher than that after 6 month treatment. CONCLUSION The onset time of single Df sublingual immunotherapy for patients sensitized to Dp and Df with allergic rhinitis is 12 weeks, and the efficacy is enhanced as time of the treatment.
Adolescent ; Adult ; Aged ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Rhinitis, Allergic ; therapy ; Sublingual Immunotherapy ; Treatment Outcome ; Young Adult

The financial compensation mechanism for public county hospitals are discussed and analyzed in the paper.Such a mechanism is analyzed by means of media coverage and literature consulting,along with field survey.Roadblocks have been found in implementation of the mechanism, namely delayed payment of capital expenditure compensation,poor support for medical equipment purchase,gaps in development key disciplines development,insufficient compensation for retirees expenses,poor definition of policy-incurred losses,and unclear compensation of public health services.in a word,it is imperative to change the unreasonable financial compensation mechanism,before the six financial compensation subsidies can be fully put in place and financial compensation made efficiently.

The paper analyzed the compensation mechanism applied in public hospitals in different localities in China,which are currently experimenting with the zero price margin for drugs.It also introduced the revenue variations resulting from this practice.It is discovered that public hospitals can hardly make their ends meet with merely governmental financial input,and that lowered income of doctors and price distortion arc evident in those experimental hospitals,with little progress in overcoming the subsidization of medical services with drug sales.The authors recommended a comprehensive reform,the mechanism of diversified health input,change of internal incentive mechanism within the hospital,improvement in the healthcare service pricing mechanism,and exploration of new operation mechanisms for public hospitals.

Objective The aim of the present study was to assess the changes of IGF-1,IGF-2,IGFBP-1 and IGFBP-3 in diabetes nephropathy,the relationships between IGFs,IGFBPs and ?_1-,?_2- microglobulin.Methods A total of 130 type-2 diabetic participants(male:52,female:78)aged 37~75 yeares in Guangdong Provincial People's Hospital were enrolled from Feb.2000 to May 2003.Serum IGF-1,IGF-2,IGF binding protein 1(IGFBP-1),IGFBP-3,creatinine(Cr),cholesterol,triglycerides,HDL,LDL,apolipoprotein B100(apoB100),apoA,HbA_1c,fasting and postprandial C-peptide,serum and urine ?_1-MG and ?_2-MG were measured.Patients were divided into clinical albuminuria(DN,n=24),microalbuminuria(MA,n=40),and normal(NOR,n=66)groups according sCr and urine Alb/Cr ratio.Results In multiple linear regression analysis,determinants of S ?_1-MG were IGF-2 、TC and age(r=0.492,P=0.0001);U ?_1-MG were IGF-2、age(r=0.307,P=0.007); S ?_2-MG were IGFBP-1、HDL and age(r=0.528,P=0.0001);U ?_2-MG were IGFBP-1、CP120 and age(r=0.407,P=0.0001);s-Cr were IGFBP-1、CP0 and age(r=0.499,P=0.0001)。Serum IGF-2 and IGFBP-1 were significantly increased in DN group[IGF-2:(889.48?65.94)?g/L vs (711.57?28.73)?g/L,P=0.03;IGFBP-1:(94.91?17.48)?g/L vs(54.81?5.04)?g/L,P=0.009].Conclusion Serum IGFBP-1 and IGF-2 are significantly increased in type 2 diabetes with nephropathy.The disorders of IGFs and lipid metabolism may contribute to the development of diabetic nephropathy.

Objective To explore the efficacy of treatment for locally recurrent rectal cancer after radical surgery. Methods In this study,the management of 107 patients with postoperative locally recurrence of rectal carcinoma admitted from August 1993 to February 2002 was retrospectively analyzed.Results Thirty-two cases were treated by reoperation combined with adjuvant therapy(group A),37 cases underwent ressction alone(group B),38 patients received adjuvant therapy alone(group C).The age of these patients was 49.3±20.7,44.4±25.4,and 52.9±29.1 respectively.The median survival time after treatment was 27.8,14.6,and 13.7 months,respectively.The five year's survival of patients in group A was better than that in group B and group C significantly(P＜0.05).Conclusions The aggressive surgery combined with adjuvant therapy improves the survival of the patients with locally recurrent rectal cancer after radical surgery.

The clinical manifestation and laboratory features of juvenile hyaline fibromatosis(JHF)are reposed in a 5-year-old girl.Clinical symptoms began at 1 year of age,which was characterized by multiple cutaneous nodules and gingival hyperplasia with normal intelligence.Histopathologic examination of a skin biopsy specimen showed that the epidermis was normal,the nodules were composed of spindle-shaped fibroblasts embedded in homogeneous,non-fibrous,eosinophilic substance,and normal tissue was disrupted.Moreover,the fibroblasts showed transparent cytoplasm arranged in an obscure bundle-like pattern.No cell atypia or necrosis was observed.PCR amplification and sequencing of the capillary morphogenesis gene-2(CMG2)revealed a homozygous splicing mutation(IVS 14+1G→T)in the patient,while both of her parents were hetemzygous for the mutation.JHF is inherited in this family in an autosomal recessive manner.

Given the significant improvement in terms of its coverage and compensation depth,China's basic medical insurance system has inherent setbacks in its structure as held by the authors.They hold that the medical insurance as the most important source of compensation for medical institutions,should further reform its structure of financing and reasonably raise the percentage of compensation; adjust the time reference and space reference for prepayment estimation such as the total prepaid amount; deepen supportive reforms for the payment manner.All these measures aim at minimizing impact of the payment control mechanism on routine medical activities and exploring diversified payment manners that are feasible.

Objective To understand the death rate and the main death causes of the senile diabetic inpatients. Methods The histories of all the death cases of senile diabetic inpatients in this hospital from 1992 to 1999 were reviewed. The death rate and causes of senile diabetics were compared with those of the non-senile diabetics. Results Senile diabetics among the total diabetic inpatients increased within 8 years (56.93% during 1992-1995 vs. 67.63% during 1996-1999,P80 yrs group being 23.60%, P

Objective To explore the efficacy of various retreatment for locally recurrent rectal cancer after radical surgery. Methods Totally 107 patients of locally recurrent rectal cancer, who were admitted from August, 1993 to February, 2002 and retreated, were retrospectively analyzed. Results Thirty-two patients were treated by resection combined with adjuvant therapy (group A), 37 patients underwent resection alone (group B), and 38 patients received adjuvant therapy alone (group C). The medium age of these three groups was 49.3?20.7, 44.4?25.4, 52.9?29.1, respectively. The median survival time of groups A, B, C was 27.8, 14.6, 13.7 months, respectively. The five-year survival rate of group A was significantly higher than that of groups B and C (P

Objective To explore the value of complete mesocolic excision ( CME) for patients with colon carcinoma. Methods The 68 patients with colon carcinoma were divided into CME group (n=34) and control group (n=34) randomly. The patients in CME group were managed CME and the control group were arranged traditional open operation. The operation condition, preoperative complications, a-mount of lymph node scavenged,and the relapse rate of the 2 groups were contrasted. Results The operation period,the hospital stays,period of passage of gas by anus,the drainage volume post 3 days of operation and the period of drainage tube extraction of CME group were respec-tively(158 ± 38) min,(13. 4 ± 4. 0),(2. 3 ± 0. 5) d,(123. 3 ± 20. 5) mL,(12. 3 ± 2. 5) d,with no difference compared to control group (P>0. 05). The intraoperative bleeding volume of CME group (112. 3 ± 35. 5) mL was less than that of control group (146. 6 ± 36. 7) mL (P<0. 05). There was no difference in complication and the amount of lymph nodes scavenged of patients between 2 groups(P>0. 05). But the amount of lymph nodes scavenged of patients in TNM Ⅱ and Ⅲ of CME group (18. 6 ± 6. 7),(22. 6 ± 8. 6) was more than that of control group (15. 2 ± 4. 8),(16. 8 ± 6. 7)(P=0. 019 0,0. 002 8). The relapse rate in CME group (0. 0%) was lower than that in control group (17. 6%)(χ2 =4. 569 9,P=0. 032 5). Conclusion CME will not increase the risks of radical operation for colon carcinoma,but can scavenge more lymph nodes and decrease the tumor relapse rate.